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We launch #UnfairToCare 2022-23 report

Community Integrated Care has today (19th December) launched Unfair To Care – 2022-23 – a ground-breaking report, delving into the roots of the social care workforce crisis.  

Last year, we partnered with the world’s leading experts in job evaluation – Korn Ferry – to conduct an independent assessment of the role of a frontline Support Worker, objectively assessing its true value across sectors. Our findings were published in our first Unfair To Care report in July 2021, providing a first of its kind, in-depth analysis. Our research debunked the myth of social care as a “low skilled” profession and found that many frontline social care workers are undervalued by as much as 39% – nearly £7,000 per year – in comparison to their peers in equivalent positions in other public funded sectors.

This year, we revisit the data and find painfully slow progress has been made. With social care vacancies rising by an unprecedented 52% this year, ‘Unfair To Care – 2022-23’, has revealed the roots of this crisis. Demonstrating that social care workers are undervalued by more than £8,000 compared to their exact equivalents in the NHS and that at current rates it will take more than 23 years to arrive at equal pay, the report warns that without urgent action, this crisis is set to escalate for more than a generation.

Providing a detailed look at the reverberations that low pay and the recruitment crisis creates on care workers, people who draw on social care and society at large, alongside exclusive polling on public views of parity between health and social care, it offers an essential analysis of one of the biggest crises facing the UK today. The full report can be found at

The 2022-23 edition of Unfair To Care startlingly reveals that social care workers would need a 41% pay rise – equalling £8,036 – to have parity with their direct equivalents within the NHS – Band 3 Healthcare Assistants. It demonstrates that modern frontline social care requires complex technical and emotional skills, to effectively support people who commonly have complex medical and behavioural needs, proving that social care is significantly undervalued.

With the cost-of-living crisis meaning that many people are no longer able to accept a job that is vocationally rewarding for significantly less pay than they could immediately command elsewhere, the sector is facing an unprecedented talent drain resulting in 165,000 vacancies on any given day.

The average Support Worker in England receives a salary of £10.01 (outside of London) – 89p per hour below the Real Living Wage, the rate that is independently defined as the minimum for a reasonable quality of life. Totalling at an annual salary of £19,573, Support Worker pay falls well short of the NHS Band 3 average take home ‘Total Pay’ of £27,609.

A Generation Until Change

The report shows that by projecting forward social care pay-trends since the incumbent Government was elected in 2019, it will take an astonishing twenty-three years for equal roles in the NHS and social care to arrive at equal pay. Despite the first edition of Unfair To Care in 2021 highlighting a then £7,444 pay gap with the NHS and an escalating attrition rate, the Government has failed to respond to issues of workforce renumeration and strategy.

Unfair To Care highlights that social care pay has tracked above the percentage increases in minimum wage rises for the first time in four years, increasing by 8.2% compared to the National Living Wage increase of 6.6%. However, the reality is that these pay rises are being funded by organisational reserves, meaning care providers are facing greater peril than ever. Analysis indicates that providers are utilising their limited financial reserves to fund these rises in a desperate bid to reduce their attrition rates as people seek more viable employment in other sectors.

Social care providers are, largely, dependent upon funding from local authorities who are at financial breaking point and have limited scope to support pay increases. A recent sector report cites evidence that 80% of providers believe that their income will not fully cover wages, with further research from the CQC Market Oversight Scheme stating that many care provider CEOs predict an acceleration of unviable local authority contracts being cancelled. With these relatively small pay rises neither being sustainable nor achieving a competitive market rate of pay that stems the exodus of care workers, providers are putting sticking plasters on gaping wounds.

Public Support For The Sector

Despite the lack of government action, Unfair To Care finds significant public concern around this growing recruitment crisis in social care. In a new Ipsos survey, commissioned by Community Integrated Care, 85% of GB adults aged 16-75 said that shortages of social care workers is a problem for society in the UK, with 67% regarding it as a ‘major problem’.

There is also significant public recognition of the shared value of both social care and the NHS. Ipsos found that 91% of respondents think that social care is important to society, with 94% recognising the NHS in the same terms, and 90% of the public classified social care as a skilled sector.

A Call For Action

Unfair To Care calls upon the Government to give an immediate and fair pay rise to all frontline social care workers. It highlights the need for the Government to apply the NHS Agenda for Change framework, which provides a system of pay bands for workers based upon skill, accountability, and experience, to ensure fair pay across these symbiotic systems.

The report clearly articulates that pay is only part of the solution needed to both fix the employment crisis that is engulfing a sector and to extend the societal impact of social care. Its recommendations include a significant expansion of training and development options, a focus on creating routes to career progression, the introduction of professional registration, campaigns to raise the esteem of the sector, investment in mental health support, and wellbeing strategies.

With social care delivering almost £59bn to the economy in 2022, and there being the potential to implement progressive reforms that improve efficiency and quality of life through delivering joined-up services, reducing the burden on family carers, and embracing innovations, Unfair To Care highlights that the Government does have scope for action.

Teresa Exelby, Chief People Officer at Community Integrated Care, says: “This current system serves no one. It is entirely wrong that this sector has 165,000 vacancies on any given day – significantly impacting the quality of life of people who should, rightly, expect reliable support built upon consistent relationships. The social care sector has real headroom to be an even greater force for good – changing lives at scale, offering greater efficiencies for public spending, and investing in local communities, but without a stable workforce, we are unable to seize this initiative.

“Change is possible, and it must come now. We understand that many sectors and industries – including the NHS – are calling for fair pay and this report does not seek to curtail or diminish their progress, but rather simply advocates for parity across these parallel sectors. For too long, consecutive governments have exploited the goodwill of people who have a vocation for care, believing that their passion offsets an expectation for fair pay.

“Now, in the midst of an unprecedented cost-of-living crisis, it is clearer than ever that this position is as untenable as it is immoral. We are calling on the Government to invest in social care now, to apply NHS terms and conditions in this parallel sector. When delivered alongside other progressive reforms, it will be making its rhetoric of levelling up an absolute reality in the most profound of ways.”

Unfair To Care has drawn on support from the Future Social Care Coalition, an alliance of more than 100 people and organisations, representing a cross-party coalition of former Ministers, private and third sector providers, trade unions, charities and those who draw upon care and support.

Phil Hope, Co-Chair of the Future Social Care Coalition, says: “Unfair To Care shows us that the recruitment and retention crisis in social care is here to stay for an entire generation unless the Government takes serious action to fix social care. Warm words about the rise in the living wage are simply not enough to retain staff.

“The current number of social care vacancies is simply staggering and will only continue to grow without a commitment to pay fair for care. Unfair To Care makes it clear that it is untenable to lurch from crisis to crisis, with just a sticking plaster to remedy the far deeper problems in social care.

“We support Community Integrated Care’s calls for an immediate and fair pay rise for all frontline social care workers and agree it is time for pay parity with the NHS.  Fair pay is the nettle that must be grasped by the Government. Failure to do so will fail an entire generation.”

Oonagh Smyth, CEO of Skills for Care, the strategic body for workforce development in social care in England, says: “Community Integrated Care have once again brought together a wide range of real-life experiences, insights and data – including from our Adult Social Care Workforce Data Set – to build on a clearer understanding by the public that our sector’s 1.5 million-strong workforce are highly skilled professionals, who deserve to be better recognised for the vital work they do in our communities. Reform of adult social care will only be successful if it addresses workforce pressures and challenges – including a workforce plan that is underpinned by data and informed by the experiences of people who work in care and draw on services.”


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