Reforming social care: ideas, delays, history


To no one’s surprise, the Queen’s Speech did not include a plan for reforming adult social care. The UK government says it is committed to bringing forward proposals.

So are we any nearer fundamental change? Social care reform had been called in the past a ‘wicked issue’ – a social problem about which those involved can hardly agree on what the definition of the problem should be, let alone on what the solution is. But we do know what the problem is, and we have known now for decades. How social care is paid for has remained the issue that every government has failed to deliver on.

Covid-19 spotlighted the huge difficulties that social care has been dealing with for too many years. The pandemic has exacerbated these – whether we’re talking about the care market, the financial pressure local government is under, or the increasing demands on mental health services. The pandemic made the position of care workers, low paid and often with poor terms and conditions, abundantly clear. Everyone involved has said something has to be done. A recent report from the House of Commons Health and Social Care Select Committee paints a bleak picture of a system on the brink of failure.

Looking back at LGIU briefings, reports and publications over the last ten years we have repeated the same issues – and I could have gone back further, a lot further. We supported the Local Government APPG’s inquiry into social care in 2011. We responded in detail to the Dilnot Report. And ten years later, as part of our Post Covid-Councils work, social care was prominent in the Unfinished Business section.

There have been a myriad of ideas for reform and from every think tank, relevant select committee, local government and health organisations, and the third sector and user groups. The reform agenda is wide-ranging – from meeting and funding individual care needs to changing around the system from being underfunded and in perpetual crisis to one that is holistic, can focus on prevention, and where people are at its centre.

This bundle brings together our recent briefings on reforming social care. No doubt, there will be many more over the next few months, hoping to influence the government and spur them on to actually deliver a plan for reform before it is too late.


Fractured and forgotten? The Nuffield Trust’s report on social care

This clear and well researched Nuffield Trust report paints a depressing picture of a system that, despite good intentions, is fractured and, combined with difficulties in oversight, teeters on the brink of failure. Read this briefing here.

Swift Read: Social care reform in the UK – can we learn from Germany?

Social care reforms have long been a key issue for local government, and now the strains have been exacerbated due to the pandemic. This briefing draws out lessons for the UK from an alternative, Germany’s long-term care insurance system, that could prove useful for shaping the future of the UK’s social care. Read this briefing here.

County Councils Network: The Future of Social Care

The CCN’s Future of Adult Social Care report is another addition to the discussion on how social care is delivered and how it fits into the wider healthcare system. It highlights the critical need for reform and proposes a system of ‘optimised local delivery’ with local government at its heart. Read this briefing here.

The Adult Social Care Market in England

This important NAO report, with its emphasis on the role of the DHSC, highlights serious issues around the oversight of the social care market. Any lack of national joined-up planning and accountability will inevitably have a negative impact on integration at the levels of system and place. Read this briefing here.

Bundle: Questions for the future of social care

To coincide with the release of our new briefing about the so-called “Feeley” report on adult social care in Scotland we released this accompanying bundle. Included are relevant recent briefings on both adult and children’s social care policy and delivery in the UK, as well as the new NHS plan for England. View this bundle here.

A new deal for social care

“Adult social care has been ‘unfinished business’ for what now seems forever”, writes LGIU’s head of briefings, Janet Sillett. This blog addresses the chronic problems that undermine adult social care and discusses how the pandemic represents a pivotal moment for reform. Read this blog here.