Correspondence

Letter from the Secretary of State for Health and Social Care to Baroness Casey of Blackstock DBE CB

Published 5 March 2026

To: Baroness Louise Casey of Blackstock DBE CB
Independent Commission on Adult Social Care

Dear Louise,

I am writing to set out how my department will take forward the recommendations for government that you set out in your letter to me on 3 March 2026 and in your speech at the Nuffield Trust Summit on 5 March 2026.

I would like to first extend my thanks to you and your secretariat for the work you have done so far. We know that when social care works well it can be genuinely transformational, supporting people to live the lives they want.

But as you have found when talking to people who are at the heart of care, and as you have laid out in your speech, that is not the experience of everyone. The issues facing adult social care are complex and deep-rooted, and social care has been in the ‘too difficult’ pile for far too long. While there have been plenty of good ideas for how to improve social care, we have lacked the broad political and national consensus needed to ensure reforms stand the test of time. That is why your role as chair of the Independent Commission on Adult Social Care (‘the commission’) is so important in helping cut through the political stalemate and identify what the country needs and wants from social care and support the government in establishing a national care service that delivers a social care system that works.

The issues that you raised at the Nuffield Trust Summit are important and highlight these challenges. While some make for difficult reading, it is vital that they are uncovered so that we can agree a collective way forward. I look forward to your recommendations for how these issues might be resolved in your subsequent reports.

I have responded to each of your recommendations to say how I am taking them forward.

Safeguarding

I strongly welcome the focus on the need to protect vulnerable adults and ensure services are safe, effective and high quality. Any form of abuse or neglect is unacceptable.

My department will create a new national safeguarding board and undertake an urgent review of adult safeguarding statutory duties and powers as you recommend.

To make immediate progress, the department will set up a new national safeguarding board, chaired by the Chief Social Worker - reporting directly to the Minister of State for Care. I will ensure that a key part of the urgent review’s remit will be to identify whether this board requires new statutory powers to be most effective, as you recommend. I will also ensure that the urgent review tests whether the current framework provides sufficient clarity and leverage in high-risk situations.

Dementia

I am extremely pleased to see the focus on improving the lives of those living with dementia, their families and carers. Dementia is one of the greatest challenges of our time. This government has made improving care for people with dementia a clear priority, including in our manifesto where we commit to put Britain at the forefront of transforming treatment.

I strongly recognise the importance of dementia trials for identifying critical ways to improve the lives of people with dementia, including through new drugs that help to slow down the progression of the disease. I agree that we should not be wasting any time.

Thank you for raising the trial on ACCESS-AD. As set out in our manifesto, we are committed to be a world leader in clinical trials in dementia. That is why my officials are already reviewing this specific trial, alongside other options, and will be reporting back to me in April on the merits and any considerations of making this investment. I will update you on the outcome of this.

I will also speak with Minister Vallance on dementia research and development (R&D) to ensure that we are doing everything we can to maximise our collective opportunities as a government.

I welcome the challenge to go faster on the Dementia and Frailty Modern Service Framework (MSF). My department and NHS England are working quickly to develop the MSF, which will set a clear direction and a long-term blueprint to improve outcomes for people with dementia in both health and care settings. I am committed to publishing an interim product in September this year to feed into NHS and local government planning cycles, and I will aim to publish the full MSF by the end of this calendar year as you recommend. As set out in the 10 Year Health Plan, your phase 1 work will inform the Dementia and Frailty MSF, so I look forward to receiving your phase 1 report to inform the MSF and meet your recommended timetable.

I absolutely support the need for strong and meaningful leadership on such an important area and will ensure there is a new dementia leadership role in the new Department of Health and Social Care to drive forward action across the health and care system. I will consider how best to empower this role to provide the necessary leadership and accountability as you suggest, including lessons learned from the Cancer Tsar role. This will feed into ongoing work to redesign the organisation as we abolish NHS England.

Motor neurone disease

Given the devastating impact that motor neurone disease (MND) has on those with this aggressive and progressive neurological condition, their families and loved ones, I very much welcome your particular focus on MND. 

I fully agree that, where someone has a severe, reasonably predictable and life-limiting condition, it is essential that we provide rapid access to the support they need - and we will take forward immediate work to develop a fast-track process, or ‘passport’, that speeds up assessments and access to care for people diagnosed with MND. I will consider how best to safely implement a process that expedites assessments and gets people with MND the care and support they need more quickly, including reviewing your suggestions on how this could be delivered.  

Finally, I understand that you and your secretariat have been engaging extensively across the country since the commission began last year and this has informed the issues that you raised. I look forward to your national conversation commencing later this year to give the country the opportunity to share what they want from adult social care. I also look forward to attending the next cross-party engagement that will be taking place soon.

Thank you again for your work so far and I eagerly await your phase 1 report later this year, setting out the medium-term practical reforms we can deliver in this Parliament to make the most of existing resources to improve the lives of those giving care and drawing upon it.

With regards,

The Rt Hon Wes Streeting MP
Secretary of State for Health and Social Care