1. WORKING AGE ADULTS WITH CARE NEEDS
March 2018

2. The November announcement on the Green Paper set out that there would be work undertaken on issues specific to working age adults with care needs
“Whilst the Green Paper will focus on care for older people, the Government recognises both the challenges faced by people of working age with care needs and the many common questions about the sustainability of the care system. Many of the discussions on the Green Paper reforms will impact on care and support for adults of all ages. However, to ensure that issues for working-age adults with care needs are considered in their own right, the Government will take forward a parallel programme of work, led jointly by the Department of Health and the Department for Communities and Local Government, which will focus on this group.” (WMS (FSS) 16 November 2017)

3. There are significant differences between older people and working age adults with care needs.
Working age adults (aged 18-64)
Older adults (aged 65 and over)
c.250k long term care recipients
(less than a third of the care population)
c.713k long term care recipients, 400k publicly funded
(56%).
Around £7.5bn of total expenditure on care (L.A. Expenditure estimated at around 6.5 bn)
Around £8.5bn of total expenditure on care (L.A. Expenditure estimated at around 5 bn)
Negligible (if any) occurrences of self-paying
Significant proportion of market is self-paying
Weekly Unit Cost:   £ 1,200+ (residential),                                      £ 900+ (nursing),
                                     £ 500 (community-estimated).
Weekly Unit Cost:      £ 560+ (residential),                                      £ 600+ (nursing),
                                     £ 186 (community-estimated).
Limited revenue raised from user charges
(around 7% in 2016/17)
Significant share of revenue raised from user charges
(around 26% in 2016/17)
Limited assets and wealth
Range of assets and wealth
Predominantly support for Learning Disability
(more than two thirds of WAA spending)
Predominantly for physical support (e.g. frailty)
Low rate of employment
Negligible (if any) employment
Numbers subject to revision

4. We will be engaging widely in this early stage to establish what stakeholders see as the key issues and priorities for action.
For example, are the key issues that:
demographic pressures are leading to growing cost pressures?
there is a lack of evidence of what the best services look like for working age adults?
there are concerns about provision of services?
commissioning could be improved?
there are disincentives for working age adults to taking up training or moving in to employment resulting from the way the system is set up?
quality is not always universally high?
there are challenges recruiting and retaining staff for some services?
technology is not being used to its full potential
transitions between services are not managed as well as they could be?
lack of join up between services and missed opportunities for independence?
housing doesn’t meet needs?
rights aren’t as clearly articulated or realised as they should be?
All of the above? / None of the above? / Something else?

5. Table Discussion - Question 6
We are currently considering the scope of the work and would welcome your views on:
What do you see as the specific challenges facing working age adults with care needs?
Do you think these issues differ for different groups?
What would help to address these challenges?

6. Table Discussion - Question 7
Has there been anything missing from today’s discussions
Table Discussion – Question 8
What do you think the overall priorities are?