Local government reorganisation can unlock opportunities for efficiency, financial resilience and strategic alignment. Bringing together two tiers of government, or disaggregating large county structures, can support clearer accountability and alignment of priorities, particularly where housing, economic development and social care intersect. The emphasis on building on existing collaborative structures, such as integrated care systems, Regional Improvement and Innovation Alliances and joint delivery platforms, is an important signal that reform should support integrated, prevention-focused care.

Crucially, the forthcoming changes have the capacity to improve equity in access, experience and outcomes of people in need of care and support by enabling more consistent service design and delivery, as well as by reducing unwarranted variation across geographies. This creates a platform to embed prevention more deeply, strengthen community-based support, and ensure that people receive more personalised, responsive care that is shaped around their needs and aspirations.

It is vital that we learn from the experience of those councils that have been through local government reorganisation. This includes how risks have been mitigated, and the lessons learned since new councils were established. Through our work with government departments, and through conversations with Chief Executives, Directors of Adult Social Care and Children’s Services, transformation leads and providers, SCIE has been gathering insight into the critical success factors for local government reorganisation.

At SCIE, the key opportunity lies in helping councils safeguard continuity of care, manage system transitions smoothly, and maintain a focus on improving outcomes for people and communities during a period of significant change.

Local government reorganisation is not an end in itself. Its success will be judged by whether it improves outcomes for people who draw on care and support, their families and carers. As plans develop and implementation progresses, the priority must remain clear: to ensure continuity of care, maintain service quality, and support improvement, while navigating a period of significant structural change.

Contact our team for more information or to find out how SCIE can support you: sciebusdevelopmentteam@scie.org.uk

Reform in stages

Adult social care in England was never designed in the way the NHS or other parts of the welfare state were after the Second World War. Instead, it evolved gradually through a series of partial reforms.

The National Assistance Act 1948 replaced the Poor Law framework but retained many of its underlying assumptions. Social care remained largely a safety net, with access shaped by means-testing and by local interpretation of eligibility. Over time, the legal framework became increasingly fragmented as new duties and powers were added through successive pieces of legislation.

A more coherent framework did not emerge until the Law Commission’s review of adult social care law, published in 2011. Many of its recommendations were implemented through the Care Act 2014, which consolidated decades of legislation into a single statute and placed the promotion of individual wellbeing at the centre of the system.

The Care Act created a framework that is more adaptable than is sometimes recognised. In effect, it operates like a balloon: the structure holds whether it is lightly inflated or filled more fully. The Act can support the constrained system that exists today, but it could equally accommodate a more ambitious settlement should government choose to expand entitlement, investment or prevention.

The legislation, therefore, provides the architecture for reform, even if the system operating within it remains limited.

Yet none of these reforms fully resolved the relationships between the system’s key components: funding, workforce sustainability, entitlement, prevention and the balance of responsibility between national and local government.

Nor did they address the structural imbalance between health and social care. The NHS remains the dominant institution in the wider system. Part of that imbalance reflects scale and funding. But part of it reflects visibility. The NHS is a nationally recognised public institution, while social care is experienced as a complex set of local services whose boundaries and responsibilities are often unclear.

The result is a system with strong statutory principles but persistent structural tensions.

The Casey Commission offers an opportunity to revisit those relationships. Not necessarily to produce an immediate comprehensive settlement, but to clarify how the system’s different parts should align.

The reform we almost had

This is not the first time social care has come close to structural reform.

In 2011, the Dilnot Commission proposed a cap on lifetime care costs. The proposal was not radical. It did not create a National Care Service or fully collectivise funding. But it would have changed the system in one important way: it would have made the state’s role more visible.

Care accounts would have tracked individuals’ progress towards the cap. Self-funders would have come into earlier contact with local authorities. The means test and the public safety net would have become more transparent.

Over time, that visibility might have altered the politics of social care.

Instead, implementation was repeatedly delayed and eventually abandoned. Care accounts were never embedded. The cap was postponed, revised and finally scrapped.

The system remained largely as it was: complex, uneven and often encountered only at moments of crisis.

Dilnot’s lesson is not simply that reform is politically fragile. It is that reform requires administrative readiness, narrative coherence and sector alignment long before legislation is enacted.

The current moment

The Casey Commission begins its work in a political environment that is both constrained and consequential.

Public understanding of social care remains limited. Fiscal pressures are acute. A general election will arrive within the next parliamentary cycle.

In these conditions sweeping reform within the current Parliament appears unlikely.

Yet Casey’s intervention matters because it recognises that the system is no longer operating within the assumptions under which it developed. People live longer with complex conditions. Expectations about independence and participation have changed. Workforce sustainability has become central to the system’s future.

The proposed Fair Pay Agreement brings this challenge into sharper focus. By establishing nationally negotiated workforce standards, it places central government in a more visible position of responsibility for workforce conditions and their funding consequences.

Historically, pressures in social care have often been absorbed through local variation in commissioning and pay. National workforce standards reduce that flexibility. Over time, they increase pressure for alignment between workforce policy, funding settlements and commissioning practice.

That alignment will not occur automatically. It will have to be shaped.

Taken together, the Fair Pay Agreement and the Casey Commission create what might reasonably be described as a design moment for social care.

The sector’s role

Government action alone will not determine whether this moment produces reform.

For many years, organisations across social care have argued powerfully for change. Providers have highlighted market fragility. Local authorities have described unsustainable financial pressures. Workforce organisations have made the case for fair pay. People who draw on care and support have spoken about inconsistency and lack of control.

These arguments are legitimate and necessary.

But when government is presented with multiple overlapping demands, without clarity about sequencing, cost exposure or risk-sharing, incremental adjustment becomes the safer political course.

Treasury caution increases. Ministers hesitate. Reform drifts.

If structural change is to be secured, the sector must increasingly complement advocacy with something else: shared design.

That means being explicit about trade-offs. Reform involves choices between pace and affordability, national consistency and local flexibility, expanded entitlement and fiscal exposure.

Trade-offs are not a constraint on ambition. They are how ambition becomes politically adoptable.

This does not require unanimity across the sector. But it does require a form of system stewardship, recognising that the long-term health of the system depends on how its different components align.

Visibility and public understanding

One of the persistent challenges in social care is its low public salience.

Many people encounter the system only when they or a family member face a crisis. The boundaries between health care and social care are poorly understood. The financial rules are opaque. There is no single institutional identity comparable to the NHS.

Polling suggests that while people value care for older and disabled people, social care rarely determines voting behaviour.

Structural changes may gradually alter this. If workforce standards are negotiated nationally, questions about how those standards are funded become more visible. If commissioning must align with workforce agreements, the relationship between national and local responsibility becomes clearer.

Visibility alone will not produce reform. But without visibility, reform struggles to build constituency.

The next 18 months

For the Casey Commission, the coming period will involve gathering evidence and shaping recommendations.

For the sector, the next 18 months represent a moment of responsibility.  The responsibility to clarify the problems government is being asked to solve.  The responsibility to align workforce reform with funding and commissioning realities. The responsibility to develop credible economic and operational analysis capable of withstanding Treasury scrutiny.

And the responsibility to work through difficult trade-offs before political decisions are required.

Reform will not emerge fully formed from a commission alone. Nor will it be secured through advocacy alone.

But Casey’s intervention signals that the conversation about the future of social care has begun again. The Care Act already provides a framework capable of supporting that future—whether in its current constrained form or as the basis for a more ambitious settlement, should government choose to expand entitlement, investment or prevention.

What happens next will depend on how we in the sector choose to respond.

Paul Burstow is Chair of the Social Care Institute for Excellence (SCIE). He served as Minister of State for Care Services from 2010 to 2012 overseeing the drafting of the Care Act and was a Liberal Democrat MP from 1997 to 2015.

Co-production is about shared power

Co-production is not just a category on a nomination form. It is a way of working. A way of thinking. A way of valuing lived experience.

At its core, co-production recognises that lived experience is not simply something to be consulted. It is expertise. When people who draw on care and support are meaningfully involved in shaping services and decisions, the result is often more responsive, more human and ultimately more effective.

Looking at this year’s nominees for the Co-Production Award, what stood out was not just innovation or success. It was humility. These were individuals and organisations quietly shifting the balance of power by listening differently, working alongside people, and designing support with communities rather than for them.

This year’s nominees included:

• Syd Coombes, Active Pathways
• Abby Cummings, 1st Grade Care (Winner)
• Sue Estcourt, Macc Community Care
• The Good Care Group
• Joan Lyon, University of Stirling
• Dawn Mitchell, Exemplar
• Sophie Sayer, Lifeways
• Chell Seymour, PA Services for You (Highly Commended)
• Ridgeway Care, Expanding Horizons
• Amy Varney, Komplex Care
• Joanne Williams, Cavell Healthcare

Each nominee reflects a commitment to doing things differently. Their work reminds us that genuine collaboration is not always loud or headline-grabbing. Often, it is built through everyday relationships—through trust, listening and the willingness to share power.

Why this matters personally

For me, this work is not abstract.

As someone with lived experience, and as Co-Chair of the TLAP partnership board and a trustee at SCIE, I do not take these spaces lightly. They represent opportunities to ensure that the voices of people who draw on care and support are not just present, but influential.

Social care, after all, is not really about services. It is about lives.

It is about dignity, belonging and choice. It is about relationships, independence and the everyday moments that shape how someone feels about their own life.

Standing on stage with Ben Shepard at the awards was a genuine highlight for me. Not because of the spotlight, but because of what that moment symbolised. Two people representing lived experience and leadership standing side by side, recognising a workforce that too often goes unseen.

Moments like that remind us that progress in social care happens when people work together across boundaries, between organisations, professions and lived experience.

A sector worth celebrating

The Great British Care Awards, including the national finals in Birmingham, are not simply about trophies or recognition for their own sake. They are about visibility.

Care work is skilled, complex and deeply human work. Yet, too often, it is undervalued or misunderstood in public conversations about health and social care.

Awards like these help shift that narrative. They provide a space to recognise dedication, creativity and compassion across the sector. They give teams the chance to celebrate the difference they make in people’s lives.

When someone takes the time to nominate a colleague or organisation, they are doing more than completing an application form. They are saying that this work matters. They are acknowledging the commitment behind it. They are expressing pride in the people and teams who make social care possible.

And in a sector that faces ongoing pressures, that sense of pride and recognition matters more than ever.

Why we continue to support the awards

At SCIE, co-production with people with lived experience of social care underpins and informs what we do, enabling us to recommend best practice in social care. 

Our involvement in the Great British Care Awards reflects something simple but important. Co-production deserves to be recognised and celebrated. The workforce deserves to be seen and valued. And excellence in care should never be invisible. It is through sharing it that we can inspire and support others to do co-production better.

Across the UK, people are building better lives every single day—often quietly, without fanfare. The awards simply shine a light on that reality.

Sometimes, shining that light is enough to inspire others, strengthen partnerships and remind us why this work matters.

Standing on that stage reminded me that when lived experience and leadership stand side by side, the whole sector moves forward together.

To find out more about the Great British Care Awards, please see here.

And to find out how SCIE can support you with co-production—through resources like our impact tool, helping you demonstrate the difference co-production makes, guidance, training and direct consultancy support, contact us here.

A moment of challenge and opportunity

While the social care sector’s challenges are well known, I also see this as a moment of real possibility. With major programmes of social care, NHS and housing reform unfolding, there is potential to address long-standing pressures and drive coherent, sustainable change across systems that improves people’s lives. This will require us—as a sector and as organisations—to become more comfortable with change and to recognise that working differently is essential if we are to deliver consistently high‑quality outcomes for people who draw on care and support.

To drive meaningful change and more effective and efficient outcomes, we therefore need to support our teams to change day-to-day practice, and we need to ensure we are focused on the individuals’ needs, not the package of the care.  One example of that is our work with Bromley Council—digital transformation has enabled us to reduce care costs by nearly 30% and administrative time by around 20%, while achieving £2 million savings in its first year.

As I look ahead, I am excited by the opportunity to support a social care sector that is striving to become more consistent, more equitable and more confident in its own potential. My focus is on identifying opportunities for SCIE to continue to use our four offers, SCIE Consultancy, SCIE Training, SCIE Insights and SCIE Resources, to drive improvements and innovation and influence national policy and practice. At the same time, I will ensure that co-production with people with lived experience of social care continues to underpin and inform everything that we do.

One of the ways we can make the biggest contribution is by shaping the national conversation on social care reform. A clear example of this is our work on national standards of care. Building on the momentum from the launch of our report, ‘Towards a National Care Service: raising national standards of care’, we are now engaging with parliamentarians, senior sector leaders and the Casey Commission to drive this agenda forward so that people can rely on a consistent baseline of care regardless of where they live.

I am proud that we are also further expanding our focus on understanding and addressing inequity through our forthcoming Equity Evidence Hub, due to launch later this year, and through our annual Co-production Week in July, for which it is the theme. The hub will bring together evidence and lived experience to show where barriers exist and what can be done to reduce them, and will serve as a practical tool that organisations can use to understand inequity in their own contexts and take informed, targeted action. The aim is to highlight steps for creating a fairer system that responds to people’s varied circumstances.

At the same time, I recognise that national reform only makes a difference if it is felt locally. This requires system change and a focus on how we are working: relationships, trust, shared ownership, and learning—not just what we are doing. That’s why, alongside our work on driving change and reform at a national level, we will also continue supporting organisations to put this into practice. For example, we are testing our housing toolkits, the value of which was evidenced in statutory guidance issued last month, with Norfolk and Cumberland, influencing the development of their housing strategies. We deliver our support not only through direct commissions from local authorities, but also through a sector-led improvement for councils, which is funded by the Department of Health and Social Care and delivered in partnership with Partners in Care and Health and is free to local authorities to access. We work directly with local authorities, providers and partners to help them implement change on the ground—and to feel more confident and prepared for what lies ahead. In doing so, we help teams develop the skills, behaviours and cultures needed to work differently: to collaborate more, learn continuously, make use of evidence, and stay focused on what truly improves outcomes for people who draw on care and support.

As we move forward, this way of working—combining robust evidence, meaningful co-production and practical support for those delivering care—will remain central to how SCIE helps the sector navigate change.

The importance of partnership working

Strong partnership working within the social care sector—and across sectors such as health, housing, education and the voluntary and community sphere—will be essential to delivering meaningful and lasting improvement. I see every day that the challenges ahead are too complex for any single organisation to address alone. I also know from experience that the most effective solutions emerge when people and organisations come together with shared purpose and mutual accountability. This commitment to greater unity and shared purpose is driving SCIE’s involvement in initiatives such as the Time to Act Reform Board—a group of social care leaders committed to a shared Social Care Future vision.

A natural part of this collaborative approach is also our work with Think Local Act Personal (TLAP). Our combined expertise enables us to promote models of care that are rooted in people’s rights, aspirations and lived experience. Through this relationship, we together amplify the voices of people who draw on care and support and strengthen the sector’s commitment to co-production and person-centred practice. We also share learning that helps organisations embed these principles in meaningful, practical ways.

Strengthening these collaborations—and creating new ones—is a central priority for me as we move forward.

Looking ahead

SCIE is well-placed to meet the moment: outward-looking, innovative and ready to support a sector that is evolving at pace. As Interim Chief Executive, I want us to build on our strengths—our independence and impartiality, our commitment to evidence, and our belief in the power of collaboration—in ways that feel practical and grounded. Equally, I am keen for us to stretch ourselves, explore new approaches and respond creatively to the challenges ahead. Above all, I want our work to remain guided by the experiences and aspirations of people who draw on care and support.

This means working closely with people with lived experience of social care, and with the organisations working alongside them every day. Our work with The National Co-production Advisory Group and SCIE’s Co-production Steering Group will, therefore, continue to shape both our understanding of the system and our contribution to its future direction. I will also be spending time in care services to keep my thinking rooted in real experiences—what pressures people face, what support makes the biggest difference, and what good looks like when it is lived rather than described.

I am grateful to colleagues and partners who contribute to this work, and I look forward to working together to shape a better future for social care.

To find out more about how we can support you, contact us, or watch our film:

Leading SCIE through challenge and renewal

Joining SCIE as Chief Executive in 2020 was both a privilege and a challenge. The charity was at a pivotal moment, facing significant financial pressures. What I saw, however, was a charity with immense potential—a trusted independent voice in the sector, with a mission that truly resonated with my own values: to support best practice, shape policy and raise awareness of the importance of social care. Together, with an incredible team, we set about stabilising the organisation, strengthening our foundations, and renewing our strategic focus so that we could continue to lead the way in improving social care.

I am immensely proud of what we have achieved collectively. From navigating complex organisational change to securing financial sustainability, every step has been driven by a shared commitment to enabling adults and children who draw on social care to live fulfilling lives. The dedication, expertise and passion of the SCIE team have been nothing short of inspiring, and it has been an honour to work alongside such talented and committed colleagues. SCIE’s reach—supporting hundreds of thousands of professionals and millions of website users of our resources—is a testament to our reputation and the quality of our work.  Just the other week, a colleague shared how our recently published Get Me To Hospital resource is already saving lives.

Driving improvement and influence across the sector

We have continued to drive improvement through our collaboration with a wide range of partners to provide innovative consultancy, expert training, extensive resources and information and evidence-based insights.  One of the aspects of my time at SCIE that I will cherish most has been the opportunity to influence best practice right across the sector, with local councils. For instance, enabling Bromley residents and their carers to have greater control over support options while making £2million savings, advising Bath and North East Somerset on their co-production strategy, and providing a new integrated mental health pathway in Croydon, preventing people being sent into inpatient settings and 117 arrangements, recognised by the CQC as a good example of improving equity and experience.

I am particularly proud of our contribution to national conversations about the future of care. Our involvement in the Commission on the Role of Housing in the Future of Care and Support; our role in the Older People’s Housing Taskforce; our leadership of support for the Accelerating Reform Fund; and, most recently, our convening power in bringing the sector together to agree a framework for national standards—culminating in our new report, ‘Towards a National Care Service: raising national standards of care’, which we launched in Westminster—reflects SCIE at its best: bringing people together, amplifying lived experience, and influencing the system in a constructive and collaborative way.

Equality and lived experience

Influence, for me, has always meant more than policy papers or strategy documents. It means championing co-production, listening deeply, and ensuring that the voices of people who draw on care and support are not only heard but embedded in decision-making.

That’s why I was so humbled to be recognised at the Black Women in Care Awards last year for allyship and commitment to equality. Equality, diversity and inclusion are not optional extras in social care; they are fundamental to delivering fair, compassionate and effective support. I have always believed that leadership in this sector must be rooted in justice, advocacy and the courage to challenge inequality wherever we see it.

Looking ahead with gratitude and optimism

None of this would have been possible without people. To the entire SCIE team—staff, associates, partners, trustees, volunteers and those with lived experience who so generously contribute their insight—thank you. Your professionalism, integrity and unwavering commitment to improving lives are what make SCIE so special. I would also like to extend my full support and warmest wishes to Gerard Crofton-Martin, who brings a wealth of experience into the role of Interim CEO from his current role as Director of Transformation and Improvement, overseeing our consultancy and training offers; I know the organisation will be in safe and capable hands.

As I move on to take up the role of Chief Executive at Yorkshire Air Ambulance, I do so with immense gratitude for my time in social care and at SCIE. I remain involved in the sector as a Trustee for Community Integrated Care, and the values that have shaped my career—compassion, service, and a commitment to making a difference—will remain at the core of everything I do.

Social care stands at a critical crossroads. Demand is rising, complexity is increasing, and the workforce continues to show extraordinary dedication despite ongoing challenges. Now, more than ever, we must invest in what works: co-production, evidence-informed practice, prevention, and genuine partnership across health, housing and care. We must continue to champion the voices of those who draw on care and support, and we must not lose sight of the human stories behind every policy decision.

So, my call to action is simple. Keep going. Keep innovating. Keep collaborating. And keep believing in the power of high-quality social care to transform lives.

SCIE has shown what is possible when knowledge, compassion and collaboration come together. I leave with great pride in what has been achieved and great optimism for what lies ahead—for SCIE, for all of you who work in social care, and for the millions of people whose lives are touched by social care every single day.

Thank you for the privilege of being part of this journey.

As a not-for-profit charity, SCIE supports the development of innovative solutions to address challenges faced by children and families, helping ensure high quality, co-produced, ethical and evidence-based practice.

Shared ownership

One of the strongest insights to emerge from both the roundtables and the report is that national standards cannot succeed unless they are developed and delivered collaboratively.

This theme was evident throughout the launch event.  SCIE’s Chair, Rt. Hon. Professor Paul Burstow, opened the event by emphasising that social care reform “cannot be designed by one part of the system alone.” He pointed to the mix of people in the room as a practical demonstration of what genuine collaboration must look like if national standards are to succeed in improving the quality and access to care across the country.  

Paul also framed the moment politically, describing the launch of the Casey Commission as a “rare opportunity to reset the conversation about adult social care”. While the report provides a clear framework, he stressed that its impact will depend on how that framework is implemented—through shared ownership and collective responsibility.

Kathryn Marsden OBE, SCIE’s Chief Executive, reinforced this message in her keynote. Reflecting on the roundtable series, she described the honesty and openness participants brought to the discussions about the tensions and limitations of national standards. That willingness to confront difficult realities, rather than sidestepping them, was identified as essential if national standards are to support meaningful reform.

National standards that start—and stay—with lived experience

A core principle running through the report, and echoed at the launch event, is that national standards must be anchored in what matters to people who draw on care and support. The framework emphasises outcomes linked to equity, prevention, integration, navigability, and the sustainable use of resources—not simply what the system finds easiest to measure.

Sojan Joseph, MP for Ashford, who sponsored the event, placed this front and centre of his address at the report launch, welcoming the report’s emphasis on ensuring that standards are “anchored in lived experience outcomes.” Drawing on his role as Chair of the All-Party Parliamentary Group on Adult Social Care, he stressed the impact of hearing firsthand experiences and the responsibility to act on them.

He also stressed that meaningful involvement is about more than better design. When people know they, or others with similar experiences, have genuinely shaped the system, confidence in its fairness and relevance grows. This confidence will be critical to the success of a future National Care Service.

This point was reinforced by Isaac Samuels OBE, SCIE Trustee and Co-chair of the National Co-production Advisory Group (NCAG) and the Think Local Act Personal (TLAP) Board. They echoed one of the strongest messages from the roundtables and report: standards will only achieve their purpose if they reflect what is most important to people.

The report tackles this problem by setting out seven foundational principles. These principles are not intended to be abstract. They are grounded in existing statutory duties, co-produced frameworks and regulatory expectations, and they reflect areas where there is already broad consensus across the sector about what good care and support must deliver for people, including unpaid carers. Without a clear set of foundational principles, national standards of care risk being reduced to technical compliance, describing service activity rather than shaping a future model of care.

National standards as a tool for learning and improvement

The report makes clear that national standards should focus on learning and improvement, not function solely as a mechanism for compliance. Their success should be judged by whether they improve outcomes and experiences that matter to people.

This was a recurring them at the launch.  Kathryn highlighted that roundtable participants consistently warned against standards becoming narrow compliance exercises that add layers of bureaucracy. In response, the report frames national standards as a mechanism for clarifying expectations and defining what is essential and non-negotiable, while deliberately protecting flexibility in how outcomes are achieved locally.

The aim is to ensure that people can rely on a consistent baseline of care and support, regardless of where they live, without constraining local innovation or personalisation. Contributors to the roundtable series described this balance—between national consistency and local discretion—as one of the most important design challenges for the next phase of work.

System challenges and pressures

The report is deliberately open about what national standards can and cannot achieve on their own. This transparency was repeatedly cited by attendees as one of the report’s strengths.

Workforce challenges were a distinct and recurring theme throughout the report launch. Sojan emphasised that national standards cannot, in and of themselves, resolve staffing shortages or market fragility. He highlighted the direct impact of workforce instability on continuity and quality, underlining the need for a comprehensive workforce strategy to accompany any programme of national standards.

Anisa Byrne, General Manager at Access Care, adds, “National standards will only succeed if we actively involve frontline workers in their design and implementation. They understand what works in practice, what creates barriers to good care, and what support they need to deliver consistently high standards.”

Participants of the roundtable series echoed this, noting that even the strongest framework can only be effective if the people delivering care have the stability and support required to put it into practice. Workforce pressures are therefore not a barrier to standards, but essential context for understanding how they can be implemented well as we move into the next stages of this work.

Momentum and a shared appetite for progress

Beyond any single theme, the launch reflected an important shift. Attendees noted the energy and buzz in the room, and a shared appetite to move beyond broad reform debates towards practical, phased action guided by the report’s framework.

Many described the framework as a “living” approach—one that should evolve over time, shaped by feedback and used initially to support learning before strengthening assurance. This aligns closely with one of the report’s core messages: national standards must be dynamic, not static.

The strength and diversity of voices at the event gave weight to the sense that the sector is ready to move forward and reinforced the report’s call for shared ownership of reform.

Looking ahead

In his keynote, Sojan reflected that “talk of reform within adult social care must, ultimately, be about improving lives” and expressed hope that the report can play a meaningful role in shaping a National Care Service that delivers dignity, security and high-quality care for all.

The publication of ‘Towards a National Care Service: raising national standards of care’ and its Westminster launch mark a significant milestone in furthering the groundwork to inform this Government’s National Care Service. But this work also sharpens the focus on what must happen next. The report sets out a clear case for a phased approach to national standards: starting with a defined purpose and scope; focusing initially on priority challenges where variation and inequity are most acute; and learning from early implementation to refine standards over time, rather than attempting to introduce a comprehensive framework all at once.

This approach recognises both the ambition of national standards and the realities of the current system. It positions standards not as a single policy intervention, but as a long-term mechanism for learning, improvement and accountability—shaped by lived experience and supported by the right enabling conditions.

Building on the momentum from the launch, SCIE is now engaging directly with parliamentarians and sector leaders who attended the event, as well as with the Casey Commission, to continue developing this agenda. Alongside The Access Group, we remain committed to convening partners, contributing evidence and learning, and supporting government as thinking on national standards evolves.

If national standards are to succeed, they must be owned collectively, tested in practice, and refined over time. The conversation at Westminster showed that there is both the appetite and the opportunity to do this well. Our focus now is on turning that shared momentum into more consistent, more person-centred experiences of care for everyone.

You can read the report here.

What happens next?

The Mental Health Act 2025 aims to modernise, strengthen people’s rights and maximise choice, autonomy and dignity. Codes of practice, offering guidance on how professions should carry out their responsibilities under the Mental Health Act 2025 are being developed this year—planning for implementation will be something that organisations will be starting to contemplate. While this means that any changes in practice won’t be immediate, this does give time to thoroughly enquire and collaborate both with those working in the sector and those drawing on care and support, regarding what they see coming down the path and where they most need support in managing the incoming changes.

Starting from the ground up will be fundamental in creating support tools that are truly meaningful, effective and impactful—redesigning systems and models of care that drastically improve the experiences of people receiving support for serious mental health issues.

SCIE’s work

Co-production with people with lived experience of social care underpins and informs what we do at SCIE—that is what enables us to recommend best practice in social care.

We therefore hosted three advisory groups on 15, 19 and 26 January, co-produced with members of SCIE’s Co-production Steering Group and the National Co-production Advisory Group (NCAG). The aim of these groups was to ensure our support offer to others around the Mental Health Act 2025 is credible, co-produced, and delivers practical, evidence-informed support; it is essential to be informed by the experiences and views of those who work in or who have a personal connection to this area of mental health care.

Those represented consisted of people working across the health, social care and voluntary sectors, as well as lived experience representatives.

Key findings

Embodying a person-centred approach, the advisory group sessions facilitated the opportunity for people to openly share their reactions, concerns and hopes around the Mental Health Act 2025. From these pivotal conversations, we heard how the changes are widely welcomed: with adequate funding, resources and support, the opportunity for effective community provision, greater autonomy for people who receive support, and reduced detentions would be a huge leap forward in terms of a modernised, recovery-focused model of care.

Equally, anxieties and concerns were raised about how the changes would be implemented, given a climate of financial challenges, workforce pressures, and the scale of the work required to develop alternative services that would meet the mark in terms of appropriate treatment pathways.

The desire for greater clarity around priorities and timescales was a recurring theme, with many feeling that a better sense of what is coming and when would enable them to steer the ship more steadily and mitigate unintended consequences for people who receive support.

Keeping up to date

We will be producing a more detailed report, outlining further key themes from the advisory groups,  in the coming weeks, which we will be using to design resources and products to most effectively support local authorities, NHS services, care providers, third sector, community providers and people who draw on care and support. One key point that was made abundantly clear by those who participated, is that having space to come together, share views and collaborate is welcome and needed as part of the change process, and the sooner conversations can start happening across the board, the better.

To ensure you receive the report and information about our resources as soon as available, please sign up to our mailing list and tick Care Act here.

At the Social Care Institute for Excellence (SCIE) and Think Local Act Personal (TLAP), our mission isn’t abstract. It’s about improving outcomes for people in receipt of care and support, ensuring their voices are central to the services they rely on. It’s about recognising inequality where it exists and taking deliberate action to make things fairer. For example:

• We’ve worked on projects to make direct payments more culturally responsive, so older people from racialised communities feel seen and respected. You can read more about this in our blog: “Direct Payments and the Power of Culturally Competent Care”.
• We challenge recruitment and leadership practices in care organisations to open doors that were historically closed to people from diverse backgrounds. This is evident in the fact that Clenton and I, coming from the global majority and drawing on our lived experience, are thriving in these roles, supporting wider involvement and leading by example. You can learn more about the TLAP team driving this change here.
• We amplify lived experience through research, guidance, and training, making sure those who experience care most directly shape the services designed for them; co-production underpins all that we do.

Why does this matter? Because race equity is not a “nice to have”, it is fundamental to human dignity, fairness, and social justice. Without it, we risk perpetuating harm and leaving communities behind. With it, we create services that work better for everyone, because care that recognises difference is care that works.

This week, and every week, I’m proud to be part of an organisation that doesn’t just talk about race equity, but acts on it in ways that make real differences to people’s lives. Race Equality Week is a chance to celebrate that work, reflect on what more we need to do, and amplify voices that have too often been ignored.

As we move forward, let’s remember: advancing equality is not a one‑off event, it’s everyday, hands‑on work that changes lives for the better.

Because at the end of the day, fairness isn’t just a policy, it’s the care we give and the support we provide.

“Injustice anywhere is a threat to justice everywhere.” – Martin Luther King Jr.

There are lots of ways to get involved in Race Equality Week 2026. To find out more, please visit the Race Equality Matters website: Race Equality Matters

To me, national standards aren’t about squeezing people into a template. They’re a shared promise across health, social care, mental health, and adult support services that the help we get will be consistent, safe, and personal. It’s about making policies real, so they affect the little things that make a house feel like home or a community feel like a place where you belong.

Looking ahead, the Casey Commission and the vision for 2028 make this even clearer. England has the Care Act 2014, but the gap between what we value and what we actually experience is still huge. Standards give us a common reference point for everyone – users, carers, providers, commissioners – guiding us toward the outcomes that matter, even if each community gets there differently.

Standards aren’t a magic fix. They won’t solve staffing crises or funding pressures overnight. But they focus attention on the things that matter: the experiences, outcomes, coordination, and personal goals of people receiving care. They push for learning, improvement, and accountability – not just ticking boxes.

For me, this is personal. Seeing national standards of care celebrated in Parliament signals that care matters, that our lives matter, and that the everyday realities of people like me – navigating multiple identities, juggling needs and support – are worth centring. My hope is that over time, these standards help make care reliable, warm, and responsive – wherever you are, whoever you are, and however your life changes.

Care isn’t just about meeting basic needs. It’s about dignity, safety, belonging, and the room to live your life fully. National standards of care are a promise to make that real – for me, for you, and for every community that deserves to be seen, heard, and genuinely cared for.

Read more about the report and the work that informed it here.

A culture of personalisation that listens and acts

What struck me most was the service’s listening and learning culture of personalisation, embodied by the registered manager, Emma. With encouragement and licence from regional and national executive teams, Emma continues to take Greenlands View on a journey of empowerment—right the way through everyone involved in the care and support provided.  
 
You could not help but smile hearing the story of this journey so far. It was not a tale of grand redesigns or shiny innovations, but of small, thoughtful decisions that shifted power towards people and, in doing so, changed outcomes. 
 
One example stayed with me. Anthony*, a resident who is non-verbal, was experiencing distress and behaviour that challenged when new staff joined the team. Rather than seeing this as something to be ‘managed’, Emma reframed the problem: how might we help Anthony feel safer and more in control? The solution was both simple and profound—Anthony became part of the recruitment process for new staff. Reasonable adjustments were made, including the use of a communication pad. By the time new colleagues arrived for shadow shifts, Anthony already knew them. The result? A marked reduction in recorded incidents and a more confident, connected team. 
 
This was not an isolated story. Another resident, Mindy*, is diabetic and previously had to return home every day between 4pm and 6pm for an insulin injection from the district nurse. Even when out enjoying time with family or staff, Mindy’s day was interrupted—often waiting in, sometimes for hours.  Emma noticed that distress increased around this time, not because of the medication itself, but because of the restriction it placed on Mindy’s life. Following consultation with Mindy, their family, the district nurse and other professionals, the service moved to tablet-based medication. The impact was immediate: fewer restrictions, more choice and a noticeable reduction in distress.

Redefining what a ‘good day’ means

Emma put it simply: a good day is when people are enabled to do what they want, no matter how small it might seem. Posting three letters. Putting a load of laundry on. These moments matter because they speak to autonomy, dignity and control. 
 
What this reinforced for me is that improving lives is not always about the latest technology or equipment, though this can offer huge potential when it is designed with people who draw on care and support. Often, it is about culture—about putting people first, trusting colleagues, and being brave enough to share power.

Leadership that enables, not constrains

Importantly, this culture is not happening in spite of the organisation. Members of the Lifeways Quality Team, who joined me on the visit, were clear that they never want to ‘clip the wings’ of registered managers. Their role is to enable positive risk-taking and creativity—providing tools, frameworks and organisational approaches that support, rather than stifle, local leadership. 
 
This aligns with Lifeways’ guiding principle of ‘Nothing about me—without me’: engaging and including people in everything that affects them. Initiatives such as Our Voices and the co-produced Quality Checkers approach—where people drawing on care and support help define, assess and celebrate what good support looks like—show how co-production can shape organisational culture, not just individual care plans. 

The Lifeways team is passionate about co-production, engagement and continuous improvement, and the Lifeways Executive Advisory Panel, a team of experts by experience, is central to that mission. They advise and support the Executive Team to ensure the people they support are heard and drive meaningful change.  The Family Advisory Panel also contribute to key strategic decisions and initiatives, ensuring family members are involved in decisions that will affect their loved ones.   

Holding on to what matters

 
There is no escaping the reality of the challenges facing adult social care. Pressures on workforce, funding and capacity are felt everywhere, and services like Greenlands View are not immune. What stood out during my visit, however, was a quiet confidence that even in difficult conditions, it is possible to hold on to what matters most. 
 
For SCIE, staying close to these everyday realities is essential. It helps us test our thinking, refine our work, and stay attuned to the voices of people who live in and work within services. More importantly, it reminds us that good care is built through relationships, trust and shared purpose—and that these foundations remain as relevant, and as powerful, as ever. 

Notes

*Pseudonyms are used    

As a not-for-profit charity, SCIE supports the development of innovative solutions to address challenges faced by children and families, helping ensure high quality, co-produced, ethical and evidence-based practice.

At SCIE, we welcome the changes as an important step forward in recognising and responding to the persistent inequalities faced by young people who have grown up in care. However, their impact will depend on how consistently they are implemented and how effectively young people are supported to access them. To truly promote opportunity and reduce structural disadvantage for care-experienced young people, changes must be made across all levels of the system.

Reducing inequality in practice 

At an interpersonal and professional level, we can reduce inequality by advocating for the care-experienced young people we work with. This means recognising their particular needs, holding ambition for them, and working alongside them to realise their own ambitions.  

In this case, this could mean professionals proactively informing care-experienced young people about their entitlement to free prescriptions, dental care and eye care, and supporting them to register with and remain engaged in services during periods of transition. It could also involve education, careers and health staff actively promoting the NHS job interview guarantee scheme and paid internships, and helping young people to prepare for and take up these opportunities. 

Every day professional practice matters, and consistent, high-quality support can make a significant difference to outcomes.  

Organisational accountability and co-production 

At an organisational level, reducing inequality requires robust accountability. We must track activity, scrutinise outcomes and hold ourselves to the highest standards. Co-producing with care-experienced people is essential in this work. It enables organisations to identify gaps in services, understand what support young people value so that it is meaningful rather than symbolic, and share power within systems that have historically excluded their voices.

Structural and system-wide change 

There is also a need to address inequality at a structural and system-wide level. This means explicitly recognising care experience as a form of systemic disadvantage and using data to identify and challenge patterns of inequality. National changes such as free access to eye care and dental services may appear small in isolation, but they are structural, universal and measurable. As such, they have the potential to create meaningful, population-level impact.  

Intersectionality and equitable outcomes 

Universal entitlements alone do not guarantee equitable impact. Care-experienced young people are not a homogenous group. Their experiences and outcomes are shaped by intersecting factors such as ethnicity, disability, religion and gender. Without attention to these differences, universal offers may benefit some young people more than others. For example, some young people may face practical barriers to attending appointments, experience mistrust of services, or need extra guidance to navigate complex systems.  

Organisations will, therefore, need to consider how young people become aware of new offers and what additional support may be required to ensure benefits are realised in practice. In other words, ensuring equitable outcomes will require targeted support alongside universal provision, informed by robust data and ongoing co-production grounded in a wide range of lived experiences. 

SCIE’s role 

SCIE works with central government to support policy and system reform, and with organisations across health, education and social care to embed change into practice. In relation to these announcements, we can support organisations to interpret policy intent, implement new entitlements effectively, and evaluate whether they are making a meaningful difference for care-experienced young people. If you are interested in how SCIE can help you to identify, design and implement change for care-experienced children in your organisation, then please get in touch with us to talk about consultancy services.    

Together, by focusing on meaningful implementation, accountability and lived experience, we can help ensure that these announcements translate into lasting, positive change for care-experienced young people. 

As a not-for-profit charity, SCIE supports the development of innovative solutions to address challenges faced by children and families, helping ensure high quality, co-produced, ethical and evidence-based practice.

Accountability can’t become blurred responsibility

Across the series, there has been broad agreement that accountability for national standards cannot sit with one organisation. People’s lives don’t fit neatly into organisational charts. Good care depends on the combined actions of government, local authorities, providers, regulators, the NHS, community organisations, and, of course, the people who draw on care themselves and unpaid carers.

Our final roundtable confronted us with an important truth: shared accountability only works if it is visible, explicit and real. Otherwise, it risks becoming what one participant memorably described as a “sticky concept”—a place where responsibility quietly drains away until no one quite owns the problem anymore. Yet this is complicated by the complexity of how care is commissioned, funded and delivered.

There were live debates about whether a single national body should hold the ring, setting expectations, tracking progress and ensuring learning is acted on. Others argued just as strongly for a more distributed model, with overlapping responsibilities across the system—a kind of accountability “Venn diagram”, where everyone can see who is responsible for what, and how those responsibilities connect.

What mattered most, though, was not the structure itself but the culture behind it. Again and again, people returned to the need for accountability that supports learning, not fear; curiosity, not defensiveness; improvement, not box-ticking. That requires a fundamental shift away from inspection as the dominant lever of raising care standards, towards helping people say, safely and honestly: “This isn’t working—and here’s what we’re learning.”

From compliance to curiosity

This shift from compliance to curiosity also reshaped how we talked about measurement. For too long, social care has been judged by what is easiest to count—visits or tasks, for example. Yet what people consistently told us matters most are things like independence, personal choice, belonging, dignity, safety, relationships, purpose and feeling at home.

Progress, as several participants said, is not always about improvement in a conventional sense. Sometimes it’s about stability. Sometimes it’s about choosing to live differently, even more quietly. National standards, if they are to mean anything, must be able to hold that complexity and allow for individual preferences and personalisation.

There was a strong consensus that stories and data both matter to the measurement of care standards. Stories give depth, truth and context. Data gives scale, leverage and credibility in systems that still run on spreadsheets and dashboards. The challenge is resisting the gravitational pull back to narrow compliance once numbers enter the room.

And underpinning all of this is trust—or more accurately, the lack of it. Many people fear that the care data and personal information they share will be used against them: to tighten eligibility, reduce support, or trigger scrutiny. If future standards are to be meaningful, they must be built on data ownership, transparency and consent, not extraction and surveillance.

Future-proofing in a short-term system

The final roundtable also highlighted the uncomfortable gap between the long arc of people’s lives and the short cycles of politics and policy. For many people, drawing on care and support is a lifelong experience, with their needs changing over time. Workforce investment takes decades. Community capacity grows slowly. Yet national priorities can change instantly.

Participants were clear that any attempt to future-proof national standards has to grapple with the realities of:

• rising care complexity and people’s longevity
• persistent workforce shortages
• fragile provider markets
• unsustainable funding models
• deeply fragmented digital infrastructure.

These directly challenge the impact and sustainability of standards.

If standards are reprioritised every electoral cycle, we will never achieve long-term improvements. If accountability sits only within current departmental structures, it will always bend towards short-term pressures or the will of the incumbent political party. Participants were clear about the need for cross-party, cross-sector consensus—whether that comes through parliamentary agreement, independent commissions, or new governance models that embed lived experience at their heart.

This matters because national standards do more than describe quality. They shape markets. They influence the kinds of services that survive or disappear. They signal what the system truly values. If we want innovation, neighbourhood-based care, personalised support and strong community capacity to thrive, then standards and accountability must actively enable them—not squeeze them out through risk aversion and rigid compliance.

Where do we go next?

If national standards are to deliver consistency, equity and quality across the country, then they must be grounded in what matters to people, responsive to changing needs, and supported by systems that encourage honesty, curiosity and shared responsibility. That is not the easiest path. But it is, I believe, the only one that will truly stand the test of time.

With the series now having concluded, SCIE and The Access Group are pulling together the insights from the roundtables and will be publishing a framework for national care standards early in 2026.

As a not-for-profit charity, SCIE supports the development of innovative solutions to address challenges faced by children and families, helping ensure high quality, co-produced, ethical and evidence-based practice.