‘Startling’ postcode lottery in social care ‘reflects perfect storm on costs, demand and staffing’

A “startling” postcode lottery for social care showing a higher rate of rejected requests for support depending on where someone lives has been branded “unacceptable” by campaigners.

The Care and Support Alliance (CSA), which represents over 60 of Britain’s leading charities, said it had analysed the latest NHS England data on 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.

The research found the North East to be the region with the highest average rate of accepted requests for care at 64% and the West Midlands to be the lowest with an average rate of accepted requests at 32%.

Within each region there were large variations in the rates of accepted requests, with the the biggest in London, where there was a difference of 64 percentage points between the local authority with the highest rate of accepted requests in the capital and the one with the lowest, the CSA said.

Even though the East Midlands had the least wide-ranging variation between accepted requests by its different local authorities, the gap was still 31 percentage points, the alliance said.

Across England, the coalition said the lowest rate of refused requests in a local authority was 12%, while the highest was 85%.

A person’s request for social care from a local authority can be rejected for various reasons, including that they do not meet the criteria for care due to their needs not being deemed sufficiently pronounced or that they have too much money to qualify for state-funded help.

But the CSA said the statutory duty local authorities have to provide care has, in recent years, been increasingly interpreted in ways that mean some people who would have qualified for state-funded help in the past are now being screened out.

The alliance suggested this is down to councils lacking the funding and sometimes the staff to meet everyone’s care needs, meaning “they are having to spread the jam more thinly”, and the CSA called on Government to increase the funding available to local authorities in line with rising demand from a growing older and disabled population.

The CSA described the variations as “startling differences (which) 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”.

Caroline Abrahams, charity director at Age UK AND CSA co-chair, 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 (pictured), executive director of strategy and engagement at Mencap, said: “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.”

The analysis comes as the CSA encouraged the public to use its new tool to check the picture for social care in their local authority area and to “join its campaign to encourage the new Government to take decisive action on social care”.

Emily Holzhausen, director of policy and public affairs at Carers UK, said: “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.”

David Fothergill, chairman of the Local Government Association’s community wellbeing board, said: “This new analysis rightly comes with a call on national Government to act urgently to ensure people can access the care and support they need to live their lives.

“Caution needs to be taken when examining data on requests for social care and subsequent support. Such information, and accompanying comparisons, often paint a two-dimensional picture of the context that councils are working within, and don’t fully take account of councils’ different approaches to supporting people with care needs and the particular circumstances facing individual councils.

“Understanding the level of unmet and under-met need is an inherently challenging task, but councils – working with partners – are doing all they can to build the most robust evidence base.

“That’s why we continue to call for funding and support to address this, alongside action on other pressing issues such as workforce recruitment and retention and more support for unpaid carers”.

A Department of Health and Social Care spokesperson said: “This research is a stark reminder of the crisis facing social care.

“We are determined to tackle this crisis head-on to ensure everyone is able to live an independent, dignified and fulfilling life.

“We will undertake a programme of reform and take steps to build a national care service, delivering consistency of care across the country.”

The new tool is available at https://act.careandsupportalliance.com/page/151615/action/1.

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