The Care Provider Alliance responds to migration changes, as minimum wage rises without extra funding 

Silence on social care in the Autumn Statement in the wake of a 9.8 percent increase in the legal minimum wage, coupled with changes in migration rules which effectively cut off viable routes for international recruitment to the care sector, leave providers with a sense of impending disaster.

Public bodies buy a high proportion of care. Many providers are thus reliant on an increase in council and NHS fee rates to allow them to increase wages. Local authorities can only increase fee rates adequately if central government increases their budgets. Instead, the government is cutting taxes and reducing funding for public services.

Demand for care is rising. Our UK care workforce is shrinking. High staff turnover and vacancy rates result from years of under-funding by the government, which has led to poor pay and employment conditions for care workers.

Over the last 18 months, international recruitment has helped to reduce vacancies in the care sector. Skills for Care data[i] show that without sponsored workers, filled posts would have declined further. This would have left even more people without the care they need[ii].

Without enough care workers to support people in the community, many deteriorate unnecessarily and end up needing emergency or urgent care in NHS hospitals. Hospital beds are thus unavailable for those who require planned treatment and there is now a record NHS waiting list of 7.8 million. 

Both UK and sponsored care workers must receive fair pay and secure income, to recognise the skill and experience required for these vital roles, as well as the value of their work to society.

The current UK national minimum wage is £10.42 per hour. For a 37 hour week, this would be a salary of £20,048 per year. The salary threshold for sponsored workers has been £20,960 per year, or £10.75 per hour. Wages for migrant care workers have thus been similar, if not slightly higher, than for UK care workers.

International recruitment is not a cheaper option. It is, however, our only option, as providers continue to struggle to recruit in the UK. We need to keep viable options open for international recruitment but ensure the process for issuing certificates of sponsorship is fit for purpose and sponsored workers are safe and well-treated.

Lack of data and appropriate controls have led to new providers, both CQC-registered and unregistered, being given large allocations of sponsored workers when they have no business record and often no contracted work. Meanwhile, well-established providers with a track record of delivering quality care have exhausted their allocation and cannot gain additional visas to match their contracted demand for staff.

Local authorities cannot access data on which providers in their areas have sponsored workers. They have often learnt of decisions to revoke sponsorship licences on the day of revocation, giving them no time to prepare for the safeguarding issues that arise. We want to see more transparency of data and encourage further improvements to processes to prevent problems arising.

The Care Provider Alliance welcomes the increase in the national minimum wage to £11.44 per hour from April 2024. We believe, though, that this doesn’t go far enough.

The starting point should be parity with the NHS for equivalent roles. This means at least £12.45 per hour, in line with NHS Band 3 Healthcare Assistants with 2+ years’ experience. If care providers are to compete with other sectors, such as retail and hospitality, care worker wages need to be £15 per hour or more.

Council spend on adult social care for 2022/23 was £23.5 billion[iii]. This contrasts with NHS spend in the same period of £181.7 billion[iv], though social care employs more people than the NHS.

The government must enable employers providing state-funded services to transform workforce terms and conditions, enhance capacity, ensure good care quality, and improve financial sustainability.

The Care Provider Alliance calls on the government to:

1. Support long-term development of our UK care workforce by providing extra investment of at least £8 billion per year to pay fair wages for care workers and ensure quality and sustainability of care services. To meet future demand, improve access to care and cover the full cost of care, we need an extra £18 billion per year[v].
2. Keep options open for international recruitment and ensure a data-driven and well-coordinated approach to commissioning and management of supply and demand of care; registration of services; and granting of Skilled Worker Visas.
3. Enable a nationally coordinated, efficient and humane process for redeploying sponsored workers if necessary. Some do not have enough work to meet licence conditions because of changes in local authority commissioning practices; some become jobless because of provider failure; and others are victims of unscrupulous agents or providers who ignore guidance or engage in unlawful activities. The Care Provider Alliance condemns exploitation of workers and abuse of the Skilled Visa route. We urge authorities to deal swiftly and firmly with those found guilty of breaching regulations or laws.

Chair of the Care Provider Alliance, Dr Jane Townson OBE said:

“Everyone wants fair pay for care workers. We also want to grow the UK workforce to meet needs. But employers cannot increase wages and expand recruitment within the UK without a corresponding increase in income, especially when margins are tight.

Public bodies purchase a high proportion of care and support services. Cash-strapped councils are already cutting costs and driving down fee rates. Without extra funding, there’s a high risk they won’t be able to increase fees to care providers enough to cover the new legal minimum wage from April 2024.

Large numbers of providers may thus become non-compliant with the legal minimum wage, or insolvent, or both.

On top of this, the government is effectively severing the lifeline of international recruitment. This is currently the only option we have to maintain and increase workforce numbers, as recruitment in the UK remains challenging.

If care workforce numbers fall and providers cease to operate, unmet need will escalate. Not only will this lead to individual and family suffering, but it will increase pressure on council and NHS services and further extend waiting lists.

Enough is enough. The time has come for meaningful change.

We urge the government to provide sufficient funding for public bodies to increase fee rates, so that providers can offer competitive pay and terms and conditions of employment to UK workers and reduce reliance on overseas workers.”

- ENDS -

About the Care Provider Alliance (CPA)

The Care Provider Alliance is a coalition of 10 associations including VODG representing adult social care providers in England. We advocate for the sector and ensure a coordinated response to the major issues that affect it.

For more information on the Care Provider Alliance visit: 

https://careprovideralliance.org.uk/about-us

[i] https://www.skillsforcare.org.uk/Adult-Social-Care-Workforce-Data/Workforce-intelligence/publications/national-information/The-state-of-the-adult-social-care-sector-and-workforce-in-England.aspx

[ii] https://www.theguardian.com/society/2023/nov/25/curbs-on-migrant-workers-would-be-dangerous-for-social-care-warns-government-adviser

[iii] https://www.instituteforgovernment.org.uk/publication/performance-tracker-2023/adult-social-care

[iv] https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget#:~:text=What%20is%20the%20NHS%20budget,as%20staff%20salaries%20and%20medicines

[v] https://www.health.org.uk/publications/long-reads/adult-social-care-funding-pressures#:~:text=Between%202014%2F15%20and%202021,budget%20for%20adult%20social%20care.