Almost 100,000 adults in England are missing out on state-funded social care due to over a decade of government spending cuts, according to a new analysis of figures from the Institute for Government (IfG).
The findings highlight the long-term consequences of underinvestment in the sector, with councils increasingly unable to meet demand for essential care services.
Despite a growing elderly population and rising rates of disability, access to publicly funded long-term care has declined significantly. The proportion of adults in England receiving such care has fallen from 2.3% in 2003–04 to just 1.4% in 2023–24. Among older adults aged 65 and over, the figure has dropped from 8.2% to 3.6% over the same period, equating to over 250,000 fewer recipients.
This decline is not due to reduced need but to policy choices and financial constraints. Local authorities, facing years of budget reductions, have had to restrict access to care services. According to the Institute for Fiscal Studies, core local government budgets are now 18% lower per person in real terms than in 2010, with the cuts heavily impacting adult social care.
The financial threshold for qualifying for state support has remained unchanged since 2010, meaning fewer people meet the criteria despite rising living costs. The policy has been maintained across successive governments, including the current Labour government, which recently confirmed the same rules for 2025–26.
As a result, more families have been forced to shoulder the burden of care. Many unpaid carers have had to reduce their working hours or leave the workforce entirely, often resulting in economic hardship. This shift has disproportionately affected women and lower-income households.
At the same time, the social care workforce is experiencing chronic shortages. Funding pressures have led providers to depend on international recruitment to fill vacancies. However, many foreign workers have reported experiencing mistreatment and exploitation, adding further strain to the system.
The IfG and Nuffield Foundation have raised concerns about major inequalities in care provision across England. Access often depends more on location than on level of need. The government has acknowledged flaws in the current funding model and has launched a consultation to overhaul how central funding is allocated. The proposed changes aim to shift resources from wealthier areas in the South East to more deprived and rural regions.
In addition, social care providers face a looming financial challenge from rising labour costs. The Nuffield Trust estimates that upcoming increases to the minimum wage and employer National Insurance contributions will cost independent care providers nearly £3 billion in 2025–26. The government is under pressure to address this funding gap to avoid further service cuts and workforce losses.
The IfG report emphasises that limiting access to care is not without cost. The reliance on unpaid carers reduces overall workforce participation, lowers productivity, and ultimately creates hidden expenses for the state. Increasing access to care would not only improve lives but also support economic resilience by enabling more people to remain in paid employment.
As demand continues to grow, experts are calling for a more sustainable, needs-based funding model that ensures fair access to care and recognises the essential role of the social care system in supporting public health and economic stability.
