Adult social care in the four countries of the UK

The latest instalment of this explainer series looks at the struggling social care provider market and the way it is run and regulated – how does this differ across England, Wales, Scotland and Northern Ireland? Earlier explainers in the series, also listed below, describe other aspects of the social care system in each of the UK countries and shed light on how the systems diverge.

Comment series

Published: 12/05/2020

It is more or less clear to people that, when they have a health need, they can easily access the NHS via their GP or A&E or other direct access clinics (such as a walk-in clinic or minor injuries unit). And, when health care is needed, it is also well understood across the whole of the UK that there will be no charge.

The same clarity is not so evident when an adult has a care need – such as when they need help dressing, bathing or preparing food. Not only is social care an entirely different system from health, organised and with mostly separate funding to the NHS, there are also a number of differences between what a citizen can expect from social care across each of the four countries in the UK.

Legislative and demographic differences have existed between the different countries’ social care systems for many years, but since formal devolution settlements in the late 1990s, Scotland, Wales and Northern Ireland have assumed greater administrative and legislative powers. The pace at which these powers have been devolved has varied between countries – in Scotland and Northern Ireland social care has been (progressively more) administratively and legislatively devolved since 1998, and in Wales legislatively since 2006. The result of 15 to 20 years of devolution is that the social care systems in each of these countries have developed in different ways. As England continues to await long-promised social care reform, the other three countries of the UK offer learning that policy-makers should heed.

In this series of explainers, we describe the social care system in each of the UK countries, and shed light on where the systems diverge and the direction that each country is now taking.

The final update in this explainer series discusses the struggling provider sector in each of the four UK countries, and describes how each country manages and regulates this group. Earlier explainers in this series are all available below.

We thank all the stakeholders across England, Wales, Scotland and Northern Ireland – from registration and regulation bodies to policy think tanks and academia – who advised on this project.