The NHS and Community Care Act 1990: is it a success for elderly people?

Abstract

The NHS and Community Care Act 1990 signified a controversial change in the government's health and social policy.1 Phase 3 of the act was implemented on 1 April 1993, transferring the responsibility for funding of patients in the voluntary sector and in private residential and nursing homes from the Department of Social Security to local authority social services departments. We studied the effects of this reform on hospital practice. From 1 April 1992 to 31 March 1994 we observed all patients aged >65 in the general medical, geriatric, and orthopaedic wards of our hospital who had been inpatients for >28 days. We observed these 766 patients weekly until discharge and noted the date when the patients became “medically stable”—that is, no longer benefiting from acute hospital care or rehabilitation—where they were discharged …