Review of Long-Term Care scheme

WQ.193/2026

WRITTEN QUESTION TO THE MINISTER FOR SOCIAL SECURITY BY DEPUTY S.J. GLEAVE OF ST. HELIER SOUTH

QUESTION SUBMITTED ON MONDAY 5th OCTOBER 2026 ANSWER TO BE TABLED ON MONDAY 12th OCTOBER 2026

Question

"In relation to the 2026 review of the Long-Term Care scheme cited in the Proposed Budget 2027–2030, will the Minister provide a copy of the review, along with its terms of reference, methodology, supporting evidence and modelling, and –

1. provide any available quantified breakdown of actual and forecast expenditure growth since 2022 between claimant numbers, care needs, duration of support and care prices, distinguishing provider fees from scheme benefit rates;
2. provide the analysis of any causes of residential and home-care price inflation, including staffing and agency costs, property costs, regulation, profit margins, competition, market capacity and any benchmarking;
3. explain  how  the  2024  LaingBuisson  review  informed  the  review,  including  which recommendations were implemented and what savings resulted;
4. identify any matters in (b) and (c) which were not examined, or for which evidence was unavailable, and explain why; and
5. advise any measures considered to address underlying care costs without reducing eligibility or care quality, including for any such measure considered –

1. estimated savings and implementation timetables;
2. how any review of such measures distinguished genuine cost reductions from costs transferred to claimants; and
3. whether these measures informed the contribution increase in the Proposed Budget 2027– 2030

Answer

The 2026 report into the review of the Long-Term Care Scheme (LTC) will be published in due course.

The LTC scheme is designed to support claimants to help meet their assessed care needs. The 2026 Budget, published in September 2025, identified the need for a 1 percentage point increase to the LTC contribution rate from 2027 to maintain the stability of the LTC fund following an increase in overall demand and a higher proportion of higher care need packages. The previous Minister for Social Security initiated a review of the scheme to ensure that incoming Ministers in 2026 would have detailed information available when considering the proposed increase in contribution rates. A separate actuarial review of the Fund is in progress and is expected to be published in early 2027.

(a)

The 2026 review confirmed that benefit expenditure growth within the LTC scheme is being driven by a combination of more claimants and increasing care needs. Administrative data from 2023 to 2025 showed growth across home-care levels, with a marked increase in level 4 home-care packages from early 2025, and continuing growth in level 4 care-home placements. The Employment, Social Security and Housing Department (ESSH) does not maintain records of provider fees. Provider fees are set in an open market which includes charity and parish providers as well as commercial providers. Where the total fees charged by the provider exceed the scheme's standard benefit rates, the claimant is responsible for meeting the difference.

(b)

The LTC scheme works within the overall care market and is not designed to control prices within the market. As such, the review did not include any analysis of care fees.

(c)

The 2024 LaingBuisson review was an independently prepared review designed to support the introduction of standard hourly and other benefit rates for home care services, with the aim of improving equity in the LTC scheme. Standard hourly benefit rates have now been incorporated into the LTC scheme. The 2024 review was a separate exercise and is not directly connected to the 2026 review

(d)

The matters listed in part (b) and (c) did not form part of the 2026 review as stated above.

(e)

ESSH and Heal th and Care Jersey continue to work together to support improvements in the delivery of care and the assessment of care needs. These improvements will take time to develop and deliver and the proposed contribution increases in the 2027 Budget reflect the need to protect the Fund's short/medium- term sustainability while these longer-term measures are developed.