Adult social care describes the activities, services and relationships that help people live independent, healthy, active and inclusive lives. It covers a great variety of services, delivered by many different providers, in a selection of settings. For example, adult social care can include domiciliary (home) care, residential care, nursing care, day care opportunities, short respite breaks and the provision of equipment.
There is significant cross over between health and social care, and there are areas where healthcare is largely provided in a social care setting, for example care for dementia, Parkinson's and end of life care.
Where an individual is assessed as having ‘primary healthcare needs’ they are eligible for NHS Continuing Healthcare. This is "a package of ongoing care that is arranged and funded solely by the NHS where an individual has been found to have a ‘primary health care need’'".[i] The package can include accommodation if that is part of the overall need, such as in a nursing home, a hospice or in an individual’s own home.
There is however no legal definition of a ‘primary health need’, this has led to disparities in how it is interpreted and as a result the number of people who receive NHS Continuing Healthcare. For example in England at the end of quarter 2 in 2013/14 59,000 people were eligible for NHS Continuing Healthcare, where as in Northern Ireland between 2006 and 2013 only 17 people had been assessed as eligible.[ii]
The Dilnot Commission for England in 2011 emphasised the importance of seeing social care as part of a wider care and support system. The Commission emphasised the importance of people receiving a coherent package of support shaped around their needs not funding streams.
"Social care supports people of all ages with certain physical, cognitive or age-related conditions in carrying out personal care or domestic routines. It helps people to sustain employment in paid or unpaid work, education, learning, leisure and other social support systems. It supports people in building social relationships and participating fully in society.
Social care is part of a wider care and support system, which includes social care, the NHS, the social security system, housing support and public health services. It also includes the services provided by third-sector organisations, and the invaluable contribution made by carers and volunteers. The state pension and private financial products also provide income that is used for care and support needs."
[i] Department of Health (2012) The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (Revised) DoH: London
[ii] Age NI (2014) The denial of NHS continuing healthcare in Northern Ireland Age NI: Belfast