Population chart shows why adult social care is such a problem for Labour
The government has said it could take up to three years to implement social care reform in the UK. Here's why it's such an urgent issue to solve.
The government is on a mission to overhaul the adult social care sector to "meet the urgent needs of our generation".
On Friday, health secretary Wes Streeting announced the first reforms that make up the "national care service", branding it "a big moment" in the sector.
In the immediate future, this means millions more in funding for elderly and disabled people to make home improvements and stay out of hospital. Care workers will also be trained to perform health checks for patients in the home to relieve pressure on the NHS.
In the longer term, improving adult social care in England is a lot more complicated. In April, an independent commission will begin a three-year commission to get to the bottom of the crisis, figuring out what is wrong with the sector and how to improve it.
The government's bold vision has been met with some scepticism. Not only do some charities think 2028 is too long a wait for these much-needed changes — warning that the sector is "crumbling" after 30 years of neglect — those in need have spent 15 years hearing from governments promising reforms that they have failed to carry through.
Here's what you need to know about how adult social care works, who is eligible for it, and why it has become such a hotly contested issue.
What is adult social care?
Adult social care provides practical support for anyone with a disability or illness who needs it to live independently, and is aged over 18.
Sometimes it is provided through the NHS, other times through a local council, and sometimes by the government.
It can cover anything from:
Personal care: Help with cooking, washing, dressing, and getting out of bed
Support in the community: Help with shopping, housework, and getting around
Care in a home or nursing home: Residential care
Reablement services: Help people regain independence
Aids and adaptations: For people's homes
Information and advice: About care and support
Support for family carers: People who care for an adult family member or friend
Many social care services are delivered by independent home care and residential care providers, which are mainly for-profit. Some voluntary sector organisations also provide social care services.
Who is eligible?
Adult social care in England is currently means tested.
This means that anyone of any age with income, assets like property and savings in excess of £23,250 cannot receive state support. This means the majority of social care users in England are not eligible for support, so costs fall entirely on the individual and their family.
State-funded adult social care is also available to those who have assets below £50,000.
If you need a paid carer to come into your home, the value of your house won't be included in the financial assessment.
But if you're paying for a care home, the value of your house will be included unless your spouse or partner is still living in it.
If you do qualify for council help with costs, you'll be offered a personal budget.
You can choose to get your personal budget in 2 ways:
A direct payment into your bank account each month
The council organises your care and you'll get a regular bill to pay towards it
CHC funding
Those in need might also be eligible for the Continuing Health Care (CHC) funding, provided through the NHS.
This is a type of adult social care funding that means those with a serious disability or illness have their full cost of care covered - whether that's in their own home or a care home.
This funding is not means tested, but it is increasingly more difficult to get, according to Age UK.
The charity said there has been a “steep overall decline” in the number of people being assessed for funding through the standard pathway – a 43% drop in the last seven years – even though the number of applicants aged 65+ has grown by 6%.
It also found that thousands of people are having NHS funding for their care withdrawn after living longer than expected.
Why is it such a problem?
The chart above gives a clear indication as to why this problem is going to get more pronounced the longer it isn't dealt with - the number of elderly people in the UK is only likely to increase in the coming years.
A crisis has been building in the adult social care sector over the last few decades, with successive promising and failing to get to grips with growing demand, under-funding and staff shortages.
England is looking at a rapidly ageing population. By the time the commission's findings are implemented, there will be four million more people over 65 — the age group most likely to need support.
The costs of care are also set to double in the next 20 years, down to inflation and the rising cost of living.
The Department for Health and Social Care estimates that one-in-seven individuals over 65 will face lifetime care costs of more than £100,000, according to the Institute for Fiscal studies.
Not only do these bills hammer those in need and their families, they are also devastating councils.
The problem is also complicated by who will fund it — and how.
While the government is keen to relieve pressures on the NHS and redirect its funding to curbing waiting lists and improving other services, councils are reluctant to take on any more financial pressure.
In November 2024, four in five local authorities were on course to overspend their adult social services budgets, while more than a third had been forced to tear up existing savings plans and impose a fresh round of cuts mid-way through the year, an Adass survey found.
They are also struggling with growing numbers of complex care cases – often following discharge from hospital – and persistent staff shortages.
It is clear, however, that adult social care providers want the government to act — and to act quickly.
Mike Padgham, chairman of the social care provider organisation the Independent Care Group (ICG), said: “The sector has had enough of reports, we need to see urgent action.”
Professor Martin Green, chief executive of Care England, warned the approach signalled yet another report “that gathers dust while the sector crumbles”.
He added: “This commission will simply confirm what we already know – how many more reports must we endure before action is taken?”
