The Economics of Self‐Directed Support

There has been growing international interest in the idea that social care would be better organised as a system of self‐directed support, where people control their own budgets for their own support. While there is significant evidence that this approach brings benefits to disabled people and those older people who need support, there is still an active debate about the efficiency and affordability of this approach. In Control has led work in England on piloting this approach, and has gathered some early evidence on the economic sustainability of self‐directed support. This article outlines the economic case for self‐directed support and some of the practical issues that will need to be confronted in order to implement self‐directed support successfully in the UK. In particular, it argues that the current service‐focused system of social care is structurally inefficient, and that self‐directed support makes much better use of the resources committed through public taxation. Finally, it contends that a rethink of the health and social care boundary will inevitably follow.