Reforms to long-term care funding in England can be as generous as a Scottish-style system of Free Personal Care

By Nuffield Foundation

A report comparing the effects of the reforms to the English long-term care financing system planned for 2020 with the long-term care systems operating in Wales and Scotland finds that the reforms will benefit people with moderate or high resources who need residential care or high intensity home care for extended periods.

But the Welsh system – which caps the weekly charge for home care at £60 – and the Scottish system – which provides free personal care for older people – will still be more generous than the English system for older people needing care in their own homes.

Long-term care funding: a comparison between England, Scotland and Wales, is published by the Care and State Pension Reform (CASPeR) team and funded by the Nuffield Foundation. It presents analysis of the different English, Scottish and Welsh systems for funding long-term care, both under the current system and projected to include the impact of the 2020 reforms in England.

How is long-term care currently funded? 

Access to publicly funded adult social care in England is currently subject to a means test which can require wealthier people to meet the full costs of their care. This will change in 2020 with the introduction of a lifetime cap on liability to meet care costs incurred to meet eligible assessed care needs.

Wales has a similar system to England but with a weekly maximum charge of £60 for home care. Scotland operates a system of ‘free personal care’ for older people receiving home care or residential care.

Length of time care is needed is a crucial factor

Comparisons between the systems depend on how long an individual needs care, especially residential or high intensity home care. The benefits of implementing any of these more generous systems in England would go to people who are not eligible for state support with their care costs – or eligible for state support with only part of those costs – under the current system.

Ruth Hancock, Professor in the Economics of Health and Welfare at University of East Anglia, part of the CASPeR research team said: “The cap on lifetime care costs which is being introduced in England from 2020 can be as generous as a Scottish-style system of Free Personal Care but only for those needing care – especially
residential care – for long periods.”

Raphael Wittenberg, Associate Professorial Research Fellow from the Personal Social Services Research Unit at the London School of Economics, also part of the CASPeR research team said: “The reforms to the English system to be implemented in 2020 will benefit people with moderate or high resources who need residential care or high intensity home care for extended periods; but the Welsh system, which caps the weekly charge for home care at £60, and the Scottish system, which provides free personal care for older people, will still generally be more generous than the English reforms for older people who need care in their own homes.”

About CASPeR

CASPeR is a collaborative project between the Pensions Policy Institute (PPI), the University of East Anglia (UEA) and the London School of Economics (LSE), funded over two years by the Nuffield Foundation, investigating the long-term impacts of both long term care and state pension reforms and their potential interactions. Visit the project page for more information.

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