There was a flurry of comment this afternoon after chancellor Rachel Reeves delivered the government’s Spending Review

Care England’ chief executive Professor Martin Green “This Spending Review gives the illusion of support without delivering the substance. Much of the funding is conditional, dependent on councils raising council tax to its limit – something many will avoid for political reasons – and channelled through NHS-led schemes like the Better Care Fund, a mechanism focused on the NHS and hospital discharge, not the broader care system that underpins it. The result is a system still starved of the funding it needs to function.

“There is no separate funding to deliver the Fair Pay Agreement. No ringfenced money to implement the Employment Rights Bill. And no support for the increased domestic recruitment costs triggered by the closure of the care visa route. Pushing these changes without addressing the financial reality undermines their credibility and effectiveness.

“We’re being asked to run faster on empty. This is not just a funding gap — it’s a credibility gap. If the Government wants to be serious about valuing care, then it must show it in the only language that matters investment.”

Care England called for three immediate commitments from government:

• Urgent funding injection to close the current underfunding gap in social care services and prevent further deterioration in support for those who rely on care.
• A dedicated and separate funding package to deliver the Fair Pay Agreement – essential for implementing improved pay, terms and conditions for care workers, without which no agreed wage deal can be realised.
• A ring-fenced, multi-year funding settlement for the social care sector to invest in its future, grow workforce and service capacity, and meet rising demand sustainably – including the implementation of the Employment Rights Bill.

Green concluded: “We can’t build a better future for social care with promises. We need the foundations first – and that starts with funding that is immediate, protected, and fair.”

David Hare, chief Executive of the Independent Healthcare Providers Network, said: “With today’s announcement of above-inflation increases in day-to-day health spending, the public will expect to see clear improvements in their ability to access the care they need.

“The Government have consistently made crystal clear that their core priority for the NHS is cutting waiting lists and getting the service back to meeting its 18-week target.

“Maximising the use of the independent sector is going to be critical in achieving this. Last year independent healthcare providers removed over 1.5 million people from NHS waiting lists and the sector are keen to make an even bigger contribution, as set out in the recent NHS & Independent Sector Partnership Agreement which makes clear the need for local areas to make greater use of the sector to drive down waiting times for patients.

“More broadly, while the Spending Review does commit to a small increase in NHS capital budgets, this will not be enough to meet the huge need for investment in new and expanded NHS services. There is a real appetite in the independent sector to partner with the NHS and invest in new state of the art facilities in local communities all across the country – from hospitals to diagnostics services and primary and community care – and we are committed to working with our colleagues in Government and the NHS to bring these partnerships to life. 

The National Care Association put out a statement: “The National Care Association, representing members within our organisation and through Providers Unite, is deeply concerned following today’s spending review announcements. While the review clearly prioritises certain industries for investment, it once again excludes social care, a vital sector that supports the most frail and vulnerable in our society. This continued omission is not only short-sighted but devastating for communities.

“The Chancellor spoke about the crumbling framework which needed investment, and the importance of a £29bn commitment to the NHS. Yet, she failed to acknowledge social care as an essential part of the health and care system, providing critical support to NHS colleagues and enabling effective delivery of acute care services.

“Once again, this government has chosen to disregard our sector that contributes £68 billion into the economy and is constantly being asked to take on additional healthcare tasks without recompense.

“We further note an increase of over £4 billion in funding for adult social care in 2028–29 compared to 2025–26. However, we urgently require the details of this funding now.

“Providers and local authorities need clarity and certainty today, not in three years’ time to ensure services remain viable and the workforce is supported.

“This urgency is compounded by a well-documented workforce crisis, which has been exasperated by years of government inaction. While the Chancellor referenced the Fair Pay Agreement for the sector which has been widely welcomed to improve the pay terms and conditions of our devoted workforce, however, once again there has been no commitment to this being fully funded.

John Ramsay, founder and managing director of Social-Ability said: “On behalf of the social care sector, I’m once again disappointed by the Government’s lack of focus and meaningful reform. Shocked? No. The first-ever fair pay agreement is a step forward – but nowhere near far enough to fix a broken care system. Despite Rachel Reeves calling social care fundamental to healthcare and multiple mentions of Carers Week during Prime Minister’s Questions, there’s still no clear plan or reform programme. The spotlight remains firmly on the NHS.

“Investment in the NHS alone won’t fix the problem. Without proper support for care homes and staff, people’s wellbeing will deteriorate, and pressure on hospitals will become unbearable. Social care cannot be an afterthought in the future NHS – it must be central.

“This crisis is growing. Dementia cases are set to rise 40% in 15 years, and our ageing population demands a properly funded, sustainable care system – now. Bed blocking remains a major barrier, with one in four hospital beds occupied by dementia patients who could be better cared for outside hospitals if social care was fit for purpose. Meanwhile, one in four adult carers and two million child carers live in poverty. Without urgent investment and reform, the strain on health and social care will only grow – putting millions more at risk.

Melanie Weatherley co-chair of the Care Association Alliance, said: “The Care Association Alliance is disappointed that the 2025 Spending Review, once again fails to deliver the urgent investment and reform needed to support adult social care. Despite repeated warnings and cross-sector calls for action, the government has chosen not to address the critical funding gap nor introduce a clear requirement for the NHS to work in genuine partnership with social care services.

“The absence of any significant uplift in funding for adult social care will continue to place unsustainable pressure on local authorities, care providers and  – most importantly – those who rely on care every day to live with dignity and independence.

“Equally troubling is the Spending Review’s silence on structural collaboration. The lack of a statutory requirement for the NHS to work hand-in-hand with social care undermines efforts to build integrated, person-centred care systems and leaves vulnerable people at risk of falling through the cracks.

“This was a pivotal moment for the government to demonstrate leadership and a long-term vision for care. Instead, the review is a missed opportunity that will deepen the crisis in social care and strain our health services even further.”

Laura Jordan, partner and head of corporate in the governance, funding and corporate team at law firm Anthony Collins, said: “Without a plan to tackle the social care crisis, the Government’s NHS spending plan won’t work. The NHS can’t thrive without better social services.

“We have fantastic people working in the care system in this country, who go above and beyond to deliver exceptional services to the people and families they support. But the system is broken and it can’t continue to run on fresh air, hard work and kindness.

“Social care services for vulnerable or disabled children, adults and elderly people aren’t a nice-to-have, they are essential to our way of life. It is a statutory obligation for local authorities to meet the needs of vulnerable and disabled people, but without the means to award reasonable fee uplifts to providers, they can’t do anything to help.

“Instead of addressing the social care crisis, Government has added to the challenges that social care providers are facing by changing the immigration rules, which will cause current worker shortages to worsen, and cutting benefits which will increase demand. Providers can’t operate without staff and adequate funding to deliver services, and more businesses will close as a result.

“Research has shown that a third of social care providers are considering exiting the market in the year ahead. This means the remainder will be spread too thin, and the people receiving support will end up paying the price.

“Baroness Carey’s Social Care Commission could make a difference, but the process is too slow and may not be able to deliver any meaningful benefits in time. The Government is ignoring social care and failing to recognise what an important role it plays in freeing up hospital beds and optimising NHS resources.”

Stephen Sorrell, social partnership director at Preferred Homes, commented: “The sector has been standing by for clarity about the next phase of the Affordable Homes Programme since this government came into office.  The significant new money announced today and an extension of the programme to 10 years will be transformative for registered providers looking to bring forward long-term pipelines – as well as for attracting further investment from institutional pension funds and other third parties into affordable housing.

“Further detail is still needed on changes that will unlock delivery of large-scale portfolios, and we will work closely with Homes England as an Investment Partner to ensure extra care housing providers like Preferred Homes can benefit from the new programme.

“With day-to-day departmental spending constrained for the foreseeable future, supported affordable housing which brings social care provision under the same roof will allow older people to retain their independence for longer and ultimately save money for local authorities and the NHS. When making capital investments in our most important social services, the government must consider the causal link between housing, health and social care – and support our sector to improve outcomes for our society’s most vulnerable older people.”

Ian Burgess, managing director and chief technology officer at Canary Care, said: “Today’s funding boost for social care and technology is a welcome step in the right direction, but the sector is in crisis and needs urgent, tangible action. The government’s commitment to more than £4 billion in additional adult social care funding and a near 50% increase in NHS tech investment by 2028-29 must be supported by significant reform.
These headline figures are set against the backdrop of a sector under immense pressure. Too often, social care is left behind in the digital revolution; investment must go beyond headline numbers and deliver real digital transformation where it is needed most.

“We heard much about the digital healthcare agenda when Labour came into power. It is time for them to start delivering. We need to move from pilot schemes and patchwork funding to systemic, scalable change. The government’s increased spending must directly support digital maturity in social care – not just in infrastructure, but also in skills, training, and the deployment of proven technologies such as remote monitoring and smart analytics.”

Suneel Gupta, head of private healthcare at audit, tax, and consulting services provider RSM UK, said: “The NHS has come out as one of the winners in today’s Spending Review, however, this boost will be consumed by pre-existing pressures faced by the UK’s healthcare system. The Chancellor’s 3% average annual real terms growth in NHS day-to-day spending is crucial to meet their goals of shifting from hospital to community care, sickness to prevention, and analogue to digital. But it’s unclear exactly how and where they will spend this money. The additional funding must be used effectively, including towards greater collaboration between the private sector and NHS, as well as investment in technology to deliver these objectives. It is key progress is monitored closely to ensure they achieve an appropriate return on investment, and relevant parties are held accountable.

“While the Spending Review included an increase of over £4bn for adult social care in 2028-29, this falls short of what is needed in the sector. The Chancellor also mentioned a fundamental reform across social care, but details are lacking on what this will look like in practice. The reform must include breaking down silos in social care, the NHS and wider healthcare industry to allow better connectivity and alignment between social care and the wider health ecosystem. Without this, it’s unlikely we’ll see a notable improvement in end-to-end care for patients.”

Sam Monaghan, chief Executive at MHA , said: “We are pleased that the chancellor has acknowledged the need for ‘fundamental reform’ in social care and that the government recognises the significant challenges facing the adult social care system. 

“Whilst we welcome the increase of over £4 billion of funding available for adult social care in 2028-29, it is imperative that the Government spell out the detail through the better care fund as soon as possible to provide certainty, although this is a drop in the ocean compared to the extra £29bn made available to the NHS. 

 “The increase in grant-funding for local government, must translate into additional funding to ensure the true costs of care are met. Providers have seen increased costs over the past decade with chronic underfunding of council-funded care placements over many years have been intensified by Covid, the cost-of-living crisis, energy price hikes, a workforce crisis and increased national insurance costs. This is not sustainable.”

Sarah Jones, chief executive at Anchor, said: “The government recognises the significant challenges facing the adult social care system and is committed to transforming the sector and supporting the care workforce. Baroness Louise Casey is leading an independent commission to build consensus on reform of adult social care. The first phase will report in 2026 and will focus on how to make the most of existing resources to improve the system. The Spending Review allows for an increase of over £4 billion of funding available for adult social care in 2028-29 compared to 2025-26. This includes an increase to the NHS’ minimum contribution to adult social care via the Better Care Fund, in line with DHSC’s Spending Review settlement. This will support the sector to improve adult social care, with further details to be set out shortly.”

Jim Kane, chief executive at Community Integrated Care said: “Fixing the NHS means reforming social care – yet today’s Spending Review delivered soundbites without substance. While the Chancellor acknowledged the vital relationship between the NHS and social care, she failed to offer meaningful, immediate steps to strengthen that partnership or address the significant challenges facing our sector.

“Support for the Casey Commission and the Fair Pay Agreement is welcome, but in the absence of clear timelines or funding, creates confusion and frustration for a sector that has grown tired of words with no action. This was a missed opportunity to provide the clarity, certainty, and investment that social care urgently needs. Despite a headline announcement of £4 billion in 2028/29, there’s no indication of how this will be used, who it will reach or when. We need that information now.

“Social care has the power to transform lives, strengthen communities, and build the resilience of our NHS. But real reform relies on ring-fenced funding, fair pay for our workforce, and a long-term plan that places social care at the heart of a strong, healthy society. It is also essential that this new NHS investment doesn’t just relieve short-term pressures but actively tackles the deep health inequalities experienced by people with care and support needs. They deserve better access, better treatment, and better outcomes – and the funding now exists to make that a reality.

“Without a clear plan, we remain concerned that what looks like progress on the surface, is not being matched by the decisive action required beneath it. We urge the government to move beyond rhetoric and commit to real, lasting investment in our sector.”

Unison general secretary Christina McAnea said: “The chancellor is trying to turn the page on the austerity disaster inflicted on communities across the UK by successive Conservative governments.

“Ministers know investing in key public services is the best way to undo the damage of the past and grow the economy of the future.

“Fourteen years of cuts and underfunding have wreaked devastation on every aspect of public life. Town centres are dilapidated, roads riddled with potholes, NHS waits too long and people feel unsafe on the streets.

“But the government could make it easier on itself by shifting the dial on taxation. Bringing in a wealth tax would generate extra money that could help fix broken Britain.

“Building thousands of affordable new homes will be music to the ears of thousands of teaching assistants, hospital porters, university security guards, town hall cleaners and other low-paid public service workers.

“More social housing means they’ll be able to live far closer to their places of work in future. In the meantime, the extension of the £3 bus-fare cap will help people better afford their commutes.

“Although the NHS will be getting an extra funding boost, the reality on the ground now is very different. Health trusts across England are making damaging cuts to jobs and services under ministers’ orders to balance this year’s budgets.

“Extra cash will always be gratefully received by hard-pressed councils. But their financial situation is so dire, it’ll take much more than £3.4bn to put them back on track.

“It’s disappointing too there was no extra cash announced to stop disability benefits being slashed. Cuts to personal independent payments mostly affect those in work and will make it much harder for them to stay in their jobs.”