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Feature Social Care

Can a worker cooperative model of social care improve the patient experience and reduce pressure on GPs?

BMJ 2024; 385 doi: (Published 18 April 2024) Cite this as: BMJ 2024;385:q783
  1. Sally Howard, freelance journalist
  1. London
  1. sal{at}

Chronically underfunded and with hundreds of thousands of roles vacant, social care is in crisis, piling pressure on frontline services and GPs. One solution comes from an old idea: a care workers’ cooperative. Sally Howard reports

For years, Kate Smyth found that getting help through private social care providers for basic tasks, such as dressing and washing, was “a nightmare.” The West Yorkshire based Smyth, 69, who is cofounder of the Disabled NHS Directors Network, has multiple sclerosis and can no longer move from the neck down. She needs “significant assistance,” she says, with her personal care.

“The people supporting me would just stop with very little notice, or they’d maybe not turn up, or turn up late, or they’d come and I’d never met them before,” she recalls. “It was scary.”

These days the picture is brighter. In October 2022 Smyth transferred her care package to Equal Care Co-Op, a cooperative and worker led social care provider. “Now I’ve got a brilliant team of nine people who are incredibly loyal and fill in regularly when we’ve got gaps at the last minute,” she says. “This means I can continue to work rather than sitting watching telly.”

This care model, which has been in operation in Calderdale since 2018 and is on Calderdale Council’s approved provider list, is a worker cooperative (a business or organisation owned and controlled by its members to meet their shared needs). In a context …

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