1. © Nuffield Trust December 2012 Projected expenditure on: care for older people to 2022 Raphael Wittenberg, Bo Hu, Adelina Comas-Herrera and Jose-Luis Fernandez Personal Social Services Research Unit, London School of Economics and Political Science

2. © Nuffield Trust Overview Analysis by the Personal Social Services Research Unit at the London School of Economics and Political Science, commissioned by the Nuffield Trust. Study of projected public expenditure on social care and continuing health care for people aged 65 and over in England. Part of the Nuffield Trust’s Buying Time: What is the scale of the financial challenge facing the NHS and how can it be met? programme. Findings are drawn upon in A Decade of Austerity: The funding pressures facing the NHS from 2010/11 to 2021/22, which discusses the implications of these projections for policy development.A Decade of Austerity: The funding pressures facing the NHS from 2010/11 to 2021/22

3. © Nuffield Trust Key findings The number of older people with disabilities is projected to increase by 31% between 2010 and 2022, under the base case assumptions that current patterns of care and the Office for National Statistics (ONS) principal population projections keep pace with expected demographic and unit cost pressures. Public expenditure on social care and continuing health care for older people is projected to increase by 37% between 2010 and 2022, under these base case assumptions.

4. © Nuffield Trust Key findings (continued) Total expenditure will vary with life expectancy: If life expectancy rises at the lower rate estimated by the ONS, the number of people with disabilities is projected to rise by 30%, and public expenditure by 35% in real terms between 2010 and 2022. If life expectancy rises at the higher rate, the number of people with disabilities would rise by 35%, with expenditure rising by 40%. If rates of chronic disease continue to rise in line with recent trends: the number of older people with disabilities is projected to increase by 54% between 2010 and 2022 public expenditure on social care and continuing health care for older people is projected to increase by 56% between 2010 and 2022.

5. © Nuffield Trust Key findings (continued) The net public expenditure on social care and continuing health care for older people is projected to rise from £9.3 billion in real terms (0.74% of GDP) in 2010 to £12.7 billion (0.78% of GDP) in 2022, assuming that current patterns of care and the ONS principal population projections keep pace with expected demographic and unit cost pressures.

6. © Nuffield Trust Personal social services (PSS) net expenditure and continuing health care (CHC) expenditure on over-65s in England under base case assumption, 2010–2022 Source: Personal Social Services Research Unit, London School of Economics and Political Science ©

7. © Nuffield Trust Personal social services net and continuing health care expenditure on social care for over-65s in England under different life expectancy variants, 2010–2022 Source: Personal Social Services Research Unit, London School of Economics and Political Science ©

8. © Nuffield Trust Personal social services net and continuing health care expenditure on over-65s in England under base case and continued trends assumption, 2010–2022 Source: Personal Social Services Research Unit, London School of Economics and Political Science ©

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