At a glance

Institute: 
Method: 
Partners: 
Health and Social Care and Housing, Communities and Local Government Select Committees
Duration: 
April to May 2018
Project Type: 

This question has been the subject of much debate over a number of decades, with numerous proposals by successive governments, inquiries, commissions, thinktanks and others being published but never successfully implemented. Despite widespread agreement on the urgent need for reform, there has been little consensus on what that reform should be.

In mid 2018 the Housing, Communities and Local Government and the Health and Social Care Select Committees held a joint inquiry into the long term funding of adult social care. They wanted to gather a range of evidence on the options for funding social care sustainably for the long term (beyond 2020) whilst bearing in mind the interdependence of the health and social care systems and the mechanism for reaching political and public consensus on a solution. Their aim was to get a cross party consensus on this complex issue to try and get an effective solution. The joint inquiry was timed to be able to feed directly into the Government’s Green Paper on the funding of social care for older people later in 2018.

As part of the inquiry the committees were interested in hearing a full range of voices on the issue. This included hearing from ordinary members of the public.

What we did

Involve approached the committees to suggest running a Citizens’ Assembly. The deliberative approach that characterises Citizens’ Assemblies makes it possible to give voice to the multiple views that exist around controversial policy issues such as this one. Having recently been involved in the Citizens’ Assembly on Brexit we knew that this model could be useful for the committees. The committees agreed and commissioned the Citizens’ Assembly on Social Care.

The Assembly was held over two weekends in April and May 2018 in Birmingham. The Assembly Members were 47 randomly selected people from England. They were initially contacted through an online survey with ICM and then recruited by our in-house team and were chosen to be a broadly representative sample of the English population (see below).

Stratification criteria

England population

Assembly members

Comparison

Age

18-34

28.60%

25.53%

-3.07%

35-54

34.10%

31.91%

-2.19%

55+

37.20%

42.55%

+5.35%

Ethnicity

White

86.30%

80.85%

-5.45%

Ethnic minority

13.60%

19.15%

+5.55%

Gender

Male

48.90%

51.06%

+2.16%

Female

51.10%

48.94%

-2.16%

Region

North

27.80%

21.28%

-6.52%

Midlands

19.00%

23.40%

+4.40%

East

11.10%

17.02%

+5.92%

London

15.60%

14.89%

-0.71%

South

26.50%

23.40%

-3.10%

Social grade

ABC1

53.20%

55.32%

+2.12%

C2DE

46.70%

44.68%

-2.02%

Big/Small state

Government should cut taxes

6.96%

10.64%

+3.68%

Neutral

40.22%

40.43%

+0.20%

Government should increase taxes

52.82%

48.94%

-3.89%

The Citizens’ Assembly on Social Care worked through a three-step process of learning, deliberation and decision-making. A team of professional facilitators supported this process, with two lead facilitators and seven table facilitators at each weekend. The facilitators guided the Assembly Members through the weekends, ensuring that everyone was heard and felt comfortable participating.

The sessions were a mixture of small group work (6-7 people) and plenary sessions. Assembly Members heard from a range of experts on the different funding models as well as from several speakers with their own lived experience of the social care system. In total participants took part in approximately 28 hours of deliberation, which equates to 1,316 ‘people hours’.

The Assembly Members made a range of recommendations, including on the:

  • Principles that should guide decisions on social care funding;
  • Balance between public and private funding;
  • Specific sources of public funding; and
  • Amount individuals should be expected to pay, and how much of their assets should be protected.

You can read the recommendations in detail in our report here.

After the Assembly weekends we presented the findings in our report to the Select Committees for consideration in their joint inquiry.

Who was involved

The Assembly was

  • Commissioned by two Select Committees; Housing, Communities, and Local Government, and Health and Social Care.
  • Funded by Parliament, The Esmée Fairbairn Foundation & the Omidyar Network
  • Informed by expert leads and expert speakers; Professor Martin Knapp and Professor Gerald Wistow of the LSE
  • Made up of 47 Assembly Members
  • Overseen by an Advisory Panel
    • Caroline Glendinning, University of York
    • James Lloyd, formerly of the Strategic Society Centre
    • Kari Gerstheimer, Mencap
    • Raphael Wittenberg, London School of Economics
    • Warwick Lightfoot, Policy Exchange
  • Facilitated by expert trained facilitators, led by Involve
  • Supported by Involve staff

What was achieved

This was the first Citizens’ Assembly in the UK to be commissioned and run by Parliament. The project was successful in engaging members of the public and in influencing the Select Committees’ findings. The Committees drew heavily on the findings and referenced the Assembly throughout their own report. The Select Committee Chairs Sarah Wollaston MP and Clive Betts MP have advocated for the findings of the Citizens’ Assembly and the model of engagement in their speeches in parliament.

It was also important that the participants felt it was worthwhile. Members rated their experience of the Assembly an average of 9.5 out of 10. All 47 Assembly Members agreed with the statement “Assemblies like this should be used more often to inform government and parliament decision-making”, with 46 strongly agreeing.

“How else would you receive informed decisions / views from the general public? not many avenues would allow people to receive 4 days of information on which to base their opinions.”

Member- Citizens' Assembly on Social Care

Reports

Click on the links below for our report and the joint Select Committee report

Method

Click here for more information on the Citizens' Assembly method.