Discover Skills for Care's policy position on the systemic challenges facing adult social care. Understand the current challenges and the transformation required to deliver the model of care we'll need in the future.
Adult social care is vital for people, for communities and for the economy. It enables people to live well, in a place they can call home - and it contributed £68.1 billion to England’s economy in 2023/24.
The sector’s workforce challenges are well-documented – including recruitment and retention, low pay and skills shortages. However, these all stem from several wider, systemic challenges that it’s important to recognise.
There’s a lack of public understanding and status. Despite the sector’s contribution during the pandemic and in our communities every day, social care doesn’t have the same kind of status as the NHS in the nation’s hearts and minds. Research carried out before the pandemic found that many people incorrectly believe that social care is free at the point of need. It’s often wrongly seen as unskilled, ‘women’s work’.
These issues have contributed to it being less of a political priority. They also mean that 54% of people working in care say they don’t feel properly valued, making social care less attractive as a career.
We believe that we need to talk more positively about social care, its value and the people who work in it. If it’s done in the right way, the creation of a National Care Service has the potential to raise the status of the sector, helping people understand what social care is and why it matters.
Sources of funding are fragmented. Funding flows to the sector from a range of different sources. Sources of public funding include local authorities, the Better Care Fund and Continuing Healthcare funding – and many people fund their own care. This creates a complex system that can be difficult for individuals, local authorities and care providers to navigate. Reliance on targeted grants reduces the scope for flexibility to deliver care to meet local needs and priorities.
We believe that the flow of public funding into adult social care should be reviewed and simplified.
The levers for change are dispersed. Several bodies hold the keys to bringing about change in adult social care: national government; local government; Integrated Care Systems; care providers; the Care Quality Commission and workforce support bodies like Skills for Care. Unless these bodies – whose responsibilities sometimes overlap - are aligned, it’s difficult to bring about meaningful reform of the workforce.
We believe we need a transformation plan for social care. If the levers continue to be dispersed, the best way to align them from a workforce perspective is through a Workforce Strategy – reinforced by a legislative mandate for workforce planning and a central body with a mandate to lead this. The Workforce Strategy should accompany a transformation plan to ensure the workforce can deliver the models of care we’ll need in the future.
The sector is large, complex and fragmented. Care is currently provided by 18,500 separate employers – 37% of them employing just 1-5 people – and 123,000 individually-employed personal assistants. It’s commissioned by 153 local authorities, with strategic planning by 42 Integrated Care Systems. The connections between these are often complex.
This means a lack of consistency when it comes to things like models of care, funding, innovation and pay, terms and conditions – and challenges with nationwide communication, workforce planning and data collection. Success exists in pockets and it’s difficult to scale it more widely.
We believe that, if the sector continues to be structured like this, it needs a central body, working with partners and decision-makers, to carry out workforce planning and development as effectively and consistently as possible – and to identify and scale innovation and successful ways of working.