On 29 September 2026, in his first conference speech as Prime Minister, Andy Burnham made a National Care Service (NCS) for England the heart of Labour’s offer for the next Parliament. He described it as ‘free at the point of use’, built on the principle that ‘everyone contributes, and everyone is covered’, and warned that ‘if we don’t fix our broken social care system, it will eventually break the NHS too’.
The proposed National Care Service aims to establish adult social care as a universal public service, operating on principles similar to those that underpin the NHS. Government’s ambition is to create a system that provides greater consistency, fairness and accessibility, ensuring people can obtain support when they need it without facing catastrophic personal costs.
Key principles outlined so far include:
England’s social care system faces well-documented challenges. Demand continues to rise due to an ageing population and increasing levels of complex need, while providers face ongoing pressures from workforce shortages, rising employment costs and constrained public funding.
The result is a system that many people find difficult to navigate, with significant variation in access and eligibility between different areas. Successive governments have recognised the need for reform, but previous attempts have struggled to secure the political consensus and long-term funding required to deliver lasting change.
The proposed National Care Service seeks to address these long-standing issues while recognising the vital role social care plays in supporting the wider health system.
For care providers, the creation of a National Care Service presents both opportunities and uncertainties.
Potential benefits could include:
However, significant questions remain, including:
Government’s announcement sets out a direction of travel rather than a completed blueprint. Detailed policy proposals, legislation and funding arrangements are expected to emerge over the coming years.
For providers, workforce leaders, people who draw on care and their families, the debate surrounding the National Care Service represents a once-in-a-generation opportunity to shape the future of adult social care.
Whatever form the final model takes, the discussion has moved beyond whether social care needs reform and towards what a new national settlement for care should look like.