Care market sustainability and fair cost of care exercise

‚ÄčAdult Social Care - Cost of Care and Market Sustainability

In December 2021, the government published its white paper for reforming the delivery of Adult Social Care (People at the Heart of Care). This sets out a 10-year vision and includes three objectives:

  • people have choice, control, and support to live independent lives
  • people can access outstanding quality and tailored care and support
  • people find adult social care fair and accessible


As part of adult social care reform, local authorities are conducting a fair cost of care exercise to establish the local cost of providing care.

They are also required to publish a Market Sustainability Plan, outlining their approach to sustainable cost rates. The Department of Health and Social Care defines 'fair' as the median operating costs for care in the area. This considers market sustainability and affordability for the authority.

Local authorities aim to move towards paying a fair rate by collaborating with providers. However, it's important to note that the rates may not directly result from the exercise. The government has provided additional funding to support local authorities in this process. It acknowledges the complexity of local care markets and the need to standardise cost reporting while recognizing the range of local costs.

More information about the Market Sustainability and Fair Cost of Care Fund.


On November 17, 2022, the Government announced a delay in implementing the financial aspects of Social Care Reforms. The new timeline sets the introduction of these elements to October 2025, instead of the previously planned October 2023.

However, local authorities are still obligated to collaborate with their local care sector. This is to establish a fair rate and disclose the outcome of the Cost of Care Exercise in their Annexe B documents. They are also required to publish their Market Sustainability Plan by the end of March 2023.

Fair Cost of Care Annexe B Reports

Annexe C Market Sustainability Plan

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