Commons Rejects Lords’ Exemption for Care Providers from National Insurance Hike

This week, the House of Commons voted against a House of Lords amendment that sought to exempt health and social care providers from the impending increase in employer National Insurance Contributions (NICs). The amendment, initially passed by the Lords with a majority of 130, aimed to shield sectors like care homes, hospices, GP practices, and pharmacies from the financial strain of the hike.

The decision has been met with significant concern from sector leaders. The National Care Association described the outcome as a “devastating blow,” warning that the additional financial burden could lead to closures of care facilities. Liberal Democrat Treasury spokesperson Daisy Cooper criticised Labour MPs for supporting what she termed a “health tax” on essential health services, suggesting that patients would ultimately bear the cost.

The NIC increase, set to take effect next month, will see employer contributions rise from 13.8% to 15%. Additionally, the threshold at which businesses start paying National Insurance on employee earnings will be lowered from £9,100 to £5,000, meaning many part time workers will now be included for the first time. This change is expected to exacerbate existing financial pressures within the health and social care sectors, already strained by workforce shortages and increased operational costs.

RCN Highlights Escalating Nurse Retention Crisis

In light of the news that Cardiff University is proposing major redundancies among nursing lecturers and potentially closing its nursing school, the Royal College of Nursing (RCN) has cited recent data that reveals a substantial increase in early career departures. Analysis indicates that by the end of the next parliamentary term, over 11,000 nurses are projected to leave the Nursing and Midwifery Council (NMC) register within their first decade of practice—a figure equivalent to the entire workforce of district nurses, health visitors, and school nurses in England.

Several factors contribute to this trend. A significant number of nurses report being under excessive pressure, with 71.1% indicating such stress – up from 59.3% a decade ago. Additionally, prolonged periods of real-term pay cuts have left many nurses feeling undervalued, prompting considerations of alternative career paths, with more than half of the 26,755 professionals who left the NMC register in the past year doing so earlier than planned.

RCN General Secretary Professor Nicola Ranger emphasised the urgency of addressing these issues, stating that without meaningful investment in the current nursing workforce and enhanced financial support for new entrants, patient safety and care quality are at significant risk, a point the CQC made this week as well.

Dentistry Faces Mounting Challenges Amidst Financial Pressures

The dental sector is also confronting increasing challenges as financial pressures mount, partly due to policy changes affecting operational costs. The rejection of the Lords’ amendment to exempt health and care providers from the NIC hike means dental practices will also face higher expenses, potentially impacting service delivery.

Additionally, workforce retention issues are not confined to nursing. Dental professionals have expressed concerns over escalating workloads, financial strains, and the sustainability of NHS dental contracts. These challenges have led to difficulties in recruiting and retaining staff, further exacerbating access issues for patients.

The British Dental Association (BDA) has called for urgent government intervention to address these systemic issues, warning that without prompt action, the public’s access to essential dental care could be severely compromised with many “desperate people are reaching for pliers or cheap flights because for many NHS dentistry has effectively ceased to exist”.

This week’s developments are another reminder of the critical state of the UK’s health and social care sectors. The Commons’ decision to reject financial relief for health and care providers, coupled with alarming trends in nurse retention and growing challenges in dentistry, requires comprehensive policy interventions. As financial and workforce pressures intensify, the imperative for sustainable solutions to ensure the delivery of high-quality care becomes ever more pressing.

🚨Introducing The On The Pulse Podcast🚨

In exciting news, in addition to celebrating 1,200 subscribers and the 30th edition milestone of the On The Pulse newsletter, today we have launched the official On The Pulse podcast , with our first episode now available on Spotify and Apple Podcasts.

Having previously written about the huge momentum behind the Providers Unite movement and their ‘day of action’ in February, we decided to take our reporting a step further and sat down with founder Katrina Hall for our premiere podcast episode. We hope you enjoy!

The On The Pulse podcast will be a semi-regular podcast with three aims:

⌚ 15 minutes (or less) per episode so it’s a minimal time commitment to listen to.

🧠 Genuinely expert analysis of the media or politics surrounding health and social care.

🔍 Informative, educational, or offering new insights unavailable elsewhere.

Here’s what we’re reading this week

Home Care Insight: House of Commons rejects NIC exemption in “devastating blow” for social care

The House of Commons has rejected a Lords amendment to exempt care providers from a National Insurance hike, raising employer contributions from 13.8% to 15%. Care sector leaders warn this will lead to closures, job losses, and reduced services. Care England and others condemned the move, calling for urgent government support and a long-term funding solution. A review of the impact is expected within six months.

Care Home Professional: Care England launches dedicated policy board to champion working-age adults in social care

Care England has launched the Working Age Adult Policy Board to better represent providers supporting working-age adults in social care. The board will address unique challenges, influence policy, and push for meaningful reforms. Sector leaders see it as a vital step toward improving support and visibility for this often-overlooked group.

Care Home Professional: £5bn in welfare cuts will lead to “unintended consequences for social care,” NCF says

The National Care Forum (NCF) has raised concerns over the UK government’s new Green Paper on benefits reform, which aims to cut £5bn while encouraging more people into work. NCF policy director Liz Jones warned that cutting Personal Independence Payments (PIP) could severely impact those who rely on it to access social care. NCF calls for greater investment in social care to support both individual wellbeing and national economic growth.

RCN Magazine: ‘Nurse lecturer redundancies are an attack on nursing’

Cardiff University is proposing major redundancies among nursing lecturers and potentially closing its nursing school, sparking strong opposition from staff and students. Lecturer Louise Crawford warns this move threatens the future of nurse education in Wales and beyond, especially amid a national nursing shortage. She argues nursing should be invested in, not targeted for cuts, and criticises the university’s leadership for undervaluing the profession. The Royal College of Nursing has condemned the proposals as “an attack on nursing.”

Health Service Journal: CQC needs to pay inspectors more, says chair

Incoming CQC chair Sir Mike Richards says inspector pay must rise to attract experienced staff, calling it a key risk. Meanwhile, Arun Chopra has been appointed chief inspector of mental health as part of efforts to rebuild CQC leadership and improve care regulation.