Care England Warns of Unsustainable Workforce Pressures in Adult Social Care Despite Increased Posts

Care England, the largest representative body for independent adult social care providers, responds to the latest findings in Skills for Care’s State of the Adult Social Care Sector and Workforce in England 2024 report.

Rising Workforce Numbers Mask a Crisis

According to the report, the adult social care sector saw a 4.2% rise in the number of filled posts, reaching 1.705 million in 2023-2024. This growth represents an increase of 70,000 filled positions over the last year. However, this seemingly positive figure masks a far more worrying reality: vacancy rates remain staggeringly high. Though vacancies have decreased from 153,000 to 131,000, they still account for 8.3% of the workforce, a rate nearly three times higher than that in the wider economy. In comparison, the NHS vacancy rate stands at a lower 6.9%, further highlighting the unique recruitment pressures faced by adult social care providers.

The high vacancy rate continues to exacerbate existing pressures on frontline staff, who are frequently forced to manage excessive workloads. Additionally, the ongoing recruitment struggles have led to increased reliance on agency staff, which in turn inflates costs and destabilises care provision. These structural issues are compounded by a lack of long-term government strategy, leaving providers in a precarious position.

Professor Martin Green OBE, CEO of Care England, commented:

“The report’s headline figure of more filled posts is welcome, but it does not tell the whole story. An 8.3% vacancy rate is unsustainable, particularly when compared to the wider economy and even the NHS. This is not just a recruitment challenge – it’s a systemic failure to build a workforce that can meet the current and future demands of social care. Without immediate intervention, we will continue to see a workforce stretched beyond its limits, which will directly impact the quality of care provided to some of the most vulnerable people in our society.”

Recruitment Struggles Intensify

The report further highlights that the recent increase in filled posts has been heavily reliant on international recruitment. However, this lifeline is being rapidly cut off due to the changes in immigration policies which prohibited overseas care workers from bringing dependents to the UK. Applications for Health and Care Worker visas have plummeted by 81% from April to June 2024 compared to the same period in 2023. Consequently, the latest report reveals that the number of international recruits entering the sector has fallen to just 8,000, nearly 70% lower than the quarterly average from the previous year. This sharp decline, driven by changes to immigration policy introduced by the previous Government and upheld by the current one, is leading to an unsustainable dependence on an increasingly limited domestic workforce.

Tens of thousands of British workers have left the sector over the past year, disillusioned by low wages, poor working conditions, and a perceived lack of career progression. The combination of reduced international recruitment and an exodus of domestic workers leaves the sector in a precarious state, with many care providers struggling to maintain minimum staffing levels.

Importantly, the Government’s decision to continue with the current restrictions has further intensified the inequalities between the health and social care sectors. While overseas carers are not allowed to bringing dependents when migrating to the UK, NHS staff and workers in other occupation codes continue to enjoy the ability to bring dependents as normal. This stark disparity not only hinders social care providers’ ability to recruit and retain much-needed international staff but also highlights the unfair treatment of care workers compared to their NHS counterparts. The sector is being unfairly burdened by immigration restrictions that undermine the critical role care workers play in supporting the health and well-being of some of the country’s most vulnerable people.

Professor Martin Green continued:

“We are facing a perfect storm. Domestic recruitment has collapsed, and the government’s immigration policy has choked off the international recruitment pipeline, which has been vital in propping up the sector. We cannot sustain this practice. What makes the situation even more frustrating is the clear inequality between the health and social care sectors. While NHS staff are still able to bring their dependents when migrating to the UK, care workers, who are just as essential, are denied this basic right. This unfair treatment further erodes our ability to attract international talent and deepens the crisis. Without a meaningful strategy to improve pay and conditions to attract domestic workers, coupled with a pragmatic approach to immigration, we will be unable to meet the ever-growing demand for care. The government must address this before the situation becomes untenable.”

Economic Contribution and the Case for Investment

Despite these challenges, the State of the Sector report reveals a significant increase in the economic contribution of the adult social care sector, rising to £68.1 billion in 2023-2024 – an impressive £8.1 billion more than the previous year. This contribution highlights the sector’s critical role in driving broader economic growth, creating jobs, and supporting local economies across the country. The report makes it clear that social care is not just a public service but a cornerstone of the UK economy, with a multiplier effect that extends far beyond the sector itself.

Yet, this economic potential remains underutilised. With appropriate government investment, social care could not only address its workforce shortages but also contribute to long-term savings in other parts of the public sector, particularly the NHS. The lack of investment risks eroding this crucial economic contribution, as the sector’s ability to grow and thrive is stifled by chronic underfunding and workforce instability.

Professor Green added:

“The £68.1 billion contribution is not just a statistic – it’s a testament to the immense value that adult social care brings to the entire country. Every pound invested in social care multiplies, creating benefits not just within the sector, but across multiple industries. If the government fails to recognise this and continues to underfund social care, we risk jeopardising this critical economic contribution. The Treasury should see this as an opportunity; investing in social care is investing in the stability and growth of the UK economy, particularly at a time when every economic lever needs to be pulled.”

A Call for Urgent Government Action

In response to these findings, Care England is urging the government to act swiftly and decisively to provide immediate support for the adult social care workforce:

• Reevaluate immigration policies that restrict overseas care workers from bringing dependents, to support international recruitment, address workforce shortages and ensure parity with NHS staff who are permitted to bring dependents.
• Provide funding to align pay, working conditions, and recruitment benefits of social care workers with those of NHS staff to ensure fairness across the health and care sectors.
• Recognise the sector’s growing billion economic contribution, and increase investment to help social care grow, create jobs, and reduce long-term public sector costs, particularly in the NHS.
• Consolidate intended reforms for adult social care within a fully funded, long-term workforce plan

The need for urgent action is further underscored by the pressures facing the NHS. Delays in social care directly contribute to NHS bed shortages and hospital discharge backlogs. By addressing the social care workforce crisis, the government can also alleviate pressure on the health system, reduce costs, and improve outcomes for both patients and care recipients, as identified by the Secretary of State for Health and Social Care, and the Lord Darzi Report.

Professor Green concluded:

“We cannot overstate the urgency of the situation. Adult social care is not a sector that can afford to be pushed to the margins of policy. The government must prioritise the sustainability of the workforce as part of its broader economic and public health agenda. Without this, the consequences will be dire; not just for social care, but for the NHS and the entire economy. How many more reports, warnings, and crises will it take for them to act? We are not just asking for support; we are demanding it – because without it, the system will fail, and the repercussions will be catastrophic.”