New report reviews adult social care across UK nations

April 29, 2021

The Institute for Government, a London based think tank, has published a new report this week: Devolved Public Services: The NHS, schools and social care in the four nations.

Governments provide social care differently in each of the four nations of the UK – and they are likely to diverge further in coming years, with the SNP and Scottish Labour proposing a National Care Service in Scotland.

According to the institute for Government, divergent paths taken since devolution should provide an opportunity for Governments to learn from each other’s experiences about what policies work best; but a paucity of comparable data on social care makes this difficult to achieve. The Institute for Government’s new report aims to fill that gap.

Some of the key findings from the report, relating to adult social care, are as follows:

  • The UK government spent £308 per head on adult social care in England in 2018/19 – as opposed to £423 per head in Wales, £443 in Scotland and £491 in Northern Ireland.
  • The Scottish government was the only Government which spent more on community than residential care in 2018/19.
  • The proportion of the English population receiving state-funded social care fell by over a third between 2006/07 and 2013/14.
  • Scotland loses more bed days per person to delayed discharges than England and Wales combined.
  • The Welsh government spends more per head on social care for working age people than the Scottish government, but significantly less per head on older people.

Grant Dalton, author of the social care chapters in the report, said, ‘Building on previous work from Skills for Care, and the Nuffield Trust, we found that static or declining budgets have meant that the Government is providing care to fewer people than it was a decade ago in England, Scotland and Wales. Spending in Northern Ireland has increased rapidly over the past five years, but even their provision has not kept up with rising demand.

‘We also find that free personal care in Scotland has had a limited impact on performance, with Scotland losing more bed days per person to delayed discharges than England or Wales. But Scotland does seem to have been most successful in transferring care from care homes into the community.’

Dalton concludes, ‘The four nations rarely release data in the same way as each other, and often do not agree on how comparable the data they do publish is. Better data is vital to understanding the performance of services. The four governments must improve the evidence on social care performance to analyse what has – and has not – worked.’

Visit the Institute for Government’s website to read the report in full.


A signed open letter has been sent to the Prime Minister, calling for a ‘1948 moment’ for adult social care and to establish a long-term and sustainable future for the sector.

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