Social care: the action we need

Social care in England is at a crossroads. All three major political parties in the 2019 general election have recognised in their manifestos that the social care system is in need of change. So what needs to be done?


Published: 28/11/2019

ISBN: 978-1-910953-72-3

Download the briefing [PDF 122.6KB]

The current social care system in England is widely regarded as unfair, complex, confusing and failing to meet growing care needs in the population.

All the main political parties have suggested in recent election manifestos that they will expand social care services to more people,  and the 2019 election presents parties with a new opportunity to address the chronic problems in social care decisively and to put the system on a sustainable footing once and for all.

We argue that a realistic and comprehensive workforce strategy is needed to combat the chronic recruitment and retention crisis that that is affecting the social care sector. We believe the scale of the workforce challenge has so far been underestimated: our new calculations show that just providing a basic package of care of one hour per day to older people with high needs would require approximately 50,000 additional home care workers now. To provide up to two hours would need around 90,000 extra workers.

It is crucial that any reform to social care fundamentally overhauls the entire system and moves away from the one-off piecemeal initiatives that have characterised policy-making in this sector thus far. Any injection of money into the system, while welcome, will need to be accompanied by realistic and sustainable proposals for delivering services to the people who need them both now and in the future.

Our analysis of the English social care system alongside our research into systems in other countries suggests that successful reform needs to focus on four main areas:

  • Clarity and consistency of offer
  • Fair and transparent funding
  • A realistic strategy for the workforce
  • Stability for organisations providing care

The issue of care transcends politics and parliamentary terms. There is now a consensus across all three main political parties that the social care system is in need of reform. The problems are well understood; the options have been exhaustively explored. It is now time for decisive action and strong leadership.

    Suggested citation

    Curry N, Hemmings N, Oung C and Keeble E (2019) Social care: the action we need. Election briefing, Nuffield Trust.

    Appears in

    • 13/12/2021
    • Sarah Scobie