Temporary Agency Workers in the
Adult Social Care Workforce
Issues in procurement and management
Department of Health Evidence for
Change Seminar
17th November 2009
Michelle Cornes, Jo Moriarty, Saidah BlendiMahota, Tim Chittleburgh, Shereen Hussein
and Jill Manthorpe
Policy Background
‘By 2020 it is expected that employers will no
longer need to rely on temporary staff to cover
tasks that would normally be carried out by a
permanent social worker and that as a result
those receiving care will be able to count on
continuity in the person providing their care’
Options for Excellence (DH, 2006)
Study Aims



To explore how local councils with adult social
services responsibilities are implementing
‘Options for Excellence.’
To assess the impact of ‘Options for Excellence’
on the employment businesses sector and what
if any role the sector is likely to play in the social
care workforce of the future.
To gain a better understanding of the
motivations, work histories, and future
employment plans of agency workers.
Methods



Case studies of progress in three local council
areas (rural, metropolitan, urban).
Interviews with: social services managers (n=18);
recruitment consultants (n=15); and agency
workers [both qualified (n=45) and unqualified
(n=15)].
A survey of local councils (n=151) in England
(36% response rate).
Hitting the Headlines
‘An under fire social services department spent
nearly £1.5 million on agency staff in just six
months… This is equal to £5,500 per agency
social worker per month – it should cost about
£2,000 for each social worker… [A local
councillor] who wanted to see how successful the
council’s recruitment campaign had been,
branded the findings shocking…’
Local Newspaper Report 2009
Literature Review
‘Agency working poses a very real threat to the
fabric of public service delivery, creating a
downward spiral in which permanent employees
leave to become agency workers to reap the
benefits of agency employment… The
institutionalisation of agency working into local
managers’ employment practices is an extremely
bleak scenario.’
Hoque and Kirkpatrick (2008)
The Agency Workforce



According to the NMDS-SC bank, pool and agency
staff account for 5.6% of the social care
workforce (Eborall and Griffiths, 2008)
Children’s services and the London boroughs are
making most use of agency staff (Barstow, 2009)
In our survey, the average spend per authority in
the 2008/9 financial year as a proportion of the
adult social care budget was 8% (the figure was
17% for London boroughs).
Implementing ‘Options for Excellence’
80% of respondents in our survey of local
authorities reported that their department had
implemented strategies to reduce the use of
agency workers:
¼ had introduced staff banks or pools
¾ of respondents had introduced managed
vendor schemes
Managed Vendor Schemes



There is good evidence that managed vendor
schemes are delivering cost savings to councils of
between 3 and 10% (IDeA, 2006)
In our survey, 60% of respondents reported that
their expenditure on agency working in 20082009 was less or the same as their expenditure in
2007-2008
Only one respondent thought expenditure would
increase in 2110/2011
Impact on quality of service
‘We have to do more safeguarding and as a result our
costs are increasing, however [our income] is being
reduced and those two don’t really match up…
Recruitment Consultant
‘…it is the [quality] parts of a recruitment service which
are quietly removed…’
Recruitment Consultant
Recruitment consultancies as ethical
businesses
‘I know local authorities that are struggling to fill their
permanent roles and I have got the perfect candidates.
However, the local authority policy is that they can’t use
agencies for permanent recruitment. When they can’t fill
a post they just keep spending another £20,000 on
putting an ad out. It doesn’t make any sense... I wish they
were keener for partnership working with us rather than
being so against us.’
Recruitment Consultant
Impact of ‘Options for Excellence’ on
Business Confidence
‘Recruitment into the [nursing and social care
sector] will continue to be challenging and will
demand more innovative strategies as well as
models for sourcing and skill development e.g.
increased reliance on bank and agency workers’.
Recruitment and Employment Confederation,
First Sector Profile for the Nursing and Social Care Group (2009)
Business as usual
‘[Local councils] tend to go round in cycles They
will put a recruitment freeze on locums… It’s
really strict and then six months later they realise
that people have left or that they haven’t been
able to recruit and then go back to using agency
staff again. So it is just kind of cyclical. They all
take turns in doing it so I won’t take [Options for
Excellence] too seriously’.
Recruitment Consultant
Perspectives of front line managers
In our survey 92% of responding authorities had
used agency workers in the 2008-2009 financial
year.
‘Agency workers will always be with us…
They are the only way to keep the show
on the road and to keep those gaps filled’
General Manager Adult Social Care
Reasons for recruiting agency social workers





Difficulties in recruiting permanent staff (80%)*
To fill a post quickly (78%)
Sickness cover (65%)
For a specific task or activity (69%)
Other reason 22%
*Percentages of responses - figures are based on multiple responses so percentages will
exceed 100%)
Advantages – a balanced approach
‘I don’t think that you necessarily have to have a
completely permanent workforce, I think there is
some value in having people who are short term
and potentially more flexible, I don’t know in
terms of how I would cut that… maybe 80/20
[permanent/agency]… I like to see a bit of a mix.’
Manager of an Integrated
Learning Disability Service
What is over reliance on agency staff?
‘If you have too many agency workers then the
[permanent staff] in the team think [the agency
workers] are getting more - I had better become
an agency worker. It can be very negative… They
[agency workers] become the more dominant
influence on the team’.
Social Services Manager
‘Many teams which rely on agency staff are
dysfunctional. They are characterised by poor
management practices. In these teams, many
permanent staff are ‘burnt out’ and the overall
culture or working environment is poor.’
Agency Social Worker
‘I had one assignment where I only did a few days
[and left]. Unfortunately it was in Children and
Families and that reinforced my view of Children
and Families these days. I don’t like it, it doesn’t
suit me and I am too old for it. It was very much
here is your case load - an extensive case load get on with it. I didn’t like the practice. I felt very
unsafe...’
Agency Social Worker
Poor management of agency workers



Giving agency workers the most complex case
load (cases that no one else wants to deal with)
Expecting them to ‘hit the ground running’ (lack
of induction especially for newly qualified social
workers)
Unequal access to training and supervision
What is under-reliance?
‘If you need to get [a service user] out of bed
then you need someone there immediately.
Whereas the services I provide don’t necessarily
need that immediate response so we are able to
manage [staff] absences more easily than
perhaps the other services [who will need to use
agency workers].’
General Manager Adult Social Work Team
Gold collar workers or just trying to find the
right team?
‘I am going now to work in a permanent position
in a relatively poorly paid London borough but I
like the job and the people and the managers;
they are a great bunch of people; they are a bit of
an old fashioned social work team but they do
understand twenty first century social work, the
post will be right for me, I know it.’
Agency Approved Social Worker
Implementing ‘Options for Excellence’
Progress Update




There is evidence that most local councils have
introduced measures to tackle over reliance on agency
workers.
There is evidence of efficiency savings and a trend toward
further reducing expenditure on agency working
Indications that agency use may increase as challenges in
recruitment and retention continue
Need to wait for next set of NMDS-SC figures to know if
the size of the bank, pool and agency staff workforce has
reduced (last reported figure was 5.6%)
Policy Recommendations



Assess the scope for partnership working with the
employment business sector – bring them to the table
when it comes to workforce planning (e.g. around the
personalisation agenda)
Produce guidance on managing agency workers - clarify
what constitutes ‘best practice’ with respects to
standards for induction, training and supervision.
In terms of recruitment and retention, encourage
strategies which look at team building, leadership and
management development.