News

Government sets £75 000 cap on social care in England

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f983 (Published 12 February 2013) Cite this as: BMJ 2013;346:f983
  1. Ingrid Torjesen
  1. 1London

The government has agreed to cap the lifetime costs that anyone would have to pay for social care in England at £75 000 (€87 000; $117 000), more than double the £35 000 recommended by Andrew Dilnot’s review of social care.1

Anyone with assets worth less than £123 000 would immediately be eligible for free residential care when the changes were introduced in 2017, the health secretary for England, Jeremy Hunt, announced to parliament on 11 February. The threshold is currently £23 250.

Under the new system, local authorities would assess eligibility for residential care or home services. To ensure a fair system, where people qualified for the same level of services regardless of where they lived, the Department of Health would introduce national eligibility standards in 2015.

If someone were deemed eligible for free residential care they would be entitled to the care element free if their assets (including their home) were less than £123 000. Anyone with assets worth more would have to fund their care themselves up to a maximum of £75 000. Everyone would be expected to pay the “hotel” costs of their board and lodging, which are expected to be around £10 000 a year.

After the £75 000 threshold had been met, the local authority would take on the cost of the care component of residential care up to a level set by the authority. Top-up fees may need to be paid by residents or their families if they were to stay on in a more expensive care home.

Any social care services that someone had paid for in their home would count towards the £75 000 threshold. Local authorities would set the cost of services that would contribute to the cap in their area and keep a running total of what someone had paid themselves. Anyone who turned 18 with eligible care needs would qualify for free care automatically, and there would be a lower cap for people of working age who developed care needs before retirement age.

The fact that the government has finally responded to the Dilnot review has been widely welcomed, but some groups have reported disappointment at the level at which the cap has been set.

Jo Webber, interim director of policy at the NHS Confederation, which represents most NHS organisations, said, “We previously warned that raiding NHS budgets to fund social care would have been akin to rearranging deckchairs while the whole health and care system slowly sank, so we are pleased to see that this warning has been heeded.”

However, Dot Gibson, general secretary of the National Pensioners Convention, said that the cap was “hugely high” and described the plans as “about as credible as a Findus lasagne.” She added, “Setting a lifetime cap on care costs of £75 000 will help just 10% of those needing care.”

Richard Humphries, senior fellow at the health think tank the King’s Fund, said that the £75 000 cap should be seen as a “starting point” and that future governments should reduce it as the national economic position improved.

Dilnot told BBC Radio 4’s Today news programme that the £75 000 cap was equivalent to £61 000 in 2010-11 prices. “It is higher than we would have wanted–£11 000 higher than the top end of our range [£50 000]—and I regret that, but I recognise the public finances are in a pretty tricky state,” he said.

The government commissioned Dilnot to review future funding models for social care. His review, which reported in July 2011, recommended that the threshold in assets that an individual should have before they could access state support for social care should be raised from £23 250 to £100 000 and that the lifetime contribution anybody should have to make towards their care should be capped.1 It recommended a cap of between £25 000 and £50 000, with £35 000 being an “appropriate and fair figure.”

The government has been criticised for its slowness in acting on the report,2 as many elderly people have continued to have to sell their homes to fund residential care.

Notes

Cite this as: BMJ 2013;346:f983

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