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National Home Care Council – 4 February 2010
Mike Martin, Director JIT
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Key messages from the MinisterReshaping Care for Older PeopleThe future shape of care at home support
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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:
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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
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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
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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
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Reshaping Care for Older People:
Imperatives: Demographic shifts
Financial pressures
Policy goals
Sustainability
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The changing shape of Scotland’s population
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Headline Projections:
65+ 85+
2006-2016 +21% 38%
2006-2031 +62% 144%
Current numbers of service users – 90,000
by 2016 + 23,000 (25%)
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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
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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?
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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
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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
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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
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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
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Current service provision by service type
People aged 65 and over
hospital est
care home
home care
all others
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Current service provision by age group
75-84
85+
65-74
97%
88%
60%
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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
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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