Broken social care will break the NHS, says the Prime Minister. His answer is a National Care Service. Here's why it is needed and what we know so far.

The speech covered housing, water, energy and the voting system, but for anyone working in the NHS, perhaps the most important part was social care. He spoke about his gran's experience of the care system, and about the care workers who looked after his dad "on poverty pay, but doing it with huge skill, humour and humanity".

What is the National Care Service?

It's a new service he said would be as significant as the creation of the NHS itself, with no care charges taken from the basic state pension. He said it would protect people's homes and savings, and give proper recognition to care workers.

Basically it's free personal care for older people, such as help with eating, bathing and using the toilet, based on need rather than ability to pay. That's a big change from now, because anyone in England whose savings and assets are above £23,250 currently has to cough up the full cost of their care. The cost of living in a care home, such as the room and meals, would still be means-tested though.

How would it be paid for?

He said it will be fully funded without borrowing, and part of the money comes from the state pension, not the NHS Pension Scheme. The "triple lock" raises the state pension every year by whichever is highest: inflation, average earnings growth or 2.5%. Spending on the state pension is now £16 billion a year higher than it would have been without it.

The triple lock stays unchanged for the rest of this Parliament. From April 2030, the pension would rise every year by at least prices or 2.5%, and hold its value against earnings over time, rather than rising with earnings in the years they're highest. He said the savings from that change would go into building the National Care Service, and the government estimates they'll reach £15 billion a year by the end of the 2030s. Those savings will be small at first, and on their own they won't be enough to fund universal social care in the next Parliament.

Why does this matter for the NHS?

On an average day in August, 13,833 patients were still in an acute hospital bed in England after they no longer needed to be there. Not every one of those delays is down to social care, but waiting for a care home place or for care at home are among the reasons recorded. NHS England puts the cost of those delayed bed days at £241 million in August alone.

In my few years of work, I've also seen patients wait days, weeks, and even months sometimes, especially those with complex needs who wait even longer. They occupy a bed space, which increases the need for corridor care. That's why Burnham also made the case for it as an NHS saving, through fewer ambulance call-outs, fewer A&E admissions and fewer vulnerable people stuck in hospital.

When will it happen?

Not in this Parliament. He said the government will start laying the groundwork now and introduce the National Care Service in phases in the next Parliament, so after the next general election, and only if Labour wins it. What hasn't been set out yet is how need will be assessed, when each phase starts, or where the care workers will come from. Those answers will come from Baroness Casey's independent commission on adult social care, which is due to report in summer 2027.