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
5 results
Clear
6 Conclusion Acknowledged
2nd Report - Adult Social Care Ref…
Unpaid carers face significant personal and financial costs due to social care reform failures.
Unpaid carers are bearing the highest cost from successive governments’ failures to reform adult social care. They provide care worth £184 billion, “equivalent to a second NHS”, but this is often unrecognised and comes at great personal, emotional and financial … Read more
Government Response
The government agrees that publishing cost estimates of delayed discharges would improve transparency and will explore how best to publish this data, acknowledging methodological challenges.
Department of Health and Social Care
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17 Conclusion Acknowledged
2nd Report - Adult Social Care Ref…
Inadequate adult social care system imposing significant costs on the NHS, particularly from delayed discharges
Social care is a vital public service in and of itself and should not be valued only for how it supports the NHS. However, the current state of adult social care is imposing significant costs on the NHS. The best … Read more
Government Response
The government agrees that publishing cost estimates for delayed discharges would in principle improve transparency but notes methodological challenges. It commits to exploring how best to publish such data, without a firm commitment to immediately produce the comprehensive data requested by the committee.
Department of Health and Social Care
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20 Conclusion Acknowledged
2nd Report - Adult Social Care Ref…
Adult social care system undermining Integrated Care System development due to funding disputes
The current state of the adult social care system is undermining the relationship building that is fundamental to the development of Integrated Care Systems (ICSs). Too much relies on local leadership, where often it feels that progress is made despite … Read more
Government Response
The government states it agrees with the conclusion and highlights its commitment of £9 billion to the Better Care Fund for 2025-26, refocusing it on prevention and community care. However, it does not explicitly commit to addressing how the current social care system undermines ICS relationships or fosters funding disputes.
Department of Health and Social Care
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23 Conclusion Acknowledged
2nd Report - Adult Social Care Ref…
Social care reform integral to creating a fit-for-future NHS, cannot be separate process
The Government will not succeed in creating an NHS fit for the future unless it effectively reforms the social care system. Social care reform is an integral part of NHS reform and cannot be a separate process. (Conclusion, Paragraph 117)
Government Response
The government acknowledges the conclusion by stating the independent commission has autonomy and its first phase will focus on supporting the health mission within ongoing reforms. However, it does not explicitly commit to ensuring social care reform is fully integrated with NHS reform and not a separate process.
Department of Health and Social Care
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25 Conclusion Acknowledged
2nd Report - Adult Social Care Ref…
Government must view social care as an enabler and driver of economic growth
The Government needs to fundamentally change how it views the social care sector, seeing it as an enabler and talking about it in those terms in the public debate - both for the invaluable service it provides to so many … Read more
Government Response
The government strongly agrees that adult social care is an important enabler for economic growth and contributes significantly to the economy. However, it reiterates that a dedicated 'growth strategy' for the sector is not considered necessary or proportionate, consistent with its response to a related recommendation.
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