Care sector leaders and key organisations across the UK have voiced a mixed but largely cautious response to Chancellor Rachel Reeves’ first spending review, unveiled this week.
While the announcement included pledges to support the health and social care workforce and investment in infrastructure, many within the residential and nursing care home sector warn that the measures fall short of addressing the deep-rooted funding crisis and growing demand for services.
Speaking to The Carer, industry figures stressed the urgent need for sustained investment, workforce reform, and long-term planning to secure the sector’s future.
Professor Vic Rayner OBE Chair of the Care Provider Alliance says:
“The government has said that the Spending Review allows for an increase of over £4 billion of funding available for adult social care and support in 2028-29 compared to 2025-26, but it is not clear what exactly that comprises.”
“In the House today, the Chancellor spoke of the government’s plans for a new national Fair Pay Agreement for social care and support workers, but she did not announce money ringfenced specifically to fund this agreement.”
“It’s imperative for a Fair Pay Agreement to work that long term and sustained ringfenced funding is provided, otherwise the moneys will inevitably need to be taken out of allocations elsewhere, which will lead to difficult decisions on how to fund fairer pay for our amazing care and support workers.”
Professor Martin Green OBE, Chief Executive of Care England, said:
“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.”
Nadra Ahmed CBE, Co-Chair of National Care Association said:
“It is beyond my comprehension that Social Care remains such a low priority from this government with the choices that they have made.
The fact we have over half a million people waiting for their Social Care assessments, hospitals are struggling daily to discharge people into communities, and we have a circa of 6 million unpaid carers, worryingly doesn’t appear to give the Chancellor any cause for concern”
Jim Kane, Chief Executive Officer 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.”
Frances Lawrence, CEO, Dementia Carers Count said:
“Additional funding for the NHS is very welcome, but today’s spending review continues to leave the burden of social care squarely on the shoulders of unpaid carers.”
“Today’s spending review was a chance for this government to set out its ambitions and priorities. Dementia carers are desperate to hear if the social care sector will finally receive the recognition and investment it so desperately needs.”
“For the one in two dementia carers caring with no support, the Chancellor’s spending priorities will feel like a missed opportunity.”
“Unpaid dementia care has been valued at £21bn. For dementia carers, caring comes at great personal, emotional, physical and financial cost.”
“The additional funding announced for the NHS is very welcome. However, we know all too well that investing in the NHS at the expense of other services is not the solution. This could even cost more in the long run.”
“The Health Foundation estimates that an extra £3.4bn will be needed by 2028/9 to meet the costs of social care. This figure rises to £6.4bn if care packages are improved.”
“Yet far from outlining the funds needed to deliver a national care service fit for the 21st century, what has been announced today will barely register for the nearly 1m dementia carers struggling across the UK. Many are already grappling with the impact of a reduction in their welfare benefits.”
“While we look to the Casey Commission for ambitious reform of social care in future, what help is there for dementia carers right now”?
Spending Review, Jennifer Dixon, Chief Executive of the Health Foundation, said:
NHS: “Given the economic and financial challenges facing the government, a real terms funding increase of 3% a year is a good settlement for the NHS. But how far the money stretches and how much it benefits patients – will depend on how much is needed to fund pay settlements for NHS staff and how well the money is spent.”
“While welcome, the extra funding is below the long-run average growth rate, so budgets will still be tight and it is essential that the NHS is fully focused on getting maximum value from every £ it spends. The government’s 2% annual productivity target for the NHS, confirmed today, is a huge ask, especially with capital investment in buildings and equipment looking constrained for the rest of the parliament, despite Lord Darzi’s warning last October about the consequences of longstanding capital starvation in the service.”
“The additional funding for technology is welcome as a first downpayment on a long-term settlement to digitise the NHS. The focus needs to be on implementation to ensure the NHS realises the benefits and patients get the 21st century care they have been promised.”
Social care: “Our research shows that 1 in 5 residential care staff are living in poverty, so we welcome the commitment to implement a new fair pay agreement for the social care workforce. But an overall increase in funding of £4bn for social care by 2028/29 is only enough to prevent a further deterioration in services and will not be sufficient to fund increases in pay or improve access to or quality of care. “
“The need for investment and reform grows ever more urgent for all the people currently going without the care they need, so we encourage the Casey Commission to move as quickly as possible with its review and to hold ministers to account for taking the action their predecessors ducked.”
Kathryn Smith OBE, Chief Executive at SCIE said:
“The Social Care Institute for Excellence (SCIE) submitted a representation to the Spending Review in February, highlighting that the social care sector urgently needs targeted investment in prevention, workforce stability, housing with care, and integrated community-based support. Without this, progress towards a National Care Service and the Government’s own missions will continue to stall.”
“Today’s announcements are a step in the right direction—but far from the bold, coordinated investment needed for effective reform,”
“Social care is not a standalone service and it does not operate in a silo. It interfaces with housing, healthcare, and mental health support. The care system can play a role in alleviating pressures across other public services, but without stable funding and investment, it could also compound them. In other words, the Government’s vision for the country depends on an appropriately resourced social care sector.”
Sarah Woolnough, Chief Executive of The King’s Fund, said:
Despite the tough economic climate, the government has prioritised health services by continuing to increase spending on the NHS for the rest of this parliament. A 2.8% average increase in total health department spending – 3% for day-to-day NHS spending – will have been hard-fought for in the spending round negotiations, despite still being lower than the historical average the NHS has received over recent years. A key challenge now will be for NHS to decide how it can deliver most value from the money that has been allocated.”
‘We know there are already trade-offs happening in the NHS due to tight finances. The Chancellor said she wants the public to have ‘an NHS there when they need it’. It is hard to see how all the things she mentions – faster ambulance times, more GP appointments and adequate mental health services and more – can be met on this settlement alone. Particularly when large parts of this additional funding will be absorbed by existing rising costs, such as the higher cost of medicines, which are currently being negotiated, and covering staff pay deals. But there is a huge opportunity offered by the government’s upcoming 10 year plan for health, so we will wait to see how this money will be translated into better, more efficient services. “
‘We welcome a firm commitment to introducing a Fair Pay Agreement for social care workers, a measure to incentivise people to work in social care which can’t come soon enough given the government has already limited overseas recruitment. But there is worryingly little detail of how much this would cost and if it would come out of the relatively small amount of additional funding announced for social care, which would leave little left for other fundamental improvements to our ailing system.
‘The NHS has faced financial pressure for more than a decade, but the signals of financial distress across the NHS have grown in recent years. This matters because financial pressures absolutely have an impact on the care patients and the public receive.
‘Today’s announcements show how much the government is willing to spend on the health service but the real prize will be the vision of a better and more sustainable health care service that will be set out in the forthcoming 10 year plan’.
