Local Solutions’ response to the Prime Minister’s plans for a National Care Service

On 29th July 2026, the Prime Minister set out a renewed national commitment to social care: a National Care Service, designed to sit alongside the NHS rather than inside it, with prevention, homecare and a valued workforce at its heart. Baroness Casey’s Independent Commission has been asked to report a year early, by summer 2027, and the Big Conversation on Care now invites the whole country to help decide what care is for and how we pay for it.

We welcome that direction. It is the most serious attempt at reform in a generation, and its instincts are right: keep people well and at home, and build the system around the person rather than the institution.

The question that matters now is a practical one. How does national ambition become support that people can see and feel in their own homes, and who is trusted to help build it?

Local Solutions has delivered social care for more than 25 years. We are one of the largest voluntary sector organisations in the Liverpool City Region, and our services also reach across North Wales and into parts of Coventry, Warwick and Wigan. Working across several local systems, and on both sides of the England and Wales border, has taught us something a single-service view can miss: good care does not begin at the hospital door, and cannot be designed around one boundary. It begins with the whole person, not a single presenting need.

This is where communities and the third sector are essential. We are not standing outside the care system waiting to be invited in. We are already delivering it, supporting unpaid carers and helping people navigate services that do not always fit together.

A National Care Service should be built on what already works in communities. This is our contribution to the Big Conversation.

What matters is what changes at home

In 2025/26, Local Solutions delivered 396,620 hours of care and supported 35,486 people across all our services. Social sector organisations like ours tend to keep and grow wealth within the communities they serve, and often give back more than they cost. For us, that works out at somewhere around £1.58 for every £1 invested.

Those numbers show our scale. But the real measure of our work is not scale. It is what it allows people to keep: their independence, and their place in the life they know.

For Lucy, who is living with Motor Neurone Disease, good care means being able to stay at home with the people who mean everything to her. As Lucy’s condition has progressed, our Homecare team has adapted the support it provides, and taken on additional training so that she can go on receiving safe, dependable care as her needs change.

Continuity is central to that. Familiar carers understand how Lucy communicates and how care fits around family life. She and her family are not asked, again and again, to explain intimate needs to someone new. Among those familiar faces is Anita, whose warmth and companionship have helped build a relationship founded on trust.

Lucy put the difference plainly:

“I couldn’t live at home without these carers.”

That is what national decisions about care must ultimately make possible.

Social care is too often discussed only in terms of hospital capacity and delayed discharge. Those pressures are real, but care is not simply a way of freeing beds. It protects people’s dignity and their ability to live an ordinary life. By the time poor support ends in a hospital admission, the effects have usually been felt at home for weeks or months already.

Prevention must be funded, not just promised

The Prime Minister is right to put prevention and independence at the centre of a National Care Service, delivered as far as possible through care at home. That is exactly where a locally rooted third sector already works.

For that commitment to mean anything, resources have to reach the organisations supporting people before their needs escalate. Prevention can be practical help that reduces the risk of a fall. It can be adapting care as a condition changes, or reaching an unpaid carer before they are worn out.

Set against an emergency admission, this kind of support can look small. Its value lies precisely in the crises that never happen. That is also what makes prevention hard to fund: the return shows up as cost avoided rather than activity delivered, and our system is far better at counting activity. But prevention is better understood as an investment than as a cost. Money that keeps someone well at home returns far more than it costs, in admissions avoided and in independence that lasts longer. At Local Solutions we have started to map our services across a prevention taxonomy, from universal community support through to targeted and acute intervention, so that the upstream work can be valued and defended on an avoided-cost basis rather than treated as an optional extra.

Yet early help is still too often funded through short-term arrangements, or treated as an add-on to the real care system. A National Care Service should recognise it as part of the system itself. That means the whole system planning together and acting earlier. It means funding that follows the person across organisational boundaries, rather than leaving families to work out the gaps between them.

Commission for relationships, not just transactions

If a National Care Service is to be built on what already works in communities, then how care is commissioned matters as much as how much is spent.

Three principles would make the difference.

Third sector first. Where a service can be delivered well by a trusted, locally rooted organisation, commissioning should start there. Not as a way of buying care more cheaply, but because closeness to the community tends to produce better outcomes. The social sector, whether charities, social enterprises, CICs or cooperatives, should not be treated as a lower-cost delivery option. We are strategic partners, with knowledge and relationships the wider system needs.

Alliance and relational models. The hardest needs rarely respect service boundaries. Alliance-based commissioning, where organisations share outcomes and risk and are funded to work together rather than compete, is far better suited to the person whose care need is bound up with unsuitable housing or isolation. Because our own work spans social care, homelessness prevention and community support, we see that whole picture every day. We are also one organisation within a much larger movement. Social sector organisations delivering public services connect through networks such as Well Placed and E3M, and a National Care Service should draw on that collective knowledge from the start.

Co-design as standard. People who draw on care, and the unpaid carers alongside them, understand what good support looks like better than any specification does. Their knowledge should shape services from the outset, not be sought once the main decisions have already been made.

None of this works without contracts that meet the true cost of good care and let organisations invest in their workforce for the long term. Relational commissioning is not a softer alternative to rigour. It is the more honest way to pay for care that lasts.

A valued workforce makes dependable care possible

The commitment to value the social care workforce matters just as much, and we welcome the intent to treat health and care staff as one workforce, with fair pay and real routes to progress.

Care workers support people with personal care and increasingly complex health needs, often at the most vulnerable moments of someone’s life. If they are to stand alongside their NHS colleagues, they must be resourced accordingly, and providers must be able to retain skilled staff and offer real continuity.

For someone with complex needs, an unfamiliar worker can mean explaining deeply personal things again, and the loss of trust that took a long time to build. For their family, a dependable team is reassurance that the person they love is safe and understood. Continuity is not an optional extra. It is part of good care, and it depends directly on how we value the people who provide it.

Unpaid carers must be part of the conversation

More than 44,000 Liverpool residents, around one in ten people in the city, provide unpaid care to a relative, friend or neighbour.

Through Liverpool Carers Centre we see their knowledge and resilience every day. We also see what happens when information, practical help or the chance of a break is too hard to find, or comes too late.

Unpaid carers often understand the person they support better than anyone. Their experience should shape decisions about individual care and about the system as a whole, and the listening has to lead to help that is easy to find and available before someone reaches breaking point. The Big Conversation on Care is a real chance to hear from the people who draw on support and the carers, workers and organisations around them. Its success should be judged by whether those voices can be seen in the decisions that follow.

Turning ambition into everyday experience

The national focus on social care is welcome, and the principles now being set out are a strong foundation. Local Solutions offers what we have learned from more than 25 years of delivering care across the Liverpool City Region and North Wales:

• Support must reach people before crisis, and prevention must be funded as an investment, not treated as an optional extra.
• Commissioning should put the third sector first, work through alliances and be co-designed with the people who use services.
• Contracts must meet the real cost of safe and consistent care.
• Care workers must be valued as the skilled professionals they are.
• Unpaid carers must be identified and supported earlier.
• Communities and community organisations must help shape decisions, not just deliver them.

A National Care Service will succeed when national ambition becomes dependable care at home and earlier help for families. That is what it means, in practice, to transform social care.

The foundations are being laid nationally. Building something that lasts will take the experience of the people, workers and locally rooted organisations who know what good care looks like every day. We are ready to help build it.

By Tom Harrison, CEO of Local Solutions

Local Solutions is a Liverpool-based charity and social enterprise delivering social care, homelessness prevention and community support across the Liverpool City Region and North Wales, with services also reaching Coventry, Warwickshire and Wigan.