The adult social care system is “fundamentally broken” and “unfit for purpose” health experts warn today (Wednesday), amid calls for a radical shake-up for service provision.

This damning indictment of the social care system comes as the Care Bill returns to Parliament and is contained in a new policy paper issued by the University of Birmingham and Birmingham City Council, following an in-depth study of adult social care provision by local authorities across England.

Professor Jon Glasby, Director of the Health Services Management Centre, and lead author of the report, said: “Local authorities across the country are struggling to meet their responsibilities in a very difficult financial and policy context. With higher levels of need, higher public expectations and widespread cuts, the previous approach to adult social care feels fundamentally unfit for purpose.”

The policy paper, entitled Turing the welfare state upside down? Developing a new adult social care offer calls for a new approach to adult social care.

The report also calls for:

  • Recognition that adult social care spending is a form of social and economic investment that helps people be active citizens, supports people to return to employment and can generate new businesses opportunities for local people
  • A closer relationship with the NHS so that scarce public resources are used as effectively as possible and the needs of people with complex needs are met in full
  • A closer relationship between local and national government so that both see themselves as partners when trying to resolve traditional dilemmas and develop new approaches.

The report states: “For many commentators, the adult social care system is fundamentally broken. This is not the fault of current workers, managers or policy makers – but there is strong consensus that we still have a 1940’s system which is increasingly unfit for purpose in the early twenty-first century.”

The study was based on a review of how local council websites frame what they do for local people and interviews with a series of leading national stakeholders and good practice examples.

Its aim was to produce a policy paper to guide local authorities’ thinking on the potential for a new adult social care “offer” to local people.

Professor Glasby added: “Rather than starting with deficits (things people can't do for themselves), we need to start with social capital and community resources (things people can for themselves and others, and everyday solutions that make sense to them). In future, adult social care needs to adopt more of a community development approach - working with individuals, groups and communities to build capacity and helping people to find new ways to achieve chosen lifestyles.”


For more information please contact Deborah Walker, PR Manager for Policy and Social Affairs, University of Birmingham, +44 (0)121 414 9041 or mobile +44 (0)7776 465138. Out of hours contact +44 (0)77889 921165 or email the Press Office.

  • Read the full version of the policy paper: Turning the welfare state upside down? Developing a new adult social care offer      
  • Professor Glasby is professor of heath and social care and director of the Health Service Management Centre at the University of Birmingham. HSMC is the leading UK centre for research, teaching, consultancy and policy advice around health and social care integration. 
  • Professor Glasby has previously been involved in: Advising the NHS Future Forum and the social care White Paper on health and social care integration; Presenting evidence to the previous Ministerial Working Group on Health and Social Care Integration; Providing expert input on this topic to Downing Street, the Department of Health, the Cabinet Office and the All Party Parliamentary Group on Adult Social Care
  • The Care Bill 2013/14 will return to Parliament today for its Report Stage in the House of Lords