Care groups are warning the government risks failing to deliver on a pledge to reform the funding system for the long-term care of elderly people in England.
In a letter to the health secretary, they suggest a commission has lost "momentum" and changes may not be put in place in this parliament.
They say the "major challenge" needs to be addressed.
The Department of Health says reform remains a government priority and the commission will report by July 2011.
Update 9 November 2010: The remainder of this story was removed after further information about the working of the Commission for the Funding of Care and Support became clear to the care groups which sent the letter.