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Financing long-term care for older people in England
- Authors:
- WITTENBERG Raphael, MALLEY Juliette
- Journal article citation:
- Ageing Horizons, 6, 2007, Online only
- Publisher:
- Oxford Institute of Ageing
- Place of publication:
- Oxford
During a decade of debate on how best to fund long-term care, British analysts have focused more on policy developments in other countries than ever before. Discussing criteria for appraising options, the paper argues that the objectives of the financing system must be considered in the light of the objectives for the long-term care system as a whole. The types of funding mechanisms discussed are private insurance, including private/public partnerships, tax-funded and social insurance models. The differences between tax-funded and social insurance models are discussed. Social insurance with hypothecation of funds is no longer part of the current debate, which now focuses on the three types of options whose properties are described in the paper: free personal care (adopted in Scotland), the retention of means-tested arrangements in some form, and a partnership model as recommended in the Wanless report. The paper agrees with the Wanless report that all three have strengths and weaknesses. Decision-makers have a window of opportunity to make reforms before the baby-boomers reach late old age.
Projections of care for older people with dementia in England: 2015 to 2040
- Authors:
- WITTENBERG Raphael, et al
- Journal article citation:
- Age and Ageing, 49(2), 2020, pp.264-269.
- Publisher:
- Oxford University Press
Background: The number of older people with dementia and the cost of caring for them, already substantial, are expected to rise due to population ageing. Objective: This study makes projections of the number of older people with dementia receiving unpaid care or using care services and associated costs in England. Methods: The study drew on up-to-date information for England from multiple sources including data from the CFASII study, output from the PACSim dynamic microsimulation model, Office for National Statistics population projections and data from the MODEM cohort study. A simulation model was built to make the projections. Results: It is projected that the number of older people with dementia will more than double in the next 25 years. The number receiving unpaid or formal care is projected to rise by 124%, from 530,000 in 2015 to 1,183,000 in 2040. Total cost of dementia is projected to increase from £23.0 billion in 2015 to £80.1 billion in 2040, and average cost is projected to increase from £35,100 per person per year in 2015 to £58,900 per person per year in 2040. Total and average costs of social care are projected to increase much faster than those of healthcare and unpaid care. Conclusion: The numbers of people with dementia and associated costs of care will rise substantially in the coming decades, unless new treatments enable the progression of the condition to be prevented or slowed. Care and support for people with dementia and their family carers will need to be increased. (Edited publisher abstract)
Health survey for England 2014: chapter 6 social care provision
- Authors:
- ROONEY Keeva, DARTON Robin, WITTENBERG Raphael
- Publisher:
- Health and Social Care Information Centre
- Publication year:
- 2015
- Pagination:
- 11
- Place of publication:
- Leeds
This chapter presents results from the Health Survey for England 2014 about the provision of unpaid social care by adults aged 16 and over. This is defined as help or support provided to someone because of long-term physical or mental ill-health, a disability or problems relating to old age and excludes any help given in a professional capacity or as part of a job. The findings show that 17 per cent of adults provided unpaid help or support to other people, with women more likely than men to do so (20 per cent and 14 per cent respectively). Prevalence of providing unpaid care was lowest among those in higher income households and increased with decreasing income. Care was most commonly provided to a parent and men were more likely than women to provide help or support for a spouse or partner, with just under a fifth doing so. Most commonly, those who provided help and support said that they did so for between 1-9 hours in the last week. However, a substantial proportion of men and women provided more care, with 27 per cent providing 10 or more hours in the last week. (Edited publisher abstract)
Demand for long term care for older people in England to 2031
- Authors:
- WITTENBERG Raphael, et al
- Journal article citation:
- Health Statistics Quarterly, 12, Winter 2001, pp.5-17.
- Publisher:
- Office for National Statistics
How best to finance long-term care has been the subject of considerable recent debate. One reason is that the numbers of people in England aged 65 and over are projected to increase by 60 percent over the next 35 years. The Personal Social Services Research Unit (PSSRU) has developed a model to make projections of demand for long-term care for older people, to 2031. This article outlines the methodology and results of the model. PSSRU projections suggest that, under central assumptions, long term care expenditure will need to rise by around 150 percent in real terms over the next 30 years to meet demand.
Health survey for England 2014: chapter 5 social care: need for and receipt of help
- Authors:
- MAPLETHORPE Natalie, DARTON Robin, WITTENBERG Raphael
- Publisher:
- Health and Social Care Information Centre
- Publication year:
- 2015
- Pagination:
- 14
- Place of publication:
- Leeds
This chapter presents information about the need for and receipt of social care among adults aged 65 and over, examining whether they receive care and how it is provided. Most of the chapter is based on Health Survey for England 2014 data but where bases are too small for robust analysis, 2013 and 2014 data have been combined. The HSE does not cover people in care homes and, within the community, it focuses on older people, who constitute by far the largest group receiving care. The findings show that 24 per cent of men and 33 per cent of women aged 65 and over needed help with at least one Activity of Daily Living (ADL) and 21 per cent and 34 per cent respectively needed help with at least one Instrumental Activity of Daily Living (IADL). There was variation according to household income, with greatest need and highest proportions receiving help in the lowest income tertile. Among people who had received help with ADLs in the last month, 82 per cent of men and 75 per cent of women had received this solely from unpaid helpers, including relatives, friends and neighbours and the picture was similar for IADLs. (Edited publisher abstract)
Care for older people: projected expenditure to 2022 on social care and continuing health care for England’s older population: research summary
- Authors:
- WITTENBERG Raphael, et al
- Publisher:
- Nuffield Trust
- Publication year:
- 2012
- Pagination:
- 12p.
- Place of publication:
- London
Projections of public expenditure on social care and continuing health care for people aged 65 or over in England from 2010 to 2022 are set out in this report. It is part of a research programme (Buying Time: What Is the Scale of the Financial Challenge Facing the NHS and How Can It Be Met) examining how the NHS and social care system in England can meet the challenge of improving patient care within a severely constrained budget. The projections were made using the Personal Social Services Research Unit long-term care projections model, which is concerned with demand for care and provides evidence on the increase in social care resources required to meet rising demand. The report describes the study methodology, including the model and assumptions on which it is based, and presents the projections, noting that projected future spending on social care and continuing health care will vary with future life expectancy.
The long-term care system for the elderly in England
- Authors:
- WITTENBERG Raphael, MALLEY Juliette, KING Derek
- Publisher:
- Centre for European Policy Studies
- Publication year:
- 2010
- Pagination:
- 46p.
- Place of publication:
- Brussels
Produced as part of a project on the future of long-term care for the elderly in Europe, this report focuses on the long-term care system for older people in England. It provides an overview of the current system, looking at assessment of care needs, availability of and eligibility for long term care services, management and organisation, integration within the system and with health and social services, and funding. It also examines demand and supply of long term care, including the need for long term care and demographic characteristics, the role of informal and formal care and the role of cash benefits, and demand and supply of informal care, formal care, institutional and home care. It concludes with a discussion of policy goals, recent reforms and current policy debate, and a critical appraisal of the long term care system.
Projections of demand for and costs of social care for older people in England, 2010 to 2030, under current and alternative funding systems: report of research for the Commission on Funding of Care and Support
- Authors:
- WITTENBERG Raphael, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2011
- Pagination:
- 34p., bibliog.
- Place of publication:
- Canterbury
Using the Personal Social Services Research Unit’s (PSSRU) aggregate long-term care projections model and the University of East Anglia’s CARESIM dynamic micro-simulation model this report presents projections of demand for social care and disability benefits for older people (aged 65 and over) in England to 2030 and associated future expenditure. The projections cover both publicly and privately funded social care, including assessments, community-based services and residential care. Long-term health care and disability benefits relevant for care such as the attendance allowance (AA) and disability living allowance (DLA) care component are also included.
Quality and cost-effectiveness in long-term care and dependency prevention: the English policy landscape. CEQUA report
- Authors:
- MARCZAK Joanna, FERNANDEZ Jose-Luis, WITTENBERG Raphael
- Publisher:
- London School of Economics and Political Science
- Publication year:
- 2017
- Pagination:
- 30
- Place of publication:
- London
This report summarises policy developments in England in relation to quality and cost-effectiveness and dependency prevention in long-term care. These policy aims focus on maximising the cost-effectiveness of the social care system, so that service users’ and carers’ quality of life is maximised within available resources. The report provides an overview of the long-term care system in England. It then reviews key recent policy developments in four areas: reducing dependency cost-effectively; strategies for maximising care coordination; supporting unpaid carers; and use of innovative care models, with a focus on technological solutions and personalisation. An appendix lists key features of the Care Act 2014 and the Better Care Fund relevant to prevention. (Edited publisher abstract)