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This report looks at workforce inequities across health and adult social care and shows that these are not only staff issues. They also affect how care is delivered. The report was commissioned by CQC and combines survey data, interviews, literature review and case studies to understand what workforce inequities look like, what drives them and what helps reduce them. 

A central finding is that race and ethnicity-related inequities were the most commonly reported. Staff also reported inequities linked to sex or gender, disability, mental health conditions and nationality. Many respondents described overlapping forms of discrimination, which matters because people do not experience these issues one at a time in real life. 

The report makes clear that workforce inequities are shaped by both workplace culture and wider systems. Staff most often pointed to managers’ attitudes, colleagues’ attitudes and organisational culture as key drivers. That matters for care equity because staff who are excluded, ignored or treated unfairly may be less able to progress, less likely to stay, and less likely to speak up when something is wrong. 

The findings also show a clear link between workforce inequities and the quality of care. The report says staff experiencing inequities reported negative effects on service quality, care quality and interactions with people using services. In particular, more than 40% of respondents experiencing or observing race or ethnicity-related inequities reported poor interactions with patients or people using services. 

From a care equity perspective, this is important because inequities affecting staff can feed through into inequities affecting people who use services. If some parts of the workforce are more exposed to bullying, poorer progression, low pay or unsafe speaking up cultures, that can affect continuity, trust and service quality. It can also be worse in parts of the system already under pressure, including adult social care, smaller providers and areas facing recruitment and funding problems. 

Another useful finding is that the most common EDI activity was not seen as the most effective. Staff training and celebrating diversity were common, but respondents were more likely to value strong complaints systems, transparent data and visible senior leadership action. This suggests that tackling workforce inequities needs practical follow-through, not just awareness activity. 

Overall, the report shows that workforce inequities are part of wider structural problems in health and adult social care. Improving care equity means paying attention to how staff are treated, who is heard, who progresses, and who feels safe at work. Without that, inequities in the workforce are likely to continue affecting inequities in care. 

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This study provides a detailed account of how the COVID-19 pandemic affected the working lives of health and social care staff. It documents high levels of burnout, declining mental wellbeing and the cumulative impact of sustained pressure during crisis conditions. Participants described how staffing shortages and job insecurity intensified workloads and reduced the capacity of services to meet demand. These pressures also affected morale and the ability of workers to provide the quality of care they aspired to deliver. 

From a care equity perspective, the findings highlight how workforce strain can deepen inequities within care systems. Workers in lower-paid or less secure roles faced greater exposure to stress and burnout, while service users experienced variable support depending on staffing levels and workforce stability. These dynamics risk reinforcing uneven experiences of care across settings. 

Overall, the study stresses the importance of workforce wellbeing as a foundation for equitable care. Addressing mental health, pay and staffing issues is essential not only for supporting workers, but for sustaining fair and reliable health and social care services in the longer term.

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This study highlights the relationship between perceived staffing adequacy, wellbeing and retention among social workers. Many participants described feeling unable to meet the needs of people they support due to insufficient staffing, alongside growing administrative demands. 

The findings show how workload pressures translate into sickness absence and intentions to leave, particularly among mid-career workers. Dependence on agency staff was described as both a symptom and a driver of instability, adding complexity to team functioning and continuity. 

From a care equity point of view, the study illustrates how workforce shortages affect both workers and service users. Where staffing levels are inadequate, social workers have less capacity to provide timely and consistent support, increasing the risk of uneven access and outcomes for people drawing on care and support. At the same time, burnout and poor wellbeing disproportionately affect those in high-pressure roles. 

Overall, the paper highlights that safe staffing is not only a workforce issue but a care quality issue. Improving staffing levels and working conditions is essential to sustaining an equitable social care system that supports both practitioners and the people they serve. 

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This study highlights the complex reasons why social care staff choose to remain in or leave roles, within intellectual disability services. While pay emerged as an important consideration, the quality of relationships with individuals receiving support was equally influential in shaping job satisfaction. 

Participants described care work as meaningful when they felt able to build trusting relationships and provide consistent support. Where organisational pressures limited this relational aspect, motivation to stay diminished, even when staff valued the work itself. 

Considering care equity, the findings point to how workforce instability can disproportionately affect people with intellectual disabilities. High turnover and staffing instability disrupts relationships that are central to continuity and quality of care, potentially leading to uneven experiences. At the same time, low pay and poor conditions reflect broader inequities faced by a workforce that is often undervalued. 

Overall, the study suggests that improving retention requires attention to both material conditions and the relational nature of care. Supporting staff to remain in post is essential not only for workforce sustainability, but for delivering equitable and person-centred support to people with intellectual disabilities. 

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This study provides insight into how paid care workers in England understand their working conditions and the role of organising in addressing long-standing challenges. Participants described organising as both a response to low pay and poor conditions and a way of asserting professional identity within a marginalised sector. 

The findings show that care workers often feel disconnected from decision-making structures that shape their work. Organising activities were framed as efforts to make everyday realities visible to employers and policymakers, rather than solely as formal union activity. 

Considering care equity, the study highlights how unequal power within the workforce affects both workers and the people they support. When care workers’ voices are excluded from policy and practice, inequities in pay, security and conditions are sustained. These workforce inequities have downstream effects on continuity and quality of care, particularly in a sector employing large numbers of women and people from marginalised groups. 

Overall, the paper suggests that supporting care worker voices is not only a labour issue but a care issue. Strengthening avenues for collective input may contribute to fairer working conditions and a more equitable and stable care system. 

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This paper highlights the increasing pressures faced by the social care workforce due to limited capacity and insufficient administrative support. Staff report burnout from covering understaffed shifts, receiving low pay, and being unable to take annual leave without burdening their colleagues. These conditions compromise staff wellbeing and restrict their ability to move beyond crisis management, limiting opportunities for training, skill development, and career progression. While staff remain committed to meeting the needs of those who draw on care and support, the current staff-to-service ratios are unsustainable. Many report having less time to provide personalised care, with the shortfall directly impacting people who are drawing on services. This is recognised as a national issue, not just an organisational one, with widespread capacity challenges across the sector. 

This article calls for urgent action to address workforce capacity, improve training, and support newly qualified social workers, who experience particularly high turnover rates. Current practice falls short of BASW’s guidance, which recommends 80% of time spent engaging with service users and 20% on administration. Limitations of the study include a homogeneous sample in regards to ethnicity and an overrepresentation of respondents from Northern Ireland. Additionally, authors note that findings may not be representative of all social workers, as those who responded to open-ended questions likely held strong views on the issues discussed.