New analysis of government data reveals that one in four older people living in rural areas were left without social care when asking their council for support.
The findings, based on the UK government’s Adult social care activity report 2024 to 2025, shows that nationally, 38.5% of people 65+ requesting social care did not receive it. This figure was higher in rural areas, where 39.8% of people 65+ went without social care, compared with 37.4% in urban areas.
Hertfordshire recorded the highest percentage in rural England, with 64.5% of 65+ people not receiving requested social care, 24.7 per cent above the national average.
Comparisons with urban areas underline that unmet need cannot be explained by demand alone. St Helens, an urban authority with a similar number of requests to rural County Durham, about 10,000 65+ people, saw 61% of people not receiving care. Six in 10 older people did not receive social care in St Helens, compared with one in 10 in County Durham.
These findings sit alongside new data from Elder showing the real-world consequences of gaps in local care provision. In 2025, Elder carers made more than 6,800 journeys within England to provide live-in care, travelling an average of 100 miles per placement. More than 2,100 of these placements were in rural areas of England.
Rural communities face particularly acute pressures. Around 9.7 million people live in rural England, and these areas are ageing faster than urban centres, with over a quarter of residents aged 65 and over, compared with fewer than one in five in urban areas. At the same time, home care provider capacity is shrinking, with many providers now delivering less care.
Local authorities are also under growing financial strain. Analysis by the County Councils Network shows that county and large rural unitary councils face around £7 billion a year in additional service pressures, while current government funding proposals would cover just 2p for every £1 of new costs, leaving councils with little flexibility to respond to rising need, particularly in high-cost rural areas.
Partnership as part of the solution
Elder, the UK’s largest home care platform, is calling for closer collaboration between councils and live-in care providers to help address gaps in access, particularly in rural and hard-to-reach areas where traditional care models struggle to operate reliably.
“Local authorities are under enormous pressure, and this isn’t about replacing existing services,” Elder Founder and CEO Pete Dowds said. “But if we are serious about tackling the postcode lottery, we need to use every care model that works in practice. Live-in care can play a vital role in areas where other services cannot consistently reach people.”
“Working in partnership would give councils more flexibility and help ensure older people aren’t left without support simply because of where they live, or forced to wait until crisis point.”
For more information about Elder, search their website: Elder Live-In Care | Get Support from Trusted Live-In Carers
