Comparing UK care systems

About the work package

Led by Professor Catherine Needham (University of Birmingham).

To better understand the factors which support sustainable care, this team’s work is comparing the care systems which have emerged over the past twenty years in the UK’s four nations (England, Northern Ireland, Scotland and Wales).

Since the UK legislated to devolve powers in the field of health and social care to these nations’ parliaments, increasing differences have developed between their care systems. These are evident in variation in attitudes and policy aims and in different practices regarding care markets, privatisation of services and reliance upon, and support for, the paid and unpaid work of care. The differences offer a ‘natural experiment’ for theorising the relationship between care policy, care arrangements and care outcomes.

Located within care regime analysis, the team is comparing care systems which increasingly differ in their policies and structures, while other variables (such as macro-economic context, life-expectancy and attitudes to ageing, care and disability) are similar. No previous studies have rigorously compared these with respect to social care.

This team, led by Catherine Needham, and comprising Professor Ann-Marie Gray, Dr Alasdair Rutherford, Maria Cheshire-Allen and Professor Jenny Phillimore, is focusing on the main features of the four UK care systems: on how they differ and deliver on wellbeing and prevention, and on how they address diversity, inequality and the needs of the care workforce, whether paid or unpaid.

The team’s work is designed to enable it to identify the changes needed to enable care systems to be sustainable with wellbeing outcomes.

This team’s main research questions are:

1. What are the key features of the UK’s four care systems?

2. How well do they deliver on legislated principles of ‘wellbeing’ and ‘prevention’ and on sustainable care? What changes are needed to do this in future?

3. How is each system responding to the care needs of culturally diverse ageing populations?

4. How does each system take account of the service and support needs of the (paid and unpaid) care workforce?

5. What learning about sustainability can be applied from other (non-UK) systems?