Adult social care workforce in England

Around 1.52 million people worked in the adult social care sector in England in 2022/23. This is more than in the NHS. The workforce was more diverse than the population as a whole and the majority of workers were women. Around a quarter of the workforce were on zero-hours contracts, including 54% of home care workers.

Recruitment and retention issues

The sector faces several longstanding workforce challenges, which, it is suggested, can impact on the availability and quality of care. These include:

• High vacancy rates: Skills for Care, the workforce development and planning body for adult social care in England, estimates an average of 9.9% of roles in adult social care were vacant in 2022/23, equivalent to approximately 152,000 vacancies. The number of vacancies decreased by around 11,000 between 2021/22 and 2022/23, partly as a result of increased international recruitment. However, vacancies remain high compared to the wider UK economy.
• Rising demand: demand for social care is rising and this is expected to continue. This is projected to lead to increased demand for social care staff.
• High turnover: Skills for Care estimates the turnover rate of directly employed staff working in adult social care was 28.3% in 2022/23, equivalent to approximately 390,000 leavers over the year. It is suggested low staff morale and burnout may contribute to low retention rates.
• Limited opportunities for career progression and little standardisation of training and qualifications.
• Low pay: care worker pay is among the lowest in the economy and it is suggested some are facing hardship as a result of increases in the cost of living.

Role of public funding

Most social care staff are employed by private sector providers who are responsible for setting their pay and conditions. However, most providers accept clients who pay their own fees and clients whose fees are, at least in part, paid by the local authority. As a result, public funding has been described as “integral to social care provision” and “pivotal to wage setting”.

Several reports have said underfunding of social care is a key factor behind workforce issues in the sector. The Government has, however, disagreed with suggestions that social care has been “chronically underfunded” and has highlighted additional investment provided at the Autumn Statement 2022. It says it expects local authorities to use this investment to “deliver sustainable improvements in adult social care services”, including addressing workforce pressures.

Government policy

The Government has taken several actions to encourage the recruitment and retention of social care staff, including national recruitment campaigns and providing funding for hospital discharge, which can be used on the social care workforce.

People at the Heart of Care white paper (December 2021)

In December 2021, the Department of Health and Social Care (DHSC) published a white paper on wider plans for social care reform. Chapter six set out the Government’s strategy for the social care workforce, which would be supported by investment of at least £500 million in workforce development over the next three years (2022/23 to 2024/25).

Next steps policy paper (April 2023)

On 4 April 2023, the Government published a policy paper outlining progress made in implementing the reforms set out in the December 2021 white paper and providing details on how the Government would spend some of the funding committed.

Among other things, the Government confirmed plans to publish a national workforce pathway for adult social care, and a consultation on the proposed pathway was published alongside the policy paper.

The paper said the Government would invest “at least £250 million” over the next two years for workforce development, which will provide additional funding for training and professional development to support people to develop and progress along the new workforce pathway.

It was noted by commentators that funding for workforce development had been reduced from £500 million to £250 million. The Government acknowledged that there remained £600 million of funding committed in the December 2021 white paper (£250 million of which was originally committed for workforce development) still to be allocated.

On 28 July 2023, the Government announced how the £600 million of unallocated funding from the December 2021 white paper would be spent. £570 million of the funding will be provided through a new Market Sustainability and Improvement Fund – Workforce Fund, worth £365 million in 2023/24 and £205 million in 2024/25. Local authorities can choose to use the funding for, among other things, increasing adult social care workforce capacity and retention.

Progress on implementation

In a November 2023 report (PDF), the NAO said progress on the workforce reforms had “been slow”. As of October 2023, delivery had started on two of eight workforce projects initiated. The other six were “still in development”.

Overseas social care workforce

Historically there has been little direct recruitment of migrant workers into social care. Most migrant workers who started to work in social care were already in the UK.

In February 2022, the Government made care workers eligible for the Health and Care Worker visa and added the occupation to the Shortage Occupation List.

This has led to increasing numbers of people arriving in the UK to take up social care jobs. Skills for Care estimates 70,000 people started direct care providing roles between March 2022 and March 2023 having arrived in the UK during the period. This is an increase from 20,000 in 2021/22 and 10,000 in 2020/21.

The increase in international recruitment has contributed to a reduction in vacancies and an increase in the number of filled posts during 2022/23 (the number of British workers reduced by 20,000 over the period). However, stakeholders have suggested it is not a long-term solution to the sector’s workforce issues. Concerns have also been raised about the ill-treatment of some international recruits.

In September 2022, the Government announced it would invest £15 million “to help boost international recruitment of care workers”. The funding is intended to help employers overcome barriers to recruiting internationally.

Other countries of the UK

This briefing covers England only. Brief information on the social care workforce in Scotland, Wales and Northern Ireland is provided in a series of explainers published by the Nuffield Trust.