Public consultation is launched on reshaping adult social care

Date published: 26 January 2022

Far-reaching plans to change the face of adult social care in Northern Ireland have today been tabled by Health Minister Robin Swann.

The reform proposals – numbering 48 in total – will be the subject of a 16 week public consultation.

A central priority of the plans is to significantly enhance both the amount and the quality of social care services – with a major focus on increasing investment to meet increasing levels of need. Growing the social care workforce and improving its pay, terms and conditions are emphasised as a “lynchpin” of reform.

Recommendations also include stronger powers to regulate and inspect independent sector providers of care – covering such areas as levels of profit and management costs. The Department of Health also intends to review the current balance between private, public and voluntary sector provision in social care. The aim will be to ensure the best balance is struck between statutory and independent sector provision.

The consultation takes place in the context of projected massive growth in demand for adult social care. Population projections for Northern Ireland between mid-2018 and mid-2043 estimate a 56.2% increase in people aged 65 and over and a 106.4% increase in those aged 85 and over.

The Health Minister stated: “Northern Ireland has waited too long for reform of adult social care – and for the sector to get the recognition and support it both needs and deserves. I am determined to put this right.

“Our current social care services do provide invaluable support for many people and we recognise the contribution of our existing workforce and of the family carers without whom the system could not work.

“However, we know that there is growing demand for adult social care and that some aspects of the current system don’t work the way we would like them to. We need to address this and that’s why we need to change how social care is organised, funded, commissioned, delivered and led. 

“The Covid 19 pandemic has highlighted the importance of adult social care services.  Social care is not easy work even in ordinary times and these have been anything but ordinary times. Social care staff have shown real commitment to the people they support throughout the pandemic, responding to the situation with kindness, care and determination to reach the people who need them.”

The Minister continued: “I would encourage as many people as possible to respond to the public consultation and get involved in the discussion about these most vital of services.

“Today sees the start of what is a two-pronged approach to making social care better and fit for the future. Alongside the public consultation, I have commissioned a full review of current charging arrangements.

“This review will involve a comprehensive assessment of the advantages, disadvantages and impact of a variety of different charging approaches including the options of introducing a cap on costs faced by individual and families.

“The whole issue of charging is both complex and extremely sensitive. The ongoing pressures on public funding are well documented and there are many competing demands for investment in health and social care. My immediate priorities – as reflected in the proposals published today - are to improve the quality and the amount of social care services and to invest in the workforce.

“I am determined to push ahead on those fronts while in parallel examining all options on the future of charging. The current system of charging contributes £173.4 million a year to the adult social care system. Replacing that system with an alternative approach that is both fair and feasible would be one of the biggest challenges facing the next Executive and Assembly. The review I have commissioned will be central to any such work.”

The 48 proposals detailed in the reform of adult social care public consultation include:

* Major new social care legislation introducing statutory duties including:

  • Duties to provide preventative and early intervention services.
  • Duties to sustain, promote and protect social wellbeing in the provision of adult social care services.
  • Duties to provide information, choice and control of service provision to service users and family carers.
  • Duties to provide equitable access to assessment of need for service users and family carers.
  • Duties to provide equitable access to services to meet eligible assessed need for service users and family carers.
  • New criteria for service eligibility for service users and family carers.
  • Duties to provide independent advocacy for service users and family carers.
  • Authority for market regulation, if required.
  • Authority for any additional powers of inspection required.

* a review of the current balance in the mixed economy of care, producing recommendations as to what balance between statutory and independent sector provision should be.

* the introduction of increased powers of inspection and regulation in relation to overhead and management costs and levels of profit.

* a more proactive commissioning approach which will actively plan and shape service provision.

*a revised locality based model of domiciliary care.

* the introduction of the offer of preventive/support visits for anyone aged over 75. This would help provide support and advice to older people, identifying social care needs and issues at an early stage.

* the introduction of an independent Carers’ Champion role. This would be similar to the Mental Health champion role established in recent years. This person would be a public advocate for family carers, ensuring their voice is heard, influencing policy and giving advice across government departments.

* expanding the availability of the Supported Living model to more people including those with complex needs who require more intensive support.

* the phasing out of shared bedrooms in care homes over a three year period except for provision for couples who wish to share a room.

* improving the pay, terms and conditions of the lowest paid in the social care workforce.

* measures to reduce the possibility of any care home resident having to move home because of a change in their care needs.

* increasing Direct Payment rates to broadly match the cost of equivalent directly commissioned services.

* continued development of a Social Care Workforce Strategy.  This will include actions to develop career pathways, supervision and support, training and education of the workforce and to raise the profile and recognition of the social care workforce.

* a revised system of regionally consistent tariff setting for adult social care services.

* working across Government to promote social care as a valuable and rewarding career choice.

Notes to editors: 

  1. The consultation can be found online: Consultation on The Reform Of Adult Social Care | Department of Health (
  2. For media enquiries please contact DoH Press Office by e-mail
  3. Follow us on Twitter @healthdpt
  4. The Executive Information Service operates an out of hours service for Media Enquiries Only between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The Duty Press Officer can be contacted on 028 9037 8110.

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