Overview of the Reform

What is adult care and support?

Adult care and support describes the activities, services and relationships that help us to live an independent, healthy, active and inclusive life.

Care and support is available to adults who require assistance due to disability, vulnerability, illness, incapacity or old age, and is designed to promote independence, social inclusion, safeguarding and wellbeing.

Government Departments deliver care and support services in two key ways:

Adult social care – The Department of Health provides or secures the majority of care and support services through adult social care, which is part of the health and social care (HSC) system.

Examples of services that are provided through adult social care include:

• day care
• domiciliary care (care in the home)
• nursing home care
• residential home care
• social work
• ‘Meals on Wheels’
• respite
• information, advice or counselling
• provision of equipment

Other support services – Other government departments also provide services which can support people to lead more independent lives. These other support services include benefits, help with housing and transport.

Not all care and support is provided by Government Departments. Carers are people who provide unpaid care to family members or friends with support needs and play a vital role in the adult care and support system.

Care and support can also be provided through voluntary & community sector organisations and local community activities.

Why do we need to reform the system?

The care and support system in Northern Ireland is currently coming under increasing pressure for a number of reasons.

Our population is getting older and, while this is of course a cause for celebration, we know that more of us will need care and support for longer as we grow older.

People today also have different ideas and expectations about the care and support they need, and increasingly want control over how their needs are met.

And all this is happening in a constrained financial climate.

The reform process

The reform process is being taken forward in 3 stages:

Stage 1 – ‘Who Cares?’

During 2012/13, the Department carried out a consultation on the discussion document ‘Who Cares?’ to facilitate the debate around the future of adult care and support and build consensus on the need to change.

This stage has now been completed and the responses to the consultation are being used to inform Stage 2.

A summary of the consultation responses is available at Who Cares? Consultation Analysis Report.

Stage 2 – ‘Power to People’

Following on from the findings of ‘Who Cares?’, and in accordance with the commitment made in the Department’s ten year vision Health and Wellbeing 2026: Delivering Together, this stage involves the development of proposals to reform adult care and support.

An Expert Advisory Panel was established to help develop the reform proposals.The Panel’s final Report ‘Power to People: proposals to reboot adult care and support in NI’ was launched in December 2017.

Details on the Expert Advisory Panel and the ‘Power to People’ Report are available here.

An action plan based on the ‘Power to People’ proposals is currently being developed and will form the basis of an extensive public consultation in 2019.

Stage 3 – Final Strategic Document

Following consultation on the action plan, this stage will involve the development of a Final Strategic Document setting out the agreed future direction and funding of adult care and support along with the reforms required. This stage will likely require legislative change, which may include the consolidation of existing social care legislation.