Constituent UK nations pool their experience of health and social care integration

Thursday 15th October 2013

Directors of adult social services from Northern Ireland, Wales, Scotland and England have come together to highlight the importance of integrated care, and the valuable contribution social care services are making in each of their four countries.

Their report* stresses that their combined experience has shown four critical factors for the successful integration of social and health care services:

  • A clearly articulated and widely-shared vision of why? How? And what benefits?
  • A medium to long-term financial strategy that is realistic about costs,
  • Flexible organisational arrangements that support a common purpose,
  • Attention to matters of culture through effective leadership

The directors report acknowledges that, throughout the UK, the state will not be able to meet the anticipated increasing demand for services without major reform in the way services are delivered.

Older people are living longer, and this is good news. However, the number experiencing poor health is growing, and the numbers of people with multiple, long-term conditions are expected to triple by 2050.

To illustrate their concern:

ENGLAND 2011/12

2.1 million people presented as potential new service users. Of those, 1 million required further attention. In total 1.5 million people received a service, of which 1.23 million were supported in their communities, with 517,000 receiving domiciliary care, 213,000 receiving residential home care and 86,000 supported in nursing home care.

Some 363,000 carers received support in carrying out their role. Over 1 million people worked in social care and the total budget was £16 billion.

WALES, 2011/12

78,000 adults were receiving a social care service at one point in time, with local authorities assessing the needs of 86,200 adults. Some 82 per cent were supported to live in their own homes and in a sample week, 22,700 adults were receiving domiciliary care.


198,000 social service workers supported 684,000 hours of home care a week during 2011/12; 211,000 weeks of respite per year; 37,500 adults in care homes costing £785.2 million per year; 63,500 people received home care costing £592.3 million. The total budget was £3 billion within social work departments for adults and older people during 2010/11.


12,421 staff working in social services, of which 38% are qualified social workers, supported 41,534 people within the statutory service. Some 12,250 residents of residential and nursing care homes had care packages and 8,140 people received statutory day care.

The directors say: while more of the same service delivery will not meet demand, it is essential that existing skills and experience, as evidenced above are utilised to best effect.


For further information, contact
Drew Clode, ADASS Media/Policy Adviser 020 8348 5023/07976 837755

* Four Nations United: Critical learning from four different systems for the successful integration of social care and health services

The report is due to be launched by representative of all four professional associations at the National Childrens and Adult Services Conference at Harrogate at a special reception on Thursday October 17 at 5.45 pm