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Updates on the National Care Service Plans: Labour’s Latest Announcements

The Labour Party first announced its vision for a National Care Service (NCS) back in 2010 in a statement published by the government under the leadership of Gordon Brown. While this had, in the interim, moved to the background, it was reignited by a Labour Party document published in 2019 that reaffirmed a commitment to creating an NCS. Following the last General Election, the current government has tasked the Casey Commission with developing a plan to make this a reality. However, as leading voices in the space have noted, this year’s report is only a starting point with long-term recommendations not expected until 2028. Guardian Angel Carers , the multi-award-winning nationwide group specialising in quality at-home care , shares the latest statements and information, including the timescales by which reform is expected to occur. Explaining the Concept of the Proposed National Care Service To date, there is only general detail on what an NCS would look like, as outlined in the Labour Party publication from 2019. However, this does set out a broad picture and focuses on expanding the adult social care sector to increase capacity and improve access to at-home and community-based care. There is little debate about the need for reform, given the data that shows how many families, especially older people, struggle to access home-based care, coupled with the strain family caregivers deal with when taking on caring responsibilities for a loved one. Some of the principles incorporated into the concept, which was also a manifesto promise, include ensuring a universal scheme that enables eligible individuals to access free personal care and domiciliary support in their own homes. Plans state the need for reforms to the social care workforce, including enhanced training and improved career paths to retain qualified workers. The ideas also point towards prevention-centric care pathways to enable more people to live at home independently for longer, reducing dependency on acute services, and developing clearer, more consistent standards and roles within social care, aligned with those used elsewhere in the NHS. Difficulties With the Implementation Timeframes for a National Care Service In its 2023/24 State of Care report, the Care Quality Commission (CQC) found that 27% of requests made for support from local authority adult social care services were not actioned or no service was provided, and that waiting times for care homes and at-home care comprised 45% of hospital discharge delays. These statistics illustrate the scale of the challenge ahead and why a lack of access to care has knock-on impacts on other aspects of public healthcare. This is a prevalent issue within the NHS, where older adults and those recovering from illness or injury are medically well enough to be cared for at home but cannot be discharged because the provisions are not available. One criticism of the Casey Commission’s ongoing work is that the initial report, expected to be published in 2026, will only outline recommendations for reforms to be implemented in a phased transition over the next decade. This will then be followed by a second report with longer-term recommendations by 2028. It has been 16 years since the Labour Party’s first announcements were incorporated into a government document titled Building the National Care Service. There are concerns that the new proposed 10-year implementation timeframe may not meet the needs of families requiring immediate assistance or those whose local adult social care teams lack the capacity to meet demand. Commentary on the Consultative Processes Assigned to the Casey Commission A point of contention is that the Department of Health and Social Care (DHSC) has stated that the Commission's work will start with building a ‘national conversation’. This is intended to focus on how to meet current and future needs, analyse how council and NHS funding for the home care sector is used, and identify consensus on the prevailing issues within social care. However, much of this work has been completed previously, during a consultation called Shaping the Future of Care Together, which was published in July 2009 and ran for four months. Members of the public, stakeholders, and organisations contributed to the process, which was the largest of its kind, with 37 events and 80 public roadshows across the country. Following 28,000 formal responses and a Care and Support Conference in February 2010, the then-government published a summary of the findings, which included strong support for preventive care as a baseline focus for an NCS and commentary on the third sector's role in its implementation. Stakeholders also shared perceptions that existing information and advisory support were insufficient and should be a priority in redesigning social care services, and that there is a need to emphasise the importance of personalised care. While the consultation highlighted that further work was required around defining the care and support to be provided by the NCS, it appears to have covered much of the groundwork now being repeated by the Casey Commission. How Home Care Professionals Could Play a Role in Social Care Reform Frustrations have arisen due to the many evaluations, publications, and consultation projects that have already been completed, which at the time were thought to be part of making an NCS a reality. Although political and economic pressures inevitably mean governmental priorities can and do change, there were already 17 separate consultations, white papers, documents and multi-year plans between 2006 and 2010 which have not yet culminated in any tangible action. One potential solution is for the DHSC to revisit earlier studies and consultations as a starting point, incorporating more recent data to bring them up to date, rather than beginning anew and accepting that real reform will be many years in the future. The government could also consider the knowledge and real-world insight of existing home care providers and organisations, including firsthand experience supporting individuals, families, and communities, which could reduce the extended timeframes in question. Those interested in any of the documents and reports mentioned and who wish to explore further details can source the original publications via the government and Labour Party websites. Read more about Guardian Angel Carers - Guardian Angel Carers celebrates success with annual conference and awards evening