By Mike Padgham
AS ANOTHER year closes it feels right to pause and reflect. Not because reflection alone changes anything, but because understanding where we have been helps us decide where we go next.
For those of us working in adult social care, the past year has felt all too familiar: relentless pressure, stretched resilience, and a quiet determination to keep going for the people who rely on us.
There is no doubt that care providers across the country have shown extraordinary commitment. Against a backdrop of rising costs, workforce shortages and continuing uncertainty about reform, services have continued to deliver care with compassion and professionalism.
Providers have stepped in where systems have faltered, supported people at their most vulnerable, and kept services open even when the financial reality no longer makes sense. That commitment deserves recognition – but recognition alone is no longer enough.
It would also be wrong to ignore the positives. In some areas, relationships with local authorities have improved, with more open conversations about pressures on both sides.
There has been greater acknowledgement of workforce challenges and, in pockets, a willingness to look again at the true cost of care. These steps matter. They show what can be achieved when engagement is genuine and grounded in reality.
However, the past year has also underlined how far we still have to go. Too many providers continue to experience a race to the bottom on fees, where price is prioritised over quality, sustainability, and outcomes. This approach is not only short-sighted, it is dangerous.
Care cannot be delivered safely or ethically on ever-lower rates, and the consequences of this approach are already being felt in fragile markets and increasing provider exits.
We also need to be honest about the challenges in working with Integrated Care Partnerships. While there are examples of progress, particularly around hospital discharge, continuing healthcare remains a significant concern.
Too often it appears to be rationed rather than properly assessed, driven by financial constraint rather than individual need. This creates pressure throughout the system and undermines the principle of person-centred care.
At a national level, recent events have once again brought social care into the spotlight. We hear renewed commitments, reform narratives, and warm words about the value of care. Yet the gap between what is said and what is delivered remains stark.
Providers are still waiting for a funding settlement that reflects reality, for workforce policy that recognises skill and responsibility, and for reform that is co-produced with those who deliver care every day.
For years, the sector has acted responsibly and constructively. Providers have absorbed cost pressures, relied on goodwill, and worked collaboratively even when the system has not worked for them. But goodwill is not a business model, and resilience is not infinite.
So, as we look to the year ahead, it is reasonable – and necessary – to ask whether the sector needs to be bolder. Not louder for the sake of it, not adversarial by default, but clearer about what is no longer acceptable and more united in saying so.
Being bolder means providers standing together, locally, and nationally, to insist on fair funding, sustainable commissioning and honest conversations about risk and capacity. It means local authorities moving away from short-term cost containment and towards long-term market stability.
It means ICPs addressing continuing healthcare in a way that is transparent, consistent and needs led. And it means national government matching its words with decisive action.
Optimism, in this context, is not naïve. It is the belief that change is possible – but only if responsibility is shared and accountability is real. Social care is not asking for special treatment; it is asking for fairness, realism, and respect.
As we move into the year ahead, the message to decision-makers is simple: the sector has done its part. Providers cannot carry this alone any longer. If government truly believes social care matters, now is the time to prove it – with funding, policy and leadership that finally match the scale and importance of the service on which so many people depend.
Mike Padgham is a care provider who is honorary president and former chair of the Independent Care Group.