The document discusses the ongoing efforts by Andrew Dilnot, chair of the Commission on Funding of Care and Support, to reform social care funding in the UK for individuals over 65. Key issues identified include the need for increased resources, protection against high costs, and better alignment of funding systems. As evidence gathering progresses, the commission aims to propose a clear, coherent framework by July 2011, addressing concerns from various stakeholders and suggesting a role for the financial services sector.

1. Searching for social care solutions Andrew Dilnot CBE Chair, Commission on Funding of Care and Support

2. Over 65 in UK

3. Over 65 in UK

4. GDP

5. Progress so far Inputted into the Spending Review Agreed Criteria with Government and developed two underlying principles Established our definition of the problem and characteristics of an ideal system Lots of evidence gathering and engagement – including devolved administrations Launched the Call for Evidence Now entering new phase of narrowing down options and working up proposals Report in July 2011

6. Publicly funded social care Net expenditure 2008-9 (millions) Older people, £7,250, 54% Physically disabled adults, £1,470, 11% Adults with learning disability, £3,570, 27% Adults with mental health needs, £1,100, 8%

7. Estimated public spend on older people in England (2010/11) £bn Personal social services for over 65s NHS expenditure on over 65s Social security benefits for those over state pension age 6% 35% 59%

8. Call for Evidence Closed at end of January with nearly 250 responses. We asked: What are the challenges and opportunities? What are the strengths and weaknesses of the current system? How should the funding system be reformed? Received lots of useful data on unmet need (which needs further work) and length of stay Interesting evidence on possible role of financial services sector

9. Direction of Reform Clear direction – a new funding system needs to include the following elements: Increased resources Opportunity for people to be protected against costs Enable people to plan and prepare Be aligned with the wider public funding system

10. Projections for age related budget expenditure 2009-2010 2019-2020 2029-2030 Health 8.0 8.5 9.3 Long term care 1.2 1.4 1.7 Public service pensions 1.8 1.9 1.9 State pensions 5.5 5.3 5.9 Education 6.0 5.9 6.0 Total 22.5 23.0 24.8

11. Future lifetime costs Total costs (care plus hotel) at 65 (in 2009/10), all care types around a third of people age 65 would not expect to spend much at all on care half face lifetime costs of over £20,000 one in ten aged 65 can expect costs of more than £150,000

12. Opportunity to be protected against care costs Working out the form of this partnership is going to require weighing up some difficult trade-offs… Which type of risk is it best for the state to take? Should there be a universal element or means-testing? What is the balance between early intervention and helping those with the highest needs? What role could the financial services sector play in the future?

13. Source: Banks, Crawford and Tetlow 2010 using Wealth and Assets Survey 2006/8 Distribution of net household wealth per adult, by age (net financial, property and private pension wealth) Household wealth

14. People need to be able to plan and prepare 50% of those with experience of elderly relatives or friends receiving care are ‘concerned’ vs. 38% of those with no experience 47% ABC1s are concerned vs. 39% of C2DEs How concerned are you about covering the costs of care in your old age should you require it in future? 46% women are concerned vs. 41% of men Source: TNS Omnibus, 2011, Base: All respondents, (921)

15. Public Funding needs to be clear, coherent and aligned We know that from the individual's perspective the care and support system can often look disjointed and uncoordinated – and that it can fail to deliver the best outcomes Boundaries with housing, NHS, benefits etc can be unclear No simple solutions here – there are different structures, agencies, funding systems involved – but it makes sense that in tackling the funding of social care we also look at how these fit together.

16. Looking forward A lot of modelling work still to be done Narrowed down our options now and are testing them We’ll be undertaking further deliberative work Further engagement with academics, key stakeholders and the financial services sector Publish in July 2011