Sir Andrew Dilnot, the economist who led the 2011 commission into social care funding, has warned that the government’s plan for an “NHS-style” National Care Service could take “many decades” to fully implement.
Speaking on 28 September 2026, Sir Andrew questioned the feasibility of the timeline and the projected costs of the proposal, which was recently outlined by Prime Minister Andy Burnham. The government’s vision involves a system where social care is free at the point of delivery, mirroring the principles of the National Health Service.
However, Sir Andrew described the likely cost of such a scheme as “very substantial.” He suggested that a service following NHS principles would require significantly more investment than currently acknowledged.
The 15-year wait for reform
The warning comes exactly 15 years after the original Dilnot Commission report was published in July 2011. That report recommended a cap on the amount individuals would have to pay for their own care, a policy that has been repeatedly delayed or scrapped by successive administrations.
Most recently, a planned £86,000 cap on care costs was officially cancelled by the Treasury in July 2024. This has left the social care system in England operating under long-standing rules that force many people to sell their homes to fund their later-life support.
Sir Andrew noted that while the ambition for a National Care Service is significant, the transition from the current means-tested model to a universal service would be a generational task. He pointed out that the country has already spent a decade and a half debating less radical reforms without reaching a resolution.
What the plans mean for current care costs
For those currently seeking or receiving care, the landscape remains unchanged despite the new national proposals. There is currently no cap on care costs in England. Under the current official charging guidelines for 2026 to 2027, the upper capital limit for state-funded support remains at £23,250.
Individuals with assets, including the value of their home, above this £23,250 threshold are generally required to pay the full cost of their care. Those with assets between £14,250 and £23,250 may receive some state help but are expected to contribute from their capital.
The government has not yet confirmed the specific funding mechanisms for the proposed scheme, leaving it unclear whether the National Care Service would be funded through general taxation, borrowing, or a specific new levy.
Next steps: The Casey Commission
The next major milestone for social care policy is the final report of the Casey Commission. Originally expected later, the report’s delivery is now due in the summer of 2027.
This commission is tasked with creating the roadmap for the National Care Service. Until that report is published and legislation is passed, the existing means-tested system will continue to determine how much citizens must pay for their support.
