Policy Document

National Health Service and Community Care Act 1990

Year

1990

Country

United Kingdom

Topic

Health

Subtopic

Long-term care

Main implications

Set obligations of local authorities regarding provision of care services.

The legislation notably requires local authorities, in consultation with private and voluntary organisations, to create and publish a plan for the provision of community care services in their corresponding localities. It directed local authorities to assess and arrange the care needs of elderly in-patients in hospitals.

Social services departments are responsible for managing community services for elderly people, unless there is a need for medical care. In detail, the Social Services are responsible for home help or home care, respite care, day care, night-sitting services, care home care, and provision of equipment to help people with day-to-day tasks. The National Health Service (NHS) is responsible for nursing; chiropody or physiotherapy; and for supplies for people who are incontinent.

Local Authorities take the responsibility for assessing the need for care, choosing someone to provide it, and making sure that it is delivered within the Local Authority's available funds. They are also responsible for developing social care for people who have a serious mental illness.

A new funding structure was introduced for people going into care homes: responsibility for funding residential and nursing home care (means tested) returned to local authorities. The NHS only provides and/or pays for the Nursing Care Service Component of a person’s long-term care service needs. All other costs and services associated with long- term care are the care recipient’s responsibility, unless he qualifies for Local Authority assistance.

If the individual has capital of more than 22,000 GBP in England (and 19,000 GBP in Scotland and 20,500 GBP in Wales), no assistance from full NHS or local authority is provided. The assistance for covering the long-term care costs is provided from the local authority if the individual’s assets are less than 12,250 GBP in England, 11,750 GBP in Scotland, and 13,500 GBP in Wales.

Benefits & Requirements

Read the Law

Full Text Source in English

1990, c. 19

Original full text source in native language

1990, c. 19

Full text web source in English

http://www.legislation.gov.uk/ukpga/1990/27/pdfs/ukpga_19900027_en.pdf

Original full text web source in native language

http://www.legislation.gov.uk/ukpga/1990/19/contents/enacted

Comments & Clarifications

The reform was informed by two White Papers published in 1989: Caring for People: Community Care in the Next Decade and Beyond and Working for Patients. To curb the rapidly rising costs of residential care, the legislation endeavoured to make local authorities purchasers of services from the private and voluntary sectors, rather than direct service providers (Walker and Maltby, 2008, p. 400). 
Effective date:  1 April 1993 (for sections relating to community care services.)

Secondary Literature & Sources

Secondary literature

Walker, A., & Maltby, T. "Older People". In Alcock, P., May, M. & Rowlingson, K. "The Student's Companion to Social Policy". Oxford: Blackwell Publishing (2008): 394-401.

Author

Alyson Silkowski
London School of Economics

Data collected in the framework of the Population and Policy Database

Cite as

SPLASH-db.eu (2012): Policy: "National Health Service and Community Care Act 1990" (Information provided by Alyson Silkowski). Available at: https://splash-db.eu [Date of access].