Market Position Statement 2025-2040 Introduction - Current landscape in Adult Social Care
The National Context
Adult social care faces considerable pressures on its resources, capacity and ability to keep up with the increasing demand for services.
Growing Population And Demand For Adult Social Care
It is predicted that the demand for adult social care is projected to increase significantly, largely due to the UK’s ageing population. The number of adults requiring care aged 18-64 is forecast to increase by 29% in 2038 compared with 2018. For people aged over 65 it is even higher at a 57% increase. The cost of care is also increasing, with a projected 90% increase in costs of care for adults aged 18 to 64 by 2038 compared with 2018 and a 106% increase for over 65s.
As is shown in the MPSs, we have seen in Walsall an increase in the numbers of people supported in their community and we expect this to continue. Those entering residential and nursing care generally need higher levels of care and support. Demand for supported living is growing and developing so is a key area of focus for the next few years. We want to increase the specialist housing options for people but also help more people to move into their own home. More people are being supported into employment despite the current economic challenges. People have told us they want to feel part of a community and develop friendships and their interests.
The past few years have had a huge impact on demand for care and support and on our care and support providers. The pandemic has increased the trend towards more care provided at home and increased use of short-term care in reablement and short-term care home placements. It has changed the way that some people have accessed day care services. The pandemic and the associated economic impact have had a major impact on care staff, and we are facing significant recruitment and retention issues across services. We want to work with people in Walsall and care providers and other partners to help tackle these issues together.
Government Funding
In recent years, the funding provided from the government for adult social care has reduced, which along with delays in government policy on future funding has caused uncertainty.
Councils across the country spent £27.1 billion during 2023/2024, an increase of £3.4 billion (14.2%) from the previous year. All councils across the country are seeing increasing demand and costs. The Local Government Association (LGA) latest projections show a gap of £2.3bn in council finances widening to £3.9bn in 2025/26 – the equivalent of around 3% and 5% of Councils’ spending on services in those years, respectively.
The increasing prevalence of overspends points to long-term underfunding and increasing levels and complexity of need. Failure to close the adult social care resourcing gap has left Council’s struggling to square their legal duty to set a balanced budget with their duty to provide statutory services. Cost of Living and the Living Wage The Association of Directors of Adult Social Services (ADASS) 2024 Autumn survey calculated that the National Living Wage increases added £1.4bn to the cost of commissioned adult social care services in 2023/24 and £1.6bn in 2024/25. The National Living Wage will rise to £12.21 in April 2025, representing an increase of 6.7%. The planned rise to employers’ national insurance is due to come into force in April 2025. This is due to cost providers £940m in 2025-26, according to think-tank the Nuffield Trust, with organisations also facing a £1.85bn bill next year from the 6.7% rise in the National Living Wage (NLW).
These funding pressures are likely to be compounded by the current cost of living crisis and rising inflation which has an impact on the people we support, as well as putting pressure on the Council, care providers and partners in the voluntary and community sector.
System Responsibilities
There is significant expectation from central government and the wider health system to support safe and timely discharges from hospital care. At the same time, adult social care is required to maintain a focus on admission avoidance, strengthen the voluntary and community sector with growing its prevention offer to reduce or delay the need for formal health and social care.
Provider Workforce Challenges
Skills for Care’s The State of the Adult Social Care Sector and Workforce 2023 report highlights that if the workforce grows in line with proposed demographic changes and demand, an extra 440,000 roles will be needed by 2035. During 2023 there were 440,000 posts filled by people who will reach retirement age in the next 10 years. Independent providers recruited 18,000 international staff from April to September 2024, compared with 105,000 in the year to March 2024, a fall of roughly two-thirds in the quarterly average. Since last March, the number of international recruits has fallen which is attributed to the ban on overseas staff bringing dependents with them when taking up roles in the social care sector. Therefore, there needs to be a big push on not only recruiting younger people into the sector and local workforce but also focusing on retaining the existing care and support workforce.