Social workers in adult social care face unprecedented crisis

Rising adult social care needs, greater complexity of cases and a tightening of NHS continuing care criteria has left the council adult social care spend in England £715 million over budget, a new ADASS report has found.

Four out of five (80 per cent) of the councils responding to the survey overspent in 2025/6.

The survey found:

• 50 per cent of directors are extremely concerned about the impact of rising costs due to increased complexity of need 
• 93 per cent are concerned by the rising cost of support for younger adults as they transition from children's services
• 91 per cent are concerned about the increased costs for adult social care resulting from shortfalls in NHS funding for those people aged 65-plus
• 87 per cent are concerned by increased costs due to increased complexity of needs for those aged 65 and over

The stark figures, published in the ADASS Spring Survey 2026, lay bare the daily realities for local authority social workers navigating skyrocketing caseloads, expanding waiting lists, and a collapsing care provider market.

The survey results are drawn from 89 per cent of councils in England with a responsibility for adult social care.

Faced with the £715 million deficit, directors need to find £909 million in savings for the next financial year.

For frontline staff, this is likely to mean stricter resource allocation, higher thresholds for service eligibility, and pressure to reduce care package costs, say ADASS.

The survey reveals two-thirds (66 per cent) of councils have seen care providers close down, hand back unviable contracts, or cease operating in a six-month window, impacting 3,964 people.

There has been a significant increase in safeguarding concerns and growing pressures supporting young people with mental health needs, ADASS reports.

Integrated Care Boards are failing to invest in services supporting people in the community – 86 per cent of directors reported an increase in mental health needs in their local areas.

Prime Minister Andy Burnham has made fixing the broken adult social care system a priority and has accelerated the timeframe for the Casey Commission to report its reform recommendations.

But Phil Holmes, president of ADASS, said: “Our latest survey highlights the disconnect between government ambitions for adult social care and the funding provided to deliver them. 

“Councils continue to be placed under huge financial pressure, with no signs of this abating. Behind every number there is person needing support, a family struggling or an unpaid carer taking on huge responsibility.”

The report reveals 408,985 people are currently stuck on waiting lists, awaiting initial care assessments, formal reviews, or the commencement of agreed care packages. 

Practitioners are increasingly supporting individuals with more complex, multi-layered needs due to the tightening of NHS Continuing Healthcare (CHC) eligibility criteria.

• 75 per cent of directors report an increase in people who would previously have been eligible for continuing healthcare, resulting in financial pressures
• 97 per cent of directors said increased NHS pressures will increase pressures for adult social care in 2026/27 
• 72 per cent said increased NHS pressures will lead to adult social care staff increasingly undertaking tasks on an unfunded basis that were previously delivered by NHS staff

Social workers are managing cases where people present with:

• Severe mental health diagnoses alongside autism or learning disabilities
• Substance misuse coupled with complex trauma
• High-risk behaviours that require specialised housing and support packages

They are also managing cases that historically would have been classified as purely medical or nursing care.

Holmes continued: “The ongoing reduction in the number of people receiving continuing healthcare flies in the face of our ageing population. 

“Increasingly frequent funding disputes are leaving people and families facing uncertainty about whether they will get the care they need, or whether their existing care will continue to be possible.”

In a direct appeal to the new Prime Minister, he said: “Councils across the country will hope his public commitment to reforming adult social care comes to fruition, helping them to deal with the highest levels of social care need and cost they have faced.

“We must make sure that our government uses this momentum so that next year’s ADASS national survey signals positive change rather than more of the same”.