Social care reform expected by 2028

Introduction

On 3 January 2025, the government announced the launch of an independent, cross-party commission to recommend reforms to the adult social care system (the “social care announcement”). This initiative aims to address current and future care needs and fulfil Labour’s election manifesto commitment to a ‘National Care Service’.

The commission’s work will be conducted in two phases. The first phase, reporting in 2026, will identify critical issues and propose medium-term improvements. The second phase, reporting by 2028, will build on the first to recommend long-term transformations, focusing on future care models for an ageing population, service organisation, and establishing a fair and affordable system.

Health Secretary Wes Streeting stated:

“By 2050, there will be four million more people over 65 in England than there are now. Without action, real social care costs are projected to nearly double by 2038 compared to 2018. This will leave more people without necessary care, burden the health service, and overwhelm the NHS.”

To avert this potential crisis and deliver on its pledges, the government must take decisive action.

The effect on the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (SI 2014/2936)

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (SI 2014/2936) (“the Regulations”) was previously set to expire on 31 March 2022, but this was extended to 31 March 2025.

Given the imminent expiry date and the Social Care Announcement, a further extension by the government is highly likely. It is improbable that the government will amend or introduce new regulations before the commission completes its two-phase review in 2028.There will likely be no changes to the Regulations before the commission’s final report. Consequently, significant regulatory changes are unlikely before 2028.

What impact does this have on health and social care providers?

The Regulations define regulated activities under Part 1 of the Health and Social Care Act 2008. They will remain in force until at least 31 March 2025, and likely beyond, pending formal confirmation from the Secretary of State, Yvette Cooper.

Key regulations frequently assessed during Care Quality Commission (“CQC”) inspections will continue to apply, including:

• Regulation 12 – safe care and treatment.
• Regulation 13 – safeguarding service users from abuse and improper treatment
• Regulation 17 – good governance
• Regulation 18 – staffing
• Regulation 20 – duty of candour.

While no official announcement has been made, a further extension of the Regulations beyond 31 March 2025 is highly probable in light of the Social Care Announcement. Providers can therefore expect the current regulatory framework to remain in place for the foreseeable future.

Conclusion

The Secretary of State to announce a further extension of the Regulations shortly. In the meantime the current regulatory framework for health and social care providers will remain in place, although substantial changes could occur after the commission’s final report in 2028.

Without an extension, the Regulations would cease to be operational after 31 March 2025, creating a regulatory vacuum. The government is highly unlikely to allow this to happen.