Why there should be a Royal College of Care Workers

Why the United Kingdom needs one, and how it’s different to a Royal College of Carers.

Caring for other humans is of paramount importance to human society. It can be a huge undertaking in a multitude of ways, requiring a blend of compassion, humour, practicality, and professional skills. Despite this, care workers are often under-valued both financially and by society. So why aren’t we treating the people who do this job as well as they deserve?

[IMAGE DESCRIPTION: Taken from the Department for Health and Social Care’s “Work in Social Care” advertising campaign, this still shows a lady caring at home for an individual who uses a wheelchair. The subtitle reads: “You have to have quite a strong heart and a strong head for this job.”]

Do you know someone who receives care? The chances are you probably do or have done in the past. You may well also know someone who provides care, and there are two distinct fields: professional care workers (for example, those who are employed by a care agency) and informal carers, who may care for a relative or neighbour and receive no or little training, remuneration, or support.

1.62 million people in the UK currently work professionally in adult social care, the majority of whom are care workers. On top of this, there are an estimated 6.5 million carers in the UK providing informal, largely family member-related care worth an estimated £57 billion to £100 billion per year. That’s one in 8 adults working as an informal carer, sometimes on top of or alongside other jobs and commitments.

I’d like to focus on something I think would really positively impact society and professional care workers, for reasons I’ll explain: the creation of a Royal College of Care Workers.

Christie Watson, nurse and author, wrote about the importance of seeing the whole person, rather than just “treating the numbers” — appreciating that getting Mrs Watson’s sodium levels and heart rate down to “baseline” is just part of the picture, and sometimes not even the most important part to Mrs Watson herself. Care workers are there, day in, day out (sometimes multiple visits a day) providing the type of relationship-centred, qualitative care that numbers are at times a bit redundant for. It may be a little reductive to put it this way, but if good health care provides good health, good social care can provide quality of life. We need to be publicly, vocally supporting and developing those who provide it.

Historically, a Royal College was simply a teaching establishment which received royal patronage and was explicitly granted the right to use the prefix Royal by the Queen. Such colleges spanned education, music, sciences, and the arts. Royal Colleges have also come to encompass professional bodies dedicated to improving and maintaining practices and standards of healthcare.

The Royal Medical Colleges — as they are collectively known — span a few different roles but are essentially membership organisations. For example, the Royal College of Physicians represents over 37,000 doctors in the UK and internationally, and the Royal College of Nursing a whopping 432,000 nurses. A Royal College may also function as a Trade Union, and allow student and retiree members. In my opinion, the heart of the organisations is this membership and the community that comes as a corollary. In addition, Royal Colleges build out many functional limbs; some kind of national yearly conference or event, bringing prominence to groundbreaking research and providing networking and support opportunities; the ability to provide training and signpost re-certification at regulated intervals and to specific national standards; opportunities for personal & professional development and career-investment.

As a case study, the College of Occupational Therapists was granted the Royal prefix in 2017. Occupational therapists provide life-changing support to people managing illness, injuries and a wide range of physical and mental health conditions across both health and social care settings. OTs in the community work alongside families, carers and care workers — as well as many other professionals — to provide the most holistic, person-centred care possible. When I worked as an occupational therapist, I was incredibly proud to be a member of a Royal College. Not only did I feel my not-terribly-well-known profession was being represented strongly at a national and international level, there were also myriad smaller but still-important benefits. I was encouraged to keep and given ideas for my folder demonstrating Continued Professional Development so that it would be more straightforward when the time came to re-register every two years (the industry standard for most healthcare professions). I was able to get particularly specialist support from the RCOT library when writing my research MSc on post-stroke language loss and practical care. There was a central London RCOT office where I could pop in and meet up with other OTs while we trained. There were regular events, a newsletter, job postings, access to academic journals, research and development advice, practice guidelines, policy and legislation. It had a singular focus: it provided me with everything I needed to be the best possible OT. We should be providing care workers with the same.

  1. A Royal College would help with public recognition and promotion of the profession

Incredibly, despite constant re-jigging and trimming of the pieces that make up national social care funding, the National Association of Care & Support Workers (NACAS) already does a staggering amount of the work mentioned above. When Chief Executive Karolina Gerlich and I discussed the idea of a Royal College, she pointed out that though policy can be slow to make, public perceptions can be even slower to change. Karolina has worked in social care for over a decade and says helping people is, quite simply, “the best job in the world”, but public awareness of the ins and outs of care work is limited, and impacted by individual stories in the media. Karolina — and I — want to see education about care workers being incorporated into early years education: wouldn’t it be incredible to have the profession better recognised and a younger person say with joy, conviction and pride: “I’m going to be a care worker!” One of the reasons I felt compelled to write this opinion piece is: how we talk about care matters. It “shapes our worldview”, and I would like a world where care is more widely appreciated and represented publicly.

2. A Royal College could unify and set standards for professionalising the care workforce, enabling them to use technology effectively

We are on the cusp of large scale technological improvements in health & social care. DotEveryone (the responsible technology think tank) put it best in their “Better Care in the Age of Automation” report, where they also voice support for a Royal College of Care Workers:

“These recommendations don’t require more money to be thrown at an already bankrupt system. Instead they show how to strengthen the care system so that future investments in technologies make meaningful change. The investment required now is the courage and imagination to see beyond immediate crises and build a social care system fit for the age of automation. […] Technology can never replace human care professionals and the complex, relationship based and creative nature of their work. But used well, technologies can assist in mundane tasks, augment the job of caring and improve people’s lives. More technology on the front line will mean more tech support and more complex decision making on the front line and carers will need the skills to do this. A better care system will depend on having people with the skills to work with technology.”

Caring is a particular role with a particular skillset, and this is liable to change with the digital era — it’s not possible to say how, exactly, or give a clear date, as technological advances don’t happen overnight. Regardless of the pace or direction, we need care workers to be supported to achieve this; thriving in their role, not just surviving the changes.

3. It would solidify care work as a profession which constitutes an essential part of the multi-disciplinary health & social care team

Having worked as an OT alongside many care workers, I can truly attest that they are a fundamental part of the multi-disciplinary team (MDT); care is one of the indispensable digits of the hands that provide support along with other health specialisms (OT, SLT, physio, medics, nurses, pharmacists, dieticians, and more), not an estranged cousin who only gets involved when the others have left.

[IMAGE DESCRIPTION: Taken from the Department for Health and Social Care’s “Work in Social Care” advertising campaign, this still shows an older and a younger man looking at photographs together. The subtitle reads: “When you care, every day makes a difference.”]

Medical Royal Colleges have covered many facets of healthcare provision from antiquity to the present day, moving with the times; the Royal College of Physicians is 501 years old, and the Royal College of Surgeons between 200 and 650 depending on when you start counting.

But on the other hand, the Royal College of GPs is only just over 50 years old, and the Royal College of Occupational Therapists 2.5. That is not to say that these practices are new; nor are they ephemeral. Do you know someone who has had a stroke? A brain tumour, perhaps? Lives with Parkinson’s? In which case, have you had the joy of seeing a Speech & Language Therapist in action? Communication is arguably the most fundamental human behaviour and I am thrilled there is (as of 1945) a Royal College of Speech & Language Therapists to support and promote this specialism; the injury, illness or experience is not new, but how we care for it and professionalise that care and treatment can continue to be improved and solidified.

We get better at caring for the unwell, the injured, the dying, and the elderly every day with new technological and scientific insights: there’s never been a better time to be alive, if you want to live in better health for longer. However, we are human, and interaction and interdependence are essential to our existence. Care work — the often-unsung hero — is as important as it has ever been, and yet the funding and infrastructure we give it are crumbling. This is not sustainable. I believe creating a Royal College of Care Workers would provide a platform for care workers to engage with other health professional peers, receiving the same respect and benefits, and an opportunity to engage with the community within which care is inextricably entrenched. Care work deserves to be promoted in the health industries, and recognised for the invaluable and essential work that is being done, every day, in billions of homes, all over the world.

There has long been a discussion (and a lamentation) regarding the unrecognised impact of good care. Creating a Royal College of Care Workers is a concrete step to improving and rejuvenating the status quo. Our entire society would benefit from it, not least because we have a rapidly ageing population which will soon require more care than ever before.

Technical writer. Former NHS OT and software developer in health tech. I enjoy open dialogue & I’m interested in helping make health & social care better!

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