Social care: Government reviews and policy proposals for paying for care since 1997

This House of Commons Library briefing considers the policy proposals of successive Governments since 1997 for how individuals should pay for their social care.


Image source: frkasb – Flickr // CC BY-NC 2.0

Unlike health services through the NHS, social care is not universally free at the point of delivery – local authority support is means-tested, and those that receive funding such support are still expected to contribute their income towards the cost.

While the issue of paying for social care has been considered in depth – by the Royal Commission in 1999, the independent King’s Fund in 2005 (which the Government subsequently acknowledged), and the “Dilnot Commission” in 2011 – and some important changes have been made, the key features of the means-test remain broadly unchanged since 1997 while the issue of very high lifetime social care bills remains unresolved.

Election analysis: health and care

The NHS Confederation has published Election analysis: what does the new government mean for health and care?  

This briefing is an initial assessment of the main takeaways for the NHS and the wider health and care system. It identifies areas of alignment and disagreement between the Conservatives and the Democratic Unionist Party in Norther Ireland, and the NHS Confederation’s priorities for the new government.

Constructive conversations with citizens when implementing new models of care

Wicked issues – complex problems that cannot be solved in a traditional fashion – are endemic in the NHS. They are nothing new. But the current challenges facing the NHS, social care and others are arguably the most ‘wicked’ yet | SCIE

scie comms

Image source: SCIE

This report summarises the findings from a research study which sought to explore how we can better broker constructive conversations with citizens to tackle wicked issues when implementing new models of care. The research was undertaken by the Social Care Institute for Excellence, working in partnership with PPL and the Institute for Government and funded by the Health Foundation’s Policy Challenge Fund.

Social Care and the NHS

The Kings Fund has released the fourth and final video in its ‘Bite-sized social care’ series Social care, the NHS and other services.   This short video explains the importance of different services working together to provide care.


Other ‘Bite-sized social care’ videos from the Kings Fund:

Digital solutions for social care


VODG (Voluntary Organisations Disability Group) has published Co-producing technology: harnessing digital solutions for social care. 

This paper outlines how health and social care providers can collaborate with service users when designing apps, websites and other digital technologies.  It recommends how providers can maximise the benefits of such new approaches, and addresses three focus areas: the locality perspective, the integration perspective and the practice perspective.

Download the full report:
Co-producing technology: harnessing digital solutions for social care.

Long-term sustainability of NHS and Adult Social Care

The House of Lords Select Committee on the Long-term Sustainability of the NHS has published The Long-term Sustainability of the NHS and Adult Social Care.

The Committee highlights the ‘short sightedness’ of successive governments for failing to plan effectively for the long-term future of the health service and adult social care.  It makes a number of recommendations including the establishment of an independent Office for Health and Care Sustainability which will be able to identify clearly the healthcare needs of a changing population and the staffing and funding required to meet these needs.

NICE guidance: managing medicines

NICE has published Managing medicines for adults receiving social care in the community


This guideline covers medicines support for adults (aged 18 and over) who are receiving social care in the community. It aims to ensure that people who receive social care are supported to take and look after their medicines effectively and safely at home. It gives advice on assessing if people need help with managing their medicines who should provide medicines support and how health and social care staff should work together.

Full guideline: Managing medicines for adults receiving social care in the community