Key messages 

• staff turnover in social care is shaped by pay, conditions and progression opportunities 

• recruitment initiatives include fast-tracked learning routes, apprenticeships and graduate programmes 

• national recruitment campaigns have been used to raise the profile of social care work 

• evidence on the effectiveness of innovations is uneven 

• most evaluated initiatives pre-date the COVID-19 pandemic. 

Policy implications 

• workforce strategies should combine recruitment with retention-focused approaches 

• learning and progression pathways may support workforce stability 

• national initiatives need alignment with local labour market conditions 

• future policy should build on a stronger and more current evidence base. 

Gaps 

• much of the evidence is pre-pandemic 

• limited evaluation of long-term impacts on retention 

• variation in study quality and outcome measures 

• insufficient insight from staff into lived experiences of innovations. 

Commentary 

This rapid review highlights the range of approaches that have been used to attract and retain social care workers in the UK. Initiatives such as apprenticeships, accelerated learning routes and national campaigns reflect ongoing attempts to stabilise a workforce facing high turnover. 

The findings also show how limited the evidence base remains. While many innovations appear promising, few have been robustly evaluated, making it difficult to assess which approaches genuinely improve retention over time. The predominance of pre-pandemic studies could arguably limit their relevance to current workforce pressures. 

Thinking about equitable social care, the review raises questions about who benefits from workforce innovations. Access to training, apprenticeships and progression opportunities may vary by role, region and personal circumstances, potentially reinforcing existing inequities within the workforce. Where initiatives focus on entry rather than conditions, they may do little to address the factors that drive turnover among lower-paid or marginalised workers. 

Overall, the review suggests that improving workforce sustainability requires more than isolated innovations. Building equitable and effective recruitment and retention strategies depends on better evidence, attention to working conditions and a clearer understanding of how initiatives affect different groups within the social care workforce. 

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.

Key statistics 

• around 65% of social workers reported insufficient staffing to adequately support people drawing on care and support 

• workers aged 30-39 reported the highest sickness absence and strongest intentions to leave 

• intentions to leave were not strongly associated with region, gender or job role. 

Key messages 

• perceptions of unsafe staffing levels are widespread 

• workload and burnout negatively affect mental wellbeing 

• increased administrative demands reduce time for direct practice 

• reliance on agency staff reflects workforce instability 

• wellbeing concerns are closely linked to intentions to leave the profession. 

Policy implications 

• safe staffing standards are needed to support practice quality and worker wellbeing 

• reducing administrative burden may help retain staff 

• addressing burnout could reduce sickness absence and turnover 

• workforce planning should consider age-related risk of exit from the profession. 

Gaps 

• the sample is weighted towards respondents from Northern Ireland 
• findings rely on self-reported data 

• further research on safe staffing thresholds is ongoing. 

Commentary 
This study highlights the relationship between perceived staffing adequacy, wellbeing and retention among social workers. Many participants described feeling unable to meet the needs of people they support due to insufficient staffing, alongside growing administrative demands. 

The findings show how workload pressures translate into sickness absence and intentions to leave, particularly among mid-career workers. Dependence on agency staff was described as both a symptom and a driver of instability, adding complexity to team functioning and continuity. 

From a care equity point of view, the study illustrates how workforce shortages affect both workers and service users. Where staffing levels are inadequate, social workers have less capacity to provide timely and consistent support, increasing the risk of uneven access and outcomes for people drawing on care and support. At the same time, burnout and poor wellbeing disproportionately affect those in high-pressure roles. 

Overall, the paper highlights that safe staffing is not only a workforce issue but a care quality issue. Improving staffing levels and working conditions is essential to sustaining an equitable social care system that supports both practitioners and the people they serve.