Now Harrow joins roster of councils limiting adult care to critical needs

Nearly 500 service users with “substantial” needs to lose out after authority overrules consultation respondents

Harrow Council in London has become the fourth authority in England to restrict its adult social services to people with critical needs.

The council, which joins Northumberland, West Berkshire and Wokingham councils, took the decision despite overwhelming opposition from consultation respondents, most of whom were service users.

Nearly 500 of its 2,800 adult service users – those deemed to have “substantial” needs – could lose a service after their next care review. Under fair access to care services guidance, substantial needs equate to being unable to carry out most personal care tasks, such as washing. Critical means being unable to carry out any key personal care tasks and having significant, possibly life-threatening, health problems.

Avani Modasia, chief officer of Age Concern Harrow, said the decision would have a “huge impact” on voluntary groups, carers and health services, with more people going into A&E – and could be self-defeating, with people developing critical needs more quickly without support. She added: “We’ve had lots of people ringing us up, worried about the impact.”

Harrow, which overspent by £1.5m on its adult care budget last year, said its annual government grant was £572 a head less than the London average, and claimed it had also absorbed a £3.5m cost shunt from its local primary care trust.It said the move, which could recoup £1.5m this year, would still leave the budget under much pressure.

The concerns have prompted Harrow to widen its definition of critical needs to include people with substantial needs who would become critical within 12 weeks (as opposed to the current six) those at risk of abuse and anyone who would have to move out of home without a service.

Mark Gillett, head of adult services, said the council was considering increasing funding for voluntary sector groups to tackle any fallout – something Modasia said was vital.


Decision at odds with government’s aim
Harrow’s decision is at the extreme end of a growing trend to increase eligibility thresholds for adult social care – in total opposition to the government’s avowed aim of investing in low-level services to promote independence. A recent Community Care survey found 30% of councils had either increased their thresholds or were planning to do so to combat what they see as inadequate government funding. ➔ Survey results at


Related article
Essential information on older people’s services

Contact the author
 Mithran Samuel

More from Community Care

Comments are closed.