The number of people in the UK aged 65 years or over increased from 9.2 million in 2011 to over 11 million in 2021, and the proportion of people aged 65 years and over rose from 16.4% to 18.6% within the same timeframe. Almost two million of those adults now request additional support in the form of adult social care. The UK is sleepwalking into a crisis – the need for publicly-funded social care for older adults has now become more pressing than it has ever been.
The lack of a national budget for social care has been a major contributor to the decline in access to care for older adults across the country. In September 2021, the Government announced they would use £5.4 billion of revenue from the Health and Social Care Levy to reform adult social care, but, just a year later, the Levy was cancelled to reverse the rise in National Insurance contributions from businesses and employees. However, as a result, the extra funds for adult social care were lost, and the sector continues to suffer.
Without the Health and Social Care Levy, publicly-funded social care is only available through local government tax revenue, putting increased pressure on local government finances. This forces local governments to spend less on social care and ultimately leads to a fragmented social care system, with some areas across the country better off than others.
This is particularly important for poorer adults who are in need of social care. For, while those with assets over £23,250 are required to fund their social care themselves anyway, those with assets between £14,250 and £23,250 can receive partial funding from the local government and those with assets under £14,250 ought to be able to receive fully-funded care. However, due to the fragmented quality of the sector, those with lower assets may only have access to insufficiently-resourced care and have to resort to funding some of it themselves regardless.
The lack of funding for adult social care also puts more strain on the NHS, as those who are not receiving adequate care are more likely to seek hospital treatment. In 2021/22, the social care sector saw 165,000 vacancies — the highest number of vacancies the sector has ever experienced.
At the same time, the quality of adult social care has been declining for years and is now sorely insufficient. According to a report by the Nuffield Trust, although the number of older people receiving state-funded long-term support has decreased by 10% since 2015/16, the number of adults over the age of 65 has risen by 8% since 2015. Indeed, between 2015 and 2020, 120,000 more people requested social care support, but 14,000 fewer people received it.
The decline in the number of people receiving social care can be linked to staffing shortages. As a result of cuts to social care workforce funding, there has been a 52% increase in vacancies in the social care sector from 2021 to 2022, as staff are leaving the sector for better wages.
Previous governments recognised the need for reform in the social care sector by commissioning the Dilnot Report to review social care in the UK and introducing the Health and Social Care Levy, which both sought to put a cap on lifetime care costs, in turn protecting people from spiralling care costs and providing more certainty around the costs of care. However, the former was not followed up on, and the latter was cancelled, making their attempts to fix the sector unsuccessful. The adult social care sector needs significant reforms to prevent it from collapsing. Without reform, it will become unsustainable.
Taylor Ross is a Research Assistant at Bright Blue. Views expressed in this article are those of the author, not necessarily those of Bright Blue. [Image: Dominik Lange]
