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Incoming PM needs to act fast, says Care and Support Alliance, as new analysis finds 2.6m aged 50+ now have some unmet need for social care 

September 2, 2022

The reforms Boris Johnson announced will not and cannot ‘fix social care’ because they don’t improve the quality and availability of care – the new Prime Minister must go further 

New analysis by Age UK for the Care and Support Alliance (CSA) * has found that a massive 2.6 million people aged fifty and above are living with some form of unmet need for care in England. This is the best estimate so far produced for the numbers of people in mid-life, as well as of above State Pension Age, who require assistance with one or more activities of daily living, like washing and eating.  

The 2.5 million over-50s in this position are equivalent to 12%, or one in eight of the entire same age population in this country.  

In response to this shocking statistic the Care and Support Alliance (CSA)*, is calling for an urgent cash injection to address the increasing pressures on the care system caused by a shortage of money and staff. Social care is chronically underfunded and many local councils struggle to meet the care needs of their communities. An ageing population as well as a growing number of disabled people of working age, means problems are escalating with central Government funding not keeping pace with the consequent growing demand for care. Unfortunately, the pandemic made an already bad situation even worse. 

Latest data by Age UK and the Care and Support Alliance show that: 

  • 70% (1.8 million) of those with an unmet need for care have difficulty dressing          
  • 18% (450,000) of those with an unmet need for care have difficulty walking across a room 
  • 47% (1.2 million) of those with an unmet need for care have difficulty bathing or showering 
  • 12% (320,000) of those with an unmet need for care have difficulty eating 
  • 36% (930,000) of those with an unmet need for care have difficulty getting in and out of bed 
  • 23% (600,000) of those with an unmet need for care have difficulty using the toilet 
  • 7% of people in their 50s have an unmet need for care, 12% in their 60s, 15% in their 70s, 21% in their 80s and older 
  • 21% (540,000) of people with an unmet need for care are often lonely, compared to 6% of people who have no need for care and 12% of people who have a need for care which is met 

    (All these statistics refer to the age 50+ population of England, and can be referenced as Age UK analysis of data from wave 9 of the English Longitudinal Study of Ageing, scaled up to the population of England using data from the 2021 Census.) 

The local authorities that are responsible for funding social care are facing severe financial pressures due to a long term lack of funding from central government. Social care providers are facing increased costs, and skilled, low-paid carers are leaving the profession in droves, often to work in retail or the NHS, where terms and conditions are more favourable. Unfortunately, at the same time people who need care are paying more but often receiving less – some have had their care packages reduced or cut altogether, and thousands of others are still waiting to be assessed by their local council.  

Furthermore, recent evidence suggests almost three quarters (73%) of Social Services Directors are reporting more breakdowns of unpaid carer arrangements (ADASS Spring Survey 2022) – with family members struggling to continue providing high levels of care without sufficient outside support. There has also been a sharp drop in the number of unpaid carers in England reporting that the person they care for has used services, allowing them to take a break from caring for more than 24 hours – 19.6 per cent (57,280 people) in 2018-19 compared to 13.3 per cent (42,800 carers) in 2021-22 (Personal Social Services Survey of adult carers in England report, 2022). The number of carers who said there had been no discussions about the support or services provided to the person they care for in the last year grew from 31.2 per cent (91,250) in 2018-19 to 36.1 per cent (116,360) in 2021 (Personal Social Services Survey of adult carers in England report, 2022). 

The Care and Support Alliance believes that the reforms that Boris Johnson announced as Prime Minister in September 2020 will not and cannot fulfil the promise he made to ‘fix social care’ because they do not improve the quality and availability of care – the things that really matter if you or a loved one needs this support, which is never a ‘nice to have’ and always a necessity. Instead, his reforms focus on subsidising the cost of care for some people who pay for their own services, especially if they need them for a long time – a good thing to do but not nearly enough on its own. The 2019 Conservative Manifesto said that older and disabled people, and their unpaid carers, deserve the support they require to live decently. At the moment we seem further away than ever from that aspiration being met.  

Caroline Abrahams, Charity Director of Age UK and Co-Chair of the Care and Support Alliance said: 

“To have as many as two and half million over-50s now living with some unmet need for care is truly astonishing, and it shows how far below an acceptable level of operation our social care services have been allowed to fall. This number is equivalent to one in eight of the entire same age population, and the lack of support must be having a huge impact on all these people’s ability to live a normal life and participate in and contribute to our society. There’s no doubt that the long term neglect of social care services by central Government is having very real consequences, not only for the individuals whose lives are at best diminished, and their families who often have to pick up the pieces, but for other public services too, especially the NHS. What folly it has been for our politicians to be so careless about such a crucial public service – it’s high time that changed and I hope our new Prime Minister will turn the page and take a more intelligent approach to social care.”  

“At the moment all the data point to social care becoming weaker as time goes on, not stronger, particularly when you look at the state of the workforce, where vacancies are increasing month by month. This is scarcely surprising when you consider how uncompetitive the terms and conditions in social care now are: the incoming administration must understand that they will not begin to turn the curve on quality and access in social care until they ensure care staff are properly recompensed for the incredible work they do.”   


Jackie O’Sullivan, Communication Director of Mencap and Co-Chair of the Care and Support Alliance said:  

“These figures are shocking enough, but with the increasing staff shortages these numbers are only going to increase unless the Government takes bold and urgent action to getting social care the funding it needs.  

“Many younger disabled adults are being condemned to living lives where just getting out of the house is a constant struggle, they then can’t work, volunteer or meet people. They just stay stuck inside.   

“We need an urgent cash injection from the Government to address all these ongoing pressures on the system caused by the pandemic and in the longer-term need funding targeted at supporting decent pay rises for our hard-working care workforce. This is the only way the sector can get back on an even keel.”   

“The years of lack of investment means the scale of the challenge is huge and demands urgent action now. The millions of older and disabled people putting up with inadequate services, if they get any service at all, need the incoming PM to get a grip of the problem and aim for transformation through proper reform, but as it stands it is never going to be possible with the meagre funding allocated by the government up to now.” 


Notes to Editors.  

Story tellers  

Steven’s story  (Age UK)  

Steven is 66, and has complex health needs. He is bedbound and has been for the past 10 months. He had a fully funded care package with included meals and giving him his medication. In September he was informed by his care agency that due to staffing problems they were withdrawing his care from immediate effect and had informed the council. No replacement care was provided. He contacted the council to ask for this to be arranged urgently but this did not happen. He contacted his GP who was unable to offer any assistance. Steven was left without access to food or water for 60 hours, which resulted in him becoming very distressed and unwell. 

 * The Care and Support Alliance represents over 60 leading charities campaigning for a properly funded social care system in England alongside the millions of older people, disabled people and their unpaid carers who need decent care. 



CSA’s statement in response to the White Paper on social care

December 1, 2021

Caroline Abrahams, Charity Director of Age UK and Co-Chair of the Care and Support Alliance, said:

“This White Paper sets out some important, long overdue policy advances, but lack of investment means any changes will be modest and slow to arrive, whereas the scale of the challenge is huge and demands urgent action now. The millions of older and disabled people putting up with inadequate services, if they get any service at all, needed the Paper to turbo-charge a process of transformation, but that was never going to be possible with the meagre funding allocated by the Treasury to it at the Spending Review. Rather than the formula one vehicle that was required, the Paper is an underpowered saloon car at best.

“Over time, the Paper’s provisions to improve data collection, spread the use of IT across the care sector and put in place a stronger workforce infrastructure are likely to prove extremely valuable, the foundations of a less intensely fragile system in future. However, in all honesty most people would reasonably expect these basics to be in place already. The fact they are not reflects how badly social care has been neglected by governments for far too long. The Paper signals an important acknowledgement that this must now change, but one can’t help but be conscious of just how far there is to go before every older and disabled person who needs a decent care service actually receives it – we are way behind some other comparable countries in this respect.  

“Meanwhile, Rome burns. Chronic workforce shortages are the biggest concern and seem to be getting worse, with uncompetitive pay the main culprit. There is nothing in the Paper to suggest the Government has any real strategy for dealing with it, given the lack of care funding overall. If COVID surges this winter because of the new variant these workforce problems will be magnified, with potentially disastrous consequences. There are similar concerns about unpaid carers collapsing after an unbelievably challenging twenty months too.

“Mapping out a positive journey is incredibly hard when you are essentially in the midst of a crisis, the ground wobbling below your feet. That’s where social care is today, and it means that until the Government does more to put out the immediate fires, any efforts to craft a better future always risk achieving much less than they should or being undermined along the way.”

CSA’s response to the 2021 Comprehensive Spending Review

October 27, 2021

Caroline Abrahams, Charity Director of Age UK and Co-Chair of the Care and Support Alliance said:

“Today, social care needed a big injection of guaranteed, additional funding for now and the future, but the Chancellor didn’t deliver it. The extra money that was announced for local government was not ring-fenced for social care and will need to be stretched thinly across council services, after a decade of under-funding.”

“The end result is that there is no relief in sight for older and disabled people who require care, and their families and carers, who are having to put up with services under extreme duress – if they can get any help at all.”

“It’s no good the Government promising the possibility of more funding for care in a few years’ time if today’s provision continues to disintegrate and more workers walk away.

“If the Prime Minister’s ambition to ‘fix social care’ is ever to be realised Rishi Sunak has to play his part by providing enough funding to make it happen. He hasn’t done so and therefore, unfortunately, the future of social care remains as uncertain as ever, with the credibility of the Prime Minister’s promise increasingly on the line.”

CSA’s response to the Government’s Health and Social Care NI increase

September 7, 2021

Caroline Abrahams, Charity Director of Age UK and co-Chair of the Care and Support Alliance said:

“Our initial assessment is that while the Prime Minister’s announcement doesn’t give us everything we wanted and we are worried about the funding, it is definitely worth having and a once in a generation opportunity to improve social care that must not be allowed to slip away.”   

“At last, there’s some hope for a better future and we all stand to gain, since any of us, at any age, could develop a need for care.” 

“If the Prime Minister’s proposals are put into action he will deserve real credit for breaking a log jam that has held back social care reform for far too long. The intense debate about how to pay for it must not obscure the paramount importance of action being taken now to stabilise and rebuild care, especially after its terrible mauling by COVID-19.” 

“At £86,000 the cap provides some much needed certainty and removes the fear of care bills spiralling to infinity, though at that level it will help fewer people than many had hoped. A more generous means test is arguably the more significant announcement for most and will result in greater numbers receiving at least some financial help. However, there is a lot of devil in the detail which we need to understand before reaching a final judgement. 

“The NHS is being given extra funding upfront and social care desperately needs that too. Unless the Chancellor delivers substantially more investment into councils’ budgets in the autumn Spending Review there’s a real risk that the Prime Minister’s announcement will fall flat.”  

“The proposals are broader than many expected and some of the non-cap elements that will be fleshed out later this year have exciting potential to increase the quality and quantity of care on offer to older and disabled people, and their families caring for them, as well as how joined up it is with the NHS, of great importance to many frail older people in particular. We look forward to hearing more.   

“It’s good to see serious investment in workforce training – though we doubt this will prevent disillusioned staff from continuing to drift away for better paid jobs elsewhere. On the care workforce we wanted the Government to go further and do more to improve terms and conditions.” 

CSA launches new #KeepYourPromiseBoris campaign

July 8, 2021

Today, the Care and Support Alliance launches its new campaign – #KeepYourPromiseBoris.

Over 100 weeks ago, on his first day, Prime Minister Boris Johnson promised to ‘fix social care once and for all.’ But we are still waiting. Millions of people who need decent care are relying on the Prime Minister to keep his promise. Social care was struggling before COVID-19 arrived, but the last fifteen months have made things even worse.

People are being urged to join the campaign and visit to write to their MP to make sure the Prime Minister delivers on his promise to ‘fix social care once and for all’ Last month, over 50 charity leaders from across the CSA wrote to the Prime Minister to ask him to fulfil his promise and bring forward proposals on social care reform. 

The CSA recently found that since the start of the pandemic, over 2 million adults in England have had their requests for care turned down. The Prime Minister pledged to fix social care in 2019 and now, as we look ahead to life beyond the pandemic, it’s time for him to deliver on his promise.

The CSA believes that with social care reform, including investing more money and giving care workers the career structure, pay and conditions they deserve, we’d have the strong and effective care system our country needs. Millions of older people and disabled people would also be better able to live decently and independently, and millions of unpaid carers would be supported.

Supporters of the campaign can visit the CSA’s micro-site, which will be live for the six-week duration of the campaign, at The site includes a link to write to your MP if you live in England.

People, including those who live in Scotland, Wales or Northern Ireland, can further support the campaign by sharing our tweet here or Facebook post here.