Social Care Reform

At the Care Association Alliance, we work with providers on the frontline of care every day, and it is from that vantage point that we have been developing a programme of reform.


We have aunched a new programme of policy papers to put the voice of frontline care providers at the centre of the national debate on adult social care reform, as the sector warns that waiting until 2028 for the Casey Commission’s final recommendations risks leaving reform too late.


The programme, titled Building a National Care Service: A Programme for Reform, will see the CAA publish a series of papers over the coming weeks and months, each addressing a distinct structural challenge facing the sector. The first paper will make the case for a nationally coherent funding framework, arguing that without a sustainable funding settlement at its foundation, wider reform will remain out of reach. Subsequent papers will address commissioning, workforce, service delivery and the relationship between health and social care.


Contributing to the Casey Commission

The CAA’s programme is explicitly designed to contribute to the work of the Independent Commission on Adult Social Care, chaired by Baroness Casey. The Commission is currently in the midst of its first phase, with cross-party discussions underway and its initial report expected in 2026. However, final recommendations are not due until 2028, a timetable that makes significant legislative reform unlikely before the next general election.


With the Commission’s evidence-gathering phase now open, the CAA believes the window to shape its thinking is critical, and that the voice of frontline providers must be central to the recommendations that emerge. The reform papers will be submitted to the Commission.


A system under pressure

The first paper in the CAA’s programme will focus on funding and make the case that the current model is neither equitable nor sustainable. Today, the financial burden of a national demographic challenge falls largely on local authorities whose budgets vary enormously from one part of the country to the next. The result is a system where access to care is shaped by geography as much as by need, where providers operate on rates that do not cover their costs, and where individuals and families face costs that are unpredictable and bear little relationship to what others elsewhere pay for equivalent support.


The paper sets out a new model for how care should be funded, one designed to reduce these inequities and put the system on a sustainable footing.


Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said:

“The Casey Commission represents a genuine opportunity to build the cross-party consensus that social care reform has long needed, and we strongly welcome its work. But the sector cannot afford to stand back and wait until 2028 for answers. The people we support cannot wait, and the pressures our members are working under cannot wait either.


“At the Care Association Alliance, we work with providers on the frontline of care every day, and it is from that vantage point that we have been developing a programme of reform. Over the coming months we will set out, paper by paper, what a genuine National Care Service should look like in practice, starting with the case for a nationally coherent funding framework and extending to commissioning, workforce and the relationship between health and care.”


Latest:

11 July 2026
Care Association Alliance sets out a national funding model for adult social care, designed to give families certainty, providers stability, and councils the resources to do their job (Read the full report here ) A new CAA report proposes pooling the financial risk of an ageing population nationally, rather than leaving it with 153 individual councils. The core of the model: ring-fenced national funding shared on a needs-based formula, a national tariff for care, and an independent body to keep it honest. Individuals keep a means-tested contribution, but with a lifetime cap and a raised capital threshold, so no one faces unlimited costs or has to sell their home. Councils keep assessment, planning, safeguarding and oversight, but are relieved of carrying a national demographic risk on a local budget. Backed by the Rt Hon Damian Green, Chair of the Social Care Foundation and former Deputy Prime Minister responsible for social care policy. The Care Association Alliance (CAA) has published a proposal for how England should fund adult social care for older people. Its report, Adult Social Care Funding Reform, describes a national funding settlement built on a straightforward idea: the cost of growing old and needing care is a national risk, and it should be met nationally, while care itself continues to be arranged and delivered locally. A national risk carried on local budgets At present, primary responsibility for adult social care sits with 153 local authorities under the Care Act 2014. They assess need, commission services and manage local provider markets. They also carry the full financial weight of demographic change, a pressure that is national in scale and rising quickly. The number of people aged 85 and over is projected to double within twenty years, and the Office for Budget Responsibility estimates that simply maintaining today's system will require public spending on social care to grow by 3.1 per cent a year over the next decade, compared with the 0.7 per cent average delivered between 2009/10 and 2022/23. That pressure shows up directly in the price of care. On average, councils pay £24.10 an hour for home care, while the Homecare Association puts the minimum sustainable rate at £32.14. The National Audit Office found in 2021 that authorities were commissioning care at below the sustainable cost of care, and the King's Fund reports that in 2025/26, council fee increases of around 5 per cent were outpaced by provider cost increases of 8 to 10 per cent. This is not a matter of councils choosing to underpay. It is what happens when local budgets are asked to absorb a national cost. Providers take the strain through thinner margins and deferred investment, and families often meet it through the higher fees paid by those who fund their own care, on average 41 per cent more than the council-funded rate. One settlement, built as a system The CAA argues that these are symptoms of a single structural mismatch, and that they need to be fixed together. Its proposed national funding settlement rests on three principles: pooling the financial risk of demographic change nationally, a statutory entitlement to support triggered by assessed need, and continued local delivery within a national framework. In practice, the settlement has five main components: A ring-fenced national care grant , distributed to councils on a needs-adjusted formula, so that funding follows need rather than local fiscal capacity. A reformed means test , with a raised capital threshold, frozen at £23,250 since 2010/11, and a lifetime cap on what any individual can be asked to pay. A national tariff for residential and home care , set at the independently assessed cost of sustainable provision, which councils commission at or above. A bundled funding model for residential care , with assessed packages that are portable when people move. A reformed Deferred Payment Agreement scheme , so that no one is required to sell their home to pay for residential care. Underpinning the settlement is an independent National Care Assessment Body, sitting outside both the NHS and local government, which would verify the cost evidence, review the tariff and report where provision falls short. Local authorities retain their role as commissioners and delivery leaders, close to their communities and provider markets, but are relieved of being the sole bearer of national financial risk. The report is explicit about what it does not propose. This is not a free care service on the model of the NHS, and it does not absorb social care into the health service. Individuals who can contribute to the cost of their care will continue to do so, within a reformed means test and a lifetime cap. The word national describes the funding architecture, not the way care is provided. The proposal is offered as a contribution to the Casey Commission, which is beginning to test public views on who should receive care, what the state should guarantee and what individuals should contribute. The CAA says funding reform is the necessary first step, and Adult Social Care Funding Reform is the first in a programme of papers it will publish over the coming months. Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said: “No family should receive worse care because of where they happen to live, and no provider should have to choose between keeping a contract and delivering care safely. These are not failings of the people running the system. They are what happens when a national risk is carried on local budgets. If we fund care nationally, price it honestly through a national tariff, and ask an independent body to keep it that way, we can give families certainty, providers stability, and councils the resources to do the job they are asked to do. “This paper is not a criticism of local authorities, who are doing a demanding job under real pressure. It is a practical plan to put the whole system on a sustainable footing, and we hope it is useful to Baroness Casey's commission as it begins its work.” The Rt Hon Damian Green, Chair of the Social Care Foundation and former Deputy Prime Minister responsible for social care, said: “The case for reform is widely accepted. What has been missing is a workable, affordable plan that a government of any colour could adopt. This paper offers exactly that, and a cross-party route to deliver it.” ENDS (Read the full report here ) Notes to editors The Care Association Alliance is the national umbrella body for local care associations in England, a member-led organisation with more than 50 local care associations, collectively representing over 10,000 independent care providers across every English region. It is a founding participant in the Care Provider Alliance. The £24.10 per hour figure is a national average local authority domiciliary care fee, not a per-council figure. It is cited alongside the Homecare Association's minimum sustainable rate (£32.14), the National Audit Office's 2021 finding on below-sustainable-rate commissioning, and the King's Fund's 2025/26 fee-versus-cost analysis, all set out in full in Adult Social Care Funding Reform (Paper One), published [DATE] 2026. Additional figures are drawn from the Health Foundation REAL Centre, the OBR, the King's Fund, the IFS and Social Care 360. The funding-gap projection runs to 2032/33. Baroness Casey's remarks were made on 7 July 2026, in a BBC Radio 4 Today interview and a speech to the Local Government Association's annual conference, in which she confirmed the Casey Commission will begin testing the views of the public this month ahead of its first report, due this year. Spokespeople are available for interview. Media enquiries: Melanie Weatherley MBE, Co-Chair of the Care Association Alliance.
13 June 2026
The Settlement - Edition 1 The monthly campaign brief from the Care Association Alliance
1 June 2026
Responding to reports that the Government is no longer considering a standalone arm’s-length body to oversee adult social care reform, the Care Association Alliance has warned that the focus must remain on how care is funded, not on the structures sitting above it, and that the sector must not be overlooked once again. Melanie Weatherley MBE, Co-Chair of the Care Association Alliance, said: “Social care does not need its own version of the NHS. An arm’s-length body sitting above the system is not what we have been calling for, and it is not what determines whether people receive good care. A national framework is essential, but it can be built within the structures we already have. What worries me is the risk that dropping the idea of a new body quietly becomes an excuse to drop social care altogether, and the sector is overlooked once again, as it has been so many times before.  The point we keep making is a simple one. What matters is not the structure sitting above the system, but the funding settlement sitting beneath it. Access to care is still shaped by geography as much as by need, providers are paid rates that do not cover their costs, and families face bills they cannot predict. None of that changes by creating or removing an organisation. It changes only with a national funding settlement, and that is the work Ministers cannot afford to leave until 2028.”

Bridgehead Communications:


At Bridgehead Communications, we are proud to support the Care Association Alliance in making the case for a new settlement for social care. This piece sets out why reform is urgently needed, not just for the sector, but to relieve the pressures on the NHS. We hope it contributes to the growing consensus that social care must be placed at the heart of any serious plan to fix our health and care system.

William Walter, Managing Director, Bridgehead Communications 


www.bridgeheadcommunications.com | wwalter@bridgeheadcommunications.com | M: +44 (0)7971 441 735


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