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Personal assistants in England and the factors associated with absenteeism

Roland, Daniel, Allan, Stephen, Chambers, Eleni, Smith, Debs, Gousia, Katerina (2022) Personal assistants in England and the factors associated with absenteeism. Frontiers in Public Health, 10 . Article Number 970370. ISSN 2296-2565. E-ISSN 2296-2565. (doi:10.3389/fpubh.2022.970370) (KAR id:97466)


Personal assistants (PAs) have become an increasingly important element of long-term care (LTC) in England since the introduction of Direct Payments in 1996 and the Care Act 2014 legislation. The PAs, who are directly employed by social care users, can perform a number of support tasks including vital assistance in activities of daily living (ADL). Internationally these roles would be classed as domestic care work, including the employment of migrant care workers, e.g. in Germany and Austria. High turnover rates and work absenteeism in this market can cause disruption of these important daily activities, causing LTC users to potentially suffer neglect and poorer quality of life. Although there is research on turnover and absenteeism in nursing workforce in hospitals and LTC workers in nursing homes, little attention has been given to reasons for turnover of PAs and even less for absenteeism, which often precedes turnover, in a workforce of over 100,000 people in England. This research aims to fill this gap in knowledge by analyzing the reasons behind the absenteeism of PAs using quantitative methods. We used survey data of PAs in England, exploring the factors associated to one form of absenteeism — sick leave from work. After controlling for a number of factors ranging from job characteristics such as number of hours worked and type of contract, socio-economic characteristics from the PA and their employer, and supply and demand factors at local government region, the findings suggest a number of factors that significantly influenced sick leave, including distances traveled to work and number of PAs employed. Following the analysis, two people with life experience of LTC discuss the findings of the study and how they compare to their experiences of the market for PAs, providing a unique perspective from the people who could benefit the most from improving PA retention and reducing absenteeism.

Item Type: Article
DOI/Identification number: 10.3389/fpubh.2022.970370
Projects: Retention and Sustainability of Social Care Workforce (RESSCW)
Uncontrolled keywords: long-term care, personal assistants, domestic care workers, absenteeism, older people, home care, sick leave
Subjects: H Social Sciences
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Personal Social Services Research Unit
Funders: Health Foundation (
Depositing User: Daniel de Araujo Joao Roland
Date Deposited: 17 Oct 2022 12:05 UTC
Last Modified: 02 Dec 2022 15:53 UTC
Resource URI: (The current URI for this page, for reference purposes)

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