More people receiving adult social care following years of decline, data shows

More people are receiving adult social care in England following years of decline, official data shows.

Councils funded long-term care packages for 858,720 people during 2023-24, up 2.8% on the year before, which in turn followed a 2.1% rise in 2022-23, according to NHS England’s annual adult social care activity and finance report.

This took the number receiving care back up to levels last seen in 2017-18 and follows a 6.3% fall in recipients, from 872,520 to 817,915, between in 2015-16 and 2021-22.

As of 31 March 2024, 650,085 people were receiving long-term care, up from a low of 613,510 in March 2022 and the highest year-end total since 2017.

Alongside this, councils boosted the number of short-term care packages they delivered to maximise people’s independence, often known as reablement services. The number of these grew by 12.2% last year, from 251,255 to 281,850.

The increases in provision came on the back of a 4.2% increase in the number of requests for care, from 2,002,055 in 2022-23 to 2,085,720 to 2023-24.

Unmet need concerns

The decline in the numbers receiving long-term care from 2015-16 to 2021-22 came despite a 9.3% rise in the number of annual requests for care during that time, leading to significant concerns about unmet need having increased and councils rationing care in response to financial pressures.

While councils increased real-terms spending year-on-year during this time, these increases were not substantial, while think-tank the King’s Fund has pointed out that much of this was absorbed by Covid-related pressures or increases in the unit costs of services.

The NHS England report showed that real-terms funding grew much more quickly in 2023-24 (7.5%) than in previous years, with gross expenditure increasing by £3.4bn, in cash terms, to £27.1bn. This was driven by funding on long-term care, which grew by £3bn between 2022-23 and 2023-24, to £21.4bn.

As well as providing more people with care, the increased spending also went into significant rises in provider fees.

The average weekly fee paid to care home providers rose by 11.6% in cash terms, from £992.80 in 2022-23 to £1,108.40 in 2023-24. This was likely driven by high rates of inflation and a 9.7% rise in the national living wage in April 2023.

Injection of government cash

The increased spending in 2023-24 came on the back of the then government making significantly more resource available to councils in 2023-24, including by diverting funds earmarked for the overhaul of the adult social care charging system. This included:

• A £1.36bn real-terms boost to the social care grant, which can be used on both adults’ and children’s services.
• A £475m rise in the market sustainability and fair cost of care fund, designed to help councils increase fees to adult social care providers, cut waiting lists for services and tackle recruitment and retention issues.
• £307m through a new adult social care discharge fund, designed to help speed up hospital discharges.
• Permitting authorities to increase the adult social care council tax precept – whose proceeds are ring-fenced for the sector – by 2% in 2023-24, up from 1% in 2022-23.
• Allowing councils to raise general levels of council tax by 3% without the need for a local referendum, up from 2% the year before.

Highest overspend in a decade and Budget concerns

However, despite their increased funding, councils overspent their budgets by £586m, the highest level in a decade, in 2023-24, according to the Association of Directors of Adult Social Services’ spring survey, carried out earlier this year.

And while councils have budgeted to increase adult social care spending by a further 9.1% in 2024-25 – on the back of another government funding boost – ADASS found that authorities were having to make £903m in savings this year, the highest annual level since 2016-17.

There are also huge concerns across the sector about the impact of last week’s Budget on funding levels for 2025-26. The government said councils’ overall resource would increase by about 3.2% next year, with an extra £600m earmarked for social care, a fund that is expected to be available for adults’ and children’s services.

However, adult sector leaders have warned that the £600m will be entirely swallowed up by the increased costs for adult social care providers of delivering a 6.7% rise in the national living wage – which will benefit many thousands of care workers – and an increase in employers’ national insurance contributions.

Improvement in timeliness of reviews

Alongside the growing number of people receiving care, councils also improved the timeliness of reviews of care and support plans in 2023-24, which are expected to take place every 12 months.

Of people who had been receiving long-term care for more than a year, 58.8% received a review during 2023-24, up from 57.1% in 2022-23.

This follows significant concerns about councils running long waiting lists for assessments, reviews and care packages in recent years.

But less funding for carer support

However, there was little improvement in provision for carers, with a 1.3% increase in the number receiving a service in 2023-24, from 356,235 to 360,815, which followed an 8.4% fall in numbers supported over the two preceding years.

Funding for carer support fell, meanwhile, from £195m in 2022-23 to £183m in 2023-24.

“These alarming figures show state funded support for carers in England has nosedived in recent years,” said charity the Carers Trust’s director of policy and public affairs, Dominic Carter.

“This is a travesty at a time when carers are taking on ever more responsibility and facing burnout as they prop up a health and social care system that’s been starved of funding.”