The demand for social care has reached unprecedented levels. The newly published Social Care 360 report by the King’s Fund paints a stark picture of the growing pressures on England’s social care system. The report highlights a surge in demand for care, financial strains on providers, and a workforce crisis exacerbated by rising costs and stagnant funding. Despite an increase in total expenditure on adult social care, fewer people are receiving support due to restrictive eligibility criteria and the failure to adjust financial thresholds for inflation.

In 2022/23, requests for support surpassed 2 million, encompassing both older people and working-age adults. This upward trend is expected to continue, reflecting a rapidly aging population, and increasing disability rates. However, despite this growing demand, fewer individuals are qualifying for support, largely due to the tightening of eligibility criteria and insufficient funding.

Recent findings from the Association of Mental Health Providers’ data mapping project reveal a concerning shift in the landscape of social care, particularly within the mental health sector. The rise in mental health needs, alongside general social care requirements, is putting immense pressure on already stretched services. This data highlights a persistent challenge: mental health support for both working-age adults and older people remains significantly underfunded relative to need. For instance, in 2022/23, £1.3 billion was allocated to mental health support for working-age adults, while only £0.8 billion was earmarked for older adults. These allocations are insufficient to keep pace with the rapid growth in demand for services and the increasing complexity of mental health needs.

In addition to mental health problems, disability rates have been rising across the board. By 2022/23, 23% of working-age adults reported a disability, up from just 16% a decade earlier (2012/13). This is reflected in the growing financial commitment to adult social care, which in 2023/24 reached £32 billion – which went to Local Authorities and the NHS – a 12.8% increase in cash terms from the previous year. However, much of this funding is being spent on residential care for older adults and community-based services for working-age adults. The two largest areas of expenditure were learning disability support for working-age adults (£7.1 billion) and physical care for older adults (£7.7 billion).

Despite the substantial increase in funding, it is important to recognise the growing financial barriers that affect both people and providers. The means test threshold for publicly funded social care remains stagnant at £23,250, despite inflationary pressures. As a result, more individuals are disqualified from receiving publicly funded care. This threshold has been a point of contention for years, with critics arguing that it fails to reflect the real-world financial challenges faced by individuals seeking support.

On the provider side, challenges are mounting. The cost of care is rising due to factors like increased staff wages, with the National Living Wage set to rise to £12.21 in April 2025. Social care providers, already struggling with funding gaps, are facing mounting pressure as they balance rising costs with insufficient reimbursements from local authorities. This financial strain is compounded by the government’s decision to raise National Insurance contributions by 1.2 percentage points from April 2025, and the reduction of the earnings threshold for employer contributions from £9,100 to £5,000 in 2025/26, potentially costing adult social care providers more than £900 million, according to the Nuffield Trust.

The sector is also grappling with workforce shortages. Despite growing demand, recruitment and retention remain significant challenges. Low wages, high stress, and limited career progression are contributing to high turnover rates, further exacerbating the crisis. The National Institute for Health and Care Excellence (NICE) has highlighted the importance of investing in the social care workforce to meet current and future needs. Their guidelines stress the need for better workforce planning, fair wages, and professional development opportunities to build a sustainable workforce capable of addressing the demands of a growing and aging population.

This precarious situation could lead to the rationing of services, which would disproportionately affect the most vulnerable members of society. Without adequate financial support and a comprehensive plan to address the sector’s challenges, mental health charities delivering services may be forced to reduce the scope and quality of care and support, leaving many people without the essential services they rely on.

The government must take immediate and decisive action to address these pressing issues. This includes not only ensuring fair wages for the social care workforce but also providing sustainable funding to meet the growing demand. A critical component of this funding should include full reimbursement of and an exemption for all mental health charities, regardless of size, from the increase in National Living Wage and higher National Insurance contributions, respectively. If the government fails to act, the risks to the quality and availability of social care services will escalate, leaving the most vulnerable in society with inadequate support.

Finally, a more sustainable and equitable funding model for social care is urgently needed. This should include revisiting the means test threshold, considering more progressive funding mechanisms, and recognising the economic value of social care workers as essential to the nation’s well-being. Only through comprehensive reform can we ensure that social care services are adequately funded, accessible, and capable of meeting the complex needs of the population.