Postcode Lottery For Care Facing The Public Today Analysis Reveals

All local authorities are struggling with under-funding, but there are big differences in the rates of requests for care being accepted both between regions and within them

CSA launches an online tool showing the state of social care by area as part of its campaign to persuade the Government to act

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 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 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 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 rejected) 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 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 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, 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 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 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.”