New analysis shows ‘widespread decline’ in adult social care

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New figures reveal the dire state of England's social care sector before the pandemic, with more people requesting support but fewer getting the help they needed. The data puts further pressure on the government to commit to reform of social care in next week’s Queen’s Speech.  

The new data is part of Social care 360, The King’s Fund’s annual assessment of the state of the social care sector. The overall picture is of deep decline, with many key indicators continuing to move in the wrong direction. 

Between 2015/16 and 2019/20, 120,000 more people requested social care support but around 14,000 fewer people received either long- or short-term support.*  

'Following a decade of neglect, there is a continuing gulf between what people need and what they receive,' says lead author Simon Bottery, Senior Fellow at The King’s Fund. 'The latest data paints a bleak picture with few causes for optimism. Even where measures have improved, there are often caveats. Local authority spending on social care has finally returned to the levels of 2010/11 but not if you take population growth into account; spending per person has fallen. Care worker pay has improved but is not rising as fast as other sectors so vacancies remain high.'

'Demand is likely to go on increasing but local authorities do not have the money to meet it. If we are to avoid reporting on a further bleak round of indicators in future years, we urgently need the long-term, wide-ranging reform for adult social care that the Prime Minister promised after the general election.' 

The report highlights six key actions that will be needed to improve and reform social care in the years ahead. 

  • More money is needed to fund the current system, with an estimated £1.9 billion extra needed simply to meet demand for adult social care by 2023/24. Funding is also needed to meet unmet need, improve the quality of services and cover the additional costs of Covid-19. 
  • Eligibility should be widened so more people are entitled to support.  
  • Workforce reform is essential to deliver better pay, training and development for staff. 
  • People need more control over the services they use, with government action needed to increase the number and quality of direct payments and support other ways of promoting choice and control. 
  • Prevention should take centre stage, with more investment in services such as reablement. 
  • Carers have taken on an even greater burden during the pandemic and need more support.  

Notes to editors

For further information please contact Harry Dayantis, Press and Public Affairs Manager at The King’s Fund on 07870 600169 or h.dayantis@kingsfund.org.uk 

*These figures include people receiving long-term support and short-term care packages. Because some people receive more than one type of support or package of care in a year, these are not exact figures but are the best available estimates for the overall output of the care system. The annual figures are provided below: 

 2015/162016/172017/182018/192019/20
Requests for support from new clients 1,810,7301,814,4151,843,9201,914,5301,930,555  
Increase in requests for support compared to 15/16 (number) 03,68533,190103,800 119,825
Increase in requests for support compared to 15/16 (%) 0.0%0.2%1.8%5.7%6.6%
Number receiving long-term care 18-64285,020 290,835292,380293,415290,075 
Number receiving long-term care 65+587,490  577,600565,385548,435548,450
Number of short-term care packages 18-24 21,44522,95025,28530,78528,180
Number of short-term care packages 65+189,545183,770187,550192,820 203,115
Total receiving either long-term care or short-term care packages* 1,083,5001,075,1551,070,6001,065,4551,069,820
Difference to 2015/16 (number)0-8,345-12,900-18,045 -13,680
Difference to 2015/16 (%)0.0%-0.8%-1.2%-1.7%-1.3%

The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.