Dr Richard Dune

26-06-2025

Image by LightFieldStudios via Envato Elements

From hospitals to home care. Understand how health and social care differ, why it matters, and what it means for integrated services in the UK

In the UK, “healthcare” and “social care” are two essential yet distinct pillars of support. While both aim to improve people’s lives, they serve very different purposes, involve different professionals, are funded differently, and operate under separate, though increasingly converging systems.

Understanding the difference isn’t just an academic exercise; it’s vital for patients, carers, commissioners, professionals, and policy-makers alike. As the population ages and more people live with complex, long-term conditions, the boundaries between health and social care are being tested. The result? A growing drive toward integration, but clarity on their distinct roles remains critical.

In this comprehensive blog, Dr Richard Dune explores the distinct purposes, professionals involved, funding models, and operational systems of healthcare and social care in the UK. 

What is healthcare?

Healthcare refers to services that diagnose, treat, prevent, and manage diseases, illnesses, and injuries. It’s what you typically think of when someone mentions the NHS, your GP appointment, a hospital admission, or a prescription for antibiotics.

Key features:

• Focus - Medical needs and clinical interventions.
• Examples - Surgery, cancer treatment, diabetes management, maternity care, and physiotherapy.
• Providers - Doctors, nurses, paramedics, therapists, and other registered health professionals.
• Settings - GP practices, hospitals, clinics, community health teams.

Healthcare is largely reactive, responding to symptoms, but it also includes preventive services, such as immunisations, screenings, and health education. Whether short-term, treating a broken arm, or long-term, like managing heart failure, healthcare remains essential to population well-being.

What is social care?

Social care offers practical support to individuals who require assistance with daily living activities. It’s not primarily medical; it’s about promoting independence, dignity, and quality of life, especially for those with disabilities, mental health conditions, learning difficulties, or age-related challenges.

Key features:

• Focus - Everyday tasks, social inclusion, safety, and wellbeing.
• Examples - Help with bathing, dressing, eating, cleaning, shopping, and transport.
• Providers - Social workers, care assistants, personal assistants, and support workers.
• Settings - Residential homes, day centres, supported living schemes, or in people’s own homes.

Social care is person-centred and relational. It protects vulnerable individuals, promotes choice and control, and plays a crucial role in reducing isolation and enabling people to live fulfilling lives.

Core differences between health and social care

Despite both being part of the broader care system, their core purposes differ significantly:

Table 1 - How the core purpose between healthcare and social care differs for core differences between health and social care

While both are essential, the contrast between medical intervention and social support creates very different service models and user experiences.

Professionals in health vs social care

The workforce differs significantly:

• Healthcare professionals are typically highly regulated, degree-qualified, and work in roles requiring specialist clinical training. This includes doctors (GMC), nurses (NMC), and allied health professionals (HCPC).
• Social care professionals include social workers (Social Work England), care assistants (often without professional registration), and domiciliary carers. Their roles are rooted in empathy, trust, and sustained human connection.

One of the greatest challenges in social care is recruitment and retention, particularly in comparison to the NHS’s structured career pathways. Yet, both sectors face workforce pressures, particularly in the post-COVID era.

Funding models - NHS vs means-tested social care

Funding remains one of the most critical differences:

• Healthcare is publicly funded through general taxation and is free at the point of use.
• Social care is means-tested. Individuals may pay all, some, or none of the cost, depending on their income, savings, and assessed needs.

For example:

• The NHS fully funds a hospital admission for pneumonia.
• Support for washing and dressing at home may cost hundreds of pounds per week unless an individual qualifies for free care.

This creates confusion, frustration, and inequality, especially for older people with complex conditions straddling both systems.

Why the distinction matters

Understanding the boundary between health and social care has practical implications:

• For professionals - It defines who is responsible for what and who pays.
• For patients and families - It shapes access, expectations, and entitlements.
• For providers - It affects contracts, regulation, and compliance.
• For system leaders - It highlights where fragmentation causes delays, duplication, or poor outcomes.

Crucially, the distinction affects how services are commissioned, integrated, and inspected by the NHS, local authorities, and regulators such as the Care Quality Commission (CQC).

Challenges in separating the two

While the distinction is clear on paper, the real world is more complex. People don’t experience life in silos, and health problems often spill into social needs and vice versa.

Common challenges include:

• Delayed discharges - Patients who are medically fit for discharge remain in the hospital due to a lack of social care support.
• “Who pays?” arguments - Health and social care bodies disagree over funding responsibilities.
• Inconsistent care plans - Health and social care assessments are often conducted separately, resulting in duplication.
• Fragmented records - Poor data-sharing across organisations hampers holistic care.

This fragmentation drives cost, frustration, and inequity, and has led to widespread calls for integration.

Towards integration - Health and social care working together

Over the past decade, England has seen a growing policy focus on integrating health and social care.

The creation of Integrated Care Systems (ICSs), 42 partnerships covering the whole country, aims to bridge this divide.

Key integration efforts include:

• Place-based partnerships - NHS Trusts, local councils, and voluntary sector organisations co-develop local priorities.
• Shared care records - Digital systems enable professionals to access consistent, up-to-date information.
• Multi-disciplinary teams - GPs, nurses, social workers, and care staff work together to support people at home.
• Care navigators and link workers - Guide patients through complex systems.

ICSs signal a major cultural shift, from “what service do we offer?” to “what does this person need?”

Real-world examples and case studies

The following real-world examples and case studies illustrate how integrated care can work in practice:

Hospital discharge pathways

In many areas, NHS Trusts and local authorities co-run discharge teams. Social care staff assess needs on the ward, organise home care or equipment, and ensure timely transitions from hospital to home, freeing up beds and reducing readmissions.

Virtual wards

Patients receive clinical monitoring at home (via technology) and practical support (e.g. meals, medication reminders) through local care services. This hybrid model supports recovery, reduces pressure on hospitals, and offers a better experience for many.

Social prescribing

A person with long-term conditions may not need more tablets, but may benefit from:

• A walking group
• Financial advice
• Home adaptations.

Social prescribing teams link healthcare to social support, often delivered by the voluntary, community, and social enterprise (VCSE) sector.

Final thoughts and recommendations

Health and social care are different, but they must work together.

Healthcare heals. Social care sustains. Both are vital to well-being. Yet, historic divisions, organisational, financial, and cultural, continue to challenge integrated working.

Moving forward, system leaders, commissioners, and policymakers should:

• Simplify eligibility and access for the public
• Align funding incentives across health and social care
• Embed integrated training for health and social care professionals
• Empower ICSs to innovate at place and neighbourhood level
• Involve people with lived experience in service design.

For providers, understanding the distinction between health and social care isn’t just helpful, it’s strategic. It enables better contracts, clearer governance, and stronger compliance.

For professionals, it means working collaboratively, respecting different roles, and focusing on what matters most: the person.

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