By Gerard Crofton-Martin, Interim Chief Executive at the Social Care Institute for Excellence (SCIE)
For decades, social care reform has been characterised by political ambition followed by retreat. Successive governments have recognised the urgency of change, only to falter when confronted with the difficult questions of funding and delivery.
The Prime Minister’s commitment at Labour Party conference to end this political ‘capitulation in the face of the social care crisis’ is therefore a watershed moment. His ambition for a person-centred, high-quality and home-first National Care Service offers a welcome opportunity to break this cycle.
The real test will be whether government can create the conditions for reform to succeed. Evidence from England and internationally demonstrates that successful reform depends on funding and helping people and organisations develop the skills and capacity they need to deliver high-quality care.
Sustainable funding is fundamental. Without financial stability, local authorities and care providers will continue to prioritise immediate pressures over prevention, innovation and long-term improvement. A home-first approach, for example, requires investment in community-based support that helps people maintain independence, rather than waiting until their needs reach crisis point.
Equally important is a skilled, supported and valued workforce. The Health and Social Care Secretary’s workforce announcements at the Labour Party conference represent meaningful progress. The challenge now is to embed these commitments within a wider programme of workforce development, leadership and system improvement, so that better conditions for care workers translate into better experiences for people drawing on care and support.
Effective reform also depends on better data and digital infrastructure, enabling services to coordinate support, understand outcomes and tackle inequalities. A person-centred system must be one that people can navigate, with accessible information, advice and advocacy that allow them to understand their rights and exercise meaningful choice and control.
None of these elements can be delivered in isolation. Together, they determine whether the promise of a National Care Service translates into better care experiences and outcomes.
One weakness of previous reforms has been the disinvestment in national improvement infrastructure to support this change. Social care requires long-term investment in the evidence, leadership, guidance and implementation support needed to translate national policy into local practice.
The Prime Minister has opened the door to a different future for social care. The Casey Commission has the leadership and momentum to design a National Care Service the public will support. Delivering it will require more than political resolve and a sustainable funding settlement. It will require sustained investment in the foundations that make high-quality, person-centred care possible.
