Personal care workers: skills opportunities and challenges
Table of contents
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.
- 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.
- The five key skills required for these workers are problem solving, teamwork, communication, learning and customer service.
- A surplus of personal care workers has been reported in two EU Member States, while there seems to be no significant shortage across the EU.
- From 2005-2015 employment in the personal care workers category grew by about 15%.
- In the coming decade the growth will continue, but at a milder rate, not expected to go further than 5%.
- Two-thirds of personal care workers hold medium-level qualifications. Between 2015 and 2025, a robust shift in demand is expected from workers with low-level qualifications to highly qualified ones.
- The vast majority of personal care workers are employed, as expected, in health, education and other service activities. By 2025, one in seven workers will be employed in health, and more than 1.2 million in education.
Who are they?
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. 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.
What skills do they need?
According to Cedefop’s European skills and jobs survey (ESJS), the key 5 skills for personal care workers are problem solving, teamwork, communication, learning and customer service. These skills could support employees in this occupation to also tackle anticipated future skill challenges (see drivers of change below).
Figure 1: Most important skills required for personal care workers
Where are they mostly in demand?
The labour market dynamics for this occupation differ across EU Member States:
Figure 2: Shortages and surpluses for personal care workers across the EU
What are the trends for the future? 
From 2005-2015 employment in the personal care workers category grew by about 15%. In the coming decade the growth will continue, but at a milder rate, not expected to go further than 5%. Nevertheless, a bit over 30% of the 2015 workforce will need to be replaced by 2025 (‘replacement demand’ ), creating about 2.8 million jobs for personal care workers. More information can be found here.
Two-thirds of personal care workers hold medium-level qualifications. Between 2015 and 2025, a robust shift in demand is expected from workers with low-level qualifications (whose share will fall from 22% to about 16%) to highly qualified ones (reaching one-quarter of the 2025 occupation workforce).
The vast majority of personal care workers are employed, as expected, in health, education and other service activities . By 2025, one in seven workers will be employed in health, and more than 1.2 million in education (close to 18% of an increase, compared with 2015).
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.  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 . 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 .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.  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”  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 . 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.
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 .
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 .
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 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 .
“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  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
 Defined as ISCO 08 groups 53 personal care workers. ILO, (2012), International Standard Classification of Occupations ISCO-08. More information on the occupation can be found here.
 The ‘other service’ subsector is a residual category that includes the activities of membership organisations, the repair of computers and personal and household goods, and a variety of personal service activities not covered elsewhere in the classification. More information on the broader sector can be found in the Skills Panorama here.
 Barnett, K., Mercer, S.W., Norbury, M., Watt, G., Wyke, S. & Guthrie, B., 2012, ‘Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study’ Lancet. 2012 Jul 7; 380 (9836):37-43. doi: 10.1016/S0140-6736(12)60240-2
 World Economic Forum, (2016), The Future of Jobs.
 European Observatory on Health Systems and Policies, (2012), Home care across Europe: current structure and future challenges.
 European Union Agency for Fundamental Rights (FRA), Certification and accreditation procedures for professionals, viewed 04 July 2016
 OECD / European Commission, (2013), A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care
 Fellows, J. and Edwards, M., (2016), Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu & Horizon Scanning, (2015), Future skills and competences of the health workforce in Europe.