By Tim Coolican and Emma Watt | August 6, 2026
Last Updated on August 6, 2026
The announcement from PM Andy Burnham to speed up social care reform has been welcomed across the sector, but not without a degree of scepticism.Tim Coolican and Emma Watt from social purpose law firm, Anthony Collins, discuss whether effective change is really possible.
For years, providers, commissioners, people who draw on care and their families have recognised that England’s adult social care system requires fundamental reform. But is it really possible and can effective change be delivered in the current parliament?
Andy Burnham has confirmed his intention to bring forward the timetable for reform by one year. With the phase one report now due later this year and final recommendations due next summer, there is renewed vigour behind the Government’s push for reform and its plans to ‘make social care more productive, preventative and give those who draw on care more power in the system’.
For care businesses, this ‘speeding up’ presents both opportunities and risks. Reform has the potential to address long-standing problems around funding, workforce shortages and integration with health services. However, periods of change can also create uncertainty, additional regulatory pressures and operational challenges.
Social care has been a long-standing interest of Andy Burnham’s. During his time as Health Secretary, he advocated for a National Care Service, and as Mayor of Greater Manchester he championed closer integration between health and social care services. More recently, he has spoken about the need to tackle social care as a national priority and has confirmed his willingness to invest significant political capital in securing reform.
His experience in Greater Manchester may provide some clues as to the direction of travel. The region has often been cited as one of the UK’s leading examples of health and care integration and the Greater Manchester Integrated Care Partnership is one of the largest and most complex integrated care systems, with a history of devolution and integration since 2016. Research carried out by the University of Manchester concluded that significant improvements were made in many parts of the health system as a result of Greater Manchester’s increased control over a range of public services. But much of the success in devolution depends on having the right people in the right roles, with the right decision-making powers. It’s not a given that the same can be replicated across the country.
The PM’s four core principles
With providers experiencing an economic and staffing crisis and growing demand for care services, faster decision-making aimed at speeding up reform is appreciated, but recommendations for change must be well thought through and adequately funded. The Big Conversation on Social Care, launched by Baroness Casey, will be seeking views on who should pay for care services that are free at the point of use, and the recommendations that follow could prove a real test of public support for a National Care Service.
To guide the Commission’s recommendations, the PM has set out four core principles:
- The system must allow people to move seamlessly between hospitals, home care and community services.
- This service must be fully and sustainably funded.
- The service must start with prevention, supporting people to live independently for longer.
- Citizens’ needs must be at the heart of plans, removing budget battle lines between organisations and making sure local social, primary and community care works together effectively.
The challenges ahead
Once we have the Commission’s recommendations, the challenge for policymakers will be to deliver them effectively and, ideally, within the current Parliament. The sector does not need additional layers of bureaucracy or unfunded obligations, and these risks are identified in the latest proposals to implement Multi-Neighbourhood Provider (MNP) and Single Neighbourhood Provider (SNP) contracting models. Providers need clarity, consistency and realistic implementation plans. Any reforms should support high-quality care and sustainable services, rather than increasing administrative burdens and layers of commissioning bureaucracy.
There are also important lessons for care businesses. Regardless of what reforms emerge, organisations with strong governance, clear leadership and effective quality assurance processes will be best placed to adapt. Periods of uncertainty tend to expose weaknesses and prompt good staff to leave at a time when the sector is already struggling with recruitment and retention. Boards and senior leaders should focus on organisational resilience, risk management and ensuring they can evidence the quality and impact of the care they provide. This is not simply about compliance; it is about building a sustainable organisation that can respond confidently to change.
In addition to speeding up reform, Andy Burnham has made it clear that he wants to address worker shortages too. He has spoken about the need to look beyond fair pay and explore ways to improve training and provide greater security of roles, with progression routes into the NHS. Encouragingly, he has also spoken about eradicating homelessness – demonstrating his understanding that preventative, locally focused measures will result in benefits for all across housing, health and social care.
Tim Coolican is a Partner and Head of Social Care and Emma Watt is a Senior Associate at social purpose law firm, Anthony Collins. Both provide legal advice and strategic support to health and social care providers, charities and social businesses.