The UK Social Care System: On the Brink of Collapse

The UK’s adult social care sector is in a precarious position, teetering on the edge of collapse. This stark reality is laid bare by the latest Sector Pulse Check Report from Hft, a leading learning disability charity, and Care England, the principal advocate for adult social care in England.

With rising workforce costs, funding shortfalls, and persistent recruitment challenges, the situation is critical. While the Government’s recent announcement of a new adult social care commission led by Baroness Louise Casey offers a glimmer of hope, urgent action is needed now—2028 will be too late for many.

Financial Strain: A Sector Under Pressure

Rising Costs with Insufficient Support

The report highlights the profound financial strain on care providers. Ninety percent of providers identified workforce costs as one of their top three challenges, with 95% stating that increases in the National Living Wage are their deepest concern. Compounding this, 85% of providers reported that local authority fee increases are insufficient to cover rising costs, leaving them to bridge the gap.

For individuals employing Personal Care Assistants (PAs) through government care funding, this has dire implications. The combination of wage increases, National Insurance contributions, and the expectation to absorb additional statutory sick pay from day one of illness is stretching limited budgets to breaking point.

A Sector at Risk: The Human Cost

The financial pressures are not just figures on a balance sheet—they represent lives disrupted and care systems failing to deliver:

• One-third of providers are contemplating exiting the market altogether, potentially leaving 275,000 individuals without vital care and support.

• Three in ten providers have already shut down parts of their operations or handed back contracts to local authorities.

• 37% have curtailed investment in future capacity, jeopardizing the sector’s ability to meet growing demand.

Recruitment Challenges: A Workforce Stretched Thin

The workforce crisis remains a critical issue. The inability to offer competitive pay continues to hinder domestic recruitment, with 85% of providers identifying low pay as the greatest barrier. International recruitment—a vital strategy for many—has been significantly impacted by changes to immigration rules, further exacerbating the shortage.

Without a workforce strategy that addresses pay, conditions, and career opportunities, the sector risks losing even more talent, leaving those who rely on care without the support they need.

Two Urgent Calls to Action

To prevent the collapse of the social care system, Hft and Care England are calling on the Government to:

1. Commit to a multi-year funding settlement in the 2025 Spending Review, ensuring that future funding accounts for wage increases, inflation, and National Insurance contributions.

2. Develop a fully funded workforce plan that aligns care workers’ pay and conditions with their NHS counterparts, ensuring care work is an attractive and sustainable career option.

Additionally, cross-party support is essential to deliver measures such as:

• Fully funding increases in Employers’ National Insurance contributions.

• Removing the ban on dependents for international care staff.

• Enforcing timely fee uplifts and mandatory payment timelines for local authority funding.

The Need for Immediate Action

Hft and Care England emphasize that the challenges in adult social care are well-documented. Robust data, such as the Sector Pulse Check, Dilnot Commission findings, and recommendations from the Darzi report, provide a clear roadmap for reform. The new commission must act decisively, consulting directly with providers to implement practical solutions without delay.

A Shared Responsibility

As Professor Martin Green of Care England aptly states:
"You cannot fix the NHS without fixing social care."

The Government’s vision for a sustainable NHS must include stabilizing the social care sector. For every day of inaction, more providers face closure, and more individuals are left without the care they need.

At PAPool, we see first-hand the vital role that Personal Care Assistants play in enabling independence and dignity. It’s imperative that we continue to advocate for a social care system that supports everyone—providers, care workers, and the individuals who rely on them.

The time for promises has passed. It’s time for action.