Welsh and English Care Acts


In England, occupational therapists working in adult health and social care are experiencing subtle, yet transformational, changes to their role.  Arguably, these changes are as a consequence of the Care Act and the impact it has had on the delivery of services since its implementation in 2014.

Soon, colleagues in Wales will also have the opportunity to experience the transformational effect changes to health and social care legislation brings, as the Welsh version of the Care Act comes into force.  In this blog, we take a brief look at similarities and differences between the two acts.

Health and social provision

Whether you an OT in England or in Wales, you will both be looking at health and social provision in terms of how older and disabled people and their carers can be supported to maintain a sense of well-being.  Also similar is the process older and disabled people have to negotiate in order to receive support.

The process starts with an assessment, which considers what the person or carers needs or wants to do in order they can maintain their well-being.  Once this has been established, a person, or their carer, receives advice or information as to the ways in which maintaining their health and well-being can be achieved.  Social care services will provide service, or direct payments if any support meets the national eligibility criteria for the provision of care.

Finally, but no less important, is the focus on prevention.  In order to prevent people developing needs, both the Welsh and the English Act are placing an emphasis on encouraging the development of preventative services.  And this is where the expertise of occupational therapists plays, and will play, an important role.  For it is the skills and knowledge the profession has on re-ablement, equipment, adaptation, and the use of advice/education  to improve independence and safety will play a vital role in delivering these services.

So what are the key differences between the Acts in England and Wales?

The health and social care needs of children is one of the biggest differences, with children being considered in the Welsh Act but not in the English Act, which will remove the often difficult time during the transition period from child to an adult.  The Welsh Act has also placed a greater emphasis on safeguarding as demonstrated by the adult protection and support order tools they have put in place a national safeguarding board, which will have a role in supporting local boards.

Finally, the Welsh Government is taking the opportunity of legislation change to motivate the NHS and social care departments to continue with moving forward with integration agenda.  It is doing this by giving itself the power in the Act, if necessary, to force partnership agreements between the local NHS and local authority departments.

The key differences are, therefore,

  • The Welsh Act includes children
  • Improved safeguarding procedures
  • A stronger push towards health and social care integration


Over the coming months and years, it will be interesting to watch whether the differences in the Welsh Care Act makes it a stronger piece of legislation when compared to its cousin act in England.  Only time will tell if this is the case.  In the meantime, if you are an OT and want to know about how the Welsh act will impact on practice, you can visit http://gov.wales/docs/dhss/publications/151217occupationaltherapyleafleten.pdf.

And remember, if you are a member of College of Occupational Therapy, then you will find an English and Welsh language version of their position statement on the act https://www.cot.co.uk/position-statements/position-statements

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