Forecasting the adult social care workforce

Forecasting the adult social care workforce October 2015 www.cfwi.org.uk CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 1

Table of contents Abstract... 3 1. Introduction... 4 1.1 About this document... 4 1.2 Project context... 4 1.3 The CfWI approach... 4 1.4 System dynamics model... 5 2. Model development... 7 2.1 Model scoping... 7 2.2 Construction... 7 2.3 Documentation... 8 2.4 Testing... 8 3. Data and assumptions... 9 3.1 Data 1 - Future population and demographic projections... 9 3.2 Data 2 - Service delivery and activity statistics... 11 3.3 Data 3 Future adult social care users with learning disabilities... 13 3.4 Data 4 2013 workforce statistics... 14 3.5 Data 5 Workforce split between service types... 17 3.6 Data 6 Annual number of new workforce joiners... 18 3.7 Data 7 Annual percentage of workforce leavers... 19 4. Demand calculation... 20 5. Supply calculation... 24 6. Model outputs... 27 6.1 Outputs... 27 References... 37 CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 2

Abstract The purpose of this document is to provide further information on the calculation represented in the CfWI s social care workforce model and the outputs it provides supporting the CfWI s Forecasting the adult social care workforce: workforce intelligence report. The calculations, assumptions and data used by the CfWI have been described with the intention of being transparent and clear, yet detailed enough to reflect the intricacies and nuances of the work. This document is not intended to stand alone but instead is provided for those seeking further information on the CfWI project, Forecasting the adult social care workforce, and in particular to the Forecasting the adult social care workforce: workforce intelligence report. All model output and technical figures and tables from the report have been recreated in this document plus additional/supplementary supporting information. No interpretation or analysis of these technical figures have been provided in this document. For further information regarding this work, please contact the CfWI via: General enquiries: mailto:enquiries@cfwi.org.uk or +44 (0)20 7803 2707. Press enquiries: pressoffice@cfwi.org.uk or +44 (0)20 7803 2712 The Centre for Workforce Intelligence 209 215 Blackfriars Road London SE1 8NL CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 3

1. Introduction 1.1 About this document This technical report provides further information on the Centre for Workforce Intelligence (CfWI) social care workforce model and the outputs it provides. The CfWI developed this model to provide intelligence on the future supply of and demand for the adult social care workforce in England over the next 15 years. The model and intelligence it provides supports the CfWI s Forecasting the adult social care workforce: workforce intelligence report. Included in this report is a description of the project purpose and the model purpose, a description of the data required and used to run the model, together with a step-by-step, in-depth description of the calculations and assumptions that have been made. The limitations of the model and data used are also detailed where appropriate. While the outputs of the model are shared within this document, analysis and review of them are not included. Analysis and interpretation of the model s output are included in the CfWI s Forecasting the adult social care workforce: workforce intelligence report. 1.2 Project context The Department of Health (DH) commissioned the CfWI to undertake a high-level holistic review of the adult social care workforce. This project was designed using the CfWI robust workforce planning framework, and aims to assess the future supply of, and demand for, the adult social care workforce in England over the next 15 years. The focal question for the review was: In 2030 what will be the shape, size and structure of the care and support workforce? In order to answer this question, the project required a model that would enable CfWI analysts to rapidly create suitable model outputs in tabular and graphical form for evaluation and analysis. 1.3 The CfWI approach The CfWI has developed a comprehensive approach to workforce modelling, the robust workforce planning framework (RWPF), summarised in Figure 1. This approach has been used in CfWI projects across health, public health and social care, most notably in the CfWI Horizon 2035 programme, looking at skills and competency needs in all three sectors over the next 20 years. The CfWI approach and related projects are described in section 4 of the Forecasting the adult social care workforce: workforce intelligence report and also in a series of comprehensive technical papers published on the CfWI (www.cfwi.org.uk) and Horizon Scanning (www.horizonscanning.org.uk) websites. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 4

Figure 1: The CfWI robust workforce planning framework The framework describes the key stages of the CfWI s workforce planning methodology. Source: CfWI For this project, the CfWI adapted its approach to model the social care workforce, and elicit and quantify some of the factors influencing workforce supply and demand in the next 5, 10 and 15 years. 1.4 System dynamics model The CfWI developed a system dynamics model to inform the 15-year forecast and workforce intelligence described in this document. The model uses Vensim DSS and Microsoft Excel software. The CfWI chose system dynamics modelling as it is most appropriate for modelling complex systems such as health and social care workforces. Another factor in choosing the system dynamics approach is that the model can be extended or revised to address additional questions or changing requirements as the project progresses. Such iteration has proved CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 5

particularly important for social care as there are many factors which can be analysed using increasingly sophisticated modelling as the intelligence and data becomes available. Microsoft Excel 2013 is the standard spreadsheet package used by the CfWI. Vensim is a commercial off-theshelf (COTS) system dynamics (SD) package produced by Ventana Systems Inc. (http://www.vensim.com). For more detailed reports on the methodology used by the CfWI, refer to the technical papers series found at: www.cfwi.org.uk/our-work/research-development/cfwi-technical-paper-series. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 6

2. Model development This section describes the development process of the CfWI social care workforce system dynamics model, developed following the CfWI s robust workforce planning framework. The development approach is based on the CfWI s formalised best practice guide (CfWI, 2014). The overarching process is shown below. Figure 2: CfWI model development process An overview of the workforce modelling stage of the CfWI robust workforce planning framework. Source: CfWI (2014b) 2.1 Model scoping The purpose of model scoping was to clearly define the purpose of the project, what was required of the model, and equally importantly, what was out of scope. A model specification document was developed with DH and delivery partners which defined the model that the CfWI would develop to meet these criteria. Throughout this project the CfWI worked with colleagues from Skills for Care (SfC) and Bournemouth University to review and collect the appropriate data for the model. The CfWI worked in partnership during the scoping phase to ensure that the model would be appropriate and fit for purpose, given the data available. 2.2 Construction The model was developed in house by the CfWI data modelling team. The CfWI chose Vensim DSS as the software to use in the modelling process as it was able to handle the complexity of the system and allowed multiple levels of data and calculation segmentation across the various calculations. SfC and Bournemouth University provided the data used at this stage. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 7

2.3 Documentation The purpose of this project is to highlight key information and provide relevant workforce intelligence that is valuable to the system, and provide stakeholders and decision makers with an evidence base to support their decision-making process. A key part of the process is to ensure clear and transparent technical information is also provided. The CfWI has produced this report to provide as much information as possible about the modelling work completed in support of its Forecasting the adult social care workforce: workforce intelligence report (CfWI, 2015). 2.4 Testing The Vensim system dynamics software contains model validation tools within the software. However, as an accuracy test, the CfWI modelling team replicated various parts of the model using other software, such as Microsoft Excel, and produced the same results. An independent member of the CfWI modelling team also reviewed the model, in line with the CfWI s standard quality assurance process. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 8

3. Data and assumptions This section describes the data and assumptions that populate the CfWI social care workforce system dynamics model. It is important to understand the information and data that support the model and analysis completed by the CfWI. The purpose of these models is to highlight key information and provide relevant workforce intelligence to support decision-making processes. In order to fully understand the outputs of the model and analysis, one must fully understand the inputs. In particular, one must understand the strengths and limitations of the data that underpins the model, as the robustness of the outputs will be restricted to that of the inputs. The CfWI calculation uses the data described below alongside their source, any assumptions made and any limitations. Future population and demographic projections from the Office for National Statistics (ONS) (ONS, 2013) Service delivery and activity statistics using the community care statistics, social services activity (CCS- SSA) for 2013-14 (Health and Social Care Information Centre (HSCIC), 2014) Future adult social care users with learning disabilities using data supplied by Emerson et al in Estimating the Need for Social Care Services for Adults with Disabilities in England 2012-2030 (Emerson et al, 2012) 2013 workforce statistics from the National Minimum Data Set for Social Care (NMDS-SC) and The size and structure of the adult social care sector and workforce in England, Skills for Care (SfC), 2014 (SfC, 2014) Workforce ratio between service types (see page 11 of this report) using the CCS-SSA data and the NMDS- SC (HSCIC, 2014, SfC, 2014) Annual number of new workforce joiners from the NMDS-SC (SfC, 2014) Annual percentage of workforce leavers from the NMDS-SC (SfC, 2014) Department of Health (2015) Social Care Funding Reform Impact Assessment (IA), IA No: 9531 3.1 Data 1 - Future population and demographic projections The CfWI does not produce its own population forecasts; it uses the 2012-based National Population Projections for England produced by the ONS. The ONS produces a number of different projections based on a series of different assumptions. By default, and for all projections produced for this project, the CfWI model uses the ONS principal assumption. High-level statistics for future demographic change and population growth, as per the ONS principal assumption, are shown below. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 9

People People FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 3: Future population size The future size of the population in England as projected by the ONS in their 2012-based principal assumption. 70,000,000 60,000,000 50,000,000 40,000,000 30,000,000 20,000,000 10,000,000 0 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030 Year Source: ONS (2013) Figure 4: Future population size split by age The future size of the population in England as projected by the ONS in their 2012-based principal assumption split by age group. 70,000,000 60,000,000 50,000,000 40,000,000 30,000,000 20,000,000 10,000,000 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Year 0 to 17 years old 18 to 64 years old 65 to 100 years old Source: ONS (2013) CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 10

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 5: Percentage change in the size of the population by age all ages As projected by the ONS in the 2012-based principal assumption by age. 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030 Year 0 to 17 years old 18 to 64 years old 65 to 100 years old Source: ONS (2013) 3.2 Data 2 - Service delivery and activity statistics Health and Social Care Information Centre (HSCIC, 2014) Community Care Statistics, Social Services Activity combine data from the Referrals, Assessments and Packages of Care (RAP) and the Adult Social Care Combined Activity Return (ASC-CAR). This provides the number of people who received local authority sector care in 2013. In the absence of any further data, the CfWI assumes the service delivery statistics in the HSCIC community care statistics are reflective of the service delivered across the entire social care system, not just the local authority funded care. The total quantity of service delivered is not used for this work; instead the CfWI calculation considers the proportional split of care delivered between age groups and genders (see section 4 of this technical report). The CfWI assumes the proportional split of older service users to younger service users in local authority establishments is reflective of the same proportional split of older service users to younger service users in all other social care sectors. The same assumption is made for the proportional split between genders. For example, if female older service users account for X per cent of the service delivered by local authorities, the CfWI assumes for this project that female older service users account for X per cent of services delivered across the entire system. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 11

People in England receive care in a range of categories, as recorded by Councils with Adult Social Services Responsibilities (CASSRs). These categories are shown below: Service type (demand type) domiciliary/community care residential care with nursing residential care without nursing other care local authority social work teams Age band 18 to 64 65 plus Service user type physical disability and other vulnerable people mental health and substance misuse learning disability Gender male female. The gender split of people receiving care is only available for each service user type and is not available for service type. The CfWI assumes the same gender split across all service types, with variation existing across service user type and age band. The available data is only split by adults under 65 years old and adults aged 65 and over. The data is not split on a sufficiently granular level to be able to assess the amount of care currently delivered for 85 years and over separately. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 12

Figure 6: Proportion of 2013 local authority care accounted for by age group The proportion of care as recorded in the local authority community care statistics for 2013 by age band. Domiciliary/ community care Residential care without nursing Residential care with nursing 36% 21% 9% 64% 79% 91% Other care Local authority social work teams 34% 33% 18 64 year olds 66% 67% 65 + year olds Source: HSCIC (2014) Community Care Statistics, Social Services Activity, England - 2013-14, Final release 3.3 Data 3 Future adult social care users with learning disabilities The report Estimating the Need for Social Care Services for Adults with Disabilities in England 2012-2030 (Emerson et al, 2012) provides an estimated number of adult social care users with learning disabilities and predicts that the life expectancy of people with learning disabilities is increasing. The CfWI model uses this estimate and calculates the annual percentage change from 2013 to 2030. The CfWI data modelling team assumes the percentage change predicted by Emerson et al for service users with learning disabilities is an appropriate replacement for the CfWI s percentage change in demand values. As Emerson et al (2012) do not provide the value by service type, the same percentage change in demand is applied across all service/demand types for users with learning disabilities. In other words, percentage change CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 13

Users with learning disabilities FORECASTING THE ADULT SOCIAL CARE WORKFORCE in domiciliary/community care demand for people with learning disabilities is the same as percentage change in residential care demand for people with learning disabilities. Figure 7: Estimated number of users of adult social care with learning disabilities Figures from report by Emerson et al (2012) 250,000 200,000 150,000 100,000 50,000 0 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030 Year Source: Estimating the Need for Social Care Services for Adults with Disabilities in England 2012-2030 (Emerson et al, 2012) 3.4 Data 4 2013 workforce statistics Skills for Care (SfC) provided the CfWI with workforce numbers for adult social care in 2013. SfC estimates the values provided based on data collected in the NMDS-SC database (SfC, 2014a), which is an online database for adult social care workforce data. Social care establishments and employers are asked to input their own data describing their workforce. While participation is mandatory for local authority funded establishments, independent sector establishments have no obligation to complete it, so there are varying completion rates across the different types of establishments over which data is collected. Local authority completion stands at 100 per cent, whereas independent completion is roughly 55 per cent. SfC report 1,522,040 social care jobs across all sectors in its size and structure report (SfC, 2014b). This is an estimate based on the NMDS-SC data combined with a methodology (described in the SfC report) for estimating the size of the incomplete data. SfC provided the statistics by job role as collected in the NMDS-SC. There are roughly 30 different recognised job roles. SfC provided the sizes of the workforce in 2013, counted by both total jobs and by full-time equivalent (FTE) jobs. The categorisation and mapping of job roles to the category names used by the CfWI are listed below: Qualified social care workers (QSW) Social workers CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 14

Registered nurses (RN) Registered nurses working in social care Occupational therapists (OT) Occupational therapists working in social care Allied health professionals (AHP) Allied health professionals working in social care Social care workers (SCW) Activities workers or co-ordinators Advice guidance and advocacy workers Care workers Childcare workers or childcare assistants* Community support and outreach workers Counsellors Educational assistants* Educational support workers* Employment support workers Nursery nurses* Other care-providing job roles Personal assistants (care and support) Senior care workers Technicians Youth offending support worker* Managers in social care (MSC) First line managers Managers and staff in care-related but not care-providing roles Middle managers Registered managers Senior managers Supervisors Support staff (SS) Administrative or office staff that do not provide care Ancillary staff that do not provide care Other non-care-providing job roles Safeguarding and reviewing officers Teachers* For this project, the CfWI used available data to map job roles to workforce categories. All job roles within a category are treated equally as calculations are applied at category level, not individual job level. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 15

Jobs FORECASTING THE ADULT SOCIAL CARE WORKFORCE Six of the included job roles (marked *) are not professions necessarily expected to work in adult social care. However, they were recorded in the NMDS-SC data collection for adult social care in 2013. The reason for this is unclear and may be down to input error or capturing some individual circumstances that do not fit the norm. The total number of jobs estimated in these six job roles is 4,456 or 0.29 per cent of the total adult social care workforce. To remain consistent with the SfC report (SfC, 2014b) the CfWI has included these groups in its subsequent modelling. Figure 8: Number of social care jobs The total number of jobs in social care as estimated by SfC grouped by CfWI-defined workforce category. 1,200,000 1,148,972 1,000,000 800,000 600,000 400,000 200,000 0 17,848 Qualified social worker 51,414 Registered nurse 22,448 Occupational therapist 113,171 Manager in social care Workforce category 1,176 Allied health professional 167,011 Other support staff Social care worker Source: SfC (total job size) (SfC, 2014b) and CfWI (categorisation) (2014) CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 16

Figure 9: Proportion of social care jobs The proportional split of jobs in social care across the CfWI-defined workforce category groupings as estimated by SfC. 1.2% 3.4% 75.5% 7.4% 1.5% 0.1% 11.0% Qualified social worker Registered nurse Occupational therapist Manager in social care Allied health professional Other support staff Social care worker Source: SfC (2014b) and CfWI (2014) 3.5 Data 5 Workforce split between service types SfC does not collect workforce statistics across the service/demand type labels the HSCIC community care statistics use. However, NMDS-SC dashboards provide service type data. The categorisation and mapping of NMDS-SC service type to the service types used by the CfWI model are shown below: Domiciliary/ community care Adult placement home Carers support Community-based services for people who misuse substances (SMC) Community-based services for people with a learning disability (LDC) Community-based services for people with mental health needs (MHC) Community healthcare services (CHC) Community support and outreach Day care and day services Domestic services and home help Domiciliary care services (adults) (DCC) Long-term conditions services (LTC) Meals on wheels Other adult community care services Other adult day care services Other adult domiciliary care services CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 17

Residential care without nursing Care home services without nursing (CHS) Extra care housing services (EXC) Rehabilitation services (RHS) Residential substance misuse treatment/rehabilitation services (RSM) Sheltered housing Short breaks / respite care Supported living services (SLS) Residential care with nursing Acute services (ACS) Care home services with nursing (CHN) Hospice services (HPS) Hospital services for people with mental health needs and/or learning disabilities and/or problems with substance misuse (MLS) Others Any other services Head office services Information and advice services (adults) Occupational/employment-related services Other adult residential care services Other healthcare services Local authority social work teams Disability adaptations/assistive technology services Shared lives (SHL) Social work and care management (adults). The CfWI assumes the proportional split between service types for each job role in the incomplete data set reflects the same proportional split for the complete data set. 3.6 Data 6 Annual number of new workforce joiners SfC provided 2012 and 2013 data for workforce joiners, for each of the workforce categories being modelled. The data pertains to the number of people who started a new job in social care. It does not distinguish whether the person is starting a job in the social care workforce for the very first time (for example a newly qualified social worker) or whether they have been working in the sector for a significant time and are just moving to a new establishment. Also, the net change in workforce size implied by considering the annual joiners and leavers (data 7) for 2012 and 2013 appears inconsistent with the actual recorded workforce size change. The CfWI s supply model is highly sensitive to these statistics, so the uncertainty surrounding their accuracy means the results of the supply modelling are not as robust as the demand modelling. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 18

3.7 Data 7 Annual percentage of workforce leavers SfC provided data for 2012 and 2013 of workforce leaver data for each of the workforce categories being modelled. The data pertains to the number of people who left a job in social care. The CfWI converted this to a percentage based on the entire size of the workforce each year. It does not distinguish whether the person is leaving the social care workforce permanently or is just leaving their current role to take up a similar one elsewhere. Also, the net change in workforce size implied by considering the annual joiners (data 6) and leavers for 2012 and 2013 appears inconsistent with the actual recorded workforce size change. The CfWI s supply model is highly sensitive to these statistics, so the uncertainty surrounding their accuracy means the results of the supply modelling are not as robust as the demand modelling. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 19

4. Demand calculation This section describes the calculations in the CfWI social care workforce system dynamics model that produce various future demand projections. The CfWI demand model considers the potential changes in future demand for the social care workforce as a result of demographic change only. While the total population size is increasing, it is not increasing consistently by age; the sizes of different age groups within the population are increasing at different rates. According to the ONS 2012 principal projection (see data 1), total population size between 2012 and 2030 is expected to increase by 12 per cent while the size of the population older than 64 years is expected to increase by 46 per cent over the same period. Different age groups will have different impacts on demand. For example, the complexities of medical conditions that accompany later life mean it is likely a 20 per cent increase in people aged 70 to 80 would have a different impact on demand from a 20 per cent increase in people aged 20 to 30. Women and men on average may also have different impacts on demand across different points in their life. Therefore, while we can assume demographic change will impact demand, future population change must be weighted by gender and age where possible. The CfWI assumes that the weighted percentage change in population size will be equal to percentage change in demand, assuming population change is the only impacting factor (other factors can be accounted for later). At this stage therefore, the potential impact of policies have not yet been included (such as those in the Care Act 2014), or the possible scenarios that might unfold in the future. This analysis is ongoing in partnership with key stakeholders, and a follow on report with further forecasts will be published in 2016. Stage 1 In order to weight the change in demand due to population change by gender and age we require some way of measuring which demographic groups have a greater requirement for service per capita. Service delivery and activity statistics are split by service user age and gender (see data 2). These statistics are divided by the number of people in the population in the same age and gender groups to calculate the amount of service and activity delivered per person for each group at the time of which the data was collected, in this case 2013. Figure 10: CfWI demand calculation stage 1 Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 20

Stage 2 The care received per person in 2013 is used as a prevalence rate for each age and gender band. This is then multiplied by the corresponding age and gender group s size for each year in the future population projections. Figure 11: CfWI demand calculation stage 2 Source: CfWI modeller team Stage 3 The future yearly care delivered is aggregated by CfWI across all age and gender bands to calculate total care delivered each year (assuming 2013 prevalence rates). Each year is then divided by the care delivered in 2013 to calculate the percentage change from 2013 for each year in the projection. Figure 12: CfWI demand calculation stage 3 Source: CfWI modeller team This produces percentage change from 2013 in service delivered as a result of demographic change only (assuming 2013 prevalence rates). The CfWI demand model considers demand change across five social care service types (also referred to as demand types): domiciliary/community care residential care without nursing residential care with nursing other care CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 21

local authority social work teams and individually for three social care service user types: people with physical disabilities and other vulnerable people people with mental health and substance misuse needs people with learning disabilities (see data 3). Future demand can be calculated by multiplying the yearly percentage change by the 2013 value for demand. The extent to which current demand exceeds, is met by, or is less than current supply is subjective and robust data to quantify this does not exist. The CfWI therefore must use a modelling assumption, namely to assume that current demand is in line with current supply. This is therefore a modelling assumption, and is not intended as a statement that this reflects the wider reality of current supply/demand balance. However, by considering future demand in relation to current supply, a necessary, quantifiable baseline point of reference is provided by which to consider future demand. For the purpose of this project the CfWI considers the following workforce categories (see data 4): qualified social care workers (QSW) registered nurses (RN) occupational therapists (OT) allied health professionals (AHP) social care workers (SCW) managers in social care (MSC) support staff (SS). With the data available it is not possible to accurately split the workforce by service user type, so the CfWI is unable to estimate future demand by service user type (although it is still able to estimate future percentage change in demand across service user types). However, data does exist that enables the CfWI modelling team to estimate the split between each of the five service types for the workforce groups (see data 5). The CfWI assumes percentage change in demand for each service type is equal across each workforce type; for example, if percentage change in demand for residential care is set to increase by X per cent by 2030, there is an X per cent increase in demand for qualified social workers working in residential care, an X per cent increase in demand for registered nurses working in residential care, an X per cent increase in demand for occupational therapists working in residential care, etc. Stage 4 Percentage changes in demand for each service type are applied to the respective current demand values, calculating a future required workforce size to meet demand. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 22

Figure 13: CfWI demand calculation stage 4 Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 23

5. Supply calculation This section describes the calculations in the CfWI social care workforce system dynamics model that produce future supply projections. The CfWI supply model estimates the potential workforce size of the future, and represents a simple accumulation and depletion calculation through the analogy of stocks and flows. Due to limited workforce supply data, the supply calculations are much simpler than the demand calculations. A graphical representation of the supply calculation and its inputs are shown below: Figure 14: CfWI supply calculation A visual representation of the supply calculation in stock-and-flow form. Source: CfWI modeller team The calculation considers a stock (the workforce), an annual inflow to that stock (people starting new positions in the workforce), and an outflow from the stock (people leaving their current positions). Each of these three elements is split by workforce category: qualified social care workers (QSW), registered nurses (RN), occupational therapists (OT), allied health professionals (AHP), social care workers (SCW), managers in social care (MSC), and support staff (SS), enabling separate projections to be produced for each workforce as well as a total workforce projection. The workforce s initial value is set to match the total number of jobs in 2013 as provided by Skills for Care (see data 4). The annual percentage of people leaving current positions is set to match the average percentage of leavers over the last two years, as also provided by Skills for Care (see data 7). There are two ways in which the number of people starting new positions is set, depending on how the model is configured. If the model is configured to provide an estimate of future supply based on recent data only, the inflow is set to match the average number of starters for each workforce category over the last two years as provided by Skills for Care (see data 6). If the model is configured to estimate the workforce recruitment required to meet demand in the future, then the inflow is set to calculate the optimal annual value each year, to ensure that the workforce stock size meets demand after any outflow is accounted for. Due to the limited data available, there is a number of considerations that should be made when reviewing any results of the supply model. Firstly, only two years of historical inflow and outflow data were available. This means that the model projections are extremely sensitive to what happened very recently with regard to leavers and joiners, and may not capture a more long-term trend, should the most recent two years be unreflective of the longer-term picture. Secondly, the CfWI was unable to distinguish between internal (people starting and leaving jobs within the social care system) and external (people starting for the first time, or CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 24

coming from other sectors, or leaving for good) workforce turnover. The CfWI is thus unable to calculate the additional recruitment needed on top of internal churn, and the estimated leavers may well include a proportion of people who immediately return, albeit in a different job. Thirdly, the last two years workforce net change in size implied by considering the joiner and leaver data does not match the net change in workforce size implied by comparing the size of the workforce from one year to the next. To address some of the uncertainty inherent in this data, the CfWI has simulated the joiner rate at five variations across the data already available: average joiner and leaver values from 2012 and 2013 joiner and leaver values from 2013 only joiner and leaver values from 2012 only the smallest joiner and leaver values from 2012 and 2013 the largest joiner and leave values from 2012 and 2013. This additional modelling addresses some of the uncertainty surrounding these figures, but should still be considered a limitation given the three issues listed above; it is simply the broadest range that can be modelled with the available data. The training pathway for qualified social workers, depicted in Figure 15, is simulated in the supply model developed for this project. The training pathways for the other job roles under review were not included in the modelling as they do not have training routes specific to the social care system. Like the workforce supply calculation, the training pathway consists of an accumulation and depletion calculation. Figure 15: Training pathway for social workers Social workers achieve a professional qualification via a defined education and training pathway. Start degree Social worker degree Successfully complete degree Join workforce Become social worker in adult services Do not complete degree Do not join workforce Become social worker in children s services Source: CfWI The key driver for the social worker training model is the recent recruitment statistics. As shown in Figure 16, recruitment has been fairly stable from 2010 to 2014 for both the postgraduate training route and the undergraduate training route. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 25

People starting degree FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 16: Recent recruitment to social work degrees at Higher Education Institutions (HEIs) Postgraduate and undergraduate social worker recruitment has remained stable in recent years. 6,000 5,000 4,000 3,000 2,000 1,000 0 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 Year Undergrad - GSCC Postgrad - GSCC Undergrad - UCAS Postgrad - UCAS Source: GSCC (2012), UCAS (2014) Given the stable recruitment in recent years, the model holds recruitment at a flat value (the most recent year s value for both the post graduate and undergraduate training route). This results in the calculated output holding level throughout the simulation. Again, due to data limitations, particularly regarding where people are joining the workforce from, it is hard to attribute the impact on the overall workforce from any variation in the number of people starting training. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 26

6. Model outputs This section contains the outputs from the CfWI social care workforce system dynamics model, as published in the CfWI s Forecasting the adult social care workforce: workforce intelligence report (CfWI, 2015). This technical report also contains supplementary and additional outputs providing greater granular detail where appropriate (i.e. splitting workforce numbers by job role). 6.1 Outputs Figures 17 to 23 show the impact population change has on demand for each of the five demand types under consideration, as well as the total across each of them, split by service user type. Figure 23 shows the average percentage change in demand across all services users from the previous six graphs on one graphic. Figure 24 shows the total workforce supply full-time equivalent (FTE) job projections generated by the CfWI model split by workforce category, while figure 25 shows the percentage change in projected FTE jobs by workforce category. CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 27

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 17: Total percentage change in demand across all demand types Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64-year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Change across all service users Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 28

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 18: Percentage change in demand for domiciliary and community services Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64-year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Domiciliary/ community care average Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 29

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 19: Percentage change in demand for residential care services Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64 year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Residential care average Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 30

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 20: Percentage change in demand for nursing care services Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64-year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Nursing care average Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 31

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 21: Percentage change in demand for other care services Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64-year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Other care average Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 32

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 22: Percentage change in demand for local authority social work teams Change in demand across each service user type, as well as averaged across all types. Percentage change in the size of the 18- to 64 year-old population and 65+ year-old population is also provided for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Year Physical disability and other vulnerable people Mental health and substance misuse Learning disability (Emerson) Percentage change in the number of 18-64 year olds Local authority social work team average Percentage change in the number of 65 + year olds Source: CfWI modeller team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 33

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 23: Percentage change in demand by service type due to population change The percentage change in the number of people by age is also shown for comparison. 50 45 40 35 30 25 20 15 10 5 0 2012 2015 2018 2021 2024 2027 2030 Domiciliary/community care change across all service users Year Residential care without nursing change across all service users Residential care with nursing change across all service users Local authority social work teams change across all service users Other care change across all service users Percentage change in the number of 18 to 64 year olds Percentage change in the number of 65 + year olds Source: CfWI analysis of ONS (2013) and Emerson et al (2012) data CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 34

FTE jobs FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 24: Future workforce supply The CfWI future workforce supply projection assuming the average of the 2012 and 2013 joiner and leaver rates is maintained. 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Year Social care worker Other support staff Managers in social care Registered nurse Occupational therapist Qualified social worker Allied health professional Source: CfWI modelling team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 35

Percentage change FORECASTING THE ADULT SOCIAL CARE WORKFORCE Figure 25: Percentage change in future workforce supply The CfWI future workforce supply projection by percentage change in FTE 30% 25% 20% 15% 10% 5% 0% -5% 2012 2015 2018 2021 2024 2027 2030 Year Social care worker Other support staff Managers in social care Registered nurse Occupational therapist Qualified social worker Allied health professional Source: CfWI modelling team CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 36

References CfWI (2014) Robust workforce planning framework: An introduction, CfWI technical paper series no. 0001, [Accessed April 2015] available at http://www.cfwi.org.uk/publications/robust-workforce-planning-an-introduction/@@publication-detail CfWI (2015) Forecasting the adult social care workforce: Workforce intelligence report, [Accessed September 2015] available at http://www.cfwi.org.uk/publications/robust-workforce-planning-an-introduction/@@publication-detail Department of Health (2015) Social Care Funding Reform Impact Assessment, IA No: 9531, [Accessed March 2015] available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/401348/social_care_fundin g_reform_ia_final_v2.pdf GSCC (2012), General Social Care Council Student figures, Sent via email [accessed July 2012] Health and Social Care Information Centre (2014) Community Care Statistics, Social Services Activity, England - 2013-14, Final release [Accessed December 2014] available at http://www.hscic.gov.uk/searchcatalogue?productid=16628&topics=0%2fsocial+care&sort=relevance&size=1 0&page=1#top Emerson, E., Robertson, J., Coles, B. and Hatton, C. (2012) Estimating the Need for Social Care Services for Adults with Disabilities in England 2012 2030. Lancaster: CeDR, cited by the National Institute for Health Research (NIHR) School for Social Care Research (2012) The future need for social care services for adults with disabilities in England 2012 30, [accessed March 2015] available at http://sscr.nihr.ac.uk/pdf/findings/sscrresearchfindings5.pdf Office for National Statistics (ONS) (2013) National Population Projections, 2012-based projections [Accessed May 2015] available at http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3a77-318453 Skills for Care (2014a) National Minimum Data Set for Social Care (NMDS-SC), [Accessed October 2014] available at http://www.skillsforcare.org.uk/nmds-sc-intelligence-research-and-innovation/nmds-sc-innovationevidence-impact.aspx Skills for Care (2014b) The size and structure of the adult social care sector and workforce in England, 2014, [Accessed October 2014] available at http://www.skillsforcare.org.uk/document-library/nmds-sc,-workforce-intelligence-and-innovation/nmds- SC/Size-and-structure/SFC-SIZEANDSTRUCTURE-NEW-MASTER-DY.pdf UCAS (2014), Student application data for 2010 to 2013, received via ftp secure transfer [13th May 2014] CENTRE FOR WORKFORCE INTELLIGENCE CfWI 2015 Page 37

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