Social care 360: access

1. Requests for support

Requests for support continue to rise

Why is this indicator important?

New requests for support to local authorities are the best available marker of demand for adult social care services. 

What was the annual change?

The number of new requests for support increased from 2.0 million in 2022/23 to 2.1 million in 2023/24. Requests for support from working-age adults and older people both grew. Requests from older people went up by 37,000 (3%), from 1.39 million in 2022/23 to 1.43 million in 2023/24. The number of requests from working-age adults increased 8%, from 612,000 to 658,000. However, receipt of care by working-age adults did not increase in proportion to requests (see indicator 2).

Overall, requests for support were equivalent to 5,700 requests every day of the year. Typically, there are around 1.5 requests per person.

What is the longer-term trend?

This was the second year, after 2022/23, when requests for support exceeded 2 million, but there is still a significant difference between the different age bands. Among working-age adults, requests for support have increased 31%, from 501,000 in 2015/16 to 658,000 in 2023/24. Among older people, requests have increased 9%, from 1.31 million to 1.43 million. Overall, the increase is 15%, from 1.81 million to 2.1 million. 

The source of requests for support has not changed significantly since 2015/16: around 4 in 5 requests originate from the community and 1 in 5 from hospital discharge. 

What explains the trends?

After a fall in 2020/21 during the Covid-19 pandemic, when requests from older people fell sharply, requests have returned to the general trend seen since 2015/16 of increasing demand for social care services.  

This is likely to reflect both an increasing older population and increasing disability among working-age adults: 23% of working age adults reported a disability in 2022/23, compared to 16% in 2012/13. 

What happened in 2023/24?

In addition to data about the number of requests for support, the Department of Health and Social Care has begun to publish provisional statistics showing the number of assessments that local authorities carry out. For the first six months of 2024/25, 285,000 assessments were carried out, of which 89,000 were working-age adults and 196,000 were people over the age of 65.

2. Access

The number of people receiving support is starting to increase 

Why is this indicator important?

Receipt of publicly funded long and short-term care are the key measures available to assess the extent to which demand for social care is being met (see indicator 1, requests for support). 

What was the annual change?

The number of people receiving publicly funded long-term care rose 3%, from 835,000 in 2022/23 to 859,000 in 2023/24. This was made up of a small increase in the number of 18–64-year-olds receiving long-term care, from 293,000 to 300,000, and a larger increase in the number of older people receiving long-term care, from 543,000 to 559,000. 

In short-term care to maximise independence (ST-Max), there was a large overall increase of 12%, from 225,000 to 252,000, made up of a 23,000 increase among older people and a much smaller 4,000 increase among working-age adults. 

What is the long-term trend? 

Since 2015/16, there has been an increase in the number of working-age adults accessing long-term care, from 285,000 to 300,000 (5.1%), and a fall in the number of older people receiving long-term care – down from 587,000 to 559,000 (-4.8%). Overall, 859,000 people received publicly funded long-term care in 2023/24 compared to 873,000 in 2015/16. 

When increases in population size are taken into account, the fall is even starker. In 2015/16, 6.0% of people aged 65 and over were receiving long-term care but by 2023/24 this had fallen to 5.2%. The percentage of the working-age population receiving long-term care was largely unchanged, at 0.9% in 2015/16 and 0.9% in 2023/24. 

With ST-Max, there has been an increase in provision for both working-age adults, up from 21,000 to 29,000 (35%) since 2015/16, and older people, up from 190,000 to 223,000 (17%). 

What explains this? 

The long-term trend in the number of people receiving long-term care can be divided into two parts: a fall from 2015/16 to 2021/22 and an increase in the past two years.  

From 2015/16 to 2021/22, despite rising requests for support, there was an overall fall in the number of people receiving publicly funded long-term care, from 873,000 to 818,000. This change was made up of a 1.4 % increase in the number of working-age adults (from 285,00 to 289,000) but a 10% fall (from 587,000 to 529,000) in the number of older people receiving long-term support.  

Three factors drove this: 

• between 2015/16 and 2021/22 local authorities faced a cut in their overall spending power but still managed to increase spending on social care in real terms. However, they had to pay more for the care they commissioned because provider costs increased due to the minimum wage. To balance budgets, they reduced the amount of care they commissioned.  

• Covid-19 additionally had an impact on demand and supply in 2020/21, with older people in particular reluctant to come forward for support and reductions in the number of services provided due to Covid-19 restrictions 

• as England came out of Covid-19, workforce capacity limited the amount of services that could be offered: adult social care vacancies rose to a record 10.7% in 2021/22.  

In the two years from 2021/22 to 2023/24, the number of people supported with long-term care rose 5% from 818,000 to 859,000. The number of working-age adults rose 3.7%, from 289,000 to 300,000, and the number of older people rose 5.7%, from 529,000 to 559,000. The factors driving this were: 

• an increase in demand after Covid-19, with overall requests for support rising by 5.4% from 2021/22 to 2023/24 

• an increase in workforce capacity: vacancies fell from 10.7% in 2021/22 to 8.3% in 2023/24 as 185,000 overseas workers arrived in the UK between 2022 and 2024 due to the loosening of visa regulations that allowed people to come to the UK to take up care worker roles  

• in 2023/24, in particular, a significant increase in social care expenditure (6.3% in real terms) by local authorities, driven by the channelling of funds initially intended for adult social care reform into supporting the existing system instead.  

One factor that has been consistent over this entire period is the means test ‘threshold’ of £23,250. This is the value of assets that disqualifies people from receiving publicly funded social care support. This figure has not increased in line with inflation, and as a consequence, fewer people are likely to be eligible for support than would have been the case in 2015/16.   

The 11% increase in ST-Max provision to older people in 2023/24 is interesting: the largest year-on-year increase since records began in 2015/16. It is possible that it marks the start of a trend towards a more preventive approach to adult social care (though local authorities have said that limitations on funding largely preclude this shift). However, it may also be a change in the type of short-term care provided: while expenditure on ST-Max rose 12%  in 2023/24, spending on other short-term support (for example, some emergency support) fell 5%.  

What has happened in 2024/25? 

Provisional statistics show a continued increase in the receipt of long-term support in 2024/25. At the end of September 2024, 673,000 people were receiving long-term support compared to 656,000 at the end of March 2024.  

3. Financial eligibility

The means test keeps on getting meaner 

Why is this indicator important?  

Unlike the NHS, social care operates a financial assessment (a ‘means test’) to decide who is eligible for publicly funded care. The levels of this are set nationally and announced each year. The ‘upper threshold’ decides the level of savings and other assets people can have and still qualify to receive publicly funded care. The lower that figure is, the fewer the people who qualify. 

What was the annual change? 

In 2023/24, the upper threshold remained at £23,250. 

What is the longer-term trend? 

The upper threshold has not changed since 2010/11. If it had increased in line with inflation, in 2023/24 it would have been £9,125 higher at £32,375, so more people would qualify for support. 

What explains this? 

By not increasing the threshold in line with inflation, successive governments have made the means test even meaner: it has become harder for people to get publicly funded social care, reducing its cost to the taxpayer. However, another key measure, the Minimum Income Guarantee, which defines the lowest amount of income an individual needing care at home must be left with after care charges, has increased in line with inflation since 2021/22 – after several years of being frozen. 

What has happened in 2024/25? 

The upper threshold remained at the same level for 2024/25 and will also be the same in 2025/26. However, the Minimum Income Guarantee rose in line with inflation in 2024/25 and is due to increase again in 2025/26. 

The previous government had plans to increase the upper threshold to £100,000 and the lower threshold to £20,000 from October 2025, along with cancellation of the introduction of an £86,000 cap on lifetime care costs. However, in October 2024, the incoming Labour government cancelled these plans.