Annex C: Market Sustainability Plan for the London Borough of Hounslow – March 2023

Section 2: : Assessment of the impact of future market changes between now and October 2025, for each of the service markets

Hounslow Council has created a data hub which publishes health and social care data, including projections of future demand. It can be viewed online.

Hounslow has a younger profile compared with the England average, but as mentioned above the local population is both increasing and ageing. The number of residents aged 65+ is anticipated to continue to increase over the next three years at a higher rate than those of a working age as shown in Table 2.

Table 2: Hounslow demographic changes (Source: GLA Population Projections -

Hounslow Demographic Change 2022 2023 2024 2025
18-64 Baseline 1% 1.9% 2.4%
65+ Baseline 3% 6.2% 9.2%

This forecast will increase budget pressures for Adult Social Care and increase demand for both care homes and home care. Demand for the 18-64 domiciliary care market is projected to increase due to the number of children transitioning into adult services with increasingly complex needs. The current number of service users aged 18-64 and 65+ by service type in Hounslow is shown in Table 3.‚Äč

Table 3: Current service users by service type (Source: Hounslow ContrOCC February 2023)

Current service users by service type Aged 18-64 Aged 65+
Home Care 289 865
Nursing   63
Nursing EMI   85
Residential   94
Residential EMI   97
TOTAL 289 1,204

NOTE: The 18-64 care home numbers haven’t been included as they are out of scope

Hounslow will look to increase the provision of more cost-effective and/or short-term alternatives to long-term (residential, nursing, and home care) services to meet the increases in demand. Overtime this would increase the range of preventative services, whilst ensuring that our most vulnerable residents receive the most appropriate services to meet their eligible needs. Details of some of the proposed initiatives (such as further investment in extra care housing and supported living) are provided in Section 3.

Given that Hounslow spends proportionally less on Adult Social Care services than the vast majority of other local authorities (150th out of 152), it is anticipated that the proposed charging reforms will have a disproportionately higher impact i.e. in terms of percentage increase in spend, given the relatively low baseline spend.

These reforms will represent a new burden for local authorities and (as has been reported by ADASS, the LGA, and the CCN) will create an additional financial pressure given that the associated costs will not be fully covered by the proposed funding increases.

Given the context of increasing demand, rising costs, comparable spend, and insufficient funding, the sustainability of both our operating model and our local market is at great risk.

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