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  • Melissa Thompson

What can the NHS learn from Japan’s Unique Social Care System?

Longevity has increased immensely over the last several years, paving the way for longer, often fuller lives of people around the world. One country’s population tops the longevity charts, claiming the title of the oldest demographic to date. Japan has long been revered for its treatment of the elderly, with an intense focus on family dynamics embedded in the culture combined with a strong healthcare system specifically for its senior population. A significant part of this success now revolves around a unique social care model that provides for older men and women living in the country.

How Japan is Different

One of the most notable differences within the Japanese social care system is the focus placed on people over the age of 65. Anyone who meets the age threshold submits an application to their local government to undergo a comprehensive test intended to fully assess their needs. Once reviewed, a local care manager offers recommendations on how to best meet the individual’s needs, and they provide a robust list of resources including service providers focused on community-based care. The plan for care is based on the local government’s budget, the range of organisations available to provide care, and public and private resources earmarked for benefits.

This is a form of insurance that many countries do not implement for their older population. Japan is able to construct and sustain its social care model by restricting the number of care homes available, shifting the burden on community- and family-based support. It also receives premiums paid for by all citizens of the country over the age of 40, and small co-payments remitted by the individual receiving care. There is universal eligibility for the programme, but the underlying operational structure is consistently reviewed to ensure it is both fiscally responsible and beneficial to those who need it most.

The idea of fostering communities and families that are keenly aware and actively engaged in supporting the elderly is a concept foreign to most other countries. However, the social care model has been highly successful in Japan, leading other developed nations to lean into suggestions for changing their initiatives. The global population is rapidly aging, which puts pressure on current healthcare systems that is unprecedented. Shifting toward a model that emulates Japan’s successful path could prove beneficial in the long run.

NHS Issues and Possible Solutions

In the UK, the NHS is the primary healthcare institution tasked with managing the medical needs of the population. The unfortunate reality is that the system has faced a long-term battle revolving around the need to keep up with a greater demand for care and tightening fiscal reigns. As the demographics of the patient population continue to increase in terms of age, the NHS is staring down even greater obstacles to maintain a high-quality system without drastic shifts.

A team of experts in medical negligence explains that the average 65-year-old costs the NHS 2.5 times more than the average 30-year old, while an 85-year-old costs five times more. These higher expenses are absorbed by the NHS which ultimately leads to short staffing, stressed and overworked nurses and GPs, and higher wait times for the patients who need care the most. When budgets fail to keep up with the increased financial burden of providing healthcare, patients suffer immensely.

Compounding the cost burden is the reality that a social care model is not fully in place in the UK. However, a recent Nuffield report offers some recommendations for the NHS based on Japan’s highly successful elder healthcare structure. These suggestions are broad, such as viewing a shift toward social-based care as a long-term project that has flexibility in design and implementation, and creating specific roles for care managers to mimic Japan’s critical players in the process. The report also recommends the development of a market of services throughout communities, but placing an emphasis on the need to consider the financial and labour impact this would have on the country. Finally, recommendations round out with a shift toward preventative healthcare, based on community support.

While the NHS has many strides to take in an effort to achieve a truly social-based care model, these ideas are a strategic start to improving the quality and accessibility of care for an aging population.


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