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Fit for the future? Rethinking the public services workforce Contents

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Chapter 1: Introduction

1.The resources of public services are at breaking point. Common themes are insufficient staff, high levels of workforce stress or burnout and, as a result, sometimes slow or inadequate service delivery. Long waiting times for vital services are often reported in the NHS, but the problem is broader than this. Staff in sectors including education, policing, and the justice and care systems are overstretched, and are sometimes unable to meet the needs of people who require support urgently. Robin Wilkinson, Chief of Corporate Services at the Metropolitan Police, stated that: “Every day the demand for public services, the demand for policing, far outstrips our ability to meet that demand and the demands of the public and of victims”.1

2.Changes in the demographic make-up of the UK will worsen this situation: population increases in both older people and people of working age who need support from public services mean an unavoidable rise in demand for services, and the working population will not keep pace.

3.The COVID-19 pandemic has put pressure on all public services and demonstrated the need for a workforce that is stronger and more sustainable. But it has also shown that more flexible approaches to public service delivery (whether that be in ways of working, training or regulation), are possible and desirable. Moving forward, public service employers need to embrace a far more flexible approach to the workforce.

4.There are two important questions relating to service provision: how can demand be reduced? How can delivery change so that more can be achieved by fewer people? Our inquiry related primarily to the workforce, so we have not considered the former question on demand in detail. On the latter question though, we have looked at the question of deploying staff (and technology) creatively, finding this to be a crucial component of any workforce strategy.

Workforce shortages

5.Capacity is a key issue within the public service workforce, now and for the future. Over and again, we heard of a lack of staff. Solace, for instance, which represents local government professionals, found that 33% of council chief executives and senior managers in England did not have enough skilled staff to run services to an acceptable standard.2 Sarah McClinton, Director of Adult Services at the Royal Borough of Greenwich, and now President of the Association of Directors of Adult Social Services, described “growing demand” coupled with “increasing vacancy rates and increased turnover”.3

6.In the context of overstretch, burnout and increasing future demand, calls for additional resource were unsurprisingly strong. Evidence called for a “public sector jobs drive”,4 “significant investment”,5 and for capacity to be afforded and built in by “central, strategic planning”.6 Hiring (and keeping), more staff is critical.

Box 1: Staffing shortfalls

Education—in 2021–22, the Department for Education (DfE) missed its teaching recruitment target for science, technology engineering and maths (STEM) subject teachers by almost 30% and missed the physics teacher recruitment target by almost 80%.7 The NHS—between 2015–21, NHS England and NHS Improvement reported an average nursing vacancy rate of 10.5%.8 Adult social care—Skills for Care reported that, in April 2022, 10% of social care posts remained vacant, up from 6% in March 2021.9 Prisons—nearly one in seven prison officers left the prison service in the year before May 2022, with three quarters of them resigning.10 Local government—in September 2021, local government body Solace reported that 33% of local authority chief executives and senior managers did not have enough staff with the appropriate skills and qualifications to run services to an acceptable standard.11

7.Any drive to recruit more people should be ambitious and avoid historical patterns whereby workforce planning has “tried to land ‘a jumbo jet on a pin’”, with strategies aiming to recruit precisely the required number of people, and no surge capacity.12 The Chartered Management Institute also noted that this had been the approach, and argued that the need for “redundant capacity” had been shown throughout the pandemic.13

Increasing demand for public services

8.Whatever the causes for overstretch historically (they are varied, widely reported and differ depending on the service), the changing composition of the UK population is likely to make it worse.

Ageing population

9.While the UK population is expected to grow over the coming decades, this growth varies significantly between different age groups, which has implications for public services. The Resolution Foundation report that:

“The ageing of the baby boomers, in combination with longevity improvements, means that the number of people in older age (65 and above) is expected to increase by around 2.5 million (20%). Projections indicate that between 2025 and 2035, the number of people in early working age (16–29) will also grow, albeit by a smaller amount (+860,000 or 7.4%). Meanwhile, due to falling fertility rates, there will be fewer children by the end of the decade, with the number of people aged 15 and under projected to decline by 1.1 million (-9%).”14

In the longer term, the Office for National Statistics (ONS) predicts that the number of older people in the UK is increasing faster than for any other age group.

10.ONS statistics show that the number of people of pensionable age will grow by 28% between 2020–45, while the number of working age people will grow by just 5%. By mid-2020 there were 42.5 million working age adults and 11.9 million adults of pensionable age. By 2045, the number of working-age adults is projected to be 44.6 million (a rise by less than 5%), and the pensionable age population is expected to be 15.2 million (a rise of almost 28%), see Figures 1 and 2. It is also worth noting that in February 2022, the Royal College of Nursing reported that a fifth of nursing registrars were 56 years of age or older. 15

11.The rising number of older people in the UK strongly suggests an increasing demand for public services, particularly in health and social care sectors.16 However, the UK’s labour supply, which public services can recruit from will not increase proportionally. This means it will not be possible to meet increasing levels of demand through recruiting more staff alone.

Figure 1: Population growth

Source: ONS, National population projections: 2020-based interim (January 2022): https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/bulletins/nationalpopulationprojections/2020basedinterim#changing-age-structure [accessed 21 June 2022]

Figure 2: Pensionable and working age population increase by 2045

Source: ONS, National population projections: 2020-based interim

Change in health profiles causing increased demand

12.Alongside an increase in the population of older people who will likely need to draw on public services for support, the public services workforce (both in health and care and beyond it), will need to respond to the changing health profile of the UK population.

13.As of 2022, a quarter of people in England have multiple health conditions. This is substantial, and has been growing: the Richmond Group of Charities believed that multimorbidity (the presence of two or more long-term health conditions) is the “new normal”.17 This is supported by data from the Office for National Statistics which show that, over the last eight years, the number of disabled people of working age in the UK has risen by almost 35%, from 6.7 million in 2014 to around 9 million.18

14.When considering demographic changes in both age and health profile in December 2020—before current rises in inflation and the Government’s proposals for reform of the social care system—the Care Policy and Evaluation Centre estimated that the spend on social services would almost double between 2018–38, and would continue to rise rapidly in the following decades.19

Public services demand and young people

15.Changes in demographics will also affect services supporting younger people. For example, the number of primary school pupils is expected to drop by over 300,000 in the next four years, while the number of secondary school pupils will increase by over 210,000.20 Due to historic over-recruitment in primary education this may mean too many primary school teachers but a shortage of secondary school teachers.21

16.Other factors will influence demand. Despite the number of children in the UK being forecast to shrink over the next two decades, the number of children in care settings is likely to increase, due to children staying in care for longer.22 Without “a dramatic whole system reset”, the Independent Review of Children’s Social Care in England projected that the number of children in care would rise from 20,000 to 100,000 by 2032.23

17.In the coming decades, public services will see a significant increase in demand which will not be met with a corresponding increase in the supply of staff.

External pressures

18.The pressures on our public services are not limited to demographic changes: the costs of simply doing business are increasing. Two examples are fuel and food. Rising fuel prices will increase the costs of running ambulances, buses, and keeping care homes warm. Rising food prices will increase the costs of running schools, staff canteens, community groups and events. These are only limited examples, and they do not touch upon the elephant in the room: as costs rise for individuals who may already be struggling, their recourse to public services increases.

Our inquiry

19.We launched our inquiry on 24 January 2022. In addition to taking oral and written evidence and holding a private seminar, we visited the Chelmsford campus of Anglia Ruskin University to view their medical training facilities (see Appendix 4). We are grateful to all who helped us with this inquiry.

20.Throughout this inquiry, we received a significant amount of evidence concerning the health and adult and children care workforces, and we have explored workforce challenges in the civil service, local government, and in the prison and police services. While, reflecting the balance of our evidence, this report includes a greater emphasis on health, care and local authority workforces, its findings and recommendations apply across other public services.

21.As many of these are devolved matters, our recommendations apply primarily to England. Many will, however, be of interest to devolved governments in the constituent nations of the UK.

Our plan for action

Box 2: Action strategy

Understand the problem by collecting and sharing workforce data Get the most out of the workforce by empowering them and thinking imaginatively about where they could be deployed Make services work for users through meaningful consultation Use technology in the most productive and informative ways Prioritise preventative services End the culture problems driving people to leave Make the offer of public service careers more attractive by fixing pensions and offering flexible working Fix the broken brand of public service careers, and get an appealing message out Create new and accessible entry routes, and properly use those that already exist Train to retain: rethink development so that skills can be recognised and used more effectively across broad careers

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