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:
