The Gerontologist, Vol 37, Issue 3 333-340, Copyright © 1997 by The Gerontological Society of America
Legislating community care: the British experience, with U.S. comparisons
Gerontology Center, Rhode Island College, Providence 02908, USA.
In 1990, Great Britain enacted the National Health Service and Community
Care Act to reduce unnecessary institutionalization, improve coordination
of community-based long-term care, and stimulate private service provision.
An overview of four major principles of the legislation is provided: the
elevation of the assessor/care manager role, the emphasis on inter-agency
collaboration across the health and social care divide, privatization of
service, and support of carers (caregivers). Preliminary findings related
to their implementation indicate incremental rather than sweeping change.
The elements of the new policy that borrow from American models of
community care--and may be difficult to transplant--are highlighted.