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Co-published with Friedrich-Ebert-Stiftung.

The UK’s social care system does not provide the care that people need. More than 1.8 million people have unmet care needs, one in four cannot undertake basic tasks such as washing and 8.8 million people, mostly women, provide unpaid care. The key reason why care needs are unmet is a lack of trained care workers.

The care workforce faces three key challenges that must be addressed:

1. Low Pay. Care workers have seen their pay fall relative to other low-pay occupations, leading to a recruitment and retention crisis
2. Poor Conditions. Stressful working conditions as well as insecure work also make it harder to recruit or retain care workers.
3. Lack of training and formal qualifications. There is little recognition of extra experience nor a path to higher pay through training.

Investing in our care workforce will address unmet care needs. It will also have other knock-on economic, environmental and equality benefits. Raising pay and conditions in this low-paid sector will lead to higher wages and employment, especially in more deprived areas. Care jobs are also green jobs, meaning they emit less carbon than other forms of work. As women undertake the majority of paid and unpaid care work, an expanded and better-paid care workforce will also help to reduce gender inequality.

We are calling for the following policies to create a care workforce fit for Britain. These policies should be phased in as part of a realistic roadmap to creating a proper care workforce in the United Kingdom and build upon the proposals in our Universal Quality Care paper.

Short term

1. Increase care pay to the Real Living Wage. This will help to improve recruitment and retention within the sector
2. Expand access to international migration within the existing migration policy. Waiving visa fees would help to raise the number of workers entering on the Health and Care Work visa
3. Registration with nationally assessed standards. This should be examined as part of a new centrally standardised Care Certificate course and be flexible enough to recognise equivalent experience.

Medium term

1. Funding to meet the Care Act eligibility criteria. There are simply too few care workers to meet needs as set out in legislation. Greater pay will lead to more recruitment and retention in the care sector
2. Create a social partnership board with sectoral barganing at its core to negotiate a long-term workforce strategy including training, progression, and conditions. The care workforce should have collective sectoral bargaining to set common standards across the sector in terms of training, progression, pay and conditions.
3. Adopt a social licencing approach to commissioning and procurement. A stronger set of regulations and standards should be used by local authorities when comissioning care.

Long term

1. Expand eligibility criteria to meet moderate needs. Expanding care services to those who meet one of the Care Act’s eligibility outcomes
2. As training improves, put care work on a path to be paid at 75% of nurses’ wages. Pay should rise commensurately with greater training and productivity of the care workforce.

A fully funded care system on this scale would not be cheap – the final package of pay at 75% of nurses’ wages with greater training would cost about £50bn more per year than we currently spend on care. This would be in line with what Nordic countries spend on care. It is, in short, what a properly funded care system actually costs.

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