Adult social care in the four countries of the UK

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 result of 15 to 20 years of devolution is that the social care systems in each of these countries have developed in different ways.

Social care reform has been delayed in England once more. Are there any lessons it could learn from the other three UK countries? And what are the social care challenges that each country share?

In this updated series of explainers, originally published in 2020, we describe the social care system in each part of the UK, and shed light on where the systems diverge and the direction that each country is now taking.

We thank all the stakeholders across England, Wales, Scotland and Northern Ireland who advised on this project, and in particular all the stakeholders who kindly gave up time to attend the roundtables that informed the development of this work.