A nationwide consultation on the future of adult social care in England has been launched, inviting members of the public to help shape long-term reform of a system repeatedly described by officials as unsustainable in its current form.
The Big Conversation on Care, announced by Baroness Casey of Blackstock, forms part of her Independent Commission on Adult Social Care, which is now expected to publish its findings next year. The commission aims to engage with one million people across England over the next ten months through a newly established online platform, open to the public, care workers, families and professionals within the sector.
According to a statement from the commission, the exercise will run in two phases. Between July and November, the focus will be on establishing what values and principles the public wants a care system to reflect, along with views on who should be eligible for state-funded support. A second phase, running from December to April 2027, will examine how social care should be funded and how any reforms would be implemented in practice.
Baroness Casey said the initiative represented "the most ambitious public conversation in a generation", intended to give the public "a direct role in shaping" adult social care. She said previous efforts to reform the sector had repeatedly stalled because governments had attempted to resolve difficult policy questions without first securing public understanding and consent.
"For too long, we have been stuck in the same cycle: crisis, promises of reform, another review, and then retreat, while the people who need care, and their families, bear the brunt," she said. She added that social care affects "every family in this country", whether through direct need for care, responsibility for a relative, employment in the sector, or through taxation that funds it.
"It is only by listening to the public that we can build the agreement needed for lasting reform," Baroness Casey said.
The consultation opens with a broad question posed to the public: when people become old, disabled or seriously ill, who should be responsible for supporting them, and how should that support be arranged. Officials say the answers gathered will help inform decisions on some of the more contentious aspects of reform, including the boundaries of family responsibility and the mechanisms for funding care fairly and sustainably.
The launch follows earlier warnings from Baroness Casey, who has previously described the adult social care system as "broken". In March, she called on ministers to take six immediate measures addressing dementia care, motor neurone disease support and adult safeguarding, citing the urgency of reform in those areas.
Alongside the launch, Health Secretary Andy Burnham confirmed he had invited representatives of the main opposition parties to take part in discussions on social care reform, a move interpreted as a signal that the issue is becoming a more prominent feature of the wider policy agenda. Mr Burnham also said he had asked Baroness Casey to bring forward her final recommendations, moving the expected reporting date from 2028 to summer 2027.
The commission was established amid long-standing criticism that successive governments have failed to deliver lasting reform to adult social care, despite multiple reviews and policy proposals over the past two decades. Funding models, eligibility criteria and the balance between state and individual responsibility for care costs have remained points of dispute across administrations.
Reaction from organisations working within the health and care sectors has generally welcomed the decision to prioritise public engagement, while emphasising the importance of ensuring that those directly affected by the system are meaningfully included in shaping its outcomes.
Hugh Alderwick, director of policy and research at the Health Foundation, said it was "right to engage the public on the options for reform and build momentum for change".
Sarah Woolnough, chief executive of the King's Fund, said it was encouraging to see confirmation that the Casey Commission intended to conduct substantial engagement with the public. She said people who rely on care and support "are closest to the system's shortcomings and best placed to explain where it is failing", adding that this should include working-age adults who depend on social care to live independently, as well as older people. "Their voices should not be lost," she said.
James White, head of campaigns at Dementia UK, said a national conversation of this scale presented an important opportunity to hear directly from people who use social care services and the families who support them. He said it was essential that people affected by dementia were placed "at its heart", and that their experiences should meaningfully shape both the commission's recommendations and the government's eventual response.
The consultation comes at a time when demand for adult social care in England continues to rise, driven by an ageing population and increasing numbers of working-age adults requiring long-term support. Local authorities, which are responsible for administering means-tested care, have repeatedly warned of financial strain linked to rising costs and constrained budgets.
The government has not set out detailed proposals for a National Care Service ahead of the commission's findings, with ministers instead framing the consultation as a necessary precursor to any structural reform. Officials have indicated that decisions on funding models and eligibility will depend in part on the outcomes of the public engagement exercise.
With the commission's reporting timeline now brought forward to summer 2027, the coming months are expected to determine how directly public opinion, gathered through the Big Conversation on Care, will influence the design of any future national system. The consultation's conclusions are likely to inform cross-party talks on reform, though the shape and timing of any legislative changes will depend on the commission's final recommendations and the government's response to them.
