limited to the poor. one of the first acts of the conservative prime minister ted heath was to pass the 1970 national insurance act, introducing attendance allowance as a universal welfare payment for those needing social care. the majority of those assessed as requiring adult social care in england are financially assessed and then expected to pay towards it, although attendance allowance, and its equivalents in other age groups (components of disability living allowance, and personal independence payments), assume income from some savings. however, for complex care needs, and residential care, this is often not enough money to fully cover the cost. financial assistance is available from local councils to cover the remainder of costs up to an amount expected to meet needs, but it remains means-tested, and is thus targeted at those whose assets and income are not sufficient to pay for their care. some local authorities have schemes which enable care costs to be postponed, though evidence in 2011 suggested this was not available from all local authorities. sir andrew dilnot conducted a review of the social care system for the cameron government, and proposed a universal lifetime cost cap of around £73,000, on the basis of pooled risk, like an insurance arrangement. he also proposed the introduction of personal budgets for every care user, allowing them to spend the funding for their social care as they see fit, rather than having to use the council provider. these changes were legislated for, and passed into law, but local councils demanded that the changes be delayed until after the next election, claiming that they did not have the money or ability required if they were to implement the changes immediately; the change was postponed until 2020, and has not yet been commenced. independently of the dilnot proposals, the administration of attendance allowance will be transferred to local councils in 2020, meaning that assessment of care needs will be merged with assessment of funding eligibility, for those who qualify for attendance allowance (individuals who have reached state pension age). this will also allow the money to pass directly from central government to the council, without needing to pass through the care user's bank account in-between; personal budgets mean that the care user still has control of how the money is spent (though it will no longer be possible to spend it on frivolous things that do not contribute towards care). a court decision means many care workers are entitled to back pay for overnight sleep shifts. many local authorities, charities and companies providing care say they cannot afford this and will fold without financial help from the government. the problem remains unresolved with some care providers facing possible bankruptcy. a director general for adult social care, rosamund roughton, was appointed to the department of health and social care in 2020, a similar position having been abolished in 2016 when jon rouse left. systemic funding problems the rapid improvements in population health that the nhs brought about caused a significant increase in life expectancy, but in turn, this caused social care to be required for longer. by the end of the 20th century – compounded by the retirement of the post-war baby boom generation – the ageing uk population, combined with increasing costs, led to the nhs finding it difficult to fully fund healthcare, with a corresponding impact on the cost of social care. in 2015, professor martin mckee of the london school of hygiene & tropical medicine said that "since 2009, ... the number of people aged 85 years and over has increased by 9%. to maintain current levels of social care would require an extra £1.1 billion ...". in 2017, the local government association estimated a £2.6bn funding shortfall by 2020 and feared some councils could be challenged in the high court for not providing a statutory minimum standard of care.; they blamed historic under-funding and increasing numbers of old people. the centre for workforce intelligence estimates that two million or more extra carers will be needed by 2025 in england alone, for both in-home care and care homes, due to growing demand. although council tax rose substantially since 1997, under the blair ministry, subsequent restrictions imposed by the cameron ministry saw it erode back towards 1997 levels. the 2017 budget gave councils access to an extra £1 billion provided centrally. however, nigel edwards of the nuffield trust think tank said that this would cover only half the £2bn funding shortfall feared in 2017–18. the housing, communities and local government committee of the house of commons reported in august 2019 that the social care system was on the "verge of collapse", with "an opaque source of revenue, partially funded by tax systems that don't spread the burden equally." the centre for health and the public interest cautioned that a large increase in public funds for the sector could just produce bigger profits for privatised operators, since many firms lack financial transparency. in 2022 the association of directors of adult social services calculated that though the hours of home care delivered had increased to 41 million by october 2021, over half a million people were waiting for care and support. these systemic problems have led to an increase in the number of unpaid carers, with around 1 in 5 adults performing this role in 2022. the lack of adequate funding for the care sector has led to a growing 'social care gap' which is projected to rise until 2032. unpaid carers are increasingly relied upon as the adult social care system is failing the most vulnerable in society. long term solutions the local government association claims "it cannot be left to council taxpayers alone to try and fix this crisis. conservative doctor sarah wollaston said: rising unmet need for social care will not be resolved without genuine cross-party working to find a long-term solution to funding. a 2017 poll found that 57% of britons were willing to pay more tax to fund social care. norman lamb (care minister under the cameron–clegg coalition) said, "this shows the clear appetite for paying a bit more to ensure that our loved ones get the care they need. with over a million older people going without the care and support they need, this has become a moral imperative." william laing, founder of laingbuisson said that it was "highly unlikely" that cross-party consensus on how to overhaul the social care system could be achieved and that "if you really wanted to professionalise the service and pay people, not the minimum wage but a decent career structure, then we're talking about several billion pounds." ahead of calling the snap general election of june 2017, prime minister theresa may identified social care reform as a policy priority, in order to address much needed funding reforms and end the "intergenerational unfairness" of existing models. the manifesto proposals, which saw a rise in the threshold for free care from £23,250 to £100,000 for over 65's and also included property in the means test and permitting deferred payment after death, were criticised as a "dementia tax". four days after the manifesto launch, may announced that these proposals would form the basis of a wider consultation on wider social care funding, which drew criticisms of a "u-turn in march 2017, chancellor philip hammond first announced a green paper on the future funding options for social care. since the announcement, the green paper was marred by several delays, with the health secretary matt hancock giving evidence to select committees citing brexit and lack of cross-party consensus as the reasons for the delay. ultimately, the green paper never materialised during may's premiership. a december 2019 poll by learning disabilities charity hft found that 59% of social care providers in england believed that the situation in social care worsened under may's time in office, compared to just 3% who said it was slightly better. on 24 july 2019, in his first speech as prime minister, boris johnson pledged to fix social care "once and for all" with a "ready-to-go" plan. since then, johnson has clarified that reforms will be put forward before the end of the next parliamentary term. in september 2021, in line with johnson's pledge to fix social care, a new health and social care levy act was to be implemented for april 2023. the levy was designed to improve social care, and deal with the backlog of patients waiting for treatment following the covid-19 pandemic the new levy means any person liable to pay national insurance, including people of pension age, is required to pay a tax equal to 1.25% of the amount of individual's earnings or profits. this increase in taxation is expected to raise £12bn a year. digitisation in 2022 only 45% of social care providers used a digital social care record, and 23% of care home staff could access the internet consistently at work. in 2022/3 the government made available £25 million to bring digital social care records into the integrated care systems with a commitment of at least 80% of social care providers having digitised care records by march 2024. brexit in august 2018, a department of health report warned that in a worst-case scenario, care workers migrating from elsewhere in the european economic area might stop coming after brexit, and the resulting shortage of care workers could become so acute that people (mostly women) would be forced to give up paid work and stay home to care for dependent relatives. in a september 2019 report, the national audit office maintained there was no clear evidence the care sector was ready for brexit. the report claimed that the care sector was fragmented and relied on 24,000 companies providing services; it also claimed that there was no central arrangement to stockpile equipment and supplies, like syringes and needles, also incontinence pads, which mostly came from or through the eu. auditors were concerned that the department of health and social care did not know what proportion of the 24,000 uk nursing homes and other providers of social care, which are often small businesses, had acted on its advice for, "robust" contingency planning over a no-deal brexit. care workforce adult social care can be understood as care to support the well-being of adults, similar to that which may be provided by a skilled relative or friend. it includes following directed care designed to maintain physical or mental health supervised by health-qualified staff, but not health treatment that would be undertaken by staff with health qualifications such as nursing. the social care workforce encompasses: those who are employed directly by councils, often under joint funding arrangements with health commissioners. those employed by companies or voluntary agencies that are commissioned through local councils to discharge their personal social services (pss) responsibilities. those employed as "personal assistants" providing care that councils have assessed as required. (this would be funded through the cared-for person being paid a "personal budget"). personal assistants employed by an adult who, having savings, is "self funding" support that a council would assess as needed. in england, the social care workforce comprises over one and half million people. an estimated two thirds of the workforce work for some 25,000 employers in the private and voluntary sectors. the remaining third work in the statutory sector, largely for 150 local councils with personal social services responsibilities. data on the social care workforce is collected and analysed by skills for care, the national workforce organization for adult social care in england. data is collected on the social care workforce through skills for care's national minimum data set (nmds-sc). a survey by skills for care in april 2019 showed that the average care worker was 59p (8%) better off, in real terms, in february 2019 than they were in september 2012, with a greater increase for those at the bottom of the pay scale. pay was higher in the south of england than in the north, but in the south east the average take home pay was lower than the cost of living. most care recipients are satisfied with their care, however a minority have serious concerns. types of work one type of work covers assessment and commissioning on behalf of local public finance, for people felt to be in need according to eligibility criteria. the public face for this activity is