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Adult social care: where next?
Adult social care: where next?
Confusion reigns over the future of adult social care, writes Dr William Burns – so where is the route to the much-promised National Care Service?
The Chancellor of the Exchequer ignited a fierce debate across the social care sector with the government’s recent decision to abandon plans to reform how people pay for adult social care in England.
Whilst the announcement left many charity leaders dismayed, CIPFA’s analysis sheds light on the deeper issues underpinning the reforms: the proposed changes, though aimed at making the system fairer for individuals, were fundamentally underfunded and councils were not ready to implement them.
Both the National Audit Office and the Local Government Association agree with CIPFA that councils were ill-equipped for such reforms. This lack of readiness raises broader questions about the viability of the social care system, which is already grappling with rising costs, increasing complexity of needs, and surging demand. Before any significant changes to how people contribute to their care costs can be made, it is CIPFA’s view that local authorities must first be placed on a stable footing, empowered to deliver high-quality and accessible care for all. Only then can we build a fairer charging system to benefit individuals.
With these reforms now scrapped, the spotlight turns to the government’s pledge to establish a National Care Service (NCS). Yet, despite Labour’s manifesto commitments, the direction remains unclear. A Fabian Society report provided a glimpse into what the route to an NCS might look like, but there has been little concrete action from government. This hesitation raises doubts about Labour’s readiness to confront the entrenched challenges within the social care system.
Adding to the uncertainty is the government’s suggestion of launching another Royal Commission on social care – 25 years after the last one recommended free personal care and a more generous financial means test. This move has sparked fears that Labour may be preparing to kick the can down the road rather than deliver meaningful change.
Meanwhile, if we look at Scotland, the SNP-led administration is pressing ahead with its own plans to establish a National Care Service. The Scottish government’s reform programme aims to ensure consistent access to high-quality social care, but the journey has been far from smooth. Initial consultations on the National Care Service (Scotland) Bill revealed significant concerns about the financial viability of the proposed system, with CIPFA raising alarms over the projected cost of more than £1 billion over five years.
CIPFA’s focus on the Financial Memorandum that accompanied the bill highlighted the potential pitfalls of centralising decision-making, which could undermine local authority autonomy. Following CIPFA’s response, the Scottish Parliament’s Finance and Public Administration Committee recommended a revised Financial Memorandum be submitted.
The Scottish Parliament passed the first stage of the NCS Bill in February 2024, but the legislation has since undergone significant revisions. With 90% of the original financial commitments stripped away, the focus has shifted towards restructuring the existing system rather than building an NCS from scratch. This compromise has left many stakeholders dissatisfied, questioning whether the revised plans will deliver the desired improvements in care quality and accessibility.
CIPFA, in its response to the ongoing reforms in Scotland, stresses that any programme of reform must deliver tangible benefits for those who rely on social care services and ensure value for public money. We can’t be certain that tinkering around the edges in Scotland will achieve this, but at least there lies a vision for change that the rest of country would do well to follow.
As the debate rages on in England, Wales and Northern Ireland, one thing is clear: the clock is ticking for Labour to set out a bold and actionable plan for the future of adult social care. Anything less risks further entrenching the systemic problems that have plagued the sector for years.
