Nursing must be at heart of government adult social care commission, says RCN

The UK government has launched an independent commission to reform adult social care in England. The commission, chaired by Baroness Louise Carey, is set to begin work in April 2025 but not due to publish its final report until 2028.

We believe this timeline will do little to solve the crisis in adult social care that exists here and now, which sees vulnerable people routinely go without care in an underfunded sector gripped by widespread vacancies and falling registered nurse numbers.

This crisis needs to be addressed now to ease the pressure on the NHS.

"Vulnerable people needing care cannot wait until 2028 for change," said Professor Nicola Ranger, RCN General Secretary and Chief Executive. "And neither can the over-worked, underpaid nursing staff who care for them."

According to a Skills for Care state of the adult social care sector and workforce report, the number of filled registered nurse posts in the sector in England decreased between 2017/18 and 2023/24, from 39,000 to 34,000.

A number of organisations across health and care have spoken out to say we need action sooner including National Care Association, King's Fund, Care England, and Health Foundation.

The commission's primary goal is to develop sustainable, long-term solutions for the adult social care system. The work will be split over 2 phases, with the first-phase report to the government expected mid-2026, looking at the issues facing social care and recommending medium-term reforms. The second-phase report is not expected until 2028, and this will make recommendations for the longer term.

The creation of the commission comes as the government has announced a package of measures for the sector, including a boost in the Disabilities Facilities Grant, and action to support adult social care including using technology to support older people living at home for longer. This package of reforms is a start in addressing the issues the sector faces but does not go far enough.

Nicola added: "Social care requires long overdue reform. Although today's announcement is a step in the right direction, the reality is that a commission due to report in 3 years' time will do little to solve the crisis in the here and now. A healthy and stable social care sector is crucial to easing pressures in NHS services.

"Social care lacks funding and is gripped by widespread vacancies, with the numbers of registered nurses declining. Nursing staff deliver the vast majority of care in the sector and must be central to any attempts to turn things around."