Towards a National Care Service

9 October 2025

By Kathryn Marsden OBE (Formerly Kathryn Smith OBE), SCIE Chief Executive Officer

The launch of the Casey Commission presents a rare and urgent opportunity to reinvent the current social care system and how we care for one another. The Government launched it as a ‘first step’ to achieving its key social care manifesto commitment—the creation of a National Care Service, underpinned by national standards of care, delivering consistency of care across the country.

Beyond this headline commitment, we still know very little about what national standards of care will look like, how they will be delivered or what they are aimed at achieving. At the Social Care Institute for Excellence (SCIE), we believe that national care standards must reflect what matters most to people who draw on care and support, drive quality improvement across the country, and support a system that is consistent, personal and fair.

That is why SCIE, in partnership with The Access Group, is stepping forward to help lead the sector drive to define national standards of care and shape the government’s reforms. Together, we are hosting a series of roundtables in October and November to co-produce a framework that will support consistency, personalisation and quality across the country.

SCIE has deep experience of bringing partners together to collaborate, innovate and improve lives. Co-production isn’t an afterthought—it’s the starting point. That’s why the roundtables will bring people who use and deliver services together to shape the future of care.

We don’t have to start from scratch. The Social Care Future vision—‘We all want to live in the place we call home, with the people and things we love, in communities where we look out for each other, doing the things that matter to us’—offers us a guiding ‘north star’. Our roundtables will drive progress towards this vision, tackling the big questions: What should standards cover? How can technology and data support them? How can they drive integration across systems? And how do we build accountability that strengthens trust and improvement?

Purpose and scope

What is missing at present is a shared understanding of what national standards will mean in practice. Should they act as baseline guarantees that safeguard against poor practice, aspirational goals that drive continuous improvement or a combination? Should they be defined in terms of behaviours, processes or outcomes?

This uncertainty also means it’s unclear what areas of care the standards should cover, how detailed they should be and whether they should apply in the same way across different types of services.

Without clarity on these points, it will be impossible to establish consistent expectations or ensure a common understanding of safety and quality. By bringing people from across the sector together, our roundtables will examine these gaps and the values, purpose and outcomes that national standards should deliver. In doing so, they will provide a foundation for a system that aspires to excellence.

Technology and data

National standards should be measurable, transparent and future ready. Yet fragmented systems and underdeveloped infrastructure mean data in social care often fails to capture what matters most to people. There are also unresolved questions about how digital tools such as AI and real-time analytics can be used responsibly, how to guarantee digital inclusion, and how issues of consent and the ethical use of personal data should be addressed.

The Access Group’s expertise will allow us to explore how digital tools, real-time analytics and data governance can strengthen accountability, transparency and continuous improvement—while ensuring that digital innovation reflects lived experience, not just system metrics.

Integration

Social care does not operate in isolation. National standards must align with housing, health, workforce and community services to create a joined-up system that supports people’s lives, not just service delivery.

The current gaps across the health and care system mean that people often experience fragmented services and varying outcomes. Drawing on diverse perspectives from across the sectors, the roundtables will examine the mechanisms, partnerships and approaches needed to ensure standards can support a more coordinated and cohesive system of care. This includes looking at how standards might align with current reform efforts in the NHS and housing sectors, promote shared outcomes across systems, and strengthen collaboration between local government, the NHS and voluntary and community services at the local level.

Accountability

Current accountability and assessment arrangements in the sector rely heavily on compliance and regulatory inspection, which can identify failings but do not always promote learning or improvement. A further gap lies in defining what accountability should mean in practice: whether it is about assurance for government, confidence for people who draw on care, or support for providers to improve.

Within the context of national standards of care, there is no clear agreement on who should own and evolve the standards over time, and how responsibility might be shared in a way that keeps the system responsive to the people it serves; standards must evolve iteratively and inclusively, responding to demographic change, evidence and feedback from people who draw on care.

We hope our framework will create a fresh vision that ensures accountability doesn’t default to narrow inspection processes and tick-box exercises—instead becoming a driver of trust and sector-wide development.

This is an opportunity to co-create a lasting framework for adult social care reform with those who know social care best—a framework that bridges the gap between ambition and practical, actionable proposals and reflects outcomes that matter to people, such as independence and emotional wellbeing, not just compliance with procedures.

Ultimately, the aim is a social care system where people experience consistent quality, dignity and empowerment no matter where they live or what type of support they require. SCIE and The Access Group look forward to working with partners from across the sector to realise this vision.