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Preferences for paying for long term care for older people
Preferences for paying for long term care for older people

Previous studies have shown that large proportions of the general population never think about social care, including the possibility that they themselves might need support at some stage. Very few people have therefore thought about preparing financially or in other ways for their future social care needs.

Moreover, the level of understanding of the current adult social care system — how it is organised, funded, eligibility, etc. — is very limited. There appears to be widespread ignorance about how to find out about the social care system or how to access support. This widespread lack of knowledge may be a contributor to the difficulties that providers, commissioners, lobbyists and others in the social care sector often encounter when trying to engage top-level decision-makers in discussion about the state of the social care sector and how well it is resourced.

Existing evidence on the public’s views towards different funding mechanisms is relatively limited. Quantitative research varies, covering a range of funding options and mechanisms, with wide variation in how these are framed in survey questions. From the research that exists, there appears no single model for funding social care that attracts most support. Universal, government provision has strong support. However, qualitative research shows that people do not always accept that there is a need for significant new funding and many believe universal provision can be funded by, for example, transferring funds from other government budgets.

The overall aim of this study is too look at public attitudes to different options for funding social care in England, in the context of an ageing population.

The study originally consisted of three components:

1) A rapid scoping review was carried out to inform a series of focus groups and a national survey examining the public’s attitudes to the funding of social care. The scoping review also highlighted other studies in England currently underway or being planned to avoid duplication of work.

2) Eight focus groups in different parts of England were carried out in the summer of 2018, and aimed to provide an in-depth understanding of people’s perceptions of behaviours in relation to planning for future social care needs and their values and priorities in relation to social care funding. Specifically, we focused on:

  • perspectives on the likelihood of needing social care
  • how people think they will get their care needs met
  • perspectives on the potential costs of care
  • barriers and facilitators to planning for social care needs
  • perspectives on different ways of paying for social care.

3) A nationally representative online survey was carried out in December 2018, supplemented with a separate boost of older people aged 65 and over carried out using a face to face interview. The survey presented a number of scenarios to respondents and asked them to choose between different funding options (i.e. whether the state or individual should pay, or whether the costs should be shared). The data collection was carried out by Kantar, Public Division.

A fourth component is planned for the first half of 2020:

4) Six focus groups, stratified by age and geography, will explore how people understand shared public-private funding for social care and the factors that influence their perceptions of what constitutes an appropriate split between the individual and the state. The qualitative research will focus on the values, aspirations, expectations, etc that people employ in constructing their views.

Initial findings from the project were presented at a webinar held on 15 May 2020. A video recording of the webinar is available below. A short summary of study findings prepared for the webinar may be accessed here>>

A paper describing the methodology of the surveys was published in spring 2020: Erens B, Read S, Knapp M, Wistow G, Wittenberg R, Mays N. (2020) 'Using vignettes to examine preferences for paying for long-term social care in online and interview surveys' Social Research Practice (9). The article may be accessed here>>

The online version of the questionnaire may be accessed here>>

Papers presenting results from the national surveys are in preparation.

A paper presenting results from the focus groups has been published in Health and Social Care in the Community and can be accessed here>>