Disability and care needs in the older population: disability benefits, social care and well-being

The project aims to deliver new evidence to sharpen policy judgements on promising directions of reform of publicly-funded support for older people with care needs. In the UK, such support consists of two main elements. Care services are available through Local Authorities and cash disability benefits are provided by the national social security system. Individuals may be entitled to one, both or neither source of help. Each element of the system operates its own assessments of an older person's care needs, and they differ in how account is taken of whether the person has a partner. People who receive care via a Local Authority pay means-tested charges for their care, except in Scotland where there is a non means-tested public subsidy towards the cost of care. Other than an element paid via the means-tested Pension Credit, entitlement to disability benefits is not affected by an older person's income or financial assets. Care provided via Local Authorities is in the form of services or a 'personal budget' which has to be spent in ways which address the recipient's care needs. Recipients of disability benefits are free to spend them as they wish. These differences mean that, irrespective of their financial value, the support from the two separate parts of the system may alleviate the adverse effects of disability on wellbeing in different ways and to different extents. Some have suggested that public funds channelled through disability benefits should be redirected to the care system. Debate on the funding of care and support for older people continues. We will contribute to this debate by providing objective and independent evidence on the likely impacts on the wellbeing of different groups of older people, of a change in the balance of funding of the two parts of the system.

We will provide evidence on:
- the extent to which the well-being of an older person is affected by the disability of his/her partner or other members of the household, and the likely consequences for their wellbeing of taking account of a partner's disability in determining entitlement to publicly-funded care services and disability benefits;
- whether equivalent-value care services and disability benefits mitigate the impact of disability on wellbeing to the same or differing extents;
- the responsiveness of the current systems of care and disability benefits to changes in older people's needs for care and whether any delays in the system affect their wellbeing;
- the likely effect on the wellbeing of different groups of disabled older people (older/younger, poor/rich, single people/couples etc.) of potential changes in the balance of public funding for care services and disability benefits, for example increasing the levels of one and decreasing those of the other, or extending the eligibility criteria for one and decreasing it for the other.

The study will involve advanced statistical analysis of four large-scale household surveys: Understanding Society, incorporating its predecessor the British Household Panel Survey; the English Longitudinal Study of Ageing; the Health and Social Care Survey of England; and the Family Resources Survey. Two of these have started to collect important new information on receipt of care services and payments for them, which we will use. Our analysis will be necessarily restricted to the household population and, because of data limitations, some of it will be restricted to England. However, policy differences between England and Scotland will be exploited in the analysis.

Evidence from the study will be useful to national and local policy makers, those representing older people and commercial enterprises providing care or insurance services. We do not aim to advocate specific policy reforms, but rather deliver evidence that will be taken into account in national policy and local implementation. That has the potential to benefit older people and tax payers, if it results in better use of public funds

The ultimate potential beneficiaries from this research are older people with care needs in the UK and UK tax payers in general, if the research is used to identify policy reforms which provide better value for tax payers' money. The more immediate impact will be felt through better-informed policy making. We aim to deliver evidence that can be taken into account in national policy development and its local implementation. The principal users of this evidence will be national policy makers (Government Ministers and their officials, MPs in both Houses of Parliament), the devolved administrations of the constituent countries of the UK, local government, voluntary organisations (e.g. those representing older people) and commercial enterprises (e.g. insurance companies and care providers) who seek to influence debate in this area. Our findings will be relevant to the work of the Department of Health, the Department of Work and Pensions and HM Treasury. While the main geographical focus of our study is the UK, our research questions are relevant to policy makers in all countries undergoing population ageing.

Beneficial to these users will be evidence on:

- the extent to which the well-being of an older person is affected by the disability of his/her partner or other members of the household and the likely consequences for their wellbeing of taking account of a partner's disability in determining entitlement to publicly-funded care services and disability benefits;
- whether equivalent-value care services and disability benefits mitigate the impact of disability on wellbeing to the same or differing extents;
- the responsiveness of the current systems of care and disability benefits to changes in older people's needs for care and whether any delays in the system affect their wellbeing;
- the likely effect on the wellbeing of different groups of disabled older people (older/younger, poor/rich, single people/couples etc.) of potential changes in the balance of public funding for care services and disability benefits, for example increasing the levels of one and decreasing those of the other, or extending the eligibility criteria for one and decreasing it for the other.

Such evidence, if acted upon, has the potential to increase the effectiveness of public services and policy in this area and enhance the quality of life of older people. This is a live area of policy debate and evidence is likely to be immediately beneficial to policy makers with benefits to older disabled people and tax payers flowing as soon as any policy reforms are implemented.

We expect our experience of dealing with the survey measurement issues relating to disability and wellbeing to have impact among survey designers and managers, including those at ONS and Understanding Society and other organisations involved in primary survey research. This impact will ultimately take the form of improvements in the quality of future surveys.

Staff working on the project will enhance their analytical and communication skills in ways which could be applied in many employment sectors.