01: Executive summary
Context 40% of people receiving adult social care support in England are working age individuals aged 18–64 with a disabled condition (a learning disability, a physical disability or a mental health condition) who make up the working age adult population, or individuals aged 65+ with a lifelong disabled condition (a learning disability or long-term mental health condition). Yet historically, there has been less of a national focus on these younger individuals and those with a lifelong disabled condition who require adult social care support to maximise their independence, compared to older adults with declining physical health, frailty, or dementia. Meanwhile, national expenditure on social care support for working age and lifelong disabled adults has risen by over a third between 2020 and 2023 in England, with forecasts for the 2024 financial year even higher, despite the total volume of individuals in this population supported not having risen over this period. Most importantly, outcomes for these adults do not appear to be improving in line with this increased expenditure, in terms of health, education, employment, and social interactions and relationships. In addition to improved outcomes, if working age and lifelong disabled adults are enabled to have better and more equitable access to the right education, employment and housing opportunities, they would also be supported to develop the skills to more actively participate and contribute to their local community through work, volunteering, and education, as they make clear is important to them and just as for their non-disabled peers. It is therefore these two cohorts of individuals (working age and lifelong disabled adults) which this programme of work explores in further detail. Programme overview The research programme was commissioned by the County Councils Network (CCN) and delivered in partnership with representative groups from across the health and social care sector, including an advisory group. It has been supported by Newton, who gathered the
evidence and insight presented. This involved bringing together analysis from several sources, including national data sets, bespoke data requests provided by a sample group of 16 participating local authorities, and change programmes undertaken by Newton. This was overlaid with the rich insight from many conversations, and the report aims to reflect the breadth and depth of the views, opinions, and examples of good practice shared. Colleagues from across CCN’s network of 20 county councils and 17 unitary authorities were invited to contribute. The purpose of the programme of work has been to: • Raise the profile of the key issues faced by individuals aged 18–64 with a disabled condition (known as working age adults) and individuals aged 65+ with lifelong disabilities. • Understand the impact on outcomes being achieved, and if these outcomes are being achieved in the most effective way. • Understand the likely changes to demand coming into the system. • Analyse in detail the different cohorts of these adults receiving adult social care and identify recent trends in package type, age, deprivation, gender, ethnicity, region, or changes in package costs. • Recommend cohorts which might require initial focus of local intervention and national policy. • Provide a series of recommendations and priorities for local action and national reform. In short, this report – the first output from this programme of work – aims to put these individuals at the centre of the national conversation on social care and help start a conversation about the key topics and issues that can make a meaningful difference to people’s lives . This is particularly timely given the new Government and the potential Royal Commission on social care, and as a result this report seeks to inform both.
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