Policy response
29 May 2012
Area of work:

This report highlights the potential future funding gap in social care and draws on the Dilnot Commission review of funding for adult social care to outline the possible options for reform.


Michelle Mitchell, Age UK, on the challenge of funding and delivering adult social care in England, and the urgent need for reform.

The Government is set to publish a White Paper and draft Bill on the future of social care. The White Paper will set out the Government’s response to the recommendations from the Law Commission (2011), but is expected to shy away from fully addressing proposals put forward by the Dilnot Commission on Funding of Care and Support.

This Nuffield Trust policy response examines the current level of funding of social care and the Dilnot Commission’s recommendations, and suggests ways of funding a fairer, more sustainable system of social care.

The Dilnot Commission recommendations have received broad support across organisations that represent care users and providers.

It is imperative that the Government’s planned White Paper addresses the underlying funding gap. Failure to address social care funding will put vulnerable older people at risk and increase pressure on the NHS.Nuffield Trust Chief Economist Anita Charlesworth

A better-funded social care system, which includes the Dilnot proposals, will require increased public spending on adult social care. Reforming social care: options for funding, examines various options for paying for this in the short and longer term.

Potential solutions identified in the paper include: minimising the cost of the Dilnot recommendations by opting for a higher level of caps; generating more productivity from existing social care services; and exploring options for redirecting elements of the health and welfare budgets into social care.

It suggests that the Government urgently needs to begin a dialogue with the public about how social care will be paid for in the future.

Some progress has been made in discussing the principle of individuals contributing their own wealth and assets to pay for their own care. But there has been much less debate on the need for additional public funding. The report also calls for a parallel focus on improving the quality of social care provision.

For further information about our work in this area, visit the dedicated area of work page on NHS and social care reform.

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