Workforce sustainability in UK health and care services

Key messages 

• workforce shortages across health and social care threaten the sustainability of services 

• recruitment and retention difficulties are linked to low pay, poor working conditions and limited career progression 

• a long-term workforce strategy integrating both health and social care planning is required 

• international recruitment remains an important component of workforce supply 

• continued policy inaction is likely to widen workforce gaps and affect service quality and outcomes. 

Policy implications 

• development of a long-term national workforce strategy that includes social care alongside the NHS 

• improved pay, conditions and career pathways to support recruitment and retention 

• workforce planning that accounts for demographic changes and rising demand for care 

• ethical and sustainable approaches to international recruitment. 

Gaps 

• limited analysis of the contribution and pressures placed on unpaid carers within the workforce system 

• the paper focuses on national workforce planning rather than regional variation in workforce pressures 

• further research is needed on how workforce strategies can be implemented across both health and social care systems. 

Commentary 
This paper examines the structural drivers of workforce shortages across the UK health and social care system. It highlights how long-standing issues in workforce planning have left services vulnerable to rising demand and demographic change. Recruitment and retention challenges, combined with workforce ageing and increasing service pressures, contribute to persistent staffing gaps. 

A key theme is the difference between workforce planning in the NHS and social care. While the NHS has national workforce planning mechanisms, social care remains more fragmented, with workforce planning largely shaped by local authority budgets and provider capacity. This creates variation in staffing stability and service provision across the system. 

Financial pressures also influence working conditions and career opportunities. Lower pay and fewer structured progression pathways in social care contribute to high turnover and recruitment difficulties, reinforcing the cycle of workforce shortages. 

In terms of care inequities, the paper highlights how workforce shortages can translate into uneven access to services. Areas with greater financial pressures or fewer available staff may experience more service disruptions and reduced continuity of care. At the same time, inequities within the workforce (particularly around pay and conditions between health and social care) reflect broader financial imbalances across the system. These dynamics demonstrate how funding structures influence both workforce stability and the distribution of care. 

Overall, the report argues that sustainable workforce planning requires coordinated policy across health and social care. Without long-term investment and strategic planning, workforce shortages will continue to affect service availability and contribute to financial and structural inequities in care provision.