Sector Pulse Check 2024

The findings in the 2024 Sector Pulse Check report illustrate how the adult social care sector is on a precipice. Download the full report below.

• 2024 Sector Pulse Check full report
• 2024 Sector Pulse Check (Easy Read)
• 2024 Sector Pulse Check (Executive Summary)
• Read our press release here

Sector Pulse Check Findings

Key cost pressures

Our research highlights how the current approach to adult social care funding simply isn’t working; the sector remains in a sustained crisis. In 2024, the top financial pressures were workforce-related costs sitting at 90.9%, utilities at 38.8%, unpaid delayed bills by Local Authorities at 29.1%, and maintenance costs increasing to 25.5% from 15.6% in 2023. Our evidence says that the best way to fix these problems would be higher pay (84%), terms, conditions and benefits aligned to the NHS (65%) and greater respect for the profession (34%) would make the biggest difference.

Impact of cost pressures

With 29% of providers considering exiting the market for the third year running due to various factor including energy prices, 75% said energy costs had increased in the last year. Smaller organisations were impacted most, a large total of 80% of smaller providers recorded a rise in energy prices. With increases in National living wage, agency workers and costs for permanent recruitment these have mounted up and created financial impacts on providers in the sector.

Funding Intervention

85% of Local Authority fee increases didn’t cover the costs of a higher National Living Wage – up from 78.5% last year. 29% of providers are operating at a deficit – 60% of those providers’ deficits have increased in the last year. Seven in ten providers with decreasing surpluses will be operating at a deficit within three years, leading to greater weaknesses in already thinly stretched services.

Workforce challenges

Financial pressures were compounded by workforce challenges in 2024. The domestic workforce is still not stepping forward to fill vacancies with 33% reporting a decrease in applications, and 34% reporting no change in the number of domestic applications in the last 12 months. The percentage of providers reporting an increase in domestic applications has fallen since last year, from 43% to 31%. 57.8% of providers report that the challenging nature of the work is affecting recruitment. Other top issues include pay rates (85.7%), poor perceptions of a career (61%), and better opportunities in other sectors (47.4%), all leading to greater problems in acquisition and retention.

Next steps for adult social care

While the report illustrates many challenges, we are filled with hope for a better future – the adult social care sector is brimming with talent, ambition and enthusiasm. The report therefore sets out pragmatic recommendations to relieve key workforce and financial pressures in the immediate term. These include:

• Fully fund the new increase in Employer National Insurance Contributions
• Enforce mandatory payment timelines for Local Authority and Integrated Care Board (ICB) payments
• Implement a Workforce Strategy and Longterm Funding Settlement

We also recognise that in the longer term, our sector needs root and branch reform and we must continue to push for this to ensure adult social care can deliver at its best. In light of this, our report sets out ambitions which we know will take additional time, political capital and finances, including the establishment of a long-term funding settlement and the publication of a long-term workforce plan for adult social care.

Post-Pulse Issues

In order to keep the findings of the report alive, Care England is releasing a series of Post-Pulse articles further exploring in-depth the issues raised in Sector Pulse Check. These instalments will ultimately highlight the significant, lasting impact of the report’s findings on the sector, with issues including care home closures, delayed discharges, efficiency savings, and international recruitment being examined in its own right, alongside corresponding suggestions for reform. By examining these topics separately, we also further emphasise their interconnectedness, underscoring the urgent need for systemic change.

If you have any questions or queries regarding the Sector Pulse Check 2024 report, please contact policy@careengland.org.uk