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Care worker organising – where is it at, and where does it go from here?

Care worker cleaning speaking with client

Care worker organising – where is it at, and where does it go from here?

by Duncan U Fisher

Since the onset of the COVID-19 pandemic and the recent period of rising living costs, workers across the labour market have received increased recognition, including some enhancements to their pay and conditions. Clearly there is a long way to go, and pay is generally not keeping up with inflation. The rewards are unevenly spread, but there are some encouraging signs in workplaces and sectors of priority being given to improvements for low-paid and insecure workers. However, the continuation of industrial action across many sectors indicates that workers remain far from content. One workforce which has seen a lack of meaningful, sector-wide improvement is adult social care, with England-based workers particularly devoid of meaningful change. In both Scotland and Wales, workers were given bonuses in recognition of their efforts during the pandemic. In both nations, sector-wide payment of the Real Living Wage is being implemented.

In England, despite the claps and increased visibility (at least at the height of the pandemic), the conditions and status of adult social care work are arguably regressing. In March 2023, the government announced it was cutting funding that it had earmarked for workforce development. It also reneged on a pledge to introduce Freedom to Speak Up Guardians in social care, which is a whistleblowing scheme in the NHS. The majority of Care Workers and Senior Care Workers – on the frontline – earn below the Real Living Wage. As inflation rises, but pay doesn’t come close to keeping up, care workers’ incomes are squeezed even further, and the ongoing high numbers of vacancies increases pressure on existing staff and further intensifies work. Recent research by the Health Foundation and the TUC  highlights the real risk of poverty faced by care workers and their families.

In summer 2022, when strike activities spread, the scarcity of care worker organising was noticeable, but it is more glaring now when workers in other sectors have continued with collective action, and when care working conditions in England show little sign of improvement. Care workers have been involved in pockets of organising recently, notably in northwest England, northeast England, Bristol, and London, but unified action on a larger scale remains elusive and distant.

Our current research in this area

At the Centre for Care, we are about to embark on fieldwork to examine some of the ongoing and recent examples of care worker organising in England. This will be varied in focus, from trade unions to campaign groups and community organising. Adult social care is a work sector of huge and growing importance, which is geographically ubiquitous and provides local jobs across the country. It deserves greater prominence in discussions about the present and future of a green, caring economy and society. Improving the quality of this work can potentially temper social inequalities along gender, class, and racial axes that the work is embedded in and drives. Our research aims to investigate organising examples and consider what have been the sparks for action, what has driven them, and what has sustained them. We are keen to consider the positives arising from these activities, the gains or wins, and the unintended or unanticipated consequences. We also want to think more broadly, as Melanie Simms and Jane Holgate argue, beyond the immediate aims of these actions, and to pay attention to notions of power, as Holgate proposes, and drivers of systemic change.

On the other hand, we are also interested in what these examples tell us about the limitations of care worker organising or the barriers that exist to expanding efforts and influence. Why haven’t the actions that we have seen prompted more widespread ripple effects? We are interested in the specificities of care work and care workers and will consider what sets them apart from settings where workers engage in sustained collective action: why, for example, is there less organising among care workers than we currently see in the health service? Is it related to the workforce being relatively less unified? What is the role of job insecurity and high turnover in adult social care, which is also marked in the health service? Is there something particular about how care workers conceive their work or identify with it that might distinguish them from others participating in strikes, for example?

One of the possible explanations for the limited effectiveness of organising in adult social care is the difficulty of knowing who is responsible, where power is held, or who to target with action or demands for change. We will investigate with attention to the complexities of the care system and strive to maintain an understanding of whose actions shape conditions at various levels. As things stand, the government is uniquely placed to deliver transformative positive change for care workers’ job quality, and thus to care quality, the two of which are so closely linked. In her tour de force landmark of recent care work literature, Stories of Care, Lydia Hayes shows how in recent decades legislation and welfare state policy have degraded adult social care work. Although some may respond to calls for improvement in conditions in the sector by arguing for employers (the majority of which are private companies) to do more, the government controls how social care is funded, commissioned, and delivered, and the Department of Health and Social Care holds responsibility for workforce strategy.


Meaningful reform of adult social care and the situation of the workforce has seen multiple delays in recent years, and what has been proposed has fallen short of significant progress towards care work becoming a secure, well-rewarded, and valued form of employment. If care workers look to government reform to improve their lot, they may continue to wait, yet by and large, workers are not acting collectively to advance their interests, like we are seeing across the economy (particularly in the public sector). Our work aims to shed light on the nature of the organising that care workers are involved in, and be of interest and use to those with stakes and interest in the present and future of adult social care work.

In the Centre for Care, Duncan works with Dr Liam Foster in the Care Workforce Change research group. They are currently researching care workers’ organising activities, including their role in trade unions, campaign groups and community organising.

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