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Elements of a long-awaited package of reform to tackle England’s struggling social care system might not be rolled out for a decade, as the government faces criticism for delaying a crucial overhaul of the sector.
A state-commissioned review, led by Baroness Louise Casey, into the crisis facing adult social care has been asked to outline polices to be phased in over a 10-year period, according to the Commission’s terms of reference.
“The Commission should produce tangible, pragmatic recommendations that can be implemented in a phased way over a decade,” according to the terms of reference, released on Friday. The review’s initial recommendations will be published in mid-2026.
“It will aim to make adult social care more productive, preventive and to give people who draw on care, and their families and carers, more power in the system,” it said.
Experts and campaigners have called for greater urgency from ministers in light of “soaring costs” that are hitting the care sector, including higher national insurance payments which came into effect last month.
The government’s plans for a so-called “National Care Service”, a publicly-funded system of social care, will also be set out under the first phase of the review, which launched earlier this week.
The second phase will yield longer-term recommendations to inform the “transformation of adult social care” and be released in 2028, the year before the next general election is expected to be held.
This stage will consider the care model needed to address “demographic change, how services must be organised to deliver this”.
The recommendations from Casey, a veteran Whitehall troubleshooter, “must remain affordable”, according to the terms of reference, “operating within the fiscal constraints of Spending Review settlements for the remainder of this Parliament”.
Government officials emphasised that the recommendations would be phased in over a period that aligned with the government’s 10-Year Health Plan for the NHS.
They added that work was already under way to reform adult social care, including a £3.7bn funding boost to support health authorities, as well as money for an extra 15,000 home adaptations for disabled people.
Simon Bottery, senior fellow at The King’s Fund health charity, said: “As too many people are left waiting too long for care, we urge the Commission to not wait until its ultimate 2028 deadline before making its recommendations.”
“The challenge may be whether the government is willing to act more urgently — or indeed at all — to implement these reforms.”
Successive government initiatives have attempted to improve how the social care system is funded only to face public backlash.
A government-commissioned study into the state of the NHS by Lord Ara Darzi last year described the crisis in provision as “dire” following decades of wrangling over the issue.
Sir Tony Blair set up a royal commission on care for the elderly at the start of the last Labour government in 1997 but rejected its recommendations for free personal care on cost grounds.
Stephen Kinnock, minister of state for care, said on Friday: “Baroness Casey’s independent commission is a once in a generation opportunity to transcend party politics and build consensus on the future of adult social care
“This government is grasping the nettle on social care reform,” he added.
