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Why are adult social care costs increasing?

August 8, 2012

The UK Government talks (constantly) about the reasons behind the increasing costs of adult social care. Undoubtedly we are all getting older, living longer, with larger numbers of older people requiring support from the statutory services. However, although the costs of aging are increasing, other sections of the population are drawing on the state for support in increasing numbers.

Every Local Authority must send data to the National Adult Social Care Intelligence Service (NASCIS) annually. Here the data are crunched, analysed, and published, both on their website (http://www.ic.nhs.uk/nascis) as well as in separate publications.

Within one of their publications – Personal Social Services: Expenditure and Unit Costs – England 2010-11- Final Release, The Health and Social Care Information Centre, 2012, p 10 – is an illuminating table of figures. This table shows how much money is spent every year on adult social care for specific groups of people. I have added the annual increase figures to their table as follows. Please check my sums as I cannot vouch for their accuracy –

ADULT Social Care expenditure, England, all figures in £millions

Client group

2005/6

2006/7

2007/8

2008/9

2009/10

2010/11

People aged 65 and over

8,390

8,660

8,770

9,080

9,390

9,440

Annual Increase

N/A

270 = c. 3.2%

110 = c. 1.3%

310 = c. 6.5%

310 = c. 3.4%

50 = c. 0.5%

These figures are enormous (e.g. 9.4 thousand million UK pounds in 2010/11), and they do show an annual, year on year increase..

However the figures for younger people are also increasing as follows –

Client group

2005/6

2006/7

2007/8

2008/9

2009/10

2010/11

Physically Disabled Adults   (18-64)

1,360

1,420

1,480

1,560

1,650

1,660

Annual Increase

N/A

60 = c. 4.4%

60 = c. 4.2%

80 = c. 5.4%

90 = c. 5.8%

10 = c. 0.6%

The figures here are much smaller, but the annual percentage increases in expenditure are either about the same or slightly larger. This is only to be expected with smaller figures.

If we look at another group of people the figures are very different –

Client group

2005/6

2006/7

2007/8

2008/9

2009/10

2010/11

Learning Disabled Adults   (18-64)

3,110

3,290

3,450

3,810

4,010

4,190

Annual Increase

N/A

180 = c. 5.8%

160 = c. 4.9%

360 = c. 10.4%

200 = c. 5.2%

180 = c. 4.4%

The expenditure figures here are smaller again that the expenditure figures for older people. However the annual expenditure increases, expressed as a percentage are much higher – e.g. at 10.4% in 2008/09. This group of people represents the largest growth sector of any group of adults receiving adult social care provision.

The final group of people represents much smaller figures and much less annual growth –

Client group

2005/6

2006/7

2007/8

2008/9

2009/10

2010/11

Adults with Mental Health   Needs (18-64)

1,060

1,070

1,120

1,160

1,220

1,220

Annual Increase

N/A

10 = c. 0.09%

50 = c. 4.7%

40 = c. 3.5%

60 = c. 5.2%

0 = 0%

The story so far is as we’re all being told, with adult social care expenditure much higher for people aged over 65 than for people aged under 65.

However the category of ‘Over 65’ brings together everyone into one age band. This includes all people within this age, regardless of individual impairment or needs. The same is not true for people aged under 65. This group is disaggregated into separate groups by impairment type and identified individual needs. If we do the same thing for people aged under 65 as they do for people aged over 65 – if we included the separate categories all together – we arrive at the following figures –

Client group

2005/6

2006/7

2007/8

2008/9

2009/10

2010/11

Total for disabled people   aged 18-64

5,530

5,780

6,050

6,530

6,880

7,070

Annual Increase

N/A

250 = c. 4.5%

270 = c. 4.7%

480 = c. 7.9%

350 = c. 5.4%

190 = c. 2.8%

This suddenly presents us with a very different picture. Here is a bit of analysis of these figures –

–          The total figures for the older population (£9,440 million in 2011) are greater than those for the younger population (£7,070 million in 2011)

–          The annual rates of increase are much higher for the younger age group than they are for the older age group

–          All the annual rates of increase for people aged under 65, except for younger people with mental health needs, are the same as or greater than the annual rates of increase for older people

–          The consistently highest rates of increase relate to younger adults with learning disabilities (the highest rate of increase being in 2008/9 of 10.4%)

–          The difference in expenditure for younger disabled adults between 2005 and 2011 = £1,540 million, while the increase for people over 65 = £1,050 million

Conclusions

It is clear from these data that the highest growth in adult social care expenditure is for disabled people aged under 65.

Over time the overall total expenditure figures will get closer to each other. At this rate of increase the figures for younger disabled people will reach, equal, then exceed, the figures for older people. In Cornwall this has already happened (last year the over 65s expenditure = c.£80m, while the figures for people under 65 was c.£83m.

What does this mean for adult social care expenditure? Do the same programmes to help people live independently aged over 65 work with younger disabled people?

Are the needs of these 2 age groups the same/similar? Or do we need to think about how we can work with organisations of disabled people to build programmes to keep younger disabled people in work, living in accessible accommodation, with the community facilities they need, for as long as possible?

The Government is wrong – It’s not that we’re all getting older, it’s that adult social care is getting younger!

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