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In December 2021, the government published its People at the Heart of Care white paper which outlined a 10-year vision for the reform of social care backed by over £5.3bn. £3.6bn of this was set aside for charging reforms (£2.2bn) and to enable local authorities to move towards paying adult social care providers a fair price for care (£1.36bn). The remaining £1.7bn was allocated for wider social care system reforms. A full breakdown of the original pledge can be seen on the right.

In November 2022, the Chancellor’s Autumn Statement delayed the charging reforms until after the next General Election, and reassigned the money backing this to prop up the system, rather than reform it:

  • £1.265bn of the £2.2bn charging reform money was split between adult’s and children’s social care in The Social Care Grant in the Local Government Settlement for 2023/24.
  • The Social Care Grant for 2024/2025 also includes £1.9bn from delaying the rollout of charging reforms.
  • The £1.36bn fair cost of care fund was also diluted in November 2022. It looks like only £486m of the original £1.36bn will be given to LAs for its original purpose (to enable LAs to move towards paying providers a fair cost of care), split across 2022/23, 2023/24 and 2024/25.
  • In 2023/2024, £162m worth of fair cost of money was combined with £400m to create a £562m Market Sustainability and Improvement Fund (MSIF) focused on building capacity and market sustainability, rather than reform. In 2024/2025 there will be a further £683m to which £162m fair cost of care money will be added for a total of £845m.
  • A second version of the MSIF was announced in July 2023 in addition to the existing one, due to the continued pressures on the social care workforce and the clear conclusion that the original fund wasn’t enough. This fund provides a further £365m in 2023/2024 and a further £205m in 2024 to 2025.


The 2023 Autumn Statement had nothing new for adult social care.

Original funding pledges from People at the Heart of Care December 2021

In April 2023 the remaining £1.7bn set aside for wider system reforms was also reduced as part of the government’s new ‘next steps to put people at the heart of care‘ plan. Of the £1.7bn originally assigned, only £572m is actually detailed over the next two years. The government claims it will use up to £729m (including the £572m) over the next two years, with an additional £600m being held back to invest in discharge measures. The money committed comprises:

  • At least £250m for workforce reforms – note that this is a reduction from the original £500m and it removes the wellbeing elements of the reforms.
  • £100m for digitising social care (£50m of the original £150m has been used).
  • Up to £50m to encourage better personalised care by strengthening insight and joining up care through better data and local authority assurance.
  • At least £35m for a new Innovation and Improvement Unit in DHSC.
  • An additional £102m to increase the level of housing adaptation support available in local areas – this now appears to have been scrapped as well, alongside the £300m housing transformation fund.
  • Up to £35m to support joining up services for people and unpaid carers


Our initial response to this announcement in April 2023 can be read here.

Fair Cost of Care Reports and Market Sustainability Plans

As part of the charging reforms, DHSC set up a Fair Cost of Care and Market Sustainability Fund which funded LAs to run ‘fair cost of care’ exercises with care homes for over 65s and home care for over 18s, over the Spring and Summer of 2022 as well as money to help LAs move towards ‘the fair cost of care’ as flagged by these exercises. Originally, £1.36bn over three years was allocated to do this, but with the delay to reform, this has been reduced to £162m for each year 2022-2023, 2023-4 and 2024-25. However, the exercises did take place.

On 1 February 2023 LAs published their Fair Cost of Care Reports, outlining the median costs of various types of services. The map below allows you to find your LA’s Report. Our analysis in conjunction with the Care Provider Alliance shows that in 2021/22, the government paid at least £2.88 billion less than the actual cost of delivering care to people in their own homes, and in care homes for those aged over 65. 

On 27 March 2023, LAs published their Market Sustainability Plans, outlining the measures they will take to move towards the fair cost of care and ensure care markets are sustainable. We are in the process of analysing these.