Last Updated on August 18, 2026
Council leaders across England are being urged to unite behind calls for urgent national reform of adult social care. This comes as new analysis from the Care and Support Alliance (CSA) reveals stark differences in what happens to people seeking care and support depending on where they live. CSA's analysis reveals a postcode lottery in adult social care, with people's chances of receiving support varying dramatically depending on where they live.
The analysis finds that on average, people living in the East Midlands and South East face the greatest barriers to accessing support, with three in four (75%) requests for adult social care not leading to formal care and support. By contrast, the West Midlands has the lowest average rate, at 62%, giving people there the greatest chance of their request leading to care and support.
However, the biggest differences are between neighbouring councils. In London, the proportion of requests not leading to formal care and support ranges from 30% in one borough to 91% in another. This means two people with similar needs living just a few miles apart can face vastly different experiences when they ask for help.
Every region in England shows significant variation. Even in the North East, which has the smallest gap between councils, the proportion of requests not leading to formal care and support still ranges from 46% to 76%.
According to CSA, the findings also show that pressures on adult social care are widespread across the country. Even in the West Midlands, the best-performing region overall, almost two in three requests (62%) do not lead to formal care and support. Meanwhile, in the South East, one local authority recorded the highest rate in England, with 93% of requests not leading to formal care and support.
CSA argues that the variation reflects years of growing pressure on the social care system – rising demand, workforce shortages, increasing costs and repeated delays to long-term reform have left councils struggling to meet needs. In addition, local factors can widen these differences further, CSA continues. Councils vary in their ability to raise income locally, while the way central Government funding is allocated has not kept pace with changes in local populations and levels of need.
CSA, which represents more than 50 of the country’s leading charities, has written to local authority leaders across England, sharing data generated using its Show Us You Care local dashboard, asking them to use their influence to help secure a sustainable, long-term settlement for social care.
In its letter, CSA acknowledges the immense pressure councils are under, with rising demand, increasingly complex needs, workforce shortages, growing costs and years of underinvestment leaving local authorities struggling to meet the needs of their communities.
But it warns that the consequences are being felt by older people, disabled people and unpaid carers, with people's experiences of seeking support varying significantly depending on where they live. The CSA says the scale of variation reinforces why individual councils cannot be expected to fix the social care crisis alone.
Commenting on the new findings, Caroline Abrahams, Emily Holzhausen and Jackie O'Sullivan, Co-Chairs of CSA, said, 'Council leaders know better than most the enormous pressures facing social care. Every day, councils are trying to balance rising demand, increasingly complex needs and growing costs against budgets that simply have not kept pace.
'The result is a system in which people's experiences of seeking care and support can look very different depending on where they live. That cannot be right.
'But this is not a problem councils can solve on their own. Local leaders cannot be expected to overcome decades of underinvestment or fix a fundamentally unsustainable system one council at a time.
'That is why we are writing to council leaders across England and asking them to join us in making the case for change. The only way to end this unfairness is through national action, backed by sustainable funding that enables every council to provide the care and support its community needs.
'The Prime Minister has made clear that lasting reform will only succeed if people and political leaders are prepared to work together. We welcome the launch of the Big Conversation on Care as an opportunity to build consensus about what people should be able to expect from a modern care and support system before decisions are made about how it should be funded.
'Council leaders have a vital role to play. They see these challenges every day and have an important voice within local government and across the political spectrum. We hope they will help encourage local people, unpaid carers and community organisations to take part in the Big Conversation, while continuing to make the case for the sustainable national settlement that adult social care has needed for far too long.
'The opportunity for lasting reform is here. We must not let it pass.'
To view CSA's Show Us You Care local data dashboard, click here.
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