Finding and keeping the right people is a challenge for care services in many parts of the world. While the pressures differ between countries, a common issue is emerging: the need for health and care workers is growing, while many systems are struggling to train, recruit and retain enough people to meet that demand.
The World Health Organization (WHO) estimates that the world could face a shortfall of around 11 million health workers by 2030. Its latest reporting also highlights the effects of ageing populations and an ageing workforce, with many experienced professionals approaching retirement. These figures cover the wider health workforce, rather than social care alone, but they underline the scale of the challenge facing services internationally. The WHO’s health workforce overview explains why shortages remain a concern even as the global workforce grows.
For care providers in England, these pressures may feel familiar. Recruitment, retention and the need to maintain consistent support are already part of day-to-day workforce planning. Looking at the global picture helps explain why these challenges are unlikely to be resolved by recruitment alone.
Why is the demand for care growing?
One important factor is demographic change. In many countries, people are living longer, and more people are likely to need support with health conditions, daily activities or more complex care needs as they age.
At the same time, the workforce itself is ageing. When experienced nurses, doctors and other health professionals retire, services lose not only staff members but also years of practical knowledge and experience. Training replacements takes time, and the number of people entering a profession may not be enough to replace those leaving it.
England faces a similar long-term challenge in adult social care. Skills for Care’s workforce projections estimate that, if the workforce grows in line with the population aged 65 and over, the sector will need around 470,000 additional posts between 2024/25 and 2040. This is a projection rather than a prediction of exactly how many vacancies will arise, but it illustrates the scale of future workforce demand. Skills for Care’s workforce report provides further detail.
The challenge is therefore twofold: services need to attract enough new people while also retaining the skills and experience already within the workforce.
Recruitment is only one part of the problem
When staffing is under pressure, recruitment naturally becomes a priority. However, bringing more people into care will not solve workforce shortages if those workers struggle to stay.
Pay and working conditions influence whether people see care as a sustainable long-term career. So do opportunities to develop, the support available from managers and whether staff feel their contribution is recognised. These factors are particularly important in roles that involve physical demands, emotional responsibility and the need to respond calmly to changing circumstances.
Retention also affects the wider team. When experienced staff leave, colleagues may need to take on additional responsibilities while new starters develop their knowledge of the service and the people they support. This can create extra pressure at a time when the team is already working hard to maintain continuity.
For managers, it is worth considering recruitment and retention together. Understanding why people leave, which roles are hardest to fill and what helps staff remain in post can provide a more useful picture than vacancy figures alone.
International recruitment brings opportunities and responsibilities
Countries experiencing workforce shortages may look beyond their borders to recruit health and care professionals. International recruitment can help people find employment and allow services to benefit from skills and experience developed elsewhere.
However, it also raises important questions. When wealthier countries recruit from places with their own workforce shortages, the effects can extend beyond the employer and the individual worker. Countries that have invested in training health professionals may lose experienced staff who are needed to support their own populations.
The WHO has long highlighted the importance of ethical international recruitment. Its Global Code of Practice on the International Recruitment of Health Personnel encourages countries to consider the impact of recruitment on health systems, particularly in countries facing significant shortages.
For providers, international recruitment is one part of a wider workforce picture, not a substitute for developing and retaining staff locally. A sustainable approach needs to consider the people already working in care, those who may enter the sector in future and the support needed to help them build a career.
What does this mean for care providers in England?
Global workforce projections can feel distant from the immediate demands of running a service. A shift still needs to be covered, residents still need consistent support and managers still have to balance staffing requirements with budgets and operational pressures.
However, the international picture reinforces the importance of taking a longer-term view. If demand continues to grow, services will need to think carefully about how they attract people, help them develop and make care a role in which they can see a future.
Training is one part of this. Providing relevant learning and opportunities to build skills can help staff feel more confident in their roles and prepare them for greater responsibility. It also gives managers a clearer way to identify development needs and support progression within the team.
Workforce planning matters too. Looking at patterns in absence, turnover, overtime and hard-to-fill shifts can help identify where pressure is building. These measures will not resolve wider funding or recruitment challenges on their own, but they can help services make more informed decisions about where support is needed.
Finally, the experience of existing staff deserves attention. Retaining people who understand the service, know the individuals they support and have developed strong working relationships can help preserve valuable knowledge and continuity. That requires more than asking staff to take on extra shifts; it means considering workload, working patterns, development and the support available to them.
Building a workforce for the future
There is no single solution to a global shortage of health and care workers. Education and training, fair employment conditions, workforce planning, ethical recruitment and staff retention all have a role to play. The balance will differ between countries and services, depending on local needs and resources.
For care providers, the wider lesson is that workforce sustainability is about more than filling today’s vacancies. It also means creating conditions in which people can develop their skills, remain in the sector and continue delivering good support over time.
The global figures highlight the scale of the challenge, but the response will also be shaped by decisions made within individual services. Understanding what helps people join, stay and progress is an important part of preparing for the workforce needs ahead.
