Last Updated on October 8, 2025

The Casey Commission should consider a national system to assess people's social care needs, says The King’s Fund in a new report. The Casey Commission, set up by the Government to explore social care reform in England, should consider the benefits of moving to a national assessment system, such as in Australia, Germany and Japan. This is a key recommendation of The King’s Fund new report, Fixing social care: The six key problems and how to tackle them.

In the current system, each local authority in England carries out its own assessment of people’s needs and finances, using national criteria, and there is wide variation in the number of people accessing care in different parts of the country.

The report says the Casey Commission should specifically consider the benefits of moving towards national assessment because it might provide greater consistency and would limit the risk of individual authorities ‘rationing’ care because of budget constraints. There may also be the potential for efficiency gains.

The report also says that more people should be entitled to publicly funded social care. Making the current means-tested system more generous, along with introducing a cap on care costs, is the ‘very minimum’ reform needed but alternatives such as free personal care, as in Scotland, or a ‘social insurance’ system such as Germany, where everyone in need receives support though may have to contribute towards the cost, are potential alternatives.

The recommendation is part of an analysis of key problems in social care - access, quality, workforce pay, market fragility, disjointed care and the ‘postcode lottery’ in access and performance. It includes an assessment of options for improvement in all these areas.

Other key recommendations from The King’s Fund include:

• The cost of providing care should be more of a partnership between the individual and the state than it currently is, with the state bearing most of the cost but the individual contributing if they can afford it.
• The Government’s proposed £500m as part of the Fair Pay Agreement for the care workforce is a welcome first step on a long-term solution. However, it will not solve long-standing issues of recruitment by itself.
• It is not sustainable for social care providers to regularly face cost rises that are far in advance of the fee increases they receive from local authorities.
• A review of NHS Continuing Healthcare, which plays an overlooked role in social care, is overdue.

Commenting on the report's publication, its author, Simon Bottery, Senior Fellow at The King’s Fund, said, ‘It would be a major change to shift away from the principle that people’s social care needs and finances should be assessed by local authorities. However, it works well in other countries and now is the time to explore whether it would be an improvement here as well.

‘The Casey Commission should consider this and other ideas in this report. However, there is also much that the Government could do in the meantime ahead of the commission reporting, including ensuring that local authorities have the finances they need to run the current system fairly and effectively.’

Kathryn Marsden OBE, Chief Executive at the Social Care Institute for Excellence (SCIE), said, 'This report offers a striking and sobering reminder that the social care system is falling far short of the standards we all expect from it.

'Social care can empower people of all ages and circumstances to live with dignity, independence and choice. It ought to be the cornerstone of a fair and inclusive society; what we are seeing instead is a system characterised by challenges.

'The report highlights that deep reform - reform that is principled and strategic - is necessary. The Casey Commission offers a once-in-a-generation opportunity to deliver this, but it can’t become just another report that disappears into Whitehall’s "too hard" box. The Casey Commission must deliver where others have failed and provide answers to the difficult questions which have led to public and political stalemates, not least how we fund our social care system.

'The report makes the case for a national system of assessing people’s needs. Bold solutions are required to address the challenges facing the social care sector, in particular those related to access, quality and fragmentation. The Government has committed to underpinning its National Care Service with national standards of care. At SCIE, we look forward to working with sector partners and people with lived experience to develop a framework for these standards.'

To read Fixing social care: The six key problems and how to tackle them, visit the King's Fund website.

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