The new government must immediately address the problem of low pay in adult social care by tackling illegal underpayment of wages, and urgently consulting the sector on a separate minimum wage and a national pay scale, two leading think tanks have said.
A new report by the Nuffield Trust and the Health Foundation examines five national policy options to increase wages for social care workers in England: better minimum wage enforcement, increasing the National Living Wage, bonuses for social care staff, a sector-specific minimum wage, and a national pay scale similar to the NHS's Agenda for Change. The study comes as the Labour government has pledged to consult with the sector on introducing a fair pay agreement to set pay, terms and conditions in social care.
The report reveals how an inadequate national policy approach to social care pay and funding has trapped staff in a cycle of low wages and poor career prospects. Care workers in the independent sector earn on average £4.88 per hour less than the average UK wage of £15.88 per hour, and 1 in 10 social care roles is currently vacant. Care workers with significant experience are insufficiently rewarded, being paid only 8 pence more per hour than new starters.
Despite this, there have been no national policy attempts to improve pay in the sector in England, beyond increases to economy-wide minimum wages. Underfunding and problems regulating the sector mean that around 15% of low-paid social care staff in the UK are paid less than the national living wage.
Despite a 24% real-terms increase in the sector’s total wage bill from 2013/14 to 2022/23, driven largely by rising demand for care and increases to the national living wage, government spending on social care only increased by 17%. The previous government’s approach to leave wage setting to commissioners and employers in local areas has left the sector with entrenched low pay, leading the authors to conclude that a more comprehensive national approach, underpinned by extra funding and stronger enforcement, is needed.
The research draws on discussions with care workers, people receiving care, policymakers, and providers, and examines case studies from New Zealand, Australia, France, Scotland and Wales. It also publishes the results of an Ipsos poll of almost 2,000 people in England, revealing that:
- 77% of the public believe care workers are underpaid.
- 89% of the public back stronger national minimum wage enforcement.
- 85% support implementing a pay scale in social care.
- 77% endorse a sector-specific minimum pay rate in social care
Commenting on the report, Nina Hemmings, Researcher at the Nuffield Trust said:
“For too long, care workers have been undervalued and underpaid. A shockingly high number are still not even paid the legal bare minimum to travel to and care for the hundreds of thousands of people in need of social care. Social care is losing valuable staff to other sectors like retail and hospitality.
“The new government is right to develop proposals to address this and their suggested national approach is more likely to succeed than one that pushes the problem onto employers. Other countries have introduced bold pay reform for care workers. But the new government will need to pay careful attention to the design and implementation of any new policies to ensure pay reaches workers’ pockets and experienced staff are retained.”
Lucinda Allen, Senior Policy Officer at the Health Foundation said:
“There is growing consensus that the government needs to do more to improve wages for people working in social care. To help address the high vacancy rates in the sector and high levels of poverty among staff, care workers must be better rewarded for their vital work. Pay is not a silver bullet; improvements to wider employment conditions are also needed.
“Beyond boosting staff pay and conditions in social care, the new government must enact wide-ranging reforms to improve access to care, better support unpaid carers, and protect people against care costs. Successive governments have broken promises to fix the funding system for social care. Labour’s new government has an opportunity to finally reform social care, improve care worker pay and leave a lasting legacy for the future.”
Notes to editors
- From ambition to reality draws on a combination of methods:
- Discussions with 40 stakeholders from across the social care sector, including care workers, people with lived experience of care, policy-makers, researchers, and people from provider organisations, trade unions, local government and charities;
- Analysis of trends using data from Skills for Care’s Adult Social Care Workforce Data Set and Office for National Statistics data;
- International evidence on implementing pay policies in Australia, France, New Zealand, Northern Ireland, Scotland and Wales.
- An Ipsos poll of a representative sample of the UK public in November 2023. This report draws on the England sample only – responses from 1774 individuals
- Skills for Care has set out cost estimates for pay policies in the Workforce Strategy for Adult Social Care (also published today, Thursday 18 July). According to these estimates, the additional costs to government could be: £30 million per year to enforce the economy-wide national living wage across the social care workforce; £3.6 billion per year for a minimum wage for care workers set £2 above the national living wage; and £4 billion for aligning pay for care workers with two or more years’ experience to NHS pay band 3. The net costs of introducing these options will vary depending on the additional on-costs, returns to the Treasury, and potential productivity gains
About the Nuffield Trust and the Health Foundation
- The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
- The Health Foundation is an independent charitable organisation working to build a healthier UK. www.health.org.uk
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- For further information, please contact the Nuffield Trust press office: press.office@nuffieldtrust.org.uk; or 020 7462 0500.