5.2 Challenges for the workforce
Health and social care providers are major employers in Scotland. To give you an idea of the scale of the workforce, in September 2011 there were the equivalent of 131,000 (Whole time equivalent (wte)) people working for the NHS in Scotland (Scottish Government, 2011) and in the same year 195,000 social services staff. This means that 8% of the total Scottish workforce was working in the social services sector. Over 80% of the workforce is female (Scottish Social Services Council, 2012a).
There have been considerable changes in the make-up of the social services workforce. In 1994, 60% worked for local authorities; by 2011 this proportion had fallen to a third of the workforce. Significant (and growing) numbers of social service workers work for the voluntary or private sectors, as you can see below:
These figures don't tell us everything about the social services workforce. For example, they do not include the increasing numbers of personal assistant s (PAs) - or volunteers, such as ꞌbefriendersꞌ and volunteer drivers. Moves towards integrating health and social care are likely to add considerable complexity to these figures. For example, social workers are increasingly likely to be employed by the NHS or new health and social care partnerships rather than local authorities. This is just one illustration of how what we may regard as familiar boundaries between health and social care, or service provider and service user, are beginning to shift.
Personalisation is, as you have seen, bringing about changes in the way that services are delivered. Public expectations of health and social care are changing, with people increasingly wanting to make their own decisions about their care and support - including the choice to remain at home if they become unwell or disabled. Musselbrook's analysis of workforce change until 2025 suggests that:
If Scotland is to deliver on expectations the future workforce will need to provide more person-centred care that will require relationships with those receiving support to be re - defined .(Musselbrook, 2013, p. 8)
Emerging challenges and questions are explored by our panel in Dumfries in the next activity.
Activity 5.1 Challenges for the workforce
Listen to the panel discussion about the challenges of personalisation and self-directed support for the workforce in Scotland. Use your learning log to make notes on the discussion. Are there any other challenges you can identify?
Transcript: Challenges for the workforce
You may have listed a range of different challenges. Some of these challenges may have been for individual members of the workforce, and others about how organisations that provide services will have to change the way they commission, design and deliver services. For example, many care services are provided through ‘block contracts’, whereas a personalised approach to service provision means negotiating contracts for different individuals in different ways to meet their agreed outcomes (Hunter et al., 2012).
Cunningham and Nickson (2011) identified the following challenges from their research about personalisation in the voluntary sector in Scotland:
- the potential for personalisation to get caught up in public service cuts and being seen – or used – as a cost-cutting mechanism
- lack of understanding in the workforce of the principles of personalisation and delivery personalised services
- overcoming cultural barriers to implementing personalisation in local authorities
- variation in the awareness, readiness, commitment and training of service providers in the principles of personalisation
- increased complexity in responding to risk
- concerns about applying personalisation principles to all groups of people, e.g. people who may be vulnerable because they are at risk of harm, or who are not able to make informed decisions about their care and support
- fears about employment, including job security, changing terms of employment and more unsocial and fragmented working hours.