As populations age and demand for social care rises, there are a number of issues which need to be addressed, including the best ways to deliver quality care for those who need it and the best ways to pay for that care. There are also broader challenges about how to invest in preventative and asset-based approaches that minimise people’s needs for formal care, and how to ensure that formal care services support informal family carers to stay in good mental and physical help. Many countries are facing this dilemma and some, such as Germany, have taken bold steps to address it. In the UK, the political debate seems stuck on issues on payment, with all different funding options rejected as not being fair to one group or another. Scotland has gone furthest in relation to reform by the provision of free personal care, but even in Scotland there has not been a move towards any kind of long-term insurance model to bring more money into the system.

A range of issues intersect with social care, and are looked at elsewhere in the handbook. Housing is a key issue, since appropriate housing can be a key way to sustain people’s independence and mobility. Technology is also an area of growing overlap with social care, as artificial intelligence offers new possibilities for a range of supports – from so-called ‘care robots’ to new communication technologies that can improve connectedness and reduce loneliness.

Social care has for years been described at a Cinderella service compared to the NHS – somewhat hidden and poorly funded. It has risen in political salience in recent years – fuelled in part by a number of scandals relating to abusive or inadequate care provision – but also due to the ageing of the so-called baby boomer generation whose expectations of care may be different to the war generation that preceded them. Calls for a care system that keeps people independent as long as possible, and provides high quality and affordable care when they need it will only get louder in the future.