Social Care eligibility thresholds briefing - Age UK

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In 2003 the Department of Health issued “Fair access to care services – guidance on eligibility criteria for ..... C
Social Care eligibility thresholds briefing Background to social care eligibility criteria In 2003 the Department of Health issued “Fair access to care services – guidance on eligibility criteria for adult social care”. This is “section 7 guidance” which means it was issued under section 7 of the Local Government Social Services Act 1970 and places a legal obligation on local authorities to act in accordance with the guidance. In 2010 the guidance was updated and is now called ‘Prioritising need in the context of Putting People First: A whole system approach to eligibility for social care’. The guidance provides local authorities with a framework for identifying people’s social care needs within a banding system, with the intention of providing “fair access” to care. On assessing individuals’ needs, local authorities must identify which of these bands they fall in to. The four bands are: • Critical • Substantial • Moderate • Low Although all local authorities must use this banding system, they have discretion to set their threshold individually within these bands, taking account of their resources, local expectations and costs. The result is that one council may choose to set their threshold at “low”, while a neighbouring council might choose to set theirs at “critical” creating the potential for significant variation in the accessibility of care across local authority borders. Changes in eligibility thresholds Since 2003 when the banding system was introduces, eligibility thresholds among local authorities have slowly been creeping up. As a result access to social care is now more restricted now than ever before. • In 2011-12, only 3 councils provide social care to people falling in to all eligibility criteria bands (low, moderate, substantial, critical). •

25 provide care to those with moderate needs and above.



The majority, 119, have a threshold at substantial.



5 councils - a higher number of councils than ever before - only provide care for those with critical needs.



In 2005-06, 40% of councils provided care to those with moderate needs. In 2011-12 this has reduced to 18%. 1

Figure 1 demonstrates how councils are increasingly shifting their eligibility criteria towards the upper end of the banding system, with 124 councils now restricting care to those with substantial or critical needs, compared to 86 in 2005-06. Figure 1

The trend has shown no sign of abating over the last year as local authorities face severe financial constraints due to the poor economic outlook and the cuts to the funding from central government. Figure 2 demonstrates the tightening in eligibility thresholds that has happened just between 2010-11 and 2011-12. Figure 2.

There is regional variation in how the eligibility thresholds are applied. Figure 3 demonstrates the differences among the regions. • The East Midlands is the most generous region, with over half of its 9 councils providing care for those with moderate needs.

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Neighbouring West Midlands is the least generous region, with all 14 councils restricting care provision to those with substantial needs.



Only 3 councils still provide care to those with low needs; two of these are in the North East.



3 out of the 5 councils that restrict care to those with critical needs are in the South East.

Figure 3

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Appendix: Social Care eligibility thresholds by year and local authority. NB missing data for years 2008-09 and 2009-10

Region L L YH

20052006 M S S

20062007 S S S

20072008 S S S

20102011 S S S

20112012 S S S

SW E L WM NW NW NW SW SE YH L SE SW L SE NW

S S M S M S M S S M S S S M S S

S S M S M S M S S M S S S M S S

S S S S S S M S S S S S S S S S

S S S S S S S S S M S S S S S S

Calderdale Cambridgeshire Camden Central Bedfordshire Cheshire East Cheshire West and Chester City of London Cornwall Coventry Croydon Cumbria Darlington Derby City

YH E L E NW

L S S S S

L S S S S

L S S S S

S S S S S S S S S M S S S S S S L (upper) S S M S

NW L SW WM L NW NE EM

S M L S S S M L

S M M S S S M M

S M S S S S M M

S S S S S S L M

Derbyshire Devon Doncaster Dorset Dudley

EM SW YH SW WM

M S M M M

M S M S M

M S M S M

M S M S S

Local Authority Barking and Dagenham Barnet Barnsley Bath and North East Somerset Bedford Borough Bexley Birmingham Blackburn with Darwen Blackpool Bolton Bournemouth Bracknell Forest Bradford Brent Brighton and Hove Bristol City Bromley Buckinghamshire Bury

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M S S M C S S S S S S L M M (upper) S M S S

Durham Ealing

NE L

S S

S S

S S

East Riding of Yorkshire East Sussex Enfield Essex Gateshead Gloucestershire Greenwich Hackney Halton Hammersmith and Fulham Hampshire Haringey Harrow Hartlepool Havering Herefordshire Hertfordshire Hillingdon Hounslow Isle of Wight Isles of Scilly Islington Kensington and Chelsea Kent Kingston Upon Hull Kingston Upon Thames Kirklees Knowsley Lambeth Lancashire Leeds Leicester City

YH SE L E NE SW L L NW

M S S S M S S S S

M S S S M S S S M

M S S S S S S S M

L SE L L NE L WM E L L SE SW L L SE YH L YH NW L NW YH EM

M S M S M S S S M S S M M M M S L L M S M S S

M S S S M S S S S S S M M M M S L S M S M S S

M S S S S S S S S S S M M M M S S S M S M S S

Leicestershire Lewisham Lincolnshire Liverpool Luton Manchester Medway Merton Middlesbrough

EM L EM NW E NW SE L NE

M S M M M S L S na

M S M M S S L S S

M S M M S S S S S

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S S S (upper) S S S S S S S M M (upper) S S S S S S S S S S L M M M S S S S S M S S M (upper) S M M S S S S S

S S S (upper) S S S S S S S M M (upper) S S S S S S S S S C L M M M S S S S S S S S S S M M S S S S S

Milton Keynes Newcastle upon Tyne Newham Norfolk North East Lincolnshire North Lincolnshire North Somerset North Tyneside North Yorkshire

SE NE L E YH YH SW NE YH

S S S na M M S S C

S S S S M M S S S

S S S S M M S S S

Northamptonshire Northumberland

EM NE

S C

S C

S C

Nottingham City Nottinghamshire Oldham Oxfordshire

EM EM NW SE

M S S S

M S S S

M S S S

Peterborough Plymouth Poole

E SW SW

M M M

M S M

M S M

Portsmouth

SE

M

M

M

Reading

SE

M

M

M

Redbridge Redcar and Cleveland Richmond upon Thames Rochdale Rotherham Rutland Salford Sandwell Sefton Sheffield Shropshire Slough Solihull Somerset South Gloucestershire South Tyneside Southampton Southend on Sea Southwark St Helens Staffordshire

L NE L NW YH EM NW WM NW YH WM SE WM SW SW NE SE E L NW WM

S S M M M M M S S S S S S M S S S S M M S

S S M M S M M S S S S S S M S S S S M M S

S S M M S M M S S S S S S M S S S S M M S

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S S S S M M S S M S (upper) C M (upper) M S S M (upper) S S M (upper) M (upper) S (upper) S M M S M M S S S S S S M S S s S S M S

S S S S S M S S M S (upper) C M (upper) S S S M (upper) S S M (upper) S S (upper) S S M S M M S S S S S S S S S S S S M S

Stockport Stockton on Tees Stoke on trent Suffolk Sunderland Surrey

NW NE WM E NE SE

S M na S L S

S M S S L S

S M S S L S M S S S S S S S S S S S M S C M M S S

S M S S L S M (upper) S S S S S S S S S S S M S C M M S S

S S S S L S M (upper) S S S S S S S S S S S M S C S S S S

Sutton Swindon Tameside Telford and Wrekin Thurrock Torbay Tower Hamlets Trafford Wakefield Walsall Waltham Forest Wandsworth Warrington Warwickshire West Berkshire West Sussex Westminster Wigan Wiltshire Windsor and Maidenhead Wirral Wokingham Wolverhampton Worcestershire York

L SW NW WM E SW L NW YH WM L L NW WM SE SE L NW SW

M na S S na S na M S S S L M S C M M S S

M S S S S S S M S S S M M S C M M S S

SE NW SE WM WM YH

S S M L S S

S S M L S S

S S C S S S

S S C S S M

S S C S S M

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