Government launches plan to overhaul social care services

BMJ 2005; 330 doi: (Published 24 March 2005) Cite this as: BMJ 2005;330:687
  1. Caroline White
  1. London

    The UK government is planning to establish a network of new posts, to be known as local directors of adult services, to bring together the health, social, community, and voluntary sectors to improve adults' social care.

    The directors will be charged with setting up teams of professionals from the different services to produce and deliver a joint strategy for care. The proposals, which are contained in a government green paper that was published on Monday, are part of an attempt to overhaul adult social care services in England.

    The plan aims to give service users greater responsibility for their own care and emphasises the need for preventive measures in order to foster greater independence and curb the rising costs of the growing number of elderly people who need care.

    The proposals also aim to change attitudes among social care staff, said the minister for community, Stephen Ladyman, at this week's launch of the green paper. “This is nothing less than a radical and dramatic overhaul of adult social care services and the way in which we think about them,” he declared.

    In a bid to end the culture of reliance, service users will be given the choice to assess their care needs themselves. And they will have the support of a “navigator” to help them negotiate the system's complexities and advise them of their options.

    Another key proposal is to extend the eligibility and take up of direct payments to users, which will be the subject of a parallel consultation. The scheme allows local councils to give users a predefined budget to plan and purchase their own personalised care services, such as respite care. Government figures show that just over 12 500 people out of 1.68 million adults using community care services opted for direct payments in 2003.

    The minister ruled out boosting the £14.4bn ($27.3bn; €20.7bn) already allocated for social care services in 2004-5, £10.6bn of which funds services for adults.

    Means testing would also continue, and funding personal care services would be “completely unsustainable,” he said.

    Consultation on the green paper will last until 28 July.

    Independence, Well-being and Choice is available at

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