Social care ‘urgently’ needs to be on an equal footing with health service, NHS leaders say

NHS leaders are calling for social care to be ‘urgently’ put on an equal footing with the health service following the publication of the latest Skills for Care ‘State of Adult Social Care Sector and Workforce’ report.

The report found that longstanding issues with pay, working conditions and access to training have made it harder to recruit and retain staff, contributing to workforce shortages across the sector.

Key findings from the 2025/26 report show the workforce has seen its slowest growth in four years. The number of vacant posts is now 96,000, down 10.5% from last year; the turnover rate in local authority and independent sectors has fallen by 1.1%; and 1.59M posts were filled, up 1.4%.

This year’s report finds that young people are underrepresented in the workforce: under-25s make up 7%, compared with 12% of the economically active population, while 59% of the adult social care workforce are over 40. This reflects the experience within the current workforce and highlights the importance of planning for future workforce changes.

Social care and its contribution to health

Statistics in this year’s report, for the first time, highlight the important role social care plays in the wider health and care system. Delegated healthcare activities—those a regulated healthcare professional assigns to a colleague in a non-regulated role—are a significant part of care delivery. Non-nursing staff carry out these activities in 59% of responding Care Quality Commission (CQC) regulated services, and an estimated 46% of direct care workers undertake them.

The findings highlight the increasingly important contribution social care makes to health and care delivery and reinforce the importance of including social care in neighbourhood health models, clinical capacity planning, workforce planning and funding decisions.

Chief executive of the NHS Alliance, Sir Ciarán Devane, said: “A fragmented social care system is a problem in itself, and because of the knock-on impact it has on the NHS. Social care must now urgently be put on an equal footing with the health service, so people get the support they need to keep them out of hospital and in their homes.

“As the government makes plans to create a better funded, universal national care service, it must make sure that social care is a great place to work, so it can attract and retain the staff the sector needs.”

Ageing population and impact on National Care Service

The report has raised questions about the scale of the challenge the Prime Minister will face in realising his ambition for a National Care Service, and about the need for a strong, supported workforce as one of the cornerstones of the reforms.

The King’s Fund said that with the closure of overseas recruitment for social care workers, social care faces a serious challenge if recruitment of British nationals does not rise to compensate. In addition, these issues will likely be further exacerbated by our ageing population. The report states that the population aged 65 and over is expected to grow by 24% to 14.1 million by 2040. It adds that increasing the workforce at the same rate would require an additional 410,000 care workers over the next 14 years.

Sarah Woolnough, Chief Executive of The King’s Fund, said: “This should bring into sharp focus the urgent need for improvements in recruitment and retention, particularly for younger workers since 18–24-year-olds make up only 7% of the social care workforce.

“Career development also matters. The Prime Minister has spoken passionately about the need to end ‘poverty pay’ for care workers but to attract long term retention, including of younger workers, alongside the Fair Pay Agreement needs to be the provision of viable, long-term career paths. There also needs to be consideration given to how to best use technology and changes in service patterns to most effectively use the care workers that the sector is able to recruit.

“Andy Burnham and the government will need to look at all these options, alongside how a future system may operate to facilitate this including our proposals, if a National Care Service will be able to stand the test of our ageing population.”

Alison Bloomer

Alison Bloomer is Editor of Pavilion Health Today. She has over 25 years of experience writing for medical journals and trade publications. Subjects include healthcare, pharmaceuticals, disability, insurance, stock market and emerging technologies.

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