Social care lottery

Postcode lottery in social care: new research shows huge gaps across England

Part of our ongoing coverage of the Casey Commission — see the full timeline.

New analysis from the Care and Support Alliance (CSA) shows just how different your experience of social care can be, depending purely on where you live. The findings come from an update to the CSA’s Show Us You Care local data tool, which tracks the pressures on adult social care in communities across England. The alliance has written to council leaders across the country, sharing local figures and asking them to back the case for national reform.

The headline figures are stark. In the worst-affected part of England, more than 9 in 10 requests for care do not lead to formal support within three months. In the best-performing area, that figure is just 3 in 10.
 

Where is the social care lottery worst?

Regionally, the East Midlands and South East fare worst, with three quarters (75%) of care requests failing to lead to formal support within three months. The West Midlands does somewhat better at 62% — though that still means nearly two in three requests go without formal support in that timeframe.

The gaps within regions are even wider than the gaps between them. In London, outcomes range from 30% of requests not leading to support in one borough to 91% in another — a 61 percentage point difference. Even the North East, which has the smallest spread of any region, still sees rates ranging from 46% to 76% between councils.

The CSA acknowledges there are real reasons behind some of this variation — differing levels of demand and deprivation, workforce pressures, local care market conditions, and councils’ varying ability to raise their own income, against a backdrop of national funding that hasn’t kept pace with population and need. But it argues that differences of this scale raise serious fairness concerns, summed up in its message:

“It should depend on your needs – not your postcode”
 

Caroline Abrahams CBE, Emily Holzhausen CBE and Jackie O’Sullivan, Co-Chairs of the Care and Support Alliance, said:

“Council leaders know better than most the enormous pressures facing social care. Every day, councils are trying to balance rising demand, increasingly complex needs and growing costs against budgets that simply have not kept pace.

“The result is a system in which people’s experiences of seeking care and support can look dramatically different depending on where they live.

“Whether someone receives the care and support they need should depend on their needs – not their postcode.

“But this is not a problem councils can solve on their own. Local leaders cannot be expected to overcome years of underinvestment or fix a fundamentally unsustainable system one council at a time.

“The only way to tackle this unfairness is through national action, backed by sustainable funding that enables every council to provide the care and support its community needs.”

CSA challenging council leaders to work with them

Alongside the letter to council leaders (external link will open in a new browser tab or window), each has been sent local data on care requests, workforce vacancies, unpaid care and delayed hospital discharges in their own area. The CSA is asking leaders to champion long-term reform, use their local and political influence to build support for change, encourage residents and organisations to take part in the Big Conversation on Care, and work with the alliance directly. It has also offered to meet council leaders individually to discuss the pressures in their area.

The timing matters: the Government has brought forward the Casey Commission on Adult Social Care, with its final report now due in summer 2027, and has committed to cross-party work on a long-term settlement. The Big Conversation on Care gives the public a direct route to help shape what a reformed, sustainably funded system should look like. As the CSA puts it, social care is delivered locally, but fixing it will take national action — and that means everyone with a stake in the system, from council leaders to unpaid carers, has a part to play.

You can check what social care looks like in your own area using the CSA’s postcode checker (external link will open in a new browser tab or window).
 

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Further reading and resources

The Casey Commission: full coverage of adult social care reform — our full timeline hub

A Moment of Reckoning — Baroness Casey’s flagship speech, our best single overview of the Commission

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