Home Care Review 25 th March 2009. Care of Older People.
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Transcript of Home Care Review 25 th March 2009. Care of Older People.
Home Care Review
25th March 2009
Care of Older People
The Purpose
Background
• Scotland’s 65+ population projected to rise by 21% between 2006 - 2016
• By 2031 it will have risen by 62%
• For the 85+ age group specifically, a 38% rise is projected for 2016
• And, for 2031, the increase is 144%
Past trend in Emergency Admission Bed Days for people aged 65 and over
2,400,000
2,500,000
2,600,000
2,700,000
2,800,000
2,900,000
1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Financial year
no.o
f bed
days
HEAT
Demographic change for population aged 65+ ScotlandPotential impact on emergency bed numbers 2007-2031
0
2000
4000
6000
8000
10000
12000
14000
16000
Y/E Mar 2007 Projected2011
Projected2016
Projected2021
Projected2026
Projected2031
Year
Be
ds
9%24%
41%
61%
84%
Calendar year ’07 estimate
P Knight Scottish Government
General Practice
Contact rates in general practice
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
4 & under 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 & over All ages
(B) Females - age categories (years)
Co
nta
ct r
ate
per
1,0
00 p
op
ula
tio
n
GP Practice nurse
FEMALE
GP Practicenurse
Longer term care of older people by Health and in Social Care Services
Current service provision by service type
People aged 65 and over
hospital est
care home
home care
all others
Current service provision by age group
75-84
85+
65-74
97%
88%
60%
Preparing for the growingolder population
Ministerial Strategic Group for Health andCommunity Care• Chaired by Minister for Public Health and Sport• Members - 4 NHS Board Chairs and 4 Local Authority Councillors • Support provided by Scottish Govt, COSLA, Tim Davison (NHS
Lanarkshire) and Sue Brace (ADSW)
Delivery Group for Health and Community Care• Chaired by Tim Davison• Membership covers NHS, ADSW, COSLA, local government, Scottish
Government , Care Commission
1. H1 Home Care Survey – overview
2. Uses of survey – Scotland Performs, SOAs
3. The way forward
History
1976 – First home care survey?1998 - Current survey began2003 - reviewed (added FPNC, supporting people
and person level data for SNS)
• Survey takes place last week March each year• Provides information on all services provided
during survey week• Home Care services provided or purchased by
LAs• Published around November each year
Home Care Clients (1976 - 2008)
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008
Year
Chart 1: Home care clients and hours provided, 1998-2008
Chart 4: Proportion of Home Care Clients by Provider, 1998 - 2008
Chart 7: Ratio of people aged 65 and over to people aged under 65 by level of service, 2008
Chart : Clients receiving home care / personal care services
Home Care clients aged 65+
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
2003-04 2004-05 2005-06 2006-07 2007-08
Home Care Clients aged65+
Home Care Clientsreceiving personal care
What currently goes well?
• All 32 LAs return completed survey
• Comparability within LAs – time series data is good
• Survey largely unchanged for 10 years – so good time series
• Comparisons with Audit Scotland SPI
Are there any issues with current data collection?
• Not all LAs can provide data on purchased services (data is estimated)
• ‘Planned’ hours vs ‘actual’ hours
• Morning/afternoon/evening/weekend services – difficult to complete
• Comparability between LAs
• Limited analysis
Outcomes & Indicators
Overview
• National Performance Framework
• Scotland Performs
• Concordat
• Single Outcome Agreements
• Resources for SOAs
National Performance Framework (1)
• The 2007 Spending Review introduced a new National Performance Framework with an overarching national purpose, five strategic objectives, fifteen national outcomes, and forty-five national indicators.
• Moving to an outcomes-focused approach to performance.
• Delivery partners - including local government
National Performance Framework (2)
Our PurposeTo focus government and public services on creating a more
successful country, with opportunities for all of Scotland to flourish, through increasing economic sustainable growth
Scotland Performs
• Scotland Performs tell us how Scotland is doing in our pursuit of our aims. It describes the outcomes we want to achieve and how well Scotland is progressing in key areas: health and wellbeing; justice and communities;
the environment; the economy; and education and skills. • Scotland Performs follows the National Performance
Framework• http://www.scotland.gov.uk/About/scotPerforms
National Indicator
• Increase the percentage of people aged 65 and over with high levels of care needs who are cared for at home
• Clients receiving 10 hours+ home care / (Clients receiving 10 hours+ home care + LA supported long stay care home residents + geriatric long stay hospital patients)
Concordat
• Spending Review agreement
• Partnership working with Local Government
• Statistical collections will remain
• http://www.scotland.gov.uk/Resource/Doc/923/0054147.pdf
Single Outcome Agreements (SOAs)
• Single Outcome Agreement (SOA) for every LA (Community Planning Partnership 2009-)
• SOAs set out local priorities/outcomes, aligned to the fifteen national outcomes.
• The SOA sets out how the Community Planning
Partnership intend to measure progress towards their local outcomes.
Resources for SOAs (1)• In developing SOAs a range of indicator were used from a range of
sources:
– the 45 indicators contained in the National Performance Framework
– Menu of local outcome indicators http://www.improvementservice.org.uk/core-programmes/single-outcome-agreements-/
– Statutory Performance Indicators
– Community Care Outcomes Framework http://www.scotland.gov.uk/Topics/Health/care/JointFuture/CommunityCareOutcomesF
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/Data/CommunityCareOutcomes
– Indicators taken from existing local Community Planning Partnership plans and local authority strategic documents
– council developed local indicators
Resources for SOAs (2)
• Data Sources and Suitability Websections on the SG website www.scotland.gov.uk/statistics
• ScotStat Network of Analysts from LG and Public Bodies local workshops and short-lived working groups http://www.scotland.gov.uk/Topics/Statistics/scotstat/analystsnet
work [email protected]
Current data collections
Home CareServices
Care Homes
Day Care
Housing Support
Free Personal
Care
Self-directed Support
Registered Blind & Partially Sighted
FPNC
Meals / Shopping
Equipment &
adaptations
Telecare
What don’t we collect?
Intermediate Care
Alarms
Day opportunities
Respite
Others?
Needs (IoRN)
Rehab / Enablement
Future
Home CareServices
Meals / Shopping
Telecare
Day Care
Housing Support
Equipment &
adaptationsCare Homes
Self-directed Support
Alarms
Needs (IoRN)
Respite
Priorities
• Better overview of number of people getting services at home and their needs
• 10+ hours – not good proxy – what should replace this?• Only collecting information on home helps at the moment
– lots of other services that ‘make a difference’• Analysis is limited to the tables we currently collect.
Don’t know overall number of people known to Social Work, etc
• The world is changing – data collection needs to adapt.
How can we do this?
1. Move to person-based data collection.– Would allow for more flexible analysis– Would allow us to look at needs as well as variety of services– Could provide us with longitudinal data– Start small and build up each year
2. Set up working group to take forward– Small group– Representation from variety of stakeholders– Make use of IT expertise (Scottish Government and IT suppliers to LAs)– Volunteers?
Contact Details
Julie Rintoul – 0131 244 5366
Ellen Lynch – 0131 244 4093
Email: [email protected]
Address: Health Analytical Services Division,
Basement Rear,
St Andrews House
Edinburgh
EH1 3DG