Reforming adult social care: what can England learn from the experiences of other countries? Available to Purchase

This article proposes principles for reforming English adult social care by drawing on the experiences of other countries. These illustrate how the funding, organisation and delivery of services could be reformed, and shed light on the potential political and social factors affecting implementation of reforms.Reforms in other countries are commonly driven by the desire to develop and/or maintain universal access to social care. Formerly fragmented, un‐co‐ordinated and locally variable arrangements are being replaced with universal schemes, with national eligibility arrangements applicable to everyone regardless of age or ability to pay. Cash payments (personal budgets etc) instead of services in kind are widely used. However, such options can have different aims, including supporting family carers and stimulating local provider markets, as well as offering ‘consumer’ choice. Policies for family carers are usually integral to overall long‐term care arrangements. Finally, even in federal systems like Germany, Austria, Spain and Australia, central governments play a crucial role in ensuring universal, equitable and sustainable social care. Central government leadership: maximises risk pooling; enhances budgetary control mechanisms; safeguards equity and quality control; and provides political legitimacy.