Correspondence

Letter to Baroness Casey: progress on adult social care reform recommendations

Published 22 June 2026

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

Dear Louise,

We are writing to update you on progress against the recommendations that you set out in your letter on 3 March 2026 and in your speech at the Nuffield Trust Summit on 5 March 2026.

We would like to thank you and your secretariat again for your work to date, which is shining a light on the deep-rooted challenges facing social care - and the essential role that adult social care plays in helping people live independent, dignified lives. Your independent commission provides an important opportunity to secure the political consensus needed for meaningful change.

This letter provides an update on the work we are rapidly taking forward to implement your initial recommendations.

Safeguarding

Abuse and neglect cannot be tolerated under any circumstances. We agree that decisive action is needed to provide national oversight and scrutiny of adult safeguarding, helping to protect the most vulnerable from harm.

In line with your recommendation, we have established a new national adult safeguarding board. The board is chaired by the Chief Social Worker, Sarah McClinton, reporting directly into Minister Kinnock, as the Minister of State for Care. It has a broad membership, with the seniority and experience required to drive change - including sector leaders, people with lived experience, experts and innovators.

The board will focus on the following initial priorities:

• work is commencing immediately to update the Care Act statutory guidance on adult safeguarding to drive better implementation and practice across a wide range of issues, including homelessness, drugs and alcohol, and transitional safeguarding
• the board will oversee an urgent review of the legal framework for safeguarding. This will:
  • identify any improvements needed to ensure that the legal framework is robust enough to respond to serious safeguarding risks
  • examine the current mechanism for escalating local safeguarding concerns to national level
  • identify what statutory powers the board might need to operate most effectively
• the board will work to strengthen national oversight of local Safeguarding Adults Boards and improve the quality of adult safeguarding practice

Dementia

The rise in dementia prevalence, mortality and morbidity has been both predictable and predicted. Despite this, when this government entered office we inherited a dearth of research, prevention, early detection, treatment and care. At best, there had been warm words with too little delivery and at worst, the consequences of dementia had been treated as an inevitability. Since July 2024 we have therefore been intensifying our work across the spectrum of dementia challenges, but we absolutely recognise that we need to go further and faster.

In the mid-20th century, the kind of progress we have since made on cardiovascular disease (CVD) would have seemed a pipe dream. It has been made possible by a symphony of innovation, across prevention, diagnostics and treatment. Today, we need the same ambition on dementia. We’ll deliver that by pulling all the levers available to us, and by harnessing a full range of innovation.

Central to our approach will be a new modern service framework for dementia and frailty, published by the end of the year. This will be an outcome-led blueprint for how we deliver a once in a generation shift for people living with dementia. It will cover faster access to care, including diagnosis and treatment and ensure the right access to support that allows them to live well in their own neighbourhoods. It will also outline how we will accelerate and prepare for the innovations that will transform care in the future.

Progress will be championed and accelerated by a new dementia tsar. They will work within and alongside the system, to catalyse progress. We will begin recruitment shortly.

In parallel, we will review how we approach dementia within the Department of Health and Social Care (DHSC) and its arm’s length bodies (ALBs) - so that we have one coherent strategy, that spans from research to practice and brings together the right capability and capacity to make progress, and the full ambition of the modern service framework, a reality.

We agree with your call for urgent investment in dementia trials. That’s why I’m pleased to confirm we have adopted the recommended target to scale participation in UK dementia trials to 2,000 people within the next 5 years, up from 377 in 2025 to 2026. Our aim isn’t just to support the science, as important as that is. It’s equally to prepare the health service for future breakthroughs, so that we have the infrastructure and care pathways we need to get innovations to patients quickly.

To support that, we are developing a package of measures to accelerate progress on the whole ‘discover - develop - deploy’ pipeline. This will include:

• investment in diagnostic research and development (R&D) calls
• increased funding for the AD-SMART trial
• standing up the next phase of the Dementia Trials Accelerator
• stronger multi-site research delivery infrastructure

This will significantly enhance the UK’s attractiveness for later-phase dementia trials and improve outcomes for patients with dementia (including those in the early stages). We will focus on delivery across the country so that people have access to life changing research, regardless of where they live.

We are keen to move at pace but need to ensure our plans are backed with the best and most recent evidence, including from the National Institute for Health and Care Excellence (NICE). You recommended that we provide funding to pilot access to 2 Alzheimer’s drugs (lecanemab and donanemab) via the ACCESS-AD consortium. NICE is holding a committee meeting on 8 July to consider lecanemab and donanemab and we will finalise our approach after that.

Motor neurone disease (MND)

Motor neurone disease is a severe, progressive and terminal condition. We agree that timely, co-ordinated care and support is essential for people to maintain their independence, dignity and quality of life. Where that support is delayed or fragmented, it exposes where the health and care system is falling short.

As a first step, we have written to all local authorities asking them to take immediate steps to improve the timeliness and co-ordination of care and support for people with MND. This includes:

• putting in place fast-tracked approaches for accessing care and support
• ensuring streamlined multi-team approaches to assessing and meeting people’s needs in line with the MND Association’s guidance on multidisciplinary working
• anticipating future needs as the condition progresses
• reviewing housing assistance policies to accelerate Disabled Facilities Grant (DFG) processes
• considering waiving the DFG means test

Building on this, we are developing a full prototype fast-track pathway for people with MND that gets them far faster access to the care and support they need. This is being shaped through intensive engagement with a wide range of experts across local authorities, the NHS, housing and the voluntary sector, including the MND Association. We will now test and refine this prototype with partners, supported by a cross-sector steering group, so that we can move quickly to a model that can be delivered in practice.

Thank you again for your work to date, which will help us deliver the national care service this country needs. We look forward to your phase 1 report later this year.

Yours sincerely,

Rt Hon James Murray MP, Secretary of State for Health and Social Care

Stephen Kinnock MP, Minister of State for Care