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Currently, unlike NHS services, social care is not free at the point of use. Find out who is eligible for publicly funded social care, how many people have requested support, and how many people's needs are not being met.

Eligibility for publicly funded social care

Currently, unlike NHS services, social care is not free at the point of use. Anyone who requests public funded social care must undergo a needs assessment and a means test, and only those with highest needs and the lowest financial assets are likely to receive support. Anyone with assets of more than £23,250 must pay for all social care themselves. Below this threshold, contributions are made by the service user and the government on a sliding scale. If service users have long-term complex health needs, the NHS may also contribute to funding.

The current thresholds for publicly funded social care mean only those with low assets and income receive funding

Requests for support

In 2021/22 nearly two million requests for adult social care support were made. Demand for care is growing, driven by changes in demographics. Demand for working-age adults in particular has increased by 22 per cent since 2015/16 ‒ partly due to the increase in adults with disabilities as more people with severe disabilities survive childhood. There are also more older people as a result of the post-war ‘baby boom’, and until recently life expectancy had been increasing.

The total number of requests for social care support has increased since 2015/16

Expenditure

In 2021/22 total expenditure by local government on adult social care was £27 billion. The majority was spent in two areas: learning disability support for working-age adults and physical support for older adults. Most of this expenditure is on long-term care, which is ongoing service or support with the aim of maintaining quality of life. The rest of expenditure goes on short-term care, which aims to maximise independence and reduce the need for ongoing support.

Social care expenditure varies by type of support and age

Unmet need

There is significant unmet need for social care ‒ Nuffield Trust estimated that fewer than half of older people with care needs were receiving support (including support from unpaid carers). Long-running cuts to local authority budgets have meant that funding has failed to keep pace with demographic pressures. Currently nearly one-third of requests for local government funding result in no support. Unmet need puts pressure on the 5 million self-identified unpaid carers in England and Wales (a figure that may be an underestimate – Carers UK research found there could be as many as 10.6 million in the UK) to provide support for their families and friends, and demand is unlikely to be met without significant funding increases.

Outcome of requests for local government funded social care in England

Costs of care

For individuals not eligible for full public funding, the total costs across an individual's lifetime will vary depending on their level of need. The government estimates that 1 in 7 adults aged 65 face lifetime care costs of more than £100,000. Even within the publicly funded sector, service-user contributions to social care have been increasing. This is due to the restrictions on public funding and the increasing costs of care. In 2021/22 service users eligible for publicly funded care contributed £3.2 billion towards their own care (note, this figure does not include people who have to fund their social care privately).

Social care income from client contributions continues to increase

The current position

Government action to address the pressures on social care has largely been rolled back. A White Paper published in December 2021 announced reforms to address the ‘catastrophic’ care costs that some individuals face in their lifetimes. But in the November 2022 Autumn Statement, the government announced that some of these reforms would be postponed until October 2025. Now, following publication of its ‘next steps’ document on 4 April 2023, many of the remaining measures from the White Paper have also been cut back or cancelled.