Baroness (Louise) Casey (photo by HM Government)
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 to report in 2028
However, the commission will not 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.
‘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 in 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.”
