A major shift is underway in healthcare with the Government having announced the abolition of NHS England. 

This radical restructuring, which could result in up to 30,000 redundancies combined with cuts at ICBs, comes at a crucial time – for both the NHS and social care. As Lord Darzi's investigation observed, the NHS's financial and operational sustainability cannot be achieved without strengthening social care. Health and social care cannot function effectively in silos; they are interdependent – and adopting a holistic approach that considers someone's journey across the health and social care systems is essential.

Social care plays a crucial role in alleviating the immense strain on NHS high-acuity services by reducing discharge delays and preventing unnecessary (and costly) admissions and readmissions – but also, and more importantly, allowing people to live rich and fulfilling lives. According to recent NHS England data, patients who are medically fit for discharge occupy 13,767 hospital beds per day.

The path forward is clear: achieving the NHS reforms will depend on a parallel investment in social care services. This is the case for all three policy shifts expected in the NHS 10-Year Plan.

Through local care services we can deliver personalised, high-quality and financially sustainable services that meet the care needs of people in their communities and allow them to live independently for longer – thus improving NHS efficiency.

What's needed is tangible investment and prioritisation of all community services to relieve the strain on local health and care systems.

However, in its current state, the social care sector faces significant and critical challenges: inflation, demographic and epidemiological changes, falling recruitment and retention, and rising demand are placing immense pressure on care and support services and impacting their quality and availability. As a result, the sector relies heavily on unpaid carers who, sadly, often do not get the recognition or support they deserve.

As the Government takes hands-on control of the NHS, we encourage it to look backwards in order to pave a way forward. During Covid, SCIE observed both health and care leaders working more collaboratively. We found that NHS-funded post-discharge care packages significantly improved the timeliness of hospital transfers and reduced lengthy hospital stays.

The human case for joint investment is critical. Take intermediate care, for example. 

Intermediate care services are provided to patients, usually older people, after leaving hospital or when they are at risk of being sent to hospital. 

Our research indicates that 70% of people who received intermediate care after a hospital stay returned to their own homes, while 72% did not move to a more dependent care setting – giving them the crucial opportunity to maintain their independence, dignity and quality of life.

The economic case for investment is also compelling: wider sector research demonstrates that every £1 invested in earlier action and support, including intermediate care, achieves an ROI of, on average, £3.17. Acting on known interventions shouldn't depend on where the benefits accrue. We should consider the effects on ‘whole systems' instead.

Beyond funding, we also need to find new ways to deliver social care more efficiently and effectively. For example, there are substantial opportunities to enhance post-discharge assessments and care, particularly through reablement services. 

Reablement is a short-term, intensive intervention aimed at helping individuals regain or maintain their independence after events like hospital admissions.

SCIE published a series of evidence-based and practical recommendations in 2024 in our Supporting client and family engagement with reablement resource to address the barriers that can prevent people from fully benefiting from reablement. 

Resources like this can help streamline care delivery, ensuring that support is targeted, timely and productive.

The Government's vision is for an NHS that is both resilient and sustainable – but turning that vision into reality requires decisive action. The adult social care sector, employing approximately 1.59m people and contributing approximately £68.1bn to our economy annually, is a ‘sleeping giant' of largely untapped potential.

If we get future reforms right, we can tackle the pressures facing both health and social care and create systems that are fit for the future.