As the owner of four award-winning nursing homes in Devon, I see first-hand the cracks in our social care system widening every day. The social care crisis is not a new phenomenon, but its scale has gone beyond the tipping point. As a society, the challenges we face in providing support for our aging population are unprecedented, and without urgent action, the consequences are catastrophic.
The growing need for social care
The demographics tell a sobering story. According to the Office of National Statistics, there are now 2.3 million people in the UK aged 85 or older, up from 1.4 million in 2010. This trend is expected to accelerate with the Department of Health and Social Care predicting that by 2038, 57 percent more adults over 65 will require social care compared to 2018.
This demand isn’t being matched by supply. Many care home providers have seen a significant reduction in council-commissioned care hours. This decline in provision leaves more than two million older adults without the care they need. Age UK estimates that 2.6 million people over 50 in England are unable to access care, a number that rises sharply with age and is growing.
A system strained by chronic underfunding
In short, local authority social care spending has fallen far short of what’s needed. Between 2010 and 2023, local authority spending on adult social care grew by just 12.3 percent – an average of one percent per year – despite inflation rates far outpacing this figure. For 2024/25, local authorities in England have budgeted just £24.5 billion for adult social care, a figure that is woefully inadequate given the current, let alone future, needs.
The underfunding of the social care sector is estimated at £8 billion per year by the Health Foundation, a figure projected to rise to £18 billion by 2032. England’s per capita spending on social care is among the lowest in Europe, a scandalous track record for one of the world’s wealthiest nations.
From social care to NHS crisis
The link between the crisis in social care and the NHS crisis is undeniable. Without adequate community support 24/7 and residential care, older adults can end up in hospital unnecessarily, placing further strain on a system already at breaking point. It has been widely reported that one in seven beds in NHS hospitals are occupied by patients who are well enough to leave, but are waiting for social care. The most likely reason they are waiting for social care is because they are waiting for funding, which local authorities are unable or unwilling to fund. The problem of delayed discharge or ‘bed blocking’ is caused by difficulties finding care homes or community care packages for elderly and vulnerable people. In other words, the A&E waiting time crisis and the social care crisis are two sides of the same coin.
Residential care beds have also seen a steady decline, partly due to sky-rocketing running costs, decades of Government inaction regarding care policies, and partly a shortfall in carers, which is a knock-on effect of the Government’s new visa rule prohibiting overseas care workers from coming to the UK and bringing their families with them. The recent change to employers National Insurance contributions will also add an enormous amount of financial pressure to already struggling care providers.
The result is that with fewer options for care, more people are left isolated, their conditions deteriorating avoidably until hospital admission becomes the default solution. This vicious cycle further deepens the crisis in both health and social care.
What needs to happen?
Ending the crisis in social care requires immediate, meaningful action. First and foremost, we need a significant injection of funding. The Nuffield Trust calculates that an additional £2.8 billion is needed to stabilise the sector, with even more required to ensure long-term sustainability.
The government must reallocate some of the £22 billion recently pledged to the NHS to bolster social care. This is not just about fairness, it’s also about practicality. The Prime Minister’s pledge to reduce NHS waiting lists will fail as social care is undermined because it plays a critical role in preventing hospital admissions, facilitating timely discharges, and reducing the shocking waiting times.
Investing in wages and funding for more training for care workers is also vital. The expectation for care workers to perform more healthcare tasks while embracing digital tools cannot be met without proper resources and support. Providers, many of which operate on razor-thin margins, cannot absorb rising costs without assistance, yet they are being asked to year-on-year.
A call for collaboration
The lack of meaningful collaboration between the NHS, Local Authorities, Government, and social care sectors is another significant barrier. Effective integration at the ground level is essential to provide seamless care for individuals. Unfortunately, policies that silo these sectors only exacerbate inefficiencies and the delays, and worsen outcomes for those in need who deserve better.
A bleak future without action
We are facing an existential threat to care and support services. The majority of care providers are small, local organisations that cannot survive under current conditions. Without immediate action, we risk a collapse of the entire system, leaving millions of vulnerable people without the support they need.
The social care crisis is a national scandal. It is time for the Government to move beyond rhetoric and prevarication and take decisive action to prevent further harm. If we are serious about ending the social care crisis, we must act now because the future of our aging population and the dignity and wellbeing of millions, depends on it.