The state of health care and adult social care in England 2024/25

Key findings

• Integrated care systems (ICSs) continue to face challenges in addressing health inequalities, shifting care closer to home, and supporting older populations.
• Leadership and shared vision appear strong, with clear accountability and shared understanding of priorities across most ICSs, though aligning funding with these priorities remains a challenge.
• Financial constraints remain the dominant barrier to progress – systems cite insufficient funding and competing national priorities as limiting capacity for transformational change.
• Partnership working with voluntary, community, faith and social enterprise (VCFSE) organisations has strengthened, particularly in addressing health inequalities.
• Data capabilities have improved in the last year but remain inconsistent, with ongoing challenges in data sharing and linkage across partners.
• There is some caution in confidence to deliver the ‘three shifts’ in the government's 10 Year Health Plan – more than half of respondents to a survey of ICS leaders were moderately confident and around a quarter expressed no confidence at all.
• From our local authority assessment programme, we can see work to increase and improve capacity in homecare services through reviews and new approaches to commissioning. We also see partnership working to try to make sure people are safely discharged from hospital and improve flow in the system, as well as proactive approaches that often involve community and voluntary sectors.