Introducing Community Care

Abstract

The NHS and Community Care Act 1990 introduced far-reaching changes into community care policy and practice in England and Wales. It gave the lead agency role to social services authorities for all the main ‘core’ groups of service users. This lead agency role was to take the form of stimulating a mixed economy of care through encouraging independent providers. At a strategic level, this was to be achieved through the publication of community care plans on the basis of wide consultation with key agencies and groups, including service users and carers. At an operational level, care management was to be used to ensure service users were offered flexible packages of care which drew upon the independent sector. Caring for People, the White Paper on community care, justified these changes by reference to the need to develop choice and user-driven services (Department of Health, 1989a) while subsequent guidance went much further in arguing that ‘the rationale for this reorganisation is the empowerment of users and carers’ (Department of Health/Social Service Inspectorate, 1991, p. 7).