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Open letter to the Secretary of State for Health and Social Care, Victoria Atkins MP

Dear Ms Atkins,  

Congratulations on your appointment as Secretary of State for Health and Social Care. We look forward to working with you and your team to deliver on the promised reforms outlined in People at the Heart of Care and secure the essential investment to achieve them.  

As you take up your new role, we will be delighted to work with you on behalf of not-for-profit adult social care and support providers, the people they support, commissioners, and the workforce, to ensure we can find a way through the challenges, to unlock social care’s potential. 

You will be very familiar with the challenges facing our society due to demographic changes, growing unmet need and a difficult economic environment. We are keen to help you maximise the potential of adult social care and reframe thinking to recognise that the care and support sector is an untapped resource full of potential to boost economic growth and combat socio-economic and health inequalities.  Amplifying the voice of our not-for-profit members, the people they support and the people they employ is at the heart of these.  

Social care and support is preventative in nature, allowing people to retain their independence for longer, doing the things they want to do, living in and contributing to their communities and the economy. As you will know, poor health and wellbeing are leading reasons for economic inactivity and low productivity in our society. Indeed, the Future Social Care Coalition outlined in their recently published Carenomics report, a very strong argument that investing in social care is essential for a secure and growing economy. 

The recent National Audit Office report on the government’s adult social care reforms reveal that there is still some way to making People at the Heart of Care a reality. The report shows that 58% of the system reform money has been reallocated, with delays to many of the workforce measures, and the entirety of the £3.6bn charging reforms has been delayed until after the general election.   

Similarly, this year’s Skills for Care workforce report shows that vacancies continue to be far too high at 152,000 posts, while the CQC’s State of Care report highlights the profound inequalities that now exist in the provision of adult social care due to state underfunding and a flawed ‘care market’ model. We must also tackle the reality that our society is ageing with all the opportunities and challenges that brings, as highlighted by the Chief Medical Officer in his report on health in an ageing society. Where care and support is not available, the burden inevitably falls upon unpaid carers, who are nearly always women. Carers UK estimated in 2022 that the number of unpaid carers could be as high as 10.6 million people.  

Ahead of the Autumn Statement next week, and as you develop your policy area in preparation for a general election, we hope to hear you amplify the importance of social care and ensure that social care is given the attention it needs and deserves, as well as pushing against any further cuts to the adult social care reforms, or cuts to the funding required by local authorities and NHS commissioners to provide good-quality social care services for their local communities. 

The National Care Forum has worked extensively with our not-for-profit and charitable members to amplify their voice as well as the voices of people they support and employ. These voices are at the heart of our work and we believe that future social care reform needs to reflect this:- 

  1. Think social care first – we need to ensure that people care about social care like they do the NHS and understand its central role in joined up health and care for people. Policymakers need to have the power of social care at the forefront of their minds, ensure it has adequate representation on Integrated Care Systems, and that there is independent analysis of current and future requirements for social care.
  2. Improve the pay, terms and conditions of the workforce – care work is intrinsically skilled and valuable and must be remunerated to reflect this. Beyond the workforce measures already being developed, we must see a long-term workforce plan. Care workers need to be paid at rates according to their skills and competencies determined by an independent review body, aligned, at the very least, with NHS Agenda for Change Pay Bands. This must be fully funded via local or central government funding models. 
  3. Invest in people, not profit – adult social care should be for people, not profit. Not-for-profit care provision ensures that all the funding from either government or citizens is directed towards the delivery of care, so that money remains in the sector and is reinvested into the workforce and to improve the quality of care – rather than leaking out of services As such, we need to see strategic commissioning to grow the not-for-profit part of the sector and develop a pathway to enable more care organisations to adopt a not-for-profit model.
  4. Create an economic growth strategy for adult social care – social care is a large employer contributing £55.7bn to the English economy, making it an essential part of the national infrastructure. We need to see the capital and revenue investment necessary to grow capacity, explore new models of care, meet net zero and environmental sustainability targets and effectively harness technology and data insights. This will generate more growth and jobs.
  5. Enshrine rights, fairness and choice for people in a National Care Covenant – co-produce and set out clearly the mutual rights and responsibilities of citizens, families, communities and the state. We need a strong role for central government to guarantee universal access to care and support, security against the costs of care, and upholding people’s rights. This will require a cross-society vision and ambition for what social care can be.  


Once again, congratulations on your appointment and we look forward to working closely with you, alongside our membership. 

Yours sincerely,  

Professor Vic Rayner OBE, CEO, National Care Forum 

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