It is widely acknowledged, by all shades of political opinion, that social care needs significant reform. Yet, it has not happened. Former Deputy PM Damian Green told delegates during his speech at Naidex 2026 that there have been around 22 attempts to analyse how to fix the sector’s problems since the early 1990s, and while some measures have been enacted, the system remains the same.
So why is this the case? According to a recent report from The King’s Fund, a leading think tank working to improve health and social care in England, one of the main reasons is that social care is simply not a public priority, and, therefore, it isn’t viewed as a vote-winning issue.
The report revealed that in a survey conducted by Ipsos in October last year, only 30 people out of 1,002 cited social care as an issue facing the country, and of these, just two cited it as the most important issue. Overall, social care was the 20th listed priority, behind the NHS, cost of living and immigration.
According to The King’s Fund, several factors contribute to social care’s low visibility as a public priority:
- Lack of understanding: People in England continue to have misconceptions about who provides social care and whether care services are free at the point of need.
- Fatalism: The public is fatalistic about change because there have been repeated attempts by governments to reform access to, and funding of, social care, but none have come to fruition.
- Fear and avoidance: Social care represents loss of independence, aging, and vulnerability, leading many to avoid the topic until they or a family member is in crisis.
- Reluctance to agree on how social care should be funded: The reality of paying for care is politically and publicly unpalatable, and there is little consensus on how costs should be covered.
Over the years, the care sector has launched countless campaigns to change public attitudes towards social care, but research suggests that these have not had the desired impact.
So how can providers and advocacy groups break this cycle, and finally turn social care into an issue the public is willing to vote for? The King’s Fund has offered the following approaches for campaigners to consider:
Clarify what motivates the ‘warm’ audience for social care
Around 30% of the public do not see social care as a ‘top-of-mind’ priority but do recognise it as a pressing issue once they are prompted. It would make sense to do more work with this audience to understand what is different about them compared with those who do not think it is a priority.
Reach people who influence attitudes to social care
Because few people have direct experience of using social care, attitudes about it appear to be driven by third parties, such as friends, family and the media. Social care could consider how it reaches out to these people and organisations, as well as people who work on the frontline.
Make use of the relationship between social care and the NHS
The most obvious way to win public support is to work out how best to link social care to the NHS in external messaging. There is evidence that social care is prioritised more when it is seen as being instrumental in improving issues that the public cares about most, particularly the NHS.
Accept that the public is in a different place from the social care sector
Campaigners need to recognise that the public’s views are rooted in a pre-Care Act understanding of social care. This has important implications for language and messaging. Ultimately, if the public is to support increased funding, such as through additional taxation, work may be needed to explain and build support for the Care Act principles underpinning social care – not simply meeting basic needs, but improving lives, for example.
Identify the social care ‘tangibles’ that resonate with the public
A more immediately profitable approach would be to clearly and consistently communicate the tangible factors that will be improved by more funding – for example, more people receiving publicly funded services, more staff, better pay, improved training, and (as with the NHS) shorter waiting times. These are more likely to resonate than focusing on abstract concepts such as choice, which may be harder for people to visualise.
Seek to build political consensus
Previous attempts by governments to reform social care may have increased public prioritisation but have tended to end in political damage. Therefore, attempts to achieve cross-party dialogue may be necessary for any government to take on social care reform, and campaigners may need to think how they can help expedite this process. Political consensus and public consensus will likely go hand-in-hand, so it will be important to understand not just what politicians of different parties say, but what voters for different parties want from social care reform.
Don’t start by talking about the money
The issue of how to raise money for social care reform is a contentious and confusing one for the public and therefore the most dangerous one for politicians. Although it cannot be avoided, it makes sense to try to resolve this towards the end of a process of reform rather than at the start, to avoid it derailing the whole project.
Find out what we still need to know
Campaigners need to think about how they can begin to answer some of these questions, as the basis for reform activity.
– What sorts of social care support do people most value? If more money was spent, what would people like it spent on?
– What drives the difference in satisfaction between people who use services, those who say they have ‘had contact’, and those who have no experience of social care?
– To what extent does media and public pressure affect government decisions to tackle social care?
– Who do people trust the most on the topic of social care – government, councils, providers, charities, people who use services?
– How much appetite is there for an increase in taxation (of any form) to pay for more/better social care?
– What arguments for more/better/different social care are most supported by people who do and do not prioritise it already?
And finally….
Present a more consistent and credible case for reforming social care
Over the years, two contrasting approaches to promoting reform have emerged in the social care sector: 1. ‘Fix’: this approach highlights the crisis in social care and its importance to keeping vulnerable people safe. 2. ‘Flourish’: this approach aims to encourage investment in a wider model of social care that focuses on people’s wellbeing and potential. The analysis of research in The King’s Fund report suggests that neither of these two main current approaches to social care campaigning will bring about reform by themselves. For social care reform to have the best chance of success, the hugely diverse and fragmented sector will need to evolve towards a more evidence-based strategy that supersedes these approaches.