This page provides an overview of social care in Tower Hamlets, along with key metrics that could affect social care. Understanding these metrics is important because they help contextualise the challenges with social care provision in each local authority. These statistics are important to keep in mind when reviewing the other pages.
Why are these metrics important? Population size and density can affect the demand for social care services. For example, if a local authority has a high population (relative to other areas), it may need to allocate more resources to meet care needs. Similarly, areas with high population density may require more care services due to the increased number of people living in close proximity. Inversely, areas with a low population density may have fewer care needs, but residents may face challenges accessing services due to the distance between them. Lastly, people in rural areas might live further away from services, which can impact their ability to access care, or make it more expensive to provide.
Understanding these metrics can help local authorities plan and allocate resources effectively.
Deprivation decile is a measure of the level of deprivation in a local authority. It is calculated by ranking areas in England from 1 (most deprived) to 10 (least deprived) based on factors such as income, employment, education, and health. A higher decile indicates lower levels of deprivation, while a lower decile suggests higher levels of deprivation. Understanding deprivation levels can help local authorities identify areas that may require additional support and resources to address social care needs.
IMD 2019 for the Lower Tier Local Authorities: Tower Hamlets
Deprivation rank is a measure of the relative deprivation of a local authority compared to other areas in England. It is calculated by ranking areas from 1 (most deprived) to 32,844 (least deprived) Lower Layer Super Output Areas (LSOA), which can be thought of as “small areas”. This rank is based on factors such as income, employment, education, and health. A lower rank indicates higher levels of deprivation, while a higher rank suggests lower levels of deprivation. Understanding deprivation ranks can help local authorities identify areas that may require additional support and resources to address social care needs.
IMD 2019 for the Lower Tier Local Authorities: Tower Hamlets
Many people want care, some receive care, but a significant number go without. What types of care are being requested? What care is actually provided? This section explores the gap between need and provision, the types of care available, and how our own data contributes to the understanding of these challenges.
Access Social Care and other Helplines providers are working to bridge this gap by providing free legal support to people who are struggling to access social care services. This first chart illustrates the types of calls we are getting.
The rest of this page distingushes between the different types of care provided to Working Age People and Older People, as we are able to disaggregate at a greater level of granularity.
Note: these values are a work in progress… expect these numbers to go up
This plot shows a breakdown of the types of requests for assistance received by Access Social Care and other helplines. Understanding the themes of these calls can identify areas where additional support and resources may be needed. For example, a high number of calls related to housing may indicate a need for more affordable housing options, while a high number of calls related to social care assessments may suggest a need for improved access to care services. The request types are:
Assessments: An assessment is a meeting or form to find out what help someone needs with daily tasks.
Care Plan: A care plan is a written agreement that lists the support you’ll get and who to contact if things change.
Carers: Carers are people who help a disabled or ill person with daily tasks.
Charging: Charging refers to checking if you can afford to pay for some of your care based on your savings.
Information Seeking: Information seeking means getting advice about available care options.
Legal Issues and Complaints: Legal issues and complaints involve reporting problems with your care to the council or an ombudsman.
Safeguarding: Safeguarding is protecting people from abuse or neglect.
Of course, high numbers also mean that people know where to call, and this number can be impacted by advocacy efforts. As a counterpoint, areas with low numbers may indicate a lack of awareness of available services or a need for more outreach to connect people with support.
To protect privacy, our minimum bin size is 5, which means that if we field 1-5 queries on a topic, we display 5.
Are you a helpline and would like to combine data resources? Let us know!
Access Social Care casework, AccessAva data, and helpline partner submissions
Working Age People
Knowing how many people are requesting social care, how many people are recieving care and what percent of people are disabled helps understand need and social care provision at a top level. For example, a high number of people requesting care may indicate a need for additional resources or services, while a low number of people receiving care may suggest a gap in service provision. Understanding these metrics can help identify areas where additional support may be needed.
MW was diagnosed with Functional Chronic Pain, she cannot walk without support, she holds on to her furniture to move around the house. She uses a wheelchair, especially when she goes out, with support from friends and family. She lives on second floor with 5 flights because of the way the building is designed and there is no lift. She never goes out because of the difficulties she experiences with the stairs. She needs help with cooking, cleaning, shopping and showering. She relies on friends and her mum who has knee replacement.
She was referred by the Social Prescriber who referred her onto also referred her to Croydon Adult Support, they told her they are short of staff to allocate her a social worker, so she was placed on a long waiting list. MW case still hadn’t progressed until the Social Prescriber, who had been recently trained on the Care Act, referred her to Access Social Care’s free legal Chatbot letter clinic.
The legal clinic volunteer completed a letter to Croydon Council with MW within a week which was sent to Adult Social Services. Access Social Care then called her after two weeks to complete a follow up survey. MW informed them that she had had an assessment and was waiting to hear back from Croydon following the panel meeting. Social Services has now done the assessment after which the panel offered MW 9 hours of social care support.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
This plot shows the types of care provided to working-age people in Tower Hamlets. Understanding the types of care available can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving personal care may indicate a need for more support with daily living activities, while a high number of people receiving respite care may suggest a need for additional support for carers.
ASCFR and SALT Data Tables 2023-24 Sheet T34
The age-standardised share of residents who report a disability is 20.1 per cent. The England mean is 17.6 per cent. This suggests that disability is more common in Tower Hamlets than in many other areas. One likely reason is the high level of deprivation. The borough sits in decile 4 on average, while England sits in decile 6, and poorer places often see higher rates of long-term health problems. The very dense urban setting may also play a part, because air quality, overcrowded housing and a fast-growing population can all add to health risks.
In 2024, 3,830 working-age adults asked the council for social care. This equals 1,165 requests for every 100,000 residents, a little above the national rate of 1,143. A higher request rate fits the larger disabled population, yet the gap is small. This may mean that information about services is fairly easy to find, or that informal family support still meets part of the need.
Looking at the type of advice sought in 2025 gives more detail. Tower Hamlets records 2.43 cases per 100,000 for assessment help, above the England rate of 1.72. Requests linked to charging also stand a touch above average. People may need extra guidance because many households have low incomes and must check what they will pay before accepting support.
The council supports 1,865 adults aged 18–64. This is 568 per 100,000 people, again above the national mean of 533. Demand is therefore turning into real service use, not simply staying on waiting lists.
The pattern of support is telling. Only 25 adults are in nursing beds and 185 in residential homes. Both figures sit below the national rate. By contrast, community-based support is strong. Direct payment with a council-managed personal budget reaches 348 per 100,000, one-third higher than the England figure. Part direct payments are also a little higher. These numbers point to a clear policy choice: help people live at home rather than in institutions. Limited land for new care homes and high housing costs may encourage this approach. Personal budgets also give residents more say in how help is arranged, which can be vital in a diverse, younger borough.
Population rose from 305,000 in 2019 to almost 329,000 in 2023, and is still climbing fast. If the disability share stays at 20 per cent, absolute numbers will rise each year. A dense borough with no rural buffer has little spare space for new buildings, so community care will remain central. Extra attention to home adaptations, local therapy teams and assistive technology is therefore important.
Money pressures are clear: more queries about charging hint at anxiety over fees. Keeping the direct payment system simple and fair, and offering clear advice, should help prevent unmet need. Finally, higher deprivation means that early health prevention, good housing and steady work all matter if the council hopes to slow the flow of new care requests.
✨ ✅ ❌Older People
Just like with Working Age people, knowing how many older people are requesting social care, how many people are recieving care and what percent of the population is 65+ helps understand need and social care provision at a top level.
Jamaican female, blind and in her 40s. She was in an emergency Bed & Breakfast with her Niece, who acts as her unofficial carer, she is unable to work but would like to go to University. She is receiving PIP but not the Daily Living Allowance which she applied for in June 2021. She is vulnerable and has a history of self harm so was assigned a rehab Support Worker. Vanessa supported her using the Chatbot to chase up her PIP Daily Living allowance application, after waiting for several months and they received a reply within a week but was awarded the lower rate.
Another Chatbot letter was sent to request an urgent assessment due to her vulnerability and this was action quickly by the LA. Vanessa also supported her to use the chatbot and ask the Social worker to be moved to a place that supports her needs and rights. As she was having to use a shared bathroom, toilet and kitchen in a place with drug/alcohol abusers and being blind with no carer, this left her vulnerable. The Chatbot was used again to raise this issue and after a few weeks she was successfully moved to a private property in another area.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
As above, it is important to see what type of care older people are being provided because it can help explain where additional work is needed.
ASCFR and SALT Data Tables 2023-24 Sheet T34
From 2019 to 2023 the share of residents aged 65 plus in Tower Hamlets rose gently from 5.6 per cent to 5.8 per cent. The England average stayed close to 18 per cent, so the borough still holds only about one-third of the national proportion of older people. The increase of 0.21 points, set against a 2023 population of 328,600, means roughly 1,700 extra older residents in five years. Services therefore deal with a small base but should expect steady growth.
In 2024 the council recorded 2,820 requests for care from people aged 65 plus. This equals 858 requests per 100,000 residents, far below the England rate of 2,438. Low demand may reflect strong family support, high levels of informal care in multi-generational homes, or barriers such as language, digital access, and awareness of rights in a diverse population.
Only 1,980 older residents received long-term services. The rate of 603 per 100,000 is about 40 per cent lower than the national figure of 1,003. Each traditional setting is used less than elsewhere: nursing home placements (43 vs 122 per 100,000) and residential care (84 vs 250) both run at roughly one-third of the England norm. Community support arranged and paid for by the council is almost absent (3 vs 137), while “direct payment only” support matches the national pattern (56 vs 55). This points to a local leaning towards personal budgets and family-managed care, but may also hint at gaps in the commissioned provider market.
A 2025 snapshot shows very small numbers of older residents asking for specific help. Requests about assessments came to 2.4 per 100,000, a little higher than the England mean of 1.7; other categories sit at or below national levels. The tiny volumes underline the limited scale of direct contact between older people and adult social care.
Tower Hamlets is the most densely populated council area in England (15,703 residents per km²) and remains highly deprived (mean decile 3.7 vs 5.9). Such factors usually drive higher need, yet observed demand from older adults is modest. The main reason is demographic: the borough is young. As today’s middle-aged residents grow older, deprivation-linked ill-health could push demand upwards faster than past trends suggest.
The current window of lower demand offers a chance to build a preventative, neighbourhood-based model. Strong outreach, clear information, and culturally sensitive support can reveal hidden need now and soften future pressure. Because space is scarce and land costs are high, expanding residential capacity later will be hard; early planning for extra-care housing, home-care workforce and trusted personal assistant schemes is advisable. A one-percentage-point rise in the older population would roughly double today’s caseload, so regular monitoring and flexible commissioning will be key.
✨ ✅ ❌When government support falls short, unpaid carers step in to provide care. However, many struggle with burnout, financial pressure, lack of social contact, and a lack of support. This section explores the number of unpaid carers, their increasing workload, and what forms of support are available.
Carers play a vital role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. The percentage of carers receiving direct payments highlights financial empowerment, the number of carers accessing services reflects local authority outreach, and the number turning to charities underscores unmet needs. Together, these data points reveal systemic strengths and weaknesses: low direct payment uptake may push carers toward charities, while effective services can reduce dependence on charitable support. Understanding these metrics enables targeted interventions to ensure carers receive the recognition and resources they deserve.
Unpaid carers play a crucial role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. Understanding the number of unpaid carers in a local authority can be complicated. On the one hand, a relatively high proportion might be indicative of not enough being done by the local authority, and/or a strong community. On the other hand, a relatively lower number can mean good service provision, lower need, lower availability to look after family, or a problem with reporting.
Still, understanding the number of unpaid carers is a baseline number that must be considered.
NOMIS NM_2213_1
These values are widely considered to be an underestimate. See this report from Carers UK for more information.
August 2021 - Patient with dementia who lives in a shared lives setting. Carer had been requesting respite from the council since September 2020. Croydon Social Prescriber helped with a referral to the local authority in March 2021. Assessment conducted, with the promise they would come back with support, which did not happen. 25 August, social prescriber used the chatbot to find the right legal wording for the situation. The email was sent at 4.52pm that day. At 5.12pm the council contacted the carer to discuss the respite. This was the impact of one letter, addressed to a senior team.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
Social contact is important for carers’ well-being, as it can help reduce feelings of isolation and loneliness. Understanding the level of social contact that carers have can help local authorities identify areas where additional support and resources may be needed. For example, a low level of social contact may indicate a need for more social activities or support groups for carers, while a high level of social contact may suggest that carers have a strong support network.
Survey of Adult Carers in England (SACE) - question 11
The type of support available to carers can vary significantly, impacting their ability to provide care effectively. Understanding the types of support available can help identify areas where additional resources may be needed. For example, a high number of carers receiving respite care may indicate a need for more support with caregiving responsibilities, while a low number of carers receiving financial support may suggest a need for additional financial assistance.
ASCFR/SALT Sheet T47
Access to information is crucial for carers to navigate the social care system effectively. Understanding how easy it is for carers to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of carers finding it difficult to get information may indicate a need for improved communication and support services, while a low number of carers finding it difficult to get information may suggest that existing services are effective.
Would you like social care information? Try our Chatbot!
Survey of Adult Carers in England (SACE) - question 17
Note: these values are a work in progress… expect these numbers to go up
Access Social Care and other Helplines help people with information, advice, and support related to social care. Understanding the types of calls received by carers can highlight areas where additional support and resources may be needed. For example, a high number of calls related to financial support may indicate a need for more financial assistance for carers, while a high number of calls related to respite care may suggest a need for additional support with caregiving responsibilities.
It is important to note that, just as in the previous section, low numbers of requests might indicate that people don’t know where to get help, don’t feel they can get (or deserve) help, or other outreach problems. This is particularly important because we often work with people where the role of a carer is not recognised, or where the carer themselves does not recognise their role.
Access Social Care casework, AccessAva data, and helpline partner submissions
In 2021 Tower Hamlets had about 18,600 people who said they gave unpaid care. This is roughly 5,932 carers for every 100,000 residents. The England average was far higher, at just over 8,200 per 100,000. A lower rate fits with the borough’s very young age profile and fast population growth; there are fewer older residents who usually need long-term care. It may also show that some carers are not coming forward, perhaps because of language, cultural factors or the high share of recent migrants.
Thirty-seven out of every hundred carers in the 2024 survey said they had as much social contact as they wanted. Nationally only 29 in a hundred felt this way. Dense housing, good public transport and strong family networks in Tower Hamlets may make it easier to stay in touch with friends and relatives. However, 58 % said it was easy to find information about services, slightly below the 59 % national figure. The small gap suggests information channels work for many carers, yet the borough still lags behind the average, perhaps because of language diversity or digital exclusion.
Formal support patterns are unusual. Only about 61 direct payments were made per 100,000 residents in 2024, around 200 actual payments when the borough’s size is considered. England as a whole issued almost 150 per 100,000. Respite provided through services to the cared-for person was also scarce, at 15 per 100,000 (about 50 instances) against a national figure of 70. By contrast, Tower Hamlets recorded 533 cases of information, advice or signposting per 100,000 people, roughly 1,750 contacts – over half again the national rate. This points to a model that stresses advice and universal offers rather than individual cash or break packages. The number of carers receiving no direct support (145 per 100,000) sits slightly above the England mean, suggesting some unmet need.
The borough’s population rose by 8 % between 2019 and 2023 and is now about 329,000. With 15,700 residents per square kilometre it is England’s most crowded local authority. It is also highly deprived: the average neighbourhood sits in deprivation decile 4 on a scale where 10 is least deprived. Crowding and low income can increase stress for carers and limit living space for the cared-for person, even if community contact feels good.
The low recorded number of carers suggests that identification remains a priority, especially as the population ages and more residents develop long-term conditions. High take-up of advice shows that carers are willing to seek help, but the borough may need to balance this with greater practical relief such as direct payments and respite. Improving access to information in community languages and through trusted local groups could raise the proportion of carers who find services easy to navigate. Given high deprivation, any expansion should target households with low income and little living space, where caring is likely to be most intense.
✨ ✅ ❌Care providers are essential for delivering social care services, including home care agencies and care homes. The quality of care they provide can vary significantly, impacting the well-being of service users. This section examines the number and types of care providers, their quality ratings, and some of the difficulties of maintaining high standards. Understanding these metrics is crucial for ensuring that vulnerable individuals receive high-quality care.
The number and types of care providers in a local authority can impact the availability and quality of social care services. Understanding the distribution of care providers directly influences people’s ability to get the care they need.
The Care Quality Commission (CQC) rates care providers based on their quality of care, safety, and effectiveness. Understanding the quality ratings of care providers can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers with low ratings may indicate a need for improved training and support, while a high number of care providers with high ratings may suggest that existing services are effective.
Framework rates are the agreed prices that local authorities pay care providers for social care services, such as home care and residential care. These rates are crucial because they determine the affordability, availability, and quality of care in a city. If rates are too low, providers may struggle to sustain services, leading to workforce shortages, poor care quality, and limited access for those relying on council-funded care.
Understanding framework rates helps assess whether local authorities are adequately funding social care, ensuring fair pay for care workers, and maintaining a sustainable care market that meets residents’ needs.
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Several providers are finding it increasingly difficult to stay in business, and sometimes several providers collapse at once. For example, when pay rises are approved without consultation and effective immediately, providers may not be able to afford to pay their staff. This can cause a chain-effect which leads to collapse in the market, and a lack of care for those who need it.
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Workforce turnover rate is a measure of the number of staff leaving a care provider over a specific period. High turnover rates can indicate issues with staff retention, such as low pay, poor working conditions, or lack of training and support. Understanding workforce turnover rates can help local authorities identify areas where additional support and resources may be needed to improve staff retention and ensure high-quality care services.
NOTE: This data series is based on regional data
Staff retention is crucial for maintaining high-quality care services. Understanding the challenges faced by care providers in retaining staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to retain staff may indicate a need for improved training and support, while a low number of care providers facing retention challenges may suggest that existing services are effective.
This dataset describes the results of a survey asking care providers about their challenges in retaining staff.
NOTE: This data series is based on regional data
Workforce_survey_data_tables, Tab 6_2
Vacancy rate is a measure of the number of unfilled positions within a care provider over a specific period. High vacancy rates can indicate issues with staff recruitment, such as low pay, poor working conditions, or lack of training and support. Understanding vacancy rates can help local authorities identify areas where additional support and resources may be needed to improve staff recruitment and ensure high-quality care services.
Recruiting staff is essential for maintaining high-quality care services, and for backfilling staff when they leave. Understanding the challenges faced by care providers in recruiting staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to recruit staff may indicate a need for improved training and support, or can point to a systemic problem, such as low pay, poor working conditions, or not enough people interested in this job type.
Staff recruitment is important as it’s one of the areas that have levers to pull outside of social care, for example, by changing how many visas are awarded to social care workers.
NOTE: This data series is based on regional data
Workforce_survey_data_tables, Tab 6_2
Tower Hamlets has 44 community-based adult social care services and just 10 residential homes. With a mid-2023 population of around 329,000, this works out at roughly 13 community services and 3 residential homes for every 100,000 residents. Nationally, councils report an average of about 64 community services and 91 residential homes in total, so the local market is small both in absolute numbers and on a per-capita basis. Land prices and very high population density – 15,700 people per square kilometre compared with an England average of 2,469 – almost certainly limit space for care homes and may encourage a stronger focus on support delivered in people’s own homes.
The borough is also one of the most deprived in England (mean deprivation decile 3.7 versus 5.9 nationally), a factor usually linked to higher care needs. A small pool of providers serving a large, deprived, and rapidly growing population (up 8% since 2019) raises the risk of unmet or delayed care, and may push residents to look outside the borough for residential placements.
The Care Quality Commission judges 13% of Tower Hamlets providers as “requires improvement” or “inadequate”, lower than the England figure of 17%. While one in eight services still needs to improve, the borough’s inspection record is above average despite the challenging operating environment. A relatively young population profile may ease pressure on older-people’s services and allow managers to focus on quality; however, continued population growth means that demand is likely to rise.
Workforce data, available for the wider London region, shows a turnover rate of 19.0%, almost identical to the national rate of 19.0%. Vacancy rates are lower than average at 6.4% compared with 8.4%, suggesting that providers are currently filling posts more successfully than peers elsewhere. Even so, two-thirds of services describe recruitment as “more” or “much more” challenging, though this is still below the England figure of 79.8%. Retention is also viewed as less difficult (56.0% versus 68.1%). In a borough where housing and commuting costs are high, these relatively positive figures hint at effective local employment practices or strong community ties that help keep staff.
In short, Tower Hamlets delivers generally good-quality care with a workforce that is no more fragile than the national picture, yet it does so with far fewer providers. The low supply, coupled with high deprivation, could mean that some residents wait longer for support, face longer journeys to residential care, or rely heavily on unpaid carers. The council may wish to:
• encourage new community providers that can operate in high-density settings, for example through shared-service hubs in housing developments;
• work with neighbouring boroughs to secure residential places while exploring vertical or small-footprint care home models locally;
• continue to invest in workforce retention, as stable staffing appears to underpin the borough’s favourable quality profile.
Maintaining current quality levels while expanding capacity will be key if Tower Hamlets is to meet the needs of its growing, and often disadvantaged, population.
✨ ✅ ❌Historically, hospital delays have been due in large part, to the inability to discharge patients into social care. We no longer have DTOC data, but we can still look at the number of hospital delays and the number of facilities requiring improvement.
CQC, as the regulator of health and social care services in England, is beginning to rate Local Authorities on their social care provision. Understanding the CQC rating of a local authority should be used as the most official evaluation of service care provision. For example, a low rating may indicate a need for improved service delivery, while a high rating may suggest that existing services are effective.
Hospital delays can have a significant impact on patient care and outcomes, and are in large part the result of not having invested sufficiently in social care. Understanding the number of hospital delays in a local authority can be a sympthom of a poorly working social care sector. For example, a high number of hospital delays may indicate a need for improved discharge planning and coordination, not enough places to discharge people to, lack of sufficient staff to assess patients, or a lack of care providers.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
This metric illustrates how long patients are delayed in hospital before being discharged. Higher average delays mean that patients are spending more time in hospital than necessary, which can lead to increased costs, reduced bed availability, and poorer patient outcomes. This also means that the beds are not available for people that might desperately need them for life-saving procedures.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
Delayed Transfer of Care (DTOC) refers to the time between a patient being declared medically fit for discharge and actually leaving the hospital. Understanding the number of DTOCs in a local authority can help identify precisely where the social care system is failing.
Unfortunately, this dataset is no longer being generated.
Reablement is a short-term service that helps people regain independence and confidence after a period of illness or injury. Understanding the number of people receiving reablement services can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving reablement services may indicate a need for more support with daily living activities, while a low number of people receiving reablement services may suggest that existing services are effective.
Coming soon!
Service user satisfaction is a key indicator of the quality of social care services. Understanding service user satisfaction can help local authorities identify areas where additional support and resources may be needed. For example, a low level of service user satisfaction may indicate a need for improved service delivery, while a high level of service user satisfaction may suggest that existing services are effective.
It is important to note that the people surveyed are already receiving service care. Notably absent are all the people that are not yet lucky enough to be receiving care.
Personal Social Services Adult Social Care Survey, question 1
Access to information is crucial for people using social care services to navigate the system effectively. Understanding how easy it is for people to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people finding it difficult to get information may indicate a need for improved communication and support services, while a low number of people finding it difficult to get information may suggest that existing services are effective.
Would you like social care information? Try our Chatbot!
Personal Social Services Adult Social Care Survey, question 13
An ombudsman is a person who has been appointed to look into complaints about companies and organisations. The number of cases received and decided by the Ombudsman is important because it provides insight into the volume of complaints about a local authority’s social care services and how effectively these complaints are being addressed. The number of cases received indicates the level of dissatisfaction or systemic issues within a council’s care provision, while the number of cases decided shows how efficiently the Ombudsman is processing and resolving complaints. A large gap between the two may suggest delays in complaint handling, leaving individuals waiting.
It is important to note that contacting the Ombudsman is widely considered a last resort, often discouraged, and sometimes penalised.
Tower Hamlets has grown fast, from about 305,000 residents in 2019 to almost 329,000 in 2023, an 8 per cent rise that is more than three times the national rate. With 15,700 people per square kilometre it is one of the most crowded parts of England. It is also highly deprived: its average Index of Multiple Deprivation decile is 3.7, well below the England mean of 5.9. These factors tend to raise demand for health and social care and can make service delivery harder.
The council reports that 99.3 per cent of people leaving local hospitals are discharged to an “acceptable” service or setting. The England average is 89 per cent, so good practice is evident. Only 4.5 per cent of discharges are delayed, compared with 12.3 per cent nationally, and the average wait is 0.32 days rather than 0.7 days. Quick and safe discharge matters in a borough where beds turn over rapidly and many residents live in small homes that make long stays undesirable. The figures suggest strong joint working between the council, NHS trusts and community providers, despite heavy pressure from a young, mobile population.
Even with efficient discharge, people’s views of ongoing support are mixed. In the Adult Social Care Survey, 63.4 per cent of respondents said they were satisfied with their care, a little below the national figure of 64.7 per cent. A different study by NatCen found 57 per cent were dissatisfied, hinting that feelings may vary by question wording or by subgroup. One likely factor is deprivation; financial stress can make users focus on gaps in provision, even when clinical processes work well. Language diversity and short tenancies may also make continuity of care harder and reduce satisfaction.
Two-thirds (67.2 per cent) of service users felt it was easy to find information, just under the England rate of 68.2 per cent. In an area with many recent migrants this small gap could still represent a real barrier, especially for people with limited English or digital skills. Improving simple, multi-language advice at key contact points may lift both satisfaction and outcomes.
The Local Government and Social Care Ombudsman received 7.6 complaints per 100,000 residents in 2024, equal to roughly 25 cases. The England mean is 4.5 per 100,000. Decisions issued were 4.6 per 100,000 (about 15 cases) versus a national 4.1. A higher complaint rate is not always negative; it can mean residents know how to challenge decisions and expect good standards. Still, the council should review themes from upheld cases and feed them into quality improvement plans.
Tower Hamlets performs very well on the technical aspects of discharge, an area where delays would quickly block high-turnover hospitals. However, user experience and complaint rates show that efficient processes alone do not guarantee people feel well supported. Rapid population growth, dense housing and high deprivation increase complexity and may widen gaps in communication or personalised care.
Maintaining strong operational performance while investing in clearer information, culturally competent support and systematic learning from complaints will be key to raising satisfaction and reducing perceived shortfalls. Given the borough’s young demographic, early action now should help contain future demand and support sustainable quality improvement.
✨ ✅ ❌We need to understand how much money is being spent on social care, and what this provides. First, let’s look at values reported by local authorities.
Gross Current Expenditure (2023-24) captures the total operational cost of services, indicating overall demand and financial commitment. This includes spending on residential and non-residential care, direct payments, and other social care services. Understanding gross expenditure helps assess the scale of social care provision and financial pressures on local authorities.
ASCFR/SALT Sheet T3
This figure reflects the net cost of social care provision to the local authority, indicating the extent of financial support required to meet service demands. Understanding net expenditure helps assess the financial sustainability of social care services and the commitment level of the local authority.
ASCFR/SALT Sheet T3
Client Contributions, otherwise known as “Charging”, show the extent to which service users offset costs. Understanding client contributions helps assess the financial burden on individuals and the local authority, highlighting the need for fair and equitable funding mechanisms.
It is important to note that not all local authorities charge for social care services, and that charging can be a barrier to accessing care for some individuals.
ASCFR/SALT Sheet T3
Income from NHS reflects external funding and collaboration with the health sector. Understanding NHS contributions helps understand the level of integration between health and social care.
ASCFR/SALT Sheet T3
Budget Cuts indicate financial constraints and potential service reductions. Sometimes, budget cuts are explicit, but other times, they aren’t mentioned directly, making tracking this information difficult to access.
As such, this data is not consistently available for all local authorities.
Access Social Care have made a series of Freedom of Information requests about the government’s own assessment of sufficiency of social care funding. The social care sector is in crisis, yet the government refuses to disclose how it determines funding sufficiency. Without transparency, there is little accountability, no independent scrutiny to improve decision-making, and government trust heavily impacted. Evidence from across the sector indicates a severe funding gap, but without open data, meaningful reform remains impossible. True solutions require honesty about the scale of the problem to then work towards a fair and equitable funding model.
The government appears to know how much money is required for social care, and yet they are not making that known.
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Tower Hamlets spends about £151 million on adult social care. This equals £46,129 for every 100,000 residents. The national figure is a little higher at £47,758. While the gross spend is slightly below average, the borough’s net spend is £43,502 per 100,000 people, which sits above the national £40,472. In other words, once outside money is removed, the council itself is putting in more than the typical authority.
Client contributions add only £2,627 per 100,000 residents, or roughly £8.6 million in total. Nationally the sum is almost three times larger. NHS contributions stand at £5,294 per 100,000 people, around £17.4 million, again well below the England rate of £7,878. Together, client and NHS funds cover just 17 percent of gross spending, compared with about 31 percent across England. The council therefore carries 83 percent of the bill.
Two linked factors are population make-up and poverty. Tower Hamlets is the most densely packed place in England, with over 15,700 residents per square kilometre. The population has grown by 8 percent since 2019, far faster than the national trend. More people means more requests for help, yet the cash for each person has not kept pace.
Deprivation is high: the mean deprivation decile is 3.7 against an England score of 5.9. Many adults therefore pass the means test and pay little or nothing towards their own care, which fits the low client contribution figure. High deprivation is also linked to poorer health, so need may be greater even though the borough has a younger age profile than most areas.
The low NHS contribution suggests joint working with the local health service is not pulling in as much money as elsewhere. Dense urban settings can favour rapid home-care visits, but they also force up wage and property costs, making care more expensive to provide and harder to staff. If NHS funds do not rise, the council must either find extra money or reduce what is offered.
Demand is likely to grow as the population keeps climbing. At the same time, outside income streams—clients and the NHS—are weak. The council’s higher net spend shows commitment, yet it may struggle to maintain this level if budgets tighten. Strengthening pooled budgets with the NHS and promoting charging policies that remain fair but reflect ability to pay could ease pressure.
Preventive work is also vital. Investing in community support that delays or avoids formal care could limit future costs. Given high deprivation, measures that tackle housing quality, employment, and early health problems may bring particular benefit.
In short, Tower Hamlets spends slightly less than average overall, but it pays more from its own pocket. With fast population growth, dense living conditions, and widespread poverty, a funding gap could open unless fresh external money or new ways of working can be found.
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