A fork in the road: Next steps for social care funding reform
The costs of social care funding options, public attitudes to them - and the implications for policy reform
May 2018

Key points
- Maintaining the current system, which sees fewer people receiving publicly-funded care every year, will lead to a funding gap of £6bn by 2030/31.
- Returning access to pre-austerity (2009/10) levels would increase this gap to £15bn. More fundamental reforms, whilst still expensive, would cost less than that and would offer the chance of a fairer and less complex system, providing support to more people.
- Implementing a 'cap and floor’ model similar to the Conservative Party proposal at the 2017 general election would cost an extra £12bn, whilst introducing free personal care for all older people with needs above the current threshold would increase the funding gap to £14bn.
- Public perceptions findings from the National Centre for Social Research’s British Social Attitudes survey reveal extremely low understanding of how social care operates, with 34% believing the government pays. When asked who should fund social care, 41% felt it should be entirely tax-funded.
- With taxation the most likely option for boosting social care funding, the findings of separate deliberative work carried out by Ipsos MORI shows most people would prefer a dedicated tax to stop the money being diverted elsewhere. Options that include the possibility of people selling their homes to cover care costs, as exists now, were found to be deeply unpopular.
Joint report with The King’s Fund, A fork in the road looks into the costs of social care funding options, public attitudes to them, and the implications for policy reform.
The report pulls together new financial modelling, public perceptions work and policy analysis to identify the current problems with adult social care in England and the costs of alternative models
It highlights low public awareness of social care and a lack of agreement on priorities for reform as major barriers to progress, despite political consensus on the need for urgent action.
It concludes that reforming the current system will be expensive, but if reform is chosen, England is now at a clear ‘fork in the road’ with a choice between a better means-tested system and one that is more like the NHS; free at the point of use for those who need it.
Further reading
Analysis
Social care funding options
Health Foundation financial modelling looking at various funding options for social care, how much they would cost and where ...
Working paper
Approaches to social care funding
This paper considers five commonly raised approaches to funding social care for older people in England
You might also like...
Blog
Health funding – finally something we can agree on
How would the UK public prefer additional funds for health and social care to be raised? Jon Sussex explores the findings fro...
Working paper
Public acceptability of health and social care funding options
This paper explores the preferences of the general public with regard to the various ways of raising the additional funds nee...
Improvement project
Creating ACE-informed places: promoting a whole-system approach to tackling adverse childhood experiences in local communities
This project is aiming to improve how effectively public services in England prevent and mitigate the negative impact of adve...
Get social
Health Foundation @HealthFdn
Why are health inequalities and the social determinants often left out from the public debate about health? Our ne… https://t.co/XjtZAONMsV
Follow us on TwitterWork with us
We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.
View current vacanciesThe Q Community
Q is an initiative connecting people with improvement expertise across the UK.
Find out more