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Health and social care roles

Health care and social care – what’s the difference?

Most of us are used to receiving health services from the NHS – by visiting our GP or dentist or going to hospital.

Some people who have health needs may also have social care needs. If you are in need of social care support for the first time, it can be confusing trying to understand who is responsible for what care, what services you are entitled to and what has to be paid for.

The National Framework for NHS Continuing Healthcare define health care and social care needs as:

  • In general terms it can be said that a health care need is one related to the treatment, control or prevention of a disease, illness, injury or disability, and the care or aftercare of a person with these needs (whether or not the tasks involved have to be carried out by a health professional).
  • In general terms it can be said that a social care need is one that is focused on providing assistance with activities of daily living, maintaining independence, social interaction, enabling the individual to play a fuller part in society, protecting them in vulnerable situations, helping them to manage complex relationships and (in some circumstances) accessing a care home or other supported accommodation.

Social care needs are directly related to the type of welfare services that local authorities have a duty or power to provide. These include:

  • Social work services
  • Advice and support
  • Practical assistance in the home
  • Assistance with equipment and home adaptations
  • Visiting and sitting services
  • Provision of meals
  • Facilities for occupational, social, cultural and recreational activities outside the home
  • Assistance to access educational facilities; and assistance in finding accommodation (such as a extra care housing)

Who decides what care I get?

If you need routine health care services (such as visiting your GP), you will access this in the normal way.

If, however, health and social care services need to decide who is responsible for your care, then your care requirements will need to be assessed. This could be, for example, if you are being discharged from hospital and are unable to return home or need some support to return home. See our information page about Hospital stays.

The two services will need to decide whether your primary needs are health care needs or social care needs.

What care do I pay for?

Simplistically put, healthcare is free (paid for by the NHS) and social care costs are met by the individual (or the Local Authority if the individual’s finances fall below the means-testing threshold).

For your care to be fully funded by the NHS (known as NHS Continuing Healthcare), your primary need must be a health care need.

If you are not eligible for NHS Continuing Healthcare, you may be referred to your local authority to see if you are eligible for help from them.

If you still have some health needs, then the NHS may pay for part of the package of support.

If your primary need is a social care need, and you are eligible for services from your local authority, the local authority will be responsible for your care. You will then have a financial assessment carried out to find out what you may need to pay towards the cost of your care.

For further information, see our Paying for care page.

What is integrated care?

Health and social care professionals are increasingly working together to help people in the community with a range of needs. If you have both health and social care needs, you may be looked after by an “Integrated Care Team” (ICT).

ICTs focus on maintaining the health and wellbeing of people in their community. They include staff from social, community, mental health, primary care and some outreach services provided by secondary care.

Who are in ICTs?

ICTs include:

  • GPs and Practice Nurses
  • Community Nurses
  • Mental Health Practitioners
  • Physiotherapists and Occupational Therapists
  • Social workers (including reablement specialists)
  • Condition specific support staff e.g. heart failure, Chronic Obstructive Pulmonary Disease, diabetes, Parkinson’s, palliative care, Multiple Sclerosis, etc.
  • Geriatricians (from secondary care) 
  • Pharmacists • Psychiatrists 
  • Paramedics

Who do ICTs support?

  • People with multiple health and social care needs. 
  • People with complex health needs. This could include people with a high number of GP and/or hospital attendances, people at risk of falling and those showing signs of neglect or who are at risk of abuse. 
  • Older people - particularly if they have long-term conditions, complex care needs and/or are approaching the end of their life. 
  • People who would benefit from early help to manage their conditions to avoid them becoming a high user of services.

Each team develops individual care plans with the patient and their family.


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