The Care Reform agenda for England and its implications for financial advice
It’s an often-repeated phrase that the care reform can has been kicked down a very long road ever since the then Prime Minister Tony Blair told the Labour Party conference in 1997 - “I don’t want [our children] brought up in a country where the only way pensioners can get long-term care is by selling their home” - instigating the Royal Commission on the Long Term Care of the Elderly three months later in December 1997.
Since then, there have been at least two major independent commissions (Wanless and then Dilnot), five white papers, and three green papers regarding social care reform in England alone. Numerous consultations and policy papers have also been produced, but progress towards meaningful, lasting reform has been limited.
The barriers to achieving meaningful reform are complex and wide-ranging. Funding and delivery has been consistently prevented by a combination of high financial costs, lack of political consensus, and the practical pressure of balancing immediate, short-term demands against the challenge of longer-term structural change. Successive governments have delayed or abandoned reforms - such as the planned cap on care costs - due to budget pressures and the need to fund immediate, inflationary pressures.
However, following his appointment as UK Prime Minister in July 2026, Andy Burnham has made social care a priority, stating that the historic failure to address Britain's social care crisis is "not defensible". He has explicitly pledged to "use some of my political capital" to finally resolve the issue and stated that he refuses to leave office having failed to do so.
With seasoned veteran Yvette Cooper appointed as Health and Social Care Secretary, it certainly feels like a pivotal moment for social care reform in England. However, the extent and nature of any actual progress will, as ever, depend on securing funding against competing government priorities.
The Casey Commission
In January 2025, Sir Keir Starmer’s government announced the establishment of an independent commission, led by Baroness Louise Casey, to set out recommendations for a ‘fair and affordable’ social care system. It has begun by ‘identifying a commonly agreed picture of the problems faced’ and is then to undertake two phases of work as follows:
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The purpose of the first phase of the commission is to set out the plan for how to implement a National Care Service, a government manifesto commitment. This should report in 2026.
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The second phase should then make longer-term recommendations for the transformation of adult social care, reporting back by 2028.
More recently Andy Burnham has announced plans to fast-track the Casey Commission review of social care funding, asking Baroness Casey to bring her overall recommendations forward by 12 months to the summer of 2027 so his administration can act swiftly to address the many problems affecting social care across England.†
So what's wrong with social care?
Different people have different opinions about what is ‘wrong’ with social care and how to fix it, but according to the influential Kings Fund* the problem boils down to six issues, consistently identified by a wide range of people and organisations:
1. Access: means testing, unmet need and selling homes to pay for care
2. Quality of care: 15-minute care visits and neglect
3. Workforce pay and conditions: underpaid, overworked staff
4. Market fragility: care providers struggling to stay in business
5. Disjointed care: delayed transfers of care and lack of integration with health
6. The postcode lottery: unwarranted variation in access and performance
These problems according to the House of Commons Adult Social Care Select Committee mean we are…'living with a broken social care system. It’s not providing adequate care to the people who need it, it’s creating ever-increasing costs for local authorities and the NHS, and it’s putting unsustainable pressure on unpaid carers, many of whom have to leave work to care for loved ones.'
But where is the money needed going to come from?
Despite Baroness Casey's formidable reputation, her efforts to ensure a degree of cross party support for her work and the prioritising of social care reform by our current Prime Minister, the proximity of the next general election, being due by August 2029 at the latest, means that securing the funding required will remain a significant challenge. This is also despite arguments by the above Committee around the mounting cost of inaction.
In 2024/25, total expenditure on adult social care rose to £34.5 billion, £7.8 billion more (29%) in real terms than in 2015/16*. This money comes mainly from local authorities’ own spending power (largely raised from council tax and business rates). From 2016/17, councils have also been able to raise a small amount of additional income from an extension of council tax, called the ‘social care precept’.
Council income has also been supplemented with central government grants. These are often short term to tackle specific identified issues, such as delayed hospital discharge, provider fee rates or workforce problems. Other social care funding comes from the NHS, which contributes to the costs of some local authority social care services.
However, people receiving publicly funded social care are also required to contribute to its costs and many people are simply not entitled to public funding at all. So a significant proportion of adult social care spending estimated to be at least 50% comes directly from self-funding individuals.
The critical need for advice remains
When it comes to regulated paying-for-care advice, even if recommendations from the Casey Commission subsequently adopted by the government of the day include an element of universal funding that finds its way onto the statute book quickly, this is unlikely to impact those needing to start to self-fund or partially self-fund their care for several years yet. When it comes to financial planning it's a case of making clients aware of the possibility of impactful reform but putting in place potential sources of funding based on the current position. Furthermore, making more people aware of the significance of immediate needs annuities as a way for self-funders to guarantee payment of care fees for life is as important as ever, given that it’s currently only those at either end of the wealth spectrum for whom this is not a significant issue.
But the need for advice goes beyond regulated paying-for-care advice. Most peoples’ care journeys begin with an urgent need for non-regulated advice in respect of four key questions:
1. Where can I get the urgent care I need now, and how will I know if it's right for me?
2. How much will it cost and who will pay - my local authority, the NHS, some other body or me?
3. Are there any state benefits or other sources of income available to me?
4. If I am to pay for my care, what are my options?
The answers to these questions are something of a moving picture and even then, there is often a gap between what should happen and what actually happens in practice.
The challenge for firms is how they can deliver this advice profitably using whichever operating model they consider:
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Full in-house provision: firms deliver both regulated (financial) and non-regulated (navigational) care advice in-house. This requires significant resources to keep up with evolving non-regulated care standards, potentially making it commercially difficult for non-specialist firms to provide a seamless, up-to-date service.
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Hybrid model: firms provide regulated “paying-for-care” advice in-house while outsourcing non-regulated aspects to specialist third-party navigators, such as My Care Consultant.
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Fully outsourced: firms refer all aspects of care advice to external specialists.
Is doing nothing an option?
Historically, firms could simply ignore care advice if it wasn’t a core market. However, the FCA’s Consumer Duty - with its rigorous focus on vulnerability, avoiding foreseeable harm, and delivering good outcomes - has effectively made "doing nothing" an unpalatable option.
Support and resources
For firms providing fully integrated advice, technical support for the non-regulated elements is essential:
Firms looking to outsource non-regulated advice or those preferring to avoid care advice, can refer clients to care navigation services:
Sources
† Casey Commission sources (for currency): caseycommission.co.uk and gov.uk – PM sets out new path to fix social care together, 29 July 2026
* https://www.kingsfund.org.uk/insight-and-analysis/long-reads/whats-your-problem-social-care
** Care Box is an online technical resource for advisers.
*** My Care Hub is a guided information service from My Care Consultant for those wishing to retain the client relationship. It's content is tailored to specific UK regions, addressing the complexities of the UK's devolved care systems, and particularly valuable for families dispersed across different regions or with family members living abroad.