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Poor pay and lack of staff threaten the future of adult social care – report

The Health Foundation is calling for an urgent shake-up in funding

The Health Foundation is calling for an urgent shake-up in funding


Picture: Charles Milligan

Almost a third of nurses in adult social care quit in the past year.

Poor pay and conditions are a major threat to care quality and the very future of the sector, analysis of adult social care in England suggests.

The Health Foundation found a turnover rate of 32.4%, with vacancies running at more than 110,000.

Funding reform

The independent charity predicts a funding gap of £4.4 billion by 2023-24 amid rising demand for social care, and staff shortages.

Local authorities in England spent a third less per person than those in Scotland and Wales in 2010-11, and this gap is widening.

Health Foundation director of economics and research Anita Charlesworth said adult social care is 'one of the victims of the current political impasse', and is calling for urgent funding reform.

Impact on vulnerable people and families 

According to the charity's report:

  • Government spending on adult social care in England was £310 per person in 2016-17, down from £345 in 2010-11.
  • This was 32% less than Scotland, which spent £457 per person in 2010-11 and £445 in 2016-17.
  • It was 9% less than Wales, which spent £445 in 2010-11 and £414 in 2016-17.

'Tackling social care reform will require decisive political action and an appropriate funding settlement,' Ms Charlesworth said.

'Successive governments have ducked the challenge and the tragedy is vulnerable people and their families are suffering as a result.'

‘We have plans for the system’

A Department of Health and Social Care spokesperson said there is a national recruitment campaign for the sector, which employs 40,000 nurses in England.

The spokesperson said local authorities had been given £3.9 billion extra funding for adult social care this year.

'We will set out our plans to reform the social care system at the earliest opportunity to ensure it is sustainable,' the spokesperson added.


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