Adult Social Care Reform: The Cost of Inaction

Health and Social Care Committee Open Inquiry
Opened: 31 Oct 2024 Parliament page
Successive governments have presented reform ideas for adult social care, yet few of these have been implemented. This inquiry seeks to understand what this inaction is costing. We will investigate the cost of inaction to individuals, the NHS, local authorities and also to the wider economy and HM Treasury, focussing … Read more
15 Recommendations
12 Conclusions
1 Report
4 Oral sessions
4 Events
Activity timeline 10 events
9 Jul
2025
Report published
5 May
2025
Report published
19 Mar
2025
Oral evidence
19 Mar
2025
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
5 Mar
2025
Oral evidence
5 Mar
2025
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
5 Feb
2025
Oral evidence
5 Feb
2025
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
8 Jan
2025
Oral evidence
8 Jan
2025
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
Oral evidence sessions 4 sessions
19 Mar 2025
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Oral Evidence
Caroline Abrahams · Age UK Dr Maria Petrillo · Centre for Care, University of Sheffield Holly Jayne Simpson Keyaan Tom Gentry · Age UK
5 Mar 2025
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Oral Evidence
Anu Singh · NHS Black Country Integrated Care Board Councillor David Fothergill · Local Government Association Dr Birju Bartoli · Northumbria Healthcare NHS Foundation Trust Hugh Evans · Bristol City Council Isabel Lawicka · NHS Providers Melanie Williams · Association of Directors of Adult Social Services
5 Feb 2025
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Oral Evidence
Anita Charlesworth · Health Foundation Ms Emily Holzhausen CBE · Carers UK Oonagh Smyth · Skills for Care
8 Jan 2025
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Oral Evidence
Kathryn Smith · Social Care Institute for Excellence (SCIE) Simon Bottery · King's Fund Sir Andrew Dilnot CBE · Commission on Funding of Care and Support
Title HC No. Published Items Response
2nd Report - Adult Social Care Reform: the cost of inaction HC 368 5 May 2025 27 Responded
Recommendations & Conclusions
4 results
Clear
1 Conclusion Accepted
2nd Report - Adult Social Care Ref…
Adult social care system fails to meet needs and lacks robust data for effective reform.
The current adult social care system does not sufficiently meet the needs of the population despite the efforts of millions of paid and unpaid carers. Financial pressures mean that those needing care sometimes only receive basic support, far from enough … Read more
Government Response
The government recognised the challenges and data limitations in adult social care, stating it would be challenging to publish an annual assessment of unmet need. It highlighted ongoing efforts by the CQC to assess all local authorities and DHSC's funding of a support programme to address identified issues.
Department of Health and Social Care
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16 Recommendation Accepted
2nd Report - Adult Social Care Ref…
Require full quantitative analysis for Adult Social Care Fair Pay Agreement impact assessments, including economic costs
We recommend that the impact assessment for any secondary legislation to establish an Adult Social Care Fair Pay Agreement be accompanied by a full quantitative analysis, including the impact on sector productivity, financial costs faced by providers and expected return … Read more
Government Response
The government commits to beginning the Fair Pay Agreement consultation this year, with secondary legislation and the negotiating body established in 2026, aiming for the first agreement within this Parliament. It also confirms an impact assessment including monetised estimates will be produced once the agreement is ratified.
Department of Health and Social Care
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21 Conclusion Accepted
2nd Report - Adult Social Care Ref…
Welcome new Better Care Fund objectives supporting preventative services over hospital discharge focus
We welcome the new objectives for the Better Care Fund to support preventative services, rather than simply focusing on solving challenges with hospital discharge. (Conclusion, Paragraph 111)
Government Response
The government agrees with the conclusion, stating it has committed £9 billion to the Better Care Fund (BCF) for 2025-26 and refocused its policy framework towards prevention and community-based care, setting new performance metrics. It is also considering longer-term reforms for 2026 and beyond.
Department of Health and Social Care
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22 Recommendation Accepted
2nd Report - Adult Social Care Ref…
Review NHS investment in the Better Care Fund to meet its preventative service focus
We recommend that the Government and the NHS review the structure and level of NHS investment in the Better Care Fund to ensure it is fully capable of meeting its renewed focused on upstream and preventative work. (Recommendation, Paragraph 112) 56
Government Response
The government agrees with the recommendation and has committed £9 billion to the Better Care Fund (BCF) for 2025-26, refocusing its policy framework on upstream and preventative work with new performance metrics. It also stated it is considering longer-term reform options for the BCF for 2026 and beyond.
Department of Health and Social Care
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Government Response AI assessment · 27 of 15 classified
Accepted 4
Acknowledged 5
Deferred 12
Rejected 6
Total 15 recs + 12 conclusions