Long-term care for older people is in need of urgent reform according to a new report from the University of Birmingham’s Health Services Management Centre.

The report recommends sweeping changes to the current system, giving patients access to personal budgets and far greater control over their own care.

‘Who cares?’ Policy proposals for the reform of long-term care will be launched at Capita's The Future of the Adult Social Care Workforce conference on 19th September.

The recent government report “The Case for Change” highlighted widespread confusion about how the current system operates and the ever increasing financial pressures caused by an ageing population and the rapid development of new medical technology.

The authors focus on potential solutions to these problems proposing a system of personal budgets similar to that already under development for community services. 

Professor Jon Glasby, the report’s author, comments: “However one looks at it the current system simply isn’t working. Too many people don’t understand the current system, and they feel that the charges they have to pay are unfair.

The model we propose is about giving older people access their own personal budget so that they can choose how best to meet their needs. 

If someone needs support, then the current system has two different approaches – depending on whether you stay in the community or go into a care home.  In our approach, both people would get access to the same level of funding – irrespective of whether they chose to use it on community services or on care home provision.

The experience from social care is that people receiving personal budgets can find more creative and innovative ways of meeting needs that makes better use of scarce resources than under the old system.”

The report argues any new system will need to address issues such as the role of families in providing care, fairness for all service users and most importantly how the system in funded.

However, the report warns that the danger in the current situation is that there could be no proper national debate about these issues because policy makers might be too focused on the technicalities of designing a new system.

As Professor Glasby adds: “Adopting the same system of personal budgets that is currently being developed in community services would free those designing the new approach to long-term care to focus on these underlying controversies – safe in the knowledge that a practical framework exists to implement the solutions they reach.

Without adopting our proposed approach, the danger is that current debates become too bogged down by the detail of producing a new system, and that we yet again fail to have a proper national debate about older people’s rights and entitlements.”


For further information or to request a copy of the paper contact: Anna Mitchell, Press Officer, University of Birmingham, Tel 0121 414 6029, Mob 07920 593946


Capita's The Future of the Adult Social Care Workforce conference on 19th September takes place at Copthorne Tara Hotel, Scarsdale Place, Kensington, London.

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The Health Services Management Centre is one of the leading centres specialising in development, education and research in health and social care services in the UK. HSMC’s prime purpose is to strengthen the management and leadership of these services and to promote improved health and well-being.