The Impact of the National Health Service and Community Care Act (NHSCCA) 1990 on the 'typologies of care' of older people with functional dependence living at home in Britain (1980-2001)

This research focused on the prevalence and incidence of the number
of older people (65 years and older) reporting Activities of Daily Living
(ADL) limitations and falling into various ‘typologies of care’ between
1980 and 2001 in Great Britain. A pooled, cross-section of six
samples of older people (n=5513) reporting one or more functional
limitations in the General Household Survey (GHS) Elderly
Supplements in 1980, 1985, 1991, 1994, 1998 and 2001 were
assigned into seven typologies of care based on the combination of
reported help for ADL limitations: unmet need, kin independence,
substitution, formal care specialisation; compensation; task
specificity; and, supplementation/complementarity. British population
estimates of these typologies are provided using published figures from
ONS (England and Wales) and General Register Office for Scotland
(Scotland). The impact of the 1990 National Health Service and
Community Care Act (NHSCCA) on functional limitations and
typologies of care is analysed and discussed. Findings show that there
has been slight increase in the number of older people reporting
functional limitations between 1980 and 2001. Receipt of informal
care to meet functional limitations needs increased over the period of
investigation to compensate for a sizeable decline in receipt of formal
services, following implementation of the NHSCCA reforms.