Nuffield Trust and IFG Expose Weaknesses in Social Care Governance in Report Commissioned by Baroness Casey

Today, (November 11) the Casey Commission on Adult Social Care will publish a report by the Nuffield Trust and Institute for Government on the governance of social care in England. This is the first in a series of research reports commissioned by Baroness Casey. It explores lessons from other countries and other public services.

Nuffield Trust Deputy Director of Research and report co-author, Natasha Curry said: “Compared to the other countries we looked at, the governance of England’s social care system is confused and complex. Overlapping and unclear roles leave dangerous uncertainty around who is responsible for important decisions, contributing to the inertia around reform England has struggled with for decades. The serious consequences of this were laid bare during the Covid pandemic.

“There is not a singular ‘correct’ way of organising a care system – other countries vary in their approaches – but we need a clear vision on how to untangle the chaotic structure the sector has currently. The Casey Commission now has the opportunity to tackle these weaknesses head on. Looking to international examples is a solid starting point, as governance arrangements in other systems allow for more strategic approaches to things like workforce planning and regulating organisations that provide care.”

Institute for Government Associate Director, Stuart Hoddinott said: “The system for governing adult social care in England has evolved haphazardly and with little clear planning. That has been exacerbated by successive governments ducking politically unpalatable decisions for decades. That has scattered responsibility for the sector across and outside government in a way that few would design from scratch.

“While no system is perfect, and all come with trade-offs, the adult social care sector is unusual compared to other services in England. There are lessons from those services, about how to improve accountability or better design funding flows, that could provide a template for social care reform. Burnham’s personal commitment to reform alongside his devolution agenda provides the opportunity to better align the sector’s form with the government’s desired function.”