Source: The Conversation – UK
For three decades, successive governments have attempted (and failed) to reform the social care system. Most debates have focused on finances: who should pay for social care and how much should each person be expected to contribute? These are of course important questions – but if we’re serious about fixing the adult social care system, we must also focus on who will deliver it.
In his recent speech on social care reform, prime minister Andy Burnham put the social care workforce front and centre – emphasising the need to improve pay, training and career progression. He also argued that care workers should be valued for their work.
The point that Burnham makes here is crucial if his party wants to deliver on their proposal to develop a national care service. Social care is not just a funding challenge – it’s a workforce challenge, too.
Previous consultations and select committee reports have shown that people drawing on care and support want to live “gloriously ordinary lives”. They want to maintain relationships, participate in their communities and access support tailored to their needs and preferences. This demands skilled and compassionate care staff who are able to build trusting connections with people.
Currently, most care is delivered by unpaid family or friend carers – around a quarter of whom live in poverty. Analysis by the Centre for Care found that the value of this “free labour” is equivalent to the budget of a second NHS – and four times the budget for publicly-funded social care.
With around 520,000 working-age adults out of work due to caring responsibilities, the economic case for supporting them back into employment is clear. But reducing reliance on unpaid care will require a larger, more stable workforce.
Considerable attention has been paid to recruitment and retention challenges in social care. The sector has increasingly relied on an international workforce to meet care demands. But recent changes to immigration rules, which have officially closed international recruitment to social care roles, means the sector can no longer rely on a pipeline of overseas workers.
There is now an urgent need to attract and retain a domestic workforce.
Like unpaid care, social care in England relies heavily on a mostly female and ageing workforce. This raises important questions about how we can diversify a future social care workforce.
Research funded by the National Institute for Health and Care Research (NIHR) is currently exploring how employers can better attract and retain groups under-represented in care work, including younger people and men.
There is also growing interest in developing routes into employment for people who are unemployed or economically inactive as a way of increasing workforce supply and creating a more inclusive labour market.
But recruitment is only part of the solution. The real challenge is creating jobs that people want to stay in.
Social care workers are supporting people with increasingly complex health needs. Recent research has found that three in five care workers are routinely undertaking healthcare tasks that would have previously been completed by registered health professionals. This includes administering medication, pressure ulcer care, blood sugar monitoring and post-operative physio recovery.
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Despite this, most continue to experience low pay, limited opportunities for progression and a lack of professional recognition – all of which affects their wellbeing.
Reforms such as the Employment Rights Act and the planned Fair Pay Agreement for adult social care may improve pay, job security and employment conditions for care workers, but they’re unlikely on their own to resolve the workforce crisis.
Findings from a national survey of the social care workforce, which collected data in 2023 and 2025, highlighted persistent concerns around workforce wellbeing.
A quarter of respondents planned to leave their employer as soon as they found another job. Across both waves of data collection the top three reasons for wanting to leave remained the same: the impact of the job on the person’s health and wellbeing, low pay and lack of recognition for the adult social care sector. Respondents with particularly low work-related quality of life scores, were substantially more likely to want to leave.
Our ongoing work, which is interviewing social care workers who have left the sector, is exploring both why people left and what could have been done to encourage them to say. Improving pay may help attract staff, but retaining them will depend on creating working environments that support both care workers and the people they care for.
Addressing these challenges requires a strong evidence-base, which is something our ongoing research is aiming to do. We are working in partnership with local authorities, care providers and people who use care to collect data that will help underpin workforce reforms.
The prime minister has called for a cross-party consensus on social care reform. But if the workforce is genuinely at the heart of reform, a cross-departmental approach is also needed. This is because the factors shaping recruitment and retention extend well beyond social care policy.
Efforts to reduce economic inactivity, support more people into work, improve youth employment rates and expand vocational routes could all help encourage more people to see social care as a rewarding, long-term career. Decisions about migration policy also need to consider the implications for workforce supply.
For decades, social care reform has focused on funding. Burnham is right to place equal emphasis on the workforce. Without it, a national care service will remain an ambition, not a reality.
Ann-Marie Towers receives funding from the National Institute for Health and Care Research (NIHR) and the Department of Health and Social Care. Funding specifically mentioned in this article includes the NIHR Health and Social Care Delivery Research Programme (HSDR) (NIHR159860) and the NIHR Policy Research Programme (NIHR206121). It also refers to the adult social care (ASC) workforce survey undertaken by Ipsos in partnership with Skills for Care, University of Kent and King’s College London, on behalf of the Department of Health and Social Care (DHSC). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Karen Spilsbury receives funding from the National Institute for Health and Care Research (NIHR), is Director for Leeds membership of NIHR School for Social Care Research and is a NIHR Senior Investigator. She is affiliated with Nurturing Innovation in Care Home Excellence in Leeds (NICHE-Leeds), a care and science partnership working to enhance quality of life, care and work in care homes. Funding specifically mentioned in this article includes the NIHR Health and Social Care Delivery Research Programme (HSDR) (NIHR159860) and NIHR Research Programme for Social Care (NIHR205721).The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Original source: https://analysis1.mil-osi.com/2026/07/31/why-andy-burnham-is-right-to-put-the-workforce-at-the-heart-of-social-care-reform/