Levelling out uneven social care provision

Local growth plans are written. Mayoral authorities and councils have mapped high-value clusters and set priorities, and much of the focus is moving to delivery. But delivering growth in every postcode also means making sure everyone can access the opportunities those plans are intended to create.New research from the International Longevity Centre (ILC), a think-tank looking at the local and global economic implications of ageing, shows how uneven social care provision stands in the way. Far from a postcode lottery, there is a postcode penalty for social care.Across upper-tier councils, we find a stark 25% shortfall in good-quality care provision, relative to need, in the areas already worse off in terms of health, income and employment. At the extreme end, Tameside has 18.5 care homes and community services rated Good or Outstanding for every 10,000 older people in poor health. Wokingham has 58.1.Health need drives most of the gap. Older people in the worst-off areas spend 54% of later life in poor health, against 45% in the best-off. Social care provision hasn't kept up.Families are filling the gap. In the worst-off areas, 5.9% of residents provide 20 or more hours of unpaid care a week, against 3.7% in the best-off. And where family caring is most prevalent, economic inactivity among 50-64 years olds is higher (averaging 30%). The link between unpaid caring and inactivity holds even between places with similar incomes.For any area trying to deliver on its growth plan, that's a pool of experienced workers sitting outside the labour market.As many councils know, the social care bill lands hardest on those least able to afford it. The social care precept is such a clear example of bad, regressive policymaking. Our analysis shows how it costs a Band D home 12% more in the poorest areas, yet raises 40% less for every older person in poor health than in the best off areas.Councils can't afford to wait for a National Care Service in the next Parliament to address this social care penalty which is holding back growth. Right now, there is a large gap between the hope and rhetoric for places to ‘take back control' and the reality of rationing care on a limited tax base compounding local disadvantage.So what would help growth plans deliver good growth in the medium term while we wait for a national settlement?Deeper equalisation, now. Central government should cover a bigger share of care costs in the worst-off places, so councils with the weakest tax bases aren't squeezing residents who already pay more.Funding that follows need. Central government should more tightly allocate social care funding to local areas according to the health needs of the older population.But areas don't need to wait. Councils, mayoral authorities and integrated care boards can help bring together the related levers for health, care and growth at local and neighbourhood level.Treat unpaid carers as part of the growth workforce. Local Get Britain Working plans are meant to align with growth plans, and they should explicitly include measures for supporting carers aged 50-64 in the labour market. Where caring is most prevalent, nearly a third of this age group are economically inactive.Build care into neighbourhood health. There's a risk neighbourhood health is treated as an NHS project. Councils and Integrated Care Boards should treat care homes, homecare providers and unpaid carers as local health assets and bring them into neighbourhood health from the start.Good growth in every postcode depends on more than high-value clusters. It depends on opportunity and good work reaching more communities, and better care is a key part of that. Fixing the postcode penalty is a necessary condition for growth that reaches all places.Ben Franklin is deputy chief executive and Rosie Fogden is director of health and economic growth for the ILC, a global think-tank focused on the economics of ageing locally and nationally

Title

LOCAL ECONOMIES

Levelling out uneven social care provision

By Ben Franklin, Rosie Fogden | 29 October 2026

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