A new report launched by the independent national charity, Community Integrated Care, exposes a persistent pay gap between social care support workers and their NHS counterparts. The charity is calling on the Government to take immediate action by uplifting care worker wages, arguing that fair pay is not only affordable, but a crucial investment in economic growth and the long-term sustainability of the NHS.
‘A Caring Economy – Unfair To Care 2025’ is the fourth edition of Community Integrated Care’s acclaimed Unfair To Care report series i. It uniquely compares the pay of social care support workers to their NHS equivalents paid under Band 3 of the NHS Agenda for Change framework.
Using exclusive measurement by global leaders in job evaluation, Korn Ferry, the charity has determined that the role of a social care support worker is a skilled, accountable and complex one, revealing that the average care worker, currently earning £12.00 per hour ii, would take home £7,120 a year more doing a comparable sized role in the NHS iii.
The charity says that the consequences of this pay disparity are severe, including high turnover rates of 26.5%, equivalent to 285,000 leavers a year, combined with vacancy rates of 9.4% or 112,000 roles iv.
These challenges create a cascade of far-reaching and negative impacts across society reducing quality of life for people who access or work in care, undermining the viability of care providers and the efficiency of the NHS, and constraining economic growth.
Recent unfunded increases to employer National Insurance Contributions and the National Living Wage, totalling around £2.8 billion v, have further exacerbated the problem, creating financial strain on care providers, with many having to make difficult choices to hand back contracts to local authorities, or in some cases, leave the care market entirely.
THE COST OF ACTION – AND INACTION
The release of this report comes at a critical moment as the Government reviews national social care policy, including proposals for a Fair Pay Agreement for care workers – acknowledging the urgent need for improved wages and the impact of low pay on the NHS. However, with the agreement not expected until 2027, at the earliest, Community Integrated Care warns that delaying action will only deepen the crisis; they claim that it will exacerbate workforce instability, continue to disrupt the lives of millions who depend on and deliver social care, and fatally undermine one of the Government’s three big shifts: moving care from hospitals to the community.
The charity argues that immediate action is needed and that increasing social care pay is both achievable and essential. Their estimates show that a 50p per hour uplift for the 1.29 million frontline care workers in England vi, would cost just £723 million per year (net) – a small proportion of the annual £32 billion in public spending on adult social care vii, and a fraction of the recent £25.7 billion NHS funding boost in the Autumn 2024 Budget. In return, fair pay would reduce costly staff turnover, improve retention, and enhance care quality – benefiting the entire health and social care system.
Previous reports have shown that providing parity of pay between social care workers and their NHS equivalents creates a ‘Social Care Triple Care Win’, improving economic growth, as lower paid workers reinvest additional wages in the local economy, increasing NHS capacity and efficiency, and transforming the lives of people who work in and draw on social care.
Teresa Exelby is the Chief Corporate Services & People Officer at Community Integrated Care, which employs over 6000 colleagues and delivers 10 million hours of publicly-funded support to 2500 adults with learning disabilities, autism, mental health conditions and complex needs.
She said: – “Once again, this year’s figures highlight the persistent undervaluing of one of society’s most vital workforces. Social care support workers are highly skilled, accountable, and emotionally resilient, delivering transformational care and support every day.
While steps toward a fairer pay framework are welcome, we cannot wait for 2027 for that to happen. That’s why we are urgently calling on the Government to fund an immediate interim pay uplift – not just because it’s the right thing to do for those working in and accessing social care, but because of the benefits it brings for wider society and the economy too.
Within our charity we’ve seen the transformational impact of raising pay and investing in carers achieving an 80% retention rate, which is above the sector average. This stability enables us to reinvest, expand our impact, and support our teams to deliver high-quality care, but sustained progress requires proper funding. With the right investment, social care can thrive – offering sustainable, rewarding careers, empowering people to live their best lives, and driving economic growth and productivity.”
Phil Hope, former Minister of State for Social Care and co-author of the report, said: –
“A ‘Caring Economy’ is a two-way street – a strong economy funds the delivery of care and support, and the social care sector, in turn, drives economic growth and enhances NHS productivity.
The sector is vast and expanding, contributing an estimated £62.1 billion to gross value added in England. Yet, despite its undeniable impact, improved care worker pay remains a contentious issue, often deemed unaffordable. This report not only challenges that perception but also highlights the substantial economic returns it can offer – reducing welfare spending, creating employment opportunities, and stimulating spending in low-income communities.
In reality, the cost of increasing care worker pay could be far lower than assumed. Better wages lead to a more stable workforce, lower recruitment costs, and greater investment in training and innovation.
It’s time to recognise social care spending as an investment in our economy and society – not just an expense.”
Vic Rayner contributed a foreword to the report in which she says:
“Reflecting back to this time last year as the 2024 Unfair to Care report was published, it felt there was an air of cautious optimism that a potential change of government might expedite the improvement of pay, terms and conditions for our 1.59 million care workers. Sadly, this year’s report, to which we contributed pay benchmarking from the not-for-profit sector, reveals we are far from closing the gap between social care support workers and their equivalents in the NHS. Social care workers are earning 30.3% less than their Band 3 NHS counterparts (this calculation does not include other enhanced terms received by NHS workers in comparison to social care workers). Meanwhile measures affecting Employers National Insurance Contributions in last year’s Autumn Budget have put providers under further financial pressures which ultimately threatens care worker jobs. Also, if increases to the National Living Wage, which are welcomed by employers, remain unfunded these financial pressures will continue along with the recruitment and retention challenges care providers have long grappled with.
Combined voices in the sector, NCF’s and our members’ included, have drawn the new government’s attention to the once in a lifetime opportunity the parliamentary majority they achieved in the 2024 General Election represents. If the government begins to see the funding of social care as an investment rather than a cost, huge potential for economic growth could be unlocked. Properly funding a sustainable social care infrastructure will also support the ambitions set out in the government’s three ‘big shifts’ – moving from hospital to community, from analogue to digital and from sickness to prevention.
A fully funded Fair Pay Agreement for care workers that addresses the thrust of this report may be a long way off. Therefore, if we are to retain these dedicated, skilled professionals who provide vital, life-changing care and support to so many people, action is needed now to improve pay.
We support the call for immediate actions to improve care worker pay detailed in this report. Additionally, we urge government to adopt the Adult Social Care Workforce Strategy which will enable the creation of long-term robust plans to support future workforce requirements while developing career pathways and qualifications for this dedicated and capable workforce.“
References: –
i www.unfairtocare.co.uk
ii Figures used are average rates for Support Worker roles in England (outside of London) and are taken from the National Care Forum’s
national pay benchmarking exercise for the not-for-profit sector, October 2024
iii NHS Agenda For Change Pay Scale for 2024/2025 Band 3 roles
iv Figures used refer to ‘direct care’ filled roles and are taken from ‘The state of the adult social care sector and workforce in England’, Skills
for Care, October 2024
v Social care providers at risk of collapse as analysis reveals cost to sector of employer national insurance hike | Nuffield Trust
vi The number of ‘direct care’ filled posts as referenced in ‘The state of the adult social care sector and workforce in England’, Skills for
Care, October 2024 – working an average 27-hour week, and including employer on-costs.
vii Social Care 360: Expenditure | The King’s Fund
