Skills for Care’s annual Size and Structure of the Adult Social Care Sector and Workforce in England report, published this week, offers a mixed picture – modest progress in stabilising the workforce, but on increasingly precarious foundations.

At first glance, the report’s headline figures suggest improvement. Filled posts grew by 3.4% in 2024/25 (accounting for an extra 52,000 roles) while vacancies fell to 7%, their lowest level since before the pandemic.

But beneath the surface, the report warns of a sector heavily reliant on overseas labour, with domestic recruitment continuing to slide:

• posts filled by people with a British nationality fell by 30,000 last year
• posts filled by people with a British nationality fell by by 85,000 since 2021/22
• the proportion of British workers in the sector is now just over 70%
• Since 2022/23 more than 230,000 overseas workers have joined the sector, plugging gaps left by domestic shortages.

International recruitment has been the safety valve for several years. And herein lies the problem the sector now faces: that short-term fix is now at an end. The number of international recruits halved last year, falling from 105,000 to 50,000, and new restrictions on the Health and Care Worker visa routewill close the door to most new overseas care workers from July.

As Simon Bottery of The King’s Fund warns, the policy that brought vacancies down was “only ever a sticking plaster”.With the pipeline closing, the risk of workforce pressures spiking again is critical.

Building a sustainable workforce

According to Skills for Care’s latest report, to meet demographic demand, the sector will need almost half a million more posts by 2040 (a 27% increase on today’s workforce).

Achieving that with neither a sustainable domestic pipeline, nor a funding settlement that allows councils to invest in care will be simply impossible.

Health and Social Care Secretary Wes Streeting’s recent move to upskill social care nurses to prescribe medicines is a welcome step towards professionalising the workforce and improving career pathways. But as Care England’s Martin Green cautioned this week, “progress resting on an increasingly precarious base”cannot be mistaken for a policy success. Without urgent action on pay, conditions, and funding reform across both adult and children’s services, England risks building its social care recovery on quicksand.

Dementia care under strain

The Skills for Care findings are echoed in a damning new report from Care England on dementia services, which highlights the human cost of workforce fragility. The charity warns people are now waiting up to two years for a diagnosis in some parts of England, compared with a maximum of 34 weeks in 2019. Average waiting times have also risen by more than a third, and the report identifies serious regional disparities and a lack of co-ordinated care.

Professor Martin Green, Care England’s Chief Executive, described the findings as evidence of a “government failure” to meet growing demand, calling for a unified national strategy, enhanced dementia-specific workforce training, and sustainable funding. He urged ministers to treat dementia care as a national priority, warning that “behind every statistic is a person whose journey could have been better if there were earlier diagnosis and more co-ordinated care”.

Both reports highlight the demographic pressures facing the social care system. With almost one million people already living with dementia and an ageing population, workforce shortages are not just a numbers problem but a direct threat to timely, dignified care. Without urgent reform, both the Skills for Care and Care England reports suggest the UK risks a dual crisis of capacity and of quality in adult social care.