State of the sector : 2021 aged care workforce insights - HESTA Super Fund
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state of the sector : 2021
aged care workforce insights
beyond
covid
and
a message
contents from our ceo
It’s a story that shows substantial improvement Our research, which expands on HESTA’s 2018
message from our ceo 02 As the national in workforce sentiment towards the aged care Transforming Aged Care report, showed COVID
overview 04 superannuation fund industry and employers, and which potentially
points to an opportunity for the sector as it looks
manifested in the sector through disrupted hours
and increased financial pressures. Approximately
methodology
dedicated to health to build the aged care workforce of the future. a quarter of our aged care members made
claims to access their super early under the
key findings and community services, Creating the future workforce was a key focus
of the Royal Commission into Aged Care Quality
Federal Government’s COVID scheme. Despite
who we spoke to
royal commission and the future aged care workforce HESTA has unique data and Safety. With forecasts of increased demand
these challenges, aged care professionals told
us they felt prouder to work in the sector than
the COVID impact
and insights from our more for services as Australia’s population ages, the
sector faces significant challenges building its
before COVID. Compared to 2019, they felt
more appreciated by their community and their
employee outlook and experiences 10 than 880,000 members workforce to the size and capability necessary
to deliver the aged care services Australians
employer, and they were more likely to advocate
for a career in aged care.
disruption to work hours working in the sector. will need.
industry outlook While it was clear through our discussions with
appreciation by employers, community and clients The pandemic impact only highlighted the industry representatives that there are systemic
These insights can help inform how we as a current workforce shortages. COVID outbreaks
industry pride and job satisfaction country meet the challenges of an ageing issues that cannot be ignored, the contrast
and the need for infection control practices, between the 2019 and 2020 results in a
population and the increased demand including visitor restrictions, across the sector
a typical HESTA member in aged care 22 for services. relatively short time and in such a challenging
put enormous pressure and stress on clients, and uncertain environment is significant.
The bushfires and now the COVID pandemic have their families and the professionals who cared These findings could provide valuable further
job intentions 24 highlighted glaring and often longstanding gaps for them. I want to acknowledge the hard work, context as the sector looks to develop
in our caring economy. Closing these gaps must compassion and leadership shown by so many workforce attraction and retention strategies
reasons for wanting to stay with or leave employer focus on the workforce and the people, often our aged care professionals during this difficult and implement the Royal Commission's
employee likes and dislikes about role members, who are so central to delivering time as they cared for and protected Australia’s recommendations.
these services and improving outcomes. seniors. Thank you.
advocating for aged care 28 We understand data is a key challenge for
We strongly believe this starts with listening to our HESTA manages nearly $60 billion in retirement the sector as it undertakes this important work.
career in the sector members to find out how they are experiencing savings for its 880,000 members. We are proud to That’s why HESTA is committed to continuing to
employers and their services work and how that shapes their attitudes to their have forged a strong connection with the health develop its workforce insights research program
leaders and managers industries, their employers and their leaders. and community services sector over 30 years. to inform solutions for the sector and shed light
More than 200,000 of our members work or have on how the global pandemic, economic recovery
As the aged care sector grappled with a Royal worked in aged care and we are extremely proud
conclusion 34 and ongoing sector reforms continue to shape
Commission into Aged Care Quality and Safety of the critical and essential work they do that is the aged care landscape.
and then a global pandemic, HESTA took two vital for our post-COVID economic recovery.
snapshots of our members working in health I wish to thank everyone who participated in
and community services (HACS). Our research We remain committed to partnering with the the surveys and in discussions with HESTA. Your
explored their workplace and industry attitudes, sector to help inform and facilitate collaborative experiences, knowledge and insights have been
experiences and outlook prior to the pandemic in solutions to address some of the biggest sector incredibly valuable and will help inform and
May 2019, and again in July 2020 during COVID. challenges, such as workforce planning. This will further the conversation about how we can
impact the working lives of a significant number create a stronger aged care system for us all.
Our data tells a fascinating story for the aged of our members and will also affect their quality
Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 care sector. of life in retirement. Debby Blakey
AFSL 235249, the Trustee of Health Employees CEO
Superannuation Trust Australia (HESTA) ABN 64 971 749 321.
© Copyright H.E.S.T. Australia Limited 2021
2 3
overview key findings
HESTA took two snapshots of its members working in health and community
services, one prior to the global pandemic and again during COVID.
The research broadened the scope of HESTA’s 2018 Transforming Aged Care report and examined
the workplace experiences, job intentions and industry outlook of professionals working across health
and community services more broadly. The research also considered the effect of COVID on the sector
at that time.
State of the Sector Aged Care Workforce Insights: COVID and Beyond is the first of three reports
and focuses on findings for the aged care sector, supported by additional HESTA data and insights.
The remaining reports explore findings for the early childhood education and care sector, and the
community and disability services sectors.
HESTA intends to use this research to provide insights that can help the sector with workforce planning
strategies and solutions to meet the growing demand for services, which can ultimately improve the
working experiences and retirement outcomes for HESTA members working in aged care and in health
and community services more broadly.
Despite the significant challenges of a Royal There are still significant workforce challenges
methodology
Commission and a global pandemic, the aged for the aged care sector. The research
care workforce returned a much stronger, more highlighted a polarised workforce. There was a
positive sentiment towards their employers significant number of unhappy and dissatisfied
and the industry during COVID in 2020 aged care respondents who felt unappreciated
HESTA undertook two online surveys of HESTA These thoughts and insights have been used compared to 2019: and who were motivated to advocate against
members, one pre-COVID (May 2019) and again anonymously throughout the report to provide their employers and their sector, potentially
during COVID (July 2020). The surveys were context to the survey results. • A
ged care employees felt more appreciated by creating difficulties for attracting the next
obtained from a random representative sample their employer and valued by their community. generation of aged care professionals:
of HESTA members working across health and The report also includes other supporting data
and insights, including data on the uptake by • A
ged care professionals felt prouder to • A
round one in three aged care respondents
community services with open super accounts
HESTA members of the Federal Government’s work in the industry, and were the second did not feel valued and appreciated by their
in the accumulation phase.
early release of super scheme due to COVID. proudest workforce behind community services community and employer.
Questions covered members’ workplace HESTA has also developed a model to measure professionals within health and community
experiences and job intentions, their the preparedness of its members for retirement. services. • B
etween 32% to 38% of aged care employees
employment satisfaction drivers, their attitudes This model has allowed HESTA to better were unlikely to recommend their employers,
• A
ged care professionals were more likely to leaders, or a career in the sector. This was a key
towards their employer and industry, as well understand the level of financial retirement
recommend a career in their industry, their concern for industry representatives.
as how COVID affected their work, financial readiness of its members who work in aged care
employer’s services and working for their
situation and industry outlook. and compare them to members working in other
employer and leader in 2020, with significant • P
rofessionals aged under 30 and nurses were
health and community services sectors. This
In 2020, 4622 HESTA members working in improvements in employee Net Promoter Score the most likely to intend to leave the aged care
data produced by this model has also been
or intending to return to work in the sector from considerably negative scores in 2019. sector in the next year or two.
included in this report. Please note data totals
completed the survey. HESTA received responses may not add up to 100% due to rounding. • S
hort-term intention to leave the aged care
from more than 1500 members in aged care –
sector decreased 10%, with a corresponding
the largest number of respondents for surveyed
Breakdown of 2020 survey increase in professionals who said they
health and community services sectors. In 2019,
537 aged care members participated.
respondents per sector intended to stay with their current employer.
In addition to the surveys, HESTA discussed the Industry Count %
findings with representatives from six industry Aged Care 1568 34%
Nevertheless, the improvement in workforce sentiment in a challenging environment
organisations, including peak bodies, employers potentially indicates an opportunity for the sector and government to implement
and unions, to seek their perspective on what Community Services 975 21%
workforce strategies and solutions to improve the standard of care for aged
was occurring in the aged care sector at the Public Hospital 593 13%
Australians now and into the future:
time and the impact of key industry issues. Private Hospital 510 11%
These interviews covered topics ranging from • S
kills development, wanting to try something different and pay were the top reasons for aged care
the impact of the Royal Commission into Aged Primary Healthcare 414 9%
professionals wanting to leave their employers.
Care Quality and Safety’s final report and Early Childhood Education 364 8%
recommended reforms to the high casualisation and Care • T
here was unanimous agreement among aged care employers, peak bodies and unions that
of the workforce and wages and conditions. improving pay, conditions and creating more skills development opportunities to ensure high-quality,
Note: excludes non-HACS professionals
sustainable jobs were key.
4 5
who we spoke to royal commission + the
in aged care future aged care workforce
The past few years have been an extremely The Royal Commission flagged the challenges
1568 aged care professionals completed the workforce survey in 2020. challenging time for the aged care sector. The
Royal Commission into Aged Care Quality and
involved in building the aged care workforce
of the future. The number of older people in
Safety, established on 8 October 2018, brought to Australia is forecast to grow significantly over
workplace role light systemic failures within the sector, including the next few decades. The number of Australians
evidence of abuse and neglect of clients in aged 85 years and over is expected to increase
residential aged care facilities and other instances from 2% of the Australian population to 3.7% by
79.2% 11.6%
LIFESTYLE
CARE
WORKER
COORDINATORS of substandard and inadequate care. These 2058, 2 with the Federal Government budgeting
/ ASSISTANTS
failures generated considerable media coverage $25.4 billion for 2022-23 aged care expenditure,
ANCILLARY and resulted in 148 recommendations for reform up from $19.9 billion in 2018-19. 3 This will have
RESIDENTIAL COMMUNITY
WORKERS in the Royal Commission’s final report. a significant impact on the number of aged
MANAGER
/ CEO
care professionals required to deliver the
4.8% 4.3%
“In terms of anecdotal evidence, we definitely different types of aged care Australians will
NURSE
OTHER
overall hear from our members that the need. According to Deloitte Access Economics
8.7% 5.2% system is getting worse. If you talk to an aged modelling, the 2020 workforce of 186,130 direct
BOTH OTHER 52.5% 17.4% 3.5% 12.6% care worker who’s been in there for 10 or 20 care aged care staff would need to grow by 70%,
years, they will all say, 'It’s declining, and which is more than 130,000 additional full-time
I’m just watching year on year that decline equivalent professionals, by 2050 to maintain
tenure work status current staffing levels.4 The Royal Commission
continue to happen and get worse'.”
indicated this number will be even higher if the
12.9% HESTA’s research indicated this environment has recommended reforms are implemented.
51.5
affected employee attitudes and experiences of
%
UNDER 12 MONTHS LOST JOB To grow the workforce to the required levels,
DURING COVID, the sector and their own workplaces. This was
the report highlighted the need for “policies and
14.1%
WILL RE-ENTER
most apparent in 2019, where sentiment was
WORKFORCE practices to drive a ‘virtuous circle’, where good
significantly negative when it came to members’
1.1% 4.6% working conditions, supportive and visionary
1 - 2 YEARS 26.7% 55.5% 12.0% attitudes to their industry and employer. Despite
management, an empowering work culture,
the challenges of COVID, the aged care sector
21.7% 5+ YEARS FULL TIME PART TIME CASUAL UNEMPLOYED, collaborative teams, relevant education and
WILL RE-ENTER experienced significant improvement in a number
training, structured career progression, and job
WORKFORCE of these measures in 2020. But while there has
2 - 5 YEARS satisfaction among care professionals underpin
been improvement, the ongoing overall negative
high-quality, person-centred care”.5
sentiment across key measures remains a
household income personal income challenge to the sector as it looks to build the
“We already know they (aged care
workforce necessary to meet expected future
professionals) leave because they
demand for services.
upskill out of the sector.”
$0 - 40k 31.0% $0 - 40k 37.8% In HESTA’s discussions with peak bodies,
employers and unions, there was unanimous In discussions with representatives across the
$40 - 60k 21.3% $40 - 60k 31.2%
agreement that improving pay and conditions to sector, there was wary optimism about the
$60 - 80k 8.5% $60 - 80k 9.1% potential for the Royal Commission to be a
ensure high-quality, sustainable jobs in the sector
$80 - 100k 6.8% $80 - 100k 4.0% catalyst for long-lasting change. Many pointed
was going to be key to attracting the necessary
$100k+ 8.5% $100k+ 3.3% to the numerous inquiries and reports into aged
people to work in aged care.
PREFER NOT TO SAY 23.9% 3.9%
PREFER NOT TO SAY 14.5% care in recent years. They said the problems are
In their final report, Care, Dignity and Respect, well known but commitment from government
0 5 10 15 20 25 30 35 0 5 10 15 20 25 30 35 40 released in early March 2021, the Royal for concrete action is needed now and, more
Commissioners stated that a “highly skilled, importantly, sustainable long-term funding
age state well rewarded and valued” aged care workforce to meet priority reform areas. Many industry
will be vital to the success of any future aged representatives with whom HESTA spoke said
9.8% care system.1 The report acknowledged there it would be challenging to fund the cost of the
NSW QLD were not enough professionals in many of the Royal Commission’s recommendations. They
24.6% 18-29 16.8% 33.1 % 13.9% large residential aged care facilities to provide noted the 2021-22 Federal Budget would be a
60+ the high-quality, person-centred care older clear indicator to the sector of the government’s
30-39 VIC SA Australians need, and said there was clear fiscal commitment to implementing necessary
30.6 % 8.9% evidence linking quality of care and quality of jobs. long-term reform.
50-59 40-49 WA OTHER
7.9% 5.5
1. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 124.. 2. Dr David Cullen and
% the Office of the Royal Commission, Background Paper 2 - Medium and long-term pressures on the system: the changing demographics and dynamics of
28.9% 19.9% aged care (2019), 3. Australian Government, Aged Care Financing Authority, Eighth report on the Funding and Financing of the Aged Care Industry (2020),
xi 4. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 125. 5. Ibid 124.
6 7
the COVID impact
The pandemic put incredible pressure on an been experiencing due to the economic impact More than 37,000 members working in residential As can be seen from the below table, aged
already stretched aged care system. By 26 March of the virus. Those who experienced disrupted aged care claimed super under the scheme, care members working in community care
2021, there had been more than 4000 cases of work patterns included professionals in aged almost 27% of HESTA members in this cohort. saw the biggest decreases in median account
COVID among aged care staff and residents in care facilities with caring responsibilities who More than 16,800 members working in aged balance (-45%), closely followed by residential
Australian residential aged care facilities.6 More needed to quarantine due to contracting the virus care made a second claim for super, which care (-40%).
than 680 aged care residents died during these or becoming a close contact. Casual employees, was typically for the maximum $10,000 they
outbreaks, the majority in Victoria. who may have worked across multiple employers, could claim under the scheme.
were also under considerable financial pressure
Throughout Victoria’s second COVID lockdown, due to a lack of leave entitlements if they needed
which started in July 2020, distressing accounts to quarantine.
emerged of aged care residents – isolated from Aged care sub-sector Median balance where account remains open after early release
their families and loved ones – deteriorating It is important to note the majority of survey
Before claim As of 15/1/21 Change
from neglect and inadequate care. This was responses were received prior to certain COVID
due in large part to severely depleted staffing measures taking effect in Victoria. These included Community care $23,364 $12,769 – 45%
levels as providers experienced disruption to the increased visitor restrictions for hospitals Residential Care $24,991 $14,975 – 40%
their operations and worked to manage infection and aged care facilities to allow carers only,
Retirement Village $27,137 $17,289 – 36%
control, often with limited support or guidance. and measures restricting Victorian aged care
employees to work at a single site.7 Victoria had
This was also an incredibly stressful time for aged also not yet reached its peak of daily confirmed
care employees. Beyond the pressures of COVID COVID cases.8 Accordingly, the full COVID Given aged care is the oldest cohort of HESTA A factor that may have contributed to the need
on their actual work, many also experienced impact as experienced by Victoria is unlikely members (see A typical HESTA member in to access super early is that, while 20% of aged
significant disruption to their work hours. This to be reflected in these results. aged care, page 20) they typically have less time care professionals were working more due to
disruption is likely to have increased the financial
to rebuild their retirement savings. In January COVID (see Disruption to work hours, page 12),
pressure many households may have already
2021, the median account balance for members nearly one in three aged care respondents said
working in community or residential aged care they had experienced a decrease in household
who accessed their super early under the scheme income.
COVID early release of super scheme was less than $15,000.
Reflecting the financial pressures experienced by The scheme allowed Australians whose jobs
the workforce, HESTA members working in aged and income were affected by the pandemic to
care were more likely to access their super early withdraw up to $10,000 from their super in the
under the Federal Government’s COVID-related 2019-20 financial year, and a further $10,000 in
early release of super scheme when compared the 2020-21 financial year up to December. Did the coronavirus
to members in other health and community
services sectors. Approximately a quarter of The proportion of HESTA aged care members pandemic have Significantly decreased
Somewhat decreased
HESTA’s members who work in aged care – more
than 45,000 professionals – applied to withdraw
who made early release claims was the largest
when compared to other health and community any impact on your The same
Somewhat increased
money from their super under the scheme, services sectors: 19.6% of HESTA members working
in the early childhood education and care sector,
household income? Significantly increased
resulting in substantial decreases in the already
low superannuation savings of many of these 16.4% in primary healthcare and 19.7% in
members. community services.
4% 8% 60% 16% 13%
Proportion of HESTA members by sector who made a claim
to access their super early under the COVID scheme
Sector % of members in that sector who made a claim Somewhat
increased Significantly
Aged care 25.6% Somewhat decreased
The same decreased
Community services 19.7% Significantly
increased
Early childhood education and care 19.6%
Primary health 16.4%
Public hospital 10.6%
6. Australian Government, Department of Health, COVID-19 outbreaks in Australian residential aged care facilities 2021) at 26 March 2021. 7. ‘Workplace coronavirus transmission driving
Victorian case numbers, including in aged care’, Australian Broadcasting Corporation, 19 July 2021 . 8. Australian Government, Department of Health, COVID-19 outbreaks in Australian
residential aged care facilities 2021
Other 17.0% at 26 March 2021.
Note: based on number of HESTA members as at 17 April 2020.
8 9
employee outlook
and experiences
HESTA’s research indicated While this sentiment is lower for aged care
than most other health and community
COVID and the Royal Commission services sectors, this is still significant. After
have significantly affected the an intense focus by media, government and
aged care workforce’s outlook and the community on the essential nature of their
work, aged care employees appear to be
workplace experiences. Like other
feeling more appreciated by their employer
health and community services and valued by the community. They are feeling
professionals, aged care employees prouder to work in the industry and have
experienced significant disruption to returned higher ratings for job satisfaction in
2020 compared to 2019.
their work hours and ability to provide
care and services. They were also While these findings do not negate the
sector’s systemic workforce issues, the
feeling less confident about the future improvement in results – which notably arose
of their industry when compared to in a highly negative external environment
most other health and community – could flag an opportunity for employers
when developing their workforce attraction
services sectors.
and retention strategies. Industry
representatives with whom HESTA discussed
Despite these experiences, a key finding the findings talked about how the 2020
that emerged through the research was an uplift environment had changed dynamically.
in positive sentiment of aged care professionals
towards their role, employer and industry. The
data showed most aged care respondents (84%)
felt somewhat or strongly supported by their
employer during the pandemic, with no significant
differences between states and territories.
How did you think
your employer supported
you during the Strongly supported
Somewhat supported
“What happens at a time of crisis
coronavirus pandemic? Did not support me is people tend to band together.
It's no different in aged care.
So, I think people probably did feel
under siege. It does knit you closer.”
42% 43% 42% 44%
48%
51%
46%
42% 38%
39% 49%
38%
16% 18%
11% 13% 11% 9%
Aged care Community Early childhood Private Public Primary
services education and care hospital hospital healthcare
10 11
disruption
to work hours
The research found one in three aged care While aged care professionals were the most Industry representatives said aged care’s Discussions with industry representatives
respondents had their working hours disrupted likely, compared to those in other health and ‘highly casualised’ workforce was a key issue indicated community care clients during COVID
due to COVID. Of the aged care respondents community services sectors, to feel their weekly for the sector, which has given rise to precarious had been concerned about safety and had cut
who experienced changes to their work hours, hours were not ideal – 14% said their hours were employment arrangements, financial pressures if back services.
60% found they were working more. More full- too few and 5% said too many – the majority (81%) employees had to take time off work due to lack
time aged care employees (29%) experienced an said their working hours in 2020 were ‘about of leave entitlements, lean staffing ratios and There was a view that there had been a pick-up
increase in work hours, compared to part-time right’. This figure increased from 2019 (77%). employees feeling overworked. in demand since the research was conducted,
(18%) and casual (14%) employees. with this likely to continue to build as the vaccine
More than half of aged care professionals roll out progressed.
who were managers, general managers or
CEOs experienced an increase in work hours, A large proportion of aged care professionals
which was not unexpected in light of the severe aged 39 and under (21%) also experienced a
disruption to the operation of aged care facilities drop in work hours due to COVID. This was also
Did the coronavirus Aged care and the need to manage staffing levels and the case for single parents (21%).
pandemic have any Community Services
Early childhood education and care
infection control during the pandemic. On 19 July 2020, the Federal Government urged
Victorian aged care professionals to stop
impact on your paid Private hospital
For other roles, safety restrictions potentially
meant care workers were the most likely to have working across multiple age care facilities
Public hospital to prevent the further spread of COVID.11
working hours? Primary healthcare
experienced a cut to their work hours (19%),
compared to 11% of nurses and 9% of lifestyle It is important to note the majority of survey
coordinators or assistants. responses were obtained prior to or just after
this announcement. This may explain why the
Aged care professionals in community care impact on paid working hours due to COVID
70% were more likely to have lost work hours, with was broadly consistent between different states
On the other
65% 30% reporting they worked less compared to just and territories, as the full impact of this policy
hand, Aged care
60% and community 11% of residential care professionals. For those had not yet taken effect.
Early education services were the working across both types of care, 26% said they
55%
and primary most likely to be worked less.
50% healthcare were working more
45% most likely to be hours…
working less
40% hours…
35%
30% Did the coronavirus pandemic have any
25% impact on your paid working hours?
20%
15%
10% Working less
20% 16% 20% 14%
Same 22% 20% 21%
5%
Working more
0%
Working Working less Working the same Working more Working
significantly less significantly more
66% 65% 65% 65% 71% 63% 70%
Just 7% of full-time aged care employees lost hours. This may also have contributed to the higher
Casual aged care employees experienced the rates of claims for the early release of super
greatest impact, with 40% of these respondents scheme among HESTA’s aged care member base.
reporting they worked less due to COVID. While
14% 13% 14% 14% 13% 17% 16%
the Fair Work Commission announced in July “I think that whole thing shows that
2020 that residential aged care professionals, casualisation is not a good thing – that Overall NSW VIC QLD SA WA Other
including casual employees, should be given people are doing lots of different things aged care
paid pandemic leave,9 concerns were raised in lots of different places to put together
about casual employees slipping through cracks a living wage.”
as they would only qualify for this entitlement if 9. Australian Government, Fair Work Ombudsman, Paid pandemic leave in some awards (2020) , at 26 March 2021.
they worked for an employer on a “regular and 10. Rachel Clayton and Yara Murray-Atfield, ‘Fair Work Commission awards paid pandemic leave to aged care workers to stop staff going to work
systematic basis”.10 sick’, Australian Broadcasting Corporation, 27 July 2020 . 11. ‘Workplace coronavirus transmission driving Victorian case numbers, including in aged care’, Australian Broadcasting
Corporation, 19 July 2021 .
12 13
industry outlook
The aged care sector has been going through a period of intense
transformation and change in comparison to other health and community
services industries.
When respondents were asked in July 2020 This potentially points to a challenge for the
how they felt about the future of their industry sector as it looks to attract the next generation of
after the pandemic, the Royal Commission had aged care professionals with the required skills.
been in operation for nearly two years with
recommended reforms due in early 2021. The Unsurprisingly, confidence levels were also lower
workforce was also just starting to experience for aged care employees who lost work hours
COVID-affected work environments. due to COVID, with 42% saying they felt moderate
to uncertain compared to professionals with
Most aged care respondents were confident unchanged hours (32%) and those who worked
about the longevity of their industry. When more (30%).
compared to the rest of the health and
community services workforce, however, aged Discussions with industry representatives
care proved to be the least confident workforce revealed there were concerns around the ability
aside from early childhood education and care. of the sector to meet the wide range of reforms
One in three aged care professionals said they proposed by the Royal Commission aimed at
felt moderate to uncertain about the future of improving standards of care and client outcomes.
their industry. These recommendations are likely to result in
substantially increased regulatory oversight
This was particularly the case for respondents and demands on the workforce, and industry
aged 50 to 59 – nearly 40% said they felt representatives raised concerns around how
moderate to uncertain about the future of their this would impact those working in the sector.
industry – followed by professionals aged 18 to 29
(36%). Nurses had the lowest confidence levels –
40% felt moderate to uncertain.
Which of the following best describes how you feel about the future
of the industry you typically work in post-coronavirus?
Confident
Moderate to uncertain
66% 58%
73% 74% 77% 79%
42%
34%
27% 26% 23% 21%
Aged Community Early childhood Private Public Primary
care services education and care hospital hospital healthcare
14 15appreciation by employers
and community
Health and community services professionals were asked to rate how Similar findings emerged when respondents Professionals in residential aged care (37%) felt
were asked to rate appreciation of their work significantly less appreciated by their employer
much they felt their skills and experiences were valued by the community by their current or most recent employer. compared to those in community aged care
and whether they felt appreciated by their employer and clients. Nearly half of aged care respondents strongly (24%). Analysing aged care respondents by roles,
agreed they felt appreciated by their employer. 40% of nurses felt significantly less appreciated
By July 2020 there had been increased focus Despite 54% of respondents feeling valued by the Those in management roles (66%) felt the most by their employer, compared to care workers
on the vital and essential nature of the health community, industry representatives told HESTA appreciated compared to professionals in other (35%), professionals in ancillary services (33%)
and community services workforce during they were surprised at the high sentiment levels. roles, including care workers (48%). and lifestyle coordinators (33%).
the pandemic, including public recognition They told stories of aged care professionals not
A significantly higher proportion of community Industry representatives believed these figures
of the hard work being done by aged care wanting to be seen in their uniforms for fear of
aged care professionals felt appreciated by their did not reflect the discussions they were having
professionals to protect residents from COVID. abuse and high levels of negativity among those
employer (60%) compared to those who worked with the sector.
It is worth noting, however, the full impact of the in the sector when it came to how they believed
in residential aged care (45%).
second lockdown in Victoria had not taken effect they were perceived. One industry representative said:
at the time this research was conducted. Nevertheless, more than one in three aged care
“There is this underlying theme that I’ve been respondents did not feel appreciated. While there “What I hear from our members and from
Health and community services professionals felt
getting for a couple of years now … was an increase in the average rating from 6.0 workers is that they’re feeling by and large
their skills and experiences were valued more by
there is a view that the community doesn’t to 6.6 out of 10 in 2020, aged care had the lowest that they like their work, that they are proud
the community during COVID than prior to the
value the work of aged care and that people average rating out of all health and community of the work that they do, but they feel
pandemic in 2019. For the aged care workforce,
don’t feel valued either by the community or services sectors in 2020.
the average rating increased from 7.0 to 7.2 out that they are undervalued broadly by the
of 10 with more than half of respondents strongly by the system for want of a better term.” Industry representatives raised concerns about community. That they feel over scrutinised by
agreeing they felt valued by the community. the significant number of respondents who gave media and royal commissions and regulation
a 0-5 rating. One industry representative raised and things like that, and that there have been
It is also important to note just over a quarter
the link between perceptions of appreciation significant reports of an exodus, of people
– 27% – of aged care respondents strongly
and standards of care, saying: “A third of from the sector, because it’s just getting all
disagreed, the second highest proportion of
the workforce is saying that they don’t feel too hard.”
members within health and community services
appreciated and we know getting workforce right
behind early childhood education and care
is fundamental to getting care right. That’s got
professionals.
red flags all over it from my perspective.”
My skills and experience are valued by the community My work is appreciated by my current or most recent employer
0-5 6-7 8 - 10 0-5 6-7 8 - 10
0 = strongly disagree / 10 = Strongly agree 0 = strongly disagree / 10 = Strongly agree
Ave. ('19) Ave. ('19)
Aged Care 27% 19% 54% 7.2 (7.0) Aged Care 35% 18% 47% 6.6 (6.0)
Community Services 18% 17% 65% 7.8 (7.3) Community Services 23% 15% 62% 7.5 (6.8)
Early Childhood Early Childhood 15% 63%
32% 14% 54% 6.9 (6.8) 22% 7.4 (6.9)
Education and Care Education and Care
Private Hospital 24% 23% 53% 7.1 (7.0) Private Hospital 33% 22% 46% 6.6 (6.2)
Public Hospital 21% 26% 54% Public Hospital 31% 22% 47%
7.3 (7.0) 6.7 (5.9)
Primary Primary
Healthcare
24% 17% 60% 7.5 (7.3) Healthcare 32% 16% 52% 6.8 (6.7)
16 17appreciation by clients
Conversely, COVID appears to have significantly “Particularly around visiting when there
affected whether health and community were lockdowns and stuff like that, there was
services respondents felt appreciated by a lot of narkiness, particularly with families.
their clients or patients. Respondents across Which is totally understandable. But I know
health and community services generally felt
that providers felt that really significantly.
less appreciated by their clients, with aged
So, staff on the ground would have as well.”
care having experienced the biggest drop in
appreciation rating.
In community aged care, the reluctance of
Discussions with industry representatives clients to continue services due to safety
indicated the levels of appreciation felt by aged concerns, breaking that continuity of care and
care professionals may have been influenced regular interaction, may have also impacted
by the visitor restrictions placed on aged care appreciation levels.
facilities and their flow-on effects for families.
But while residential aged care facilities
were urged in March 2020 to implement
visitor restrictions, Victoria’s increased visitor
restrictions to only allow carers had not yet
taken effect at the time the majority of survey
responses were received.
I feel appreciated
by my clients or patients 2019
/ the parents of the 2020
0 = Strongly disagree
children I work with 10 = Strongly agree
73%
70% 68%
62% 64%
62% 62% 61%
59%
56% 55%
50%
Aged care Community Early childhood Private hospital Public hospital Primary
services education and healthcare
care
18 19industry pride
and job satisfaction
The aged care workforce is prouder to work in their sector according Respondents also
to the survey findings obtained during COVID.
appeared to experience
While there were substantial increases in pride While most aged care professionals returned higher job satisfaction
scores across health and community services similar average pride scores, nurses in aged
in 2020, aged care experienced the biggest care had a significantly lower average score during the pandemic.
jump in average pride score compared to the of 7.8. Lifestyle coordinators and care workers
other sectors. The aged care sector returned were the proudest to work in aged care, with Approximately half of health and community
the highest average pride score (8.4 out of 10) respective average scores of 8.7 and 8.6. services respondents said they felt satisfied
second only to community services (8.6). with their role at their employer. While aged
Given the significant challenges the sector
had faced over the period the surveys were care professionals returned the lowest average
“Maybe it’s the sense of people in the sector satisfaction rating for their role (7.2), they
conducted, industry representatives were
going, 'Yeah, my job is really important, not experienced the biggest jump in average score
surprised at the improvements in pride score
just because what I do is business as usual, within the sector. Having an average score now
for the sector.
but because there is a pandemic and there’s exceeding seven was also a positive for the
an added level of importance and value to One industry representative said: industry, as it indicated overall stronger positive
what I do in keeping people safe in residential sentiment.
“Staff, particularly when the Royal Commission
care and then providing essential services to
was announced, they’d be out and they’d have Residential aged care professionals were the
people in their homes.' Maybe that’s what’s at the uniform on, and someone would have a crack least satisfied with their role (7.1) compared to
play because to me, the thing that changed at them. Which is why overall, this is surprising.” community aged care professionals (7.5) and
most between (the two research snapshots) those working across both areas (7.7). Nurses in
was the pandemic.” aged care also showed significantly lower levels
of job satisfaction.
The challenges nurses face in terms of
workload, support and staffing numbers are
I feel proud to work in this Industry well documented. Discussion of the findings with
unions have also indicated career development
8.4 8.6
8.2 8.3 8.3 8.3 pathways are particularly important to nurses,
7.8 7.9 8.0
7.6
7.0 with many looking to upskill into the hospital
6.7
sector where pay and conditions are seen to be
better. While professionals in other roles returned
an average score for job satisfaction between
7.2 to 7.6, nurses reported an average score of
2019
6.7 out of 10.
2020
0 = Strongly disagree
10 = Strongly agree
Aged care Community Early childhood Private Public Primary
services education and care hospital hospital healthcare
I feel proud to work this Industry How satisfied are you with your role at your employer?
8.4 8.6 8.7 8.4 8.4 7.6 7.6
7.8 7.2 7.1 7.1 7.2 7.2 7.1 7.3
6.9 6.7
6.6
2019
2020
0 = Strongly disagree 0 = Extremely dissatisfied
10 = Strongly agree 10 = Extremely satisfied
Ancillary Care worker Lifestyle Manager/ Nurse Other Aged Community Early Childhood Private Public Primary
services coordinator/ CEO/GM Care Services Education and Care Hospital Hospital Healthcare
assistant
20 21a typical HESTA member retirement readiness
in aged care HESTA has developed a model to measure the retirement readiness of its members.
Aged care professionals are the least prepared for retirement. Just 23.8% of aged care members
are retirement ready, compared to 28.1% of early childhood education and care members,
29.6% of community services and 38.2% of primary health.
AGED CARE : EARLY CHILDHOOD COMMUNITY PRIMARY
23.8%
EDUCATION & CARE : SERVICES : HEALTH :
28.1% 29.6% 38.2%
218,090
HESTA members in aged care
working retired
gender super balances
HESTA’s aged care members are predominantly women. Aged care professionals Women Men Women Men
have the lowest median
super balances across $22,496 $15,611 $136,861 $157,935
health and community
men services.
While working women in
84.5 % aged care have a higher
median balance compared
15.5 % to men, their median super
balance at retirement is
13.3% lower.
women
age where NT
The aged care workforce is the oldest cohort they work 0.2%
of HESTA members. 43% are over the age of 50.
QLD
53 47
This is higher than community services (37.4%),
early childhood education and care (23.4%) % % 13.2 %
and private hospitals (39.8%).
METRO REGIONAL WA
A greater proportion of professionals aged 65+
work or have worked in aged care compared 9.0% ACT
to other health and community services sectors.
1.4% NSW
0.1% 28.4% 28.5% 32.1% 10.9%
36.0%
HESTA’s aged care SA
VIC
< 18 18 - 34 35 - 49 50 - 64 65 +
members work or
have worked mainly
10.5% 26.4%
in metropolitan areas TAS
47,127
and along the east
salary $ coast of Australia*. 3.2% *Unknown: 0.2%
The estimated median salary for
HESTA members in aged care is per year before tax.
what kind of work RESIDENTIAL COMMUNITY RETIREMENT
are estimated to earn less than CARE : CARE : VILLAGES :
39.3
HESTA’s aged care
% $50,000 a year before tax –
76.9% 13.8% 9.3%
the greatest proportion behind members work or have
early childhood education and worked predominantly
of aged care members care professionals (40.6%). in residential care.
as at 28 February 2021
22 23reasons for wanting to stay
job intentions with or leave employer
With a dwindling supply of younger professionals The intention to leave the aged care industry A lack of skills development and wanting to Providing employees with more variety of
entering the workforce and a generation of dropped from 27% in 2019 to just 17% in 2020. In try something different was a big driver of work could potentially be a low-cost way for
aged care professionals about to retire,12 staff addition, there was a corresponding 10% increase dissatisfaction across aged care and health and employers to fulfil the desire to try something
shortages present a significant challenge for in respondents who said they intended to stay community services generally in 2020, with aged different and increase job satisfaction. Training
the sector given the growing demand for aged with their current employer rather than move care professionals citing pay as their third reason and development opportunities and pay can be
care services. HESTA’s 2018 report, Transforming within the industry. why they would choose to leave their employers. harder to change due to business constraints,
Aged Care, indicated nearly a quarter of the Pay was the top reason for community aged care time and resourcing. Developing strategies and
workforce may be intending to leave the sector It is important to note the survey was undertaken professionals wanting to leave their employer – starting conversations with employees around
entirely within the next one to five years.13 This is in July 2020 when there was still very high levels perhaps unsurprising as aged care professionals ways to incorporate greater variety into their
potentially a significant barrier for the sector in of economic uncertainty and job insecurity are among the lowest paid in health and roles can potentially be implemented more
developing a skilled workforce of a size sufficient across the community. The increased ‘stickiness’ community services.14 quickly and at comparatively much lower cost
to meet Australia’s future aged care needs. of employees to their employer and industry may than other long-term drivers of dissatisfaction.
therefore have been influenced by perceptions “You’re asking people to do what is incredibly
This research investigated the short-term career of the job security of the sector relative to other emotionally and physically arduous work, so Conversely, the top three reasons in 2020
plans of aged care employees, including the industries that have typically drawn those seeking there does have to be at the outset a sort of for those wanting to stay with their employers
top reasons behind employees wanting to stay to leave health and community services. higher level of motivation to do that nature of were because they derived personal fulfilment
in or leave the sector, as well as the aspects of work when you’re not being paid particularly from their job, the location of their employer
their roles they liked and disliked the most. These An industry representative told HESTA: well,” an industry representative said. and because they enjoyed working with their
findings may help the sector improve attraction, “There’s a lot of uncertainty around the colleagues or co-workers.
retention and development of skilled aged care The research also showed differences by age.
economic situation generally. If they're in A lack of skills development and wanting to try These reasons were consistent for aged care
professionals. stable employment, they may potentially feel something different were key reasons for younger across 2019 and 2020.
While there was a general decrease across safer where they are than if they look at what’s aged care professionals (aged 39 and under)
health and community services in the intention happening in competing industries.” who flagged they wanted to leave their employer, Location featured prominently across health
to leave the industry in the short term, the biggest while older employees cited dissatisfaction with and community services generally, potentially
year-to-year change was evident in the aged the organisation, pay and not getting the training indicating more personal care pressures during
care workforce results. they need as the top reasons to leave. COVID.
Industry Top three reasons to leave their employers
Which of these best describes your short-term plans 1. 2. 3.
(i.e. for the next year or two) for your role at your employer? Aged Care I want to develop new skills I want to try something different I’m not paid enough
There are not enough career
Community Services I want to develop new skills
opportunities
I want to try something different
Industry Stay with employer Move within industry Leave industry
Early Childhood
I want to develop new skills I want to try something different I’m not paid enough
Aged Care 75% (65%) 6% (8%) 17% (27%) Education and Care
Community Services 73% (71%) 10% (9%) 17% (20%) There are not enough career I’m not happy with the
Private Hospital opportunities organisation I work for
I want to try something different
Early Childhood Education and Care 76% (67%) 6% (15%) 19% (18%) There are not enough career
Public Hospital I want to develop new skills I want to try something different
opportunities
Private Hospital 76% (71%) 3% (3%) 21% (26%)
I’m not happy with the
Public Hospital 76% (70%) 9% (10%) 16% (20%) Primary Healthcare I’m not paid enough
organisation I work for
I want to try something different
Primary Healthcare 76% (68%) 7% (10%) 17% (22%)
Numbers in brackets are 2019 results
Industry Top three reasons to stay with their employers
Casual and part-time employees were more likely These professionals were the most likely to plan 1. 2. 3.
to plan on leaving the industry (21% and 20%, on exiting the industry, with 35% of professionals
Aged Care Job is personally rewarding Location Colleagues / co–workers
respectively) than full-time professionals (17%). under 29 and 25% of professionals aged 30 to
A significantly higher proportion of residential 39 indicating they plan to leave aged care in the Community Services Job is personally rewarding I like the company I work for Colleagues / co–workers
aged care professionals (21%) is planning to next couple of years.
Early Childhood
leave the industry in the short-term compared to Education and Care
Colleagues / co–workers Location I like the company I work for
community aged care professionals (8%). Nurses in aged care were the least likely to stay
with their current employer (65%) and were also Private Hospital Colleagues / co–workers Location Job is personally rewarding
The research also showed it could be a challenge the most likely to plan to leave the industry (26%).
Public Hospital Colleagues / co–workers Job is personally rewarding Location
to keep younger professionals in aged care.
Primary Healthcare Colleagues / co–workers Location Job is personally rewarding
12. Suzanne Hodgkin, Jeni Warburton, Pauline Savy and Melissa Moore, ‘Workforce Crisis in Residential Aged Care: Insights from Rural, Older Workers’
(2017) 76 Australian Journal of Public Administration 93, 93 . 14. Sandy Cheu, ‘Union launches case to lift aged care wages’, Australian Ageing Agenda, 12 November 2020
13. HESTA, Transforming Aged Care (2018), 14. < https://www.australianageingagenda.com.au/executive/policy/union-launches-case-to-lift-aged-care-wages/>.
24 25employee likes
and dislikes about role
Across health and community services, purpose, culture and convenience, Industry Top three most-disliked aspects of members' roles
or having work fit into the broader life demands of a professional, 1. 2. 3.
were the consistent drivers of satisfaction. Aged Care Salary
Not enough opportunities
Benefits
for growth
Not enough opportunities
Health and community services professionals Pay was identified by the Royal Commission Community Services for growth
Salary Benefits
generally agreed the rewarding nature of their as a clear barrier to attracting the quality and Early Childhood
Salary
Not enough opportunities
Benefits
job and their colleagues or co-workers were the quantity of people that will be required to enter Education and Care for growth
most-liked aspects of their roles. the sector to meet predicted future demand and Not enough opportunities
Private Hospital for growth
Salary Benefits
lift standards of care. Not enough opportunities
Location also featured strongly in the top three Public Hospital for growth
Salary Hours not flexible
reasons for liking their job in 2020. There was unanimous agreement on the need Not enough opportunities
Primary Healthcare Salary Benefits
to lift wages and conditions in the sector when for growth
This may have been driven by concerns around HESTA spoke with industry representatives. There Note: the survey response ‘none of the above’ has been excluded.
avoiding public transport due to the pandemic. was also widespread uncertainty about how
Economic impacts disrupting households may this would be funded, with many saying it rested
have also seen caring demands increase for with government to put the system on a more
this predominately female workforce, which we sustainable, long-term footing. However, they noted a nursing job in aged Having clear career progression and clarity
know already bears the burden of unpaid care care lacked the prestige and pay of jobs in the around what professionals need to do to
responsibilities. Union representatives noted the sector had hospital sector, particularly the public sector. progress was an aspect flagged in the Royal
been relying on the commitment many working More experienced nurses in the sector typically Commission’s final report in relation to
For the aged care workforce, what they liked in the sector had for their clients, with many
about their role was consistent with their reasons had ‘put up’ with lower levels of pay as they were building the aged care workforce. The Royal
employees staying in the sector despite long-term dedicated to caring for their clients. Commissioners said they heard evidence that
for staying with their employers. This was also unhappiness with pay.
consistent between different aged care role types current career paths were non-existent in
and for residential aged care professionals, “It’s very common, particularly through the aged care for most direct care staff, and they
“Aged care workers doing it for the love not encouraged a collaborative approach between
however nurses named their colleagues and co- Royal Commission, for us to hear from our
the money is just a very long-standing and the Federal Government, education providers,
workers as their top choice, followed by location. members that they’re very dedicated to the
consistent theme,” one union representative aged care providers and unions.16 The report
residents,” an industry representative told
Those working in community aged care were more said. “So, it’s interesting that the intention to also flagged rewarding career pathways as
HESTA. “They do the work because they have
likely to mention flexibility of hours and liking leave the sector is down but it’s I guess not a key component for the sector in relation to
a long-term relationship with the people that
the organisation for which they worked as the particularly different to what we already know. improving the attraction and retention of aged
they’re providing the care for. So, they’ve
most-liked reasons. Location and the proximity of Aged care workers do actually tend to stick care professionals.
multiple clients who may need services in a shift basically accepted the lesser rate of pay
around in the sector for quite a long time.” Industry representatives consistently noted the
may also have been a factor in this satisfaction because they feel what they’re doing is
driver featuring prominently for this cohort. really important.” lack of career pathways and skills development
Other industry representatives talked about the as an ongoing challenge for the sector. One
The challenges the sector faces in providing need to push for health sector parity when it representative said: “If we’re talking about why
For aged care professionals planning to leave
employees with high-quality, appropriately came to pay but talked about the overall cost of people intend to leave the sector or why is it
their employer or industry, not having enough
valued work was clearly demonstrated when such a move as being a barrier. Attracting nurses happening, we already know they leave because
opportunities for growth or promotion was
it came to the top reasons members gave to work in the sector for example is challenging, they upskill out of the sector.”
the top dislike, followed by salary. Nurses also
for disliking their work.15 Members identified with an industry representative noting it was
flagged the lack of opportunities to develop
salary as the most-disliked aspect of their jobs, typically younger nurses starting out in their
new skills.
followed by a lack of opportunities for growth or career who were more likely to work in the sector.
promotion and benefits.
Industry Top three most-liked aspects of members’ work Job intention Top three most-disliked aspects of members’ roles
1. 2. 3. 1. 2. 3.
Not enough opportunities
Aged Care Job is personally rewarding Colleagues / co–workers Location Stay with employer None of the above Salary
for growth
Not enough opportunities
Community Services Job is personally rewarding Colleagues / co–workers Flexibility of hours Move within industry Salary Benefits
for growth
Early Childhood Not enough opportunities I do not get to develop
Colleagues / co–workers Job is personally rewarding Location Leave industry Salary
Education and Care for growth new skills
Not enough opportunities
Private Hospital Colleagues / co–workers Job is personally rewarding Location Other Salary
for growth
Benefits
Public Hospital Colleagues / co–workers Job is personally rewarding Location
15. The survey response ‘none of the above’ has been excluded.
Primary Healthcare Job is personally rewarding Location Flexibility of hours 16. Commonwealth, Royal Commission into Aged Care Quality and Safety, Final Report: Care, Dignity and Respect (2021), vol 1, 125.
26 27You can also read
