Kieran Lucia on Incisive Health’s new report in partnership with Age UK

‘Care deserts’ are local areas of the country where sufficient social care services are unavailable, no matter the individual or local authority’s ability to pay, meaning the social care needs of the local population go unmet. Care deserts develop because the market for social care becomes so dysfunctional that either providers decide that it is financially unsustainable to operate and deliver the capacity required or because there are insufficient staff to deliver care. Our findings are set out in a new report, Care deserts: the impact of a dysfunctional market in adult social care provision, and covered widely today, including by the BBC, The Guardian and The Daily Telegraph.

Our detailed mapping, included in the report, utilised population data at the postcode sector level to visualise the availability of care home and nursing home beds per 1,000 over 65 population. This allowed us to present a headline estimate of the number of postcode sectors with no care home beds and nursing home beds.

As part of our research we focused on four key market indicators – the availability of workforce, care home beds, care home beds with nursing, and the domiciliary care market. For each of these indicators, we see evidence that the social care market is not operating in a way capable of providing care to everyone who needs it:

  • The social care workforce crisis is worsening, with vacancy rates rising. In some areas of the country, the lack of specialist workers in particular is now severely limiting the care that providers are able to offer. In Devon, for example, we found cases of care homes reducing their bed capacity because of a lack of available staff
  • The number of care home beds has reduced over the last five years, at a time of rising need. These reductions are not evenly distributed around the country, leaving provision in some areas even more precarious. In York, for example, nearly one in five care home beds has been lost in the last three years
  • The situation for care home beds with nursing is even more acute. Despite a slight rise in the total number of beds nationally over the last five years, some local areas, such as Hull, have lost more than a third of their nursing beds in the last three years
  • The domiciliary care market is in crisis with the number of hours of care provided falling by three million over the last three years[1]

In 2017, the Competition and Markets Authority (CMA) argued that the market-based approach to social care was unsustainable without additional public sector funding.[2] Based on our findings, we can go further: the current model has broken down in some areas of the country and is no longer capable of delivering care to people in need. Immediate action is needed to stabilise the system and set it on the course to delivering sustainable care in the long-term.

[1] LaingBuisson, Homecare and Supported Living Report, 2018

[2] CMA, Care home markets study; final report, November 2017