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

2011)

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

(2014)

91 ICM research conducted for

Anchor, 2011

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

2015)

Chapter 3 - What Is The Diagnosis? Or Why Are We Failing Our Elderly?

27