Turning the welfare state upside down ? ’ Developing a new adult social care offer

Acknowledgements About HSMC The Health Services Management Centre (HSMC) is the leading UK centre for research, teaching and consultancy with regards to health and adult social care. The Centre's Director, Professor Jon Glasby, has advised Downing Street, the Department of Health and the Cabinet Office on the future of health and social care, and has worked with the NHS Future Forum and the 2012 social care White Paper team to advise about the creation of more integrated health and social services. He is also a Senior Fellow of the national School for Social Care Research and a former Board member (2003-2009) of the Social Care Institute for Excellence. HSMC has previously worked with Birmingham City Council to evaluate the closure of local authority care homes for older people, to review joint commissioning and to support the creation of the Health and Well-Being Board. HSMC's Dr Helen Dickinson was also the founding Director of the Public Service Academy established jointly by the University and City Council. This discussion paper was commissioned by the Adults and Communities Directorate of Birmingham City Council in order to help inform future debates about service provision. We are grateful to the interviewees who took part in the study – and the title of this paper comes from a quote from one of our participants. Any errors are those of the authors, and any overall themes identified are our interpretation of the data rather than something that can be attributed to any specific individual or to the City Council. Figure 1 is an image used widely by Simon Duffy at the Centre of Welfare Reform and we are grateful to Simon for finding and popularising such a powerful image. 3 Summary For many commentators, the adult social care system is fundamentally broken. This is not the fault of current workers, managers or policy makers – but there is strong consensus that we still have a 1940s' system which is increasingly unfit for purpose in the early twenty-first century. This was already becoming apparent before the current financial crisis – albeit that a very difficult funding environment has brought these debates to the fore and made them even more urgent. Against this background, the Health Services Management Centre at the University of Birmingham was commissioned by Birmingham City Council Adults and Communities to produce the current policy paper to guide the Council's thinking on the potential for a …