Across adult social care, the debate about reform and what this might actually mean is increasingly shifting - from whether we can afford to act, to whether we can afford not to. Both options carry risks for the whole of society but slowly we are building an evidence base which can be used for impartial and informed guidance in this debate.

Recent work led by Cordis Bright for the Joseph Rowntree Foundation highlights the scale of what has too often been overlooked: low pay is not simply a workforce issue, but a systemic inefficiency that carries significant hidden costs. With around 40% of care workers paid below the Real Living Wage and persistently high turnover, the sector absorbs substantial financial and operational pressures through recruitment, training, and service instability.

This evidence aligns closely with the tone and urgency of Baroness Louise Casey’s recent address to the Nuffield Trust Summit. Her call for a “moment of reckoning” underscores a system that has evolved without a clear political settlement. Fragmented across institutions, reliant on low-paid labour, and lacking coherent accountability. The consequences are felt not only by the workforce, but by individuals and families navigating a system that is too often complex, fragile and under strain.

From a Cordis Bright perspective, these two strands—evidence on hidden costs and a renewed national discussion on reform—point to the same conclusion: investment in the social care workforce is not a marginal policy choice, nor should it be a point of political difference, but fundamental to the systems sustainability. As debate accelerates, the sector has an opportunity to reframe low pay not as a cost pressure, but as a critical lever for stability, quality and long-term value.