Homecare Association Autumn Budget Representation 2026

Homecare is economic and health infrastructure. It supports almost 1.5 million older and disabled people, enables unpaid carers and family members to remain in work, creates jobs in every community and helps the NHS move care out of hospitals. Adult social care contributed £77.8 billion in gross value added to the English economy in 2024-25, and the wider sector employs more than 1.7 million people across the United Kingdom.

Yet the way publicly funded homecare is purchased is undermining these benefits. Public bodies fund around 80% of homecare, but many buy isolated contact minutes from a highly fragmented market, guarantee providers no work and pay rates below the cost of lawful delivery. This transfers financial risk from commissioners to providers and, ultimately, to a predominantly female and increasingly international workforce. It also acts against the Government's objectives for fair pay, guaranteed hours, immigration compliance, prevention and neighbourhood health.

Social care is conventionally treated as a cost item. This mis-frames the problem. Homecare is productive economic infrastructure. It enables labour market participation, prevents expensive acute treatment, and creates employment in every community.

The Government faces a choice. It can continue underfunding, allowing providers to exit, services to contract, hospital beds to block, workers to be exploited, and rising numbers of people to go without the care they need. This guarantees rising NHS costs and failure to achieve neighbourhood health integration.

Or it can recognise that the £3.25 billion homecare funding gap represents avoidable acute costs. Funding homecare adequately stems hospital admissions, clears discharge pathways, and enables the shift to preventative care that the NHS 10-Year Plan and the Prime Minister's preventative state vision require.