England could introduce health checks for 65-year-olds, modelled on Japan’s system, in a bid to ease pressure on adult social care, a new report suggests.
Preventative assessments could improve quality of life and reduce care home admissions, the Institute for Public Policy Research (IPPR) has said.
In 2023/24, local authorities spent £23.3bn on adult social care. The think tank argues earlier intervention could ease financial pressure and improve outcomes.
Sir Andrew Dilnot, who made reform recommendations more than a decade ago, supports the plans, describing the current shortfall in provision as “yawning and indefensible”.
The Casey Commission is reviewing England’s adult social care system and will design a framework for a national care service – a central Labour pledge.
Its first phase is due to report next year, with full implementation expected in stages over the next 10 years. However, social care leaders have warned that some measures may not come into force until 2036. The second phase of the commission, setting out longer-term reforms, is due to report by 2028.
The IPPR recommends that all adults turning 65 and people receiving disability-related benefits should be automatically assessed for their care needs.
It says any reform should include a “right to live and age well”. It also advises the government to adopt elements of Japan’s approach, which includes regular, proactive assessments and wide-ranging support.
In Japan, all adults are assessed when they turn 65 for support needs ranging from help with daily tasks to residential and nursing care for long-term conditions.
“Care is managed by community comprehensive support centres, which employ long-term care specialists, care managers, and social workers,” the report said.
“This model emphasises preventative care and home-based services, reducing both cost and reliance on institutional care while supporting family caregivers.
“Japan has half the number of people in care homes as the UK, despite a much older population.”
Other proposals include investment in local exercise groups and community facilities to help older and disabled people stay healthy and independent, as well as better training for carers to provide tailored support.
The IPPR also calls for a cap on care costs, as recommended by the Dilnot Commission, and more funding from central government. Labour dropped its plans for an £86,000 cap on care costs last year.
Sir Andrew, who led the 2010 review of adult social care, said: “The IPPR paper argues powerfully and persuasively that good social care provision can be a wonderful way of enhancing human flourishing.
“For far, far too long we have had a social care system that fails us all – those who need care, those who provide care, and those who might need care in the future.
“Acting now can transform lives for those with care needs, create a vibrant and exciting care sector, and finally fill this yawning and indefensible gap in our collective welfare provision. Let’s do it.”
He has previously criticised delays to reform, saying the government could feasibly set out a long-term plan by the end of the year.
IPPR research fellow Dr Annie Williamson said: “A proactive approach to adult social care, including universal MOT-style assessments at 65 and early support, could help people maintain independence for longer while reducing long-term costs.
“A shift to prevention will mean fewer care home admissions, better quality of life for older adults, and more sustainable funding. As the UK grapples with rising demand and strained budgets, this kind of forward-thinking reform offers a way out.”
A Department of Health and Social Care spokesperson said: “Through our 10-Year Health Plan, we will shift healthcare from treatment to prevention to help people live longer, healthier lives.
“This includes diagnosing and treating conditions earlier, predicting and preventing problems before they become serious, and helping people to live healthier lifestyles.
“At the same time, Baroness Casey has begun her work on the Independent Commission into adult social care, which will start a national conversation and provide recommendations for a National Care Service that is fair and affordable for all – and works alongside the NHS.”
