Adult social care in London achieves ‘impressive efficiencies’ and is ‘critical to NHS performance’ – but faces growing funding challenge

  • By JackGraves

Adult social care services in London have delivered almost half a billion pounds of efficiencies since 2015 and saved the NHS around £4.6 million a year through avoiding unnecessary hospital stays, according to new research from London Councils.

As well as highlighting the success of adult social care in the capital, the umbrella group warns that the sector faces a funding gap of £540 million by 2025 unless the national shortfall in adult social care finances is addressed.

In its State of Adult Social Care in London report published today, London Councils reviews the progress made by services in improving efficiency and coping with budget pressures. Boroughs achieved £480 million in adult social care savings between 2015/16 and 2017/18 through increased efficiency.

This has been secured through improvements to adult social care provision. Many boroughs have focused on supporting service users to stay in their own homes, which has led to the capital reducing costs by having the lowest rates of admission to nursing and residential homes per 100,000 people of any region in England [1].

The research also provides fresh evidence of adult social care’s crucial contribution to alleviating pressure on the health service. London is one of England’s top-performing regions in minimising delays to transfers of care from hospital, with boroughs’ adult social care services providing prompt support and care arrangements to help Londoners avoid unnecessary hospital stays.

Calculating the number of avoided unnecessary stays in London hospital beds, London Councils estimates that the boroughs save the NHS around £4.6 million a year through reducing delays in transfers of care [2].

Cllr Ray Puddifoot, London Councils’ Executive Member for Health & Care, said:

“Adult social care services are essential for meeting Londoners’ needs and supporting their wellbeing, but they’re also critical to the performance and sustainability of the NHS in the capital.

“Boroughs are proud of the excellent work carried out by adult social care services across the capital. The sector has shown itself capable of adapting, innovating, and achieving impressive efficiencies – even in the face of a highly-challenging financial environment.

“However, the capital’s growing population means more and more Londoners need social care. It’s vital that services get the resources they need to cope with increasing levels of demand.”

Demand for adult social care is increasing rapidly in London, with the capital’s population growing particularly among groups likely to require social care. Even though London has a generally younger population than the rest of the country, the number of Londoners aged 65 and older is expected to increase by 71% by 2039 – a faster rate than any other region in England. In the same time period, the number of Londoners aged 90 and older is set to grow by 156% [3].

London also has a higher proportion of people of working age needing social care provision. For example, the number of working-age Londoners with a learning disability is expected to increase by 7.8% by 2035 and with impaired mobility by 14% [4].

Taking into account demographic changes, as well as other cost pressures such as the implications of the national living wage and changes to deprivation of liberty safeguards bringing new responsibilities to care managers, London Councils estimates that the gap between adult social care costs and the funding provided to boroughs will reach £540 million by 2025.

London Councils is committed to working with the government to find a long-term funding solution for adult social care that addresses demographic growth, the increasingly complex needs of individual service users, and the rising cost burden on local authorities.



Notes to editor:

  1. Source: NHS Digital data on long-term support needs met by admission to residential and nursing care homes:


  1. This figure has been calculated by comparing social care delayed transfers of care (DToCs) in 2017/18 (the government set local authorities targets for reducing delayed transfers of care in 2017) and 2018/19, which saw a year-on-year reduction of 19,244 days. Using NICE’s estimate of a bed day costing £222, uprating for inflation, and considering a 5% margin of error, we estimate this to have produced a saving in the region of £4.6m.


  1. Source: The Office for National Statistics’ subnational population projections for England:


  1. Source: the most recent data available from PANSI (Projecting Adult Needs and Service Information):


  1. The Local Government Association has calculated that by 2025 there will be a £3.5 billion national funding gap in adult social care.