Social care is one of the most important public services in the UK, yet it is often poorly understood. Unlike the NHS, which is free at the point of use, social care is usually means-tested and delivered through a complex mix of local authorities, private providers and voluntary organisations.
For many older people, social care provides essential support with everyday activities such as washing, dressing, preparing meals and staying independent at home. It can make the difference between someone being able to live safely in their own community and facing unnecessary challenges.
However, the system is under growing pressure, raising important questions about whether it can meet the needs of an ageing population now and in the future.
Why is social care struggling?
The challenges facing social care have developed over many years.
People are living longer, which is a positive achievement. However, longer life expectancy also means more people are living with long-term conditions such as dementia, arthritis, frailty and multiple health needs that may require ongoing support.
At the same time, local authorities, which are responsible for funding much of adult social care, have faced significant financial pressures. According to the House of Commons Library, adult social care is now the largest area of council spending after education, with local authorities in England spending £23.3 billion on adult social care in 2023/24.
Government figures show that gross expenditure on adult social care in England reached £29.4 billion in 2024/25, an increase of 9% on the previous year. Despite rising spending, demand for care continues to increase, placing pressure on services and those who provide them.
The workforce challenge
One of the biggest issues facing the sector is staffing.
Adult social care employs around 1.6 million people in England, making it one of the country’s largest workforces. However, there were still around 111,000 vacant posts in 2024/25, with providers continuing to report difficulties recruiting and retaining staff.
Pay remains a significant concern. Care workers play a vital role in supporting older and vulnerable people, yet many organisations argue that relatively low pay, demanding work and limited career progression make it harder to attract and retain experienced staff.
A stable and skilled workforce is essential if social care is to provide consistent, high-quality support.
The impact on older people and the NHS
When social care struggles, the effects are felt across society.
Older people may face delays in receiving support at home or difficulties finding suitable residential care. Families often step in to provide unpaid care for loved ones, which can have a significant impact on their own health, finances and wellbeing.
The NHS also feels the consequences. When appropriate care is not available in the community, some people remain in hospital for longer than necessary despite being medically ready to leave. These delays reduce hospital capacity, increase pressure on emergency services and make it harder for health services to respond to rising demand.
Access to publicly funded care has also become more restricted in some areas. Changes to eligibility criteria, combined with financial pressures on councils, have affected the support available to many people who need help.
These pressures highlight the need for a more sustainable approach to funding and delivering social care.
What needs to happen next?
Successive governments have recognised the challenges facing social care, but many proposed reforms have been delayed or only partly implemented. While additional funding has been announced in recent years, many experts argue that the sector still needs a long-term solution.
As members of the Later Life Ambitions (LLA) campaign, we believe every older person should be able to access high-quality care when they need it, regardless of where they live.
We are calling for:
A National Social Care Framework that establishes clear standards across the UK and reduces differences in access and quality depending on location.
A sustainable funding settlement that moves away from short-term solutions and provides long-term certainty. This could include options such as a dedicated social care levy or ring-fenced funding.
Investment in the care workforce, including fair pay, high-quality training and clearer career pathways to support recruitment and retention.
Better integration with the NHS, so older people experience joined-up care rather than having to navigate separate systems.
Looking ahead
Most people will either need care themselves one day or know someone who does. Social care is not an issue that affects only a small number of people, it is a vital service that supports independence, dignity and quality of life for millions.
The challenges facing social care have developed over decades and there are no quick fixes. However, without meaningful reform, the pressure on older people, families, carers and public services will continue to grow.
The question is no longer whether social care needs reform. The question is whether we are prepared to give it the priority it deserves.
Sources and evidence
The figures and evidence referenced in this article are based on the following sources:
- House of Commons Library, Adult Social Care: Funding and Expenditure
- Department of Health and Social Care, Adult Social Care Finance Report, England 2024 to 2025
- Skills for Care, The State of the Adult Social Care Sector and Workforce in England
- Care Quality Commission, The State of Care
- Association of Directors of Adult Social Services (ADASS)
