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Age UK uncovers unfair care funding postcode lottery

Published on 11 January 2012 12:30 AM

New research from Age UK shows that the Personal Budget system in England, which is meant to enable adults to have greater choice in choosing and paying for domiciliary and day care, is highlighting huge regional differences in the amount of care older people receive.

A 'personal budget' is a sum of money allocated to an individual who is assessed as needing personal assistance and support services in a non-urgent situation. This allows them to choose, with appropriate support, how to spend that money to meet these needs in a way that best suits their life situation and aims.

In November 2011, Age UK made a Freedom of Information Request to all English councils with adult social service responsibilities to find out how well the system of personal budgets is working in practice for older people.

The results show that personal budgets set by some local authorities will buy up to seven times more care than other local authorities.

Some of the disparity can be explained by differing eligibility criteria. However there are still substantial differences in the personal budgets being paid by local authorities that have the same thresholds of eligibility for social care.

Other findings include:

  • Among local authorities that restrict their care to those with 'substantial' and 'critical' needs, the amount of care that an average personal budget can buy varies between 3 hours and 18 hours a week.
  • Over a region the differences average out but there are still substantial variations with personal budget holders in the South East on average able to buy in 11.5 hours of care per week whilst  those in the West Midlands only receive enough money for 7.5 hours.

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More about personal budgets

Personal budgets are a way of allocating money to individuals who are eligible for state-supported social care. People can make a choice of taking their personal budget as a cash amount and using that money to pay for the services they want, having the local authority manage the budget on their behalf, or a mix of the two.
 
The money can be spent in a whole range of ways which may mean paying for traditional local authority services such as home care or day care; alternatively it may mean buying services from the private sector. The Government has stated that it would eventually like to see all users of care services to move onto personal care budgets.

Vast differences revealed

Age UK's Freedom of Information request found vast differences in the amount individuals are allocated, according to region. Even taking into account the varying regional costs of care, the large fluctuations in the personal budget prices are extreme and demonstrate a postcode lottery of care funding that fails older people, precisely at the point of need.
 
Age UK Charity Director Michelle Mitchell commented, 'The current system is unfair, opaque and confusing. The amount of care older people can buy in varies by up to seven times across the country. Some of this variation is because councils provide support at different levels of need which means that people living in different parts of the country are entitled to different levels of support.

'This results in a postcode lottery which is widely deemed to be not fair. By the time older people need to buy care services they are less able to move area to access better services and this new research shows that they may be stuck with vastly different levels of care from one borough to the next.
 
Mitchell continued: 'We want the Government to show vision and leadership by urgently adopting the recommendations of the Dilnot and Law Commissions reports to create a fair and sustainable social care system.'
 
Average personal budget broken down by region, demonstrating how many hours of care can be purchased:

Region Average personal budget for service users aged 65+ Hours of home care per week affordable with the average personal budget
East Midlands £163 8.7 hours
East £201 11.2 hours
London £179 8.5 hours
North East £166 9.9 hours
North West £153 10.5 hours
South East £226 11.5 hours
South West £179 10 hours
West Midlands £140 7.5 hours
Yorkshire and the Humber £142 7.7 hours
England  £171 9 hours

Personal budgets are failing older people

The FOI findings by Age UK add to existing evidence showing that personal budgets are failing older people:
 
In early 2011, Laing and Buisson carried out a survey of home care providers in the South East. They found that:

  • Personal budgets appear to have the effect of reducing the number of hours of homecare that the recipient is able to purchase.
  • People who have a personal budget are increasingly being moved away from their original provider to a cheaper one by social services. A significant number will get a direct payment so they can stay with the original provider and either reduce their homecare hours or top-up the fees themselves.

Last updated: Oct 06 2017

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