Independent care providers have “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”, care provider leaders have said.
Responding to comments that “no one is in charge” of England’s adult social care system made by the Independent Commission on adult social care chair Baroness Louise Casey during a speech to the National Children and Adult Services Conference, Care England chief executive Professor Martin Green OBE said the report reinforced concerns that providers have been left to sustain services despite years of policy drift.
“Baroness Casey is right. Successive governments have been asleep at the wheel,” said Professor Green.
“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,” he added.
Baroness Casey’s comments came as the Commission published a report on sector governance, developed with the Nuffield Trust and the Institute for Government, warning that England’s social care system is characterised by fragmented accountability, inconsistent commissioning and a lack of clear national leadership.
Care England said the weak national stewardship identified in the report is felt across the sector, with councils struggling to balance budgets, providers facing unsustainable fee rates and families encountering variation in access to support between local areas.
Reform and stewardship
The governance report also flagged concerns around unequal access to care, short-term funding arrangements and the absence of a consistent framework for accountability across adult social care.
Care England said its Priced to Fail report published earlier this autumn estimated the residential and nursing care funding gap will reach £2.36 billion in 2025/26, adding that reform should focus on outcomes, transparency and financial resilience rather than debates over ownership models alone.
The National Care Forum also backed the Commission's calls for more radical reform of the system.
Chief executive Vic Rayner OBE said: “Baroness Casey is right that social care needs fundamental reform, not more tinkering around the edges,” adding a National Care Service should place not-for-profit provision at its heart, enabling public funding to be reinvested in local services and workforce development.
Both organisations said they are ready to work with Baroness Casey, the government and the wider sector to build a future care service, with Professor Green adding that “independent providers want to help build the future care service that the people they already support deserve.”
He said the 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.”
