Fresh analysis from carehome.co.uk found that 62 per cent of people enquiring about care anticipate paying privately, despite the availability of NHS and local authority funding. The findings suggest that many families are either unaware of the support they may be entitled to, deemed ineligible, or forced to self-fund while waiting for assessments and funding decisions.
The data also revealed stark regional disparities. Nearly three-quarters of care seekers in South East and South West England (73 per cent) expect to self-fund their care, compared with 46 per cent in Scotland, 50 per cent in North East England and 55 per cent in Wales.
North–South divide in NHS Continuing Healthcare
The analysis highlights significant regional inequalities in access to NHS Continuing Healthcare (NHS CHC), the only form of adult social care funding that is not means-tested and fully covers care costs for people with complex health needs.
People in northern regions are more likely to rely on NHS funding. In North East England, 11 per cent of care seekers expect NHS CHC to fund their care, compared with 10 per cent in the North West. In contrast, just 5 per cent of people in the South East, South West and East of England expect to receive NHS CHC support.
The findings reinforce long-standing concerns that NHS CHC operates as a postcode lottery, with outcomes varying widely depending on location. They align with previous research by the Nuffield Trust, which found higher eligibility rates in the North but lower spending per eligible recipient compared with the South.
Families left exhausted and out of pocket
Lisa Morgan, head of the nursing care fee recovery team at Hugh James, said the findings reflected what families experience daily.
“Too often, people end up paying privately for care because funding is delayed, unclear or never properly explored,” she said. “Families regularly seek advice exhausted and distressed, having been told there is ‘no funding available’ or left to self-fund for months while they wait for assessments or decisions.”
She added that access to NHS CHC remains highly inconsistent, with many eligible individuals either not assessed at the right time, wrongly refused, or left in prolonged limbo.
“Even where local authority funding is available, it often falls short of the true cost of care,” Morgan said. “Families are regularly asked to pay unlawful top-up fees without being offered a genuine alternative placement that meets assessed needs within the authority’s budget.”
Local authority funding still limited
Alongside NHS funding, one in five care seekers (19 per cent) rely on means-tested local authority support. The highest levels of council-funded care were recorded in Scotland (35 per cent), North East England (25 per cent) and Yorkshire (21 per cent). South East and South West England recorded the lowest levels of local authority support.
However, rising care home fees mean public funding frequently fails to cover full costs. According to carehome.co.uk, 12 per cent of families are paying top-up fees in addition to local authority funding. Wales recorded the highest proportion of top-up payments at 18 per cent, while families in southern England were least likely to pay them.
‘A system families struggle to navigate’
Sue Learner, editor of carehome.co.uk, said the figures show private payment has become routine rather than exceptional.
“Families are often making urgent care decisions with limited information, and many don’t realise support may be available until they’ve already committed to significant costs,” she said.
She added that care funding in the UK has become fragmented and difficult to navigate, with multiple funding routes and complex rules creating confusion at critical moments.
“With the average cost of a residential care home for self-funders now close to £67,500 a year, this is a major financial decision,” Learner said. “People need clear, accessible information much earlier, before they reach a crisis point.”
