Implications of setting eligibility criteria for adult social care service in England at moderate needs level

The introduction of Fair Access to Care Services (FACS) guidelines in 2003 provided local authorities with a common framework against which to assess needs and set local eligibly thresholds for the provision of supported care. Since their introduction, many authorities have tightened eligibility thresholds such that only those with critical or substantial levels of need are entitled to receive publicly-funded care across much of the country. Using national statistics and data from a PSSRU national survey of local authorities in England, this report describes estimates of the likely impact at present and up to 2020 on client numbers and expenditure of introducing a national eligibility threshold at the ‘moderate’ FACS level. According to a central set of assumptions, it is estimated that overall client numbers would increase at the 2010 baseline by 23% nationally (26% among older people, 28% among younger adults with physical disabilities, 11% among younger adults with learning disabilities and 17% among younger adults with mental health needs). Gross expenditure corresponding to these figures is estimated to increase by approximately 17% for older people, 19% for adults with physical disabilities, 9% for adults with learning disabilities and 13% for adults with mental health needs.