Adult social care funding is a hot topic right now, with our ageing population placing a growing pressure on the NHS and local authorities.
With the government expected to publish a green paper on social care funding this autumn, the scale of the challenge has been highlighted by a new study.
According to the study published in the Lancet Public Health journal, the adult social care system is “at breaking point”, with the number of people aged 85 and over who need round-the-clock care set to double in a 20 year period.
It found that over 65 year olds who need 24 hour care are also forecast to rise by a third.
The study, which was carried out by Newcastle University and the London School of Economics and Political Science, modelled population data between 2015 and 2035.
Elderly people aged over 85, who we often refer to as ‘the oldest old’ in society, are the fastest growing demographic in the country.
Their numbers are set to grow by 1.5 million by 2035, resulting in an even greater need for care services.
Because the oldest old in society are likely to develop long-term health conditions including dementia and diabetes, their care needs are set to become increasingly complex.
The study found that the number of over-85s needing daily assistance with tasks including dressing, bathing and going to the toilet is forecast to nearly double to 446,000 people by 2035.
At the same time, more than a million over 65s are expected to require 24-hour care services to help with similar needs. This is potentially problematic because the number of unpaid carers in society is in decline.
According to Professor Carol Jagger, senior author of the report from the Newcastle University Institute for Ageing, relying on unpaid care from family members is unsustainable.
Professor Jagger said:
“The challenge is considerable. "Our study suggests that older spouse carers are increasingly likely to be living with disabilities themselves. "On top of that, extending the retirement age of the UK population is likely to further reduce the informal carer pool, who have traditionally provided for older family members."
A growing number of adults over the age of 65 are, according to the study, living independently. It forecasts an increase of 60% by 2035 for older adults living independently.
Of these, older men are more likely to remain independent in later life, but older women are expected to spend nearly half of their remaining life with low dependency needs, and more years in need of 24-hour care.
This is because disabling long-term conditions, such as arthritis, are more common in women than men. A rise in obesity is also hitting women harder than men, and men have probably benefited from reductions in cardiovascular disease.
The researchers behind the study categorised care needs as high dependency if round-the-clock care was needed. Care needs were described as medium dependency if help was required at regular times each day.
It was categorised as low-dependency if care needs could be provided in the community.
With adult social care services facing a £3.5bn funding gap by 2025, even maintaining existing levels of care for people in later life is likely to be financially challenging for local authorities.
Ahead of the Budget this autumn, we know that Prime Minister Theresa May has already pledged an additional £20bn funding a year funding for the NHS from 2023 onwards.
A Department of Health and Social Care spokesperson said:
"In the autumn we will set out our plans to reform adult social care alongside our long-term plan for the NHS, so we can address the challenge of our growing ageing population head on and ensure services are sustainable for the future."
It will be interesting to see what is proposed in the green paper when published and whether this goes far enough to address not only existing pressures on social care funding but also this expected rising demand for care. Based on the forecasts in this new study, the government has a sizeable challenge to address.