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.