From the launch of the Casey Commission to the publication of the 10 Year Health Plan, and from parliamentary scrutiny of reform to long-overdue investment announcements, the story of 2025 is one of slow but visible movement. Yet, as we prepare for the Autumn Budget on 26th November, there remains a strong sense that the most important work still lies ahead.
Kicking off the year with a bang
January saw the announcement of the Casey Commission, an Independent Commission on Adult Social Care led by Baroness Casey of Blackstock, which will recommend how to reform the adult social care system. While Casey’s reputation for cutting through bureaucracy is well known, many across the sector were frustrated by the extended timetable – phase one to report by mid-2026, and phase two in 2028.
Another commission must not become another delay. The millions of people who rely on care and support today cannot wait another three years for meaningful change. Our vision for the Casey Commission remains clear – it must be a vehicle for action, not just analysis, focused on sustainable funding, workforce reform and co-production with those who draw on care and support.
A turbulent start to spring
March brought two major developments that set the tone for much of the year. The first was the Spring Statement, in which fiscal restraint was once again the watchword. While framed around stability and ‘a decade of national renewal’, the social care headlines told a different story. Changes to PIP eligibility risked pushing 150,000 people out of entitlement to carers’ benefits by 2029/30 – a £500m reduction in support.
The outcry was swift, and Government ultimately removed the proposal, launching instead a full review of the PIP assessment system under Sir Stephen Timms. The Timms Review now has a vital opportunity to rebuild trust and ensure that assessments are rooted in dignity, fairness and lived experience.
The second announcement was the abolition of NHS England. Described by the Prime Minister as a ‘bureaucratic barrier’ and ‘unaccountable quango’, its dissolution marks the most significant restructuring of NHS governance in over a decade. Under leadership from Sir Jim Mackey and Penny Dash, NHS England will gradually wind down over the next two years.
While the implications for social care remain unclear, this kind of structural reform will only succeed if it deepens collaboration, rather than reinforcing silos. With Labour’s five key ‘missions’, including a commitment to ‘Build an NHS fit for the future,’ the delivery of its 10 Year Health Plan will depend on genuine partnership with social care, especially in regards to neighbourhood health and local communities. Without that integration, the ‘three shifts’ – from hospital to community, analogue to digital and sickness to prevention – risk remaining words on a page.
Cost of inaction laid bare
In May, the Health and Social Care Committee published its landmark report, Adult Social Care Reform: The Cost of Inaction. The Committee’s conclusions were stark – adult social care continues to face rising demand, workforce shortages and chronic underinvestment. Individuals are experiencing unmet care needs, deteriorating health and reduced quality of life. The knock-on effects for the NHS, local government and the wider economy are immense.
I gave evidence to the first public session of the inquiry, highlighting that the real cost of inaction is borne by people, families and communities every day. The Casey Commission should therefore not be another report which gathers dust in Whitehall; it must be bold where others have been cautious, inclusive where others have excluded and rooted in evidence and experience from the outset.
Signs of progress
By the summer, attention turned to the Spending Review 2025, described by the Chancellor as a blueprint for ‘Britain’s renewal.’ It was pragmatic, politically careful and heavily shaped by the need to rebuild public confidence ahead of the next election.
For the DHSC, the review brought modest real-terms growth of 2.8% in resource spending, alongside headline investments in digital transformation, tobacco cessation and community-based care. The £4bn allocated for adult social care will help the sector meet rising demand, but many have rightly pointed out that it falls short of the levels needed to deliver real reform.
The Chancellor’s reference to backing the ‘first ever fair pay agreement’ has since been substantiated by £500m investment. While welcome, there are concerns that with this support not due to start until 2028, this injection of money will only represent a modest pay increase.
Still, there were genuine bright spots. Government’s new £39bn affordable housing programme will help tackle one of the most persistent barriers to wellbeing and independence. Housing and care are inseparable – better housing options prevent care needs from escalating and reduce the demand for social care and NHS services by preventing falls, reducing loneliness and improving wellbeing.
Then, in July, the long-awaited 10 Year Health Plan was published. Following Lord Darzi’s investigation and a national conversation on NHS reform, the plan reaffirmed the ambition to deliver the ‘three shifts’. The plan was welcomed but its success will depend on partnership with social care. Integration cannot be an afterthought; it must be the foundation. With 43 pilots now underway as part of the rollout of new neighbourhood health services, the social care sector has a closing window of opportunity to be brought in as partners in their creation; otherwise, we risk entrenching and repeating previous failed attempts at integration.
The challenges of integration were laid bare at the conclusion of July when the UK COVID-19 Inquiry’s Module 6 concluded five weeks of evidence on the pandemic’s impact on adult social care across England, Scotland, Wales and Northern Ireland. Module 6 of the Inquiry has confirmed what the sector has been saying for years – the vulnerabilities that shaped the pandemic response were not created by COVID-19, they were the product of decades of underfunding and piecemeal reform. Many of the systemic weaknesses exposed during the crisis are the very issues identified as far back as the Dilnot Commission in 2011. They remain unresolved today.
Meanwhile, the sector itself continued to demonstrate its capacity for innovation and growth. New data from Skills for Care showed that the workforce has grown for a third consecutive year and now contributes almost £78bn to the national economy – more than the accommodation and food services sector. That is an extraordinary achievement and testament to the dedication of providers, staff and volunteers across the country. At a time of uncertainty, these numbers tell a powerful story – social care is not standing still. It is growing, adapting and proving its economic as well as social value. When investment and innovation align, the results are transformative.
A Christmas wish list
As we approach the Autumn Budget, SCIE’s message to Government is clear – the social care sector has demonstrated resilience, creativity and economic value, but now it needs long-term certainty to thrive.
Our Christmas wish list for the Chancellor includes five key priorities:
- Achieving the left shift: Investment must move upstream – from crisis response to prevention. Community-based care and early intervention improve lives and deliver proven returns on investment for the NHS. Shifting resources leftwards is both morally and economically essential.
- Improving health and care data: We need a comprehensive review of health and care data, addressing persistent gaps in areas such as waiting times, unmet need, home-based intermediate care and supported housing. Better data, including the insights and experiences from people drawing on care and support, means better policy, planning and outcomes.
- Harnessing local government reform: With new devolved authorities emerging through the English Devolution and Community Empowerment Bill, we have a rare opportunity to redesign how social care is organised, delivered and integrated with other place-based services such as housing, planning and health. The devolution agenda must be grounded in co-production, evidence and place-based partnership.
- Expanding housing options: Affordable, accessible and adapted housing prevents care needs from escalating. Investment in supported housing must be a central pillar of the prevention agenda, helping people remain safe, independent and connected. We have a fantastic opportunity for Government’s forthcoming housing strategy to promote choices for people to age in place.
- Supporting the workforce: A fully funded fair pay agreement is essential if we are serious about valuing the social care workforce. And for the millions of unpaid carers who underpin the system, financial recognition and flexible employment support are urgently needed.
Final thoughts
If 2025 was the year of cautious progress, 2026 must be the year of delivery. The policy foundations for reform are already known – sustainable funding, fair pay, prevention, integration and co-production. What is needed now is follow-through. Looking ahead to the Autumn Budget, we urge the Government to match its rhetoric of renewal with the resources to achieve it. Because social care is not simply a service; it is fundamental to the fabric of society, enabling people to live gloriously ordinary lives.
What are your 2026 sector predictions? Comment on this feature or join the conversation to share your thoughts.
Kathryn Marsden OBE is Chief Executive at SCIE. Email: [email protected] X: @SCIE_socialcare