Nuffield Trust: The pandemic has only added to the effects of years of delay to meaningful social care reform

Natasha Curry responds to the NAO report on the adult social care market in England.

Press release

Published: 25/03/2021

Responding to the National Audit Office report on the adult social care market in England, Nuffield Trust Deputy Director of Policy Natasha Curry said:

“The report by the National Audit Office exposes the fundamental flaws and fragility of the social care provider market in England. Organisations providing adult social care were struggling long before the pandemic took hold, with years of delay to any meaningful reform of the sector storing up the problems exacerbated by the pressure of Covid-19.   

“Years of real-terms cuts to local authority budgets have seen the market eroded with effects being felt by people in our society who depend on care and support. Organisations providing care are too often paid at or below cost for council-funded clients, with the result that they either turn down council contracts, collapse, or charge people paying for their own care higher fees. The impact of this unstable system inevitably falls on care workers and the people receiving care, many of whom struggle to access the essential and high quality services they deserve.

“But the question of reform can no longer just focus on financing the sector, the provider market is not fit for purpose and needs comprehensive reform. We need the sustainable solution promised by the prime minister which moves us beyond the short-term approach which has led to the lack of innovation and accountability in the sector. The Nuffield Trust will be publishing a comprehensive review of the key problems with the market in the coming weeks ahead of making recommendations drawing on international experience later this year.”

Notes to editors

  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  • For more information or to arrange an interview, please contact Simon Keen on 07780 475 571 or