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