Bridgehead Communications

Key findings: Adult Social Care Funding 2022/23

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Bridgehead Social Care2022/23

Adult Social
Care
Funding

A visual guide to how adult social care is funded in England, tracing the £28.3 billion flow from central government and local authorities through to long-term and short-term care provision.

£28bn

total spend 2022/23

By the numbers

£28.3 billion. One year. Where it goes.

£28.3bn

Total adult social care spend, England 2022/23

65%

Of all spend goes to long-term support

£9.76bn

Care delivered in people's own homes

£4.6bn

NHS Continuing Healthcare, funded by the NHS

Key findings

What the data shows

01

Adult social care spend reached £28.3 billion in England in 2022/23 across all provision types.

02

Long-term support takes 65 per cent of the total: £18.4bn, nearly two-thirds of all spend.

03

Care at home (£9.76bn) and care homes (£8.64bn) are split almost evenly.

04

Home care is the single largest care-at-home component at £3.08bn, ahead of supported living.

05

NHS Continuing Healthcare (≈£4.6bn) is funded entirely by the NHS for those with a primary health need.

06

The Better Care Fund (£2.14bn) pools NHS and council budgets to join up health and social care.

01 / 08

Spend by support type

Total adult social care spend reached £28.3 billion in 2022/23. Long-term support accounts for the largest share at 65 per cent (£18.4bn), followed by other support at 15.4 per cent (£4.35bn) and short-term support at 3.4 per cent (£0.95bn).

The remaining share relates to NHS Continuing Healthcare (≈£4.6bn), which is funded by the NHS and flows separately from local authority budgets.

£28.3bn

Total ASC spend

65%

Long-term share

15.4%

Other support

3.4%

Short-term support

02 / 08

Long-term support: care at home vs care homes

Of the £18.4bn in long-term support, care at home (£9.76bn) and care homes (£8.64bn) are roughly equal in scale, a near 53:47 split.

The balance reflects a long-running policy shift toward supporting people to remain in their own homes wherever possible, rather than in residential settings.

£9.76bn

Care at home

£8.64bn

Care homes

53%

Home's share of long-term

03 / 08

Inside care homes: nursing vs residential

Of the £8.64bn spent on care homes, residential care (£6.36bn) accounts for nearly three-quarters. Nursing care (£2.28bn) covers those with more complex health needs requiring on-site nursing staff.

The 74:26 residential-to-nursing ratio reflects the overall population of care-home residents, the majority of whom do not require registered nursing.

£6.36bn

Residential care

£2.28bn

Nursing care

74%

Residential share

04 / 08

Inside care at home: where the £9.76bn goes

Home care (£3.08bn) and supported living (£2.9bn) are the two largest components of care-at-home spend, together making up well over half of the total.

Direct payments (£2.02bn) give service users cash to arrange their own support, putting control in the hands of the people who use care.

£3.08bn

Home care

£2.90bn

Supported living

£2.02bn

Direct payments

05 / 08

Who receives long-term support: age and need

Long-term support recipients skew older: 62 per cent are aged 65 or over, though the working-age group (18–64) accounts for a significant 38 per cent.

Physical support is the leading primary support reason at 42 per cent, followed by learning disability (29%), memory and cognition (15%) and mental health (14%).

62%

Recipients aged 65+

42%

Physical support

29%

Learning disability

06 / 08

Other support: what the £4.35bn covers

The £4.35bn “other support” category encompasses commissioning and service management (£0.39bn), social care activities (£0.37bn), assistive equipment and home adaptations (£0.039bn), and carer support (£0.035bn).

The bulk of the category is a residual covering wider council social care overhead and services that do not fit the principal long-term or short-term classification.

£0.39bn

Commissioning / mgmt

£0.37bn

Social care activities

£0.035bn

Carer support

07 / 08

How councils are funded: the upstream picture

Local authorities draw revenue from three main sources: government grants (£59.7bn) remain the largest single stream, supplemented by council tax (£36.6bn) and business rates (£17.6bn).

Adult social care absorbs approximately £22bn of that total, around one-fifth of all local authority spending, making it by far the largest discretionary service councils must fund.

£59.7bn

Government grants

£36.6bn

Council Tax

£17.6bn

Business Rates

How the money flows

Six routes to a care budget

NHS Continuing Healthcare

Fully NHS-funded care for people whose primary need is a health need. It flows outside local authority budgets.

≈ £4.6bn · NHS-funded

Better Care Fund

A pooled budget that joins up NHS and council spending to support timely discharge and independence at home.

£2.14bn · NHS + council

Adult Social Care Grant

Ring-fenced central government grant to councils, helping them meet rising demand and provider cost pressures.

£1.71bn · Central grant

ASC Discharge Fund

Targeted funding to speed safe hospital discharge into community, home and short-term care settings.

£0.50bn · Discharge

Council-commissioned care

Local authorities commission most long-term care, funded through council tax, the adult social care precept and grant.

Local authorities

Self-funders

Many people pay for their own care, assessed against means-tested thresholds before any council support begins.

Private contribution

08 / 08

Central funding routes into local authorities

Central government channels social care funding through several routes. NHS Continuing Healthcare (est. £4.6bn) is the largest, funded entirely by the NHS.

The Better Care Fund (£2.14bn) integrates health and care, while the Adult Social Care Grant (£1.71bn) and ASC Discharge Fund (£0.5bn) provide further targeted support to councils.

£4.6bn

NHS CHC (est.)

£2.14bn

Better Care Fund

£1.71bn

ASC Grant

£0.50bn

Discharge Fund

Conclusion

Following the money is the first step to making the case for sustainable social care funding.

Adult social care in England absorbed £28.3 billion in 2022/23, with nearly two-thirds going to long-term support and the balance split almost evenly between care at home and care homes.

Mapping how funding flows, from NHS Continuing Healthcare and the Better Care Fund through to council-commissioned care and self-funders, shows where pressure is concentrated, and where reform could have the greatest effect.