New research shows how better pay and training could rescue social care in England

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Republished from the LSE Business Review Blog (12 October 2025).

Low pay, job insecurity and post-Brexit recruitment challenges are plaguing the adult social care sector in England. With rising demand and chronic underfunding, work conditions are only getting worse. Andreas Georgiadis and Andreas Kornelakis suggest ways to improve the situation, including better pay and training.

Adult social care suffers from a long-standing “workforce crisis” in England. Recent reports from industry bodies highlight the challenges to the sector’s workers and their ability to offer high quality care. Staff in social and health care are overworked, exhausted and stressed, sometimes to the point of becoming ill, leading to absenteeism or quitting altogether.

Increased workloads and time pressures arise partly due to increased demand for services by a rapidly ageing population. At the same time, over half of adult care providers said they faced challenges recruiting new staff; 31 per cent struggled to retain employees. Difficulties in recruitment and retention intensified after Brexit, as the sector relied heavily on migrant workers.

It is widely known that adult care is one of the lowest paying jobs in the UK. Forty-three per cent of all adult social care workers in England are paid below the real living wage. It will continue to be challenging for care providers to retain pay differentials between those on the wage floor and those with more experience and qualifications. But pay levels are not the only challenge for care workers, as they also face problems of job insecurity and unpaid overtime.

For example, most of those who do home visits are not compensated for the time they spend travelling to homes, which can make up to a fifth of their working day. The use of contingent contracts in social care may deliver some cost savings for providers, but has the drawbacks of job insecurity for workers, and concerns about service quality. Continue reading →

The important role of homecare workers in dementia palliative care and interventions to support them

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Fatima MujtabahFatima Mujtabah, right, recently graduated from King’s College London in Adult Nursing. (797 words)

Dementia Palliative Care and Homecare Workers

Dementia is a term used to describe a range of conditions affecting the brain that get worse over time. With no cure, dementia is a life-limiting condition, but few people recognise this. As such, the care needs of people affected by dementia are not always met. It is reported that around 90,000 of people diagnosed with dementia require formal social care and about 2/3 of this population live and die at home. This highlights the importance of homecare in the provision of high-quality palliative and end of life care. Yet, current research shows that people with dementia who live at home are more likely to receive poorer quality end-of-life care compared to those in formal care settings such as care homes. Homecare workers have a central role in allowing people to die within their own homes. Continue reading →

At HSR 2025: On new roles in UK health and social care

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Antonina SemkinaDr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. Antonina brought together contributions for this blog from the other presenters at this Health Services Research conference session in Newcastle. (773 words)

One of the core functions of conferences is to allow colleagues to present and discuss work in progress. Here we share the results of a fruitful session where colleagues researching the introduction of new roles in health and social care saw many important parallels that will help them in developing and sharpening their analysis.

On the 2 and 3 July 2025 Newcastle University hosted the 18th annual Health Services Research conference. It featured nine thematic streams including Person Centred Care, Workforce, Digital, Social Care and Health Inequalities. Delegates had an opportunity to attend research discussions and Pecha Kucha sessions (short form presentations), workshops (e.g., ‘How do we know if HSR impacts on Policy?’ led by Unit Director Professor Annette Boaz), plenary sessions (e.g., ‘The 2030 workforce: how will innovative research deliver impact’?), meet ups (e.g., for Early career researchers) and to view research posters.

HSR UK 2025 conference poster

One of the research discussion sessions in the Workforce stream featured four presentations related to various new roles being developed in UK health and care services. Unit researcher Dr Antonina Semkina presented on the ‘New Roles in Health and Social Care: What is the nature of new care coordinator roles?’ project that she is conducting as part of the Health and Social Care Workforce Policy Research Unit programme of work. The research project, developed in collaboration with the Unit Public Contributors Involvement and Engagement group, focuses on what kinds of new care co-ordinator roles are being created, what tasks are delegated to them and the implications for various stakeholders (e.g., colleagues’ workload). Continue reading →

The role of relationships when women navigate experiences of homelessness and violence

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Carolin Hess in Rabat

Carolin Hess in Rabat

PhD student at King’s, Carolin Hess, reports from the International Sociological Association Forum.

I am grateful to have received a SSPP PGR grant to attend the ISA (International Sociological Association) Forum in Rabat, Morocco (6.-11th of July 2025).

With over 4,000 presenters from over 100 countries, and a (multilingual) schedule running from 9am to 8pm over five days, the conference offered a great overview of current debates in sociology and an excellent environment for connections. I attended presentations and met other scholars working on (women’s) homelessness, healthcare access and social policy in the UK and internationally. Some interesting conversations following these sessions sparked ideas for future research and potential collaborations. Being in Rabat and having some time in the evenings to drink mint tea together and explore the medina (old city) and local food, added to the experience.

At the forum, I also had the opportunity to present findings from my doctoral research project on “the role of relationships when women navigate experiences of homelessness and violence”. I presented in a session on Bodies, (trans) Genders and Violences, alongside researchers exploring the materiality of the gaze, conceptualization of violence, and experiences of (trans) bodies. With about 15-20 people attending the session, the subsequent discussion provided some helpful new perspectives on gender and performativity.

I would like to thank the SSPP, as well as my NIHR doctoral fellowship for their financial support to attend the conference and to make it possible for me to travel overland from London via Paris and Madrid. While a slower, and often more expensive way to travel, taking train, bus, and ferry felt like a more memorable and sustainable choice, allowing me to appreciate the distance (and providing ample of time to get some work done along the way!).

Carolin Hess is a PhD student at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s.

Dementia Community Research Network Annual Community Engagement Event!

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Geeti Kabra

Geeti Kabra reports from the event

The Dementia Community Research Network (DCRN) is a growing network of researchers, public contributors, and community-based dementia support services working together to improve dementia care and research in South London. The DCRN aims to make dementia research more inclusive, accessible, and relevant to diverse communities.

With thanks to generous funding from the NIHR, as a part of the National Festival for Applied Dementia Research, the DCRN hosted its second community engagement event on Monday, 19 May. In line with our goal of community engagement, we chose a venue in the heart of South London, Stanstead Lodge, a charity for people over the age of 50. The aim of the event was to bring together people affected by dementia, local service providers, and academic researchers, in an effort to facilitate exchange of information.

This year, we were pleased to welcome over 80 people, including those affected by dementia, carers, members of the public interested in dementia charities and care partners. We were proud to host stalls from our community partners, including Age UK, Arts for Dementia, Home Instead and Butterfly Café, Join Dementia Research, and Two Mindful Bees. Researchers from King’s College London and Queen Mary University of London also showcased their work at stalls including stalls from the Cicely Saunders Institute and its Public Involvement Forum, the Health and Social Care Research Workforce Unit, and the CARE Network. We welcomed some new organisations this year, including Imago, supporting unpaid carers, and Age Exchange, hosting social activity reminiscence arts groups for people living with dementia and their carers.

People at a gathering Continue reading →

In recognition of the contribution of older people’s day centres to preventive agendas

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Katharine Orellana

Katharine Orellana

Katharine Orellana, Research Fellow at the Health and Social Care Workforce Research Unit at King’s, introduces a new article she co-authored with Kritika Samsi, Senior Research Fellow at the Unit: Older people’s day centres’ preventive work: views of day centre providers and their stakeholders. (576 words)

We asked older people’s day centre stakeholders and others working in health and social care about their views on day centres’ preventive function. Our findings, published in the International Journal of Qualitative Studies on Health and Wellbeing, highlight how work undertaken in day centres falls under the radar as a systemic contribution to the prevention agenda within health and social care.

Despite repeated government focus on growing community health and care services and current preventive efforts aiming to reduce pressure on the NHS and to move more care into the community, there has been a failure to invest in day centres.

Our research aimed to further understandings of how day centres can contribute to health and social care’s preventive agenda. We identified perceived strengths and opportunities at all three levels of prevention: primary (prevent), secondary (reduce) and tertiary (maintain). There were also systemic opportunities, such as day centres being in a position to capture and use evidence, and more joined-up working. Continue reading →

Widening Participation and Apprenticeships in health and social care: Report and Call for Research Participants

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Cat Forward reports from a roundtable event held by the NIHR Policy Research Unit in Health and Social Care Workforce as part of two studies in its current programme of work – on Widening Participation and Apprenticeships. If your NHS Trust or Integrated Care System is interested in taking part in these studies, do get in touch with catherine.forward@kcl.ac.uk. (414 words)

As part of its core programme of work, the Unit hosted a hybrid roundtable event on 2nd April 2025 with 88 online and in-person attendees from NHS trusts, NHS-England, local authorities, academia, public representative bodies and the charity sector. The event titled “Refreshing approaches to Widening Participation and Apprenticeships: The New Agenda?” sought to facilitate discussion about existing Unit work, to share current and best practice in Integrated Care Systems and Trusts, as well as discussing directions future research might take. Continue reading →

Social work, neglect and the renewal of ‘poverty aware practice’

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Carl PurcellCarl Purcell, of the Health and Social Care Workforce Research Unit, King’s College London, reflects on a recent meeting of the Social Work History Network (17 June 2024). (791 words)

At a recent seminar organised by the Social Work History Network Dr Michael Lambert, Professor June Thoburn and Professor Marian Brandon reflected on the history of the concept child ‘neglect’ and how this has been redefined and responded to by policymakers and social workers.

The evacuation of children from towns and cities during the second world war exposed the appalling suffering of many children living in desperate poverty. Lady Allen of Hartwood was spurred to write a letter to The Times that provoked a remarkable political response.  Following the Curtis Report (1946), and subsequent inquiries, the Children Act 1948 established local authority Children’s Departments to make arrangements when children, including neglected children, needed to be received in to care. Subsequently, the Children and Young Persons (Amendment) Act 1952 provided powers to actively investigate neglect.

Many health and social work professionals working in this space located the underlying causes of neglect in the personal characteristics of parents. Jones wrote: “Their lives are characterised by dirt, disintegration and disorder. They are often shiftless, apathetic, irresponsible to an almost incredible degree”[1]. But some social policy writers were critical of this perspective.  Barbara Wootton argued: “About the only common characteristics of these families, it seems, are the financial ones”[2]. Continue reading →

How the spread of Christianity informed state responses to poverty

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Dr Karen Lyons, emeritus professor of international social work at London Metropolitan University, reflects on a Social Work History Network webinar (24 April 2024) examining the development of ‘global’ social work values. (748 words)

Social work is generally understood to be a ‘local’ activity, particular to the society and communities within which it is practised.

It is also increasingly identified as a global profession with common values. But is this supposedly global nature in fact a construct prescribed by Britain and the US in the development and the dominance of a particular form of Western thinking?

These questions were recently explored at an event organised by the Social Work History Network. Mark Henrikson, of Massey University, Auckland, New Zealand, took us back a great deal further than the commonly understood origins of social work. He showed how the Church has played a significant role in how societies have viewed people who were poor or ‘different’ in some way.

Henrikson traced the origins of ‘Western’ social work thinking and values, with its current emphasis on individual choice and responsibility, through biblical texts to Calvinism, which took hold in some parts of Europe from the 16th century and spread to North America. Continue reading →

Remembering Jeremy Swain and his contribution to our work on homelessness

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Maureen Crane, Visiting Senior Research Fellow, King’s College London.

Jeremy Swain

Jeremy Swain

It was with deep sadness I heard about the death on 27 May 2024 of Jeremy Swain. He was a key figure in tackling homelessness and particularly rough sleeping for decades. Following a volunteering experience with the Cyrenians in London, Jeremy became a street outreach worker at Thames Reach in 1984 followed by periods as a resettlement worker and then a housing service manager within the organisation. He became Chief Executive of Thames Reach in 1999 and remained in the post until 2018, when he became Deputy Director for Homelessness and Rough Sleeping Delivery at the Ministry of Housing, Communities and Local Government. He was responsible for overseeing programmes developed through the Rough Sleeping Strategy, and later became a senior adviser for the Covid-19 Rough Sleeping Task Force. In 2017 he received a City Lit Lifetime Achievement Award for his contribution in helping people who had been homeless to develop the skills and confidence to gain employment.

I first met Jeremy in 1994 when starting fieldwork for my PhD. I was keen to interview older people who were homeless and he gave permission for me to visit Thames Reach’s hostels to see if any residents would be willing to take part. He showed great interest and enthusiasm in research on homelessness and understanding why people become homeless and what is needed to help them move on. He commissioned Tony Warnes (former Professor of Social Gerontology, University of Sheffield) and myself to undertake evaluations of programmes and services within Thames Reach, and he worked closely with many other homelessness sector service providers in London, including with Charles Fraser, former Chief Executive of St Mungo’s. Collectively these organisations commissioned us to undertake comprehensive studies of the needs of single people in London who were homeless and of the role of hostels in the early 21st century.

Over the years Jeremy continued to be a great supporter of my research on homelessness, both at the University of Sheffield and at King’s College London. He was always keen for his organisation to participate in our government-funded research, and Thames Reach staff and service users played an active role in studies such as the Three-Nation Study of the causes of homelessness among older people, the FOR-HOME study and Rebuilding Lives. Through his knowledge, guidance and support over many years, he helped steer our Homelessness Research Programme to what it is today – from relatively small evaluations of services to large scale, multi-site studies concerning people who are homeless and services for them.