The UK’s adult social care sector is teetering on the brink of collapse, according to the latest Sector Pulse Check Report by leading learning disability charity Hft and Care England, the foremost voice advocating for adult social care in England.
Whilst the Government’s announcement on 3 January of a new adult social care commission headed up by Baroness Louise Casey has been welcomed by the two organisations, the survey findings in the report reveal a sector that cannot wait until 2028. Hft and Care England are calling on the Government to take urgent action to prevent dire consequences for those who draw on care and support, providers and their staff, with two key policy asks:
Firstly, to commit to a credible, multi-year funding settlement for adult social care in the 2025 Spending Review, to financially support providers who have suffered years of underfunding, and ensure future funding accounts for wage increases, inflation, and National Insurance contributions.
Secondly, a fully funded plan to support the workforce and bring care workers’ pay and conditions in line with their NHS counterparts, arguing that status and respect are just as crucial as wages to make care work an attractive career for the next generation.
In support of these two key recommendations, Hft and Care England believe the Government should look for cross party support to deliver a number of urgent measures, including:
- Fully fund the increase in Employer National Insurance contributions, or exempt care providers entirely
- Removing the ban on dependents for international social care staff
- Enforce fee uplift announcement from the start of each new financial year, and mandatory payment timelines for local authority and Integrated Care Board payments, with penalties for delays*
The two leading organisations believe that the new commission does not need to spend months looking at what the issues are – it should work directly with the sector and use data such as the robust, multi-year Sector Pulse Check, Dilnot Commission findings and recommendations from the Darzi report to be able to identify and focus quickly on the actions to be taken.
Based on responses from more than 200 small, medium and large adult social care providers – collectively responsible for supporting over 128,000 people – the annual Sector Pulse Check report gives an overview of the current state of the social care sector and presents the case for urgent change.
90% of providers cited rising workforce costs as one of their top three cost-pressures, with 95% reporting that increases in the National Living Wage are their deepest concern. This is due to the shortfalls in fee increases from local authorities to cover these costs – reported by 85% of providers – leaving them to absorb the gap.
Due to the increasing financial pressures:
- Three in ten providers have been forced to close parts of their organisations or hand back contracts to local authorities
- One-third are considering leaving the market altogether, which would leave an estimated 275,000 people without the care they rightly expect and are legally entitled to – set to become more of a reality following the changes to National Insurance contributions in the 2024 Autumn Budget
- 37% have curbed investment into building future capacity for care
Domestic recruitment continues to be a struggle for providers, with 85% of providers reporting that the biggest barrier to recruitment is pay rates. To improve recruitment and retention, providers highlighted that conditions and benefits aligned to the NHS would make the biggest difference to people entering the sector.
International recruitment was the most frequently reported method for filling vacancies, with 40% employing this strategy. Unfortunately, changes to the UK’s immigration rules has led to a severing of this lifeline, as providers reported a significant drop in international applications.
Steve Veevers, chief executive of Hft, says:
“The Government’s recognition of the urgent challenges facing adult social care is a welcome step forward and we look forward to working with Baroness Casey’s commission. However, the sector can ill afford a lengthy process to identify the solutions. The evidence is already clear. This year’s Sector Pulse Check is the next critical step for outlining clear, actionable solutions. It provides a detailed, up-to-date picture of the sector’s pressures and highlights urgent priorities such as workforce shortages, funding instability, and improved support for care workers.
“While the announced reforms show promise in improving coordination between health and social care, immediate action is crucial to stabilise the sector and ease the growing strain on care providers and the NHS.
“We urge the government to consult with Hft and other providers who have done the research and are ready to collaborate on practical, immediate measures. The Sector Pulse Check provides the roadmap—now we need action to ensure the care sector’s future through decisive steps, not deferred promises.”
Professor Martin Green OBE, chief executive of Care England, said:
“Providers face impossible choices: absorbing unsustainable costs, changing their care models, cutting back on services, or shutting their doors entirely. This isn’t just a warning, it’s a crisis unfolding in real time. Years of unrelenting financial strain and a workforce stretched to breaking point have left social care hanging by a thread. Without immediate intervention, the consequences will be devastating for those who rely on care every single day.
“Carers deserve a workforce strategy that serves as a testament to their unwavering dedication – a blueprint for meaningful change that ensures they’re properly paid, given real opportunities for development, and recognised for their vital contribution to society. This requires not just funding but a cross-party commitment to implement transformative, long-term solutions for the sector.
“The Government talks of delivering ‘an NHS fit for the future,’ but let’s be clear: you cannot fix the NHS without fixing social care. We are ready to work alongside Baroness Casey and the Government to turn this commission into a catalyst for genuine change. But let’s be clear: the status quo is no longer an option. Every delay, every failure to act, pushes more care providers out of the sector and leaves more people without the support they need.”
The full report will be available to read on Hft’s website from Tues 14 January here https://www.hft.org.uk
