The combination of growing demand for long-term care and higher expectations of care staff needs to be set in the context of long-standing concerns about the sustainability of recruitment and retention of front- line staff in the United Kingdom. Organisational and work environment factors are associated with vacancy levels and turnover rates. The aim of the current analysis was to investigate changes in turnover and vacancy rates over time experienced by a sample of social care employers in England. Taking a follow-up approach offers potentially more accurate estimates of changes in turnover and vacancy rates, and enables the identification of any different organisational characteristics which may be linked to reductions in these elements over time. The study constructed a panel of 2964 care providers (employers) using 18 separate data sets from the National Minimum Data Set for Social Care during 2008–2010. The findings indicate slight reductions in vacancy rates but the presence of enduring, high turnover rates among direct care workers over the study period. However, the experience of individual employers varied, with home-care providers experiencing significantly higher turnover rates than other parts of the sector. These findings raise questions around the quality and motivations of new recruits and methods of reducing specific vacancy levels. At a time of increased emphasis on care at home, it is worthwhile examining why care homes appear to have greater stability of staff and fewer vacancies than home-care agencies.
Hussein, S., Ismail, M. and Manthorpe, J. (2016) Changes in turnover and vacancy rates of care workers in England from 2008 to 2010: Panel analysis of national workforce data. Health & Social Care in the Community. 24(5): 547-556.
Founder and Director
Shereen Hussein is a Health and Social Care Policy professor at the London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom.
Shereen Founded the MENARAH Network in 2019, through an initial grant from the Global Challenge Research Fund, UKRI. She is a medical demographer with expertise in ageing, family dynamics, migration and long-term care systems. Shereen regularly collaborates with the United Nations, the World Health Organisation and the World Bank in policy and research focused on ageing in the Middle East and North Africa Region.
Shereen received her undergraduate degree in statistics and a postgraduate degree in computer science at Cairo University. She completed an MSc in medical demography at the London School of Hygiene and a PhD in quantitative demography and population studies at the London School of Economics and Political Science, United Kingdom.
Director, Analytical Research Ltd, and Affiliate Research Fellow, Oxford Institute of Population Ageing, University of Oxford, United Kingdom
Mohamed Ismail is a quantitative researcher whose work develops mathematical and computational frameworks to better understand ageing dynamics and long-term care systems, with a particular focus on how time spent in care shapes future demand, costs, and system behaviour.
With a background spanning engineering, computer science, and mathematical finance, he brings a structured, model-based perspective to complex social challenges. His recent research focuses on duration-dependent processes, how individual-level dynamics translate into population-level outcomes, and the development of tractable models of ageing and long-term care.
His recent work includes the development of a new index-based framework for estimating long-term care needs in data-scarce settings, with evidence from the Middle East and North Africa, published in Population Health Metrics in 2026. His research also examines long-term care policies and financing in the region, including how care systems can be integrated into broader economic and social development strategies.
Mohamed began his career as a quantitative analyst with global financial institutions, including Merrill Lynch, HSBC, Mizuho Financial Group, and Credit Suisse, before transitioning to quantitative social research. In 2009, he founded Analytical Research Ltd, applying statistical and mathematical modelling to policy-relevant questions in ageing and care.
He has collaborated with academic and policy institutions across the UK, Europe, Australia, and the Middle East on research spanning population ageing, migration, and long-term care systems. His work appears in peer-reviewed journals and international policy reports, including contributions to reports by the U.S. Census Bureau, United Nations, World Bank, and World Health Organization.
Mohamed has been a core member of the MENARAH Network since 2019, contributing quantitative and interdisciplinary perspectives to research on ageing and long-term care in the Middle East and North Africa.
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