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Major analysis uncovers huge variation in care demand

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A major new analysis of social care data has found a fall in the proportion of older people seeking social care and uncovered huge variation in demand between councils.

The research by the King’s Fund combines for the first time publicly available, annually published data from sources including NHS Digital, NHS England, the Office of National Statistics and the Care Quality Commission.

It found the number of requests for adult social care increased to 1.8 million last year but there are 13,000 fewer older people receiving long-term support than in 2015-16 while council spending on social care had falen in real terms by £700m since 2010-11.

simon bottery

simon bottery

King’s Fund senior fellow Simon Bottery has urged government to make more money available for social care

The proportion of working age adults requesting social care has increased by 4% since 2015-16, at a time when the proportion of older people doing the same has dropped by 2%.

However, due to the growth in population, the volume of people requesting support has grown over the period from 1.31 millon to 1.32 million older people and from 500,000 to nearly 524,000 working age adults.

Despite this increase in requests, the number of over-65s receiving long-term social care has fallen by 20,000 since 2015-16, while 7,000 more working age adults are receiving support.

The report says a freeze since 2010-11 in the value of assets people can hold and still be eligible for state-funded care could explain the drop in older people being supported as thresholds have not kept pace with inflation.

It adds the adoption by councils of an ‘asset based’ approach which diverts applicants to support provided by voluntary and community organisations, as well as self-help support to promote independence and resilience, could also contribute to the trend.

However, the report cites the Health Survey for England which found unmet need among over-65s remained high, with 22% reporting their needs were not being met in 2017 – slightly down from 26% in 2011.

The report also found significant variation in demand across England. There were 1,554 requests for support for every 100,000 18-64-year olds in 2017-18. However, requests in different areas ranged from 5,655 to 287.

For older people, the average in England was 13,160 per 100,000 over-65s but the range of variation was 77,220 to 3,306.

The report adds: “There are likely to be a range of reasons for these differences from large-scale demographic differences between local authorities and levels of deprivation to administrative differences in contact handling and recording practice.”

Simon Bottery, senior fellow at the King’s Fund and lead author of the report, said there is little evidence that the government “understands or is willing to act” on rising demand and high unmet need.

He added “The social care green paper, which still has no release date over two years after it was announced, is an opportunity to set out the fundamental reform we desperately need.

“But while the green paper is delayed, the government must focus on what it can do to support people now. Putting more money into the system in this autumn’s spending review would help people to get the help they need while longer-term reform takes effect.“

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Readers' comments (2)

  • Please can you hyperlink to external reports when referring to them in the story?

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  • It would be good practice to include a link to the report in stories such as this.

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