Inquiry into Covid-19 social care crisis should be led by Citizens' Assembly, report urges - RSA

Inquiry into Covid-19 social care crisis should be led by Citizens' Assembly, report urges

Press release

People must scrutinise Covid-19 response

  • People’s Health and Care Commission with a Citizens’ Assembly at its heart would build public confidence in integrating health and social care systems.
  • Generational digital divide: only 6% of over-55s accessed any online health services during the pandemic, compared to 25% of 18-34 year-olds, report notes.
  • Surge in people power: 26% were involved in supporting their local community during the pandemic, compared to 12% who volunteered locally before.


A Citizens' Assembly-led Commission into Covid-19 is needed to break the integration of health and social care deadlock, a think-tank report argues. 

Reimagining the future of health and social care by the RSA (Royal Society for the encouragement of Arts, Manufactures and Commerce) finds a serious lack of interaction between the health and social care systems during the pandemic. 

The report calls on the Department for Health and Social Care to fund a ‘People’s Commission on Health and Social Care’, which would:  

  • Encourage joined-up policy thinking by allowing citizens to critique the successes and failings of the whole system – including the NHS, social care providers including care homes, central government and local authorities. 
  • Bring randomly selected members of the public, with quotas for BAME representation, together with policy experts to co-design the ‘new institutions’ the government calls for as part of its Covid-19 recovery strategy.  
  • Have the power to question experts from across the health and social care system in England, Whitehall and councils, and highlight how they can better work together. 

The RSA argues this would help embed citizens’ lived experiences of health and social care during the pandemic – both for Covid-19 related treatment and other needs – into the NHS Forward Plan, by bypassing traditional silos between councils, the NHS and within central government. 

A survey of 2002 adults in the UK, conducted by Opinium to accompany the report, also finds: 

  • The crisis has unlocked more ‘people power’ in the health system: 26% were involved in supporting their local community during the pandemic: 12% only continued something they had already been doing, 2% continued something they had already been doing and did something new, 13% started something new.  
  • The crisis has not spurred a significant shift to digital services in the NHS – but the appetite is there: while 25% of those aged 18-34 have accessed online GP services (including video consultations) during the pandemic, this falls to just 6% of those aged 55-plus. Likewise, face-to-face consultations remain the preferred option for accessing GP services compared to online appointments or phone calls for all age groups, but this comprises just 35% of 18-34 year-olds compared to 59% of over-55s. However, the appetite for digital is there as 72% of respondents agree or strongly agree that video/online appointments should be expanded in a future NHS. 
  • Younger people are less supportive of tax rises to fund the health service: of those who want to see a rise in NHS funding (61%), increasing general taxation is the preferred option for all age groups. However, while 38% overall want to see income tax increased to provide extra funding, this falls to 31% of those aged 18-34 compared to 44% of over-55s; 28% of 18-34 year-olds think extra funding should be delivered from “savings” from the existing budget, compared to just 13% of over-55s. 


The report also calls for: 

  • Greater funding for health and social care delivery, administered at the local level to meet “context specific needs”.  
  • Upskilling social care workers to make better use of digital technology. 
  • Central government to review procurement rules and contracting requirements for health and social care to encourage more innovation and cross-working.  
  • The NHS and its partners to introduce much better predictive modelling where actions taken in one system has a direct knock-on effect on another, potentially separately governed, system. This has meant that decisions taken with regards to the NHS may have had knock on consequences in the separately administered care system. Such predictive insights have apparently lacking in the UK response to the current pandemic, the RSA argues. 
  • Central government to conduct a ‘digital access strategy’ to improve digital take-up, taking age, location and other factors into account. 
  • Local authorities to create legal spaces for local experimentation in integrating health and social care through “regulatory sandboxes”. 


Hannah Webster, report co-author and senior researcher at the RSA, said: 

“As the whole of government looks to develop ‘new institutions’ as part of Number 10's recovery strategy, it must include deliberative democracy methods like Citizens’ Assemblies to give power back to ordinary people. Collectively, we have all made sacrifices over the past few months and we must have a say in how the future of health and care is funded and run. 

 “Despite much talk of integration over the years, health and social care remain separate systems that interact poorly, while digital opportunities are still an add-on rather than core to service delivery. 

“This health epidemic requires bold new thinking to prepare for the future and provide access to the very best health and care for all. By putting citizens in control, such as through a People’s Health and Care Commission, with a Citizens’ Assembly at its heart, we can finally break through the health and care deadlock which has confounded political leaders for a generation and more.” 




For a live/pre-record interview or embargoed report copy, contact:

Ash Singleton, Head of Media and Communications,, 07799 737 970. 



The RSA (Royal Society for the encouragement of Arts, Manufactures and Commerce) is an independent charity which believes in a world where everyone is able to participate in creating a better future.  

Through our ideas, research and a 30,000 strong Fellowship, we are a global community of proactive problem solvers, sharing powerful ideas, carrying out cutting-edge research and building networks. We create opportunities for people to collaborate, influence, and demonstrate practical solutions to realise change.  

Our work covers a number of areas including the rise of the 'gig economy', robotics & automation; education & creative learning; and reforming public services to put communities in control. 

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