Free personal care: what older people pay for care in England now, and what Scotland shows

What was announced

Free personal care for older people in England, based on need, not ability to pay

The Government's announcement of 29 September 2026 commits to a National Care Service in the next parliament, phased in, with Baroness Casey's independent commission due to report on how to implement it by summer 2027. It says the adjusted triple lock is projected to reduce State Pension spending by 15 billion pounds a year by the end of the 2030s and 50 billion pounds a year by 2050. These are the Government's own projections; neither the cost of free personal care nor the size of the funding gap it leaves has been published.

Covered

Personal care: help with eating, bathing and using the toilet, free to older people assessed as needing it.

Not covered

Bed and board in a care home, which remains subject to a means tested contribution, as in Scotland.

Unchanged

Councils will continue to disregard the value of a home where a partner or dependant lives there, and deferred payment agreements remain available.

Paid for by

Adjusting the triple lock from April 2030: the State Pension rises by at least inflation or 2.5 per cent, with an earnings link over time, instead of the highest of the three every year.

Timetable

The current triple lock is kept until April 2030. The care service is for the next parliament, in phases; the commission reports by summer 2027.

Source: GOV.UK, 29 September 2026.

England today

Councils spend £12.0bn on long term care for over 65s. Those people pay £3.6bn of it

Councils in England spent £29.4bn gross on adult social care in 2024-25, 8.6% more than the year before in cash terms. Long term care for people aged 65 and over was £12.0bn of it, and those people paid £3.6bn back to councils in charges, 29.6 per cent of the gross cost. Across all ages client contributions were £4.7bn, up 13.8% on the year, and DHSC reports they are now councils' largest source of income for social care, ahead of the NHS. Residential and nursing care take 62.8% of the 65 and over long term budget. The average cost to councils of a week of residential or nursing care was £1,185.55, and of an hour of home care bought from an outside provider £23.56.

Gross current expenditure, £m, 2024-25. Source: DHSC Adult social care finance report, Table 44.

Council by council

How much of the cost older people pay back varies from council to council

Dividing each council's charges income from people aged 65 and over by what it spends on their long term care gives a rough measure of how much of the bill comes back from the people being cared for. The median council recovers 29.1 per cent. The highest, Thurrock, recovers 54.1 per cent; the lowest, Hackney, 8.6 per cent. The means test is set nationally, though councils have some discretion over charges for care at home, and the spread also reflects who each council supports: their income and savings, the mix of care home and home care, and how many better off residents arrange care privately and so never appear in council figures. The data does not separate these, and the ranking is not a measure of how generous a council is.

Client contributions from people aged 65 and over as a share of gross spend on their long term care, 2024-25. Computed from the DHSC per council finance data; the 153 councils sum exactly to the England totals.

Who gets support

396,300 people aged 65 and over were getting long term care from their council

Councils in England received 1,301,885 requests for support from new clients aged 65 and over in 2024-25. On 31 March 2025, 396,300 people in that age group were receiving long term care arranged by their council: 154,330 in residential or nursing homes and 241,870 in the community, mostly at home. Of those, 46,235 were paying the full cost themselves for care the council arranged. Beyond them are people who pay care homes directly: the ONS estimates 37.0 per cent of England's 372,035 care home residents were self funders in 2022 to 2023, from 26.4 per cent in the North East to 47.5 per cent in the South East. Self funders are the group whose bills free personal care would change most directly.

Self funded residents as a percentage of all care home residents, 1 March 2022 to 28 February 2023. Source: ONS, Care homes and estimating the self funding population, Table 3 (experimental estimates with confidence intervals of about 3 to 4 points).

The Scottish model

Scotland has paid for personal care since 2002. The weekly payment is now £260.30

Free personal care began in Scotland for people aged 65 and over on 1 July 2002 and was extended to adults of any age in April 2019. At home the personal care itself is free, though other help such as housework can be charged. In a care home, the council pays a flat weekly amount towards the fee of a self funding resident, £260.30 for personal care and £117.10 for nursing care from April 2026, and the resident pays the rest, including accommodation and living costs. In 2024-25, 10,780 of 28,340 long stay residents aged 65 and over, 38 per cent, received those payments, costing £186m. A further 47,560 people aged 65 and over received personal care at home, at an estimated £538m; with adults under 65 the personal care at home bill was £842m. The payment was frozen at £171 a week from 2015-16 to 2017-18 and has risen faster since 2021-22.

Flat weekly payment towards the personal care element of a self funder's care home fee. Sources: Scottish Government FPNC methodology, Appendix 1; Scottish Parliament committee report on the 2025-26 rates; mygov.scot for 2026-27.

“You can get personal care for free from your local council if your care needs assessment shows that you need it. You can get this regardless of your age, income, savings or relationship status.”

Who provides it

111,000 vacant care posts in England, a vacancy rate of 7.0 per cent

Skills for Care estimates there were 1.60 million filled posts in adult social care in England in 2024/25 and 111,000 vacancies, a rate of 7.0 per cent, down from a peak of 10.5 per cent in 2021/22. Turnover was 23.1 per cent. The median care worker was paid £12.00 an hour in March 2025, 56p above the National Living Wage. Making personal care free would not by itself add carers: if more people come forward for assessed care, the same workforce has to deliver it.

Vacancy rate, all sectors, all job roles. Source: Skills for Care, workforce estimates 2024/25, statistical appendix Table 4.14.

The ageing population

England's over 65s grow by 29 per cent by 2040, its over 75s by 37 per cent

The ONS 2024 based projections put England's population aged 65 and over at 10.98 million in mid 2024 and 14.15 million by 2040. Those aged 75 and over, who account for most care, rise from 5.46 million to 7.47 million. The OBR's July 2026 projections put public spending on adult social care at 1.2 per cent of GDP now, rising to 1.8 per cent by 2075-76 before any new policy.

People aged 75 and over, mid year, principal projection. Source: ONS National population projections, 2024 based, England summary.

How it is paid for

The triple lock has raised the State Pension 89 per cent since 2011. Earnings set it 6 times

Since April 2011 the basic and new State Pension have risen each year by the highest of average earnings growth, price inflation or 2.5 per cent (with the earnings leg suspended for April 2022). DWP's own record shows earnings set the rise 6 times, prices 6 times and the 2.5 per cent floor 4 times; compounded, the 16 increases from April 2011 to April 2026 add up to 89 per cent. The OBR says the lock has cost around three times what was expected when it began. From April 2030 the Government will keep the inflation and 2.5 per cent floor but, in DWP's words, over time the pension is set to rise in line with average earnings. DWP's analysis of 29 September 2026 puts the saving against the current lock at 15 billion pounds in 2039 to 2040 and 50 billion pounds in 2049 to 2050, in cash terms.

Annual uprating of the basic and new State Pension and the basis DWP records for it. Sources: DWP Abstract of benefit rate statistics 2025, Table 1; DWP announcement of 4 April 2026 for April 2026.

State Pension spending as a share of GDP under the OBR's July 2026 baseline (triple lock continues) and its two alternatives. The OBR's figures predate the Government's announcement; its earnings path is a guide to the adjusted lock, not a costing of it. Source: OBR Fiscal risks and sustainability, July 2026, Chart 3.11.

“In any given year it will go up by at least inflation or 2.5% and anything more that is needed to retain that value. This means that over time the State Pension is set to rise in line with average earnings.”

Questions this raises

What the figures do not settle