On 29th July 2026, the Prime Minister and Baroness Casey launched the The Big Conversation on Care together with a renewed commitment to improving pay, training and progression opportunities for the care workforce, and a ministerial team to drive that work. With this flurry of announcements, finally it feels like this vital public service stands on the precipice of what could be its biggest ever transformation.
Social care and support play a vital role, helping to enable communities to thrive and promoting economic prosperity. When properly resourced and designed around individuals’ needs, it enables people to exercise choice and control over their lives, build relationships and community connections, feel a sense of purpose and contribute to the economy. Social care supports local employment, reduces inequalities and helps improve health outcomes. It also relieves pressure on other public services, including the NHS.
Sam Monaghan, Chief Executive at MHA, one of NCF’s provider members delivering care and support to older people, used a blog published in July 2026 to express his belief that now is the time for Government to reframe adult social care as a priority. He wrote, ‘As Andy Burnham sits down to consider his priorities and those of his Government, there is a real opportunity to place adult social care where it belongs – at the heart of our national infrastructure, sitting alongside the NHS.’
He continued, ‘I strongly believe that adult social care should be seen not only as a public service but as a major economic and social asset. Investment in care supports labour market participation, community resilience and healthier ageing, and should be reflected and considered in growth policies.’
Successive governments have failed to grasp the precious opportunity to reverse the fortunes of this (often under-appreciated) sector. However, despite the challenges, the most important requirement is the political will to make a change. We are optimistic that the current Government is well placed to lead this, bolstered by robust recommendations from the Casey Commission and the results of the forthcoming Big Conversation on Care.
We need a Government that is bold in implementing transformational adult social care reform, founded on the exceptional work of the sector. NCF has worked closely with our care and support provider members to identify the steps Government could take to bring about the essential reform required, supporting Labour to stick to its own plans laid out in the 2024 Labour Party election manifesto. This included creating a National Care Service, underpinned by national standards while being locally delivered.
These reforms are desperately needed and, as Baroness Casey has observed, are years overdue. They must be introduced via a new, inclusive national conversation which the public understands, underpinned by significant capital and revenue investment, placing high-quality, sustainable care and support at the centre of communities. In NCF’s view, four key principles should underpin the Government’s approach, as follows.
A National Care Service with a not-for-profit care and support ethos
Not-for-profit care and support providers are the backbone of preventative, community-based services. They ensure that all funding is directed towards the delivery of care and support and they are deeply embedded in the communities they serve.
Recently, Andy Burnham and Louise Casey have criticised ‘profiteering’ in adult social care. Consequently, we believe this is an opportunity to design a National Care Service with a not-for-profit ethos. Enabled by joint working across health and social care, this will ensure public investment strengthens community resilience, improves outcomes and maximises social impact.
A shift from a narrow focus on time and task towards a person-centred, outcomes-based approach is also critical to ensure adult social care and support achieves its full potential in supporting people to live their lives well, enabling earlier support where needed to prevent escalating health and social care needs. To support this, Government should work with partners to co-design new commissioning standards which promote adult social care and support’s potential for a transformative impact on lives and communities.
Investment in our exceptional social care workforce to ensure they are properly valued
Every day, social care services support hundreds of thousands of people to live fulfilling, independent and connected lives. NCF alone represents 177 not-for-profit organisations that operate over 7,900 services and employ over 138,000 people, and in so doing, provide care and support to over 264,000 people.
However, this workforce is often underappreciated and underpaid and this needs to change. Government’s commitment to implement a fair pay agreement in 2028/29 is welcome but action is urgently needed before then; care and support workers need better pay now.
To make this possible, Government should bring forward funding for care and support providers delivering public contracts to enable them to sustain Real Living Wage rates for their staff. It should also fully fund the costs of the fair pay agreement, accompanied by consistent, robust guidance for commissioners, to ensure employers can be confident of being able to afford to comply with their legal obligations regarding pay, terms and conditions for their staff.
Adoption of new technology and innovation – ensuring care for the future is smarter and greener
New technologies, digital innovation and AI have the potential to transform how people access social care services and outcomes. This has many implications, including how people with care and support needs use technology to increase their own autonomy in how they live, how staff design and deliver care and support, and how data is recorded and shared to improve the effectiveness of services.
To help the sector maximise its potential, a dedicated strategy is needed to develop and harness the transformative power of AI and other emerging technologies, and these innovations need to be matched by innovation in workforce roles, so that care and support staff feel confident and skilled in how to make the most of technology and innovation. This could be through the development of new roles, such as Care Technologists and Adult Social Care Data Analysts.
At the same time, especially at a time of rising and more unpredictable temperatures, unpredictable energy supply and rising prices, it is important for the adult social care sector, alongside the rest of the economy, to decarbonise itself and improve its sustainability. In the NHS, the Greener NHS Programme is forging ahead with these issues; a similar programme is urgently needed for social care.
This should include access to capital funding that not-for-profit care and support providers can use to support decarbonisation and modernisation, recognising that many are unable to access other national grant funding, either because they fall outside the eligibility requirements or the funds are too complex to access for smaller organisations.
It is notable, when reviewing Government’s 10 Year Capital Plan for Health and Social Care, that despite the title, the capital funding outlined in the plan is almost entirely for the NHS, not for social care: ‘…Government’s plan for capital investment to transform healthcare infrastructure over the next decade’.
A care system which embeds rights, fairness and choice for people
Ultimately, the purpose of social care and support is to enable people to live their best lives, in their own communities, near to the people and places they love. To maximise the potential of social care to improve lives and reduce pressure on other services (including the NHS), we all recognise that people are the experts in their own lives and those of their loved ones. Therefore, their voices and expertise must be at the centre of all work to co-design the development and delivery of care services, alongside commissioners and providers.
Local, regional and national government leaders must use their combined powers to guarantee universal access to care and support, provide security against the costs of care and uphold people’s rights across the care and support system; these principles should be placed at the heart of any new National Care Service model that is developed and implemented in the future.
Transformational change on this scale will require far more than just money. There will be an important role for all of us in social care (and beyond), requiring a spirit of partnership, an eagerness to change and adapt, the celebration of innovation and a culture of learning from one another.
However, more funding and investment will be needed if reforms are to succeed – this is estimated as an extra £6.4bn in 2028/29, rising to an extra £12.7bn in 2034/35, representing a 3.9% annual real-terms increase overall, in order to meet rising levels of demand from both an ageing population and rising levels of health and care complexity.
NCF and our members stand ready to work with Andy Burnham, Yvette Cooper, Angela Rayner, Baroness Casey and Government to help make a National Care Service with a not-for-profit ethos a reality and ensure the social care workforce feels fully valued for the enormous contribution it makes.
Will social care finally experience a signification transformation? Comment on this feature or join the conversation to share your thoughts.
Professor Vic Rayner OBE is Chief Executive at NCF.
Email: [email protected] Linkedin: @National-Care-Forum