Last Updated on July 28, 2026

Government is falling short on its promise to 'fix the crisis in social care', says a new report from the Public Accounts Committee (PAC). The report highlights that chronic understaffing, rising waiting lists and patchwork funding has placed sustained pressure on local authorities. Alongside the report, the PAC is calling for stronger leadership, long-term financial support and a clear workforce strategy to address key shortfalls in the adult social care sector.

In 2021, the Department of Health and Social Care (DHSC) set out a 10-year vision for adult social care. In the same year, Government committed £5.4bn funding over three years, on top of existing budgets, to reform adult social care. However, in April 2023 plans for system reform were revised, scaling back short-term plans to £729m over the period 2022-23 to 2024-25. In addition, Government has no roadmap for achieving its vision, or any targets or milestones beyond 2025, with nothing meaningful in place to demonstrate progress.

Workforce vacancies in the sector, which employs around 1.6 million people, exceeded 152,000 in March 2023, a vacancy rate of almost 10%. The PAC fears the workforce plan set out to address this shortfall is insufficient to the scale of the task. According to the report, the DHSC’s future reliance on overseas staff raises significant questions of the impact of proposed visa restrictions and risks of exploitation. The demand for adult social care services in rural areas is of particular concern to the PAC, as it is set to rise against a backdrop of chronic understaffing in these communities.

In 2022-23, local authorities supported more than one million people with care needs, at a cost of £23.7bn. As of Autumn 2023, there were almost half a million people awaiting attention on their case, and £2.7bn in additional funding was allocated in 2022 in response to emerging pressures. However, the PAC remains unconvinced whether Government knows if it is achieving value for money from this additional funding, and seeks assurance that funding for market sustainability and improvement has not instead ended up increasing profit margins for some providers.

The PAC’s inquiry challenges Government on whether there will ever be a multi-year funding settlement that will allow local authorities to set out long-term programs to achieve the transformations needed in this sector. Given it has a 10-year vision for adult social care reform, the report urges the DHSC to set out how it will ensure more stable funding, and what it can do to give local authorities greater certainty to plan in the long-term.

In response to the report's publication, Dame Meg Hillier MP, Chair of the Committee, said, 'Years of fragmented funding and the absence of a clear roadmap has brought the adult social care sector to its knees. Waiting lists are rising, the sector is short tens of thousands of essential staff and local authority finances are being placed under an unsustainable amount of pressure.

'The decision to dedicate a single chapter in the Adult Social Care Reform White Paper to the social care workforce does not do justice to the level of work that will be required and feels to us like a bit of a cop-out. While an NHS-style workforce strategy for social care may not be feasible, the DHSC must set out how it will how it provide leadership across the sector to identify and address workforce challenges.

'Whilst we welcome the increase in funding, we fear this will do little to address the key challenges faced by the sector in the absence of a well-funded multi-year strategy. A 10-year vision is all well and good, but this alone is not enough to bring about the fundamental changes this sector so desperately needs.'

Caroline Abrahams, Charity Director at Age UK, said, 'There are at least 1.6 million reasons to reform and refinance social care – the number of older people in our country with some unmet need for care and support – but apparently that's still not enough to stir our politicians to determined action. Everyone knows that restoring social care will cost money and take sustained effort but, as this report points out, the optimistic vision the Government set out two years ago has been largely gathering dust, with no coherent plan that we can see to actually bring it about.

'Meanwhile, waiting lists are rising, workforce vacancies top 150,000 and local authorities are considering cuts to social care next year as one by one they run out of cash. It seems increasingly likely that the Government will have to bail local services out of a hole this autumn but, as the Committee observes, these short term rescue packages are terrible value for money for us as taxpayers. We'd get much more bang for our buck if Ministers took a longer term, more strategic approach – if they actually published a funded plan to reform social care and then stuck to it.

'We are already hearing too many stories of older people not getting the help they need, unpaid carers buckling under the strain and dedicated care professionals leaving for better paid jobs elsewhere. Care staff certainly deserve a good pay rise, but by raising the national minimum wage without also making available the money to fund it, a positive move from the Government risks pushing care services – including those run by voluntary organisations such as Age UK – further into the red. In this respect, rather than painting an overly gloomy picture, the Public Accounts Committee's report may actually be understating the challenges facing older people in need of care, and those whose job it is to commission and provide it.'

Independent Care Group (ICG) Chair, Mike Padgham, said, 'Here we are presented with more evidence – this time from MPs themselves – that the Government continues to fail the care of older and vulnerable adults in this country.

'We applaud the Committee for setting out in such stark and uncompromising terms the way the Government has continued with short-term, sticking plaster actions to try to support a s system that is failing and on the brink of collapse.

'But we wonder how many more of this type of report there will have to be before anyone in Westminster heeds the wake-up calls and takes some action.

'We have 1.6 million people going without the care they need, a shortage of 152,000 staff in the workforce and people who provide homecare and residential care cutting back services and exiting the market.

'This report from MPs rightly identifies short-term, “patchwork” measures that have had little impact. It seems to everyone delivering care and many waiting to receive care, that the Government has no plan for social care and that is a desperate place to be.'

Professor Martin Green OBE, Chief Executive of Care England, said, 'The recommendations in the report are ambitious and essential in equal measure. But this type of aspiration is what we need to reform the social care system and ensure our sector is fit for the future. All the evidence points to a sector that needs cross-party commitment to long-term planning. The recommendations are a damming picture of the current state of care. Now, it is incumbent on the Department of Health and Social Care to act. In the year of a general election, neglecting social care means neglecting the millions that live and work in the sector.

'What the system needs is long-term, sustained root and branch reform and for the Government to be held to account with measurable targets. It’s about time we stop letting the Government get away with marking its own homework. This month’s Spring Budget made it clear adult social care is not high on the Government’s agenda. Well, the gauntlet has been thrown by this report. We need accountability and responsibility to rise to the challenge.'

Sam Monaghan, Chief Executive at Methodist Homes (MHA), said, 'We agree with the Committee’s sentiments that the Government must support the adult social care sector with sustainable plans, rather than piecemeal funding. As PAC also points out, this must include a clear workforce strategy to address the thousands of vacancies in the sector.

'We need more people to view caring for others as a professional career choice, with good career pathways and consistent training, and roles that are skilled and valued. Crucially, the issue of pay and pay differentials must also be addressed.

'We’re continuing to advocate for the creation of a Social Care Council to act as an independent body that would raise the profile and professional status of those working in the sector. This Council would tackle key issues, such as pay scales and recruitment - helping to drive the long-term reform that social care so desperately requires.'

Tom Marsland, Policy Manager at national disability charity, Sense, said, 'Report after report has shown how desperately social care is being failed. For years, the system has been under-funded, under-resourced and under-staffed, having a devastating impact on those who rely on social care to live happy and healthy lives. This report’s conclusion that the Department for Health and Social Care is not providing the leadership needed to meet the country’s future needs is alarming, but sadly not surprising for those of us in the social care sector.

'The Government cannot continue patch this issue up with short-term funding which does little to address the roots of the crisis. We urgently need long-term funding and a social care workforce plan to guarantee the future of social care.'

To read the new report in full, visit the UK Parliament website.

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