Largest care provider representative supports new research commissioned by Casey Review

• The report identifies fragmented accountability, short-term funding and inconsistent commissioning as drivers of unequal access and market instability.
• Care England says a National Care Service should strengthen national stewardship and accountability while preserving local knowledge, provider capacity and a diverse care market.

Care England, the largest and most representative body for independent adult social care providers in England, is responding to research by the Nuffield Trust and Institute for Government for the Independent Commission on Adult Social Care. The findings expose how fragmented responsibilities, short-term funding, low prioritisation by successive governments, and inconsistent commissioning leave people facing unequal access to support and services, struggling to plan for the future. It describes the current system as existing off the back of “incremental and, at times, accidental developments that stem from the absence of a ‘design moment”.

Professor Martin Green OBE, Chief Executive of Care England, said:

“Baroness Casey is right. Successive governments have been asleep at the wheel. People who need care, their families and those who support them have lived with the consequences for years. The report does not say that the independent sector has failed, but that the independent sector has stood up when successive governments have failed and provided a diverse range of services in spite of chronic underfunding and inconsistent and restrictive commissioning practices.

 

“The consequences of this lack of stewardship is that councils struggle to balance their books, providers struggle to make inadequate fees cover the care people need, and families struggle to understand why support available in one area cannot be found in another. The research directly feeds into Lady Casey’s characterisation of equitable social care provision as being the ‘Sixth Beveridge Giant’ that any citizen should expect the government to provide for.

 

“Our own research has documented how those pressures build. Local authority funding continues to fall behind costs. Funding available for training, better pay and improvements are squeezed while decisions around minimum wage increases, and the local authority budgets that must deliver them, are often made in relative isolation in a siloed government that has treated social care as the NHS’ poor relation rather than the core public service it should be.”

Care England’s Priced to Fail analysis estimates that the residential and nursing care funding gap has grown to £2.36 billion in 2025/26. Separately, the Homecare Association estimates an additional £2.3 billion is needed across council- and NHS-funded homecare in England in 2026/27 to meet statutory minimum wage costs and sustain provision.

The report also explores the future balance between public, not-for-profit and for-profit provision, but recognises the diversity of ownership models and warns that any change must consider provider exit, lost capacity and unintended consequences. Care England says reform should be evidence-led and focused on outcomes, transparency and financial resilience rather than ideology about ownership.

Professor Martin Green concluded:

“Independent providers want to help build the future care service that the people the already support deserve. This report gives the Commission a strong basis to move from diagnosis to design, and Care England wants to work constructively with Baroness Casey to help shape a settlement and a National Care Service that works for people, families, staff and providers.”