Andy Burnham has put social care back on the agenda – now comes the hard part

Burnham has put social care at the centre of political debate, while that’s welcomed by Care England and the wider sector, and long overdue, this attention is only the first step.

Many politicians before Andy Burnham have recognised that the state of social care in the UK is unsustainable and promised to ‘fix’ social care or ‘grasp the nettle’. Burnham himself attempted to pioneer reform in the sector almost two decades ago. Clearly, understanding and recognising that there is a problem isn’t the issue here, and doing so is not revolutionary. Delivering tangible and long-lasting solutions is the issue. The barriers to reform are well understood; what has been missing is lasting political will and implementation. Care England’s recent Two Years of Promises scorecard reinforces this point. While it recognises genuine progress in areas including local government funding, carers’ support and employment rights, it also concludes that delivery remains uneven and that many of the fundamental reforms promised to the sector have been left incomplete. The key question is: what will Burnham do differently to succeed where previous governments have fallen short?

The centrepiece of Burnham’s proposals is a National Care Service, a service which many would expect to function similarly to how the NHS does, free at the point of service. The idea has intuitive appeal and could help raise the status of social care as something to be celebrated, like its health counterpart; however, it needs more than a compelling vision. We do not yet know what a National Care Service will look like but establishing one could take years and may distract from immediate challenges facing the sector.  What many who are not in the sector realise is that social care is already funded substantially by and yet local authorities have long struggled to commission care sustainably on a consistent basis because of funding constraints, not necessarily because they lack commitment. In terms of scale, as of December 2024, 96% of supported living provision was funded by local authorities, alongside 89% of care homes for younger adults, and 57% of older people’s care homes. Regardless of how delivery could change, care is largely publicly funded, but not at a rate that’s sustainable. Councils across England spent £715 million more than budgeted on adult social care in 2025/26, a trend likely to carry on with the number being around the same amount the year prior.

Structural funding reform alone though, will not solve the crisis within the sector, as the challenges which face social care are not monocausal. Alongside funding pressures, the sector faces persistent workforce shortages, rising costs, increasing demand and complexity of need, and inconsistent commissioning practices. A sustainable solution must therefore address these interconnected pressures alongside funding.

Importantly though, it seems as though this Government, and many in the sector, agree with what the end goal should be, in terms of how our sector is viewed. As we put in our report The Power of Care, adult social care should be viewed as essential national infrastructure, underpinning the NHS, supporting families to remain in work, strengthening local communities and contributing to economic growth that isn’t limited to a particular place. At his , Burnham meaningfully echoed this point, which was cause for celebration amongst those who receive, provide, and work in care.

That said, the route we get there will not be easy, and any new model must address these interconnected challenges which have plagued the sector for successive years, rather than simply shifting responsibility.

It is true that funding remains one of the biggest hurdles Burnham has to address. Reform, and the blue-sky thinking on the future of social care, cannot happen without an honest conversation about how social care is funded. However, while we need to address the “big picture” problems, Burnham needs to draw his attention rightly to the operational challenges that have remained largely unaddressed, and workforce reform is a perfect example. Keir Starmer’s Government made the biggest attempt of recent years by introducing the Fair Pay Agreement as a step towards workforce sustainability, alongside wider employment reforms through the Employment Rights Act. But legislation alone will not deliver a sustainable workforce.

Unless providers and commissioners are funded to meet those increased costs, workforce reforms risk becoming difficult to deliver. Long-term funding still needs an answer, and every attempt to reform funding has encountered fierce political opposition. Proposals to recover social care costs from a person’s estate after their death, labelled as a “death tax” by critics, demonstrate how politically contentious funding reform remains and could undermine hopes of achieving genuine cross-party consensus, as Burnham intends. Any solution to the funding issue needs to be sustainable, fair, and capable of surviving changes in government.

Burnham does have his work cut out for him. On top of all of what has already been discussed, this Government must do more to protect, sustain and build our workforce; both domestically and internationally. Although the latest Skills for Care data points to improvements in workforce stability, the sector has always struggled with recruitment and retention, and social care continues to experience higher vacancy and turnover rates than much of the wider economy. Pay is a big part of this, and as mentioned, the last Government introduced the Fair Pay Agreement to address this but pay must be considered in the context of the wider pressures facing the workforce, including the real-terms erosion of care workers’ earnings, what we have described as the Silent Pay Cut. This is compounded by the increasing challenges providers face in recruiting internationally, on which we have continually had to provide guidance for our members. Workforce reform in social care therefore requires real career progression, a sustainable approach to international recruitment opportunities and ensuring that providers have the means to support their staff. Working in care must be recognised as a skilled profession and given the credit it deserves; something Burnham paid credit to already.

Importantly, and it should go without saying, the sector must be involved from the outset. No true reform can be designed in isolation, and as the independent sector provides around 84% of adult social care in England, any successful National Care Service will rely on meaningful partnership with providers currently trying to deliver the care needed, in a system that doesn’t support them.

It is vital to consider what is actually at stake here; The Casey Commission’s Big Conversation provides a useful starting point for thinking about what successful reform should ultimately achieve, putting people’s experiences and outcomes at the centre of the debate. Reform should ultimately be judged by whether it delivers better outcomes for older people, independence for disabled adults, more support for families and unpaid carers, and timely access to high-quality care. Care England, our members, and the wider sector all stand ready to work with Burnham. His inauguration has given many hope, where there hasn’t been for some time. It’s his duty, and our ambition, to ensure his government deliver on the hope invested in him and develops reforms that are centred on the people who draw on care.

Burnham deserves credit for bringing social care back into the national conversation. But his success cannot be measured by headlines or ambitious announcements; it should be measured by whether reform is deliverable and properly funded, in partnership with the sector. This is a rare opportunity to implement lasting changes, but only if those delivering care are part of shaping it.