PM sets out National Care Service plans to provide free personal care for older people

A National Care Service providing free personal care to older people would be established in the next Parliament under plans announced by Prime Minister Andy Burnham.

The proposed service would provide personal care based on need rather than ability to pay, covering support with everyday activities including eating, bathing and using the toilet. The government says it would be introduced in phases as savings become available and workforce and provider capacity are built up.

The plans are intended to address the longstanding challenges facing England’s social care system, including the financial risks faced by people who require care and the pressure placed on the NHS when people cannot be discharged from hospital because appropriate social care is unavailable.

Under the proposals, the current State Pension Triple Lock would remain in place until April 2030. It would then be adjusted so that the State Pension rises by at least inflation or 2.5% each year, with an additional link to earnings intended to ensure its value keeps pace with average earnings over time.

The government estimates that the change would reduce state pension spending by £15 billion a year by the end of the 2030s, rising to £50 billion a year by 2050. The savings would be used to fund the new National Care Service, with the government stating that the service would be fully funded rather than financed through borrowing.

The current Triple Lock would be maintained throughout the present Parliament, which the government says would increase the State Pension by more than £2,000. From April 2030, the revised system would guarantee annual increases of at least 2.5% or inflation, whichever is higher, while allowing for further increases where required to maintain the pension’s value relative to earnings.

Baroness Casey’s independent Commission on Adult Social Care will recommend how and when the National Care Service should be built up. Her report is due in summer 2027, with the Commission’s work being informed by public deliberation and ongoing cross-party discussions.

The proposed service would not cover bed and board. Existing means-tested council contributions would continue to apply to these costs, while the value of a home would continue to be excluded from financial assessments where a partner or dependent relative lives there. Deferred payment agreements would also remain available to eligible people who need help meeting care costs without selling their home during their lifetime.

The government says around three in four adults over 65 are expected to need care and support during later life, while one in seven face costs of more than £100,000. It argues that the current system can result in people with similar needs facing different financial arrangements depending on whether their support is primarily associated with health or social care.

The proposed National Care Service is intended to address this variation by providing free personal care according to need. However, its scope and detailed operation have yet to be determined, with Baroness Casey’s Commission expected to make recommendations on how the service could be delivered in practice.

The plans also link social care reform to pressures on the NHS. The government says inadequate social care contributes to pressure on A&E departments and delays in discharging patients who are medically ready to leave hospital.

The National Care Service would be built up as savings from the revised pension arrangements increase, alongside the development of the workforce and provider capacity required to deliver the service. The government has said legislation to change the Triple Lock will be introduced during the current Parliament.

The announcement follows wider work by Baroness Casey’s Commission, which is due to continue engaging with the public through the next phase of its ‘Big Conversation on Care’.

The government has described the plans as a response to what it calls a “broken” social care system and said the reform is intended to provide greater security for people in later life. The Prime Minister has also argued that failure to address social care would continue to place significant pressure on the NHS.