Shaping the future of care of older people in Scotland

1
Shaping the future of careof older people in
Scotland
2
The changing shape of Scotlands population
3
Some headline projections

• Scotlands 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

4

Calendar year 07 estimate
P Knight Scottish Government
5
Demographic change for population aged 65
Scotland Potential impact on specialist care
services 2007-2031
94
1-9 hrs Home care
26
10 hrs Home care
Care Home
Cont h/care (hosp)
Projection
P Knight Scottish Government
6
Health and social care expenditure Scottish
population aged 65 (2007/08 total4.5bn)
7
(No Transcript)
8
Current service provision by service type
9
Current service provision by age group
65-74
75-84
97
85
88
60
10
What this all means for Scotland

• A new 600 bed hospital every 3 years for 20 years
• A new 50 bed care home every 2 weeks for 20 years
• 2.8 billion investment in sheltered housing to
  stand still
• Virtually all school leavers into the care sector
  by 2030

11

• all this will require by 2016
• 22 increase in health and social care
  expenditure extra 1 billion!
• while
• 8 reduction in public expenditure
• Institute of Fiscal Studies estimate
• it just doesnt add up!

12
The policy response Shifting the Balance of Care
Old Care Model Geared towards acute conditions Hospital centred Episodic care Disjointed care Reactive care Patient as passive recipient Self care infrequent Carers undervalued Low tech New Care Model Geared towards long-term conditions Embedded in communities Team based Continuous care Integrated care Preventative care Patient as partner Self care encouraged and facilitated Carers supported as partners High tech
13
EXAMPLETELECARE DEMENTIA
Wristcare
VideoPhone
Medication Reminder
14
Reshaping Care of Older People

• Vision and engagement
• Demographics and funding
• Care at home
• Care homes
• Planning for ageing communities
• Healthy life expectancy
• Workforce
• Care pathways

15
An outcomes focus what it means

• Frail and vulnerable people supported to live at
  home
• Control and decisions with the individual
• Strong, caring, supportive communities
• Fairness and equity
• High quality environment
• Contributing to local economy

16
It has to be outcomes

• How well do our services help achieve our policy
  goals?
• How can we help people stay out of the formal
  care system?
• How can we support self care?
• Is it a change of philosophy and approach
  support not services?
• We are doing it now in pockets whats
  stopping the spread?

17
Some emerging ideas

• Better integrated approaches
• - across health, housing and social care
• - across paid, unpaid and volunteer care
• More anticipatory and preventative care
• - support to unpaid carers/volunteers
• - telehealthcare
• - contact and connect support
• Better crisis care
• - appropriate rapid response
• - 24/7 cover
• - telehealthcare

18

• Develop and support volunteer and unpaid care
• - older people as carers
• - back-up for unpaid carers
• - ? Fiscal incentives (reserved matters)
• More complex care at home
• - integrated approaches across acute, primary
  and social care
• - telehealthcare
• Focus on re-ablement/outcomes/goals
• - rehabilitation
• - support to do not services done to
• - more personal budgets/Self Directed Support