The halo effect: Reimagining Australia's care workforce

The halo effect: Reimagining Australia’s care workforce to help solve the broader skills shortage

By Frances McMurtrie, Zac Hatzantonis, Ben Zhang, Brett Jones, Karen Chia, Chris Westhorpe, Kerryn Dillon.

19 September 2022

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When government and business leaders came together for the federal government’s Jobs and Skills Summit recently, how many of them relied on a care worker so they could attend? One in ten? A quarter? In fact, many Australians¹ depend on childcare workers, aged care workers and/or disability carers, either for direct support, or for support of a family member. 

At the Jobs and Skills Summit, a range of topics were covered in an effort to get the economy moving from raising skilled migration caps to removing barriers to participation for people living with a disability, as leaders searched for new workforce solutions. Many of the answers, however, lie with the care sector. 

For instance, more than 116,000 women were locked out of the labour market in 2021 because they couldn’t access or afford the childcare they needed². By improving childcare services we’d significantly boost workforce participation rates across all in-demand industries. Investment in the sector will turbocharge Australia’s economic recovery and, at the same time, ensure all Australians receive the care they deserve. Similar impacts could be achieved through meeting the demand for aged and disability care, which would support workforce participation in the care economy as well as other industries more broadly.

Connecting our thinking about the care economy to the broader economic landscape is how we’ll get the biggest bang for our productivity buck – because the care economy offers an exponential return on investment (ROI) for governments. As outlined in the above examples, the care sector creates a ripple or ‘halo’ of productivity benefits.

However, while care work comprises a staggering 3 of the top 10 most-in demand professions³, it is facing a severe skills shortage.
 

This skills shortage is being driven by three key challenges which inter-relate and compound one another:

1. Increased demand for services: Australia’s expanding – and ageing – population means demand for care is up. The number Australians aged over 65 is expected to grow from 16% in 2021, to 20% by 2031⁷; the number of NDIS participants is projected to increase by 84% by 2030⁸; and the number of employed people in child carer roles is expected to increase by 30% between 2021 and 2025.⁹ Moreover, the services required are increasingly for people with more complex needs (both physically and psycho-socially), and the demand for in-home aged and disability care is also growing.^10,11
2. Ageing workforce: High proportions of care workers will reach retirement age in the next decade. For instance, the median age of staff working in community aged care is 50 years, while 44% of disability workers are aged over 45 years.^12,13 The physical demands of traditional care work can make it hard for a workforce that is moving towards the retirement age, and failing to attract new younger workers into the care workforce.
3. Poor value proposition: Care sector roles are typically low paid, have limited job security due to increasing casualisation of the workforce, and have highly demanding roles. Requirements for qualifications and training are also variable across these sectors. Each of these factors contribute to a poor employee value proposition for attracting and retaining workers.^14,15,16

Together, these three challenges have created enormous existing (and anticipated) workforce shortages for the sector.

There is widespread acknowledgement of these issues, and extensive effort has already been made by Government and peak bodies organisations to develop clear strategies to address the care work skills shortage. These strategies and plans set out clear positioning on improving core elements of the care worker experience, including pay and recognition, training and wellbeing.^17,18,19,20

While these are important interventions, they do not seek to fully address the fundamental demand for and requirements of care work. This means that the care industry is likely to continue to attract individuals who are motivated by the opportunity to deliver better outcomes for their community but may not be able to tap into broader talent pools motivated by other factors. We believe that in order to bridge the gap between the supply of workers who have an intrinsic interest in delivering care, and our growing demand for care services, we need to reach new talent pools who bring a broader set of skills and capacity to the sector. To do this, we need to reimagine how we do care in Australia.

This will lead to better outcomes for both care recipients and their carers, while also alleviating the sector’s skills shortage. It will also unlock the sector’s significant potential for solving the broader skills shortage, by enabling more parents and caregivers to enter the labour market.

So how do we reimagine care? We believe this can be achieved through three interconnected steps, incorporating role augmentation and digital capabilities, elevation of the traditional care role, and investment in pay and conditions. 

1. Supplement traditional care work with role augmentations and digital capabilities

There are many elements of traditional care roles which require appropriate qualifications and training. These typically centre on a care worker’s ability to provide safe and effective support for some of our most vulnerable community members.

However, there are other elements of traditional care roles which do not require this same level of training or expertise. For example, picking up groceries, helping out in the garden, doing drop offs to care providers or other appointments. These elements could be delivered through people other than care workers, and through the use of technology. Think: virtual care or telecare, computerised decision-making support for complex care, and providing virtual training and support for care workers. We call these role augmentations, and we firmly believe they’re part of the solution.

Potential role augmentations include:

• Telecare: Indispensable during the COVID-19 pandemic, telecare should be used to complement person-to-person support, and to create efficiencies. Delivery models which use a virtual workforce (such as the NSW Government’s 24/7 warmline, Hear2Talk) could play a critical role in the delivery of care. 
  
• Fiscal incentives: A range of allowances already exist to enable people receiving pensions to boost their income through employment.^21,22,23 These could be leveraged to encourage retired workers, or those receiving other pensions to participate in the care workforce. Similarly, let’s consider returns on HECS debts, tax breaks, and other concessions, as well as emerging models like the UK’s Care Bank²⁴, which delivers bespoke staffing solutions by matching nursing support to the needs of individual healthcare facilities.
• Sharing economy: Here lies a huge opportunity to address the skills shortage. One in five Australian adults work in the sharing economy²⁵ meaning this is a large, flexible workforce which could be engaged to deliver certain elements of care work. For example, partnering with ride-share providers to deliver medication, or with task platforms to complete lower-value tasks, or even providing social connection and personal care (assuming the right quality approvals are in place).
• Robotics: We only need to look to sectors like mining, manufacturing, and retail to see how robotics can be used to alleviate workforce shortages. The care economy must invest in tech and tap into a talent pool of coders, developers, and engineers to advance the use of robotics in the care sector.

Governments should also look to invest heavily in digital – and data – capabilities. Access to new talent pools, and matching the supply of skills with consumer demand, can be achieved via the effective use of data. For instance, data can be used to identify latent workers (such as students or recent retirees) who could support virtual modalities for activities like onboarding customers to new programs, initial triage/intake calls or post-care support and follow up. They can then direct these workers into the highest impact modalities. Or data can be leveraged from existing digital platforms (such as physical monitoring devices) to drive care decisions.

2. Elevate the traditional care role

If role augmentations could be created and delivered, workers in traditional care roles could have their duties elevated to focus on their most specialised and critical skills – creating meaningful connection for some of our most vulnerable community members. 

Instead of being ‘care workers’, what if our traditional care roles became ‘relationship specialists’, or ‘connection consultants’? These roles would be tasked with parts of the care role which are absolutely essential in delivering client outcomes, but which can be overlooked in the rush of getting everything else done. Activities like just sitting with care recipients, talking with them, sharing activities which add meaning to their lives, and building their connection to friends and community could become a central focus of skilled care workers. This shift in focus would benefit those receiving care and help improve the overall value proposition of care careers.

If this shift occurred, training and education could also be elevated for the sector. Care workers could access specialised training in building relationships and facilitating wellbeing outcomes, and increase recognition of the specialised skills and knowledge needed to effectively provide care. This new conceptualisation of care workers could draw a broader talent pool who are motivated by building these specialised skills, and who would not have otherwise sought a care role when it still involved lower-value tasks.

3. Invest in lifting pay and conditions

Of course, care is only an attractive profession if it’s a viable one. Governments need to reassess pay and conditions for care sector workers if we’re serious about solving the skills crisis.

Working conditions vary widely between care roles. The acute health sector, for instance, tends to boast above average award conditions, while the childcare sector suffers from high casualisation and loses talent to the primary education sector as a result. Across the entire care sector, however, there is scope to improve conditions.

And certainly, there’s scope to improve pay. There’s a fundamental structural problem with the way we pay carers in Australia, with workers in care sectors paid 33% less, on average, than workers in other sectors. At a time when real wage growth is stagnant, and the cost of living is rising, lifting care worker wages would go a long way in the battle to attract talent. In addition, if actions 1 and 2 are enacted, wages will need to be calibrated to the new skills and expertise brought into the sector. Movement is already occurring in this area, with the Federal Government recently announcing that it will support pay increases for the aged care sector.²⁶

Right now, Australia has a rare opportunity to step up and address the acute skills shortages in the care sector. The need is already pressing and will only grow in the years ahead. But if we seize this moment, we can massively boost Australia’s economic recovery and, at the same, ensure all Australians receive the care they deserve. This is the time to act.

References

_{¹ During 2019–20, over 1 million people received support from aged care services in Australia (Department of Health 2020), although some people used multiple programs more than once during the year. Meanwhile, in the March quarter 2020, 45.1% of children aged 0-5 years and 31.8% of children aged 0-12 years used approved child care (Department of Education and Department of Employment and Workplace Relations). And around 1 in 6 Australians, or 4.4 million people, live with a disability, with more than 449,900 participating in the National Disability Insurance Scheme (NDIS).
² https://www.abc.net.au/news/2022-08-30/mothers-need-childcare-support-to-fill-workforce-gaps/101384022
³ https://www.news.com.au/finance/work/careers/the-ten-most-indemand-professions-in-australia/news-story/1c7da6bc910f4e46e198716799e23747
⁴ https://www.ceda.com.au/NewsAndResources/MediaReleases/Health-Ageing/Australia%E2%80%99s-dire-shortage-of-aged-care-workers-req
⁵ https://www.abc.net.au/news/2021-04-09/disability-support-worker-shortage/100057026
⁶ https://www.smh.com.au/politics/federal/government-must-tackle-skills-shortage-to-deliver-childcare-promise-20220527-p5ap6w.html
⁷ Duty Of Care: Meeting The Aged Care Workforce Challenge, Ceda (2021)
⁸ NDIS Annual Financial Sustainability Report 2020-21
⁹ https://nationalindustryinsights.aisc.net.au/industries/community-services/childrens-education-and-care#data_sources_and_notes
¹⁰ https://www.gen-agedcaredata.gov.au/www_aihwgen/media/2020-21-GEN-Topic-Updates/People%20using%20aged%20care/People-using-aged-care-fact-sheet-2021.pdf
¹¹ https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/housing/type-of-housing#living
¹² https://agedcare.royalcommission.gov.au/system/files/2020-06/RCD.9999.0256.0017.pdf
¹³ https://www.nds.org.au/images/workforce/Australian-Disability-Workforce-Report-Feb-2018-v4.pdf
¹⁴ https://agedcare.royalcommission.gov.au/publications/final-report-executive-summary
¹⁵ https://www.abc.net.au/news/2022-08-10/childcare-early-education-crisis-point-workforce-shortages-wages/101319424
¹⁶ https://www.abc.net.au/news/2022-09-02/disability-support-worker-shortage-takes-toll-on-clients/101337474
¹⁷ https://www.health.gov.au/resources/publications/a-matter-of-care-australias-aged-care-workforce-strategy
¹⁸ https://www.dese.gov.au/workforce/resources/national-care-and-support-workforce-strategy
¹⁹ https://www.dss.gov.au/disability-and-carers-publications-articles/ndis-national-workforce-plan-2021-2025
²⁰ https://www.acecqa.gov.au/national-workforce-strategy
²¹ https://www.dss.gov.au/seniors/programmes-services/working-after-pension-age
²² https://www.servicesaustralia.gov.au/income-test-for-jobseeker-payment?context=51411
²³ https://www.servicesaustralia.gov.au/working-while-youre-getting-disability-support-pension?context=22276
²⁴ http://www.care-bank.co.uk/
²⁵ https://www.smh.com.au/money/planning-and-budgeting/more-australians-boost-their-income-through-the-sharing-economy-20180427-p4zc25.html
²⁶ https://www.abc.net.au/news/2022-08-08/commonwealth-promises-fund-pay-rise-or-aged-care-workers/101311572}