The Care Workers’ Charity Responds to ADASS Autumn 2025 Survey
The Care Workers’ Charity (CWC) is calling for urgent Government action following the publication of ADASS’s Autumn 2025 Survey, which reveals a system under intensifying pressure; marked by deepening financial instability, workforce shortages, rising delegated healthcare tasks, and a diminishing adult social care voice within Integrated Care Systems (ICSs).
Directors of Adult Social Services project a £623 million overspend for 2025/26, a sharp rise from £586 million in 2023/24 and £564 million in 2024/25. They also estimate that at least £869 million in savings will be required in 2026/27, a figure likely to grow as costs and complexity increase.
Government restrictions on international recruitment are further destabilising the sector. Directors warn that reduced access to international care workers risks undermining local care markets, increasing reliance on costly agency workers, worsening unmet needs, and contributing to hospital discharge delays.
Instability among care providers is also rising: 4,254 people have been directly affected by provider closures, ceased trading or contract hand-backs since 1 April 2025, compared with 4,056 in the previous six months.
Adult social care’s influence within ICS structures continues to weaken. Only 10% of Directors report having significant influence, while 34% say they have very little or none, highlighting the impact of ongoing ICB reorganisation.
Delegation of healthcare tasks from the NHS to care workers is increasing rapidly, with 74% of Directors reporting growth. Yet in ADASS’s Spring 2025 Survey:
- Only 16% are satisfied that care workers are appropriately remunerated
- Only 26% believe health partners provide the resources needed
- 67% say delegated tasks are being carried out without NHS training, supervision, or funding
Nationally, 49% of Directors say they have no agreement with health partners setting out how delegation should take place. Where agreements do exist, 70% cover training, 78% cover competency assessments, and only 64% protect against unfunded cost-shifting.
Karolina Gerlich, CEO of The Care Workers’ Charity, said:
“These numbers are not just warnings; they are the reality of a system pushed past breaking point. Care workers are absorbing the consequences every day: taking on more complex clinical tasks without training or pay, and working in services stretched to their limits.
It is unacceptable that delegated healthcare responsibilities are being shifted onto an already overstretched workforce without proper training, supervision or remuneration. Care workers deserve pay, protection and parity, not to be treated as a stopgap for NHS pressures.”
The Care Workers’ Charity supports the report’s recommendations and urges the Government to act immediately. Key priorities include:
Supporting the Workforce
- Provide £300 million for winter 2025/26 to stabilise recruitment and retention ahead of the Fair Pay Agreement (due 2028).
- Fully fund the Fair Pay Agreement and all costs arising from the Employment Rights Bill.
Delegated Healthcare Activities
- NHS partners must provide training, competency sign-off and ongoing review.
- Care workers carrying out delegated clinical tasks must be properly remunerated.
- NHS activities of daily living must not be re-badged as means-tested social care.
Prevention
- Fund councils to independently evaluate preventative adult social care projects.
- Support national peer learning and resource sharing linked to current academic research.
For further information, please contact Sophie Henry at The Care Workers’ Charity at sophie@thecwc.org.uk.