Baroness Louise Casey is to chair an Independent Commission into adult social care, which will be undertaken in two phases and completed by 2028. In the recently published terms of reference, outlining the scope of the Commission, the Department of Health and Social Care states that the Commission should ‘produce tangible, pragmatic recommendations that can be implemented in a phased way over a decade [and] will aim to make adult social care more productive, preventative and to give people who draw on care, and their families and carers, more power in the system’. The Commission’s recommendations ‘must remain affordable, operating within the fiscal constraints of Spending Review settlements for the remainder of this Parliament’.
The sector reacts to the terms of reference
MPs and leading figures in the sector have argued that a decade is too long to implement reform, with the Chair of the Health and Social Care Committee, Layla Moran MP, stating, ‘Inaction, and the current state of affairs, are harming those who need care, the people delivering care, the NHS, local Government, the Treasury, and the economy. […] Unless the Government measures the true cost of inaction and can make a convincing case to the Treasury, the recommended reforms that come out of the Casey Commission will be doomed to fail.’
While welcoming the establishment of the Commission, Professor Martin Green OBE, Chief Executive of Care England, has expressed concern that ‘if we’re not prepared to act in the short term, there may be little left to reform in the long term’. He said, ‘Hundreds and thousands of those drawing on care today, especially older people, may not live to see the benefits of a transformed system unless the Commission brings forward immediate improvements alongside its longer-term vision. We need bold interim steps, not just plans for a decade from now.’
Simon Bottery, Senior Fellow at The King’s Fund, has urged the Commission not to wait until its 2028 deadline before making its recommendations. He said, ‘The challenge may be whether the Government is willing to act more urgently – or indeed at all – to implement these reforms. It will be essential that the Government commits to providing the necessary funding to implement the reforms the Commission recommends. While the Government may feel its priority is the upcoming 10-year plan for health, adult social care must not get put to the back of the queue yet again.’
The National Care Forum’s Chief Executive Officer, Vic Rayner, pointed out the continued financial pressure and strain on the social care system, stating, ‘While it will need to focus on the long term, it is imperative that the Government understands we cannot wait until the Commission’s recommendations are published before taking action. This must include setting aside sufficient funding in the Spending Review so as not to curtail the important work Baroness Casey is undertaking. Building a social care system fit for the future can only be achieved by ensuring it is built on solid ground.’
There is no doubt the sector is concerned that reform may come too late. Layla Moran MP concluded, ‘We want this report to change the narrative on social care, and to act as a catalyst for building a strong and long-lasting case for reform. It might seem that reforms will be costly and difficult but continuing with inaction will cost us all more.
If the next decade brings more delay, the adult social care sector will be left treading water — reacting to crisis rather than shaping its future. The Casey Commission’s 10-year timeframe may sound pragmatic, but for those delivering care on the ground, it feels like another way to kick urgent reform into the long grass. Without structural change, we will see increasing pressure on already stretched services. Demand will grow, but systems and funding will not keep pace. Providers will be forced to do more with less, and the cracks will widen — in safety, staffing and sustainability. Quality of care will become harder to maintain, and public confidence could decline even further. The sector’s workforce will bear the brunt. Dedicated people will continue to enter the sector for the right reasons, but burnout, poor conditions and lack of career development will drive too many away. We risk losing experienced staff faster than we can replace them, leaving teams demoralised and under-supported. But I am hopeful — because I have seen what is possible when leaders do not wait for permission to make progress. Even without reform from the top, there are things we can control. We can redesign roles, invest in supervision, use technology more wisely and build supportive workplace cultures. We can work with regulators rather than against them — but challenge them where needed. If we wait for reform to fix everything, we will still be waiting in 2036. But if we act now — with collaboration, creativity and a real focus on people — we will shape a stronger sector ourselves. That is where real leadership lies. And if care can do it, then so can education, health and beyond. Lucy Corner, Managing Director, Cornerstone Care. Email: [email protected] LinkedIn: @Lucy-Corner The truth? There will not be a sector left. We are already at the edge, watching it crumble. While the Casey Commission may offer hope, the brutal irony is that irreversible decisions are already being made before the report has even left the runway. What is the point of reform if the very foundation is being pulled out from under us in the meantime? As a provider, I have watched employers’ National Insurance contributions increase, visa restrictions and late funding settlements pile up like wrecking balls, all delivered with no warning and no care for the real-world impact. No provider can offer security or progression to staff with this level of instability. We cannot plan. We cannot increase wages. We cannot protect our teams. How do we continue to hold up this system while being punished for simply trying? Through Providers Unite, I have witnessed the exhaustion, resilience and unwavering heart of those working in care. This is not just a job, it is a calling. We do not recruit for convenience; we recruit for values. For people who lead with compassion, who show up when it is hard and who keep going long after the shift ends. We are not just ticking boxes. We are managing crises, supporting families, navigating constant change all while carrying the emotional weight of the work. Care is one of the toughest, most meaningful roles there is. And it is time that was recognised in policy, in pay and respect. We need change – urgent, meaningful and system-wide. The promise of a decade-long roadmap means nothing if we bleed out in the meantime. I do not want another conversation; I want to be part of the action. Reform cannot come after we have been wiped out. Katrina Hall, Director, Bay Care Group. Email: [email protected] LinkedIn: @Katrina-(Kat)-Hall