University of Leicester eBulletin

Ten Years of Community Care Leaves Older People in Crisis

May 2002
No 92

New Help the Aged report: Nothing Personal: rationing social care for older people

Ten years of chronic underfunding of community care has resulted in older people facing increasing rationing of key services says a new in depth study entitled Nothing Personal: rationing social care for older people commissoned by Help the Aged and carried out by the University of Leicester.

Changes in policy, such as the withdrawal of the NHS from almost all long-term provision, the redefinition of nursing care, and changes in capital limits for residential and nursing home care - have not only put additional demands on over-stretched local authorities, but led to a disproportionate allocation of resources going into hospital care at the expense of social care.

Furthermore, central government guidance to target resources to those in most acute need has resulted in serious cuts in preventative help.

"Funding has simply not kept pace with need and this is having disastrous consequences for older people" says Gail Elkington, Policy Officer at Help the Aged, "It is recognised that prevention is a key principle of social care.  Yet more and more people are facing barriers, rationing, uncertainty and long delays.  We urgently need to see this chronic inadequacy in funding addressed in the Chancellor's forthcoming Comprehensive Spending Review.

"We also want to see far greater transparency from local authorities about what people can expect from service providers.  For example, many older people find that the eligibility criteria are tightened or cut.  They fear charges may be levied.  Reductions in staffing levels are leading to long waiting times for assessment and services."

The report, carried out by Nuffield Community Care Studies Unit at the University of Leicester and financed by the Community Fund, looks at the policies and practices of six local authorities across England and Wales in determining how older people can access social care.  It is based on interviews with local authority social services departments, voluntary sector and independent providers of care services, older people who use the services and their carers.

Another worrying factor exposed in the study is the opening gap in the quality of care, as independent providers attempt to manage with the lower fees that local authorities offer.

Help the Aged is calling for:

        greater resources for social care services

        fairer and more even distribution of social care servces

        higher priority to be given to so-called 'low level' needs

        an end to the arbitrary differentiation between social care and health care.  Social care funding is well below that of the NHS.

Note to Editors

1.            A copy of the full report, Nothing Personal is available price 15 (inc p&p) from Jenny Havis, Help the Aged, 207 221 Pentonville Road, London N1 9UZ

2.            National Statistics on home care (CSSRs) published March 2002 show that 395,000 people receive home care.  The number of contact hours of care has risen by three per cent, off set by a four per cent fall in the number of households receiving home care.  This shows that councils are having to provide more intensive levels of support for fewer people .

For further information contact: Rachel Harford/Hilary Carter Tel: 020 7 239 1940, ISDN for Radio interviews: 0207 713 1340,, email:

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