Image: UK Government, licensed under the Open Government Licence v3.0
The Big Conversation on Care: Now Is the Time to Be Heard
Adult Social Care | August 2026
At the end of July, Baroness Louise Casey launched the Big Conversation on Care, giving people across England a direct opportunity to help shape the future of adult social care and the proposed National Care Service.
The timing is significant. Prime Minister Andy Burnham’s commitment to reform adult social care has brought the subject firmly back onto the national agenda. The challenge now is to move from political intent to a system that works better for the people who rely on it.
The Big Conversation will run as part of the Independent Commission on Adult Social Care and is asking some fundamental questions: who should receive support, what should families reasonably be expected to do, and how should care be funded fairly and sustainably?
These are difficult questions, but they are also questions that families already confront every day.
The reality behind the consultation
In my work as an independent advocate, I regularly support people facing care assessments, financial assessments, NHS Continuing Healthcare questions, pressure around care home fees, hospital discharge and decisions about how care should be provided at home.
What strikes me repeatedly is that the system can be difficult to understand even for families who are organised, informed and determined. For someone dealing with a sudden deterioration in a loved one’s health, a dementia diagnosis or an urgent hospital discharge, that complexity can quickly become overwhelming.
That is why the public conversation about reform needs to be grounded in lived experience. A future system must not only look coherent on paper; it must be understandable and workable at the point when somebody actually needs help.
A voice for families – and for those receiving care
Baroness Casey has emphasised the importance of public understanding and consent if lasting reform is to succeed. That feels particularly important in social care, where expectations about the respective responsibilities of the individual, the family, local authorities and the NHS are not always clear.
The Big Conversation therefore represents more than another consultation exercise. It is an opportunity for people who receive care, unpaid carers, families, care workers and professionals to explain what works, what does not, and what a fairer system should look like.
Independent advocacy has an important part to play in that discussion. Good advocacy is not simply about challenging decisions. It is about making sure that people understand their rights and options, that their wishes remain central, and that complex processes do not prevent them from having a meaningful voice.
From conversation to delivery
There is understandable caution across the sector. Adult social care has seen many reviews, commissions and promises of reform over the years. The real test will therefore be what follows the conversation: clear recommendations, sustainable funding and practical implementation.
There are encouraging signs of momentum. The Government has reiterated its commitment to a National Care Service, while the Casey Commission is gathering evidence ahead of its first-phase recommendations. But families needing support today cannot wait for a future system to solve every current difficulty.
For now, people still need to understand the Care Act, local authority responsibilities, care funding, NHS Continuing Healthcare and the choices available to them. They also need to know when to ask questions and when independent support may help.
The RJ Advocacy view
The Big Conversation on Care is an important opportunity and one that should be taken seriously. If reform is to command public confidence, the voices of people receiving care and the families supporting them must be heard alongside those designing and delivering services.
The question is no longer simply whether adult social care needs reform. There is widespread recognition that it does. The more important question is whether we can now build a system that is fairer, clearer and more sustainable – while keeping the individual at its heart.
At RJ Advocacy Services, our commitment remains unchanged: to help individuals and families understand their options, make informed decisions and secure the support they deserve.
Making quality care a reality.
Useful links / sources
- The Casey Commission – The Big Conversation on Care: caseycommission.co.uk
Department of Health and Social Care – The Prime Minister’s Commitment to Adult Social Care: socialcare.blog.gov.uk