28 October 2025
By Kathryn Marsden OBE, SCIE Chief Executive Officer and Anisa Byrne, The Access Group General Manager
Social care in England is characterised by marked variation in access and quality. In some better-resourced areas, services provide timely, personalised support that empowers people to live with choice, independence and dignity. In others, overstretched local systems struggle to meet people’s basic needs, with unpaid carers often shouldering the financial, emotional, social and physical costs.
The government has committed to creating a National Care Service underpinned by national standards to address these profound inequalities. It launched an independent commission into adult social care, chaired by Baroness Casey, as a ‘first step’, but questions remain—particularly around the definition and design of national standards.
But what do we mean when we talk about care standards? How might a focus on standards help us tackle the current system’s problems—whilst also enabling better, more effective and responsive personalised care?
Last week, the Social Care Institute for Excellence (SCIE) and the Access Group hosted the first of four roundtables to help lead the sector towards a framework within which national care standards can be developed. Convened using Chatham House rules, we brought together people who draw on care and support, representatives from the independent, third and statutory sectors, and care providers to explore what we mean by national standards, their purpose and their potential to drive improvements in social care.
Background
National standards are not a new idea, nor are they unique to social care. Across the UK and internationally, governments and regulatory agencies have long used standards to promote consistency, accountability and improvement. The aim has been to set out what good looks like and then to measure progress and achievement towards these goals.
Care standards have been used to set out what people can expect from the care system. For example, Scotland introduced National Care Standards as early as 2002, later evolving these into the Health and Social Care Standards in 2018 to strengthen a rights-based approach to quality and dignity. Similar frameworks exist in Wales, Ireland and across Europe.
In England, the NHS implemented National Service Frameworks (NSFs) from 1999, ten-year programmes to raise quality and consistency in areas such as mental health, older people’s services and long-term conditions. The NSFs sought to tackle variations in care, especially inequalities resulting from where people live. Though NSFs were discontinued in 2013, they provide valuable lessons on defining and measuring ‘what good looks like’ across complex systems and for people with ongoing health and care needs. An important legacy of the NSFs was a greater focus on measuring care outcomes and improving the use of data, especially by health and social care commissioners.
More recently, social care policy in England has focused on embedding principles of wellbeing, independence and choice. The Care Act 2014 established these as legal duties as well as an ambition, and frameworks such as Think Local Act Personal’s Making It Real statements translate them into lived experience outcomes “I” statements. These are not national standards in themselves, but they express the values any system of standards should seek to uphold, ensuring that people who draw on care and support have voice, control and meaningful choice in their lives. They also provide a useful benchmark for assessing the quality of individual experiences, services and local systems.
At the same time, regulatory reform is underway. The Care Quality Commission’s (CQC’s) Single Assessment Framework introduces a more consistent, data-informed approach to quality and improvement across services and systems. It also incorporates “I” statements from Making It Real, linking performance assessment more closely to people’s lived experiences. The CQC also uses “We” statements: quality statements that care providers, commissioners and system leaders should live up to for delivering high-quality, person-centred care.
Generating fresh ideas about the purpose and role of national care standards
Over the four roundtables, we will start to develop ideas about the purpose and role of national standards in a future care system. One insight from the first roundtable was that care standards must balance three interdependent aims:
- People’s experiences of care and support—ensuring voice, dignity and personal outcomes.
- Quality and safety of care and support—fostering effective, safe and compassionate practice.
- Care system performance—driving improvement, accountability and integration across services.
While there is broad consensus about the vision for social care—as captured by Social Care Future’s call for everyone to live “in the place we call home, with the people and things we love”—achieving it in England depends on how we use the tools already at our disposal. Fully realising the ambitions of the Care Act and embedding the Making It Real statements across the sector may provide the strongest foundation for developing meaningful, person-centred national standards.
This is where the roundtable discussions began. Together, the participants expressed different views about the purpose of national care standards, what problems they might help us address, and what difference they will make to people who draw on care and support, as well as care providers, professionals and local systems. Three themes stood out from the discussions: a focus on core principles or values, embedding co-production and reframing the purpose of social care itself.
Values
Participants agreed that national standards should promote fairness and consistency so that the availability and quality of care and support are not determined by where someone lives or how their care is funded.They should empower people to understand their rights, navigate the system with confidence and have clarity about what they can reasonably expect from services.
Participants also agreed that national standards should underpin individual-centred care and prioritise outcomes that matter to the people who draw on care and support—rather than focusing on top-down, organisational processes—and should support people to make meaningful choices about their own lives and care.
Co-production
Participants stressed that the development and implementation of national standards must be co-produced with people who draw on care and support—as well as their families and carers. The co-production process must be meaningful, sharing power and giving people real influence over how standards are designed, applied and reviewed. Only by reflecting the priorities, needs and aspirations of the people they will impact the most can care standards drive real improvement and shift care provision from transactional to relationship-based. By focusing on what matters to people, we can also improve the efficiency of care services and stimulate innovation in technology and models of care.
Reframing social care
The roundtable discussions suggested that a framework for care standards could help shift the narrative around social care from crisis and deficit to one that recognises it as essential infrastructure—vital to how communities function and enabling people to live with dignity, connection and purpose. Conceptualising care in this way holds implications for the workforce, whose roles and skills will be better valued.
Looking ahead
Defining what national standards of care should be, and, crucially, what they are for, is not a straightforward task. The first roundtable surfaced important questions that remain unresolved. These include:
- Flexibility. How can national standards provide clear guidance while allowing local adaptation and innovation?
- Aspirations. Should standards define minimum protections or strive for excellence?
- Responsibility. Who should be accountable for implementing, monitoring and maintaining standards?
- Reach. Who are the standards for—the people who draw on care, providers, commissioners, regulators, or all of these?
- Technology. How can and should digital tools and systems be used to support the delivery, monitoring and improvement of national standards while maintaining choice and human connection?
The first roundtable demonstrated the real value of open, cross-sector conversation. It surfaced the principles that must underpin any credible answer to our inquiry. Key points emerging from the deliberations were that national standards will only succeed if they are grounded in shared values, shaped through genuine co-production and supported by partnership across people, places and professions. What emerged was not a fixed blueprint for care standards, but an initial set of conceptual building blocks for what care standards can and should aim to achieve: fairness, trust and equity in our social care system, with a prominent focus on care experiences.
As we continue this roundtable series, we will draw these insights together, exploring the practical options available to government and the Casey Commission as they seek to translate the ambition for care standards into practical approaches and actions.
The second roundtable will explore how data and technology can underpin national care standards that are measurable, person-centred, and future-ready.
Sector stakeholders were approached to participate in this roundtable series in August. The series has now hit capacity. If you are interested in joining the waiting list for this series, please contact George Appleton, Head of External Affairs at george.appleton@scie.org.uk
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 social independent charity working with organisations that support adults, families and children across the UK.
About The Access Group
Access Health, Support and Care, part of The Access Group, is a leading provider of health and care management software, trusted by over 14,000 registered care locations, over 25 NHS Trusts and more than 200 local authorities across the UK. For more information, please visit: https://www.theaccessgroup.com/en-gb/health-social-care/
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
