The Costs of Qualifying a Social Worker

Transcription

1 British Journal of Social Work Advance Access published August 23, 2011 British Journal of Social Work (2011) 1 19 doi: /bjsw/bcr113 The Costs of Qualifying a Social Worker Lesley Curtis *, Jo Moriarty, and Ann Netten Lesley Curtis is Research Officer in the Personal Social Services Research Unit at the University of Kent. Her main research interest is cost estimation. Previous work includes self-funded admissions to care homes and the assessment process for elderly people. Jo Moriarty is Research Fellow at the Social Care Workforce Research Unit. She has particular interest in dementia support and service development. Current and previous research addresses ageing and ethnicity, social work education and user participation in social care. Ann Netten is Professor of Social Welfare at the University of Kent, Canterbury. She joined the Personal Social Services Research Unit in 1987 and has been director of the Kent branch of the Unit since November Her research interests include cost estimation and economic evaluation of health and social welfare interventions (including criminal justice), care of older people, developing theoretical approaches to the evaluation of community care and measuring quality and outcomes in social care. *Correspondence to Lesley Curtis, University of Kent PSSRU, Cornwallis Building, University of Kent at Canterbury, Canterbury, CT2 7NF, UK. [email protected] Abstract Cost containment is a priority in most social care systems and there is an increasing importance in using staff in the most effective way within available resources. Previous work has revealed that the social worker does not remain in the profession for as long as health professionals and this situation has far-reaching consequences for workforce planners. Given that a major overhaul in social work is underway, it is important to address questions such as how much could be saved if social workers were to remain in the profession for longer and how we should target the limited stock of professional expertise (or human capital). In this article, we have explored the full opportunity costs of qualifying social workers that incorporates the human capital cost implications of developing a skilled workforce. A survey of Practice Educators has been carried out in order to determine the actual cost of the practice learning placements undertaken. When all the costs are added to the cost of providing a social worker, the unit costs increase is more than twice or three times that of health professionals. This is due to the short working life and highlights how important it is to establish the causes of social work attrition. Keywords: Social worker, education and training, costs, Social Work Taskforce Accepted: July 2011 # The Author Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.

2 Page 2 of 19 Lesley Curtis et al. Introduction Based on a year-long review of the social work profession in England, the third Social Work Taskforce (2009) report made fifteen recommendations for major reform. These included a proposal for a new system for forecasting levels of supply and demand for social workers, which, in order to attract the right people in the right numbers, could: model policy, demographic and other changes onto overall numbers of social workers needed in future years; and advise on the implications of these changes for education, training and continuing professional development (Social Work Taskforce, 2009, p. 53). The previous Labour government accepted all of the Task Force recommendations (Secretaries of State for Health & Children, Schools and Families, 2009) and established a new Social Work Reform Board in order to implement them. The current coalition government expressed its commitment to implementing the Task Force recommendations and set up a separate review of child protection services (Hansard, 2010). The Social Work Reform Board has since confirmed that it is working on developing a supply and demand model for social work (Social Work Reform Board, 2010). The Task Force concerns reflected a wider unease among policymakers, employers and social work educators that workforce planning was less developed in social work than in other professions such as medicine and nursing, where there is much tighter central government control over the number of places on qualifying programmes that are made available each year. The advent of the social work degree has brought substantial increases in the number of students enrolling on social work qualifying programmes (Evaluation of Social Work Degree Qualification in England Team, 2008). Evidence from full-time undergraduate students progression (Hussein et al., 2009) suggests that, despite some misperceptions, while overall attrition from social work qualifying programmes has risen slightly since the introduction of the degree, it still remains comparatively low and is certainly comparable with other students in higher education (National Audit Office, 2007). What may be more crucial is that, once qualified, previous work has revealed that the social worker does not remain in the profession for as long as other professionals (Curtis et al., 2009). With an expected working life of only 7.7 years compared to twenty-five years for a doctor and sixteen years for nurses, social workers have to be trained at a faster rate than doctors and nurses in order to maintain the requisite number of qualified social workers. Average vacancy and turnover rates in local authorities are around 10 per cent (Local Authority Workforce Intelligence Group, 2007a, 2007b), seemingly much higher than for teaching and nursing (Moriarty, 2010). As a result, many local authorities have relied

3 The Costs of Qualifying a Social Worker Page 3 of 19 heavily on social workers trained outside the UK (Hussein et al., 2010). This situation has far-reaching consequences for financial and workforce planners, resulting in staff shortages and also an overall increase in the cost of training the workforce. As a result, social work retention difficulties have been a priority in local government for many years, with local authorities introducing various strategies in order to retain social workers for longer and to avoid having to recruit new staff (Local Government Analysis and Research, 2009). Although successful retention strategies will reduce the cost of recruitment to local authorities, in times of financial restraint, it is important not only to consider the costs faced by individual employers, but to consider the wider resource costs borne by society. The most important contributor to ensuring the workforce has the appropriate skills is the process of education and training, both pre and post education. If we are to target our resources most effectively, we need to understand the full resource implications of training social workers and, ideally, to be able to integrate this in economic evaluation of policies, interventions and alternative approaches to delivering social work in a way that allows us to make best use of the limited qualified social care workforce. In economic evaluation, we use unit costs, which draw together the full resource implications of a unit of activity (such as an hour of social work time), including salaries, support costs and so on. An approach to including the investment costs of training into the unit costs has been developed for a variety of healthcare professionals (Netten and Knight, 1999; Curtis and Netten, 2005, 2007). If applied to social workers, this type of information should assist us in addressing questions such as how much money could be saved if social workers were to remain in the profession for longer and how we should target the limited stock of professional expertise (or human capital). With skill mix initiatives being debated in Europe and the emphasis now on delivering health and social care in partnership, it is important, too, that we appreciate all the costs involved if changes were made to the professional mix and social care staff were given the opportunity to extend their roles into those of other professionals. In this paper, we describe an approach to estimating the full opportunity costs of qualifying a social worker. We discuss how the results of a survey carried out in England are used in order to estimate the full societal cost of the social work degree including the practice learning placements undertaken by all social work degree students. By taking into consideration the number of years the social worker is expected to use his/her qualification, these costs can be treated in the same way as physical capital for the purpose of estimating the annual cost, as their value is not used up in the process of producing the service. In doing this, we draw on previous work using a method of annuitisation developed for health professionals in which the annual opportunity cost of the investment in human capital reflects the period over which the benefits are delivered

4 Page 4 of 19 Lesley Curtis et al. (Netten and Knight, 1999). We also investigate the impact of including this investment on the unit costs (such as cost per hour) of providing a social worker and examine whether this increase compares with that of health professionals. Method Here, we discuss the components of a social worker s education and training and the sources of information used to calculate these costs, including a survey undertaken specifically for this purpose. In health economics, it is good practice to value resources based on the notion of opportunity cost. The principle of opportunity costs is to ensure that all the resources used to provide an output, in this case to qualify a professional, are valued rather than just those relevant to the public funders and local authorities. They represent the cost of using resources for a purpose, measured as their value in their next best alternative use and are particularly important when valuing the benefits forgone in order to complete the training. We describe how the total cost of education and training is annuitised and how costs incurred over a period of longer than one year are discounted to produce an annual cost of education and training, thereby making it possible to add it to other annual cost components of a social worker, such as salary and overhead costs. Education and training The main qualification route for social work is currently the three-year undergraduate degree with the option of a two-year postgraduate qualifying option for those with a first degree in another subject, with the exception of a small group of students undertaking fast track entry routes into the profession such as the Step Up to Social Work programme. Both degrees currently require the student to undertake 200 days of assessed practice, giving them experience in at least two practice settings with at least two user groups. For the undergraduate programme, the placements are either completed in two years or they are spread over the three years of the course. For those students on the postgraduate programme, the placement is spread over the two years. The components of the cost of training social workers are therefore the costs of tuition, infrastructure costs of support (such as libraries), living expenses or loss of earnings by the individual during the period of training and also the costs or benefits from the practice learning placement.

5 The Costs of Qualifying a Social Worker Page 5 of 19 Tuition and infrastructure costs Ideally, the costs of the tuition of social service professionals and any infrastructure costs would be estimated on the basis of resource inputs required for each course. However, to establish the cost of any one course would require an in-depth analysis of the training process and financial data and to establish the average cost nationally would also require financial data from each university. The potential for this type of approach was explored but proved impractical within the remits of the current study. The objective therefore was to provide reasonable estimates for social work students based on the amounts allocated per student by the Higher Education Funding Council for England (HEFCE) and the tuition fees per full-time equivalent (FTE) student. HEFCE currently provide a block grant to each institution providing the course based on the previous year s student numbers and Higher Education Institutions usually assign the social work degree to a combination of two cost centres, one of which is for subjects with a fieldwork element and one of which is for all other social studies subjects. To calculate a cost per student, therefore, we used the amounts allocated for subjects with a fieldwork element and also for all other social studies subjects ( 5,153 and 3,964, respectively) and weighted them to reflect the allocations of one university that was able to assist in the study (75 per cent at the higher amount and 25 per cent at the lower amount). The additional funds for programme providers based in London allocated by HEFCE was then applied to 15 per cent of students based on the premise that around 15 per cent of social work students are studying in London (Evaluation of New Social Work Degree Qualification in England, 2008). Assuming that these students are equally divided between those studying in inner and outer London, we applied the weighting of 8 and 5 per cent that is allocated to course providers in inner and outer London, respectively (HEFCE, 2004). Although a bursary is paid to students by the NHS Business Authority, an organisation that administers bursaries for social work students on behalf of the Department of Health to assist students with the cost of the tuition, in order to avoid double counting, this has not been included in the estimate of tuition costs. Living expenses In order to get a fully comprehensive estimate of the cost of training, we need to take into account the costs borne by the students. Although an estimate of loss of earnings would be appropriate for this purpose, this would require assumptions about students employment before the course. Living expenses have therefore been used as a proxy, as these would

6 Page 6 of 19 Lesley Curtis et al. otherwise be funded by working. These are based on information provided by the National Union of Students for expenses on books, stationery, travel, rent and other essential items of expenditure during the period of study. A bursary is paid to students by the NHS Business Authority and grants are made available by the Local Authority for the social work qualifying programme to assist the students to meet the additional living costs they incur. As with the bursary s contribution to tuition costs, this funding, however, has not been included in the analysis in order to avoid any double counting. We have, however, included the amount of funding allocated for student travel to placements provided by the NHS Business Services Authority, as this additional cost would not have been factored into the amount quoted by the National Union of Students for living costs. Although the agency offering the placement is also expected to contribute towards the travel costs incurred while carrying out placement duties, this amount has not been included, as policies for the reimbursement of students vary from agency to agency (Jigs, 2010) and have not been researched for this study. Student loans are also taken out by some students to cover their costs, which they currently repay once they are earning over 15,000. Inevitably, interest payments on these loans escalate over time and represent a cost to the student. As these costs will vary from student to student, in this paper, they have been excluded from the overall costs, as no information is available on loans taken out by social work students. This approach is consistent with that taken for other professionals. Practice learning placements As mentioned earlier, all social work qualifying programmes (undergraduate and postgraduate) require that the student must successfully complete 200 days in at least two practice settings with at least two user groups and, in the case of the undergraduate degree, these days are completed either over two or three years. Nationally, there is evidence that the most common option is 100 days in years 2 and 3; however, some universities offer the placement in other combinations over the three-year duration of the course, such as in combinations of 40/80/80 or 40/60/100. Postgraduates complete 100 days of assessed practice in each of years 1 and 2 of the programme. Courses with practice learning placements attract higher funding from HEFCE than courses without placements in recognition of the costs to the higher education establishment for organising and supervising the placement. This portion of funding has therefore been included above under tuition costs. Additional funding is also provided by the GSCC for the design and delivery of social work degree courses and to cover the costs incurred by the universities for the administration, planning and

7 The Costs of Qualifying a Social Worker Page 7 of 19 distribution of the placements as well as the costs incurred by the service providers for holding the placement. We also need to ensure that we cover the full cost of the time incurred in order to supervise and prepare for the placement and to offset this by the benefits that having the student brings. To estimate this, we undertook a survey of Practice Educators (PEs) (on-site and off-site supervisors) with the aim of costing all the time spent in preparing for and supervising the placements and the time provided by the students that would benefit the organisation. A questionnaire was first piloted with one university before sending the questionnaire out more widely together with an accompanying letter to describe the aims of the survey and how the information would be used. This was sent via the Joint University Council Social Work Education Committee (JUC SWEC), which has access to all the social work qualifying programmes in the UK and who forwarded it to their seventy-one plus member universities running the course in England. Although the precise number of universities taking part in the research is not known, it is estimated that around eighteen universities forwarded the questionnaire on to their placement co-ordinators to respond. Formal ethical approval was not sought for this survey, given the nature of the information requested and the absence of any risk to the participants. The survey was completed on a voluntary basis, with any personal information such as salaries provided in ranges to avoid being too specific. As well as salary ranges of the on-site and off-site PEs, information on placement settings, duration and year of placement and type of degree programme was requested and also information on how much time the PEs and others in the organisation spent preparing for and supervising the student. This includes formal and informal supervision time, induction and assessment time, time spent in meetings to discuss the placement and time preparing reports. In the case of the off-site supervisors, travel time was requested. For the purpose of costing the benefits the student brought to the organisation, the on-site PEs were asked how much time the student spent carrying out the duties of a social worker or other members of staff without direct oversight from anyone else in the organisation (either a social worker or social work assistant/administrator) so that the costs of the placement could be offset by these benefits. With this information, we were able to calculate the cost of the time spent preparing for and supervising the student by calculating a unit cost per hour based on the midpoint of the salary band provided by the PEs and multiplying this by the average amount of time spent on these activities. In this calculation, care was taken to apportion the amount of time provided by the PE according to the number of students being supervised. To calculate the cost of the time spent by others in the organisation involved in training and supervising the student, we multiplied the average amount of time by the average unit cost of an hour of a PE s time for those supervising in the placement organisation. The cost of an off-site PE was added to the

8 Page 8 of 19 Lesley Curtis et al. appropriate number of placements that reported having off-site supervisors in 2007 (27.7 per cent). An insufficient number of questionnaires were received from off-site PEs to provide a breakdown by setting, but an average has been taken for years 2 and 3 of the undergraduate programme and for the two years of the postgraduate programme. This total cost of supervision and preparation was then offset by the benefits provided by the student. The benefits that the student provided to the placement organisation were based on the amount of time the student performed the duties of a social worker or another member of staff, which was usually a social work assistant or an administrator. The unit cost of a newly qualified social worker and an unqualified assistant, 18 and 15 per hour, respectively (British Association of Social Workers, 2009), were used to estimate the value of this contribution. The amount of time spent supervising, preparing and travelling to and from the placements was calculated by multiplying the amount of time spent on these activities by an average unit cost of 32, which was based on the mid-point salary of those participating in the study. Clearly, the resulting estimates are based on salaries provided by the PEs taking part in the study and on assumptions that have been made about the salaries of the social workers and others who are being replaced in the organisation. It is important therefore that we recognise the increased salary levels in London. Using the salary information from the Local Government Earnings Association Analysis and Research (2009), a social worker working in London can earn an average of 18 per cent higher than the mean for England (excluding London). In order to estimate the cost of a placement taking place in London, we have therefore inflated the cost provided by the PEs in the survey by this amount and also have increased the benefits provided by a newly qualified social worker and social work assistant by the same weighting. As before, the cost of the off-site assessor (now inflated by the London weighting) has been added to the appropriate number of placements (27.7 per cent) in order to reflect the national picture. Total investment costs When estimating costs, we need to ensure that all have been identified and that double counting has been avoided. The costs of the postgraduate and undergraduate programmes were first calculated separately by totalling the tuition costs, placement costs and living expenses. To produce a weighted total for both programmes, these sums were then adjusted to reflect the proportion of students qualifying through each programme (72.5 per cent for the undergraduate route and 27.5 per cent for the postgraduate route) (GSCC, 2010).

9 The Costs of Qualifying a Social Worker Page 9 of 19 Calculating the annual cost The resources tied up in delivering social care through a social worker consist of their salary and associated oncosts, direct and indirect overheads, capital overheads and the investment costs of training. In terms of estimation, ongoing opportunity cost is for the most part measured by the expenditure associated with identified activities. The annual opportunity cost of an investment in either physical or human capital, however, should reflect the period over which the benefits are delivered and should allow for the distribution of the costs over time, thereby taking account of the lower value that is put on future costs and outcomes. The period over which the benefits are delivered is the number of years a professional is expected to work, taking into account periods of exit from the workforce. This estimate for a social worker has been calculated using Labour Force data and is reported in detail in previous work (Curtis et al., 2009). In order to allow for the distribution of the costs over time, the estimated costs of each year are multiplied by the appropriate discount factor (currently 3.5 per cent per annum as recommended by HM Treasury), which reflects the time preference rate and the number of years from the base year that the cost will be incurred. The precise method can be found in previous work (Netten and Knight, 1999). Annual training costs were then added to the other cost components of a social worker already reported in previous work (Curtis, 2009) and unit costs were calculated both with and without training costs. Results Here, we provide the breakdown of costs as discussed above. We then report the annual equivalent cost and the cost per hour of a social worker. Tuition and infrastructure The average amount allocated by HEFCE per FTE social work student taking account of those studying in London was 4,903 at 2008/09 prices. Tuition fees have been based on the standard fee per FTE student (home and EU) for 2008/09 and the median tuition fee charged by forty-three universities providing the social work postgraduate course in 2008/09 (Guardian, 2009). They are 3,145 and 3,419, respectively. Based on the proportion of students qualifying via the undergraduate and postgraduate routes in 2007/08 (GSCC, 2009), the weighted annual fee was 3,197.

10 Page 10 of 19 Lesley Curtis et al. Living expenses Estimated living expenses were 9,755, based on 2007/08 prices and up-rated to 2008/09 prices using the Retail Price Index, and adjusted to account for the 9 per cent of students studying in London (Evaluation of Social Work Degree Qualification in England Team, 2008). A fixed contribution towards placement travel expenses of 575 for full-time undergraduate courses and for students on a full-time postgraduate course are covered by the student bursary and added to living expenses for the purpose of this analysis. Practice placement Seventy-two PEs or supervisors responded to the online/postal survey distributed by JUC SWEC, of whom 76 per cent were on-site PEs and 24 per cent were off-site PEs. Off-site PEs are usually employed by the university or agency to undertake the role of PE who partner a practice supervisor who is on-site. Ninety per cent of questionnaires were received from those supervising the undergraduate degree and 10 per cent were received from PEs supervising the postgraduate programme. The majority were fulltime placements (86 per cent) and 14 per cent were part-time. Twenty-nine per cent were year 1 placements, 42 per cent were year 2 and 29 per cent were year 3 placements. Questionnaires were returned from PEs supervising placements in a variety of settings from course providers in England, with the majority of questionnaires being received from PEs within Children and Families (39 per cent) and the next largest category being from Mental Health (24 per cent). Eleven per cent of questionnaires were received from supervisors working in either Adult or Older People settings and the remainder (26 per cent) of the questionnaires were from other settings, namely palliative care, adoption, substance misuse, youth offending, learning disabilities and physical disabilities. Table 1 shows the number of hours provided in supervision and the number of hours received from the student for a 100-day placement. As identified above, there were sufficient data to provide a breakdown by setting for the undergraduate placement but not for the postgraduate placement. As not all placements have an off-site assessor, this time has been added separately and is appropriate for 27.7 per cent of placements nationally. Table 1 shows that supervision and preparation time ranges from 148 hours (222 hours including off-site PE) for Children and Families to 191 hours (265 hours including off-site PE) for Adult/Older People for 100 days of the placement. Supervision and preparation time for 100 days

11 Table 1 Costs and benefits (in hours) for a 100-day student placement Undergraduate hours Mental health Children and Families Adult/Older People All other settings Supervision time on-site, PEs Preparation time on-site PEs Supervision time others in the organisation Supervision and preparation time off-site PEs Total supervision and preparation without off-site with off-site Benefits social worker Benefits other staff Total benefits Postgraduate hours The Costs of Qualifying a Social Worker Page 11 of 19

12 Page 12 of 19 Lesley Curtis et al. of the postgraduate placement was 145 hours (219 hours with the off-site PE). Estimates concerning the amount of time the PE recorded that students carried out duties of a social worker or a social work assistant/administrator ranged from 167 hours for Children and Families to 242 hours for all other categories for an undergraduate placement and 265 days for a postgraduate placement. Table 2 shows that the total cost for 100 days of all undergraduate placements, after taking into account the benefits provided by the students, ranged from 1,625 to 3,178, with a weighted average cost for all settings of 2,334. In placements in which there were off-site PEs as well as on-site supervisors, the placements ranged from 5,100 to 6,652, with a weighted average cost for all settings of 5,809 (includes 100 per cent of off-site cost). Adults/Older pwas the least costly setting and Mental Health the most costly. The average cost of the off-site PE for 100 days was 3,475. Of total costs, 52 per cent were associated with supervision, 35 per cent with preparation and travel costs accounted for 13 per cent. If the 40/80/80 combination of placement were completed by the student, Adult/Older people would still be the least costly at 1,731 ( 4,977 with off-site costs) and Mental Health would be the most costly at 3,067 ( 6,312 with off-site costs), with a weighted average cost of 2,433 ( 5,678 with off-site costs) for 100 days of the placement. The cost of the off-site PE would be 3,245. Table 3 provides the comparative costs of a full 200-day placement for the undergraduate and postgraduate degree for out-of-london students and those studying in London. It also provides a weighted average cost of both placements to reflect the proportion qualifying through each route. In this table, the cost of the off-site assessor has been adjusted to reflect the appropriate number of placements (27.7 per cent). Total costs Table 4 provides the total costs of the undergraduate and postgraduate programme separately and combined, when adjusted to account for the proportion of students qualifying through each programme (72.5 and 27.5 per cent, respectively) (GSCC, 2010). Included in this table is the money the GSCC provide to support the engagement of service users and carers involved in the design and delivery of the degree. This was 850,000 in 2008/09, which, when divided by the number of students qualifying in 2007/08 (4,555) (GSCC, 2008), was 187 per student. The total amount is subject to variation every year. Table 4 also shows the total investment after allowing for the distribution of the costs over time to give the total investment incurred during the working life of the social worker and also the expected annual cost to

13 Table 2 Breakdown of the costs for a 100-day practice placement Mental Health Children and Families Adult Services/Older People All other undergraduate cost weighted by setting Costs Supervision on-site PE 4,024 3,710 3,175 3,273 3,590 2,295 Preparation on-site PE 1,333 1,448 1,494 1,258 1, Supervision from Others ,625 Supervision and preparation 3,475 3,475 3,475 3,475 3, off-site PE Total Costs with off-site 9,532 9,351 8,655 8,764 9,153 5,629 without off-site 6,057 5,876 5,180 5,290 5,678 4,655 Benefits Student replacing social worker 1,730 2,055 2,430 3,038 2,158 2,408 Student replacing another 1,150 1,298 1, ,185 1,013 member of staff Total benefits 2,880 3,353 3,555 3,653 3,343 3,421 Costs minus benefits with off-site 6,652 5,998 5,100 5,111 5,809 2,208 without off-site 3,178 2,523 1,625 1,636 2,334 1,234 Postgraduate The Costs of Qualifying a Social Worker Page 13 of 19

14 Table 3 Estimated cost of a 200-day London placement compared to actual costs based on sample Undergraduate degree based on sample Undergraduate degree with London weighting Postgraduate degree based on sample Postgraduate with London weighting Weighted average of undergraduate and postgraduate degree based on sample Undergraduate and postgraduate degree with London weighting Page 14 of 19 Lesley Curtis et al. Total costs 13,281 15,672 11,256 13,283 12,724 15,015 Total 6,687 7,891 6,842 8,073 6,729 7,941 benefits Costs minus benefits 6,594 7,781 4,414 5,209 5,994 7,074

15 The Costs of Qualifying a Social Worker Page 15 of 19 Table 4 Total cost split by cost component to qualify a social worker Tuition Practice placement Living expenses Total Annual cost Undergraduate 23,824 6,298 28,465 58,587 21,800 Postgraduate 16,366 4,351 20,876 41,802 15,248 Both 21,983 5,763 26,266 54,012 20,097 reflect the returns on the investment over time. The total cost of the undergraduate course was 58,587 and the total cost of the postgraduate programme was 41,902 at 2008/09 prices. When adjusted to take into account the proportions qualifying as graduates or post graduates, the total cost was 54,012. Nearly half of the costs (undergraduate and postgraduate) relate to students living expenses (59 per cent), 10.5 per cent for the practice placement and 40.5 per cent relate to tuition costs. We estimated that, after taking into account the expected working life of a social worker and its distribution over time, the equivalent annual cost of the investment training was 20,097. The undergraduate course incurred annual costs of 21,800 and postgraduate qualifying routes 15,248. When added to the main cost components (salary and overheads) of a qualified social worker, which have been identified in previous work (Curtis et al., 2009), the annual cost increased by 45 per cent, from 44,505 at 2008/09 prices to 64,602. This resulted in an increase in the cost per hour of to Discussion Resources are becoming increasingly scarce, and it is important that we use them to best effect. To do so, we need a good understanding of the full costs of alternative approaches to improving recruitment, retention and use of social work staff. Human capital costs are a fundamental but often neglected element of this. In this paper, we have used a method of annuitisation developed for health professionals in which the annual opportunity cost of the investment in social workers reflects the period over which the benefits are delivered. Incorporating the costs of education into estimates of the unit costs of social workers has required information both about the initial investment costs and about the length and distribution of the expected working lives of social workers. These both affect the costs, as the return on the investment is fundamentally dependent on social workers patterns of employment. This paper has shown that the investment costs of education and training a social worker raise the overall annual level of investment in a social worker substantially, increasing the unit cost by 45 per cent and the overall annual investment from 44,505 to 64,602. Despite a social

16 Page 16 of 19 Lesley Curtis et al. worker having very similar total opportunity costs of education and training to other professionals for which this work has been carried out, such as nurses and physiotherapists ( 54,012 compared with 59,415 and 55,015, respectively), when annuitised and discounted over time, the unit costs of these health professionals increased by only 18 and 14 per cent, respectively (Curtis and Netten, 2005, 2007; Curtis et al., 2009). The reason for this discrepancy is that the expected working lives of these professionals are a lot longer (sixteen years for nurses and twenty-four for physiotherapists) compared with less than eight years for a social worker. This has implications for the equivalent annual cost of qualifying the professionals, which, at 20,097 for a social worker, is substantially higher than that of a nurse ( 6,518) and physiotherapist ( 4,501) (Curtis, 2009). Given the level of investment necessary to train social workers, this suggests it may be preferable to invest resources in policies to retain current (rather than recruit and train new) social workers. The practice placement The results of the practice placement survey can be used to inform the debate about the way in which universities and agencies can deliver effective partnerships in the delivery of social work education. Our estimates reflect the experiences of PEs who identified supervision time spent by others in the organisation as well as their own time supervising and preparing for the placement and allow for the benefits gained from the placement. The relative value of the cost components (tuition, living expenses and practice placement) of education and training have also been highlighted in this paper, with living expenses accounting for nearly half of the total costs. It is possible that the changes proposed by the Browne Review (Independent Review of Higher Education Funding and Student Finance, 2010) will create pressures for accelerated qualifying programmes such as the Step Up to Social Work Initiative or the controversial two-year qualifying programme in probation. If these changes were implemented, it should be borne in mind that, with a more intensive programme, tuition costs may rise, but these costs would be offset by lower living costs. We have noted above that practice placements for the undergraduate degree are carried out in various combinations, with 100 days in years 2 and 3 being the most commonly accepted option. Although we found a small cost differential between the options, no evidence is yet available in terms of outcomes for students as to which is the better option. We also identified differences in the costs of different settings, with mental health settings being the most costly. The reasons why costs of supervision vary between settings is outside the scope of this study and it is not known whether they relate to differing supervision practices in different settings or differences in caseload and caseload complexity.

17 The Costs of Qualifying a Social Worker Page 17 of 19 Limitations of the study All cost studies require assumptions, and this is no exception. Moreover, although care has been taken to check our sources, including the estimates provided by PEs, some caution should be taken when interpreting the results. For example, some PEs were very specific about time spent on different activities, whilst others tended to provide more of a rough estimate and possibly to round up the time. Furthermore, when taking into account the benefits provided by the students in terms of how much time the students performed the duties of a social worker or another member of staff (either a social work assistant or an administrator), the estimates provided by the PEs were inevitably subjective. Whilst some PEs might value certain administrative tasks, it is possible that others might not, therefore omitting them from their estimates. PEs from only eighteen of a possible seventy-one universities took part and the indirect approach used to recruiting PEs means that we cannot be clear about reasons for non-response. Furthermore, the replies from PEs were unevenly distributed between the different universities and this should be borne in mind, particularly when drawing conclusions between the costs of the different settings. It should be noted, too, that there are many problems associated with predicting future employment patterns based on historical information and this is particularly relevant when drawing conclusions about the expected working life of professionals. Although our pragmatic approach based on the data provided by the Labour Force Survey (Curtis et al., 2009) gives us a good approximation of the likely return, it should be borne in mind that the data are historical and possibly not representative of the social workforce of today or of the future. Conclusion This paper has used the same approach taken for health professionals of including the costs of maintaining a skilled workforce explicitly into the unit costs of social workers. In doing so, the effects of working life on the annual costs of education and training have been demonstrated, highlighting the importance of investing resources in policies to retain current (rather than recruiting and training new) social workers. For such policies to be well founded, clearly it is important to establish the causes of social work attrition, which is a problem both for male and female social workers (Curtis et al., 2009). Burnout is a well-known phenomenon in the field of social work and its causes have been well documented. However, in the last few years, positive steps have been taken to address the reputation of the profession and it is

18 Page 18 of 19 Lesley Curtis et al. hoped that these changes will provide social work with an opportunity to regain focus (GSCC, 2008). Of course, by gradually changing the nature of social work, it is hoped that, once trained, social workers will remain for longer in the profession, thereby increasing their expected working life and reducing the annual investment. Ideally, therefore, any changes to the expected working life should be monitored and future work should rework the calculations in this paper with the new expected working life. By doing this, policy makers will be better equipped to make decisions about whether to invest in policies to retain existing staff rather than recruit and train new social workers. Acknowledgements We should like to thank Helen Wenman (GSCC) for all her valuable comments on this article. This study was funded by the Department of Health under the Costs Quality and Outcomes Programme. Responsibility for this article is the authors alone and the views expressed do not necessarily reflect those of the Department of Health. References British Association of Social Workers (2009) Thinking about a Career in Social Work, available online at Curtis, L. (2009) Unit Costs of Health and Social Care 2009, Canterbury, University of Kent, Personal Social Services Research Unit. Curtis, L. and Netten, A. (2005) Are pharmacists worth the investment in their training and the ongoing costs?, Pharmaceutical Journal, 274(7339), pp Curtis, L. and Netten, A. (2007) The costs of training a Nurse Practitioner in primary care: The importance of allowing for the cost of education and training when making decisions about changing the professional-mix, Journal of Nursing Management, 15(4), pp Curtis, L., Moriarty, J. and Netten, A. (2009) The expected working life of a social worker, British Journal of Social Work Advanced Access published April 1, 2010, /bjsw/bcp039. Evaluation of Social Work Degree Qualification in England Team (2008) Evaluation of the New Social Work Degree Qualification in England. Volume 1: Findings, London, King s College London, Social Care Workforce Research Unit. Guardian (2009) Social Work Postgraduate and Masters courses , available online at 17/postgraduate-social-work-courses-table. GSCC (2008) Future of social worker making a real difference, available online at GSCC (2009) Personal correspondence with the General Social Care Council, London.

19 The Costs of Qualifying a Social Worker Page 19 of 19 GSCC (2010) Personal correspondence with the General Social Care Council, London. Hansard (2010) Written Ministerial Statements, Children Schools and Families, 10 June 2010, Column 18WS, Munro Review (Child Protection), London, Hansard, available online at wmstext/100610m0001.htm. HEFCE (2004) Funding Higher Education in England How HEFCE Allocates its Funds, Higher Education Funding Council of England, Bristol. Hussein, S., Moriarty, J. and Manthorpe, J. (2009) Variations in Progression of Social Work Students in England: Using Student Data to Help Promote Achievement: Undergraduate Full-Time Students Progression on the Social Work Degree, London, General Social Care Council. Hussein, S., Stevens, M. and Manthorpe, J. (2010) International Social Care Workers in England: Profile, Motivations, Experiences and Future Expectations: Final Report, London, Social Care Workforce Research Unit, King s College London. Independent Review of Higher Education Funding and Student Finance (2010) Independent review of higher education funding and student finance, web-based publication, available online at Jigs (2010) Placement travel costs, Carespace General Student Forum, 1: 7 December 2010, available online at placement-travel-costs-9162.aspx. Local Authority Workforce Intelligence Group (2007a) Adults Social Care Workforce Survey: Main Report 2006, London, Local Government Association. Local Authority Workforce Intelligence Group (2007b) Children s, Young People s and Families Social Care Workforce Survey: Main Report 2006, London, Local Government Association. Local Government Analysis and Research (2009) Local Government Earnings Survey, England and Wales 2008, London, Local Government Association. Moriarty, J. (2010) Competing with myths: Migrant labour in social care, in M. Ruhs and B. Anderson (eds), A Need for Migrant Labour? Labour Shortages, Immigration and Public Policy, Oxford, Oxford University Press. National Audit Office (2007) Staying the Course: Student Retention on Higher Education Courses in England, London, The Stationery Office. Netten, A. and Knight, J. (1999) Annuitising the human capital investment costs of health service professionals, Health Economics, 8(3), pp Secretaries of State for Health & Children, Schools and Families (2009) Government Response to the Social Work Task Force, London, Department for Children, Schools and Families/Department of Health. Social Work Reform Board (2010) Building a Safe and Confident Future: One Year On: Progress Report from the Social Work Reform Board, London, Department for Education. Social Work Task Force (2009) Building a Safe, Confident Future: The Final Report of the Social Work Task Force, London, Department for Children, Schools and Families.