At a time when all local authorities are struggling with insufficient funding, official statistics demonstrate that the chances of getting vital life changing care vary hugely across England because of a pronounced postcode lottery. This is the stark finding of
research
Research is a way of finding out information which could come from books, or asking people what they think.
by the Care and Support Alliance (CSA), which represents more than 60 leading charities campaigning for decent care for all those who need it and their unpaid carers.
The new analysis draws on the latest figures for the numbers of requests for care made by older and disabled people to their local authorities, and the proportion that each
local authority
A local authority is also called a
council
A council is also called a local authority. They are a group of people who make decisions about some of the things in the area where you live. These include: schools,
social care
Social care means the services that give care and support to people who need it.
(support for people), parks and dustbin collection.
. They are a group of people who make decisions about some of the things in the area where you live like schools, social care (support for people), parks and dustbin collection.
accepts or rejects (see Notes to Editors for the reference). If a local authority rejects a request for care they may direct that person to a local resource such as a day centre instead, or to a voluntary
organisation
An organisation are a group of people who work together.
for informal support, if those exist locally. They may also signpost them to local sources of information and advice, so they can find out about and organise their own care. All these responses will be counted as rejected requests for care.
The research shows that the North East is the region with the highest average rate of accepted requests for care at 64%, and the West Midlands is the region with the lowest average rate of accepted requests for care at 32%. However, within all regions there are big variations in the rates of accepted requests by local authorities as the table below shows.
This variation is most pronounced in London, where there is a difference of 64 percentage points between the local authority with the highest rate of accepted requests, and the one with the lowest. The region with the least variation between local authorities is the East Midlands, but the difference is still quite marked here at 31 percentage points.
In London, the rates of requests being rejected by local authorities within just a few miles of each other range from 84% (7 in 8 of each requests) to 20% rejected. And across England as a whole, the lowest rate of refused requests in a local authority is 12%, and the highest rate of refused requests in a local authority is 85%.
These are startling differences and the CSA says that they reflect a perfect storm at a national level of rising demand for care, rising costs of care, regionally specific recruitment and workforce challenges, and the long term underfunding of local authorities, all compounded by years of central Government dither and delay regarding social care reform.
In addition, there are local factors which can amplify these variations. Some councils are better able to raise revenue locally than others, to help them compensate for the
cuts
Cuts are when there is less money to pay for things like clubs and support.
to central Government funding they have experienced over the years. Added to this, the way funding is allocated to local authorities hasn’t been updated for some years, meaning the allocations no longer always reflect the needs of the current local population.
Local authority duties to provide social care are set out in
law
Laws are the rules that everyone in the country has to follow. If you don't follow the rules you can get in trouble with the police.
and although they have some discretion over how they fulfil them, a person with a given level of need and resources is entitled to expect to receive a broadly similar response, regardless of where they live. The CSA says that these statistics show this is by no means currently the case, leading to a real sense of unfairness.
The analysis is released as a new CSA tool is launched which shows people how national government inaction on social care is having a real impact in their area, inviting them to join its campaign to encourage the new Government to take decisive action on social care: https://act.careandsupportalliance.com/page/151615/action/1
The CSA is urging the new Government to urgently get to grips with the desperate problems individuals and families are facing accessing good social care. It must act quickly so older and disabled people can get the care they need. Good social care supports people to live their lives: to get up and out, work, see the people they love and be independent. Yet currently at least 2.6 million* people go without at least some of the care they need.
Caroline Abrahams Charity Director at Age UK said:
“It is sometimes said that one person’s postcode lottery is another’s local
democracy
A democracy is where everyone can have their say and be listened to. England, Scotland, Wales and Northern Ireland are all a democracy.
, but these variations in the proportions of requests for care that are accepted by local authorities are simply too big. It’s not as if care is an optional extra: if you need it, it’s essential, so it’s reasonable to expect a broadly consistent response wherever you live. The variations our research has revealed are in large part due to the struggles of local authorities in meeting surging demands for care with insufficient resources. Government needs to grip this problem and act so older and disabled people, and their unpaid carers, get the support they need.
Jackie O’Sullivan Executive Director of
Strategy
A strategy is a plan to show what an organisation, or a person, wants to do and how they are going to do it.
and Influencing at Mencap said:
“Good social care is transformational and can make a hugely positive difference to your life, but there isn’t enough to go round and its availability is unequally distributed. People don’t fit neatly into boxes or boundaries and so nor should care. The scale of this postcode lottery for a crucial public service is unacceptable and underlines why our new Government must waste no time in reforming and refinancing social care.
The Budget
The
Budget
A budget is a plan where you look at how much money you have and how you will spend it.
is the plan
the government
The Government are the people who run the country. The Government decide how much
tax
Tax is the money that pays for things like schools, hospitals and the police. There are different types of taxes like
income tax
Income tax is the money that is taken out of the money you earn every month. It helps to pay for things we all need like hospitals and schools.
,
VAT
VAT is also called Value Added Tax. VAT is the extra money you pay when you buy things. The money goes to the government to pay for things like schools and hospitals.
and
council tax
Council Tax is the money that people pay to the council. It helps to pay for things like social care (support for people), parks and dustbin collection.
.
people should pay and how things like the National Health Service (NHS) should work.
has for what it will spend money on and how it will raise money to pay for the spending. The Budget tells us if there will be any changes to how much people pay for things.
due in the autumn is a great opportunity for them to begin to get a grip of the problem by giving local authorities additional resources to meet the demand for social care.”
Emily Holzhausen Director of Policy & Public Affairs at Carers UK said:
“Ministers have said they want to build a National Care Service and one of the measures of success should be how quickly these variations between and within the English regions can be reduced over the next few years. That won’t be possible though unless and until the big shortfalls in the cash available to local authorities to fund social care are addressed by the Government.
“We urge everyone to access the new tool we are making available, to find out what social care is like in their area and to join with us to press the Government to take the action that’s so badly needed.”
| % of requests where no care was provided regional average | Local authority with lowest rejection rate (% of requests where no care was provided) | Local authority with highest rejection rate (% of requests where no care was provided) |
East Midlands | 57% | 44% | 75% |
East of England | 52% | 36% | 62% |
London | 55% | 20% | 84% |
North East | 46% | 12% | 59% |
North West | 58% | 23% | 80% |
South East | 62% | 27% | 85% |
South West | 63% | 22% | 80% |
West Midlands | 68% | 31% | 83% |
Yorkshire and The Humber | 56% | 27% | 73% |
-ENDS-
Note to Editors:
All requests for care and support received by local authorities are recorded and presented annually by NHS Digital. This analysis is based on figures taken from the Adult Social Care Activity and Finance Report, England 2022/23 by NHS England, published on 7 December 2023. Requests for Support - NHS England Digital
*Age UK analysis from September 2022 found 2.6m people aged 50 and above are living with some sort of unmet need in England. This does not include younger adults and so the true figure will be higher.
The Alliance’s new campaign tool can be found here: https://act.careandsupportalliance.com/page/151615/action/1
Additional words– as to why people get turned down for care.
CSA said:
"People who ask their local authority for care may be turned down for a number of different reasons. The simplest is that they don't meet the criteria - typically that their needs are not sufficiently pronounced, or that they have too much money to qualify them for State funded help, given that social care is subject to a very strict means-test.
"That's fair enough you may think BUT, over the last few years, it is clear that although the law itself hasn't changed, it is increasingly being interpreted by local authorities in ways that mean that some people who would have qualified for State funded help with their care ten or fifteen years ago, are now being screened out. Why? Because local authorities often simply lack the funding, and sometimes the staff, to do anything other than 'ration' the care they offer their local population - in other words, they are having to spread the jam more thinly. This problem manifests itself locally but the fault lies with national governments that have failed to increase the funding available to local authorities in line with rising demand from a growing older and disabled population.
"Across England as a whole just over half of all requests for care made to local authorities are turned down. To add to the sense of unfairness though, some local authorities are better placed than others to compensate for the lack of central Government support through their local capabilities. For example, some have the opportunity to raise more money locally if their area is relatively prosperous, while others have more care professionals because of the way their local jobs market works. These differences help to explain the marked 'postcode lottery' for care that we are highlighting in our release.
"In summary, nationally, social care is grotesquely under-resourced, but to make things even worse for the public, the way this plays out locally is really varied, so where you live matters much more than it ought to if you need care."