Social Care Support Workers Still Take Home £7,048 Less A Year Than NHS Counterparts, New Research Reveals
The national social care charity, Community Integrated Care, has today published the fifth edition of its landmark Unfair To Care report, providing the most comprehensive annual analysis of the pay gap between frontline adult social care workers and their NHS counterparts.
Published as Baroness Casey makes her first public comments from her review of adult social care in England – acknowledging the scale of the challenge ahead and the crucial role of the workforce – the report finds that, despite five years of sustained campaigning and a narrowing of the gap from 39% in 20212, a significant structural pay divide between social care and the NHS remains.
Despite a 6.7% increase in the National Living Wage to £12.21 in 2025/26, support workers still take home £7,048 less per year than NHS Band 3 colleagues carrying out roles of equivalent scope and complexity – virtually unchanged from the £7,120 gap recorded last year.
With providers facing a 9% rise in operating costs and full implementation of the Fair Pay Agreement on the horizon but still years away, the report warns that the sector cannot afford to stand still.
Key findings
• 28.6% – the take-home pay gap between social care support workers and NHS Band 3 staff in 2025/26
• £7,048 – the annual pay rise a social care support worker would need to achieve take-home pay parity with an NHS Band 3 equivalent
• 43.3% – the total reward gap when NHS pension and benefits entitlements are included, representing a £10,990 annual difference
• 9% – the average rise in operating costs for care providers in 2025/26, driven by unfunded increases in Employer National Insurance and the National Living Wage
• 7% – the overall adult social care vacancy rate, three times the UK-wide rate of 2.3%6
About the research
At the core of Unfair To Care is an independent evaluation of social care support worker roles using the world-renowned Korn Ferry Hay Guide Chart-Profile Method. This rigorous, evidence-based framework assesses the physical, environmental and emotional demands of the role – and consistently finds that frontline adult social care support work is at least equivalent in job size to an NHS Band 3 role. Despite this, the pay parity that equivalence should demand remains elusive.
The report draws on the National Care Forum’s pay benchmarking for the not-for-profit sector, which shows the average hourly rate for social care workers in England (excluding London) is £12.60, against a Band 3 NHS base pay midpoint equivalent to a £25,767 annual salary – before NHS allowances, unsocial hours premiums and enhanced benefits are factored in.
The report also applies its findings to the Government’s planned Fair Pay Agreement, due to take effect in 2028/29 with £500 million of funding. The report’s modelling shows that this level of investment is expected to deliver an uplift of 68p per hour above the National Minimum Wage for direct care workers. Yet, even if that funding had been available in 2025/26 at current pay rates, social care support workers would still earn 29p per hour less than the NHS baseline – a 2.3% shortfall equating to £567 a year.
On take-home pay, the picture is starker still: direct care workers would still be taking home £2.92 per hour less than their NHS equivalents – a 22% gap worth £5,710 a year. In other words, the gap would narrow, but the unfair pay differential would not be eliminated completely.
The report also raises concerns that, if employer on-costs are absorbed within the 68p uplift, the amount reaching workers could fall to approximately 50p per hour, further limiting the agreement’s impact.
Community Integrated Care is calling on the Government to act now rather than wait for the Fair Pay Agreement to take effect. Its key recommendations include:
Interim pay uplifts in 2026/27 and 2027/28 to narrow the gap and stabilise the workforce ahead of full implementation.
• Full flow-through of funding from local councils to care providers, including employer on-costs such as National Insurance and pension contributions.
• A clear method for determining fee levels that reflect the true cost of care.
• Investment in recruitment, training and retention alongside any pay floor increase.
• No backdating of additional pay unless the required funding is clearly identified and passed through in full and on time.
Teresa Exelby, Chief Corporate Services and People Officer at Community Integrated Care, commented: “Five years ago, the take-home pay gap between social care support workers and equivalent NHS roles stood at a stark 39%. Today, it stands at 28.6% – still a significant £7,048 a year. Whilst progress has been made, narrowing the gap is not the same as closing it.
We’re now entering a moment of real possibility. The Government’s commitment to a statutory Fair Pay Agreement, coupled with the work of the Casey Commission, creates a genuine opportunity to address structural inequality that has persisted for decades. Yet our modelling shows that even under the proposed financial envelope, a notable difference in take-home pay would remain.
Social care is delivered by skilled professionals exercising judgement, accountability, and a deep compassion every day. If the changes now underway are funded properly and implemented with discipline, there is a real opportunity to strengthen workforce stability and build a more sustainable future. The direction is clearer than it has been for some time. The responsibility now is to ensure this moment leads to tangible change – and that fairness is delivered fully, not partially.”
Tauseef, a person supported by Community Integrated Care in Stockport, said: “It’s good to see some recognition of how vital Support Workers are, and the difference they make in enabling people with support needs to live our lives and do the things we enjoy. But if I’m honest, we’re still a long way from where we need to be.”
“Support Workers are still not being paid fairly, and too many are going without the proper support and training they deserve. People with lived experience like me are still not being listened to in the way we should be. Every person with a disability deserves truly great support – but right now, that’s not the reality for enough of us. That’s exactly why our Unfair To Care campaign matters so much, and why there is still so much more work to do.”
The report also highlights wider threats to the sector, including immigration policy changes expected to reduce international workers by up to 50,000 in a year, tax freezes estimated by Care England to strip £1.4 billion from care workers’ take-home pay before the Fair Pay Agreement begins, and additional cost pressures arising from the Employment Rights Act 2025.
