Unmet need

This section presents an alternative and more detailed analysis of Table 3 from the main HACE 2023-24 national results, which formed part of the main findings for unmet need in help, care and support for everyday living. This table reported on reasons why people thought that they weren’t receiving all the care, help or support that they felt that they needed. The alternative presented here removes respondents who reported that these scenarios were “not applicable” to them (4,378 respondents, 29%) and has also included manual recoding of the open text responses to this question in the percentage estimates. This was done to focus directly on those who reported an unmet need for help and care services. The original Table 3 in the national results reports on total respondents to the question, including those without an unmet need. This means that the percentages reported there do not reflect the frequency of different experiences of unmet need for help and care services. The percentages reported in this alternative analysis do. Please be aware that the results presented in this section will therefore be different to those in the main HACE 2023-24 national report around unmet need.

You should use the results presented in this report for describing people’s reasons why they say they are not receiving all the help or care services that they feel they need. The exception is if you want to report on the percentage of respondents who selected “not applicable” when asked about their unmet care needs. For that percentage, you should use the figure presented in the HACE 2023-24 national report.

Unmet need in 2023-24

For the first time in HACE, in 2023-24 respondents who reported needing help, care and support with everyday living were asked about their experiences of unmet need. This included both respondents who reported receiving some form of support and respondents who reported that they had not had any support but felt that they needed some. They were asked :  

“If you are not receiving all the help and care services for everyday living that you feel you need, which options best describe your situation? Please tick all that apply”  

The response options presented were as follows:

‘I am not sure I am eligible’

‘I did not know how or where to ask for help’

‘I do not qualify for services’

‘My current care service is not enough’

‘I have had an assessment, but care has not been provided’

‘I contacted my local authority and have not heard back’

‘I am waiting to be reassigned to a different provider’

 ‘Other’

Respondents could select more than one option and had space to leave an open text response in a comment box accompanying the option “Other”.   

The most common reason provided for why people felt that they needed more help and care services, was that they weren’t sure if they were eligible for more, or any, support, with 44% of respondents selecting this option.   

The second most common reason provided for why people felt that they needed more help and care services, was that they did not know how or where to ask for help, with 33% of respondents selecting this option.   

The least common reason provided for why people felt that they needed more help and care services, was that they were waiting to be reassigned to a different provider, with 2% of respondents selecting this option.  

Following the manual recode of the “other” box detailed in the introduction and data and methodology sections, a similar rate of respondents selected “other” and/or “my care service is not enough” to describe why they thought they had not received all the help and care services they felt they needed.

Table 2: ‘I am not sure I am eligible’ was the most common reason people selected, when asked about why they were not receiving all the help or care they felt they needed.

Weighted percentage responses to the question ‘If you are not receiving all the help and care services for everyday living that you feel you need, which options describe your situation?’, 2023-24. (Alternative analysis to Table 3 from HACE 2023-24 national report). 

Note: Respondents could tick more than one option, and therefore the sum of all the options may not add to 100 percent.  

It is notable from the open text responses to this question that the unmet needs described in these results include, but are not confined exclusively to, adult social care. Respondents who left a comment described a wide range of service needs, including but not limited to need for: mental health care, hospital care, housing support, dental care, cash benefits, carers support, occupational therapy, physiotherapy, gender reassignment services and blue badge permits.   

Given that the open text box for this survey question was optional, and a minority of respondents chose to leave an open text response (1,600 respondents in total), it is not possible to estimate from these responses what proportion of people with an unmet need for support with everyday living require which kind of support. However, they do give us some indication of the broad spectrum of needs described in the survey.   

There was considerable overlap between the responses in the open text box and the pre-existing unmet need categories. For example, the most common unmet need mentioned in the ‘other’ category was delays in receiving assessments or in the commencement of care (184 mentions), whilst the second was inadequate service provision for needs (112 mentions), overlapping with the existing question response option “my current care service is not enough”.  However, some new themes emerged that went beyond the pre-existing options. For example, several respondents noted the inaccessibility of services, especially due to difficulty navigating forms, information, and gatekeepers to the service (55 mentions). Additionally, respondents highlighted the unavailability of required support (36 mentions), whilst others were reluctant to source support due to concerns around overburdening the system (17 responses). A table listing all themes identified is available in Annex A.  

Further work analysing unmet need for help care and support with everyday living, and for support for unpaid caring in the 2023/24 results is also underway.