Select Committee · Health and Social Care Committee

Adult Social Care Reform: The Cost of Inaction

Status: Open Opened: 31 Oct 2024 15 recommendations 12 conclusions 1 report

Successive governments have presented reform ideas for adult social care, yet few of these have been implemented. This inquiry seeks to understand what this inaction is costing. We will investigate the cost of inaction to individuals, the NHS, local authorities and also to the wider economy and HM Treasury, focussing not only on the financial … Show more

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Reports

1 report
Title HC No. Published Items Response
2nd Report - Adult Social Care Reform: the cost of inaction HC 368 5 May 2025 27 Responded

Recommendations & Conclusions

6 items
3 Recommendation 2nd Report - Adult Social Care Reform: … Rejected

Develop robust methodology for measuring care's impact on people's lives, health, and the economy.

The Government must also develop a robust methodology for measuring the impact of care on people’s lives, the wider health system, and the economy. As well as supporting the case for reform, such methodology would help councils to deliver outcome-based commissioning, which is more likely to provide people with meaningful … Read more

Government response AI summary
The government rejected the recommendation to develop a robust methodology for measuring the impact of care. It stated that existing procedures for impact assessments for policy or fiscal decisions relating to the workforce are sufficient and a new form of cross-government impact assessment is not …
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Department of Health and Social Care
8 Conclusion 2nd Report - Adult Social Care Reform: … Rejected

Local authorities face unsustainable adult social care costs, impacting other essential public services.

Local authorities are buckling under the strain of the costs of providing adult social care. The current system is unsustainable. Failure to reform adult social care, especially the funding structure, comes at a significant cost to local authorities. The increasingly high proportion of spending on adult social care is crowding … Read more

Government response AI summary
The government agrees adult social care supports economic growth and highlights current efforts like the Employment Rights Bill and investment in digital tools, but it explicitly rejects developing a dedicated adult social care 'growth strategy'.
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Department of Health and Social Care
19 Recommendation 2nd Report - Adult Social Care Reform: … Rejected

Mandate Casey Commission research into NHS costs and savings linked to adult social care failures

We recommend that the Casey Commission undertakes research to better understand the costs that the NHS is bearing as a result of failures in adult social care, and where the NHS is saving money due to good social care. This should be used in future departmental budget setting processes and … Read more

Government response AI summary
The government states that the independent Casey Commission has the autonomy to decide its research, implying the government will not direct it to undertake the specific cost analysis recommended or commit to continuing such analysis itself.
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Department of Health and Social Care
24 Recommendation 2nd Report - Adult Social Care Reform: … Rejected

Require Baroness Casey to outline adult social care's role in the 10-Year NHS Health Plan

In her first report, Baroness Casey should set out the immediate steps that the Government needs to take to ensure the adult social care sector can play its vital part in the three shifts for NHS reform. Achieving these should be the measure against which the success of the 10-Year … Read more

Government response AI summary
The government states the independent commission has autonomy to make recommendations and that its terms of reference already align with supporting the government's health mission, but does not commit to ensuring Baroness Casey sets out the immediate steps or assessments as specifically recommended.
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Department of Health and Social Care
26 Recommendation 2nd Report - Adult Social Care Reform: … Rejected

Develop a growth strategy for adult social care informed by productivity study, highlighting regional growth.

We recommend that the Government produce a growth strategy for the adult social care sector, including a focus on its potential to drive regional growth. This should be informed by a detailed study of how to improve productivity in the adult social care sector, which we recommend the Casey Commission … Read more

Government response AI summary
The government rejects the recommendation for a dedicated adult social care 'growth strategy', arguing it is not proportionate or necessary given the sector's core purpose of individual wellbeing. While acknowledging social care's economic role, it notes the Casey Commission's independence for studying productivity, without committing …
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Department of Health and Social Care
27 Recommendation 2nd Report - Adult Social Care Reform: … Rejected

Commission research to quantify the full costs of inaction on adult social care reform.

We recommend that the Government commissions research with the aim of fully quantifying the cost of doing nothing on adult social care reform. That research should seek to quantify costs to individuals, including unpaid carers and care workers, to local authorities, to care providers, to the NHS and to the … Read more

Government response AI summary
The government rejects commissioning a dedicated study to quantify the cost of inaction on adult social care reform. It states it already commissions a wide range of research and data through the NIHR to inform its approach to reform.
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Department of Health and Social Care

Oral evidence sessions

4 sessions
Date Witnesses
19 Mar 2025 Caroline Abrahams · Age UK, Dr Maria Petrillo · Centre for Care, University of Sheffield, Holly, Jayne Simpson, Keyaan, Tom Gentry · Age UK View ↗
5 Mar 2025 Anu Singh · NHS Black Country Integrated Care Board, Councillor David Fothergill · Local Government Association, Dr Birju Bartoli · Northumbria Healthcare NHS Foundation Trust, Hugh Evans · Bristol City Council, Isabel Lawicka · NHS Providers, Melanie Williams · Association of Directors of Adult Social Services View ↗
5 Feb 2025 Anita Charlesworth · Health Foundation, Ms Emily Holzhausen CBE · Carers UK, Oonagh Smyth · Skills for Care View ↗
8 Jan 2025 Kathryn Smith · Social Care Institute for Excellence (SCIE), Simon Bottery · King's Fund, Sir Andrew Dilnot CBE · Commission on Funding of Care and Support View ↗

Who gave evidence

18 witnesses
WitnessOrganisationSessions
Anita Charlesworth · Senior Economic Adviser Health Foundation 1
Anu Singh · Chair NHS Black Country Integrated Care Board 1
Caroline Abrahams · Charity Director Age UK 1
Councillor David Fothergill · Chair of the Community Wellbeing Board Local Government Association 1
Dr Birju Bartoli · Chief Executive Northumbria Healthcare NHS Foundation Trust 1
Dr Maria Petrillo · Research Associate Centre for Care, University of Sheffield 1
Holly 1
Hugh Evans · Executive Director for Adults and Communities Bristol City Council 1
Isabel Lawicka · Director of Policy and Strategy NHS Providers 1
Jayne Simpson 1
Kathryn Smith · Chief Executive Social Care Institute for Excellence (SCIE) 1
Keyaan 1
Melanie Williams · President Association of Directors of Adult Social Services 1
Ms Emily Holzhausen CBE · Director of Policy and Public Affairs Carers UK 1
Oonagh Smyth · Chief Executive Officer Skills for Care 1
Simon Bottery · Senior Fellow (Social Care) King's Fund 1
Sir Andrew Dilnot CBE · Chair Commission on Funding of Care and Support 1
Tom Gentry · Head of Health Influencing Age UK 1