Care workers: skills opportunities and challenges (2019 update)

Summary

Personal care workers typically provide care, supervision and assistance for children, patients and the elderly, convalescent or disabled people in an institutional or residential setting.

Key facts:

• Around 7.8 million people were employed as personal care workers in 2018. Employment in the occupation grew by 15.8 per cent between 2006 and 2018.
• Employment is projected to grow by 4.6 per cent over the period 2018 to 2030. This underestimates the exact level of employment demand.  In order to replace those workers who will leave the occupation for one reason or another – an estimated 4.2 million between 2018 and 2030 – and meet the projected growth in demand over the same period, around 4.6 million job openings will need to be filled.
• In the workplace, teamwork, creativity and resolution and gather and evaluate information are the most important tasks and skills of care workers.
• 85 per cent of care workers are employed either in health & social care or education sector.
• Two-thirds of personal care workers hold medium-level qualifications. Between 2018 and 2030, a robust shift in demand is expected from workers with low-level qualifications to highly qualified ones.

Tasks and skills

Personal care workers [1] typically provide care, supervision and assistance for children, patients and the elderly, convalescent or disabled people in an institutional or residential setting. The tasks performed by personal care workers in the health services are usually simple or routine and include assisting patients with mobility, washing and other personal needs. Therefore these workers do not take over tasks that demand extensive medical knowledge or training. Depending on their main work environment, these workers are further classified to health care assistants, who work in hospitals, nursing homes etc. and are supervised by health professionals or associate professionals; and home-based personal care workers.

Childcare workers and teachers’ aides deal with, supervise and actively participate in enhancing the children’s physical, emotional and intellectual development both in schools and preschools.

According to Eurofound's Job Monitor, teamwork, creativity and resolution and gather and evaluate information are the most important tasks and skills of care workers.

Figure 1: Importance of tasks and skills of care workers

Note: The importance of tasks and skills is measured on 0-1 scale, where 0 means least important and 1 means most important.

What are the trends for the future? [2]

The vast majority of personal care workers are employed, as expected, in health, education and other service activities. These sectors have bright employment outlook, which drives the future demand for care workers. The employment level of personal care workers across sectors is expected to increase by 4.6 per cent between 2018 and 2030, a further increase following the 15.8 per cent growth over the period 2006 to 2018. Employment growth of care workers has mixed forecast in Europe – it is positive in 19 countries, mostly in southern and eastern Europe will increase the care workers’ employment, while decline is expected in the remaining nine.

Figure 2: Future employment growth of care workers in European countries (2018-2030, in %)

The 4.6 per cent growth in employment understates the growth in demand for people to work as personal care workers. Over the period 2018-2030 an estimated 4.2 million people are projected to leave the occupation for one reason or another such as retirement [3] . Given the projected increase in employment over the same period, this will result in about 4.6 million job openings that will need to be filled between 2018 and 2030.

Figure 3: Future job openings of care workers (2018-2030)

With regards to education level, two-thirds of personal care workers hold medium-level qualifications. Between 2018 and 2030, a robust shift in demand is expected from workers with low-level qualifications (whose share will fall from 20 per cent to about 13 per cent) to highly qualified ones (reaching 28 per cent of the 2030 occupation workforce).

More information about this occupation can be found here.

Which drivers of change will affect their skills?

Mainly influenced by developments in health, education, and other service activities, personal care workers’ skills are expected to respond to a set of main drivers of change.

• Over the next decade, demand for personal care workers is expected to grow due to the demographic shift towards a more ageing population in Europe (for example, the share of citizens over 60 years old will be around 37% by 2050.  [5] In comparison, the overall European population will increase by only 1.5% during the same period) and the subsequent care needs of such a population. Simultaneously, socio-economic developments (such as rises in retirement age in several EU countries and the growing participation of women in the labour market) further weaken the availability of family members to provide unpaid care to relatives in need and children.
• To accommodate the new demographic structure, long-term care services are expected to increase in number and extend in duration, as chronic morbidity escalates with age. Multimorbidity (the occurrence of two or more chronic medical conditions in one person) also spikes in the 65+ age group  [6]. As a significant share of personal care workers supports and tenders for the elderly, they will be called to respond to opportunities for new services that an older society will create  [7].The importance of soft skills (such as communication skills, active listening, clear speaking, tact, and negotiation skills) will become more acute, given that medical and psychological conditions of people change as life expectancy increases.  [8] Personal care workers will also need observation skills to check physical and mental health on a daily basis, and the “ability to follow set rules and protocol”  [9] in order to avoid potential risks for the patients.
• Technological change and IT developments in particular will significantly impact care services. More and more IT devices and applications which concern health management, monitoring and sharing medical records, questions to professionals etc. become available to the wider public  [10]. This trend empowers patients and reformulates health care provision. The accelerating use of e-tools in medical health diagnosis and health care provision will increase the need for personal care givers to stay abreast of technological change; be aware of new software and applications available on the market to respond to patients’ needs; and be able to use them or to help the customer become acquainted with them.
• Risk of automation: As a part of its Ditigitalization and future of work project, Cedefop estimates the risks of automation for occupations. The most exposed occupations are those with significant share of tasks that can be automated – operation of specialised technical equipment, routine or non-autonomous tasks – and those with a small reliance on communication, collaboration, critical thinking and customer-serving skills. The risk of automation is further accentuated in occupations where employees report little access to professional training that could help them to cope with labour market changes. Care workers are reportedly an occupation with very low risk of automation.  

How can these skill needs be met?

The impact of these drivers will vary among the different sub-occupations of personal care workers.

Those working as teachers’ aids and overall in child care, will need to remain abreast of the technological innovations in learning while being adept in supporting children develop social skills. Their challenges and opportunities to develop their skills could be developed concomitantly with those of teaching professionals. Nonetheless, this sub-occupation bears less regulation limitations and requirements compared with teachers. Few EU Member States predict qualification or training requirements for all professionals that work in child care. Hungary offers an interesting example as all employees working directly with children/families and providing personal care, either social, child welfare or child protection workers, need to fulfil a compulsory six-year vocational training   [11].

Personal care workers employed in health care will probably enjoy more employment demand, which should be paired however with training provision. For example, the qualification level and training of staff in long-term care can be a quality proxy for the overall service provided, especially where a specialised monitoring system is not in place  [12].

More elderly patients, linked with chronic and multi-morbidity and a greater influence of IT formulate a framework of skills and competences that these workers increasingly need to perform well. These skills may be purely technical (e.g. IT), but also ‘soft’, such as communication, coordination, and collaboration between patients and all health professionals[13] to fit in the new forms of health care provision.

Monitoring the quality of facilities offering care to children and the elderly would be prudent, to eliminate, among others, skills gaps, shortages, and mismatches. This holds for all occupations and sectors, however, quality of care towards the (augmenting) elderly cohort and that of children could be identified as a policy priority. Identifying and responding to any skill gaps of the workforce delivering health care can, not only support these workers employability but also facilitate the transition to more home care of patients  [14].

“At EU level, there are several actions under development to assist Member States to better anticipate skills' needs and competences in the healthcare sector: an EU skills council in the area of nursing and care, which will review the competence profiles of the nursing and care sector, and a pilot health care assistants expert network and database  [15] which will examine the scope of skills and competences required from healthcare assistants for uptake by national education and training programmes. In addition, the EU joint action on health workforce planning will develop European guidelines on forecasting methodologies and analyse future skills need in the healthcare sector.”

Source: European Commission, Commission Staff Working Document on an Action Plan for the EU Health Workforce, 2012