Healthcare is the hardest sector to hire in right now. 30% of NHS clinicians plan to leave within one to three years. Care homes have vacancy rates that haven't dropped below 10% in years. Domiciliary care agencies are turning away clients because they can't find the staff to serve them.

If you're trying to hire care workers — whether for a residential home, a supported-living service, or a domiciliary care agency — you already know the problem. The question is what to do about it.

This guide is practical. No theory, no fluff. Just the steps that actually work.

Why healthcare hiring is broken

The usual approach goes something like this: post a job ad, wait for applications, call through the list, chase people who don't answer, eventually screen a handful, run compliance checks, and hope the best candidate hasn't already gone somewhere else.

The whole thing typically takes two to four weeks. That's two to four weeks of rota gaps, overtime costs, and agency fill-ins at £25–£35 per hour.

Three things are making it worse. First, the candidate pool is shrinking — fewer people are entering care as a career. Second, candidates have more options than ever, so they won't wait around. Third, most care providers are still running hiring processes designed for a world where they had more applicants than jobs.

That world is gone. You need a process built for a candidate-short market.

Step 1: Respond to every application within hours

This is the highest-impact change you can make. In healthcare hiring, speed is the strategy.

Most candidates apply to multiple jobs at once. The providers who respond first have a massive advantage. Yet many care homes take days — sometimes over a week — to make first contact with an applicant.

Every hour that passes after someone applies, the chance of hiring them drops. Aim to contact every applicant within 4 hours of their application. If you can't do that with your current team, automation is the answer.

Lily contacts every applicant by phone within hours — day or night, weekdays or weekends. Because care workers often apply outside office hours, a system that works at 11pm on a Saturday is not a luxury. It's a necessity.

Step 2: Screen for fit, not just qualifications

Healthcare hiring has unique screening requirements. You're not just checking whether someone can do the job. You're checking whether they're legally allowed to, whether they're safe to, and whether they'll stay.

A good screening process in care covers right to work status, DBS history, relevant experience (personal care, medication administration, dementia care), availability and shift flexibility, understanding of safeguarding and dignity, and reason for leaving their previous role.

The mistake many providers make is treating screening as an admin task that happens after the interview. In care, screening should happen before the interview. It saves you from interviewing candidates who can't pass compliance checks, and it gives you better information to work with when you do sit down with someone.

Lily's AI phone screening asks structured questions tailored to care roles, scores every response the same way, and flags compliance issues before a manager spends a minute of their time. The average screening time is 0.83 days — compared to the 9-day industry average.

Step 3: Run compliance checks in parallel

In healthcare, compliance isn't optional. eDBS checks, right to work verification, reference collection — these are all mandatory before someone can start. And they're often the biggest bottleneck.

The traditional approach runs these sequentially: screen first, interview second, compliance third. By the time everything clears, three weeks have passed and the candidate has moved on.

Run compliance checks alongside screening instead. Request references on day one. Trigger eDBS and right to work checks as soon as a candidate is screened. That way, when someone reaches the interview stage, they're already on their way to being clear.

Lily automates eDBS, right to work, and reference requests as part of the screening workflow. Everything is tracked in one dashboard with a full CQC-ready audit trail.

Step 4: Stop relying on agencies as a first resort

Agencies have a place in healthcare hiring — but they shouldn't be your default. At £3,750 to £6,250 per placement (typical care sector agency fees), the costs add up fast. And agency staff often don't stay. You've paid a premium for someone who leaves in three months.

Direct hiring is cheaper, produces better retention, and gives you more control over quality. The challenge has always been that direct hiring takes too long. But when you automate screening and compliance, the speed gap between agency and direct hire disappears.

At Sonderwell, switching from agency-heavy hiring to Lily's end-to-end platform resulted in 127% more hires per month at a flat fee of £300 per hire. That's a fraction of agency costs, with better outcomes.

Step 5: Build your employer brand for care workers

Care workers talk to each other. They share experiences of hiring processes — both good and bad. If your application process involves ghosting, long waits, and impersonal communication, word gets around.

On the other hand, a process that respects candidates' time, responds quickly, and treats people well becomes a recruitment advantage in itself. Candidates refer their friends. Applicants who aren't right for this role come back when the next one opens.

A 100% response rate to every applicant — even those you don't take forward — is one of the most powerful things you can do for your employer brand. It costs almost nothing and compounds over time.

What good healthcare hiring looks like

Here's the process that works: applications come in on Monday morning. Every applicant is screened by phone on Monday. Compliance checks begin automatically. By Tuesday, the manager has a ranked shortlist with scores and compliance status. Interviews happen on Wednesday. An offer goes out on Thursday. The new care worker starts the following week.

Total time from application to start: under 10 days. Total cost: £300 per hire. No agency. No rota gaps. No panic.

Start here

If you're currently taking more than a week to go from application to offer, start by mapping every step in your process and asking: does this need to happen in this order? Can it run in parallel? Can it be automated?

How to hire care workers faster in healthcare