영국 지역사회보호의 최근 동향과 시사점

Recent Developments of Community Care in U.K. and Its Implications

This paper reviews a wide range of issues and major changes in the 4th stage of UK's community care development, for over 20 years. Several new implementation tools were introduced since the National Health Service and Community Care Act 1990. This act had given the lead agency role to social services authorities for all the main core groups of service users and actively required the stimulation of a mixed economy of care. At a strategic level, this was achieved through wide consultation with diverse service professionals on the basis of care management, user empowerment, care continuum with the emphasis upon the leading role of primary care within the community. In addition, supports and assessment for carers, and integrated care system were the focus of continuous attention. Although service rationing and dilution was also in the center of concern under the budget constraints, UK's community care service scheme has surely been advanced in terms of inter-departments coordination, quality control, and the supply of a wide scope of health and social services. Through this review, useful guidance for Korean society is drawn as follows: improvement of early intervention and user empowerment, more extensive use of assistive technology including telecare and monitoring, growth of nonprofit sector suppliers, tailored joint-service provision of health and social care, enhancing the autonomy of local governments, promoting a more flexible work environment for diverse professionals, and finally necessity of comprehensive supports for carers.