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Around 1.52 million people worked in the adult social care sector in England in 2022/23, 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, including:

  • 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 because 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.
  • 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.
  • 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 the wages of other service worker jobs are catching up.

Several reports have said underfunding of social care is a key factor behind workforce issues in the sector. The Government has, however, disagreed that the sector is 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

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).

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 introduce a national workforce pathway for adult social care, the first phase of which was published in December 2023.

The policy 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. Around £54 million of this will be used to support up to 37,000 people to enrol on a new Level 2 Adult Social Care Certificate between June 2024 and March 2025.

In July 2023, the Government announced how £600 million of unallocated funding from the December 2021 white paper (including £250 million originally committed for workforce development) would be spent. £570 million of the funding will be provided through a new Market Sustainability and Improvement Fund – Workforce Fund, which local authorities can use, among other things, to increase adult social care workforce capacity and retention.

International recruitment

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 an increase in the number of people arriving in the UK to take up social care jobs, which contributed to a reduction in vacancies and an increase in the number of filled posts during 2022/23.

However, stakeholders have suggested that immigration 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 December 2023, the Government announced future changes to the visa rules aimed at reducing immigration. As part of the changes, social care workers will not be allowed to bring dependents (that is, partners and children) on their visa. Concerns have been raised that this could exacerbate existing workforce pressures if it leads to a reduction in the number of people coming to the UK to take jobs in social care. However, the Government has said it does not think the change will lead to a significant reduction in demand.

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.


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