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Long Term Care Reform in England: A Long and Unfinished Story

Chapter

Abstract

After a general description of the structure of the long-term care system as it has historically developed in England, this chapter documents some major changes that have taken place in the organization and delivery of long-term care in England over the past two decades—specifically the introduction of quasimarkets. It also documents the failure over the same period to achieve reform in the critically important area of funding. It shows that one series of policy preoccupations—quasimarkets and choice—has been pursued so consistently and assertively over two decades by Conservative, Labour and Conservative-Liberal Democrat coalition governments alike, when all have found more fundamental funding reforms much harder to achieve. Furthermore, this chapter describes the changes introduced in the institutional setting of the system in order to improve its efficiency, by supporting better collaboration between services, by introducing intermediate care services and by improving new approaches to home care. Finally, a review of the role played by diverse social and institutional actors in the revision of the system is presented as well as an interpretation of the mechanisms of change and the impact of the reforms.

Keywords

Local Authority National Health Service Social Care Residential Care Term Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Association of Directors of Adult Social Services/Local Government Association (ADASS/LGA). (2003). All our tomorrows: inverting the triangle of care. London: Association of Directors of Adult Social Services/Local Government Association.Google Scholar
  2. Audit Commission. (1986). Making a reality of community care. London: Audit Commission.Google Scholar
  3. Audit Commission. (1997). The coming of age: Improving care services for older people. London: Audit Commission.Google Scholar
  4. Audit Commission. (2000). The way to go home: Rehabilitation and remedial services for older people. London: Audit Commission.Google Scholar
  5. Audit Commission. (2010). Financial management of personal budgets. London: Audit Commission.Google Scholar
  6. Care Quality Commission. (2010). The state of health care and adult social care in England. Key themes and quality of services in 2009. London: Care Quality Commission. Downloaded from www.cqc.org.uk.Google Scholar
  7. Carers UK. (2007). Carers save UK £87 billion per year. www.carersuk.org/Newsandcampaigns/News/1190237139. Accessed 5 Feb 2008.Google Scholar
  8. Churchill, N. (Ed). (2008). Advancing opportunity: Older people and social care. London: Smith Institute.Google Scholar
  9. Comas-Herrera, A., Wittenberg, R., & Pickard, L. (2004). Long-term care for older people in the United Kingdom: Structure and challenges. In M. Knapp, D. Challis, J. L. Fernández, & A. Netten (Eds.), Long-term care: Matching resources and needs. Aldershot: Ashgate.Google Scholar
  10. Commission for Social Care Inspection (CSCI). (2008). The state of social care in England 2006–07. London: Commission for Social Care Inspection.Google Scholar
  11. Commission for Social Care Inspection (CSCI). (2009). The state of social care in England 2007–08. London: Commission for Social Care Inspection.Google Scholar
  12. Davey, V., Fernández, J. L., Knapp, M., Vick, N., Jolly, D., Swift, P., Tobin, R., Kendall, J., Ferrie, J., Pearson, C., Mercer, G., & Priestley, M. (2007). Direct payments: A national survey of policy and practice. London: LSE, PSSRU.Google Scholar
  13. Department of Health. (1998). Modernising social services. Cm 4169. London: Department of Health.Google Scholar
  14. Department of Health. (2000). The NHS Plan. A plan for investment, a plan for reform. London: Department of Health.Google Scholar
  15. Department of Health. (2001a). National service framework for older people. London: Department of Health.Google Scholar
  16. Department of Health. (2001b). Valuing people: A new strategy for learning disability for the 21st Century. Cm 5086. London: The Stationery Office.Google Scholar
  17. Department of Health. (2004). Dramatic fall in delayed discharges. Press release 2004/0196, 17 May.Google Scholar
  18. Department of Health. (2008). Putting people first: A shared vision and commitment to the transformation of adult social care. London: Department of Health.Google Scholar
  19. Department of Health. (2011). Fairer care funding: The report of the commission on funding of care and support. London: Department of Health.Google Scholar
  20. Department of Health and Social Security. (1988). Community care: An agenda for action. London: HMSO.Google Scholar
  21. Dowling, B., Glendinning, C., & Powell, M. (2004). Conceptualising ‘successful’ partnerships. Health and Social Care in the Community, 12(4), 309–317.CrossRefGoogle Scholar
  22. Drakeford, M. (2006). Ownership, regulation and the public interest: The case of residential care for older people. Critical Social Policy, 26(4), 932–944.CrossRefGoogle Scholar
  23. Duffy, S. (2004). In control. Journal of Integrated Care, 12(6), 7–13.CrossRefGoogle Scholar
  24. Ellis, K. (2007). Direct payments and social work practice: The significance of street-level bureaucracy in determining eligibility. British Journal of Social Work, 37(3), 405–422.CrossRefGoogle Scholar
  25. Fernández, J. L., Kendall, J., Davey, V., & Knapp, M. (2007). Direct payments in England: Factors linked to variations in local provision. Journal of Social Policy, 36(1), 97–121.CrossRefGoogle Scholar
  26. Glasby, J., & Littlechild, R. (2004). The health and social care divide: The experiences of older people (Revised 2nd ed.). Bristol: The Policy Press.Google Scholar
  27. Glasby, J., & Littlechild, R. (2006). An overview of the implementation and development of direct payments. In J. Leece & J. Bornat (Eds.), Developments in direct payments. Bristol: The Policy Press.Google Scholar
  28. Glendinning, C. (2007). Improving equity and sustainability in UK funding for long-term care: Lessons from Germany. Social Policy and Society, 6(3), 411–422.CrossRefGoogle Scholar
  29. Glendinning, C., & Lloyd, B. (1998). The continuing care guidelines and primary and community health services. Health and Social Care in the Community, 6(3), 181–188.CrossRefGoogle Scholar
  30. Glendinning, C., & Means, R. (2004). Rearranging the deckchairs on the Titanic of long-term care – is organisational integration the answer? Critical Social Policy, 24(4), 435–457.CrossRefGoogle Scholar
  31. Glendinning, C., Hudson, B., & Means, R. (2005). Under strain? Exploring the troubled relationship between health and social care. Public Money and Management, 25(4), 245–252.Google Scholar
  32. Glendinning, C., Challis, D., Fernández, J. L., Jacobs, S., Jones, K., Knapp, M., Manthorpe, J., Moran, N., Stevens, M., & Wilberforce, M. (2008). Evaluation of the individual budgets pilot programme: Final report. York: Social Policy Research Unit, University of York.Google Scholar
  33. Glendinning, C., Jones, K., Baxter, K., Rabiee, P., Curtis, L., Wilde, A., Arksey, H., & Forder, J. (2010). Home care re-ablement services: Investigating the longer-term impacts (Prospective Longitudinal Study). (Working Paper No. DHR 2438). York: Social Policy Research Unit, University of York.Google Scholar
  34. Glendinning, C., Moran, N., Challis, D., Fernández, J. L., Jacobs, S., Jones, K., Knapp, M., Manthorpe, J., Netten, A., Stevens, M., & Wilberforce, M. (2011). Personalisation and partnership: Competing objectives in English adult social care? the individual budget pilot projects and the NHS. Social Policy and Society, 10(2), 151–162.CrossRefGoogle Scholar
  35. Godfrey, M., Keen, J., Townsend, J., Moore, J., Ware, P., Hardy, B., West, R., Weatherly, H., & Henderson, K. (2005). An evaluation of intermediate care for older people. Final report. Leeds: Institute of Health Sciences and Public Health Research, University of Leeds.Google Scholar
  36. Grimshaw, D. (2002). Qualitative research on firms’ adjustments to the minimum wage. Manchester: European Work and Employment Research Centre.Google Scholar
  37. Grimshaw, D., & Carroll, M. (2006). Adjusting to the national minimum wage: Constraints and incentives to change in six low-paying sectors. Industrial Relations Journal, 37, 22–47.CrossRefGoogle Scholar
  38. House of Commons Health Committee. (2010). Social care (Third Report of Session 2009–10, Volume 1, HC 22–1). London: House of Commons.Google Scholar
  39. Humphries, R., & Forder, J. (2010). Options for funding long-term care; the partnership model compared. Quality in Ageing and Older Adults, 11(4), 30–35.CrossRefGoogle Scholar
  40. Joseph Rowntree Foundation (JRF). (2006). Paying for long-term care. York: Joseph Rowntree Foundation.Google Scholar
  41. Kasparova, D., Marsh, A., & Wilkinson, D. (2007). The take-up rate of disability living allowance and attendance allowance: Feasibility study (Research Report 442). London: Department for Work and Pensions.Google Scholar
  42. Laing and Buisson. (2005). Care of elderly people: UK market survey 2005. London: Laing and Buisson Publications Ltd.Google Scholar
  43. Leadbeater, C. (2004). Personalisation through participation. A new script for public services. London: Demos.Google Scholar
  44. Leadbeater, C., Bartlett, C., & Gallagher, N. (2008). Putting people first. Facing the challenges of scaling up personal budgets. London: Demos.Google Scholar
  45. Lewis, J. (2001). Older people and the health-social care boundary in the UK: Half a century of hidden policy conflict. Social Policy and Administration, 35(4), 343–359.CrossRefGoogle Scholar
  46. Lewis, J., & Glennerster, H. (1996). Implementing the new community care. Buckingham: Open University Press.Google Scholar
  47. Means, R., & Smith, R. (1998). From poor law to community care: The development of welfare services for elderly people. Bristol: The Policy Press.Google Scholar
  48. Means, R., Morbey, H., & Smith, R. (2002). From community care to market care? The development of welfare services for older people. Bristol: The Policy Press.Google Scholar
  49. Means, R., Richards, S., & Smith, R. (2003). Community care: Policy and practice (3rd ed.). Basingstoke: Macmillan.Google Scholar
  50. Moran, N., Glendinning, C., Stevens, M., Manthorpe, J., Jacobs, S., Wilberforce, M., Knapp, M., Challis, D., Fernández, J. L., Jones, K., & Netten, A. (2011). Joining up government by integrating funding streams? The experiences of the individual budget pilot projects for older and disabled people in England. International Journal of Public Administration, 34(4), 232–243.CrossRefGoogle Scholar
  51. Morris, J. (2006). Independent living: The role of the disability movement in the development of government policy. In C. Glendinning & P. A. Kemp (Eds.), Cash and care: Policy challenges in the Welfare State. Bristol: The Policy Press.Google Scholar
  52. Needham, C. (2007). The reform of public services under new labour: Narratives of consumerism. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  53. Newman, J., Glendinning, C., Hughes, M. (2008). Beyond modernisation? Social care and the transformation of welfare governance. Journal of Social Policy, 37(4), 531–557.CrossRefGoogle Scholar
  54. OECD. (2005). Long-term care for older people. Paris: Organisation for Economic Co-operation and Development.CrossRefGoogle Scholar
  55. Pearson, C. (2006). Direct payments in Scotland. In J. Leece & J. Bornat (Eds.), Developments in direct payments. Bristol: The Policy Press.Google Scholar
  56. Prime Minister’s Strategy Unit. (2005). Improving the life chances of disabled people. London: Cabinet Office.Google Scholar
  57. Royal Commission on Long-Term Care. (1999). With respect to old age: Long-term care – rights and responsibilities. London: The Stationery Office.Google Scholar
  58. Schofield, P. (2007). Are there reasons to be worried about the ‘caretelisation’ of residential care? Critical Social Policy, 27(2), 155–180.CrossRefGoogle Scholar
  59. Skills for Care. (2008). Employment aspects and workforce implications of direct payments. Leeds: Skills for Care.Google Scholar
  60. Skills for Care. (2010). The state of the adult social care workforce in England 2010. London: Skills for Care.Google Scholar
  61. Streeck, W., & Thelen, K. (Eds.). (2005). Beyond continuity. Institutional change in advanced political economies. Oxford: Oxford University Press.Google Scholar
  62. Wanless, D. (2006). Securing good care for older people. Taking a long-term view. London: Kings Fund.Google Scholar
  63. Windle, K., Wagland, R., Lord, K., Dickinson, A., Knapp, M., D’Amico, F., Forder, J., Henderson, C., Wistow, G., Beech, R., Roe, B., & Bowling, A. (2008). National evaluation of partnerships for older people projects: Interim report of progress. (PSSRU Discussion Paper 2612). Kent: Personal Social Services Research Unit, University of Kent.Google Scholar
  64. Young, J. (2009). The development of intermediate care services in England. Archives of Gerontology and Geriatrics, 49, S21–S25.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Social Policy Research UnitUniversity of YorkHeslingtonYorkUK

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