PhD Study: Who Makes It In and Who Waits? Temporal Dynamics in Adult Formal Care amid Funding Cutbacks
This research is led by Barshana Goswami as part of her PhD Fellowship. For more information about Barshana, please check our PhD Fellowships pages
What are we trying to do?
The aim of this research is to understand how the use, determinants (factors that influence) and entry requirements of community-based formal social care have changed over time for older adults, especially in the context of austerity measures in England. The aim is to understand if and how factors affecting formal care receipt in general, and state-commissioned care in particular, have progressed, and if entering the system has become more restrictive over time. We want to deliver a clear picture of care pathways at a time when social care systems face intense strain due to harsh cuts, growing demand and evolving family structures, and offer evidence-based recommendations for policymakers and providers.
Why is this important?
Since care in England is means-tested, understanding whether and how wealth and socio-demographics can influence who receives this care is vital in ensuring fair access and addressing equity concerns. There are gaps in up-to-date scientific research examining such trends and how this relates to the existing social care policy in the country.
From a policy standpoint, this research provides evidence to evaluate whether current legislation and ways of funding align with the evolving needs of an ageing population with complex health and care needs. Local authorities must anticipate where and how demand for formal care will grow - the findings from this study on need, affordability and socio-demographic variations have the potential to inform this and may help refine long-term planning and organisation in the sector.
How are we doing it?
The research will answer three main questions:
- The first aim is to look at current predictors of who can access formal care using the most recent available data (2018-19) from the English Longitudinal Study of Ageing (ELSA). We are also looking at publicly-funded care to see if and how the predictors change.
- We use the findings from the first study to see how the relationships between identified predictors and formal social care, including state-commissioned care, have changed over time using a repeated cross-sections approach - essentially answering the question by looking at what used to be an important determinant in the past and what is become increasingly important now.
- In the final stage, the research builds on previous findings to look at how specific factors affect people receiving care for the first time. We look at the social care modules of ELSA to identify different patterns that individuals can be classified into, such as: a. when someone starts care for the first time, did they have their needs not met in previous years? b. do they continue or discontinue using care? c. do people have needs but never receive the care? This approach helps us answer some crucial questions - for example, has the “bar” or threshold for accessing care risen, remained stable or lowered? And, what can this tell us about the responsiveness and effectiveness of the existing care system to growing demand?
Who we are working with
More information
Senior Programme Lead
Mike Spence