National Home Care Council – 4 February 2010

Mike Martin, Director JIT

Key messages from the MinisterReshaping Care for Older PeopleThe future shape of care at home support

Home care at the heart of good community care

Huge impact on ‘quality of life’Gone through change … more change ahead

Key messages from the Minister:

More Key Messages ….Dementia Dementia Strategy being developed 5 key areas:

o Treatment and managing behaviouro Diagnosis and patient pathwayso Improving general service response to dementiao Right and dignity and personalisationo Health improvement, public attitudes and stigma

Been subject to extensive consultation – and more consultation during March/April

Overall aims – early diagnosis– person centred– support to stay at home

More key messages …

End of Life Care at home

‘Living and Dying Well’ – Scotland’s first national action plan

Achievements to date o Delivery plans in each NHS Board areao Engagement with key stakeholderso Improved visibility and focus

Working group looking at Care at Home and Care Homes

Final key messages ….

Joined up strategies and deliveryBig challenges ahead – and we are well

placed to meet themCollaboration between statutory sector,

service users/carers/patients/providers and workforce

Reshaping Care for Older People:

Imperatives: Demographic shifts

Financial pressures

Policy goals

Sustainability

The changing shape of Scotland’s population

Headline Projections:

65+ 85+

2006-2016 +21% 38%

2006-2031 +62% 144%

Current numbers of service users – 90,000

by 2016 + 23,000 (25%)

Financial pressures:

More of the same results in 2016 +22% (£1.1 billion)

2031 +74% (£3.4 million)

At the same time ….

2016 -10%-14% reduction in public expenditure

Policy goals -

“To optimise independence and wellbeing at home or in a homely setting”

How well do current services help meet this agreed policy goal?

Health and social care expenditure Scottish population aged 65+ (2007/08 total=£4.5bn)

Other Social Work

Care Homes

Home Care

FHS

PrescribingCommunity

Other Hospital care

Emergency admissions

£1.4bn

£0.8bn£0.4bn

£0.4bn

£0.4bn

£0.3bn

£0.6bn£0.2bn

Demographic change for population aged 65+ Scotland Potential impact on specialist care services 2007-2031

0

40000

80000

120000

160000

200000

Actual2007

2011 2016 2021 2026 2031

N of

peo

ple

1-9 hrsHome care

10+ hrsHome care

Care Home

Cont h/care (hosp)

Projection

26%

94%

P Knight Scottish Government

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

The Reshaping Care for Older People Programme

Govt/NHS/COSLA initiative 8 workstreams

o Vision and engagemento Demographics and fundingo Care at homeo Out of home careo Healthy ageingo Planning for ageing communitieso Complex care/care pathwayso Workforce

Public launch and extensive engagement programme – March-Summer

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%

Emerging Proposals: The Headlines

Reinforce and restate the policy goals Reshaping attitudes and expectations Honesty about resources Explicit about a focus on outcomes Older people – asset not burden Supported Self Care Community Capacity Building Integrated/Person centred approaches More/better complex care at home/excellent care pathways Shifting resources to follow the person Action to secure healthy “added” years Supporting the workforce, unpaid carers and volunteers

Emerging ProposalsCare at Home Better integration Re-ablement focus Expand and integrate telehealthcare Good assessment, planning and review [Talking Points] Support unpaid carers Support volunteers More complex care at home Better crisis care at home