Councils in England are three times more likely to deny individuals social care support in some areas compared to others, creating a significant disparity known as a "postcode lottery," according to an analysis by a coalition of charities. The Care and Support Alliance (CSA) stated that its findings expose the "unfairness" of the current system and highlight the urgent need for long-term reform.
The analysis of official data regarding requests for adult social care support, which can include services like home help or placement in a care home, showed a substantial difference in outcomes based on an individual's location. During the 2024/25 period, the East Midlands and South East regions reported the highest rates of applications resulting in no support being provided, at 75 percent. In contrast, the West Midlands had the lowest regional rate, with just under two-thirds (62 percent) of requests leading to no support, according to figures from the Department of Health and Social Care.
However, the CSA noted that these disparities are not confined to regional levels, with significant variations also occurring within regions. For example, London's results showed that the proportion of requests not leading to formal care and support ranged from 30 percent in the borough of Bexley to 91 percent in Lambeth. This means that individuals with similar care needs living just a few miles apart can experience vastly different outcomes when seeking assistance.
While the gap in support between different council areas was smallest in the North East, it still fluctuated between 46 percent and 76 percent depending on the specific location within that region, the CSA reported. Portsmouth recorded the highest proportion of requests not leading to care nationally at 93 percent, while Bexley had the lowest at 30 percent.
In some instances, a request for care may be withdrawn by the applicant or result in no provision of support if the individual has passed away. Councils may also offer assistance with social care support but refuse to fund it, contingent on the applicant's asset value.
While the CSA acknowledges that some variation in the fulfillment of support requests is expected between councils, reflecting differences in local communities and demand patterns, the "scale of the differences revealed by the data raises serious questions about fairness." The coalition has urged council leaders to recognize that these challenges are widespread across England and that "too many people are left without the care and support they need, while others face very different charges depending on where they live."
Caroline Abrahams, Emily Holzhausen, and Jackie O'Sullivan, co-chairs of the CSA, stated that councils are continually attempting to manage rising demand, increasingly complex needs, and growing costs with budgets that have not kept pace. They emphasized that this is a problem councils cannot resolve independently, citing decades of underinvestment and an unsustainable system that cannot be fixed one council at a time. The CSA is advocating for national action, supported by sustainable funding, to ensure all councils can provide the necessary care and support their communities require.
They welcomed Prime Minister Andy Burnham's support for a cross-party approach to fixing social care and the launch of a public survey aimed at building consensus on public expectations for a modern care system. The CSA believes that "the opportunity for lasting reform is here. We must not let it pass."
Mr. Burnham has previously suggested that "difficult, difficult decisions" regarding taxation might be necessary to address the social care crisis, estimating that fixing the system could save the National Health Service billions of pounds annually. He described the failure of successive governments to address the crisis as a "major dereliction of public duty."
Baroness Louise Casey's review of social care is anticipated to release its phase one report in the autumn, with a final report and recommendations for reform expected next year.
A spokesperson for the Local Government Association commented that individuals seeking care and support should have access to high-quality services that promote independence. They noted that councils are working diligently to provide this support despite significant and increasing financial pressures, and that the current adult social care funding model is outdated and requires reform.
A Department of Health and Social Care spokesperson acknowledged that the current system is failing many older and disabled individuals, with consequences for families and communities. The department affirmed the government's commitment to "fix the adult social care system."