Proposals on long-term funding for adult social care in England are unlikely to be delivered before 2028 at the earliest, the government has confirmed.
Health and Social Care Secretary Wes Streeting promises to “finally understand welfare reform”, and an independent commission will begin work in April.
But the commission, chaired by Baroness Louise Casey, will not publish its final report until 2028.
Councils and healthcare providers say it is too long to wait for reform of vital services already on their knees.
The government also announced immediate plans to get health workers to carry out more health checks and increased funding for services to help older and disabled people stay in their homes.
Social care means help for older or disabled people with everyday tasks such as washing, dressing, taking medicine and eating.
Only those with the most complex health needs receive free social care from the NHS, so most care is paid for by councils.
In England, only people with high needs and savings or assets of less than £23,250 are eligible for such help, leaving an increasing number of people to fund themselves.
Some face paying hundreds of thousands of pounds for their care and may be forced to sell their own home as a result.
The government’s ultimate goal is “a new National Care Service, capable of meeting the needs of older and disabled people in the 21st century,” Streeting said.
He said he had invited opposition parties to sit on the commission “to build a cross-party consensus to ensure the National Care Service survives governments of different shades, just as our NHS has done for the last 76 years.” .
Baroness Casey, who has led several high-profile investigations including homelessness, the Rotherham child exploitation scandal and the Metropolitan Police, said she was delighted to “lead this very important work”.
In government she is considered an outspoken person, with good cross-party ties and someone who gets things done.
Still, putting together a plan for a National Care Service that meets the needs of an aging population and is affordable is perhaps its biggest challenge yet.
There is agreement that the care system has been in crisis for years, struggling with growing demand, lack of funding and staff shortages.
The problem has been reaching a political agreement on how the overdue reforms will be financed.
In 2010, Labor plans to fund social care were labeled a “death tax” at that year’s election, and Conservative plans were called a “dementia tax” at the 2017 election.
There have also been numerous commissions, reviews and consultations over the past 25 years that have failed to bring about change.
The Dilnot Commission’s 2011 plan to limit personal care costs came the closest: It was signed into legislation but not implemented.
Was finally scrapped by the new Labor government last summer because he said that the last conservative administration had not set aside money to finance the reform.
However, providing sufficient support to people in their own homes, care homes and supported living remains a pressing issue.
The care systems in Scotland, Wales and Northern Ireland are slightly more generous, but all face the pressures of rising demand and tight finances.
“Our aging society, with care costs set to double in the next 20 years, demands longer-term action,” Streeting said.
The government had promised a National Healthcare Service in its manifesto, although it provided few details.
The independent commission will work with care service users, their families, staff, politicians and the public to recommend the best way to create a care service that meets current and future needs.
“Millions of older people, disabled people, their families and carers depend on an effective adult social care system to live their lives fully with independence and dignity,” said Baroness Casey.
“An independent commission is an opportunity to start a national conversation, find solutions and build consensus on a long-term plan to fix the system.”
The commission will report to the prime minister and its work will be divided into two phases.
The first phase will identify critical issues and recommend medium-term improvements. This will be reported in mid-2026.
The second phase will look at how to organize care services and finance them for the future. This report is not due until 2028, one year before the next elections.
Independent health think tank King’s Fund urged the government to “speed up the clock”.
“The current reporting timeline until 2028 is too long to wait for people who need social care and their families,” said its chief executive, Sarah Woolnough.
Councils, which are under enormous financial pressure, pay for care services for most people.
Melanie Williams, president of the Association of Directors of Adult Social Services, agreed that “the timelines are too long.”
She believes much of the evidence and options on how to reform adult social care are already known and is concerned that “remaining deadlocked until a commission concludes will be to the detriment of people’s health and wellbeing”.
Around 835,000 people received publicly funded care in 2022, according to the King’s Fund. The charity Age UK estimates that there are around two million people in England who have unmet care needs and, according to workers’ organization Expertise for Care, while 1.59 million people work in adult social care in England , there are currently 131,000 vacancies.
Helen Walker, director of Carers UK, which represents millions of unpaid family carers, said families were “under intense pressure and providing more care than ever”.
When older or disabled people can’t get the help they need in the community, they are more likely to end up in the hospital or stuck in a ward when they are ready to leave.
Amanda Pritchard, chief executive of NHS England, said: “We hope this very important action plan and commitment to creating a National Care Service will help to better support people and relieve pressure on hospital wards.”
The government also confirmed that an additional £86 million would be spent before the end of the financial year in April to help many older and disabled people stay in their homes.
The money comes on top of a similar sum announced in the Budget for the next financial year.
In total, it should enable 7,800 disabled and elderly people to make vital improvements to their homes, which should increase their independence and reduce hospitalisations, the government says.
Other changes include:
- Better career paths for care workers
- Better use of technology and new national standards to help older people live at home longer
- Improve the skills of healthcare workers to perform basic checks, such as blood pressure management.
- a new digital platform to share medical information between the NHS and healthcare staff.
