What is the National Care Service and will care homes be free?

Prime Minister Andy Burnham has announced plans for a new National Care Service in England. These plans include offering free personal care to those who need it.

If you or someone close to you lives in a care home, you may wonder whether these plans will change how much you pay. This guide explains the proposals and what they mean for care homes and your family members who live there.

What is the National Care Service?

The proposed National Care Service (NCS) aims to provide personal care based on people’s needs rather than their ability to pay, with public funding covering the cost.

Currently, adult social care in England is different from healthcare.

• NHS medical care: Available to everyone free of charge whenever they need it.
• Adult social care: Strictly means-tested. In England, people with capital above £23,250 will usually need to pay for their own social care. However, some assets, including property in certain circumstances, may be excluded from the financial assessment.

The proposed NCS would change this by providing free personal care based on need, not what older adults can afford.

Free personal care would not mean that care home stays are completely free. Under the proposals, eligible personal care would be publicly funded, but residents might still have to contribute towards accommodation and everyday living costs, depending on their circumstances.

Why is a National Care Service being introduced?

The NCS aims to address challenges in England’s social care system, including rising demand, funding pressures and differences in the support available across the country.

The Prime Minister has highlighted the close connection between social care and healthcare. When people cannot access the support they need, they may spend longer in hospital after they are medically ready to leave. This can put additional pressure on NHS services.

The NCS aims to tackle six main problems in social care:

• Postcode lottery: Unlike the NHS, which is free for everyone no matter where they live, social care varies widely by region. Local councils decide who gets care and what kind, based on their own budgets.
• Individual care costs: Social care is means-tested, with a strict upper capital limit of £23,250 in England. People with capital above this will usually need to pay for their own care. Although certain assets may be excluded from the financial assessment.
• Strain on local authority budgets: Local councils pay for adult social care, but many councils have cut extra services. Or they have made it harder to qualify for care, creating serious financial problems.
• Recruitment struggles: The care sector faces staffing shortages due to low pay, poor job security, restrictions on overseas recruitment, and low domestic uptake.
• Delayed hospital discharges: Patients sometimes stay in hospital beds because care home beds are scarce. This can prevent other people accessing hospital care.
• Ageing population: More people are living longer, often with several long-term health problems, such as dementia. Every year, more people need social care, but the system cannot keep up with the growing demand and limited funding.

What has the government announced?

At the Labour Party Conference on Tuesday 29 September 2026, Prime Minister Andy Burnham explained the government’s plan for a publicly funded NCS.

Key elements of the proposal

• Main proposal: Free personal care for all older adults based on need, not ability to pay, protecting people from very high care costs as they get older.
• Core principles: Based on the NHS, focusing on early prevention, helping people stay independent at home, and combining health and social care services.
• Casey Commission role: Baroness Louise Casey and the Independent Commission on Adult Social Care are developing the plan for how the service will work and be funded.
• Expected timetable: The government plans to develop the NCS following the Casey Commission’s recommendations. The exact start date is not yet confirmed.
• Legal status: The proposals have not yet become law. Existing social care funding rules, including England’s £23,250 upper capital limit, continue to apply.

Legal experts support the ambitious plans but also point out the challenges ahead. James Arrowsmith, a partner in social care at Browne Jacobson, says: “Putting social care on an equal footing with healthcare is vital if we are to manage NHS resources. With this in mind, a National Care Service is the type of bold idea the UK needs to engage with the ageing population challenge.”

However, Mr Arrowsmith warns that there are still important structural questions: “What is uncertain is whether, and to what extent, structural change may be part of a move to a National Care Service. This includes questions as to whether responsibility will stay with local government in the long term, how funding will be calculated and distributed, and what the role of the private sector will be.”

Will care homes be free under the National Care Service?

No, care homes won’t be completely free. Even if personal care is free, similar to how it is Scotland, residents may have to pay for accommodation and living expenses. This depends on their situation and any financial support they’re entitled to.

Personal care	Help with basic daily tasks like washing, dressing, eating, and using the toilet. The proposed NCS would cover eligible personal care needs, although the assessment and funding arrangements have not yet been confirmed.
Nursing care	Medical care given or overseen by registered nurses. Eligible nursing home residents already receive NHS-Funded Nursing Care, which contributes towards the cost of nursing provided by registered nurses. People who qualify for NHS Continuing Healthcare have their full eligible care costs covered. It is not clear yet whether the NCS will also cover nursing care
Accommodation	Your care home room and the building’s facilities. The NCS does not cover these costs, but existing council means-tested support will remain for low-income residents.
Food & living costs	Residents may need to contribute towards the costs of meals, heating, laundry and general upkeep, depending on their income, savings and eligibility for financial support.

What could free personal care mean for care home residents?

If introduced as proposed, free personal care could reduce what some care home residents pay for help with washing, dressing, eating, and other everyday activities. This could include:

• Washing and bathing: Help getting in and out of the bath or shower, washing hair, or bed baths for residents with restricted mobility.
• Dressing and grooming: Help with putting on clothes, shoes, fasteners, and personal care like shaving, nail care, and hair care.
• Using the toilet: Help getting to the bathroom, managing incontinence, and staying clean.
• Eating and drinking: Help cutting food, feeding, and encouraging fluid intake.

When will the National Care Service start?

The government plans to establish the NCS in stages over the next Parliament, but it has not confirmed the exact start date for free personal care.

Changes to the State Pension Triple Lock from April 2030 are intended to help fund the service. Until new legislation takes effect, existing social care funding rules continue to apply.

Will the National Care Service replace local authority care?

The current proposals do not set out plans to remove local councils’ responsibilities for assessing care needs and arranging adult social care.

The aim is to make care more consistent across England, while allowing local councils to continue arranging services for people in their communities. The proposals also aim to make it easier for the NHS and social care services to work together.

Will the National Care Service be like the NHS?

The proposed NCS would follow some of the NHS’s principles, including providing support based on need. However, social care would still focus on helping people with everyday activities and maintaining their independence, rather than providing medical treatment.

What does the National Care Service mean if I need a care home now?

If you or a family member needs care right now, start making arrangements based on the current funding rules, as the NCS proposals are still being developed.

“Andy Burnham’s speech certainly inspired hope. We are beginning to see this political will translate into action – prioritising a culture where care professionals can thrive and develop must remain a continuing priority.“

— Laura Chinyere-Ezeh, Senior HR Consultant at Browne Jacobson

If you’re arranging care or reviewing care costs, the following support may be available:

• Care Needs Assessment: Contact your local council to arrange an assessment of your care and support needs. This can help identify the support that may be available.
• Financial Means Test: If your assessable capital is above £23,250, you will usually need to pay for your own care, although some assets may be excluded depending on your circumstances.
• NHS Continuing Healthcare (CHC): If you have complex long-term health needs, ask whether you may qualify for an NHS assessment. Eligible people can have the NHS fully fund their assessed care needs, including care home accommodation.
• NHS-Funded Nursing Care (FNC): If you live in a nursing home and need care from a registered nurse, ask whether you qualify for an NHS contribution and how it is reflected in the home’s fees.

Does the National Care Service apply across the UK?

No, the National Care Service plans apply only to England. Social care rules are handled separately in different parts of the UK:

Wales and Northern Ireland both have their own social care funding rules and eligibility criteria.

Scotland already provides free personal and nursing care for eligible people, although you may still need to pay for accommodation and living costs.