that doesn't explain the current paucity of age-appropriate housing. Why is the
housing market not delivering what people want and need?
Some have pointed to planning related reasons. A National Housing Federation
report in 2011 found that only 45 per cent of surveyed local authorities had a
housing strategy for older people87, and another study found two-thirds of planning
applications for new retirement housing were initially refused first time round88 (by
comparison, nearly 90 per cent of applications are accepted 89). What is clear is
that central and local government are not prioritising the promotion of an adequate
market for social housing for older people.
3.6 Issues with the provision of care
One key underlying tension in the current system is that while health is free
at point of entry; social care is means tested.90 And state support for care is
falling-real-term net spending on social care for older adults in England fell
by 15 per cent between 2009/10 and 2012/13 (from £7.8 billion to £6.6
billion). The King's Fund reported that 26 per cent fewer people aged over 65
now receiving publicly funded social care in 2012/13 than were five years
earlier, with further cuts still to hit. With more than half of social care being paid
for privately, and as care costs continue to rise, ever greater pressure is placed
on individuals to support themselves in old age.
So are they saving? Research by Anchor found that 48 per cent of adults have
not given any thought at all to how they will pay for their own care. The survey
also found that only 6 per cent of Britons have begun to set money aside for
their future care needs.91 The answer is a pretty clear no. Ultimately, there is
a lack of debate/understanding about the need to save and pay for care.
There is therefore a pressing need to inform the public and especially younger
people about the cost of care and the need to save for their future care needs. If
future generations are unable to access good quality care then this will greatly
increase the pressure on primary health and social care providers.
3.7 Options for post-hospital care
Between 2013 and 2014 NHS England estimated that around 32 per cent of
delayed transfers of care days were attributable to patients awaiting residential
home placements (11 per cent), nursing home placements (11 per cent) or a
care package in their own home (10 per cent).92 These figures show that a
significant number of delays are attributed to the inability to find care.
The reasons for these delays in post-hospital care are not straightforward. Care
England - the representative body for independent care providers - rejected
the claim that there isn't enough capacity in the market.93 Our interviewees
told us that often there was a lack trust and understanding of the post hospital
care options available. And in some instances local authorities are not moving
quickly enough to sort out care packages.
It is therefore a confused picture with doubtless all of these factors playing a
part. However, there are a number of improvements that could be made to
bring greater clarity about the provision of post hospital care. For example,
better communication and understanding of all the post-hospital care options
across all sectors would improve patient outcomes and increase the efficiency of
the system. Additionally, and to echo a point made above, there is a need for
financial incentives to be improved to ensure that the needs of the patient come
before the pressures facing services providers-financial or otherwise.
87 National Housing Federation,
Breaking the mould (February
88 Professor Ball, M, Housing
markets and independence in
old age (May 2011)
89 Department for Communities
and Local Government, Planning
applications April to June 2014
England (2 October 2014)
90 King's Fund, A new settlement
for health and social care
91 ICM research conducted for
92 NHS England, Delayed transfers
of care statistics for England
2013/14 (May 2014)
93 Care England, "A&E crisis not
due to shortage of residential
care home beds" (7 January
Chapter 3 - What Is The Diagnosis? Or Why Are We Failing Our Elderly?