The government will set up an independent commission to recommend long-term reform to adult social care, it announced today.
The body, which will be led by former senior civil servant Baroness (Louise) Casey, will examine the key issues facing the sector today before recommending changes designed to help achieve the government’s ambition of creating a ‘national care service’ and based on a cross-party consensus.
Care minister Stephen Kinnock said the Casey Commission would “tackle both the immediate issues and the fundamental challenges that must be addressed if we are to get our adult social care system back on its feet and fit for the future”, with a view to ensuring “everyone is able to live with the dignity, independence and quality of life that they deserve”.
Casey review due to report in 2028
However, the commission is not due to issue its final report until 2028, sparking concerns that the challenges facing the sector will deepen in the meantime.
Alongside the announcement, the Department of Health and Social Care (DHSC) pledged a series of other changes to adult social care, including:
- Increasing the 2024-25 budget for the disabled facilities grant (DFG) by £86m, to £711m, to fund more home adaptations for disabled and older people to enable them to remain independent for longer.
- Skilling up social care staff to carry out more health tasks, such as blood pressure checks, to reduce the need for people to travel to NHS settings.
- Developing a shared digital platform for health and social care to enable staff to share information in a timely fashion.
- Creating national standards and guidance on the use of technology in social care to enable people needing care, families and providers to choose the most effective and safe tools.
- Reforming the Better Care Fund – which pools a portion of NHS and local authority budgets – to focus it on tackling emergency admissions, delayed discharges and admissions to long-term residential care.
Third commission on social care reform in three decades
The Casey Commission is the third independent commission on social care reform in England to be created over the past three decades.
It follows the Royal Commission on Long Term Care for the Elderly, set up by the New Labour government to examine the short and long-term options for developing a sustainable funding system. While some of its recommendations, delivered in 1999, were accepted, ministers rejected its key proposal of introducing free personal care for those aged 65 and over.
Eleven years later, the coalition government established the Dilnot Commission, to examine how to deliver a fair, affordable and sustainable funding system for social care in England.
Its proposals – chief among them a cap on people’s lifetime liabilities for personal care – were accepted and enacted through the Care Act 2014. However, despite successive governments promising to introduce versions of the commission’s proposals, such plans have all been dropped, most recently by the current Labour administration.
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‘Political point-scoring’
“Previous attempts to reform adult social care have failed due to a destructive combination of party political point-scoring and short-term thinking,” said Kinnock. “Baroness Casey’s commission will build cross-party consensus, and will lay the foundations for a national care service that’s rooted in fairness and equality.”
The commission will begin work in April this year, delivering an initial report in mid-2026, setting out the key issues facing the sector and recommendations for medium-term reform.
The second phase, reporting by 2028, will recommend long-term reforms, which the DHSC said would “look at the model of care needed to address our ageing population, how services should be organised to deliver this, and how to best create a fair and affordable adult social care system for all”.
Commission welcomed but concerns over timescales
Sector bodies welcomed the announcement of the commission, but raised concerns about the length of the timescales it was working to.
Association of Directors of Adult Social Services (ADASS) president Melanie Williams said it looked forward to working with Casey on the project, but warned: “Unfortunately, the timescales announced are too long and mean there won’t be tangible changes until 2028.
“We already know much of the evidence and options on how to reform adult social care…and worry that continuing to tread water until a Royal Commission concludes will be at the detriment of people’s health and wellbeing.”
For Age UK, charity director Caroline Abrahams described the announcement as “unequivocally good news”, but raised concerns about the government’s willingness to implement the commission’s recommendations, as well as the timeframes involved.
“Even if all goes well the reality is that it will be the early 2030s before older people and their families get substantial benefit from a transformed approach to social care – fully thirty years after Japan and Germany modernised their social care systems,” she added. “That’s a source of profound regret and it leaves today’s older people and their families to make the best of a system that is widely agreed to be letting many down.”
King’s Fund chief executive said that the commissioned offered the opportunity “to break the cycle of failure to reform social care”.
She added: “We believe the first phase of the commission should focus on funding and on measures the government could quickly get on with implementing, such as work to improve the use of data and technology in the social care sector, better integration with the NHS and making adult social care a more attractive career. Work on many of these issues is already underway but should be sped up.
“But we urge the government to accelerate the timing of the second phase of the commission which focuses on creating a fair and affordable social care system. The current timetable to report by 2028 is far too long to wait for people who need social care, and their families.”
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The funding and the politics are the issues. We know what needs to be done. We have ‘pilot projects’ that have been running for twenty five years or more that need to be rolled out.
Then issue is getting the public to agree the funding and the issue within the issue is that the demographic that will benefit most, the over 65s, are both the wealthiest and the least inclined to pay taxes or vote for parties that advocate raising taxes.
How true. Over the past decades people have become so self centred and just don’t want to contribute to the vital services that we all need. That is until a member of their family need such services, then they expect gold standard care and are quick to want compensation should anything dare to go wrong
Really. My parents contributed their whole life and then some. They were also promised cradle to grave. Perhaps a closer look at wasted finance and general mismanagement would be a better route.
Older people and vulnerable are being let down badly, no one is crying out about that. And why denounce those who want good care? Would you not want the same for your loved ones?
As to things going wrong, Why should you not be accountable for negligence and poor practices? Everyone else has to be.
Absolutely agree with you. I have contributed all of my life to taxation and still do. Older and disabled people should not be ignored due to political and financial restraints. As a society we have a duty of care to take a human rights based approach to the health and care of everyone
We have little faith in any governments response to any commissions findings . Little change over the years has once again seen us dropping down in another European league table ! By 2030 when any change could possibly be implemented how many elderly, deserving,hard working tax paying citizens of the UK will have spent their final years in need of help and the support that was unavailable ? Entirely due to successive governments cowardice in the face of an expensive difficult and contentious overhaul of another vital service to the British public !
Is it so surprising that many would like to quit this mortal coil before they suffer themselves, become an intolerable burden upon their family and an ever service depleted society
As I have only just added my name and email address I think that is highly unlikely that this is a duplicate comment !
Surely it’s time the government commissioned full audits of all care providers starting with home care providers because I have done a lot of auditing of such for Councils and every single one without exception is charging councils significantly more than the care they are delivering – bringing back millions to the Social Care Budget for recycling so more people can get the care they need and increasing care capacity in the community. It really isn’t rocket science.
I feel passionate about this area of great need and consideration across the UK and would like to volunteer to be part of the review group and make a positive contribution to this critical project. Thank you.
Pam Hornor
Delighted to see what looks like a real opportunity at last. Louise Casey is an interesting choice to lead & hopefully will bring some common sense solutions to tricky complexities mostly ignored by others eg context, intergenerational family dynamics, role of VCs underpinning funding solutions.Welcome Kings Fund urging immediate action on technology & integration with healthcare. Love to contribute. What’s Com Care planning?
What could you contribute Julia?
Are you insane. We have known what the issues are for years. Ask the families. How much will this commission cost?. And how will you tackle immediate issues and yet wait till 2028 to publish.
Labour hang your head in shame.
Can anyone actually point out a positive concrete outcome from the many previous commissions, enquiries and the like Dame Casey has chaired? Just one. As far as I can see we still have homelessness, police forces are still impacted by misconduct, Rotherham review made next to no difference. Serial failures all in my view. As will the this one from the Baroness I’ll venture.