The UK government must fully fund the introduction of a £10.50-an-hour minimum wage for adult social care care workers in England, its migration advisers have urged.
The Migration Advisory Committee (MAC) said a lack of public funding – leading to inadequate pay and conditions – was behind the significant recruitment and retention difficulties the sector faced.
While a £10.50 minimum wage – at a cost of at least £2.1bn to the public purse – was necessary, it was not sufficient, the MAC said in a government-commissioned report on adult social care and immigration.
“We would…strongly emphasise that an increase of this magnitude is not enough to address the issues presented by low pay in the sector and urge the government to go significantly further as quickly as possible,” the report said.
The MAC’s call comes amid a worsening workforce situation for adult social care, with vacancies hitting 10% in March of this year, up from 5.9% in May 2021, and the number of filled posts down 4.6% on March 2021 levels.
Impact of ending freedom of movement
The government commissioned the MAC to carry out a review of the impact of ending free movement of people from Europe and its replacement with a so-called “points-based immigration system” for skilled workers, introduced in December 2020.
This initially prevented care workers from coming from abroad to work in social care in the UK on health and care worker (H&CW) visas, though permitted some senior care workers on relatively high pay to do so. The government then expanded the route to more senior care workers, in March 2021, and opened it to care workers, on an interim basis, from February 2022, so long as they earned at least £10.10 an hour.
The current salary threshold excludes half of care worker roles and two-thirds of senior care worker roles, though the MAC found 9,000 senior care staff had been sponsored by employers to come through the skilled worker route as of February 2022. It also pointed out that dependants or partners of UK citizens or other migrants, who do not require a health and care worker visa, were an important source of labour for the sector.
The MAC urged further action to ease immigration requirements including making permanent the availability of H&CW visas for care workers and removing ongoing charges for employers using the route.
‘Years of underfunding’
However, while it found the ending of freedom of movement had contributed to staff shortages, the sector’s workforce problems predated this and were “the result of years of policy decisions not to fund the social care system properly”.
As a result, the sector has not been able to respond to rising vacancies and turnover by raising pay to attract more staff to work in the sector.
This has seen adult social care’s average pay advantage over competing occupations – such as retail and hospitality – fall from 5% in 2011 to 1% in 2021.
While adult social care has benefited from successive above-inflation rises in the national minimum wage and national living wage – which now applies to those aged 23 and above – this has led to a significant compression of wages in the sector.
Little reward for experience or progression
In 2020-21, care workers with more than five years’ experience were paid just 6p an hour more than those with less than one year’s experience, down from between 26p and 37p prior to 2017 and 12p in 2019-20, found Skills for Care’s annual state of the workforce report last year.
The MAC also found that senior care workers earned just 74p an hour more on average than care workers, despite additional responsibilities that sometimes involved leading teams.
This was in marked contrast to the NHS, where the Agenda for Change system set out a well-defined career and pay progression path. This was a particular issue for nurses, who could work in either sector, and among whom vacancies in adult social care are running at 18%.
Minimum pay rates
In Scotland and Wales, the respective governments have funded minimum pay rates for care staff above the £9.50-an-hour national living wage. These are, currently, £10.50 and £9.90 an hour, respectively, applying to staff in publicly-funded care roles in Scotland, and registered direct care staff and personal assistants in Wales.
The MAC said the UK government should follow suit and fully finance immediately a £10.50 minimum for care staff funded through the public sector in England, saying this was a “prerequisite to attract and retain workers in social care”.
This would cost £2.1bn, if existing pay differentials were maintained. However, the MAC argued that differentials between staff needed to increase, to improve progression, and that the £10.50 minimum would need boosting “as quickly as possible”.
As well as improving pay rates, the MAC said care staff needed to be paid their hourly rate for travel time and sleep-in shifts. While the former should be paid in accordance with mininimum wage regulations, the committee found this was not always the case.
And while the Supreme Court ruled last year that care staff were not entitled to the minimum wage – or national living wage, as relevant – for time spent asleep, the MAC said not paying them their full rate for these hours “presents the potential for employees to be exploited and underpaid”.
Sector ‘losing staff in droves’
Sector bodies urged the government to implement the MAC’s core recommendations.
“Care employers are losing people in droves to warehouses, supermarkets and online retailers able to pay significantly more for less stressful work,” said UNISON head of social care Gavin Edwards.
“No bluster, no slogans, the government must adopt the MAC’s recommendations now, so the Cinderella care sector can attract the new recruits it needs and retain experienced staff too.”
The Homecare Association particularly welcomed the MAC’s call to remove immigration skills charges from providers employing care staff on the H&CW visa, while also backing its calls for increased funding to raise pay.
“Recruiting and retaining home care workers has never been more difficult,” said chief executive Jane Towson.
“After years of government under-investment in the sector, the removal of infection control funds, the rapid increase in the cost of living, the homecare sector is in a precarious state.
‘Staff burnt out, providers stretched’
“Care workers are burnt out from the past two years of providing care non-stop through the pandemic, and a proportion are leaving the sector entirely to hospitality and retail where jobs have higher pay rates and less responsibility. Providers have never been more stretched, waiting lists for homecare are at an all-time high and the true value of careworkers is becoming ever more apparent.”
In response to the report, a government spokesperson said: “We would like to thank the Migration Advisory Committee for their continued work on this area.
“This report calls for cross-Whitehall consideration including on funding for social care, pay, conditions and workforce strategy, alongside immigration policy.
“The government will consider the MAC’s recommendations carefully and respond in due course.”