We continue examining the challenges facing the care sector, offering a forward-looking perspective. In this article, we focus on professionals, reflecting on which profiles and capabilities are most appropriate to address the evolving demands of care systems.
This issue is not limited to workforce shortages in relation to increasing demand. It also concerns the fact that the current professional model used to organize services is no longer fully aligned with the type of care expected by service users, public administrations, and societal values. Likewise, it does not always ensure the desired quality of care nor support a sustainable balance between costs and outcomes.
While acknowledging the importance of workforce shortages, a model based solely on increasing staff numbers—without redesigning roles, competencies, autonomy, and knowledge use—is unlikely to address structural challenges such as staff overload, limited personalization, excessive bureaucracy, and low job attractiveness.
It is therefore necessary to reflect on what types of professionals are truly needed, with which qualifications and responsibilities, and which organizational arrangements can effectively support and leverage these capabilities.
A sector facing complex challenges requires evolved roles
For many years, the care sector has operated through a relatively simple but clearly defined division of roles: direct care, support services, technical profiles, nursing, medical staff, and management. While this structure remains relevant, current challenges require a reconsideration of functions and responsibilities across all profiles.
The adoption of person-centered approaches, deinstitutionalization processes, integrated care, and service digitalization calls for changes not only in organization, but also in culture and methodology.
Care work does not always present the same level of complexity, nor should it consistently fall on the same roles. Excessively rigid structures tend to generate inefficiencies: underutilizing highly qualified staff while overloading frontline workers with tasks that do not always add direct value to individuals.
Direct care professionals
In residential, day-care, and home-care services, support systems continue to rely heavily on direct care professionals. Although their formal training includes competencies related to daily living support, relational care, and observation, in many organizations this role is still narrowly defined: task execution, routine coverage, and activity reporting under time constraints.
Looking ahead, direct care professionals should not be defined solely as executors of basic care tasks. They should be recognized as qualified observers of individuals’ daily lives, capable of identifying changes, needs, preferences, and opportunities across functional, emotional, and relational dimensions.
This perspective implies several developments in their functions and competencies:
- Moving from a “task-time” logic to a “situation-need” approach, promoting autonomy and decision-making
- Taking an active role in generating relevant information for care personalization
- Expanding interdisciplinary knowledge in coordination with other professional profiles
- Strengthening communication and relational skills
- Developing transversal competencies such as adaptability, coordination, self-awareness, and problem-solving
In the coming years, the organizations that will consolidate more robust and effective models will not necessarily be those with greater resources, but those capable of directing and making effective use of their professional capital. This involves promoting higher levels of qualification across technical, relational, and organizational dimensions, as well as ensuring that organizational structures enable the effective use of such competencies.
In this context, the evolution of the sector depends not only on increasing resources, but on the capacity to reorganize roles, responsibilities, and working methods in line with emerging needs, enabling greater anticipation, adaptability, and personalization of care.