SOCIAL POLICY zyxwvutsr 8r ADMINISTRATION ISSN zyxwvutsr 0144-5596 VOL. 30, No. zyxwvuts 1, MARCH 1996, PP. 39-53 zyxwvu H a l f w y There? Policy, Politics and Outcomes in Community Care Melanie Henwood, Gerald Wistow and Janice Robinson Abstract The community care reforms which followed the 1989 White Paper “Caring for People” were apparently focused zyxwv on addressing the needs o fpeople requiring long-term care, and on achieving improved outcomes and better quality of life. The agenda set out zyxwvu by the White Paper wasf o r community care in the next decade and beyond. Half way through this decade, we question the extent to which the objectives of promoting choice and independence f o r users and carers have been achieved. The paper drams particularly on a programme of monitoring conducted jointly zyxwvuts ly the ~ u~eld Institute for Health and the King’s Fund, based on national and local focus groups meeting over a two-year period. I t proposes a framework f o r evaluation which consists of four components: the dejinition of desired outcomes; specijication of service systems necessary to deliver such outcomes; promotion of access to services; and the development of supporting operational policies and resource allocation mechanisms. This framework offers a substantial step beyond much of the monitoring of the community care reforms which has taken place to date. This has assessed progress largely in terms of the establishment of new systems andprocesses. We conclude that such changes were essential building blocksfor delivering better-quality community care services, and in the short term it may have been legitimate to view their establishment zyxwvu as proxies for progress towards delivering user-centred services. However, monitoring and evaluation should now be increasingly oriented towards ensuring that these changes are infact producing the desired service outputs and user outcomes. Wepropose that our framework offers one such wayforward. Key words Community care Users and carers Outcomes Focus groups The stated objectives of the 1989 White Paper Caringf o r People (Secretaries of State, 1989) were to secure significant improvements in the quality of life for Address for Correqmndence: Melanie Hcnwood, Old Daiu Cottage, Park Hall, Heatkote, Nr Towcestn, Northants, “12 7LD. zyxwvutsrq @I Blackwell Publishers Ltd. 1996,108 Cowlg Road, Oxford OX4 IJF, UK and 238 Main Street, Cambridge, MA 02142, USA.