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
6 results
Clear
3 Recommendation Rejected
2nd Report - Adult Social Care Ref…
Develop robust methodology for measuring care's impact on people's lives, health, and the economy.
The Government must also develop a robust methodology for measuring the impact of care on people’s lives, the wider health system, and the economy. As well as supporting the case for reform, such methodology would help councils to deliver outcome-based … Read more
Government Response
The government rejected the recommendation to develop a robust methodology for measuring the impact of care. It stated that existing procedures for impact assessments for policy or fiscal decisions relating to the workforce are sufficient and a new form of cross-government impact assessment is not accepted.
Department of Health and Social Care
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8 Conclusion Rejected
2nd Report - Adult Social Care Ref…
Local authorities face unsustainable adult social care costs, impacting other essential public services.
Local authorities are buckling under the strain of the costs of providing adult social care. The current system is unsustainable. Failure to reform adult social care, especially the funding structure, comes at a significant cost to local authorities. The increasingly … Read more
Government Response
The government agrees adult social care supports economic growth and highlights current efforts like the Employment Rights Bill and investment in digital tools, but it explicitly rejects developing a dedicated adult social care 'growth strategy'.
Department of Health and Social Care
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19 Recommendation Rejected
2nd Report - Adult Social Care Ref…
Mandate Casey Commission research into NHS costs and savings linked to adult social care failures
We recommend that the Casey Commission undertakes research to better understand the costs that the NHS is bearing as a result of failures in adult social care, and where the NHS is saving money due to good social care. This … Read more
Government Response
The government states that the independent Casey Commission has the autonomy to decide its research, implying the government will not direct it to undertake the specific cost analysis recommended or commit to continuing such analysis itself.
Department of Health and Social Care
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24 Recommendation Rejected
2nd Report - Adult Social Care Ref…
Require Baroness Casey to outline adult social care's role in the 10-Year NHS Health Plan
In her first report, Baroness Casey should set out the immediate steps that the Government needs to take to ensure the adult social care sector can play its vital part in the three shifts for NHS reform. Achieving these should … Read more
Government Response
The government states the independent commission has autonomy to make recommendations and that its terms of reference already align with supporting the government's health mission, but does not commit to ensuring Baroness Casey sets out the immediate steps or assessments as specifically recommended.
Department of Health and Social Care
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26 Recommendation Rejected
2nd Report - Adult Social Care Ref…
Develop a growth strategy for adult social care informed by productivity study, highlighting regional growth.
We recommend that the Government produce a growth strategy for the adult social care sector, including a focus on its potential to drive regional growth. This should be informed by a detailed study of how to improve productivity in the … Read more
Government Response
The government rejects the recommendation for a dedicated adult social care 'growth strategy', arguing it is not proportionate or necessary given the sector's core purpose of individual wellbeing. While acknowledging social care's economic role, it notes the Casey Commission's independence for studying productivity, without committing to the specific recommended study.
Department of Health and Social Care
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27 Recommendation Rejected
2nd Report - Adult Social Care Ref…
Commission research to quantify the full costs of inaction on adult social care reform.
We recommend that the Government commissions research with the aim of fully quantifying the cost of doing nothing on adult social care reform. That research should seek to quantify costs to individuals, including unpaid carers and care workers, to local … Read more
Government Response
The government rejects commissioning a dedicated study to quantify the cost of inaction on adult social care reform. It states it already commissions a wide range of research and data through the NIHR to inform its approach to reform.
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