With the UK Budget now delayed until late November and the Scottish Budget not expected until mid-January, a cloud of uncertainty is hanging over businesses across the country.

For many, key announcements in the Budget can make or break a business.

Nowhere is this more keenly felt than in the health and social care sector, which finds itself facing a period of financial limbo as we approach the sectors busiest and most challenging season.

Winter always places enormous pressure on care providers. Illness and seasonal viruses affect both residents and staff, increasing demand on already stretched services. For care homes, the strain is compounded by an enduring recruitment crisis that shows no sign of easing.

This year may well prove to be one of the most difficult yet.

The increase in national insurance contributions (NIC) has landed heavily on a sector that is already at a breaking point. Unlike many other industries, care homes cannot simply raise prices or streamline services to offset rising costs. Staffing levels are rightly regulated to ensure patients safety and dignity.

The fees we receive per resident are determined by public bodies and any attempt to expand capacity in the short term is hampered by the significant capital investment required for new facilities. In Glasgow for example, the rates set for 2025/26 are £1,013 per week for nursing care and £881 per week for residential care.

These sums may appear substantial on paper, but they do not adequately reflect the true costs of delivering high-quality, safe, and compassionate care in today’s economic climate.

To put these numbers into context two in five care homes are at risk of collapse because of the rising NIC costs, according to a recent report, with less than one third of operators believing they will be able to offset the cost through fee increases.

Added to these financial pressures are tightening immigration rules, which make it harder to attract and retain the overseas workers who are essential to the running of our health and care services.

The truth is simple: without migrant workers, there would be no functioning healthcare system in the UK, whether in hospitals, community care, or residential homes.

I am not convinced that either the UK or Scottish government fully appreciates the severity of the challenges we face. Every week we hear of smaller, well-performing community care homes being forced to close their doors, not because of poor standards, but because of impossible economics.

The impact is felt most deeply by residents, their families and the communities who lose vital local services.

Health and social care is not a discretionary service; it is a fundamental pillar of our society. If governments at every level do not act with urgency, they risk undermining a system that millions rely on every single day.

The care sector has weathered countless challenges, but we cannot do it alone. Now is the time for government to show leadership, provide clarity and deliver the support that healthcare providers so desperately need.

The upcoming UK and Scottish Budget offer a chance to do exactly this.

Lissa Di Giacomo is the managing director of Oakminster Healthcare