28 January 2026
Social care in England is marked by stark geographic variation. People with similar needs can face very different experiences depending on where they live: from timely, personalised support that enables independence and dignity, to long waiting lists, high eligibility thresholds and unmet basic needs.
This is what is meant by the social care postcode lottery – a system where access to support, quality of care and outcomes are shaped less by need and more by local circumstances, capacity and interpretation of duties. The consequences are serious: people’s safety, independence and wellbeing are put at risk, while unpaid carers are left to absorb growing financial, emotional and physical pressures. These impacts fall hardest on marginalised communities, deepening existing inequalities.
The Government has launched the Casey Commission as a first step towards creating a National Care Service, underpinned by national standards of care. While this commitment signals ambition, there remains limited clarity about what national standards should cover, how they should operate in practice, and how they would genuinely reduce today’s postcode lottery.
SCIE’s new report, titled ‘Towards a National Care Service: Raising national standards of care’, supported by The Access Group, follows extensive engagement with the sector. It argues that the core challenge facing social care is not a lack of values or vision, but the inconsistent translation of those shared principles into people’s day-to-day experiences of care and support. England already has strong foundations in the Care Act 2014 and a widely shared understanding of what good care should enable – people living the lives they choose, with dignity, connection and control.
However, those values are applied unevenly across the country. This inconsistency is what has produced the postcode lottery in access, quality and outcomes. The report, therefore, frames national standards of care not as a prescriptive blueprint for services, but as a mechanism for clarifying expectations so that people can rely on a consistent baseline regardless of where they live.
SCIE’s proposed framework sets out how national standards could define what is essential and non-negotiable, while deliberately protecting flexibility in how outcomes are achieved locally. The emphasis is on standards that specify what good care delivers for people, rather than mandating uniform processes or service models. In this way, national standards could help expose and reduce unjustified variation, strengthen accountability, and support learning and improvement across the system, without stifling innovation or personalisation.
Crucially, the report is clear that national standards alone cannot fix the deep-rooted challenges facing social care, including workforce shortages and financial pressures. Their impact depends on how they are designed and implemented, and whether they are supported by the right system conditions, from data and accountability to commissioning capability and co-production infrastructure.
Kathryn Marsden OBE, Chief Executive of SCIE, said:
It is indefensible that, in this country, two people with the same social care needs, living only a few miles apart, can experience completely different levels of support. That postcode lottery undermines people’s dignity, independence and safety, and it places intolerable pressure on families and unpaid carers who are left to fill the gaps.
National standards of care offer a practical way to close that gap – not by imposing a one-size-fits-all model, but by making clear what people should be able to expect from the system wherever they live. Done well, they can translate long-standing values in social care into clearer, outcomes-focused expectations that are rooted in lived experience and backed by accountability.
But we also need to be honest about the context. Social care operates in a complex, resource-constrained system, shaped by workforce shortages, financial pressures and shifting political priorities. Poorly designed standards risk becoming symbolic, compliance-driven or disconnected from reality. This is not about quick fixes. Ending the postcode lottery will require sustained commitment, careful implementation and a focus on learning and improvement – not just ambition on paper.
As the Casey Commission builds momentum towards its final report in 2028, this is the moment to get the foundations right – starting with clarity about what good care should deliver, and how we reduce variation in people’s experiences without losing what makes care personal and local.
Kathryn Marsden OBE
Chief Executive at SCIE
Sojan Joseph, MP for Ashford, said:
The levels of inequality in our adult social care services have been far too high for far too long. We cannot build an NHS fit for the future unless we address these deep structural issues in our adult social care system.
I am pleased the Government is taking steps to address the significant challenges in our adult social care sector, both through funding and fundamental reforms to the sector, such as funding for home modifications to give people more independence and allow them to be discharged from hospitals, embracing new technology, and making social care a desirable and respected profession – both through the pay increase given to carers last year and through a shift in culture.
I look forward to working with the Government after Baroness Casey’s Commission concludes to ensure that her findings are implemented and our adult social care system is fixed for everyone, not just those fortunate enough to live in a postcode that provides better services.
Sojan Joseph
MP for Ashford
Call to action
SCIE is calling for national standards of care to be developed iteratively and collaboratively, with early action focused on testing what works in practice. Initial steps should prioritise co-production and piloting, working with people who draw on care and support, carers, providers, commissioners and system leaders to test how outcomes-focused standards operate on the ground.
The report sets out a phased approach to developing national standards of care, with an initial focus on priority challenges in social care and areas of interface with health, where variation in access, experience and outcomes is most acute. It proposes starting with a small number of high-impact touchpoints, while supporting a shift towards prevention and early intervention and strengthening data and system intelligence. These early standards would be developed, tested and refined over time, working alongside government and the Casey Commission as thinking progresses, aligned with its expected timelines.
SCIE and The Access Group will support this work by continuing to convene partners, contribute evidence and learning, and work alongside government and the Casey Commission as thinking develops – helping ensure that national standards evolve into a credible tool for reducing the postcode lottery ahead of the Commission’s final report, expected in 2028.
About SCIE
The Social Care Institute for Excellence (SCIE) improves the lives of people of all ages by co-producing, sharing, and supporting the use of the best available knowledge and evidence about what works in practice. We are a leading independent social care charity working with organisations that support adults, families and children across the UK.
If you have any questions regarding this submission, please do not hesitate to contact Molly Pennington, Press and Media Relations Officer, at molly.pennington@scie.org.uk