Care England calls for adult social care to be recognised as an essential national infrastructure
Care England has called for adult social care to be recognised as “essential national infrastructure” in a new report which argues that the sector is critical to people’s independence, the sustainability of the NHS, local economies, and the wider functioning of society.
The report, The Power of Care, argues that adult social care must no longer be treated as a marginal or crisis-only service. Instead, it says the sector should be understood as a core part of national life, underpinning family stability, community resilience, the labour market, and public services.
Drawing on 177 survey responses and 17 interviews with care providers, care workers, people drawing on care and support, family members, and sector representatives, the report finds that social care is widely valued, but is operating within a system that is too fragile, fragmented, and short-term to meet current and future demand.
It highlights rising complexity of need, financial pressure, workforce strain, inconsistent integration with health services, and a growing reliance on unpaid carers and families when formal support is delayed or inadequate.
A central finding of the report is that social care matters far beyond those who directly receive support. It describes care as the practical and emotional support that enables people to maintain routines, confidence, dignity, relationships, work, and participation in their communities.
When social care is reliable and well-coordinated, the report argues, families are able to return to being partners, sons, daughters, and parents, rather than becoming default carers and system coordinators.
The report also stresses the close relationship between adult social care and the NHS. It finds that social care plays a vital role in preventing avoidable deterioration, supporting hospital discharge, enabling recovery, and helping people remain independent after illness or injury.
However, Care England warns that this relationship remains too fragmented, with delayed discharge, poor information-sharing, weak communication, and unclear responsibilities continuing to create pressure across both systems.
The report argues that better integration should not mean making social care more like the NHS. Instead, it says social care must be treated as an equal partner, with its own distinct contribution to prevention, recovery, independence, and long-term support.
It states that neighbourhood health models and wider NHS reform ambitions will not succeed unless social care providers and local government are meaningfully involved in planning, pathway design, and delivery.
The report also makes an economic case for investment in adult social care, describing the sector as a driver of growth rather than simply a cost to the public purse.
It notes that social care employs around 1.6 million people in England and contributes approximately £78 billion to the UK economy each year. It also cites evidence suggesting that every £1 million invested in adult social care could generate between £5 million and £7 million in economic benefits within one year, rising to £22 million over two decades.
According to the report, social care supports the wider economy not only through direct employment and local spending, but also by helping unpaid carers remain in work and reducing pressure on other public services.
Providers interviewed for the report described social care as part of the civic fabric of local communities, supporting jobs, careers, local suppliers, volunteering, family stability, and community resilience.
However, Care England warns that these benefits are being constrained by a lack of long-term stability. Providers highlighted uncertainty around funding, commissioning, workforce pressures, and infrastructure as barriers to investment and improvement.
The report says this uncertainty limits providers’ ability to expand, innovate, modernise care environments, invest in digital systems, or build the workforce needed to meet increasingly complex needs.
Workforce pressure is identified as one of the sector’s most significant challenges. The report finds that care workers are widely recognised by respondents as skilled, compassionate, and essential to good outcomes, but that low pay, limited progression, recruitment challenges, and insufficient recognition are undermining stability.
It argues that workforce conditions are directly linked to care quality, because continuity, trust, and strong relationships are central to good support.
The report also highlights the condition of the care estate and wider care infrastructure as a major long-term issue. It warns that many care settings are no longer suited to future demand, particularly as people’s needs become more complex.
It adds that investment must not be limited to care homes, but should also include homecare, supported living, community provision, and digital systems that help people remain well and independent outside hospital and institutional settings.
Care England concludes that the strongest examples of good social care already exist across the country. The challenge, it says, is not defining what good care looks like, but creating the funding, workforce, commissioning, and system conditions that allow high-quality, personalised, and preventative care to become standard practice rather than the exception.
To achieve this, the report sets out a three-phase reform plan.
In the first 12 months, it calls for action to stabilise the sector through a clear multi-year funding trajectory, fee rates that reflect the true cost of care, a funded Fair Pay Agreement, reduced duplication in oversight, and national expectations for discharge standards and communication between health and social care.
Over the following one to three years, the report recommends better alignment across funding, commissioning, workforce reform, and integration. This includes cost-reflective local government funding settlements, longer-term outcome-focused commissioning, structured career pathways, expanded training, and stronger involvement of social care providers and local government as equal partners in Integrated Care Systems.
In the longer term, Care England calls for a cross-government social care settlement that recognises the sector’s role in economic participation, community stability, and public service sustainability. It also recommends sustained investment in care infrastructure and commissioning models that prioritise prevention, reablement, and long-term outcomes.
Professor Martin Green OBE, Chief Executive at Care England, said: “For too long, adult social care has occupied an uneasy and often diminished place in national debate. Although it touches all of us, underpins family life, supports the functioning of local communities and sustains the wider health and care system, it is still too often framed as a marginal service.
“Our central argument is something which we can all agree; adult social care must be understood not as a peripheral or residual service, but as essential national infrastructure. That it is fundamental not only to people’s independence and quality of life, but equally critical to the sustainability of the NHS, the labour market and stability of family life.
“It is also an economic powerhouse with the means to boost local communities and the nation as a whole. These are practical claims, grounded in the everyday reality of what social care enables, prevents and sustains.
“As this report will show, much of the improvement and innovation is already happening. The challenge is for the system to enable this at scale.”
