Faster social care reform urged as providers ‘facing impossible choices’

Social care can “ill afford” to wait three years for final decisions on reform, leaders in the sector said, as a new report highlighted the ongoing strain faced by providers.

An annual survey of organisations caring for some 128,000 people in England found providers feeling forced to close parts of their organisations, handing back contracts to local authorities and considering leaving the market entirely.

Workforce pressures were cited as the top cost-pressure by nine in 10 providers, of which the national living wage increase, to come in from April, was said to be the biggest challenge.

But the pressures will since have ramped up, the report authors, learning disability charity Hft and Care England, said, as the survey of 206 small, medium and large social care providers took place before further challenges emerged from the October Budget, notably the planned increase in the rate of employers’ national insurance contributions (NICs).

Hft and Care England have now repeated calls for the Government to either fully fund the increase or exempt care providers entirely, saying delays are pushing more care providers out of the sector and leaving more people “without the support they need”.

Their report referred to previous analysis by the Nuffield Trust think tank which said the NICs hike could cost the adult social care sector more than £900 million this year, “more than wiping out the extra funds allocated to social care at the recent Budget”.

While Hft and Care England both said they are willing to work with the independent commission into reform of social care, led by Baroness Louise Casey, they echoed others who have called for a plan by the end of this year, rather than a final report in 2028.

Last week Sir Andrew Dilnot, who produced recommendations for reform more than a decade ago, said it is “completely unnecessary” to wait three years and that it is “perfectly feasible” for the Government to set out by the end of 2025 what it is going to do.

Steve Veevers, chief executive of Hft, said: “The sector can ill afford a lengthy process to identify the solutions.

“The evidence is already clear. This year’s Sector Pulse Check is the next critical step for outlining clear, actionable solutions.

“It provides a detailed, up-to-date picture of the sector’s pressures and highlights urgent priorities such as workforce shortages, funding instability, and improved support for care workers.”

Among its other recommendations, the report called for the ban on international social care staff being able to bring dependants with them to be scrapped, and for local authorities to have mandatory timelines by which to make payments for care, with penalties for delays.

Care England chief executive Professor Martin Green said: “We are ready to work alongside Baroness Casey and the Government to turn this commission into a catalyst for genuine change.

“But let’s be clear: the status quo is no longer an option. Every delay, every failure to act, pushes more care providers out of the sector and leaves more people without the support they need.”

He said providers are facing “impossible choices: absorbing unsustainable costs, changing their care models, cutting back on services, or shutting their doors entirely”.

He warned that unless there is “immediate intervention, the consequences will be devastating for those who rely on care every single day”.

National disability charity Sense backed calls for “more haste than the current timelines”, adding: “Every day that passes, is a day thousands of disabled people carry on bearing the brunt of our broken social care system”.

David Fothergill, chairman of the Local Government Association’s community wellbeing board, said: “Councils work incredibly hard to support people who draw on care and support, but adult social care has faced decades of underfunding, leaving services at breaking point.

“Local authorities are under unprecedented financial pressure, exacerbated by inflation, rising demand, an increase in employer national insurance contributions, and workforce challenges.”

Responding to a plea from Liberal Democrat leader Sir Ed Davey in the Commons last week to speed up the work on reform, to make 2025 “the year we finally rise to the challenge of fixing care”, Sir Keir Starmer said he wanted “cross-party consensus” on the issue.

The Prime Minister noted social care funding announced in the Budget as well as an increased carer’s allowance and funding for the disabled, but did not commit to a new timetable for the commission, which is split over two phases, with the first to report to Sir Keir in mid-2026.

A Department of Health and Social Care spokesperson said: “We are taking action now by increasing funding to allow disabled people to stay in their homes, boosting the carers allowance, professionalising the workforce and making available up to £3.7 billion extra for social care authorities in 2025-26, including an £880 million increase in the social care grant.”