Report Calls For End Of The Social Care Postcode Lottery
The postcode lottery in social care remains one of the most pressing challenges facing England’s care system a report has revealed, highlighting that two people with identical needs can receive vastly different support – one benefiting from timely, person-centred care that preserves their independence, the other facing lengthy waits, restrictive eligibility criteria and fundamental needs going unmet.
Where someone lives shouldn’t determine the quality of care they receive, the report says, yet local variations in funding, capacity and policy interpretation continue to create a system where geography trumps need. The human cost is considerable: vulnerable people’s safety and dignity are compromised, whilst unpaid family carers shoulder ever-increasing burdens. These inequalities hit marginalised communities hardest.
The Government’s Casey Commission represents an important opportunity to address these disparities through the development of a National Care Service with consistent national standards.
However, critical questions remain: what should these standards encompass? How will they work in practice? And crucially, can they truly deliver the consistency and quality that service users and their families deserve?
SCIE’s new report, titled ‘Towards a National Care Service: raising national standards of care’, supported by The Access Group, follows extensive engagement with the sector. It argues that the core challenge facing social care is not a lack of values or vision, but the inconsistent translation of those shared principles into people’s day-to-day experiences of care and support. England already has strong foundations in the Care Act 2014 and a widely shared understanding of what good care should enable – people living the lives they choose, with dignity, connection and control.
However, those values are applied unevenly across the country. This inconsistency is what has produced the postcode lottery in access, quality and outcomes. The report, therefore, frames national standards of care not as a prescriptive blueprint for services, but as a mechanism for clarifying expectations so that people can rely on a consistent baseline regardless of where they live.
SCIE’s proposed framework sets out how national standards could define what is essential and non-negotiable, while deliberately protecting flexibility in how outcomes are achieved locally. The emphasis is on standards that specify what good care delivers for people, rather than mandating uniform processes or service models. In this way, national standards could help expose and reduce unjustified variation, strengthen accountability, and support learning and improvement across the system, without stifling innovation or personalisation.
Crucially, the report is clear that national standards alone cannot fix the deep-rooted challenges facing social care, including workforce shortages and financial pressures. Their impact depends on how they are designed and implemented, and whether they are supported by the right system conditions, from data and accountability to commissioning capability and co-production infrastructure.
Kathryn Marsden OBE, Chief Executive of SCIE, said:
“It is indefensible that, in this country, two people with the same social care needs, living only a few miles apart, can experience completely different levels of support. That postcode lottery undermines people’s dignity, independence and safety, and it places intolerable pressure on families and unpaid carers who are left to fill the gaps.
“National standards of care offer a practical way to close that gap – not by imposing a one-size-fits-all model, but by making clear what people should be able to expect from the system wherever they live. Done well, they can translate long-standing values in social care into clearer, outcomes-focused expectations that are rooted in lived experience and backed by accountability.
“But we also need to be honest about the context. Social care operates in a complex, resource-constrained system, shaped by workforce shortages, financial pressures and shifting political priorities. Poorly designed standards risk becoming symbolic, compliance-driven or disconnected from reality. This is not about quick fixes. Ending the postcode lottery will require sustained commitment, careful implementation and a focus on learning and improvement – not just ambition on paper.
“As the Casey Commission builds momentum towards its final report in 2028, this is the moment to get the foundations right – starting with clarity about what good care should deliver, and how we reduce variation in people’s experiences without losing what makes care personal and local.”
Sojan Joseph, MP for Ashford, said:
“The levels of inequality in our adult social care services have been far too high for far too long. We cannot build an NHS fit for the future unless we address these deep structural issues in our adult social care system.
“I am pleased the Government is taking steps to address the significant challenges in our adult social care sector, both through funding and fundamental reforms to the sector, such as funding for home modifications to give people more independence and allow them to be discharged from hospitals, embracing new technology, and making social care a desirable and respected profession – both through the pay increase given to carers last year and through a shift in culture.
“I look forward to working with the Government after Baroness Casey’s Commission concludes to ensure that her findings are implemented and our adult social care system is fixed for everyone, not just those fortunate enough to live in a postcode that provides better services.”
