We need to talk about adult social care

Demographically, we are in a different place than we were 30, 40, 50 years ago and the demographics will continue to change, impacting all elements of our lives. In the UK, there are now more than 11.8 million people aged over 65 years. The over-75s population is set to double in the next 40 years and the UK care system will continue to feel the strain.

In England, there were more than 1.8 million new requests to local councils for adult social care in 2015/16; one quarter were from adults aged 18–64, with the remainder from those aged 65+ (NHS Digital, 2016). Many requests were for support with personal care, others for more long-term support. It is difficult to know exactly how many people need long or short-term care, but demand is expected to rise.

Publicly funded social care in England is rationed and means tested, which is distinct from NHS care. The publicly funded element of provision, to assist the poorest members of our society, fell by 8% between 2009/10 and 2016/17 (Charlesworth et al, 2017). In the adult social care workforce across England 9400 domiciliary care services were registered with the Care Quality Commission as of September 2018. Within these services, the estimated workforce is 520 000: about 505 000 with the independent sector and 19 000 with local authorities.