BABICM Poster 2026

Time Efficiency and Cost-Effectiveness in Support Worker Recruitment: A Comparative Analysis of Specialist Care Agency Versus Case Manager Direct Recruitment Models

Authors: Haxon, D; Jones, C; Linton, L; Purdy, K; Taylor, M (2026)

Introduction

Securing consistent, high-quality support worker services is critical for effective and sustainable care; however, the recruitment and retention of suitable staff for complex packages of care is a challenging aspect of case management (1). Social Return Case Management conducted a comparative study to investigate the most time-efficient and cost-effective recruitment method: utilising specialist care recruitment agencies versus direct, case manager (CM) led recruitment, an activity many CMs are often asked to perform.

Affording a client the opportunity of successful recruitment and retention of staff requires effective use of human resources, finance and recruitment expertise. Maximising these elements should ensure clients are recruiting and retaining high-quality staff (2)(3).

It is hypothesised that the use of specialist care recruitment agencies can meet this need in a more time- and cost-effective way and support the long-term retention of staff compared to CMs facilitating this process with, at times, less experience, expertise and resources.

Methodology/Approach

We undertook a detailed cost and time analysis to compare the expenses and hours associated with recruiting and retaining support workers for each service model. This included the direct recruitment costs and resource allocation managed by CMs versus costs associated with external agencies.

The study included 5 participants, comprising 3 CM companies and 2 specialist care recruitment agencies. Quantitative data were derived from answers to standardised questions regarding the time and cost of recruiting one support worker per client with complex care needs in the last 18 months.

During the course of the data gathering process, additional anecdotal and qualitative information was received that was not suitable for statistical analysis and direct comparison within the data set. However, this information was considered within the wider context of the study.

Results/Findings

Based on statistical analysis of quantitative data, there is a significant difference between CM companies and specialist care recruitment agencies in terms of cost and time effectiveness, with each showing a distinct strength. Specialist care recruitment agencies are demonstrably more time-efficient in the initial hiring process, spending an average of only 16 hours to recruit one support worker, compared to an average of 41 hours by CM companies. This suggests that specialist care recruitment agencies are more time-effective.

CM companies show greater effectiveness in the later stages of the recruitment funnel, converting candidates into retained employees at a much higher rate. CM companies achieved an Offer Acceptance Rate of 96.7%, compared with 30% for specialist recruitment agencies. Furthermore, the 12-Week Retention Rate was 93.3% for CM companies, exceeding the specialist recruitment agencies' rate of 85%. CM companies also proved more effective in initial screening, with an 86.7% Shortlisted-to-Interview Rate compared to 68.4% achieved by specialist care recruitment agencies.

Conclusion/Implications

The results partly support our hypothesis regarding short-term time efficiency of specialist recruitment agencies but indicate an interesting additional outcome regarding long-term benefits of CM direct recruitment and retention.

The optimal strategy therefore depends on client needs. Specialist care recruiters suit urgent, quick vacancy fills, whereas the CM model is superior for long-term stability, which is core to CM good practice detailed with the BABICM competencies (4).

These findings are limited by a very small sample size; therefore, future research is required using a similar methodology with a larger, more diverse sample of companies and models. It is recommended that a further study also explores the value of brain injury training for support worker retention (5); and the potential impact of the Employment Rights Act (2025) (6) on support worker recruitment in the medico-legal context, especially for settled cases involving finite funds.

References

(1) Norman A, Holloway M, Dean J, Patterson A, Needham-Holmes B, Curro V, et al. Working Within a Perfect Storm: The Current UK Care Crisis in Community Neurorehabilitation. Journal of Long-Term Care, 2024. Available from https://journal.ilpnetwork.org/articles/10.31389/jltc.336  [Accessed: 02/02/2026]
(2) Northern Ireland Social Care Council: Evidence review - what works in recruitment and retention of social care workers? [Internet]. 2023. Available from: https://niscc.info/app/uploads/2023/09/What-works-in-Retention.pdf [Accessed: 15/01/2026]
(3) Kings Fund: Health and Social Care Committee workforce inquiry: recruitment, training and retention in health and social care [Internet]. 2022. Available from: https://assets.kingsfund.org.uk/f/256914/x/c231b020c9/submission_health_social_care_committee_workforce_inquiry_recruitment_2022.pdf  [Accessed: 15/01/2026]
(4) BABICM Standards & Competencies Guide - BABICM [Internet]. BABICM. 2024. Available from: https://www.babicm.org/standards-guide-public/  [Accessed:15/02/2026]
(5) Grewal J, Kennedy CJ, Rinni Mamman, Janelle Breese Biagioni, Garcia-Barrera MA, Schmidt J. Understanding the barriers and facilitators of healthcare services for brain injury and concurrent mental health and substance use issues: a qualitative study. BMC Health Services Research, 2024. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11295555/  [Accessed: 15}
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