England's care home capacity gap will nearly double by 2043
A CareHomeGuide analysis combining live bed capacity data with ONS population projections shows the shortfall in care home provision relative to the ageing population is set to widen sharply over the next two decades.
England has roughly 306 care home beds for every 1,000 people aged 85 and over today. If the number of beds does not grow, that figure falls to 186 per 1,000 by 2043, a relative decline of 39%, as the population aged 85+ grows by 65% over the same period.
This builds on an earlier CareHomeGuide finding that bed capacity relative to the 85+ population already fell by 18% between 2011 and 2025. The gap is not stabilising. On current projections, it more than doubles.
The headline numbers
- 459,604 registered care home beds in England today, across 14,572 open homes (CareHomeGuide database, August 2026)
- 1,501,095 people aged 85+ in England in 2025, rising to 2,473,292 by 2043 (ONS 2022-based subnational population projections, migration category variant)
- 306.2 beds per 1,000 people aged 85+ in 2025
- 185.8 beds per 1,000 people aged 85+ in 2043, if bed numbers stay flat
- To hold today's ratio, England would need roughly 298,000 additional beds by 2043, nearly two-thirds more capacity than exists now
England care home beds per 1,000 people aged 85+, 2025-2043
Two different problems, not one
Splitting the national figure by local authority shows two distinct patterns, and they are not the same places.
Fastest-growing demand is concentrated in rural and suburban districts: Milton Keynes (+113% by 2043), South Derbyshire (+102%), Uttlesford (+97%), West Oxfordshire (+93%), Northumberland (+92%). These are areas where the 85+ population is set to more than double, often from a smaller existing base.
Thinnest current supply is concentrated in inner London and a scatter of other boroughs: Haringey, Kensington and Chelsea, Hackney, Westminster and Camden all have fewer than 160 beds per 1,000 people aged 85+ today, against a national figure of 306.
This is not coincidence. London's care home land costs make the large single-storey buildings the sector typically needs harder to site, while London's population itself skews younger than surrounding counties, in part because many people move out to Kent, Sussex, Hampshire and similar areas on or before retirement.
Over the same period, England's population aged 85+ grew by 25.8%, from 1.19 million to 1.5 million, while total bed capacity rose by just 7.2%, from 452,048 to 484,703, as of the most recent archive snapshot (July 2026).
A council in the first group faces a capacity crunch it may not yet be planning for. A council in the second group is already short and will fall further behind. Neither problem is solved by the other.
Fastest-growing 85+ population by 2043
By contrast, some of the best-provided areas today are former industrial and seaside towns: Middlesbrough (564 beds per 1,000), Leicester (474), Stoke-on-Trent (459), Blackpool (437). These areas still see the same direction of travel, a decline of 30-44%, just from a stronger starting position.
Fewest beds per 1,000 aged 85+ today
Methodology
Bed count: Total registered beds across all currently open care homes in the CareHomeGuide database (care_homes table, England only), queried 10 August 2026. 14,387 of 14,572 open homes (98.7%) have a recorded bed count; the remainder are treated as zero, so the true total capacity is marginally understated. Care homes are matched by CQC location ID; closed or re-registered homes are excluded.
Population data: ONS Subnational Population Projections, 2022-based, migration category variant, on 2023 local authority geographies. Published 24 June 2025. ONS now recommend the migration category variant as the principal variant for England. This dataset was affected by a correction issued the same day it was released: an earlier, non-final version had been published in error and was replaced. The methodology below uses the corrected file. The 2011 comparison figure uses ONS mid-year population estimates for England (single year of age, mid-2011), a separate, actuals-based dataset rather than a projection.
Age band: Single years of age 85 to 89 plus the 90-and-over band, summed, for each local authority.
Geography: 296 local authority areas at district, unitary, London borough or metropolitan borough level. Where CareHomeGuide records beds at county level (for example Kent, Essex, Hampshire), the underlying district-level ONS projections were aggregated to match, using ONS's own Local Authority District to County (April 2023) lookup. This covered 153 of 153 local authority values in the CareHomeGuide database and captured 99.9% of total registered beds.
- This is a flat-supply scenario, not a forecast. It shows what happens if bed numbers do not change, not a prediction that they won't.
- The Greater London Authority has raised concerns about the reliability of the 2022-based subnational projections at local authority level, particularly once broken down by age, noting differences from past trends of several thousand residents in some boroughs. This analysis includes London but flags the caveat.
- A small number of local authority-level figures in the underlying CareHomeGuide dataset appear anomalous (very low home or bed counts relative to known population) and likely reflect address-matching gaps rather than genuine local shortfalls. These have been excluded from the "worst provided for" ranking pending verification.
- Bed capacity is a proxy for care availability, not a direct measure of quality, staffing, or actual accessible vacancy.
About this data
CareHomeGuide is an independent directory covering every CQC-rated care home in England. This analysis draws on a historical CQC archive of 393,163 records spanning 2011 to 2026, combined with ONS demographic data. The full council-level dataset is available on request.
Published by CareHomeGuide.uk, the independent directory of CQC-rated care homes in England. Free to use and cite with attribution.