From April 2026, a care worker calling in sick on Monday morning will qualify for statutory sick pay (SSP) from that first day – a welcome change that promises better security. But, without matching funding increases, homecare providers face impossible choices – breach employment regulations, cut quality or exit the sector entirely.
Government is right to improve sick pay protections – care workers deserve this security. The question is not whether this change is needed but whether the funding framework can support it. Currently, SSP becomes payable from day four of sickness, with three unpaid waiting days. The reforms remove the waiting days and the Lower Earnings Limit, so most employees will qualify. For low earners, SSP will be the lower of the flat rate (£123.25 in 2026/27) or 80% of normal weekly earnings. A new Fair Work Agency will enforce compliance alongside minimum wage and holiday pay.
The challenge lies in how SSP interacts with homecare’s flexible working patterns. SSP remains calculated using qualifying days – the days an employee normally works. When entitlement starts immediately, ambiguity about working patterns becomes expensive. In homecare, with rotas that flex weekly and widespread use of bank and zero-hours contracts, providers face uncertainty about evidencing qualifying days and determining how far SSP runs where staff with less than three months’ service have only ‘agreed to work’ particular shifts.
One large provider’s experience illustrates the sensitivity – moving from full contractual sick pay to SSP-only produced a 7% swing in sickness within a month. If more generous day-one SSP pulls in the opposite direction, cost consequences will be significant. Homecare Association modelling suggests day-one SSP could add 11-29p per hour to providers’ costs, depending on absence levels.
This sits atop a structural funding gap. Our Homecare Deficit analysis shows 29% of public bodies pay rates below direct staffing costs at minimum wage. Some London councils pay only £17-£18 per hour, though our calculated Minimum Price for Homecare for 2026/27 is £34.42. Adding new SSP liabilities without explicit recognition in fee setting leaves providers facing non-compliance, cutting quality or exiting regulated provision.
International experience shows more generous sick pay usually ties to tighter obligations and broader social insurance. In Germany, employers typically pay 100% of wages for six weeks, with statutory health insurance covering around 70% thereafter; doctor’s certificates are required after three days. The Netherlands mandates at least 70% of wages for up to two years, within social partnership frameworks that spread risk between employers, insurers and the state – all priced into sector funding models. By contrast, UK homecare providers must carry new day-one SSP risk within fragmented, under-funded commissioning, without earlier certification requirements or shared financing structures.
For day-one SSP to succeed in homecare, three things are essential. Firstly, national guidance must give clear, worked examples on qualifying days, zero hours and variable patterns, so providers, payroll teams and inspectors apply rules consistently. Secondly, commissioners must build realistic SSP cost assumptions into 2026/27 fees, drawing on provider modelling rather than optimistic forecasts. Finally, SSP reform should align with wider work on fair pay agreements, prevention and workforce sustainability, and not be treated as a standalone legal tweak.
Care workers should not have to choose between health and income. Equally, providers should not have to choose between compliance and survival because funding has not caught up with policy intent. Without realistic funding, this reform risks accelerating the very workforce shortages it aims to solve.
Dr Jane Townson OBE is Chief Executive Officer at the Homecare Association. Email: [email protected] X: @homecareassn