Delayed hospital discharges and long A&E waits could all be features of life with a national care service if crucial funding and workforce issues are not resolved, insiders have warned.
Andy Burnham’s pledge to give all older people who need it access to free personal care, regardless of their ability to pay, has been widely welcomed by those working in adult social care.
But despite hopes that a universal care offer could alleviate pressure on the NHS – and in turn tackle corridor care – experts say falling overseas recruitment and funding shortfalls stand in the way of delivering a safe and sustainable service.
How getting your RDA (recommended dose of art) can transform wellbeing
Visiting a museum or art gallery every month for a “recommended dose of art (RDA)” can transform wellbeing, according to a report.
At least 60 minutes per month inside a gallery or museum could help cut depression, lower stress and improve health, according to the study from the Art Fund charity.
What do the figures tell us?
50%
Evidence in the report shows how a 2019 study on 2,148 adults found a 32 per cent lower risk of depression from going to museums, theatre and cinema every few months.
This rose to a 48 per cent lower risk for people who attended once a month or more, according to the data, taken from the English Longitudinal Study of Ageing.
- Daisy Fancourt, professor of psychobiology at University College London (UCL), who wrote the foreword to the report said adopting a monthly habit can make a difference.
The expert view
Regular engagement and meaningful encounters with art are now recognised as an important contributor to our health and wellbeing, and the evidence suggests they should be viewed as health-promoting behaviours, alongside having a balanced diet, regular exercise and spending time outdoors.
Daisy Fancourt
What other studies have also found
Another study published this year in the journal, , found “evidence that authentic art viewing engages biological processes linked to stress reduction and immune modulation”.
A further study found community cultural engagement was associated with a lower risk of developing dementia.
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Why Ryanair is warning customers to book summer flights now
The boss of Ryanair has warned travellers to book their summer flights sooner rather than later, with plane ticket prices set to “rise dramatically” next year.
The budget airline said it expects short-haul airfares – like those for trips from the UK to Europe – to increase tickets by 20 per cent.
Why are ticket prices soaring?
Fuel prices have increased dramatically due to the US-Israeli war on Iran. Ryanair said it expects jet fuel prices to remain “elevated well into 2027”.
Short-haul airfares must therefore rise to reflect “much higher” cost of aviation fuel prices. There will also be fewer seats available as airlines reduce capacity to try to control costs, according to Ryanair.
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But raising fares won’t fully cover spiralling fuel costs. The airline, therefore, is mulling pay freezes, reducing crew numbers and increasing its use of AI to cut costs.
“Unless there is a swift resolution of the Middle East conflict we expect jet fuel prices to remain elevated well into 2027,” said O’Leary.
A closer look at the figures
€2.15bn
The company revealed that profit after tax fell by 15 per cent to €2.15bn (£1.79bn) for the half-year to September, compared with a year earlier.
Revenues increased by 3 per cent to €10.08bn driven by 6 per cent increase in passenger numbers. But the firm saw operating costs lift by 10 per cent.
- Earlier this year, Ryanair said it would cut its traffic target for the year from 216 million passengers to 214 million in an effort to offset increases in unhedged fuel costs.
What you need to know about new Buy Now Pay Later rules
Buy Now Pay Later (BNPL) lenders – like Klarna and Clearpay – have been officially regulated since July, meaning their rules of use have quietly changed.
Here is what that means for you.
What you need to know
Stricter checks
The new regulation mean users have stricter background checks on their ability to repay loans.
Purchases blocked
If you fail, then your purchase via BNPL will be blocked.
Borrowing figure
There are different affordability checks for different purchases, partially based on how much is borrowed.
Shoppers given stronger rights
Why were the regulations needed?
- BNPL regulations are designed to help prevent people from falling into unaffordable debt.
- Lenders must now direct shoppers who fall into financial difficulty towards debt advice rather than immediately referring them to debt collectors.
- Treasury minister Rachel Blake said the rules deliver promised consumer protections.
Protecting consumers
It is not fair that people using these products have had fewer rights than if they had paid by credit card. These new rules protect the consumer — with proper checks before credit is offered, real rights when things go wrong, and support rather than pressure if someone falls into financial difficulty.
Rachel Blake, economic secretary to the Treasury
How to avoid being blocked
Sara Williams, a former volunteer debt adviser at Citizens Advice who posts tips as Debt Camel on social media, told the BBC just how consumers can avoid being blocked by BNPL lenders.
- Slow down your purchases: If your budget is tight, ensure that what you are buying is essential or see if you can postpone the spending.
- Be more careful about what you buy: Avoid needing a high credit limit to buy lots of clothes in different sizes.
- Cancel subscriptions: Escape the trap of having to use BNPL to make up for the cost of previous payments.
- Talk to debt charities: If you are using BNPL for essentials, speak to charities for help and access to food bank vouchers.
Your quick guide to the US midterms
Americans are heading to the polls for the 2026 midterm elections on 3 November.
In these pivotal elections, voters will decide which party controls Congress for the rest of Donald Trump’s presidency – and the Democrats have high expectations.
What are the midterms?
Midterms allow voters to elect members of Congress – one-third of the Senate and all members of the House of Representatives.
Votes are held in the middle of each four-year presidential term. While the president is not up for election, they are largely a referendum on their party.
The party that controls Congress has the power to shape laws and act as a government watchdog.
Control of Congress up for grabs
Trump’s Republican Party currently has power in the White House and both chambers of Congress – the 435-strong House and the 100-member Senate.
Their majority is slim, but it means they have the power to bring their preferred laws to the floor and have them signed off by Trump.
To win a majority in the Senate, Democrats need to flip four Republican-held seats, while holding on to all their own. In the House, they need a net gain of three seats.
What do the polls tell us so far?
Democratic candidates lead in well over the 218 seats (of 435 total) needed to flip control of the House, polls suggest. They are tied or narrowly ahead in Senate races.
It comes as Trump’s approval ratings hit an all-time low of 32 per cent, according to a September Reuters poll.
Despite this, recent US political history holds many examples of opinion polls being proved wrong. For example, Trump outperformed predictions on his way to White House victories in 2016 and 2024.
What are the key issues?
More than 53 million people, of the total 210 million registered voters, have alreaady cast their ballots by voting early, with more Democrats doing so than Republicans.
There are also signs that Hispanic voters who veered to Trump in 2024 might be returning to Democrats because of frustration over the economy and some of Trump’s immigration enforcement tactics.
- Domestic issues like consumer prices are likely to affect the outcome of many races and could erode support for Republicans.
- Inflation remains above the level targeted by the US Federal Reserve, partly down to the war that the US and Israel started with Iran in February.
- However, immigration and the growing influence of AI and big tech remain high on voters’ minds.
From blockades to impeachment
What it means for Trump
- If the Democrats win either the House or the Senate then Trump will find it difficult to get laws through Congress.
- Democratic control of either chamber would also mean they could use committees to investigate aspects of the Trump presidency.
- Corruption allegations, the controversial new White House ballroom and violent ICE tactics could be subject to scrutiny.
- There is also a debate within the Democratic Party about whether to impeach Trump, which means to bring charges in the House that will form the basis for a political trial in the Senate.
- However, a two-third majority is needed in the Senate for such a trial to be successful, which is highly unlikely.
Why Gen Z protests are sweeping the continent
Youth-led protest movements spread to Germany and Switzerland over the Halloween weekend, and demonstrations continued in France, Spain, Italy and Portugal in a continent-wide wave dubbed “Europe’s hot autumn”.
Protests in dozens of cities
Events were organised in dozens of cities by student groups, trade unions and movements such as Gen Z Regelt (“Gen Z takes charge”) in Germany, or the Yellow Vests in France.
Protesters cite a range of causes from the cost of living, lack of employment and housing, and funding for public services, to the rise of far-right political parties and rearmament in Europe.
Where are the youth marching?
France has seen the largest protests, with hundreds of thousands joining marches on Saturday. Police fired tear gas and stun grenades to disperse crowds.
- In Germany, tens of thousands joined events in around 30 locations. The majority passed peacefully, but looting and clashes with police were reported in Berlin, Frankfurt and Hamburg.
- In Spain, local authorities arrested protest leaders and sealed off parts of Barcelona to avoid unrest.
- In Portugal, thousands marched over housing costs and wider affordability issues.
- In Italy, students and workers took to the streets in several cities on Friday, with the Union Sindicale di Base (USB) union estimating over a million took part.
Same issues hitting youth
Housing is a key issue in most European countries and it’s clearly a major issue in the current wave of protest. This is absolutely clear in Spain but I think it also applies elsewhere.
Analysts suggest the movements spreading across Europe have much in common. David Madden, an associate professor of sociology at the London School of Economics, told The i Paper affordable housing is a “key issue”.
What else did Madden say?
[Youth protesters] talk a lot about the idea that the future was stolen from them, that the things that were promised to them have been made much harder to acquire. Secure, affordable housing is central to this. It’s not something that people feel they can take for granted anymore.
David Madden, an associate professor of sociology and director of the Cities Programme at the London School of Economics
‘The Government is making it so hard for overseas workers’
While the Government plans to deliver universal access to free care, it is simultaneously introducing stricter immigration rules for foreign care workers.
Home Secretary Shabana Mahmood announced on Monday that under new Indefinite Leave to Remain rules, care workers who arrived in the country after May 2025 will have to wait 10 years before they can qualify for ILR – double the time of those who arrived before then.
It follows a crackdown last year on the international recruitment of care workers and a ban on care workers’ dependents.
The King’s Fund found that if current trends continue, only 10,000 overseas care workers will be recruited this financial year – less than a tenth of the number in 2023/24 – as the number of British new starters is already falling.
Michelle Hawley, a registered care manager at Caremark Preston, a private domiciliary care company, believes all care for older people who need it should be free.
But she is among those who doubt the workforce gap can be addressed ahead of the rollout of a national care service, given the Government is “making it so hard for overseas workers to come into this country and do the job”.
“It’s a shame because a lot of these overseas workers, they’ve got degrees… I had a doctor apply for a care assistant role,” she said. “I do have non-English carers in the company and they are absolutely amazing.”
The sector’s reliance on international workers is well-documented. Two-thirds – or 1.075 million postings – of the adult social care workforce were occupied by Britons in 2025/26.
International care workers are also less likely to leave the sector, with the turnover rate for foreign nationals at 21.6 per cent, compared to 38.2 per cent of UK nationals, between March 2025 to March 2026.
The number of roles filled by British workers has fallen by over 130,000 since 2020/21 – including a 40,000 drop in the last year, according to Skills for Care.
The British Medical Association has warned that underfunding and poor staffing in care prevents patients from being discharged from hospital and compounds the strain on the NHS.
“Care workers play a vital role in keeping people well at home and in the community to prevent avoidable hospital admissions, and also do the necessary work for safe discharges that free up much-needed beds,” said Dr Tom Dolphin, BMA council chair.
Skills for Care estimates that by 2040 – based on growth of the population aged 65 and above – the sector may need 410,000 extra new posts.
Danielle Jefferies, senior analyst at The King’s Fund, said: ‘The divergent trend lines of the growth in demand for care workers and the expected fall in new international recruits that the sector relies on paints a bleak picture for where the social care workforce will be unless there is significant intervention from the Government.”
A survey of more than 2,000 adults by homecare provider Bluebird Care found that less than a third of people would consider a career in care.
“A national care service will only succeed if we value the people who deliver care in the same way as those who work in our NHS,” said Bluebird Care CEO Jonathan Gardner.
The Department of Health and Social Care said it is developing a workforce plan to support recruitment, retention and career development. “We are also establishing the first ever Fair Pay Agreement for care workers and making over £4.6bn additional funding available for adult social care in 2028-29,” a spokesperson said.
‘Disabled people of working age left out’
GP Steve Taylor has often seen the failures of social care due to poor resourcing of services.
He said it should not be treated as an afterthought to avoid “delayed discharges, mean delayed admissions, long waits in A&E, reduced access to hospital beds, fewer operations [and] GPs dealing with patients taking hours to resolve, reducing access for everyone”.
Dr Taylor added that it is “vital the healthy and wealthy aren’t the ones who decide” what a national care service looks like.
As an independent commission on adult social care is underway, Burnham has pledged non-means tested access to free social care for older people. This means many who can afford to pay for support will receive it, but disability rights organisations are concerned that some of the most vulnerable people – disabled people of working age – will be left out of the picture.
Fazilet Hadi, head of policy at Disability Rights UK, said Burnham “failed to mention” the increasing care charges that working age disabled people currently have to pay “from extremely low incomes”.
Hadi also worries the commission and the Government have a “very paternalistic notion” of what social care is due to the focus on personal care, centring on tasks such as washing and eating. “For us, social care is about being supported to live a life, whatever that means for people,” she said.
Dr Jane Townson, CEO of Homecare Association, which represents over 2,100 home care organisations across Britain, welcomed plans for free personal care – but suggested inadequate pay could worsen under a national care system.
“What we’re worried about is that there will be a trade-off between the number of people receiving free care and the amount of money available to deliver it,” she said.
The Homecare Association estimates that a minimum of £34.42 per hour is needed to cover the cost of employing a homecare worker on the National Living Wage. However, the average council fee rate is £25.05, according to the Association of Directors of Adult Social Services.
As councils struggle with soaring adult social care demand, spending is under heightened scrutiny.
Townson said one of her member organisations was supporting a 97-year-old woman receiving end of life care when the council moved her to a different provider days before she died because it was cheaper.
Demand for personal care is likely to increase when it’s free, but there are no guarantees yet that providers or staff will be better off, either.
Many of these workers are already not paid for waiting time or travel between appointments, Townson said: “In many places, there isn’t enough money in the system to cover those costs, and that’s why many care workers don’t get paid for it, even though they should.”
When commitments are not funded properly, it sometimes results in providers handing back contracts, Nuffield Trust fellow Camille Oung said. “There needs to be a conversation about how we fund these appropriately and sustainably so as not to destabilise the sector.”
‘Families shouldn’t be responsible for paying a top-up’
Simon Bottery, a senior fellow leading on adult social care at The King’s Fund, said a universal care service would need national funding to mitigate unequal access, and national criteria for assessments carried out by local authorities to determine who is entitled to support – and how much.
A national care service should also include a cap on care costs, so there is a limit on the amount people contribute towards their care over their lifetime, he said.
Care campaign group Rights for Residents is calling for every care receiver to have the legal right to an advocate, a close relative or friend of their choice, who can support them in health and care settings.
Sian Kilcoyne, 65, a former care manager from Bolton, informally takes on this role for her 90-year-old mother, visiting her several times a week and maintaining responsibility of organising her finances, appointments and wellbeing.
Kilcoyne’s mother has Alzheimer’s and rheumatoid arthritis, and lives in a care home that costs more than £1,000 a week, with additional charges if she needs to attend appointments.
“I understand the cost of providing care, but these arrangements create further pressure for families who remain actively involved,” Kilcoyne said.
Under the Government’s proposals, Kilcoyne’s mother, who sold her house and pays for her own care could benefit from free personal care.
“I do not receive Carer’s Allowance and have not yet reached the new state pension age,” Kilcoyne said. “I don’t think families should become responsible for paying a top-up… that’s forcing families to pay it and they might not have it.”