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Thursday, 18 September 2014

Report: Costs of Adult Social Care in England

Written by The Editorial Team

This Health and Social Care Information Centre summary provides information about the money spent on adult social care by the social services departments of Councils with Adult Social Services Responsibilities (CASSRs) in England.

It contains information taken from CASSR administrative systems used to record personal social services expenditure and income. The data are used by central government for public accountability, policy monitoring and national accounts, and by local authorities to assess their performance in relation to their peers.

This report combines provisional data  from 152 CASSRs provided via the Personal Social Services: Expenditure and Unit Costs return (PSS-EX1) and relates to the period 1 April 2013 to 31 March 2014.

Final data for 2013-14 are due to be published in December 2014; after submitting the provisional data underlying this report CASSRs have an opportunity to update their data in response to validation queries from the Health and Social Care Information Centre which assess the integrity of the data.

Gross current expenditure  has been quoted within this summary unless otherwise stated. National level information is provided by client type and service area in this summary.

Trends are generally shown over a five year period where broadly comparable and a ten year comparison is made in relation to gross current expenditure. Data on grants and unit costs are broadly comparable over a four year period only. Due to changes in the composition of social care funding and expenditure over time, caution should be exercised when considering long term trends.

Data at a regional and CASSR level are available via the National Adult Social Care Intelligence Service (NASCIS). NASCIS provides a set of analytical, querying and reporting tools.

Key facts

Gross current expenditure by CASSRs on adult social care in England in 2013-14 was £17.2 billion. This is almost unchanged (a decrease of less than half of one per cent) in cash terms from 2012-13, which is the equivalent of a one per cent decrease in real terms.

Over the five year period from 2008-09 , when the figure was £16.1 billion, expenditure has increased by seven per cent in cash terms; a decrease of three per cent in real terms. Over the ten year period from 2003-04, when the figure was £12.5 billion, expenditure increased by 38 per cent in cash terms and 10 per cent in real terms.

In 2013-14 the proportions of expenditure by client type have seen slight variations to those recorded in 2012-13. 51 per cent (£8.8 billion) of expenditure in 2013-14 was on older people (those aged 65 and over), compared to 52 per cent in 2012-13.

Expenditure on people aged 18-64 with learning disabilities accounted for 31 per cent (£5.3 billion) of gross current expenditure, compared to 30 per cent in 2012-13.

Expenditure on people aged 18-64 with physical disabilities accounted for nine per cent (£1.6 billion), the same proportion as 2012-13. Six per cent (£1.1 billion) of expenditure was spent on people aged 18-64 with mental health needs, compared to seven per cent in 2012-13.

Other adult services accounted for two per cent (£270 million) and less than one per cent was spent on asylum seekers (£10 million) and service strategy (£50 million) combined; these proportions are unchanged from 2012-13.

The proportions of expenditure by type of service in 2013-14 remained the same as those recorded in 2012-13; over the five year period from 2008-09, there have been some changes to these proportions.

Expenditure on day and domiciliary care increased in 2013-14 to 45 per cent (£7.8 billion), from 43 per cent in 2008-09. The proportion for Residential care remained unchanged in comparison to 2008-09, at 44 per cent (£7.5 billion). The remaining 11 per cent (£1.9 billion) of expenditure was spent on assessment and care management in 2013-14, compared to 12 per cent in 2008-09.

The proportion of expenditure on direct payments has continued to rise; accounting for eight per cent in 2013-14, compared to seven per cent in 2012-13 and four per cent in 2008-09.

In 2013-14 £1.4 billion of expenditure was on direct payments compared to £1.2 billion in 2012-13; an increase of ten per cent in cash terms and eight per cent in real terms. Over the five year period from 2008-09 when the figure was £610 million, expenditure on direct payments increased by 125 per cent in cash terms and 103 per cent in real terms.

Grants for adults aged 18 and over (excluding service strategy) have seen a reduction. In 2013-14 grants amounted to £250 million, compared to £290 million in 2012-13; a decrease of 13 per cent in cash terms and 15 per cent in real terms. Over the four year period from 2009-10 when grants also totalled £290 million, there has been a decrease of 13 per cent in cash terms and 19 per cent in real terms. Grants as a proportion of ‘provision by others’ remained unchanged at two per cent over this period.

The average cost per adult aged 18 and over supported in residential care, nursing care or intensively in their own home was £601.47 per week in 2013-14, compared to £601.63 in 2012-13; a change of less than half a per cent in cash terms, but a two per cent decrease in real terms. Over the four year period from 2009-10, when the average cost was £609.13, it represents a decrease of one per cent in cash terms and eight per cent in real terms.