Free at the point of use: the National Care Service announced today
What happened
The Prime Minister, Andy Burnham, used his keynote speech to the Labour Party conference in Liverpool today, 29 September 2026, to announce a National Care Service for England. He described it as "a person-centred, high-quality care service that starts in the home". It would be free at the point of use, in the same way the NHS is. He put it bluntly. "Broken social care will break the NHS too," he said. He called the plan "a landmark policy as significant as the NHS itself". He also said politicians had dodged this for years, and included himself in that, saying they had been "cowardly" about social care. Speaking to NHS staff, he said: "We have let you down too, left you under intolerable pressure." Two things came with the announcement. First, a way to pay for it. The Government intends to change the state pension "triple lock". At the moment the state pension rises each year by whichever is highest of three things: inflation, average wage growth, or 2.5%. Under the plan, wage growth would be dropped from that list. The pension would rise by inflation or 2.5%, whichever is higher, while still holding its "value relative to earnings over time". City A.M. reported this could save around £15 billion a year by 2040, and that money would go towards care. Second, a timetable. Baroness Louise Casey, who is leading the independent commission on adult social care, has been asked to finish her review by summer 2027. The full proposals would then be put to voters at the next general election, and introduced in the next parliament. So nothing changes for anyone this week. This is a plan, not a new service.
Why this matters
Adult social care is the everyday help people need to manage. Washing and dressing. Getting out of bed and into a chair. Making meals. Remembering medicines. It happens in care homes, but far more often it happens in people's own homes. It is also the part of the system most people find baffling, and only find out about in a crisis. The NHS is free when you need it. Social care is not. Councils means-test it, so what you pay depends on your income and savings, and the rules differ from the ones next door. The knock-on effect reaches the NHS. When care at home is thin or slow to arrange, more people end up calling an ambulance, sitting in A&E, or staying in a hospital bed after they are well enough to leave. That is the link the Prime Minister was pointing at. Two things make today worth reading about rather than filing away. One is scale. Building an NHS-style care service is not a tweak. LocalGov, reporting the speech, noted estimates from independent healthcare researchers that such a system could cost more than £18 billion a year by 2035. The other is that the money is being named. Politicians have announced care reforms before and left the funding vague. Naming the pension triple lock is a real choice with real losers, which is why it drew immediate argument.
What the evidence actually says
It is worth being clear about what is settled and what is not. Settled: the speech happened today, and the commitment was made. The wording above is what the Prime Minister said, as reported by Nursing Times, LocalGov and City A.M. Settled: Baroness Casey has been asked to report by summer 2027. Her commission is already running a public consultation, the Big Conversation on Care. Not settled: almost everything you would actually need to know. Who would qualify. What "starts in the home" means in practice. How councils fit in. What happens to the people paying care fees today. None of that has been published, because the review has not finished. Not agreed: whether the funding adds up. The Institute for Fiscal Studies' deputy director, Jonathan Cribb, said removing the wage-growth part of the triple lock would not raise enough on its own. The Nuffield Trust's Natasha Curry warned the Prime Minister to "tread carefully" on how wide the service is and what it costs. The Health Foundation and the King's Fund welcomed the announcement but said the detail is what will decide whether it works. There is also a workforce question. The Royal College of Nursing pointed out that the number of nurses working in social care has fallen by about a third over the past decade. Its chief executive, Professor Nicola Ranger, said: "A national care service which starts at home will need to be led by registered nurses." One more point that is easy to miss. Social care is devolved. The Casey commission and this announcement cover England. Scotland, Wales and Northern Ireland run their own systems.
Qurexa perspective
We deliver prescriptions and groceries across Lincolnshire, and a fair number of those deliveries go to people who draw on social care, or to the family members holding things together for them. That gives us a narrow but honest view. We see the seams. The carer visit that does not line up with when the tablets are due. We are not going to pretend a delivery service is an answer to any of this. It is not. Today's announcement is about how care is paid for and organised, and that is decided well above our heads. The one thing we would say is this: the consultation that feeds into it is open now, and it is asking ordinary people, not experts. If you are one of the households invited, your view counts as much as ours does.
Practical advice
Nothing changes for you today. If you or a relative pay for care now, keep paying it. If you are waiting on a council assessment, that process is unchanged. Be careful with what you read next. A speech attracts a lot of confident explanation. Until Baroness Casey reports in 2027, anyone telling you exactly who will get free care is guessing. If you want a say, there is a real deadline this month. Letters inviting people to register for the Public Panel on Care started arriving on 21 September. If a letter came to your address, you can register using the details inside it up to Sunday 11 October. Around 125 people will be chosen. You do not need any knowledge of social care to take part. It covers England, is open to anyone aged 18 or over at an invited address, and the panel meets over several weekends between November 2026 and April 2027 in Birmingham and London, plus online sessions. There is no other way in, so do not bin the letter. If you are an unpaid carer, today does not change your position, but it is a reasonable moment to check you are getting what already exists. Ask your council for a carer's assessment, which you are entitled to in your own right. If you take several medicines, ask your pharmacist about anything that makes the routine simpler. Repeat prescriptions, delivery, dosette boxes and medicine reviews exist now and do not depend on any of this. And if you are worried about your state pension, wait for the detail rather than the headline. The proposal is for the next parliament, after an election, not for this year's uprating.
What to know
On 29 September 2026, Prime Minister Andy Burnham announced a National Care Service for England in his Labour Party conference speech in Liverpool. It would be free at the point of use and would "start in the home". It would be paid for by changing the state pension triple lock: the pension would rise by inflation or 2.5%, whichever is higher, with wage growth dropped, while keeping its value against earnings over time. City A.M. reported an estimated saving of about £15 billion a year by 2040. Baroness Louise Casey has been asked to complete her review of adult social care by summer 2027. The proposals would be put to voters at the next general election and introduced in the next parliament. Nothing changes for anyone now. Independent bodies, including the Institute for Fiscal Studies and the Nuffield Trust, have questioned whether the funding is enough and warned that the detail will decide it. Social care is devolved, so this covers England only. If you received a letter about the Public Panel on Care, registration closes on Sunday 11 October 2026. Sources: Nursing Times, "PM announces national care service to help 'let down' NHS staff", 29 September 2026 — https://www.nursingtimes.net/policies-and-guidance/pm-announces-national-care-service-to-help-let-down-nhs-staff-29-09-2026/ ; LocalGov, "Burnham promises to build a National Care Service", 29 September 2026 — https://www.localgov.co.uk/Burnham-promises-to-build-a-National-Care-Service/65015 ; City A.M., "Burnham pledges to reform triple lock to fund new National Care Service", 29 September 2026 — https://www.cityam.com/burnham-pledges-to-reform-triple-lock-to-fund-new-national-care-service/ ; Wired-Gov / Department of Health and Social Care, "Thousands invited to register for Public Panel for Independent Commission on Adult Social Care", 21 September 2026 — https://wired-gov.net/wg/news.nsf/articles/Thousands+invited+to+register+for+Public+Panel+for+Independent+Commission+on+Adult+Social+Care+21092026121000?open= This article is for general information and does not replace advice from a doctor, pharmacist, social worker or other qualified professional. If you have questions about your own care, medicines or benefits, speak to your GP, your pharmacist or your local council.
Related articles
Six hours, not never: the ICU filter notice the MHRA issued today
The UK's medicines and devices regulator has issued a new safety notice to hospitals, and it is about timing. On 13 October 2026 the Medicines and Healthcare p…
Eight pages to a minister: what the data guardian says trust is worth
On 12 October 2026, the government published a letter about who should be trusted with NHS patient data. It was written by Dr Nicola Byrne, the National Data G…
Update: the tests came back, and it was not plague
This is a follow-up to a story we covered on 5 October, when nearly 200 people were being monitored after the death of a laboratory worker in Siberia. There has…