James Lloyd articles
Attendance allowance (AA) is a weekly cash payment to older people with disabilities by the Department for Work and Pensions, worth between £59 and £73. It is a contribution to the extra costs of living with a disability and rarely, if ever, receives any discussion in policy debate. This is odd given the scale of the AA – it is paid to around 1.5 million older people in the UK at a cost of around £5bn each year.
To bolster the evidence base on AA and explore how we can make better use of it, the Strategic Society Centre and Independent Age recently published some new research and policy analysis. Analysing data from the government-funded English Longitudinal Study of Ageing, we found that most people receiving AA are female and aged over 80. The most common difficulties with activities of daily living experienced by recipients are dressing (including putting on socks and shoes) and bathing or showering. Over half are unable to do work around the home and more than 40% have difficulty shopping for groceries. Unsurprisingly, informal care from a family member is the most common source of support to AA recipients, including from a son or daughter (36.1%) and a partner (29.8%).
A notable feature of AA recipients is very low levels of private pension income, compared with the general population of those aged 65 and over. The median private pension income of AA recipients is less than £25 per week, and one quarter also receive means-tested pension credit.
The most striking feature of those receiving the benefit is how few receive local authority support. On our estimates, there are around a million people in England receiving AA but not receiving council-funded care. This raises interesting policy questions around how best to support this “missing million” who are not systematically targeted with information, advice and the other types of support that the forthcoming care bill envisions for the local authority care system. In our work, we identified strong potential in three distinct approaches.
First, by digitising the rich, comprehensive data that the Department for Work and Pensions gathers on AA recipients, the government could share this data with councils, clinical commissioning groups and health and wellbeing boards to build a far better picture of need and support in local populations, and plan and target services accordingly.
Second, ensure all new claimants are systematically offered information and advice following an application regardless of whether an award is made. As most recipients live on very low incomes they need to get the most from every pound they have available, even if that just means checking every six months to see if there is a cheaper taxi service available. There’s no real reason why government and local partners shouldn’t ensure that all 1.3 million AA recipients in England have recourse to a personalised information and advice service via the telephone.
Third, support “independence-behaviours”, approaches that allow people to live independently at home for longer. One of the great virtues of AA is that it is an unrestricted cash payment – the original “direct payment” – and it therefore enables people to work out the best ways of achieving the outcomes they want in their life. But this doesn’t mean there is not a role for informing recipients of how others spend the money, and encouraging individuals to review the ways in which they adapt their lives.
Ultimately, this is an opportunity to re-launch attendance allowance – built around the principle of “Make every contact count” – so that the system becomes more focused on the outcomes recipients achieve in their lives, in addition to attempting to ensure older people with a disability are not living in poverty. That is why we named our report Independence Allowance.
25th June 2013