Intended for healthcare professionals


Adult social care in England: more disappointment, delay, and distraction

BMJ 2021; 374 doi: (Published 14 September 2021) Cite this as: BMJ 2021;374:n2242
  1. Jon Glasby, professor of health and social care
  1. Department of Social Work and Social Care, School of Social Policy, University of Birmingham, Birmingham, UK
  1. J.Glasby{at}

New proposals do little to further much needed structural reform

Two years ago the prime minister, Boris Johnson, promised, “We will fix the crisis in social care once and for all with a clear plan we have prepared.”1 Unfortunately the resulting policy paper2 isn’t very clear, isn’t really a plan, and won’t fix very much.

This may not surprise many people who draw on care and support in England or people working in social care, who have been waiting decades for meaningful funding reform. At least 12 major reviews, visions, and white or green papers have emerged since the 1990s,3 and policy makers have failed to fully implement the funding proposals in any of them. Typically, successive governments start exploring major reform, only to stall, delay, or quietly abandon the idea when it seems too difficult to resolve.

Everyone agrees that there isn’t enough money to meet the needs of an ageing society with an increasing prevalence of multiple long term conditions, and the pandemic has highlighted the tragic neglect and fragmentation of the sector even more starkly than before.4 Alongside …

View Full Text

Log in

Log in through your institution


* For online subscription