What are the ONS 2022-based projections?

They are the Office for National Statistics' official subnational population projections, which model how each local authority's population by age is expected to change over the coming decades from a 2022 base. They are the standard reference for long-range care demand planning.

What is the flip in a care market?

It is when an area that looks adequately supplied with care beds today becomes short within 15 to 20 years, purely because its over-85 population grows while bed numbers stay flat. A balanced market on today's data can be a clear shortage against 2043 demand.

Should I plan a care scheme against today's demand or future demand?

Both, but the horizon matters because a care home is a multi-decade asset. A scheme that only just works against today's 85-plus population can look very different, better or worse, once you apply the area's own projected growth to 2043.

Ageing population projections and care demand to 2043

Threshold Guides · 9 min read · England & Wales

A care home you fund and build in the late 2020s will still be trading in the 2050s. That is why the single most important number in a care appraisal is not today's bed gap but the trajectory of demand, and why the Office for National Statistics (ONS) 2043 projection horizon deserves your attention. A market that looks comfortably supplied now can be materially short within the life of your first mortgage.

What the ONS projections actually say

The ONS 2022-based subnational population projections model how each local authority's population, by single year of age, is expected to change over the coming decades. For care developers the band that matters is the population aged 85 and over, because that is where care-home demand concentrates.

Across England, the ONS projects that the 85-and-over population will grow by roughly 65%, from about 1.47 million in 2025 to around 2.42 million by 2043. That is not a gentle drift. It is close to a doubling within a single generation, and it lands on a care estate already running at about 32.5 registered beds per 100 people in that age band. Because the people who will be 85 in the early 2040s are largely those aged 65 to 84 today, this is one of the most locked-in trends in UK demography.

The maths of standing still

Hold bed numbers flat while the denominator grows by 65% and the supply ratio collapses. An area that sits exactly on the national rate today, and never adds a bed, drifts well below it as its residents age. Simply to stand still against the national benchmark, England needs a very large number of additional beds by 2043, and that is before allowing for the beds lost as older, weaker homes close.

Illustrative worked example. Take a catchment with 3,000 residents aged 85 and over today. At the national rate of 32.5 beds per 100, it supports about 975 beds. If that population grows by the national 65%, it reaches roughly 4,950 people aged 85 and over, which at the same rate implies about 1,609 beds. So even a catchment that is perfectly supplied today faces an implied shortfall of more than 600 beds by 2043 if nothing new is built. (Figures illustrative, using the ONS growth rate and the national bed rate only.)

The flip: balanced today, short tomorrow

The most valuable opportunities are rarely the areas that are visibly undersupplied now, because everyone can see those. They are the areas that look balanced today but age quickly. Call it the flip: a catchment sitting on or above the national bed rate this year, whose own projected 85-plus growth pushes it into clear shortage within 15 to 20 years.

These places are easy to miss with a snapshot and obvious with a projection. A site that only just fails to stack against today's demand can look compelling once you apply the local growth rate, and the reverse is also true: a strong-looking area with flat demographics may be a market to hold rather than chase.

National growth hides local extremes

The 65% figure is an England average, and averages conceal the spread. Growth in the 85-plus band varies widely between local authorities: some coastal, suburban and exurban areas are projected to grow far faster, while a few urban areas grow more slowly. Because care catchments are local, the number that matters is your area's own projected growth, not the national one. Two neighbouring authorities can face very different futures, so a regional average is no substitute for pulling the specific local projection for the catchment you are appraising.

This is exactly the cut you can browse in the Threshold care data pages, where every English local authority carries its current bed rate alongside its projected 85-plus change to 2043, so you can see which balanced-looking markets are about to flip.

Planning a scheme against future demand

Designing to today's gap alone risks building a home that is full on opening and undersized a decade later. Practical ways to plan against the trajectory:

Model both years: run the demand and bed-gap calculation at the current population and at the 2043 projection, and judge the scheme against both.
Weight higher-acuity provision: the fastest-growing need is among the oldest and frailest, which favours nursing and dementia-registered beds over basic residential.
Check the closure pipeline: weak-rated and older stock is likely to leave the market, so effective future supply is lower than today's raw bed count implies.
Size for the decade, not the day: a scheme that looks slightly ambitious against current demand may be correctly sized against the demand it will actually operate into.
Revisit the catchment: as local demand deepens, even a tighter catchment may support the scheme, which strengthens rather than stretches the case at appraisal.

Projections are a guide, not a promise

Population projections are among the more reliable long-range forecasts, because most of the people who will be 85 in 2043 are already alive and countable today. They are still estimates. Migration, mortality improvements and policy can move them, and a projection of population is not a projection of occupancy: it tells you how many people will be in the age band, not how many will choose or be funded to enter a care home. Treat the trajectory as a strong planning signal, checked against local knowledge, rather than a guarantee.

Used that way, the 2043 horizon turns an appraisal from a photograph into a forecast. See how the demand picture converts into money in the guide to occupancy, fees and revenue, or run any specific site now with Threshold Care.

Frequently asked questions

What are the ONS 2022-based projections?: They are the Office for National Statistics' official subnational population projections, which model how each local authority's population by age is expected to change over the coming decades from a 2022 base. They are the standard reference for long-range care demand planning.
How fast is the over-85 population growing?: The ONS projects England's population aged 85 and over to grow by roughly 65%, from about 1.47 million in 2025 to around 2.42 million by 2043. Growth is uneven, and many areas are projected to grow well above the national rate.
What is the flip in a care market?: It is when an area that looks adequately supplied with care beds today becomes short within 15 to 20 years, purely because its over-85 population grows while bed numbers stay flat. A balanced market on today's data can be a clear shortage against 2043 demand.
Should I plan a care scheme against today's demand or future demand?: Both, but the horizon matters because a care home is a multi-decade asset. A scheme that only just works against today's 85-plus population can look very different, better or worse, once you apply the area's own projected growth to 2043.

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Care figures are statistical estimates from official open data (CQC HSCA Active Locations, ONS population and 2022-based subnational projections) under the Open Government Licence. England coverage. Not investment or valuation advice.