The King's Fund responds to the Prime Minister’s remarks on social care and the Casey Commission announcing its planned public engagement exercise
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Responding to the Prime Minister’s remarks on social care and the Casey Commission announcing its planned public engagement exercise, Sarah Woolnough, Chief Executive at The King’s Fund, said:
‘It’s good to see confirmation that the Casey Commission will conduct meaningful engagement with the public. People who rely on care and support are closest to the system’s shortcomings and best placed to explain where it is failing. This includes working age adults who rely on social care to live more independently, as well as older people. Their voices should not be lost.
‘This sends a very clear signal that the government wants to make meaningful reform to adult social care before the end of this parliament. But it will also open the floodgates to questions about how any type of reform will be funded, so what they do next will be critical.
‘The Prime Minister has done the first part of his job by putting this at the top of the political agenda and offering to work cross-party to find solutions. The public should expect the other major parties to engage in good faith with these talks so that they can be part of the generation of politicians that helped solved one of the greatest societal problems of our time.
‘Our research shows public awareness and understanding of social care remains remarkably low despite how many people’s lives it touches, one in three believe, wrongly, that social care services are generally free at the point of need. The government must show the public what they stand to gain and first win the argument for the need for reform before talking about how to fund it.
‘This would flip the rhetoric of death and dementia taxes on its head and show the tangible benefits this could make to people’s lives. By taking this approach, the new Prime Minister could secure the public buy-in for reform needed to carry through politically difficult choices and succeed where those before him have failed.
‘People should not have to worry that the care they rely on will disappear because their care home went bust, that support will depend on their postcode, or that loved ones will be moved far from family. Reform should mean people can get care that is reliable, close to home and shaped around their lives while care workers are paid and supported to stay in the jobs they love.’
Key facts and figures related to social care:
One in seven people aged 65 will face lifetime care costs of over £100,000.
33% of people believe that social care services are generally free at the point of need.
Delayed discharges cost the NHS £2.7 billion in 2025/26. That is a rise of 7.5% on the previous year.
In March 2025, the percentage of the public saying – unprompted – that social care (or related issues) was one of the most important issues facing the country was 4%. This is the same as the percentage in March 2024.
Prioritisation is much lower than for the NHS. Unprompted, 29% of people said ‘National Health Service/Hospitals/Healthcare’ was one of the most important issues for the country in March 2025, compared to 35% in March 2024.
In 2024/25, 2 million people made requests for social care from local authorities (1.3 million aged 65+; 700,000 aged 18-64).
889,000 people received publicly funded long term care in 2024/25 (576,000 aged 65+; 313,000 aged 18-64). Since 2015/16, there has been an increase in the number of working-age adults accessing long-term care during the year, from 285,000 to 313,000 (10%), and a fall in the number of older people receiving long-term care – down from 587,000 to 576,000 (2%).
The 'upper threshold' for social care has remained unchanged at £23,250 since 2010/11, despite inflation. If the upper threshold had increased in line with inflation, it would have been £10,404 higher at £33,654 in 2024/25. The ‘upper threshold’ decides the level of savings and other assets people can have and still qualify to receive publicly funded care. The lower that figure is, the fewer the number of people who qualify.
Total expenditure on adult social care in England increased by £1.4 billion in 2024/25 to £34.5bn and increase of 4.1% in real terms. In 2024/25, total expenditure was £7.8 billion more (29%) in real terms than in 2015/16.
Local authorities spent similar proportions of money on long-term support for working-age adults (£11.5 billion) and older people (£12.0 billion) in 2024/25.
In 2024/25, the average weekly fee paid by local authorities in England for care home places for working-age adults rose by 3.6% in real terms to £1,823. The average weekly fee for older people’s care home places increased 3.3% to £1,019. The average hourly rate for externally commissioned home care rose 3% in real term to £23.56.
In real terms, since 2015/16 the average weekly fee for working-age adults has increased by 18%, the average weekly fee paid for older people has increased by 38%, and the average hourly rate for home care has increased by 22%.
Since 2012, there has been an 8,000 fall in the total number of care home places, made up of a 14,000 decline in residential home places, offset by a 6,000 increase in nursing home places. In 2012, there were 6.1 residential home places and 5.2 nursing home places for every 100 people aged over 75, but by 2024 this had fallen to 4.4 and 4.2 respectively.
Between 2023/24 and 2024/25, the vacancy rate fell from 8.3% to 7.0% and the number of vacancies fell from 126,000 to 111,000. There was a continued gap between the vacancy rate in adult social care and the vacancy rate in the wider economy (2.4%). The percentage of unfilled posts in the NHS (which is calculated differently from the vacancy rate in social care) was 6.7%.
Median care worker pay in the independent sector in March 2025 was £12.00 per hour. Skills for Care, the industry workforce body, says this represents an increase of 6.3% in real terms since 2023/24. In 2012/13, care workers were paid more than retail sales assistants, but in 2023/24 they were paid roughly the same.
The number of carers receiving direct support from local authorities was lower in 2023/24 than it was in 2015/16. It has fallen from 314,000 to 308,000. There has also been a shift in the type of support they receive.
Fewer carers (30% in 2023/24 compared to 31% in 2015/16) now receive paid support and more receive advice, information and signposting (55% in 2023/24 compared to 50% in 2015/16). The number of people provided with respite care delivered to support their carers fell from 57,000 in 2015/16 to 36,000 in 2023/24.
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