In the autumn of 2022, the UK government faced critical decisions regarding adult social care reform in England. The adult social care sector was under severe strain, with record-high staff vacancies, financial instability among care providers, and growing demand for services. Meanwhile, the NHS was also stretched, with hospital discharges delayed due to limited social care capacity. A long-promised reform to cap lifetime care costs, based on the 2011 Dilnot Commission’s recommendations with an aim of preventing catastrophic care costs, was set to be implemented in 2023. But in November 2022, economic pressures – exacerbated by post-Covid-19 challenges and recent market instability – meant the Treasury was reassessing its £3.6 billion funding commitment for the policy reform amidst wider budget cuts. Local councils called for a delay given their difficult financial position, while advocacy groups like Age UK, which represented older people, urged immediate action, warning not to kick the decision into the long grass, like successive governments had before them. The Treasury, the office of Prime Minister Rishi Sunak, and the Department of Health and Social Care had to decide what to do.

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