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Adelina Comas-Herrera, Derek King, Linda Pickard and Juliette Malley

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Presentation on theme: "Adelina Comas-Herrera, Derek King, Linda Pickard and Juliette Malley"— Presentation transcript:

1 Adelina Comas-Herrera, Derek King, Linda Pickard and Juliette Malley
PROJECTIONS OF FUTURE EXPENDITURE ON LONG-TERM CARE FOR OLDER PEOPLE IN ENGLAND Raphael Wittenberg, Adelina Comas-Herrera, Derek King, Linda Pickard and Juliette Malley

2 AIMS OF THE STUDY PSSRU study, funded by the Department of Health, on two related issues: Whether expenditure on long-term care will remain sustainable in the face of demographic and other pressures; What should be the balance between public and private expenditure on long-term care. 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

3 MIXED ECONOMY OF SUPPLY
INFORMAL UNPAID CARERS PUBLIC SECTOR PRIVATE FOR-PROFIT SECTOR VOLUNTARY SECTOR 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

4 MIXED ECONOMY OF FINANCE
HEALTH SERVICES – NATIONAL HEALTH SERVICE - TAXATION SOCIAL SERVICES – CENTRAL AND LOCAL TAXATION AND USER CHARGES DISABILITY BENEFITS - SOCIAL SECURITY SYSTEM - TAXATION 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

5 ROYAL COMMISSION COMMISSION RECOMMENDED FREE NURSING AND PERSONAL CARE
ENGLAND IMPLEMENTED FREE NURSING CARE ONLY SCOTLAND IMPLEMENTED FREE NURSING AND PERSONAL CARE WALES IMPLEMENTING FREE NURSING CARE AND HOME CARE 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

6 AIMS OF THE MODEL The PSSRU model aims to make projections of:
Numbers of disabled older people Volumes of long-term care services Long-term care expenditure: public and private Social care workforce 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

7 MODEL STRUCTURE: FIVE MODULES
Numbers of older people by age, gender, functional disability, household type/informal care and housing tenure Residential and non-residential services Health and social services long-term care expenditure Expenditure by source of finance Social care workforce 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

8 NUMBERS OF DEPENDENT OLDER PEOPLE
Age (five bands) and gender Disability (six groups- IADLs and ADLs) Household type (five categories) Housing tenure (two categories) Informal care (by spouse, children, others) 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

9 Disabled Older People by Disability, England, 2002
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

10 Disabled Older People by Source of Informal Care, 2002
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

11 SERVICES AND BENEFITS Residential care – in residential homes, nursing homes and hospitals Home care, day care, meals Day hospital, community nursing, chiropody Assessment and care management Disability benefits 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

12 SOURCES OF FUNDING Service recipients divided between NHS, social care and privately funded clients Gross costs of social services divided between user charge and net public cost 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

13 KEY BASE ASSUMPTIONS Older population changes in line with latest official population projections Prevalence rates of disability remain unchanged Supply of informal care: by spouses reflects marital status projections, by children unchanged Patterns of care remain unchanged: no allowance for rising expectations Real unit costs and GDP rise in line with official projections: supply increases to match projected demand on this basis 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

14 PROJECTED LONG-TERM CARE EXPENDITURE AS PERCENTAGE OF GDP, 2002 TO 2041
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

15 PROPORTION OF PROJECTED EXPENDITURE THAT IS PRIVATE
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

16 PROJECTED EXPENDITURE (£M) BY SOURCE OF FUNDING, 2002-2041
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

17 PROJECTED NUMBERS OF SOCIAL CARE STAFF, 2002 TO 2041
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

18 SCOPE OF SCENARIOS Mortality rates – official variant projections
Disability rates – falling rates Informal care – less care by children Rises in real unit costs Patterns of care – shift to home care, carer-blind services Funding arrangements – free personal care 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

19 PROJECTED EXPENDITURE, 2041, UNDER ALTERNATIVE ASSUMPTIONS ABOUT LIFE EXPECTANCY
02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

20 PROJECTED EXPENDITURE, 2041, UNDER ALTERNATIVE ASSUMPTIONS ABOUT FUNCTIONAL DISABILITY
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21 CONCLUSION Expenditure on long-term care will need to increase significantly over the next 40 years to keep pace with demographic pressures and real rises in the unit costs of care Expenditure projections are sensitive to assumptions about future mortality and disability rates and real rises in the unit costs of care 02/01/2019 G:\SRC\OUTPUTS\BSG2000.PPT

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