The Health and Care Act 2022 reshaped how social workers operate in England, mainly by creating integrated care systems that join up the NHS and councils, and by returning CQC oversight of local authority adult social care. Several linked charging reforms, including the £86,000 care cost cap, were later delayed and then scrapped, so they never took effect.

Key Takeaways

• The Act created 42 integrated care systems across England, each built from an integrated care board and an integrated care partnership.
• It returned a legal duty for the Care Quality Commission to assess how well councils deliver their adult social care functions.
• The £86,000 care cost cap and linked charging reforms were delayed to October 2025, then cancelled in 2024, so they are not in force.
• Integrated working changed how social workers share information and coordinate care across the NHS and councils.
• Adult social work sits under continuing legal change, including the 2026 Supreme Court shift in deprivation of liberty law.

What the Health and Care Act 2022 Changed

The Act received Royal Assent on 28 April 2022 and dismantled much of the 2012 competition-based NHS structure in favour of collaboration. Its biggest practical change for social workers was the integrated care system, which formalises joint working between the NHS, councils and local partners across England. It also returned a Care Quality Commission duty to assess council adult social care performance, and set mandatory information standards for how care data is collected and shared.

What is an integrated care system?

An integrated care system is a partnership that plans and coordinates health and care for a defined area. Each of the 42 systems in England has two parts: an integrated care board, which commissions most NHS services, and an integrated care partnership, which brings together the NHS, councils, providers and communities. The aim is joined-up care shaped around a local population's needs.

Integrated Care Systems and What They Mean for Social Work

Integrated care systems change how social workers coordinate care rather than what their statutory duties are. Closer NHS and council working should smooth hospital discharge, information sharing and multi-agency planning, though the results depend heavily on local relationships. The Act also ended the delayed-discharge fines regime, shifting the focus onto joint discharge planning, which is central to hospital and discharge social work.

Mandatory information standards now require commissioners and providers to collect and share data consistently, so social workers can access and use case information more reliably across services. The Act also made learning disability and autism training mandatory for health and care staff, delivered as the Oliver McGowan Mandatory Training.

What Happened to the Care Cost Cap

The headline charging reforms did not happen. The Act paved the way for an £86,000 lifetime cap on personal care costs, a right for self-funders to have care arranged by their council, and a "fair rate for care", originally set for October 2023. The start date was pushed to October 2025, and the government then cancelled the reforms in 2024. Social workers should treat the pre-2024 cap guidance as withdrawn.

Is the £86,000 care cap in force?

No. The £86,000 care cost cap and the linked charging reforms were delayed from October 2023 to October 2025, then scrapped by the government in 2024. They are not in force, and there is no confirmed replacement cap. Means-tested charging under the existing Care Act 2014 rules continues to apply.

The Act and Adult Social Work in 2026

The Act's structures now sit alongside newer legal change that matters more day to day for adult social workers. CQC assessment of council adult social care is live, which raises the stakes on assessment quality and timeliness. Rising demand across adult services continues to outpace supply, feeding the pressure behind social work caseloads and the reliance on locum cover.

Deprivation of liberty law has also moved. The 2 June 2026 Supreme Court AGNI ruling replaced the Cheshire West acid test with a multifactorial assessment, which reshapes statutory work for adult practitioners and specialists such as the Best Interest Assessor. The Act funded workforce measures including Approved Mental Health Professional accreditation, one route into the higher-paid statutory work covered in mental health social work locum roles.

Frequently Asked Questions

What is the Health and Care Act 2022?

The Health and Care Act 2022 is UK legislation, in force from 2022, that restructured the NHS in England around collaboration rather than competition. It created integrated care systems, returned CQC oversight of council adult social care, set mandatory information standards, and paved the way for charging reforms that were later cancelled.

How does the Health and Care Act affect social workers?

It changes how social workers coordinate care rather than their core duties. Integrated care systems push closer NHS and council working, information standards standardise case data, and CQC assessment of councils raises the stakes on assessment quality. The charging reforms that would have widened eligibility did not take effect.

Is the £86,000 care cap still happening?

No. The cap was delayed from October 2023 to October 2025, then cancelled by the government in 2024. It is not in force and has no confirmed replacement. Charging still follows the existing means-tested Care Act 2014 rules.

What is the difference between an ICB and an ICP?

An integrated care board commissions most NHS services for its area and is accountable for spending and performance. An integrated care partnership is a wider body that brings together the NHS, councils, providers and communities to set the health and care strategy. Both sit within one integrated care system.

Did the Health and Care Act change hospital discharge?

Yes. The Act ended the delayed-discharge fines regime and reinforced joint discharge planning between the NHS and councils. In practice, discharge depends on social work capacity to arrange safe onward care, which is why hospital and discharge roles remain in steady demand.

Talk to a specialist social work team

Charles Hunter Associates provides specialist social work recruitment across adults, children's and statutory teams, so contact us if you want roles that fit how the sector is changing.