The Prime Minister’s speech at the Labour Party conference brought adult social care into the government’s wider reform agenda through the announcement of a National Care Service (NCS). In addressing care workers directly, he acknowledged the low pay associated with their work while recognising the skills and contributions involved in providing care and support. This recognition is significant in a sector where longstanding concerns about pay, employment conditions, recruitment and career development have been extensively documented.
The announcement raises important questions about how commitments to workforce recognition relate to the structural conditions in which care workers are employed. Research undertaken through the ESRC Centre for Care’s Research Group on Care Workforce Change, alongside findings from other studies, provides evidence relevant to understanding these questions.
Workforce reform cannot be separated from funding and commissioning
Although the Prime Minister addressed care workers directly, the government’s written announcement of the National Care Service provides limited detail about workforce arrangements. It acknowledges that implementation will take place in stages, reflecting the time required to develop funding and workforce and provider capacity.
Additional commitments were outlined by the Secretary of State for Health and Social Care, Yvette Cooper, including a workforce plan, career pathways, training, specialist skills development and a national collective pension scheme. These sit alongside the planned Fair Pay Agreements, intended to establish minimum standards for pay, terms and conditions across adult social care.
These commitments address important aspects of workforce policy. However, research from the ESRC Centre for Care indicates that workforce outcomes are influenced by factors extending beyond individual employment policies.
In our study, Policy Drivers of Social Care Workforce Change: United Kingdom Insights, Impacts, and Future Directions (Hussein and Kispeter, 2025), we examined policy drivers of workforce change across the four UK nations, drawing on a review of evidence and consultations with 25 social care stakeholders. The research identified commissioning arrangements, market structures and long-term funding as central influences on workforce outcomes.
Stakeholders identified local authority commissioning and contracting practices as particularly important in shaping pay, job quality and employment conditions. They also highlighted the tensions between workforce professionalisation, personalisation and health and social care integration. These findings underline the importance of considering workforce reforms alongside the funding and organisation of care provision.
Related research on England’s adult social care market (Li and Hussein, 2026), undertaken through the NIHR Policy Research Unit in Health and Social Care Systems and Commissioning, documents the complexity of the care market and changes in the composition of providers. The analysis found a decline in the number of smaller care homes alongside growth in domiciliary care agencies, particularly single-location providers. These developments provide important context for considering how national employment standards operate across different types of care organisations.
The proposed Fair Pay Agreements therefore need to be considered in relation to commissioning, provider funding and the capacity of employers to implement agreed standards. There is also the separate issue of compliance with existing employment legislation, including minimum wage requirements relating to travel and working time in domiciliary care.
Professionalisation is about more than qualifications and clinical skills
The Prime Minister’s recognition of care workers’ skills is relevant to a longstanding debate about how care work is valued and what constitutes professional development in the sector.
Our research within the ESRC Centre for Care has examined the relationship between professionalisation and other social care policy objectives. In Combining professionalization and personalization in English long-term care: analysing stakeholder views through a workforce lens (Kispeter and Hussein, 2026), we identified care workers’ autonomy, training and registration as three important areas where these policy objectives intersect.
The study found that stakeholders regarded workers’ practical autonomy and training as supporting personalised care. However, they also identified tensions associated with formal training and registration requirements, particularly for personal assistants. The findings highlight the importance of understanding professionalisation more broadly than the introduction of qualifications or regulatory requirements.
In particular, we argue that care workers’ autonomy should be recognised as a dimension of professionalisation, alongside pay, employment conditions, training and registration. The ability to exercise judgement and make practical decisions in response to people’s needs is an important aspect of care work, yet it receives relatively limited attention in policy definitions of professionalisation.
Our wider Centre for Care research also identified the emphasis placed by stakeholders on clinical and health-related competencies, including medication administration and support with specific health conditions. While these competencies are important, care workers also draw on interpersonal, relational, practical and embodied skills in their everyday work.
This issue also extends to digital skills. Our research on digital technologies in social care found that workers’ digital knowledge and practical problem-solving were not always recognised, despite their role in responding to limitations in the technologies used in care settings.
The proposed workforce plan raises questions about how this broader range of skills and knowledge will be reflected in training frameworks, career pathways and occupational recognition.
International comparative evidence provides a further perspective. In Registering Care and Support Workers in Australia: International and Local Learnings (HumanAbility and Hussein, 2026), research examining workforce registration arrangements in Australia and internationally identified the importance of clear regulatory purposes, proportionate requirements, appropriate qualifications and investment in training and support. The findings emphasise that workforce registration needs to be considered alongside wider workforce development arrangements.
Recruitment, retention and the role of migration policy
Workforce development also needs to be considered in relation to recruitment and retention.
Research undertaken with colleagues beyond the Centre for Care adds evidence about the employment factors associated with workers’ decisions to remain in or leave care work. In a longitudinal analysis of survey data from 1,791 UK social care workers during the COVID-19 pandemic, Saloniki and Hussein (2025) examined factors associated with intentions to leave employers and the care sector.
The analysis found that higher job satisfaction was associated with lower intentions to leave, while satisfaction with pay, promotion opportunities and work-life balance varied. The findings also highlighted the complexity of workforce retention, including differences in workers’ experiences and the relationships between job support, employment attitudes and intentions to leave.
Migration policy represents another dimension of workforce planning. In the ESRC Centre for Care working paper From Crisis to Chronic Shortage: The Future of Adult Social Care Workforce Recruitment in the UK (Hamid and Hussein, 2026), we examined changing immigration requirements and the administrative and recruitment pressures facing care providers.
Drawing on existing literature and informal stakeholder interviews, the paper documents how changes in immigration rules, sponsorship arrangements and compliance requirements intersect with persistent workforce shortages and funding constraints. It highlights the connections between migration policy and the organisation of the care labour market.
These findings indicate why workforce planning cannot be considered independently of migration policy, employment conditions and the circumstances of existing migrant care workers.
Recognising social care in its own right
The National Care Service announcement places particular emphasis on older people’s care. However, adult social care encompasses a much wider range of services and people, including working-age adults with disabilities, people with long-term conditions, and those receiving support to participate in everyday and community life.
As documented in our analysis of England’s adult social care market (Li and Hussein, 2026), care is provided through diverse settings, funding arrangements and types of provision, including residential care, domiciliary care, supported living and community-based support.
This diversity matters when considering the workforce. The skills, relationships and responsibilities involved in supporting independent living, personal choice and participation extend beyond health-related tasks.
Our research on workforce policy drivers (Hussein and Kispeter, 2025) also found that stakeholders identified tensions in approaches to health and social care integration, particularly where structural reforms received greater attention than differences in workforce pay, training, career opportunities and occupational recognition.
The development of the National Care Service therefore needs to recognise the distinct purposes of social care, rather than treating its workforce primarily in relation to NHS capacity or health service priorities.
From recognition to workforce policy
The government’s announcements address several longstanding areas of workforce concern, including pay, pensions, training and career progression. They also leave important questions about how these measures relate to the organisation and funding of adult social care.
The evidence from the ESRC Centre for Care’s Research Group on Care Workforce Change highlights the interconnected nature of workforce policies. Commissioning, funding, professionalisation, personalisation, integration and migration policy all shape the circumstances in which care is provided and the experiences of those delivering it.
Our wider research adds evidence on workforce retention, care market structures and international approaches to occupational recognition and regulation.
Taken together, these studies provide a basis for assessing the workforce elements of the National Care Service as further policy details emerge. Recognition of care workers is an important part of the policy discussion, but the substantive questions concern pay and employment conditions, the quality of care jobs, professional autonomy, and the extent to which workforce policy reflects the full range of skills and responsibilities involved in social care.
Research referenced
ESRC Centre for Care – Research Group on Care Workforce Change
- Hussein, S. and Kispeter, E. (2025). Policy Drivers of Social Care Workforce Change: United Kingdom Insights, Impacts, and Future Directions. Research report and policy brief, ESRC Centre for Care.
- Kispeter, E. and Hussein, S. (2026). Combining professionalization and personalization in English long-term care: analyzing stakeholder views through a workforce lens. Frontiers in Sociology, 10, 1719789. https://doi.org/10.3389/fsoc.2025.1719789
- Hamid, M. and Hussein, S. (2026). From Crisis to Chronic Shortage: The Future of Adult Social Care Workforce Recruitment in the UK. Working Paper 7, ESRC Centre for Care.
Evidence from other research programmes and collaborations
- Li, K. and Hussein, S. (2026). Understanding the Adult Social Care Market in England. NIHR Policy Research Unit in Health and Social Care Systems and Commissioning.
- Saloniki, E.-C. and Hussein, S. (2025). UK Social Care Workers’ Intention to Leave During COVID-19: A Longitudinal Analysis. Journal of Long-Term Care, 327–343. https://doi.org/10.31389/jltc.390
- HumanAbility and Hussein, S. (2026). Registering Care and Support Workers in Australia: International and Local Learnings. HumanAbility, Australia.
About the author
Shereen Hussein leads the Care Workforce Change Research Group for the Centre for Care. Shereen is a Professor of Health and Social Care Policy at the London School of Hygiene and Tropical Medicine. She is an established multi-disciplinary research leader with extensive social care and health research experience working primarily with policymakers in the UK and internationally. Her background is in medical demography, statistics and computer science.
