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Options for long-term care: economic, social and ethical choices
- Editors:
- HARDING Tessa, MEREDITH Barbara, WISTOW Gerald
- Publisher:
- HMSO/National Institute for Social Work
- Publication year:
- 1996
- Pagination:
- 152p.,bibliog.
- Place of publication:
- London
Examines the debate around long term care and proposes a different approach to planning for future long term care. Concludes that the increase in expenditure needed over the next 30 years is not so great as to be a cause for alarm, though some reinvestment may be needed in the short term. Suggests that affordability is a question of political choice, rather than economic imperatives. Reviews the values underpinning long term care and proposes a broad based strategic approach. Looks at the issues from the point of view of disabled people as well as older people. Concludes with 2 chapters comparing the situation in the United States and in Germany.
Changes in the patterns of social care provision in England: 2005/6 to 2012/13
- Authors:
- FERNANDEZ Jose-Luis, SNELL Tom, WISTOW Gerald
- Publishers:
- University of Kent. Personal Social Services Research Unit, London School of Economics
- Publication year:
- 2013
- Pagination:
- 40
- Place of publication:
- Canterbury
Even before the current public spending austerity programme was introduced, the adequacy of adult social care spending was of concern. This report quantifies what changes have taken place in net local spending and provision (recipients of care) between 2005/06 and 2012/13. The authors produced two sets of indicators of social care coverage over time: an observed and a standardised data series. The first is based on the raw data for the number of adult social care recipients collected by the Health and Social Care Information Centre. The second was generated using multivariate regression analysis to ‘control for’ the influence of socioeconomic indicators of social care need. Recent trends in the number of adults receiving social care services indicate that across all user groups, some 320,000 fewer people received local authority brokered social care in 2012/13 than in 2005/6, a 26% reduction in the number of care recipients. 260,000 or 31% fewer older people received services in 2012/13 than in 2005/6 (observed data). The standardised estimate of reduction was greater: 333,000 or 39% fewer clients. Some 37,000 or 24% fewer adults aged 18-64 with physical disabilities received social care support in 2012/13 than in 2005/6. The standardised estimate showed a reduction of 50,000 or 33%. A reduction of 30,000 (21%) was observed in the number of service recipients aged 18-64 with mental health problems. The standardised estimate for this group showed the largest proportional fall in the volume of service recipients (48%). In contrast with other client groups, the observed data for adults aged 18-64 with learning disabilities receiving services increased by about 7,000 (5%). However, the standardised indicator suggests a fall in activity: some 7,000 fewer service recipients in 2012/13 than in 2005/6. Recent trends in net adult social care expenditure demonstrate that changes in levels of expenditure vary significantly, depending on the user group considered. Aggregated across all user groups, the analysis suggests a drop in need-standardised net social care expenditure between 2005-06 and 2012/13 of approximately £1.5 billion at 2012/13 prices. Moreover, almost all reductions in expenditure are concentrated in 2010/11 and 2011/12. The largest reduction in expenditure is concentrated on care services for older people: an £890 million reduction between 2005/06 and 2012/13. The shortfall increases to just above £1.6 billion using the standardised estimate. Local changes in social care coverage find marked differences in patterns of changes across local authorities and between service user groups. Some 95% of local authorities in England were observed to have reduced the number of older people receiving services in the period 2005/6 to 2012/13: in 35% of authorities, the decrease was 40% or more. Overall, the findings indicate significant reductions in service provision, both in terms of coverage (numbers of people receiving care) and in terms of the amount of public resources invested (net expenditure). This analysis was partly funded with a grant from the Care and Support Alliance. (Edited publisher abstract)