Access to publicly funded long-term social care varies dramatically between demographically similar local authorities, with some councils supporting up to twice as many people as their nearest statistical neighbours, according to new analysis from The King's Fund.
The think tank said the findings expose a social care ‘postcode lottery’ and has called for a new national assessment system as part of wider reforms towards the creation of a National Care Service.
The analysis found that almost six in ten (59 per cent) local authorities had long-term care access rates at least 20 per cent above or below those of their nearest statistical neighbour for working-age adults and/or older people. The largest variations reached 101 per cent for working-age adults and 60 per cent for people aged over 65.
Among older people, Thurrock supported 7,680 people per 100,000 population with long-term care, compared with 4,810 in neighbouring statistical comparator Medway, a difference of 60 per cent. For working-age adults, the largest gap was found between Torbay and Telford and Wrekin's access rates, with Torbay’s 101 per cent higher despite the authorities having similar socio-economic profiles.
The King's Fund said differences in access are likely to reflect a combination of local need, wealth, council resources, funding capacity and variation in how eligibility assessments are applied, despite national criteria set out under the Care Act.
The findings come as the Government accelerates work on social care reform, with the Prime Minister bringing forward the reporting timetable for Baroness Casey's review and reiterating plans to bring in a state-funded National Care Service if re-elected at the next election.
Call for national reform
Alongside the analysis, The King's Fund has proposed a package of reforms including universal access to publicly funded care with user co-payments, a cap on lifetime care costs, nationally funded social care and clear national entitlements to support.
The organisation said the changes would reduce unwarranted variation in access, ensure everyone received at least some state-backed support and shift local authorities from acting as gatekeepers of funding to helping people access care and coordinate services.
The King's Fund senior fellow for social care and report co-author Simon Bottery said: "A national care service, which the Prime Minister has promised, must be genuinely national and ensure that all people, wherever they live, have the same access to social care support.
"Our new proposals for an 'equal access' national assessment would help prevent this issue of unwarranted variation and ensure that access to social care support is not decided by your postcode."
Mr Bottery said reform should also include a cap on care costs and fairer national funding arrangements.
"Currently, one in seven people aged 65 will spend at least £100,000 in lifetime care costs," he added.
"The Prime Minister and Baroness Casey's commitment to reform is clear, but we are still awaiting the concrete policies that will turn this vision into a reality."
