England’s adult social care crisis, marked by escalating costs and growing demand, could find significant relief through the introduction of Japanese-style health MOTs for individuals turning 65, a new report from the Institute for Public Policy Research (IPPR) suggests. This preventative model, which involves automatic health assessments, aims to enhance the quality of life for older adults while potentially reducing the need for costly care home admissions. The IPPR’s call for early intervention comes amid a looming £23.3 billion care bill for local authorities in 2023/24, underscoring the urgency of reform.

Inspired by Japan’s system, where all citizens turning 65 undergo assessments coordinated by community comprehensive support centres staffed by long-term care specialists, care managers, and social workers, the approach focuses on preventative care and home-based services rather than institutionalisation. Japan’s model offers services ranging from help with everyday tasks like cooking and dressing to nursing care for chronic conditions. The consequences speak for themselves: Japan has only half the number of care home residents compared to the UK, despite its population being significantly older. The IPPR report stresses that such a system would not only support older adults and their families better but also represent a more efficient investment, potentially invigorating the economy rather than draining it.

Complementing the call for early assessment, the IPPR advocates more investment in community resources such as exercise groups and centres that promote health and social engagement among older adults and those with disabilities. Moreover, it highlights the need for better training and development for carers, enabling more personalised and effective support. Central to the proposed reforms is also the implementation of a cap on care costs. While Labour scrapped an earlier plan to impose an £86,000 cap on individual contributions towards social care in 2022, the IPPR insists this remains an essential component, alongside increased central government funding, to provide sustainable and equitable care.

Sir Andrew Dilnot, who chaired the landmark 2010 commission on adult social care reform, endorses these recommendations. He characterises the current care system as “failing us all” and calls for immediate, transformative action to bridge the “yawning and indefensible gap in our collective welfare provision.” Dilnot suggests that while the ongoing Casey Commission’s longer-term review may not report until 2036, the government is capable of announcing and beginning reforms much sooner, even within the current year.

Despite this consensus on the need for reform, significant challenges remain. A report from the House of Commons Public Accounts Committee criticises the government’s decade-long reform plan as having “gone awry,” highlighting the Department of Health and Social Care’s lack of a coherent strategy beyond 2025 amidst rising financial pressures and a severe workforce shortage with over 152,000 vacancies in adult social care as of March 2023. The Public Accounts Committee questions whether recent funding boosts—amounting to £2.7 billion—have effectively addressed these systemic issues, urging urgent, decisive action.

Adding to the challenges, England’s largest local councils have called for a delay in rolling out a cap on social care costs, originally scheduled for October 2025. The County Council Network points to a £30 billion funding shortfall and recruitment difficulties as critical constraints, warning that the policy will be unfeasible without additional financial support. This hesitation is echoed by a cross-party group of MPs who argue that reforms lack a strong financial rationale in part due to the absence of reliable data on the long-term costs of inaction, including the burden on the NHS from delayed hospital discharges linked to social care deficits. They stress the importance of robust research to guide effective and sustainable reform.

From a broader perspective, the value of Japan’s approach to measuring and enhancing social care outcomes is illustrated by academic research validating tools such as the Japanese version of the Adult Social Care Outcomes Toolkit (ASCOT) for both service users and carers. These instruments assess domains like control over daily life and dignity—key measures underpinning effective social care. Adopting similar outcome-focused frameworks may provide the UK with clearer metrics to evaluate and improve care quality, supporting the shift towards preventative, personalised services that the IPPR recommends.

Government officials have responded by reaffirming the commitment to prevention and early intervention within the 10-Year Health Plan, which aims to shift healthcare from reactive treatment to proactive care. The Department of Health and Social Care also emphasises its support for the Casey Commission’s ongoing work to develop a national care service that complements the NHS and remains fair and affordable for all.

As England grapples with the mounting pressures of an ageing population and constrained resources, the IPPR’s vision for automatic health assessments at 65 and a preventative, community-focused care system inspired by Japan offers a compelling blueprint. While financial, workforce, and political hurdles remain, there is a growing consensus among experts and policymakers that early and strategic reforms are essential to secure a sustainable and humane adult social care system for the future.

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Source: Noah Wire Services