As part of the engagement and dissemination activities for the Retention and Sustainability of Social Care Workforce RESSCW project, Professor Shereen Hussein was invited to share some of the findings at the International Labour Organisation (ILO), Geneva, in 2022. This project is funded by the Health Foundation and is a collaboration between the London School of Hygiene & Tropical Medicine, the University of Kent, UCL and Skills for Care.

A workstream of this project was dedicated to investigating the impact of COVID-19 on the UK’s Long-Term Care (LTC) workforce. It involved several rounds of surveys complemented by key stakeholders’ interviews. Some findings highlighted the massive increase in workload and working hours and significant increases in unpaid sick leave among the workforce. However, one of the striking findings of the surveys was a substantial increase in the level of abuse faced by the workforce, especially during 2021. Workers from minority ethnic groups and those working in care homes were particularly at higher risk of incidences of abuse. The abuse was perpetuated by service users, their families, managers, co-workers and even the public. Some of the survey analyses were published in this article.


The findings of this strand of work are of particular interest to the ILO as they have had extensive work promoting decent working conditions for LTC workers. For example, a recent ILO report notes how the demand for LTC provision is escalating worldwide; however, ‘it is characterized by a range of decent work deficits, largely attributable to gender-biased undervaluation and discriminatory factors‘. The report provides essential recommendations related to the training and well-being of LTC workers. These developments are crucial for countries in the MENA region as they start developing their LTC markets. Another aspect of the LTC workforce relates to the reliance on migrant workers, especially women. This is happening in both more developed countries as well as in the Middle East. Such demand, accompanied by unregulated and fragmented LTC markets, increases the risk of exploitation of workers and those receiving care, a topic discussed in further detail in this article.

In a previous Policy Brief, the ILO had developed vital messages to achieve decent working time for nursing personnel, including LTC workers, which is directly linked to their well-being. The RESSCW findings highlight that workers’ well-being was highly compromised due to the COVID-19 pandemic. Policy interventions should be implemented to mitigate this effect and ensure a sustainable LTC workforce. The ILO has developed several standards to ensure the quality of work and the well-being of LTC workers, including when violence and harassment are involved.

As we move into the post-COVID recovery phase globally, governments and care providers need to consider the sustainability of the LTC workforce. ILO has been doing important work in this area. In this video, Maren Hopfe, Technical officer at the ILO, highlights the particular vulnerability of LTC workers during COVID-19, which the RESSCW study has highlighted.

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Professor of Health and Social Care Policy, the London School of Hygiene and Tropical Medicine, UK

Shereen Hussein is a Professor of Health and Social Care Policy at the Department of Health Services Research and Policy (HSRP) at the LSHTM. She is a Co-Director of the PRUComm policy research unit. She is also an Honorary Professor at the University of Kent and King’s College London in the UK and the University of Southern Queensland in Australia.

Shereen is a demographer with expertise in labour-migration, sociology and economics. Her primary research revolves around ageing, family dynamics, migration and long-term care. Shereen has previously worked with the United Nations, the Population Council, the World Bank, and the League of Arab States. Her current research focuses on ageing demographics, long term care demand and migration within the UK and Europe and the implications on policy and practice.

Shereen has conducted extensive research on population ageing and its impact on long term care and health policy and practices in the UK, internationally and in the Middle East and North Africa (MENA) region. She has contributed to recent United Nations’ policy response to ageing in the region through collaboration with UN-ESCWA and directly providing expert consultations to several countries in the region including Turkey, Oman and Egypt. Shereen leads many large research projects on ageing and long-term care in the UK and contributes to a large project addressing responses to dementia in developing countries STRiDE. Shereen is the founder and lead of the MENARAH network.