Wanless Social Care Review

In March 2006, the King’s Fund published the first comprehensive analysis of the demand for social care for older people in England and estimates of spending requirements over the next 20 years. (See Securing Good Care for Older People: Taking a long-term view). The review, led by Sir Derek Wanless, has already had a major impact on thinking and policy development in this area.

The King’s Fund is following up the report during 2007 with a programme of events across England and Scotland in partnership with a number of other organisations. Through the Caring Choices initiative we are facilitating an informed debate about roles, responsibilities and risks within our social care system of the future, and the trade-offs we are prepared to make as individuals and as a society.

Background

The King’s Fund commissioned Sir Derek Wanless to:

examine the technological, demographic and health trends over the next 15 to 20 years that are likely to affect the demand for and nature of social care for older people in England
in the light of this, identify the financial and other resources required to ensure that those who need social care are able to secure comprehensive and high-quality services
consider how such services might be paid for, bearing in mind the King’s Fund’s commitment to reducing inequalities in health and social care.

Sir Derek, former NatWest Group chief executive, led a team of economists and social care specialists based at the King’s Fund. The review was undertaken in collaboration with the Personal Social Services Research Unit (PSSRU) at The London School of Economics. The review followed Sir Derek’s two reports for the Treasury on future health care spending in the United Kingdom and on public health in England.

The review team concluded that social care for older people in England will require sharp increases in funding to meet the demand for high-quality care over the next two decades.

Simply keeping pace with population changes caused by increasing numbers of older people – and not seeking to improve care services or the way they are funded – would require total spending (public and private) on social care for older people to increase from the 2002 level of £10.1 billion (1.1 per cent of GDP) to £24.0 billion (1.5 per cent of GDP) by 2026. Achieving more ambitious goals for social care would mean increasing GDP to 2.0 per cent by 2026.

The review found very serious shortcomings in social care provision and funding arrangements. It recommended that to enable more people to receive care fairly and cost-effectively, there should be more ambition in the outcomes sought for social care and that the current means-tested funding system should be scrapped and replaced with a partnership model. Everyone in need would be entitled to an agreed level of free care, after which individuals’ contributions would be matched by the state up to a defined limit. People on low incomes would be eligible for benefits to fund their contributions.

The review argued that reconfiguring services in this way would be cost effective and could provide more community-based care, including better access for those with moderate needs; better support for carers; and improved services for people with dementia.

Responses to the review

Read responses to the review

In the media

Green Paper on social care funding

Visit our special section pulling together commentary and resources surrounding the government's announcement to produce a Green Paper on social care. More on the social care Green Paper