National Care Service: What care homes need to know

2025 brings in new regulatory changes the government proposes to enforce. One of these changes is in the form of the national care service (the “NCS”) which may sound very familiar to some, but in case you have never heard of it, the initiative focuses on the adult social care sector. Below, we have set out the background to this reform and what it will mean for care home providers.

Where did the National Care Service come from?

Back in 2010, Gordon Brown’s Labour party released a paper titled ‘Building the National Care Service,’ which introduced the concept of the NCS. Some of the proposals included supporting people to stay in their homes rather than moving into residential care homes and making a commitment that anyone staying in residential care for more than two years would receive free care after the second year. Plans for this were abandoned following the coalition government between the Conservative and Liberal Democrat parties.

In 2019, Jeremy Corbyn’s Labour party released a paper titled ‘Towards the National Care Service’ which again proposed changes for the sector, such as introducing free personal carefor older people over the age of 65 who needed it. The hope was that it would reduce admissions into care homes and hospitals by ensuring people would have the support in their own homes.

With the change in UK government and Labour no longer sitting on the opposition bench, they can once again revisit their proposal of a NCS.

The government had announced that a 10 Year Health Plan will be published in spring of this year which will involve three strategic shifts to how care is delivered, moving it from hospital to the community, from analogue to digital, and from sickness to prevention.

What impact could this reform have on care homes?

Arguably it is long overdue, with The House of Commons Committee of Public Accounts stating that they “have repeatedly highlighted the need for reform…[and] have also stressed the importance of long-term funding and the need for the Department of Health and Social Care to urgently tackle the problems faced by the social care workforce.”

The government’s desired outcome is that “Services will be locally delivered, with a principle of ‘home first’ that supports people to live independently for as long as possible.”

Following a request from Wes Streeting (Secretary of State for Health and Social Care), Fabian Society created a roadmap detailing how the NCS could work.

For ease, we have set out the points that focus specifically on care homes:

• The NCS would provide long-term certainty and funding to build new facilities to overcome the current situation of insufficient development of specialist housing and modern care homes
• The NCS would promote joint delivery of health and care to people with significant clinical and support needs including named care coordinators and joint teams for people living at home, and better NHS services in care homes
• The NCS would consider an increased role for social security in funding residential care so that housing and disability benefits contribute towards future increases in care home spending.

On 3 January 2025, the government announced their vision to deliver a new and improved adult social care sector that would be split into two phases:

• Phase 1, reporting in 2026, will identify the critical issues facing adult social care and set out recommendations for effective reform and improvement in the medium term. It will recommend tangible, pragmatic solutions that can be implemented in a phased way to lay the foundations for a national care service
• Phase 2, reporting by 2028, will make longer-term recommendations for the transformation of adult social care. It will build on the commission’s first phase to look at the model of care needed to address our ageing population, how services should be organised to deliver this, and how to best create a fair and affordable adult social care system for all.

The scrapping of Scottish National Care Service

The Scottish government created their own draft bill back in June 2022 to introduce their own version of NCS. However, on 23 January 2025, Maree Todd, the Minister for Social Care, Mental Wellbeing and Sport announced they would no longer be implementing it.

In a statement to the Scottish Parliament, Maree Todd said: “We made considerable effort to find compromise and a way forward. But it is clear those proposals are not supported by this Chamber. I have concluded that we must deliver our Scottish National Care Service without legislating for structural reform, securing a different means to deliver our goals…” (emphasis added). Read the full statement from Maree Todd here.

The Scottish government’s decision to scrap its plan to create an NCS has not had any impact on Labour’s plans, and, for now, the party seems committed to reforming the industry.

How care home providers can prepare themselves

It’s clear that we won’t see changes for a while yet, as Wes Streeting told the Guardian:

“I think the key thing about a national care service is that it’s a journey, not an event. We would not be able to deliver this overnight or even in a single parliament.”

At this stage, the Labour party has not provided specific proposals in their announcements about the NCS, so we don’t yet know whether their two-phase plan will incorporate changes proposed in Brown or Corbyn’s papers or whether they intend to start afresh.

Nevertheless, you should keep it on your radar and remember that HCR is always ready to assist with any changes that might affect your business.