Social care delivery plan 2023 to 2026

It’s nearly three years since the launch of the Health and Social Care Workforce Strategy, and since then we’ve seen significant challenges caused by a worldwide pandemic, the cost of living crisis, the war in Ukraine and the impact of Brexit.

But, despite these difficulties our aim remains the same, which is to have a motivated, engaged and valued health and social care workforce, with the capacity, competence, and confidence to meet the needs of the people of Wales.

There have been significant challenges over the last three years, but we’ve made progress, as you can see in our delivery plan annual report. But despite this progress, social care is facing major workforce challenges, with difficulties attracting people into the sector, recruiting enough people, and retaining the existing workforce.

Alongside these challenges, the workforce is still feeling the ongoing impact of the pandemic and the efforts that were made to keep services going, keep people safe and meet increasing demand. Staff well-being is also being affected by increased levels of stress, fatigue and burnout, along with perceived poor working conditions and a lack of professional development opportunities.

These workforce issues are a priority to solve as we move forward. We must act quickly to resolve the challenges facing the existing workforce and deal with the issue of attracting new people into the workforce. We need to create the right conditions to allow people to deliver quality services.

We can’t provide high quality health and social care services and support to the people of Wales without our workforce, who work in a range of statutory, private or voluntary provider services, as volunteers or carers. All these workers and volunteers are included in this strategy.

When we describe the workforce, we include foster carers, volunteers and unpaid carers. The actions we include, where relevant, apply to these groups just as much as they do to the more traditional definition of the workforce.

We also want to improve services in Wales in line with the Social Services and Well-being (Wales) Act and the A healthier Wales ambitions, to deliver care closer to home and to improve the quality of support for vulnerable children and adults of all ages. The pandemic had a significant effect on the workforce, but more critically across our communities, especially for those who rely on good quality care and support. We’re now seeing greater pressure on the sector caused by more families living in poverty, and increased demands because of demographic changes.

The 2023 to 2026 delivery plan builds on the progress made so far and includes developments based on feedback we heard from engagement with the sector. It describes the actions that will help to move the workforce forward over the next three years, and includes:

• new actions, based on your feedback
• existing actions that will carry on as they’re essential to our work
• the next phase of development of previous actions.

The actions build on areas we can take forward effectively in partnership with our health colleagues. These areas of joint work include well-being, the mental health workforce plan, leadership, and workforce development to support integrated care and support.

The actions of the workforce strategy have also led to the development of sector specific workforce plans for:

• the direct care workforce
• the social work profession
• the mental health workforce, developed in partnership with Health Education Improvement Wales (HEIW).

These plans help to support the aims of the workforce strategy and have actions in common, such as well-being approaches, attraction, and recruitment. They also include actions that are specific to the relevant part of the sector.

The delivery plan is structured under each of the seven themes of the workforce strategy.

1. An engaged, motivated and healthy workforce
2. Attraction and recruitment
3. Seamless workforce models
4. Building a digitally ready workforce
5. Excellent education and learning
6. Leadership and succession
7. Workforce supply and shape

For each theme we’ve summarised the main issues and identified the most important actions to contribute to our 2030 ambition.

The ambition of the workforce strategy won’t be achieved by one partner or one stakeholder alone. We need collaborative and partnership working at all levels. The progress made so far has been based on effective joint working in a range of areas, which will continue through the next phase of delivery.

We recognise that we have an important role to play to support the implementation of the workforce strategy, so we’ve included in Appendix A the actions we’ll take to support delivery in the first year of this next phase.

What you told us

The sector wants us to prioritise its well-being. This was clear from what we heard during the engagement work we carried out in 2022. The workforce is often described as fatigued, exhausted, and burnt out, so it’s crucial that this theme continues and carries on the work already done in the last few years.

As the workforce becomes more diverse, we must put safeguards in place to support people to become and remain valued members of an inclusive workforce.

The sector also made it clear that it wants equal access to the well-being offer and parity between social care and health. This parity isn’t just in pay, but also in wider terms and conditions, including more flexibility in working arrangements and creative solutions to employment contract offers. The workforce wants better ways of gathering their views and they want to see action being taken because of those views. They were clear that the little things matter as much as the big changes.

Work has begun in several important areas where we’ve introduced a Health and well-being framework where employers and employees can measure their organisation against an agreed set of standards. We have, for the first time, a universal mental health support service that’s free at the point of access for the whole workforce across health and social care. We’ve also built peer networks that provide mutual help and support for managers to help build resilience.

We’ve started essential work around terms and conditions for social workers, and we’ve supported the work of the Social Care Fair Work Forum who are working on a career progression framework that aims to be linked to pay.

We recognise that there’s much more to do to make sure the sector is highly valued and the workforce feels appreciated. The preventative agenda for well-being is just as important as people taking responsibility for their own health and well-being, but the workforce needs support, time and space to do this.

Our ambition by 2030

The health and social care workforce will feel valued and supported wherever they work.

Workforce strategy actions 2023 to 2026

1. Support employers to embed workforce well-being in their organisations by implementing and refreshing the Health and well-being framework.
2. Work towards parity, fair reward and recognition through the Social Care Fair Work Forum and WLGA led consideration of social work terms and conditions.
3. Support workforce well-being by promoting and developing well-being resources and services, including Canopi and the Care Worker Card.
4. Maintain and develop peer support networks, communities and a national conference to share different ways of improving workforce well-being.
5. Carry out research and engagement work, including an annual independent survey of registered workers, and use what we learn to improve our understanding of how to support workforce well-being.

How we’ll measure progress against the actions

• We’ll use the annual independent survey of registered workers to help us decide what to focus on in future.
• We’ll use what we learn from the evaluation of the Health and well-being framework to decide what our future priorities are.
• We’ll report on how the well-being resources and support services are being used.

What you told us

The workforce strategy describes our ambition for the social care sector to be a model employer, and for there to be a positive change in how a career in social care is perceived by the public.

During our engagement work you told us that retention is as just as important as recruitment, and that we need to focus on the existing workforce as well as the future workforce. We had significant discussions about whether the theme of retention is missing from the strategy, but we’ve decided not to include it as its own theme as retention should improve once many of the actions in the strategy are achieved.

Looking at the future workforce, you explained that perceptions of a career in social care need to change. You want more of an emphasis on working with schools and colleges, so we can talk to young people at the beginning of their career journey. You also want to show people the value of apprenticeships as a way of entering the social care sector.

You supported our continued efforts to run pre-employment programmes, which give those taking part job seeking skills and a better understanding of the sector, which will hopefully help improve retention.

We need to show that working in social care can be fulfilling, rewarding and socially valuable. We’re working to make it more attractive, by improving the overall terms and conditions and offering clear career pathways for those who want to progress.

We want to attract a diverse range of people into careers in social care and social work that reflect the communities within which they work. We also want to support the ambition of Stronger, Fairer, Greener Wales: A Plan for Employability and Skills, for social care to continue to be an important part of the foundational economy across Wales. This extends to supporting work around international recruitment, as we look as far and wide as possible for our workforce.

We know there are big challenges and an enormous amount of work to do, but we also know there are around 84,000 people in this sector who love the work they do. They provide fantastic support, day in and day out, and are true champions and ambassadors for the sector. We need to help them feel proud of their work and promote the sector as a positive place to work.

Over the last couple of years, we’ve used those ambassadors and champions in our WeCare Wales campaign to tell positive stories about why they work in the sector. These stories have been shared in print, on radio, through online articles, social media and television campaigns and we’ve tried to target underrepresented groups, including men and Welsh speakers.

Our ambition by 2030

Health and social care will be well established as a strong and recognisable brand and the sector of choice for our future workforce.

Workforce strategy actions 2023 to 2026

6. Provide clear approaches to engagement with the sector, to support a co-ordinated approach to attract workers into social care.

7. Develop and implement plans to continually promote social care as a career of choice.

8. Develop ways of widening access to careers in social care, including pathways for volunteers

9. Improve sector recruitment practices.

How we’ll measure progress against the actions

• We’ll report on the number of vacancies.
• We’ll report on the changes in public perceptions of the social care sector.
• We’ll report on the reach and engagement levels of each WeCare Wales campaign.
• We’ll report on the numbers of people moving into education and/or employment from the Introduction to Social Care programme.

What you told us

Current policy makes it clear that we want to provide care at home, or as close to home as possible, which is consistent with the wishes of people receiving care and support. The pandemic and ongoing workforce challenges have made this ambition difficult as there’s been an increase in the number of people referred to and remaining in hospital. But, if there were enough staff within the workforce people could be supported to have care and support at home or in the community.

This came sharply into focus last autumn and winter when efforts were made to try to increase the capacity of community placements to relieve some of the pressure facing the NHS. It has since been agreed that this needs to become core business for both health and social care.

Work is taking place to decide what the new ways of working across boundaries should look like. Once this is confirmed, we can decide on workforce solutions for these new models and service designs. It’s likely that this change in culture and service delivery will take place step-by-step, and there won’t be extensive changes overnight. But, either way, we need to be ready to support the workforce across health and social care to make that transition.

For adults living in our communities, there’s a critical connection between social care and services such are housing, which allow individuals to live as independent lives as possible. New approaches such as the strategic primary care programme and integrated community services mean the workforce needs to work differently.

For vulnerable children, the main aim will always be to help families stay together wherever possible. This relies on a sufficient and stable social care and social work workforce, so that families receive meaningful and consistent support. Where it isn’t possible for families to stay together, children and young people need a safe and loving environment to call home, and access to therapeutic support. This needs a skilled workforce that offers continuity to build meaningful relationships. There's significant cross-sector development work taking place, including eliminating profit, making sure there’s a consistent advocacy offer, and enhancing the role of the corporate parent.

Work has already begun to develop the role of trusted assessor and to make sure this is supported through relevant resources and training. Work has also started around increasing access to learning pathways into nursing, reablement roles in social care settings and developing trauma informed practice.

During our engagement work, you were clear that there should be a focus on what the person receiving care and support and their carers need. You felt that the workforce should be given permission to develop and adopt new ways of working, including working across professional boundaries. You asked for a collaborative approach to shared problems, but felt that communication was the biggest barrier to seamless working.

Networking in safe places, where people can freely explore and share solutions would encourage innovation and promote new ways of working, but true seamless working would need to be considered alongside new models of joint commissioning.

Our ambition by 2030

Multi-professional and multi-agency workforce models will be the norm.

Workforce strategy actions 2023 to 2026

10. Implement initiatives to support working across health and social care boundaries

11. Develop ways of supporting multi-professional working.

12. Identify and respond to workforce implications of new policy drivers and service models

How we’ll measure progress against the actions

• We’ll give progress reports against the ambition of the mental health workforce plan.
• We’ll give progress reports about the numbers of social care workers taking up places on nurse training and returning to the social care sector after graduation.
• We’ll report on our progress against the actions related to new policy drivers and service models.

What you told us

During our engagement work, you told us that the pandemic had given us an opportunity to make significant progress in the use of digital skills and technology, and you don’t want us to lose momentum. You want to make sure that parts of the workforce aren’t digitally excluded and you want us to make the most of opportunities to invest in infrastructure and a skills development programme.

Learning through digital platforms needs to be accessible, and bitesize learning opportunities help with this approach. It creates greater equity of access, as does the use of mobile technology. The message was clear that “one size doesn’t fit all.”

We’ve supported the sector in the shift to digital, through targeted increases in funding and by developing national learning modules to make sure content is consistent. More needs to be done, but it must reflect what the workforce needs, which varies as not everyone uses and accesses digital content in the same way. This was clear in the Shift to digital learning research the Social Care Institute for Excellence (SCIE) carried out for us in 2020.

Our ambition by 2030

The digital and technological capabilities of the workforce will be well developed and in widespread use to optimise the way we work, to help us deliver the best possible care for people.

Workforce strategy actions 2023 to 2026

13. Implement ways to enhance the digital literacy and confidence of the wider health and social care workforce in Wales.

14. Create opportunities to widen access to digital learning and development.

15. Find out what digital skills are needed to implement new digital service models.

How we’ll measure progress against the actions

• We’ll report on the digital literacy audit.
• We’ll report on what actions are taken following the digital literacy audit.
• We’ll report on the number of new e-learning modules that are developed and taken up by the social care workforce.

What you told us

Making learning and development available to more people was a common theme in the feedback you gave us.

You told us that equality and inclusion was important for the current and future workforce, and we needed to:

• treat learning, development and CPD with the same level of importance as qualifications
• offer more opportunities for you to learn Welsh and improve your Welsh language skills.

Your feedback showed us how important it was to have clear career pathways linked to learning. It’s important that it’s easy for you to move from learning and developing skills that are job-specific to more formal qualifications.

This means we should consider the opportunities for “grow your own” development models, that give the current workforce the chance to learn while they earn.

This would address concerns about the financial pressures linked to learning, and the debt that can come with more traditional full-time learning programmes.

To professionalise the social care workforce, you felt you needed more support to grow the capacity of the sector to assess and educate for all vocational and professional pathways.

We’ve already made more support available regionally and locally through our Workforce Development Programme. This is both in terms of grant and non-grant elements of the programme, and focuses on sponsored places for the social work degree.

Along with increased bursaries from Welsh Government, we’re trying to make the professional pathways more accessible and attractive to a wide range of learners, but we recognise more is needed.

We’ve carried out significant work to support the sector with the health and social care vocational qualifications that were introduced in 2019 and 2020, and in 2023 changes were made to how level 2 and level 3 are assessed. Further work is planned soon on level 4 and 5 qualifications.

We need to make the most of this investment to make sure we employ and retain social care staff in Wales, so we can:

• have a sustainable workforce for the future
• have routes into education and training that are attractive and accessible to our local population and communities.

Our ambition by 2030

The investment in education and learning for health and social care professionals will deliver the skills and capabilities needed to meet the needs of people in Wales.

Workforce strategy actions 2023 to 2026

16. Work with education providers to make sure education meets the needs of the health and social care system, and includes programmes offered in Welsh.

17. Continue to invest in increasing the numbers of health and social care professionals who are trained in Wales, with a focus on value.

18. Make it easier for people to start health and social care careers by removing barriers and developing the work-based learning model.

19. Develop ways of improving the workforce’s skills and knowledge.

How we’ll measure progress against the actions

• We’ll report on the percentage of the workforce with a required qualification and how many are working towards a required qualification.
• We’ll report on the key metrics from the Social Care Wales Workforce Development Grant programme (SCWWDP)
• We’ll report on the number of social work students who are sponsored and who have accessed the degree through vocational pathways.

What you told us

In line with the workforce strategy, we worked with HEIW to agree compassionate leadership principles and a ‘compassionate leadership behaviour compass’, which explains how to create compassionate leaders and cultures in health and care.

All national leadership and development programmes for social care and social work managers and leaders are based on these principles.

It was refreshing to see there’s universal support for the way we use and promote compassionate leadership. But, the workforce wants compassionate leadership roles to be modelled from top to bottom and space to use compassionate leadership, even in high pressure situations.

You also felt we need to focus on making a compassionate team culture that:

• reflects leadership values
• finds ways of rewarding people who don’t want to become leaders or managers but want to remain in practice.

You told us that you thought developing the Gwella site was very positive, but it wasn’t well known and needed to be marketed better. This would help make the most of it and create a culture of compassionate leadership and organisational development.

We also had a lot of strong feedback about the need for local workforce planning to include:

• succession planning
• the benefits of joint leadership development across health and social care
• thorough ways of mentoring new managers and leaders, focusing on well-being.

We know that social care organisations that practice and embed compassionate and collective leadership have a more engaged workforce, which leads to better health outcomes for people.

To have a strong social care service, we need to have compassionate leadership at all levels and professional groups.

Our ambition by 2030

Leaders in the health and social care system will demonstrate collective and compassionate leadership.

Workforce strategy actions 2023 to 2026

20. Create accessible leadership development resources and programmes for individuals and organisations, based on the compassionate leadership principles.

21. Develop a talent management pipeline for leadership roles.

22. Find ways to support services to develop and embed positive cultures.

How we’ll measure progress against the actions

• We’ll report on how many people took part in leadership and management programmes, and how happy they were with the programmes.
• We’ll share updates about new leadership programmes, including evaluation of initial delivery.

What you told us

Workforce planning should be a core function of workforce supply and demand based on service planning and modelling.

But, you felt that we don’t understand our workforce well enough or have the data and intelligence that helps us to plan the workforce effectively. This includes being confident about predictions of how many people are needed to work in the sector in the future, when taking into account the expected growing demand for services.

You told us it isn’t just about numbers, but about understanding what people can offer across sectors, including skills and capabilities, gaps and areas of duplication.

You felt that volunteers are an important part of workforce planning, and we need to be more inclusive of them. This includes providing learning and development opportunities and career pathways for volunteers where needed.

Our responses to workforce issues tend to be reactive, for example our recent work to better understand the significant increased use of agency workers.

But we know we need a clear and up-to-date picture of our current workforce, and to better understand why workers change employers or leave the sector.

We’ve started to get more current and detailed workforce data, but this is still a work in progress. We need to find ways to turn that data into something we can use when workforce planning locally, regionally and nationally.

This isn’t just about employment. Better ways of workforce planning will help us decide how we commission education and learning opportunities, so we’re not only able to recruit from an existing population, but also have enough people in the education system to meet future demands.

We know more people will need to use social care over the next 20 years, so it’s essential we have effective workforce planning systems in place to meet this demand.

Our ambition by 2030

We will have a sustainable workforce in sufficient numbers to meet the health and social care needs of our population.

Workforce strategy actions 2023 to 2026

23. Build capacity and capability in workforce planning and development across health and social care, supported by a standardised approach.

24. Develop workforce responses for professionals and key parts of the sector.

25. Find out what a National Care Service would mean for the workforce.

How we’ll measure progress against the actions

• We’ll publish workforce data annually, showing trends on the most important metrics.
• We’ll give progress reports in line with workforce planning findings and recommendations.

View the Social Care Wales delivery plan for 2023 to 2024, aligned to the ambition of the workforce strategy.

• Appendix A

The consultation is now closed.

Thank you for taking the time to tell us what you think.