New report July 2026
Social care should enable people to live safely, independently and with dignity. However, people’s experiences of care are not equal.
Where someone lives, their financial circumstances, health condition, ethnicity, age, gender and access to informal support can all influence the support they receive.
Experiences are also shaped by how services are organised, how easy the system is to understand, and how much time, confidence and support people have to navigate it.
This report presents a rare, in-depth qualitative study of how people drawing on care and support, and unpaid carers, experience inequities in social care in England. Commissioned by SCIE and conducted by Thinks Insight & Strategy, it builds on SCIE’s wider work on care equity, including the Care Equity Evidence Hub.
Its distinctive contribution is to show how different forms of inequity interact and accumulate across people’s care journeys, shaping access to support, experiences of care, and people’s sense of choice and control.
Previous work to understand and address inequity rightly considers population groups, deprivation and protected characteristics.
However, this research suggests there is a further dimension that deserves greater attention: how different forms of disadvantage and exclusion can interact and compound, creating barriers that are often not visible through quantitative data, population profiling or traditional approaches to understanding need.
Unclear information, long waits, fragmented services, changing professionals and the repeated need to explain or prove needs can compound across a person’s care journey. For some people, this contributes to exhaustion, reduced trust and withdrawal from support altogether.
The findings show why lived experience is essential to understanding and addressing care inequity.
What this research adds
Existing evidence identifies care inequities linked to factors such as geography, income, ethnicity, disability, age, gender, health condition and digital access. While these factors are often examined separately, this research shows how they interact and accumulate across people’s care journeys.
It suggests that care equity is not only about whether services are available or whether someone meets eligibility criteria. It is also about whether people can find, understand, shape and sustain support without being worn down by the process.
Participants identified six priorities for a more equitable care system:
- a named point of contact to help people navigate services
- greater continuity and consistency of carers
- clearer and more proactive information about support and entitlements
- more consistent provision across different areas
- better pay, training and support for the workforce
- greater use of trusted community organisations and culturally appropriate services.
Together, these changes could reduce the work placed on people and unpaid carers, while improving dignity, trust, choice and control.
About the research
The study used a multi-phase qualitative approach involving 50 people drawing on care and support and unpaid carers across Westminster, Dudley, North Tyneside and Wiltshire.
Participants reflected a range of care needs, backgrounds, financial circumstances and experiences of formal and informal support. The research was exploratory rather than representative, providing detailed insight into how different inequities are experienced and interact in people’s lives.
Co-producing the research
Members of SCIE’s Co-production Steering Group and wider co-production network helped shape the research throughout.
People with lived experience contributed to the research design, interpretation of findings, recommendations and final report. This helped ensure the research remained grounded in the experiences of people drawing on care and support, and unpaid carers.
Explore more about care equity
This research builds on SCIE’s Care Equity Evidence Hub, which brings together evidence about inequities in access to, experiences of and outcomes from care and support.
Work with us
SCIE works with partners across health and social care to improve equity in practice. For more information about this research or SCIE’s work on care equity, contact insights@scie.org.uk.