Rural Elderly Facing ‘Terrifying’ Social Care Crisis

Report warns that higher home care costs and greater distances are condemning those living outside major towns and cities

Elderly and vulnerable men and women living in rural parts of the country are facing a ‘terrifying’ crisis situation in terms of poor access to social care and other challenges brought about by geographical isolation and public – sector austerity. This is according to a new report published today by Rural England CIC.

The report, “Issues Facing Providers of Social Care at Home to Older Residents in Rural England”, highlights the acute, and often unique, challenges affecting the rural elderly in terms of home-based social care, related to demographics, service provision and costs. The challenges include older people making up a significantly higher percentage of the total population in rural areas and more than one in nine rural people currently providing unpaid care.  Together these facts lead the authors to call on Government and service providers to take steps to stave off a worsening situation that risks abandoning vast numbers of vulnerable individuals simply because of where they live.

Rural councils, on average, pay significantly more (13%) than urban councils when commissioning adult social care services. (£15.61 an hour compared to £13.78)[1]. Yet among the challenges identified by the report are that lower population density in rural areas – with less clustering of service users in the same area – prevents economies of scale. This means providing care at home can be prohibitively expensive. At the same time, there is significant pressure on local authorities to achieve cost savings in social care, which can result in a lessening of the home care that is offered or a reduction in quality.

The report also flags the ‘penalty of distance’, whereby health services are typically further away and often inaccessible by bus (especially with services reducing). In addition, home care staff are typically not paid for travelling time despite needing to go further to tend to the needs of service users.  With the ever worsening of public transport in rural areas, for those older people without access to a car[2] a medical appointment, even with a GP can be a real struggle. As a result, the authors warn that, for the rural elderly, first contact with social services is often at a ‘moment of crisis’ – reducing the opportunity for sometimes lifesaving earlier intervention.

Data shows that the percentage of the population aged 85 and over, the group most likely to need care, is 3% in rural areas compared to 2% in urban. Ageing of the population is also fastest in rural areas.

As this continues, it will place increasing demands on social care providers, with the report warning that these pressures are likely to be felt most acutely in those rural areas with the highest proportions of older people. The impacts on individual rural council budgets from the growing demand for funded social care were described by one interviewee for the report as ‘terrifying’.

It is clear that changing legislation to address the care issues is going to be a long process, which will not even start until the summer of 2018 with the promised publication of a Government Green Paper. This report clearly demonstrates that immediate pressures being faced by rural councils and providers, need to be addressed much earlier and that Government neds to take action now to address them.


[1] Calculated from NHS (2016) Personal Social Services: Expenditure and Unit Costs, England 2015-   16. Hourly rates for home care

2 The State of Rural Services 2016 report, Rural England CIC, 17th January 2017


Edel Harris





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