The new commission on social care reform should deliver final proposals by the end of this year, not by 2028, as planned, according to the author of the last major review of the sector.

Andrew Dilnot told MPs that a host of challenges facing people who need care, families, care staff, councils, providers and the NHS had gotten worse because of a failure to reform the system since his commission reported in 2011.

The economist was speaking to the House of Commons’ health and social care select committee in the wake of the government’s announcement of a commission – headed by Baroness (Louise) Casey – to draw up proposals for adult social care reform.

Casey, a former senior civil servant who has led several other public service reviews in recent years, is due to issue an initial report next year and her final conclusions by 2028, a timeframe heavily criticised by sector leaders.

Casey ‘should report by end of 2025’

Dilnot, who led the last social care commission, in 2010-11, said Casey should be able to deliver her recommendations by the end of this year, and would only be prevented from doing so by a lack of political will from government.

“I think Louise Casey will very quickly work out what needs to be done,” said Dilnot. “And I think she should say what needs to be done as quickly as possible…I think it would be perfectly feasible for the government to expect by the end of 2025, [to be able to say] ‘actually, we know what needs to be done’.”

He added: “It really is a matter of political courage and political decision-making. We know things can happy very quickly once a government, a House of Commons, decides to get something done.”

What Dilnot recommended

Dilnot’s 2011 report made two key recommendations:

• Increasing funding for the existing means-tested system, to address unmet and under-met need.
• Extending the means-test to enable more people to take advantage of state-funded care and capping people’s total costs for their personal care, to insure the population against catastrophic care costs.

The first recommendation fell foul of the austerity policies of the 2010s, but the coalition government legislated to enact the second through the Care Act 2014. However, its implementation, due in 2016, was first delayed and then ditched altogether by the Theresa May government.

It was then revived in modified form, in 2021, under Boris Johnson, but its implementation was delayed again before the plan was scrapped by the current Labour government on attaining power last year.

Dilnot’s list of costs of failing to reform social care

Dilnot said the priorities for reform remained the same but the need to take action had become more urgent since his report, listing several costs arising from a failure to act:

1. The potentially large and unknowable costs faced by individuals. “I’ve often likened needing social care to being in a shop with no prices,” said Dilnot. “Because you know how much it will cost each week or month for your partner, your mum or your grandma to be looked after, but you don’t know how long it’s going to go on for.”
2. Self-funders paying more for their care than local authorities.
3. People having to build up savings in case they need a lot of care. “80% of 65-year-olds will need social care before they die, but the amount they will need is unknowable and most of them actually won’t need very much and a small number will need an awful lot,” Dilnot said. “But in the current system all of them are faced by needing to set aside a lot of money in case they are one of the unlucky ones. So, a significant cost of inaction is that many people, not with especially large amounts of income and wealth, are setting aside money that they won’t actually need because there is no pooling of the risk.” 
4. Premature loss of function and loss of life arising from unmet need.
5. The difficult decisions families face about, for example, making home adaptations now or saving money should a loved-one need care in future.
6. The impact of informal care on people’s ability to work and function.
7. The direct effects on the NHS of inadequate social care. “If you are an elderly person with significant social care needs, you’re very likely to have some continence challenges,” Dilnot said. “That’s quite likely to lead, if you don’t have a downstairs loo, to you falling down the stairs and ending up in hospital unnecessarily.”
8. The indirect impact on the NHS. “Because there isn’t good social care that we can get people into when they need to leave the NHS, we have NHS hospitals that have many people in them who don’t need to be there,” said Dilnot. “The frustration that causes to clinicians is extraordinary.”
9. The impact on providers. “The lack of a functioning market means that there are very low returns to innovation and investment and so not much innovation and investment going on,” said Dilnot. “[Providers] are squeezed – we have endless stories of providers handing their contracts back to local authorities because they simply can’t make things work…This could be an area where we could see economic growth if we had a sensible model. We don’t so we can’t.”
10. The impact on care staff. “Staff are under really intense pressure and are not paid enough and have every few opportunities for career progression,” Dilnot added. “All of that is a function of the model we have.”
11. The impact on local authorities. “The inadequate funding of social care means all other services that local authorities provide are being squeezed and the decisions that local authority staff are asked to make would try the wisdom of Solomon,” he told MPs. “If any of you wants to experience a really stressful period, go and sit alongside somebody who is making decisions in a local authority about how to allocate resources to people who desperately need care.”

Asked by MPs why his reforms had not been implemented, Dilnot said: “Somehow, for reasons I don’t quite understand, not enough people make enough noise about [social care], so it feels like an easy thing to pull back on.”

He added that, while there had been consensus on what needed to change in social care, there had not been sufficient agreement on how this would be paid for.

‘Tiny amounts of money’ required to reform care

This is despite spending on adult social care – roughly £30bn a year currently – amounting to just 2% of total public spending – and the reforms that Labour scrapped last year being due to add a further £5bn a year to costs over the long-term. This compares with a £22.6bn increase in annual NHS funding, from 2023-24 to 2025-26, announced by Labour last year.

“So these are tiny amounts of money compared to overall levels of public spending and very small amounts of money compared to the amounts of money that have been added, with enormous support, to the health service budget,” he added.

Dilnot said that, while improvements to the current means-tested system should be funded through general taxation, there was a case for exploring a different way of resourcing an expansion of people’s entitlements to social care.

He said the health and social care levy – a 1.25 percentage point supplement to national insurance, introduced by the Boris Johnson government, in part to fund social care reform, but then scrapped under Liz Truss – was “quite an interesting idea”.

“I think that one of the things that Baroness Casey will undoubtedly want to look at is whether there’s an argument for something like that,” Dilnot added.

Social workers are divided on whether they would pay more tax to boost spending on services including social care, a Community Care poll has found.

This follows the government’s decision to scrap the planned cap on care costs and a training fund for adult social care workers, citing the need to address the gap in public finances it claimed had been created by the Conservatives.

The decision was made despite the Labour Party having pledged to implement the cap and associated reforms to adult social care charging during the election campaign.

At the same time, the party also promised not to raise the three major taxes – income tax, VAT and national insurance – limiting its capacity to tackle the pressures on public finances.

A recent Community Care poll amassing 2,800 votes asked social workers whether they’d be willing to pay more tax to increase public spending on services, including social care. It revealed mixed results.

While a third (31%) said taxes were already too high and that “the government needs to be more efficient”, a majority (69%) were in favour of some form of tax increase. However, they were split on the methods.

One group (26%) backed tax rises without qualification, on the grounds that “we need more funding”.

A comparably-sized segment (25%) said taxes should only rise for “the wealthiest”, while the rest (18%) said they would only be willing to pay a social care-dedicated tax.

Calls to tax the wealthy

Practitioners commenting on the related articles shared their ideas for raising revenue to pay for provision.

Andrew was firmly in the camp of taxing wealthier people.

“Until the government bites the bullet and taxes the rich, super rich and big corporations properly and fairly, in other words when these people actually pay their fair share, then there will be no fully funded, efficient public services,” he said.

Similarly, Berni backed the idea of making council tax more progressive by increasing levies on those with more expensive properties.

“I think changing the council tax banding would be a good place to start and should raise more money for local councils,” she said. “It does not seem right that I pay the same CT as someone who owns a very expensive property, who has the means to pay a fair amount.”

A social care-specific tax

She also mooted the idea of a social care-specific levy but warned that this would be a “slippery slope”.

However, Jeremy was of the view that the new Labour government may well bring such a tax in.

“It would not surprise me if a care levy was introduced to be deducted from earnings similar to national insurance,” he said. “That doesn’t solve the current challenges but it would enable [Rachel] Reeves to say she is tackling the problem unlike previous chancellors.”

‘People should pay for their care if they have the money’

Others were of the view that the cap on care costs was not the best use of public spending in any case.

Jackie pointed out that most of the benefit would go to people with higher levels of savings, rather than poorer people, adding: “I do still believe if people have the money they should pay for own social care.”

Others pointed to the significant burdens it would place on already stretched councils.

“There is no way at all the local authority I work for would be able to implement this ‘cap’ properly or fairly,” said Anna Borne.

“We would need a lot more social workers, finance assessment staff, and a lot more funding.”

“I agree, I work in a local authority and we simply could not afford it,” added Rebecca. 

“Nor, do we have the workforce to carry out the thousands of extra assessments. It was a terrible idea in the first place.”

What are your thoughts on increasing taxes to boost public spending?

People face a “massive postcode lottery” in access to adult social care according to official data, charities for older and disabled people and carers have warned.

There were wide differences between and within regions in the proportion of people whose requests for care and support were granted in 2022-23, found an analysis of NHS England data by the Care and Support Alliance (CSA).

The alliance said this showed that councils were screening out people who should be eligible for funded care because of a lack of resource to meet need.

Variations in access to care

According to the NHS England data, 58% of requests in 2022-23 in England ended with no care being provided, which includes cases where the person was signposted to other organisations, such as charities, offered universal services or died while waiting for a response.

However, the average ‘rejection rate’ varied significantly between regions, ranging from 46% in the North East to 68% in the West Midlands, found the CSA.

There were even bigger variations between local authorities, with the proportion of rejected requests ranging from 12% to 85% across English councils. The region with the biggest internal variation was London, where the rate varied between 20% and 84%, while the narrowest gap was in the East of England (36% to 62%).

Councils rationing care, say charities

The CSA said that the scale of the variations meant that councils were turning away people who were eligible for funded care because of a lack of resources, as defined by the single national threshold for care and support set by regulations under the Care Act 2014.

“Over the last few years, it is clear that although the law itself hasn’t changed, it is increasingly being interpreted by local authorities in ways that mean that some people who would have qualified for state funded help with their care ten…years ago, are now being screened out,” said Age UK charity director and CSA chair Caroline Abrahams.

“Why? Because local authorities often simply lack the funding, and sometimes the staff, to do anything other than ‘ration’ the care they offer their local population – in other words, they are having to spread the jam more thinly.”

‘Access to care should not depend on where you live’

For the Association of Directors of Adult Social Services, chief executive Anna Hemmings said: “Access to good quality care shouldn’t be dependent on where you live, but years of lack of investment in social care and financial pressure on local government means councils across the country face a challenge to provide the level of care and support we’d expect for ourselves or family members.

“Social care should be there for all of us but that requires government to commit to investing in a long term, fully funded plan to provide more support to unpaid carers, build a workforce able to deliver the care we need and shift to providing more support at home and in the community.

“We need to show our politicians that social care is a priority that requires action and investment, so that we build a care and support service we can all rely on when we need it.”

Suggested reasons for variations in access

Though the CSA did not interrogate the data further, it suggested various reasons for the variations.

For example, they could be down to some areas having relatively more care staff due to stronger labour markets, some councils being better able to raise resources locally to fund care services and the government’s formula for funding adult care being out of date and no longer reflecting population need.

At a national level, the annual number of requests for care grew by 10.6% from 2015-16 to 2022-23, while the number of people receiving long-term care or short-term reablement services fell by 2.1%, according to analysis by the King’s Fund.

Decline in numbers receiving care nationally

The think-tank’s senior fellow for social care, Simon Bottery, said: “It’s certainly true that rationing of publicly-funded social care by local authorities is a likely explanation for the overall decline in the number of people receiving adult social care since 2015-16, despite an increase in requests for support.

“Funding cuts have hit some local authorities harder than others so these differences could well be a factor in the amount of care provided in response to requests for support.”

However, he said there were other possible explanations for the variations between areas.

This included some authorities making a shift towards a more strengths-based model of care, “with requests for support intended to be addressed through voluntary support in communities rather than automatically through provision of paid-for social care”.

Other possibilities included that some councils had self-assessment tools that may reduce the number of formal requests for care, while Bottery also pointed to past Local Government Association research which found that 78% of the variation in per person spending on older people’s care could be explained by demographic and other factors.

Cap on care costs scrapped

The CSA’s findings were released as the new Labour government announced it would not take forward planned reforms to the system of charging for adult social care. These would have introduced an £86,000 cap on people’s private spending on their personal care and made the means-test for accessing services much more generous.

As a result, it would have resulted in councils funding services for many people with eligible needs for care who currently do not qualify for services on the basis of their wealth.

However, it would not have addressed the issue raised by the CSA of people with eligible needs not receiving the care they are entitled to because of rationing by councils.

Sector leaders have urged the government to “change course on social care” after a week in which it cancelled the cap on care costs and a planned increase to workforce training funding.

In an open letter to health and social care secretary Wes Streeting, more than 30 leaders said the decisions had “raised alarm bells” for those working in, and receiving, social care.

And in a reference to the pay settlements granted to public sector staff outside of the sector, they said these were “a bitter pill for social care in a climate where other public services and their workforces are finally having their contribution recognised”.

The letter was signed by the heads of seven of the major umbrella bodies for care providers: learning disability body ARC England, the Association of Mental Health Providers, Care England, the Homecare Association, the National Care Association, the National Care Forum and the Voluntary Organisations Disability Group.

Other signatories included the heads of the Social Care Institute for Excellence, Learning Disability England, which represents people with learning disabilities and their families and several providers and local provider associations.

Ditched social care policies

Their intervention came days after the government first scrapped the adult social care charging reforms, due to come into force in October 2025, and then ditched the adult social care training and development fund proposed by its Conservative predecessor.

Both decisions were made to tackle a £21.9bn projected overspend on public spending, which chancellor Rachel Reeves said had been bequeathed to Labour by the Conservatives. This was despite £9.4bn of the funding gap being down to the incoming government’s decision to accept recommendations on public sector pay made by independent review bodies.

In their open letter to Streeting, the sector leaders acknowledged the “hugely challenging” economic situation. However, they stressed that social care was critical to delivering some of the new government’s key ambitions.

“Without high quality social care, it will be impossible to fix the broken NHS,” they said. “Without high quality social care, it will be impossible to sustain economic growth. Without high quality social care, it will be impossible to lift-up our communities and the people that live in them.”

‘Change course on social care’

The letter added: “We now need to see positive action on social care. There is time, political capital, and the expertise of a united social care sector to make this happen. We urge the government to change course and we stand ready to help you transform social care for the millions who work in it and most vitally, rely upon it.”

The sector leaders also referenced Labour’s two key policy pledges on social care: to introduce a fair pay agreement for the workforce and, over the next decade, to set up a national care service.

The fair pay agreement is designed to raise pay, terms and conditions for staff and will be legislated for in the forthcoming Employment Rights Bill, though the government is yet to say how the improvements will be funded.

It has also not fleshed out what it means by a national care service.

In their letter, the sector leaders said they needed “assurances about the timeframes and support needed to move to a national care service and the introduction of a fair pay agreement for care workers”.

Scrapping the cap on care costs is “another example of social care being tossed aside”, according to the architect of the reforms.

Economist Sir Andrew Dilnot told BBC Radio 4’s Today programme that the government’s decision meant that society had “failed another generation of families”.

A commission led by Dilnot, which reported in 2011, drew up proposals to insure people against very high costs for their social care, including two key elements:

• A cap on their lifetime liabilities for personal care, after which these costs would be picked up by the state.
• A much more generous system of means-testing, enabling people with assets of up to £100,000 to receive some state-funded care, up from £23,250.

While successive governments have agreed to implement a version of the reforms, they have then either ditched or delayed them.

Reversal of election commitment

During the election campaign, the now health and social care secretary Wes Streeting said that the Labour Party was committed to implementing the changes – slated for commencement in October 2025 by its Conservative predecessor – because he wanted to give the sector “certainty” about the future.

However, this week chancellor Rachel Reeves cancelled the policy, which would have set an £86,000 cap on personal care costs, in order to save £1.1bn by the end of 2025-26. This was so the government could deal with what she said was a significant unexpected overspend on government expenditure left by its predecessor, a view rejected by the Tories.

Following Reeves’ announcement, Dilnot told Today: “I think it’s a tragedy and it’s also very disappointing given what was said in the election campaign.”

Social care being ‘tossed aside’

He added: “To rip this up is unbelievably disappointing for hundreds of thousands of families who need care, for the people who are providing it, for those who are trying to make decisions about it. It’s another example of social care – something that affects people at some of the most difficult points in their lives – being given too little attention, being ignored and being tossed aside.”

According to an impact assessment published in 2022, around one in seven older people will face personal care costs in excess of £100,000 during their lifetime. Illustrating the benefits of the proposals, the assessment said that:

• A person with £145,000 in chargeable assets and an income of £239 per week could deplete 84% of their assets after five years in residential care under the current system, whereas under the reforms, this would drop to 57%, a saving of £40,000.
• A person with £55,000 in chargeable assets and the same income could deplete 57% of their assets after three years’ domiciliary care under the current system, compared with 30% under the reforms, a saving of £15,000.

‘We have failed another generation’

“We have to recognise that we have failed another generation of families,” Dilnot told Today. “[Funding social care] is something that we truly can’t all do on our own, we do it much better together, like we do with the National Health Service.”

He also rejected the idea that the proposal was expensive, adding that the saving made by Reeves in cancelling the reforms was worth 1/1000th of annual public spending.

“So, the arguments for action for the government here are really powerful, the cost of acting is not great and the transformation of lives of those who need care, their families and those who are providing it are transformative,” he added. “I really hope that after this blip we get back to a serious plan.”

Decision ‘pushes care burden onto individuals’

Charities also voiced disappointment about the impact on older people and their families of the government’s decision.

Emily Hindle, policy manager at Alzheimer’s Society, said: “We are very disappointed at the UK government’s decision not to proceed with the cap on social care costs in England.

“While we appreciate the financial challenge the new government faces, this decision pushes the burden onto individuals who pay around £100,000 for care on average when they are already dealing with dementia’s devastation on their lives.”

For Age UK, charity director Caroline Abrahams said that the decision was “really bad news for all those older people who were hoping against hope for some relief from their sky-high care bills – in the short term at least it seems they are on their own”.

She said the government needed to tackle this issue as “part of a broader package of measures designed to stabilise and reform social care – and sooner rather than later”.

‘No plan to address core issue in adult social care’

Think-tank the King’s Fund said the decision was regrettable and meant that the government had “no plan to address the core issue in adult social care –the growing mismatch between the population’s need for support, and the availability of publicly funded care”.

Its chief executive, Sarah Woolnough, referred to Labour’s commitment in its election manifesto to build a cross-party consensus to reform adult social care, saying that the party needed to “work at pace to deliver it”.

Her equivalent at fellow think-tank the Nuffield Trust, Thea Stein, cited the fact that, under the Conservatives, the charging reforms were delayed in order to plough the allocated funding into meeting day-to-day spending pressures on social care.

“We urgently need to move social care reform from being tomorrow’s aspiration to being today’s priority,” she said. “Care users and their families are feeling the effects of this right now, and the new government needs to make a statement about their intention to improve this dire situation.”

Reforms ‘unfunded’ and ‘ignored disabled people’

The Voluntary Organisations Disability Group, which represents providers of services to disabled people, was more sanguine about the government’s decision, saying the reforms were unfunded and “ignored millions of disabled people drawing on social care” because of their focus on older people.

However, its chief executive, Rhidian Hughes said: “That said, the pressures of increasing unmet need are not going away, and an urgent solution is vital for state-funded social care and support…We need government reform with a significant focus on improving commissioning coupled with an injection of funding to address the growing funding gap.”

The County Councils Network (CCN), which had lobbied for the reforms to be delayed again, said that implementing the reforms in October 2025 “could have had some catastrophic consequences for council finances, health and care systems and individuals who currently receive services”.

Shortages of social workers to implement changes

This was both because of the lack of funding allocated to the reforms, but also the “acute workforce and system pressures” facing councils, said its adult social care spokesperson, Martin Tett.

Analysis by the consultancy Newton for the CCN found that authorities would have needed an additional 4,443 social work staff to implement the reforms – all things being equal – because of the many thousand additional assessments, care plans and reviews required for existing self-funders entering the system.

Tett added: “We must remember that reform to social care encompasses much more than charging reform. We want to work with this government on other key reform agendas, such as addressing the recruitment and retention crisis in the care workforce and on ensuring the day-to-day care services are sustainability funded and reformed in the long run.”

‘Doing nothing comes at a cost’

For the Association of Directors of Adult Social Services (ADASS), president Melanie Williams said: “We are of course disappointed that government has decided not to proceed with charging reform, in particular those changes that would have supported people with the least means to access state-funded care and support. However, the absence of allocated funding for the reforms and sufficient time to deliver them by October 2025, is why we previously called for the timeline for delivery to be reviewed.

“Whilst it is clear that any reform of adult social care will be at a cost to the Treasury, it should not be forgotten that continuing along the same path that we are on also comes at a cost, not only in monetary terms, but most importantly to the lives of people who draw on care and support, their carers and family not able to access the care and support they are need to live the lives they want.”

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The government has scrapped the planned cap on care costs to help tackle a black hole in the public finances it claimed was left by the Conservatives.

Chancellor Rachel Reeves announced today that the adult social care charging reforms, due to be implemented in October 2025, would be cancelled, saving £1.1bn by the end of 2025-26.

This is despite the Labour Party indicating it would implement the reforms during the election campaign.

The move was roundly condemned by the architect of the reforms – economist Sir Andrew Dilnot – and older people’s charities, though council leaders stressed they would not have been able to implement the changes next October.

‘Unfunded commitment after unfunded commitment’

Reeves made the announcement in a statement to the House of Commons on Labour’s spending inheritance from its Conservative predecessor.

Reeves claimed that the government as a whole was due to overspend budgets by £21.9bn by the end of 2024-25 because the Tories had made “unfunded commitment after unfunded commitment, knowing that the money was not there”.

The unfunded spending pressures cover the asylum system, health, rail services and aid to Ukraine.

However, just under half – £9.4bn – is the result of a decision Labour has taken to accept the recommendations of the independent pay review bodies for various public servants, including NHS staff, teachers and police officers.

This is because the bodies had proposed rises of 5-6%, well above the 2% baked into the government’s accounts at the last major review of spending, in 2021.

Multiply delayed reforms

Reeves’s statement seemingly sounds the death knell for a reform agenda conceived thirteen years ago by an independent commission – led by economist Sir Andrew Dilnot.

They were put into law through the Care Act 2014, then had their implementation delayed from 2016 until 2020 and were subsequently scrapped by Theresa May’s government, in 2017.

Boris Johnson’s administration then revived the plan in 2021 before delaying their planned start date from 2023 to 2025 after lobbying by council leaders that they would be unable to implement the changes.

At the same time, they rerouted £3.14bn in funding over three years from the charging reforms to bolstering councils’ day-to-day adult social care budgets.

What Labour said during election campaign

During the election campaign, the Conservatives pledged to implement the changes, as planned, in October, though think-tank the Institute for Fiscal Studies (IFS) pointed out that no funding had been allocated to doing so.

Labour indicated that it would also implement the changes, with the now health and social care secretary Wes Streeting saying that he was “committed” to the changes and wanted to give the sector the “certainty and stability” of knowing that what had been planned would take place.

However, in a document to accompany the statement, the Treasury said that the Conservatives had committed to introducing the adult social care charging reforms in October 2025 “but did not put money aside for them”.

Reforms ‘now impossible to deliver’

“The reforms are now impossible to deliver in full to previously announced timeframes,” it added.

The decision to cancel the reforms will save £30m in 2024-25 and £1.075bn in 2025-26, the document said.

Shadow chancellor Jeremy Hunt, Reeves’s predecessor as steward of the country’s finances, said that Reeves’s argument “was not credible”.

“Those public finances were audited by the OBR [Office for Budget Responsibility] just 10 weeks before the election was called. We are now expected to believe that, in that short period, a £20 billion black hole has magically emerged,” Hunt added.

Review of government spending

Reeves also announced how decisions on government spending would be determined in future.

On 30 October, she will deliver a Budget, confirming final spending totals for 2024-25 and levels for 2025-26, including relating to central government spending on local authorities and how much councils are able to raise locally through council tax.

She also announced she had started the process for a three-year spending review, covering 2026-29, which will conclude in spring 2025.

In response to this announcement, the Local Government Association (LGA) said the review needed to address pressures on councils that it had estimated as being worth £6.2bn from 2025-27.

Social care costs ‘pushing councils to the brink’

“Right now, councils are being pushed to the brink with rising adult social care costs, children’s placements and temporary accommodation,” said Pete Marland, the chair of the LGA’s economy and resources board.

“Any further funding reductions in the years ahead would be an unthinkable prospect with councils of all types already struggling to protect the services which bind our communities together and protect our most vulnerable from cutbacks.”

The government must delay “unfunded” adult social care charging reforms by at least a year as most local authorities are not prepared to deliver them by the target date of October 2025, county council leaders warned today.

Authorities would need an additional 4,443 social work staff to deliver the reforms, which include an £86,000 cap on people’s lifetime personal care costs. This is up from a 2022 estimate of 4,300 additional staff, found updated analysis by consultancy Newton for the County Councils Network (CCN).

Separately, a CCN survey of 35 of the 37 county authorities found 86% were “not well prepared” to deliver on the reforms, which would make many more people eligible for state-funded care, by next October.

Two-year delay to reforms

That date was set by the previous Conservative government in November 2022, when it delayed its previous implementation target by two years following calls to do so by CCN and other council bodies, who said they were not ready.

In doing so, it recycled £3.14bn of the £3.6bn it had allocated for implementing the reforms into grant funding to help councils shore up their day-to-day social care services for adults and children from 2023-25. The rest of the money is being used to help councils work towards paying providers a ‘fair cost of care’, an element of the reforms (see below).

During the election campaign, the Conservatives and Labour both committed to implementing the reforms in 2025 if elected. However, think-tank the Institute for Fiscal Studies pointed out there was no funding allocated to do so.

£30bn cost over nine years 

Newton’s analysis for the CCN found that the total cost of the reforms over nine years was £30bn, up from its 2022 estimate of £25.5bn. This comprises:

• £18.6bn (up from £13.9bn) to fund care for people made eligible for support through the more generous means-test and the cap.
• £9.2bn (down from £9.7bn) to fund a fair cost of care for residential care providers.
• £2.2bn in operational costs (up from £1.9bn).

The latter is driven by the increase in the number of needs assessments, financial assessments, reviews and care and support plans required for self-funders who become eligible for funded care or to have their placements arranged by their local authority, or who want to take advantage of the cap in future.

More social work staff needed

Newton’s original analysis said councils would need an additional 4,300 social work staff, along with 700 financial assessors, to cope with the additional workload.

It has now increased the social work requirement to 4,443, though, as with the previous analysis, this is based on operational processes remaining as they are, without more efficient ways being delivered. This figure compares with a current adults’ social worker workforce of 18,500.

In response to CCN’s survey, 86% of councils said they were not well prepared to implement the reforms and 92% backed a delay of a year or more.

Almost all respondents (97%) said they were “very concerned” about the shortfall in funding and 80% said they predicted that they would not be able to fulfil their Care Act duties if existing social care resource was repurposed to fund the charging reforms.

‘Impossible to implement reforms by target date’

“To put it bluntly, it will be impossible to implement these reforms next autumn in the current timescales and with no funding committed to the reforms,” said the CCN’s adult social care spokesperson Martin Tett.

“Equally, the government cannot take money currently being spent on day-to-day adult social care services for these reforms, with our survey showing it will have devastating consequences for councils and the thousands of people who rely on local authority care.

“We have always supported the principles of the reforms, as they will make the system fairer. But if the government is to proceed with the reforms, then it must delay them by at least a year – but likely more – to reassess the real costs and set out a way to fully-fund them.”

Labour’s post-election social care actions

Since Labour won power, health and social care secretary Wes Streeting has asked his officials to provide a progress update on implementation of the charging reforms (source: Channel 4 News).

The new government has also included plans for a fair pay agreement for adult social care staff in an Employment Rights Bill announced in this week’s King’s Speech.

However, this will cost money – as yet unallocated by the government – because it will require councils to increase fee rates to providers to enable them to pay their staff more and invest more in training.

This casts doubt on its ability to fund the charging reforms as well, particularly given its commitment not to raise income tax rates, national insurance, VAT or corporation tax, fiscal rules limiting public borrowing and several other calls on public spending, such as NHS and defence.

Also, the Times has reported (behind paywall) that Labour is considering setting up a cross-party Royal Commission on the future of social care which, should it happen, may also prompt it to pause the charging reforms.

History of delayed reforms

The reforms were themselves the result of an independent commission – led by economist Andrew Dilnot – which reported in 2011, with its proposals enacted in the Care Act 2014.

The then government had planned to implement the changes in 2016, but this was then put back to 2020, before the idea was scrapped in 2017 under Theresa May’s premiership before being revived by Boris Johnson in 2021.

Responding to CCN’s call to delay the reforms, a Department of Health and Social Care spokesperson said: “We know that people are suffering without the care they need, and we are committed to ensuring everyone lives an independent, dignified life.

“We are going to grip the social care crisis, starting with the workforce by delivering a new deal for care workers. We will also take steps to create a national care service underpinned by national standards, delivering consistency of care across the country.”

Labour’s return to power last week was greeted with a chorus of welcomes from adult social care organisations in England – along with a chorus of demands of the new government.

Broadly, these were for significant investment in, and reform to, the sector to address issues including unmet need, workforce shortages and inadequate care.

For many, these challenges are the legacy of the Conservatives’ 14-year period in office.

The ‘austerity’ decade

This began with the decade of “austerity” in the 2010s, during which councils’ available budgets fell by 29% in real-terms (source: National Audit Office [NAO]).

While authorities strove to protect adult social care from these cuts, their spending on the service was only marginally higher 2019-20 than 2010-11, after taking account of inflation.

Image: treety/Adobe Stock

According to the Association of Directors of Adult Social Services (ADASS), authorities had to make £7.7bn in adult social care savings during the decade to manage increasing demand and cost pressures without extra resource.

One result was a significant fall in the number of people who received long-term care, from 872,520 in 2015-16 to 838,530 in 2019-20 (source: NHS Digital).

These pressures were driven by the expected – an ageing population and growing numbers of people with multiple and complex needs – and the unexpected.

For example, the Supreme Court’s landmark Cheshire West judgment, by widening the definition of a deprivation of liberty, triggered a tenfold increase in councils’ Deprivation of Liberty Safeguards (DoLS) caseloads, from 13,700 in 2013-14 to 137,540 in 2014-15.

Modernising the law

The middle of the decade saw the implementation of the Care Act 2014, unifying and modernising the previous panoply of social care legislation into one statute that made promoting wellbeing and preventing, reducing or delaying need the service’s central missions.

Alongside this, it created rights to support for carers and rights to advocacy for those who would otherwise struggle to participate in key processes, placed councils under a statutory duty to investigate adult safeguarding concerns and sought to improve the transitions process for young people.

Photo: Gary Brigden

However, the legislation’s vision soon ran into the realities of the fiscal constraints and pressures on the service.

To take one example, a study published in 2021 found that assessments of, support for, and spending on carers fell in the years following the act’s implementation – contrary to its intent – because of funding pressures.

Care Act deemed a ‘failure’

Key aspects of the act were not implemented, including rights of appeal against council decisions and the so-called ‘Dilnot’ charging reforms, which were designed to make the means-testing system more generous and cap people’s liabilities for their personal care.

The latter were originally due to be implemented in 2016 and were then delayed until 2020 before being scrapped under Theresa May’s government in 2017 – though not for good (see below).

In its 2021 white paper, People at the Heart of Care, the government concluded that the full spirit of the Care Act had not been realised. A 2022 report by a House of Lords committee went further and declared the legislation a failure.

“Far from ensuring individuals’ wellbeing, care services tend to be reduced to a minimum and designed to enable people to survive, rather than to live and thrive,” it said.

The tragic impact of Covid

The austerity years were followed by the tragedy of Covid-19. This would have always hit social care hard given that people who used the service – older people and those with multiple health conditions – were at particular risk from the disease.

But the impact was compounded in the early stages by government policies to free up 15,000 hospital beds in March 2020 and for care homes to make their full capacity available. This led to many people with asymptomatic Covid being discharged into residential care.

Photo: thodonal/Adobe Stock

From March 2020 to April 2021, there were 27,179 more deaths than expected among care home residents, while there were 9,571 excess deaths reported among home care users over a similar timeframe (source: the Health Foundation).

In addition, over 900 care workers lost their lives to Covid up to May 2021, while the workforce was worst hit of all occupational groups by long Covid.

At the same time, many people were left at home without a service, and adult safeguarding concerns were delayed, during lockdowns, worsening unmet need, risks of harm and the strain on unpaid carers.

The devastating impact of the pandemic on adult social care triggered an increased focus on the sector – and apparent recognition of its value – from the Conservative government.

The Tories’ reform agenda

Its first response was the People at the Heart of Care white paper, published in late 2021, which allocated £3.6bn to reviving the Dilnot charging reforms, and a further £1.7bn to assorted other changes designed to improve services, from 2022-25.

These included raising qualification levels and the status of the workforce (£500m); expanding specialist housing for people with care needs (£300m); promoting the digitisation of the sector to improve productivity (£150m); enhancing commissioning (£70m), and supporting carers (£25m).

However, much of this reform agenda subsequently unravelled in the face of the severity of day-to-day pressures on services.

Severe pressures remain

The number of staff vacancies increased by 50% to 164,000 in the year to March 2022, while the number of people on waiting lists for assessments, reviews and care packages grew by 37%, to 542,000, from November 2021 to April 2022.

Meanwhile, there was a 57% rise, to over 13,000, in the number of hospital beds occupied by someone fit for discharge, in the two years to December 2022 (source: the Health Foundation), in part because of social care shortages.

Amid such pressures, council bodies argued that it was all but impossible for them to implement the Dilnot reforms in line with the planned start date of October 2023, given the scale of the changes required. These included:

• Recruiting sufficient practitioners and overhauling systems in order to be able to assess and review many thousands of self-funders coming forward to take advantage of the more generous means-test or be considered for the cap on care costs.
• Upgrading their case management systems in line with revised financial assessment procedures and to track people’s progress towards the cap.

Reforms delayed or shelved

In response, the government pushed the start date of the reforms back by two years, ploughing most of the allocated £3.6bn into shoring up day-to-day social care services, including for children. 

Photo: gguy/Adobe Stock

This was accompanied by giving authorities permission to raise council tax by 3% and the adult social care precept – which is ring-fenced for the sector – by 2% per year, along with additional grant funding, from 2023-25.

Then in July 2023, it shifted £600m of the remaining reform funding into core services, having already halved its investment in workforce development.

The Conservatives also shelved their plan to replace the DoLS, and the use of Court of Protection orders to authorise deprivations of liberty in the community, with a more streamlined system, the Liberty Protection Safeguards (LPS).

This was despite DoLS caseloads having continued to mount, topping 300,000 in 2022-23, with the average case taking 156 days, leaving many thousands of people unlawfully deprived of their liberty.

Impact of increased funding

The resulting increase in government funding for adult social care from 2023-25 has had a definite impact.

Councils budgeted to increase spending on the service by 10% in real terms (£2bn) in 2023-24 and have planned to raise expenditure by 9.2% in real terms (£2.1bn) this year.

This has helped fund two consecutive 10% increases in the national living wage, benefiting tens of thousands of care workers, chiefly in the independent sector.

Along with increased international recruitment, which was promoted by the Conservative government, at least until late last year, this appears to have had an impact on workforce sufficiency.

Skills for Care figures show that the sector vacancy rate fell from 9.9% in March 2023 to 8% in April 2024.

No let up in challenges

However, the extra funding clearly did not solve the challenges facing the sector. At 8%, its vacancy rate was more than double the economy-wide average (3.0% as of autumn 2023, according to the Office for National Statistics).

Waiting lists not only remained high but grew, by 8% to 470,576, from March to August 2023, reported ADASS. And the number of people awaiting discharge from hospital has remained stubbornly around the 13,000 mark, shows NHS England data.

Photo: IQoncept/Adobe Stock

Meanwhile, the Local Government Association (LGA) has calculated that councils would need an additional £5.1bn in 2026-27 compared with 2023-24 to maintain services at existing levels, because of funding pressures.

Lack of certainty over funding and reform

Unsurprisingly, this has prompted calls for further funding for adult social care. However, the Conservatives also faced criticism for how they resourced the sector, particularly through their reliance on short-term grants, sometimes provided with little notice.

“There are concerns that short-term funding does not support value-for-money decision-making,” said the NAO, in a report on adult social care reform published in November last year. “It can lead to a lack of time to review savings options to make good rather than quick decisions.”

The same NAO report also raised significant concerns about whether the Dilnot charging reforms were deliverable by the revised target date of October 2025.

This was not just because of the amount of work this would involve, but also because the Department of Health and Social Care (DHSC) had disbanded the programme board responsible for overseeing the changes.

Unfunded commitments to charging reform

Both the Conservatives – in their manifesto – and Labour – in media interviews – committed to implementing the charging reforms by October 2025 during the election campaign.

But, as think-tank the Institute for Fiscal Studies (IFS) has pointed out, the outgoing government left no funding to implement the changes, meaning fresh resource would need to be found by the new Labour administration.

This is in addition to all the preparatory work that would need to be carried out by civil servants, councils, IT firms who supply case management systems and care providers.

Unsurprisingly, ADASS concluded the chances of the reforms being implemented in October 2025 were “quite low”.

Labour’s offer on adult social care

The party’s election manifesto was not short of pledges on adult social care. These comprised:

• A programme of reform to create a national care service, underpinned by national standards, delivering consistency of care across the country, ensuring high-quality care and ongoing sustainability, and ensuring providers behave responsibly.
• A principle of ‘home first’ that supports people to live independently for as long as possible.
• Local partnership working between the NHS and social care on hospital discharge.
• An agreement setting fair pay, terms and conditions, and training standards for adult social care workers, following widespread consultation.
• Guaranteeing the rights of care home residents to see their families.
• Asking regulators to assess the role social care workers can play in basic health treatment and monitoring.
• Providing councils with multi-year funding settlements.

Is more austerity on the cards? 

However, while councils will no doubt welcome the predictability of multi-year funding settlements – something also pledged by the Tories – they will have noted, with alarm, the lack of commitment to increase their funding.

This is particularly so in the context of Labour’s pledges not to increase income tax rates, national insurance or VAT and limit borrowing so that public debt is on course to fall as a share of national income over the medium-term.

Based on these pledges, the current state of the public finances and likely increases in the NHS, overseas aid, defence and childcare budgets, the IFS has sketched out possible trajectories for local government funding over the coming years.

Under these, council spending would rise by between 0.4% and 2.5% per year in real terms up to 2028-29, with the even the latter falling well short of what the LGA has calculated that authorities need to stand still over the coming years.

This has led to accusations of authorities facing a further round of austerity – albeit less stringent than that of the 2010s – something that Labour has vigorously rejected.

No funding for fair pay agreement

The party also did not pledge any resource to implement its fair pay agreement for the sector, placing significant question marks against its impact.

The IFS has calculated that, if this involved setting a sector minimum wage that was £1 an hour above the national living wage (NLW), it could cost the public sector about £200m-£360m a year; a £2-an-hour boost could cost £750m-£1.2bn a year.

The party’s other pledges on social care, meanwhile, remain open to significant interpretation.

Questions for Wes Streeting and Stephen Kinnock

For example, what does “a principle of “home first” mean in practice, what will the party do differently to speed up hospital discharge and what will its proposed national standards to drive up care quality amount to?

Health and social care secretary Wes Streeting (credit: Labour Party)

Most significantly of all, what is a national care service?

The new health and social care secretary, Wes Streeting, and minister for care Stephen Kinnock will be expected to provide answers to these questions and address the lack of funding in their plans for adult social care over the coming weeks and months.

It will be through their answers that we will know how different a Labour government will be to its Conservative predecessors.

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The Labour Party has made no funded commitments on social care in its general election manifesto, published yesterday.

While the party said it would introduce a fair pay agreement for adult social care workers and indicated it would implement the current government’s adult social care charging reforms, it did not allocate any resources to either, prompting criticism that the policies would trigger cuts elsewhere.

The party, which is widely tipped to win power on the 4 July election, also set out a longer-term plan to create a “national care service”, which it said would deliver “consistency of care across the country” through national standards that ensured “high-quality care and ongoing sustainability”. However, it did not set out further detail on what this would look like nor how it would be funded.

On children’s social care, it said it would strengthen regulation of the sector – though did not set out how – and introduce a “single unique identifier for children and families” to prevent them “falling through the cracks of public services” and aid information sharing.

However, like the Conservatives, Labour did not commit to implementing the current government’s children’s social care reforms, which are mostly still at the testing stage and would likely carry a multi-billion pound price tag when fully rolled out.

Lack of funding commitments

Also, while it promised to provide councils with multi-year funding settlements – a pledge also made by the Tories – there was no commitment to address overall funding levels, despite the Local Government Association saying authorities in England faced a £6.2bn funding gap over the next two years.

The lack of funded commitments on social care is similar to the position put forward by the Conservatives in their manifesto, published earlier this week.

Labour also followed the Tories in committing to reform the Mental Health Act 1983 (MHA), which the opposition party said would “give patients greater choice, autonomy, enhanced rights and support, and ensure everyone is treated with dignity and respect throughout treatment”.

This is a similar vision to that set out in the current government’s draft Mental Health Bill, which it failed to follow with full legislation to reform the MHA despite this being a commitment in the 2019 Conservative manifesto.

However, as was the case with the Conservatives, there was no reference to Labour reviving the Liberty Protection Safeguards, which is designed to provide a more efficient alternative to the for the Deprivation of Liberty Safeguards, but whose implementation was shelved by the current government last year.

Fair pay agreement not costed

Labour said its proposed fair pay agreement would set “fair pay, terms and conditions, along with training standards” for adult social care staff.

However, there was no reference to the investment required to bring this about in the costings section of the party’s manifesto, despite increases in minimum pay for care staff necessitating councils raising their fee rates for providers. The Local Government Association has calculated that the April 2024 rise in the national living wage, from £10.42 to £11.44 an hour, would cost councils £1.6bn in commissioned adult social care costs during 2024-25.

Labour’s manifesto made no mention of the party introducing the current government’s planned reforms to the adult social care charging system, including a £86,000 cap on people’s lifetime liabilities for personal care and an increase, from £23,250 to £100,000, in the savings threshold above which people are ineligible for council-funded care.

When quizzed about the issue on BBC Radio 4’s Today programme on 14 June, shadow health and social care secretary Wes Streeting indicated the party would implement the reform in line with the current government’s planned start date of October 2025.

‘Next to no detail on social care’, warns think-tank

“Well, we’re not planning to change that at this stage,” he said. “We want to give the system certainty and stability as they plan for the post-election, if there is a Labour government.”

However, after the Conservatives also pledged to keep to the October 2025 date, think-tank the Institute for Fiscal Studies (IFS) pointed out that the current government had allocated no funding for this, with the originally allocated resource having been ploughed into day-to-day council budgets.

The Association of Directors of Adult Social Services (ADASS) agreed that this meant the likelihood of the policy being implemented in October 2025 was “quite low”.

Commenting on the Labour manifesto, the IFS was also critical of the lack of detail on its plan for a national care service.

“The manifesto commits to major reforms in adult social care, but provides next to no detail on how or when these would be implemented, or what final form they would take. This includes a commitment to create a ‘national care service’ and to introduce a collective pay agreement in adult social care. With no specific funding set aside for these changes, paying for them would mean less for other services, unless taxes or borrowing were increased.”

Risk of further squeeze to ‘already strained budgets’ 

Fellow think-tanks the Health Foundation, King’s Fund and Nuffield Trust, issued similar criticisms of the lack of detail and costings for the party’s adults’ services plans.

“The promises on social care reform could best be described as a plan to come up with a plan,” said King’s Fund chief executive Sarah Woolnough. “The current social care system in England is not fit for purpose and many people’s needs go unmet, yet it is one of the most over-looked and ignored policy challenges in recent decades.

“Labour’s plan for a fair pay agreement for care workers would help attract more people to work in the sector, but unless that increase in pay is matched with commensurate increases in local government funding, it will further squeeze already strained care provider and local council budgets.”

For ADASS, director of policy and analysis Michael Chard issued a similar message.

“Neither Labour or the Conservatives have told us how they plan to stabilise and support adult social care currently or committed any new funding to it,” he said.

“Labour’s fair pay agreements provide hope for tackling poor pay and conditions for care workers, but again, lack the detail in terms of how they will be funded and timelines for delivery. Without any plans for how to meet immediate pressures, these future ambitions will worry those working and using in adult social care today.”

‘Missed opportunity’ to help children and families

As in adult social care, there was no funding allocated to children’s social services in the manifesto, while there was also a limited policy offering, which prompted criticism from the Children’s Charities Coalition, which comprises Action for Children, Barnardo’s, the Children’s Society, NCB and the NSPCC.

“There was little concrete commitment in the manifesto to help struggling families as early as possible and no plan to transform support for children in crisis,” it said. “The number of families in need of children’s social care support is growing and the number of children in care is at a record high. We think this is a missed opportunity which risks letting down the children and young people most in need of help.”

Fellow children’s charity Become was similarly critical of the major parties’ manifestos in general.

“Whilst it is welcome that children in care are mentioned in the Conservative, Labour and Liberal Democrats’ manifestos, all parties fall significantly short of the reforms needed to address the huge challenges children’s social care is facing,” said CEO Katharine Sacks-Jones. “Without investment and a clear plan, the care system will remain in crisis and the experiences of care-experienced children and young people won’t improve.

Also commenting on the manifestos in general, Association of Directors of Children’s Services vice-president Rachael Wardell said: “First and foremost we need any new government to put in place a long-term plan for childhood to invest in children’s futures and to close the funding gap in children’s services so that services can meet children’s and families’ needs.”

“There are a number of areas in the system that must be addressed immediately, such as growing pressures in children’s social care and SEND services as well as the need to support children’s health and wellbeing, particularly their mental health,” she added.

What else has Labour pledged?

Other relevant measures for the sector put forward by Labour included introducing legal safeguards for children and young people around strip-searching. This issue came to prominence through the case of Child Q, a 15-year-old black girl strip-searched by police at her school in London in 2020 without the presence of an appropriate adult, actions which a review found were both traumatic and harmful for her and likely to be influenced by racism.

Labour also pledged various measures to prevent young people being drawn into crime, including introducing an offence of criminal exploitation of children, setting up a network of youth hubs, including mental health and youth workers, and mandating referral of those caught carrying knives to youth offending teams.

A Conservative manifesto pledge to implement a cap on adult social care costs and associated charging reforms is unfunded, a think-tank has warned.

The Institute for Fiscal Studies (IFS) said the plan to implement the changes in October 2025 would require cuts elsewhere, because the funding originally allocated to the scheme had been diverted and the party did not allocate any funding to the policy in its manifesto costings.

In their election manifesto, published today, the Tories pledged to enact “planned reforms to cap social care costs from October 2025”, a timetable established in 2022 when the government delayed its original implementation date by two years.

Original care cap funding diverted

Ministers had earmarked £3.6bn from 2022-25 to implement the reforms, including an associated plan for councils to pay providers a fair cost of care (see box above). The IFS said that ministers had also budgeted further funding for the reforms up to 2027.

The delay enabled councils to retain the 2022-25 allocation to shore up their social care services, with £3.14bn made available for adults and children’s services from 2023-25 and the rest retained for the fair cost of care policy.

While the government has not set spending plans for 2025-26 onwards, it has pencilled in real-terms public spending increases of 1% a year up to 2028-29, against a 2024-25 baseline.

The IFS said ministers had rolled the resource allocated from 2025-27 for the charging reforms into these “tight” spending plans, meaning it was not available to implement the policy.

Pledge entails cuts elsewhere, says think-tank

The think-tank said likely and planned increases to the NHS, defence, overseas aid, schools and childcare budgets, under a re-elected Conservative government, meant “unprotected” service areas, including local government and social care, faced cuts.

“With no funding in the manifesto for this policy, paying for [the adult social care charging reforms] would therefore further deepen cuts to other unprotected service areas,” the IFS added.

Fellow think-tank the Nuffield Trust also raised concerns about the deliverability of the policy, with chief executive Thea Stein saying: “Given the state of local authority finances and the fact that the original money earmarked for the cap has been redirected into day to day running costs, it is difficult to see how this promise can be fulfilled.”

For the King’s Fund, chief executive Sarah Woolnough said that it was “positive” that the Conservatives had recommitted to the charging reforms, though she added: “To meet that challenging deadline for implementation, there will need to be sufficient local authority funding and capacity to get the reforms off the ground.”

The Conservative Party has been approached for comment on the issue.

Labour’s manifesto did not mention the charging reforms at all, though shadow health secretary Wes Streeting subsequently will be published on Thursday (13 June); it has previously said it is committed to the charging reforms but has not set out how it would be paid for.

MHA reform restated, but no reference to LPS

The Tory manifesto also pledged to continue with the broader social care reforms set out in policy papers in 2021 and 2023, including improving housing for older people, support for unpaid care and workforce recruitment and retention, including through enhancing training.

The party also restated its commitment to reforming the Mental Health Act 1983, saying it would legislate to do so in the first parliamentary year after the election.

This repeats a commitment from the Conservatives’ 2019 manifesto that it failed to fulfil, despite publishing draft legislation to overhaul the act in 2022.

However, there was no reference to reviving the Liberty Protection Safeguards (LPS), the replacement for the Deprivation of Liberty Safeguards, which the government shelved last year, having originally planned to implement it in October 2020.

Local government funding

The Conservatives also said they would provide local authorities with multi-year funding settlements.

This answers a longstanding call from council leaders for the government to end its approach of financing the sector on a year-to-year basis, undermining authorities’ ability to plan.

However, responding to this on X (formerly Twitter), the Association of Directors of Adult Social Services said that, while welcome, this was insufficient to address the pressures on social care.

Our Directors have long called for multi-year funding to plan & invest in local care & support over a no. of years, instead of relying on cash injections. But this alone isn’t enough, we want to see a commitment to a fully funded plan to meet our country’s care & support needs.

— ADASS (@1adass) June 11, 2024

Welfare reform plan criticised

Overall, the manifesto pledged tax cuts or additional spending worth £17.7bn a year by 2029-30, which the party said would be paid for by tackling tax evasion and avoidance (£6bn) and reforming the welfare system (£12bn).

On the latter, it referenced proposals set out in a policy paper published in April this year to curb spending on personal independence payment (PIP), which is designed to meet the extra costs of disability for people of working-age.

Plans include tightening criteria to access personal independence payment (PIP) and potentially replacing cash payments by services for people with mental health conditions, on the grounds that they may not face the same costs as people with physical impairments.

According to government data, the number of PIP recipients rose from 2.2m to 2.8m from 2019-20 to 2022-23 and is projected to rise to 3.8m by 2025-26.

However, the IFS seriously questioned whether the party could make savings on the scale it envisages from either cutting the numbers on PIP or reducing the value of the support they receive.

“The manifesto contains very little information on what kind of policy the Conservatives have in mind,” the think-tank said. “It is difficult to have much confidence in the £12bn goal.”