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7 reasons we need the Green Paper

Where is it?

What's happened in the 700 days since the Green Paper was first announced and why we need it NOW

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There are 1.4 million older people in the UK struggling without the help they need. And with the NHS losing £500 a minute as unsatisfactory levels of home care result in an overreliance on hospital care, this situation is quickly reaching breaking point.

The promise

This perfect storm of underfunding, the unmet need of some 1.4 million people aged 65+, and declining access to care services will ensure we get to that point. Back in the March 2017 Budget (8 March), help appeared to be at hand when the Government said it would publish a Green Paper on social care – making a manifesto commitment to it in that year’s subsequent General Election.

Social care refers to helping people live their everyday lives, assisting in tasks we may take for granted, such as getting up in the morning, preparing meals and washing.

Constant rescheduling

Since then, however, the date of publishing has been delayed six times. ‘Summer 2017’ became the ‘end of 2017’, which was soon changed to ‘Autumn 2018’, and so on – all while older people and their families across the country struggle without the help and support they so desperately need.

The danger of delays

At present, we’re told we can expect it “at the first opportunity in 2019”, supposedly before April. We hope so, because these delays have a damaging effect. For context, tomorrow (7 February) marks 700 days since the Green Paper was announced, and during that time the following has happened:

    1. 54,025 older people have died waiting for care to begin. That's 77 loved ones dying per day, around 3 every hour.
    2. 626,701 requests from older people left them unable to access the care system. That's 895 claims without formal care support every day.
    3. 7,240 older people have lost their homes and any savings through the cost of social care. That's 10 older people draining their savings every day.
    4. £476,939,017 has been wasted by the NHS through delayed discharge due to lack of social care. That's almost £500 wasted every minute.
    5. 1,263,844 older people have developed an unmet need, such as being able to wash or dress. That's 1,805 more people in need every day.
    6. 195,065 paid social care roles have become vacant. That's 279 jobs every day.
    7. 1,988,102 older people have become carers in the UK. That's 2,840 extra older people struggling every day.

Read the technical note below to see the sources for these figures.

What’s next?

So what do we do? You can start by reading more about the Care in Crisis campaign, and telling us how these issues have affected you, to add your voice to the many calling for progress. These include Scott, who says, ‘We are all getting older – would you want your loved ones to be forgotten?’ Or Mana, who recognises the social care system is ‘unsustainable in the future in its current state’.

We want to hear from you

Have you been affected by the delays in the Green Paper? If so, we'd like to hear from you, so your story can help illustrate this issue in need of urgent action.

Join the conversation

If you have thoughts on this topic, or similar experiences you'd like to share, get in touch on our social channels.

7 reasons why we need the Green Paper: Technical note

Nesta Caiger, Jose Iparraguirre, Joel Lewis and Elizabeth Webb

February 2019

This technical note accompanies the Age UK published on 6th February 2019 entitled ‘7 reasons why we need the Green Paper’ and outlines as to how we arrived at our estimates including our sources of data and brief summaries of our analyses. For further detail on our methodologies please contact research@ageuk.org.uk.

All our estimates refer to older people aged 65 and older in England, unless otherwise specified. We have estimated statistics for the 700 day period between the announcement of the Green Paper on 8th March 2017 and 7th February 2019.

54,025 older people have died waiting for care to begin. That's 77 loved ones dying per day, around 3 every hour.

This figure is based on 2017/18 data from NHS Digital which showed that 28,170 older people (aged 65 and over) died before social care services could be provided between 1st April 2017 – 31st March 2018. This is an average of 77.18 people a day. We make the assumption that this average remained the same throughout the 700 days between 8th March 2017 and 6th February 2019, leading to an estimate of 54,025 deaths among people aged 65 and over. Source.

626,701 requests from older people left them unable to access the care system. That's 895 claims without formal care support every day.

This figure is based on 2017/18 data from NHS Digital which showed that 326,780 requests for social care from people aged 65 and over resulted in ‘no services provided’. This is an average of 895.29 people a day. We make the assumption that this average remained the same throughout the 700 days between 8th March 2017 and 6th February 2019, leading to an estimate of 626,701 older people. Source.

7,240 older people have lost their homes and any savings through the cost of social care. That's 10 older people draining their savings every day.

This figure is based on 2017/18 data from NHS Digital which showed that the route of access into social care services for 3,775 older people (aged 65 and over) was being a ‘self-funder depleted funds’. This is an average of 10.34 older people a day. We make the assumption that this average remained the same throughout the 700 days between 8th March 2017 and 6th February 2019, leading to an estimate of 7239.73 older people.

£476,939,017 has been wasted by the NHS through delayed discharge due to lack of social care. That's almost £500 wasted every minute.

We estimated the cost to the NHS of delayed transfers of care (DTOCs) due to social care using NHS England data on Delayed Transfers of Care published on 10th January 2019, which includes data up to November 2018. For the period from December 1st 2018 to February 7th 2019 we made the assumption that there were the same rate of DTOCs as in the equivalent period the previous year. We calculated the cost to the NHS of these DTOCs using a value of £346 per bed day , and subtracted the cost of the social care required, with appropriate rates for nursing homes, care homes and nursing care to give an estimate of the cost of DTOCs due to social care during the 700 days between 8th March 2017 and 6th February 2019 of £476,939,017.

1,263,844 older people have developed an unmet need, such as being able to wash or dress. That's 1,805 more people in need every day.

Using data from the English Longitudinal Study of Ageing (ELSA) waves 7 (2014/15) and 8 (2016/17) we calculated how many people aged 65+ in England transitioned from not having an unmet need at wave 7 to having an unmet need at wave 8. As the two waves of data are collected 2 years apart we divided this number by 730 to give the average number of people who developed an unmet need each day. We used ONS mid-year population estimates to scale this figure up to the English population. We make the assumption that this average daily rate remained the same throughout the 700 days between 8th March 2017 and 6th February 2019, leading to an estimate of 1,263,844 older people developing an unmet need.

195,065 paid social care roles have become vacant. That's 279 jobs every day.

The 2017/18 Skills for Care adult social care workforce statistics estimate that there were 1,265,000 employees working within adult social care in England, and that these roles had an 8.04% vacancy rate. This implies an estimated 101,712.30 vacant roles within care, or 278.66 a day. We make the assumption that this average daily rate remained the same throughout the 700 days between 8th March 2017 and 6th February 2019, leading to an estimate that 195,064.69 vacant roles developed in this period. Source.

1,988,102 older people have become carers in the UK. That's 2,840 extra older people struggling every day.

Using data from Understanding Society: the UK Household Longitudinal Study (UKHLS) waves 6 (2014-2016), 7 (2015-2017) and 8 (2016-2018) we identified respondents who made the transition into being a carer, that is those who did not have a caring responsibility at one wave and did at the subsequent wave. We then took the mean proportion of older people taking on caring responsibilities between waves 6 and 7 and between waves 7 and 8 to smooth any possible jumps associated with short term period effects. As the waves of data are collected approximately one year apart, we divided this mean by 365 to give us an estimate of the mean proportion of older people taking on a caring responsibility each day. We used ONS mid-year population estimates to scale this figure up to the UK population. We make the assumption that this average daily rate remained the same throughout the 700 days between 8 March 2017 and 6 February 2019, leading to an estimate of 1,988,102 older people having taken on a caring responsibility.

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Last updated: Apr 29 2019

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