Welsh ministers have approved publication of a programme document setting out the next stage of work towards a National Care Service, alongside an annual report on the work of the National Office for Care and Support.
The decision, dated 26 October, was agreed by ministers responsible for health, social care and finance.
The programme document is titled A National Care Service for Wales: Working Together to Strengthen Social Care and Provide Better Care and Support.
Ministers have also approved publication of the National Office for Care and Support Annual Report for 2025–26.
The decision marks a further stage in the development of social care reform, although approval to publish documents does not itself establish that new services or structural changes have been delivered.
Why does Wales need social care reform?
Social care supports people who need assistance with daily living, including older people, disabled people and individuals with complex support needs.
Services can include care at home, residential care, support for unpaid carers and assistance enabling people to live independently.
In Wales, local authorities play a central role in assessing needs and arranging social care, working alongside the NHS, independent providers and voluntary organisations.
This creates a complex system involving different organisations, funding arrangements and responsibilities.
Reform proposals have sought to improve consistency, coordination and the experience of people receiving support.
The relationship between health and social care
Health and social care services are closely connected.
People who are medically ready to leave hospital may still require care arrangements before returning home.
Where suitable support is unavailable, discharge can be delayed, creating pressure on hospital capacity and affecting patients and families.
Effective social care can also help people maintain independence and reduce avoidable demand on health services.
However, improving coordination requires more than changing organisational structures.
It depends on workforce availability, adequate funding, information sharing and the ability of services to respond to individual needs.
Workforce pressures
Social care is labour-intensive, with service quality depending heavily on the availability and skills of care workers.
Recruitment, retention, pay, training and career development are therefore central considerations in any reform programme.
The relationship between public funding and the costs faced by care providers is also important.
Without sufficient workforce capacity, structural reforms may have limited effect on the support people actually receive.
What should the programme explain?
The forthcoming document provides an opportunity to clarify what the National Care Service is intended to deliver and how progress will be measured.
Important questions include whether people will experience more consistent access to support across local authority boundaries, how services will be coordinated with the NHS and what responsibilities will sit with national and local bodies.
The programme should also explain how reforms will be funded and what changes people receiving care can expect.
The accompanying annual report could provide evidence of progress, but its contents need to be examined before conclusions can be drawn.
Why it matters
Social care affects the independence, dignity and wellbeing of thousands of people across Wales, as well as their families and unpaid carers.
The proposed National Care Service has the potential to influence how support is organised and delivered.
The public-interest test will be whether reform improves access, quality and consistency rather than simply changing administrative arrangements.
Publication of the programme and annual report should provide a clearer basis for examining progress and holding ministers accountable for delivery.
