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Imperatives for Change: Shaping the Future of Care

Imperatives for Change: Shaping the Future of Care. Mike Martin - JIT. The changing shape of Scotland’s population. Some headline projections. Scotland’s 65+ population projected to rise by 21% between 2006 - 2016 By 2031 it will have risen by 62%

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Imperatives for Change: Shaping the Future of Care

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  1. Imperatives for Change: Shaping the Future of Care Mike Martin - JIT

  2. The changing shape of Scotland’s population

  3. Some headline projections • 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%

  4. Where to start? Hospital admission

  5. HEAT

  6. 84% 61% 41% 24% 9% Calendar year ’07 estimate P Knight Scottish Government

  7. And in the community at large…

  8. 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

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

  10. Extracts From: Re-shaping Care for Older People Joint Leadership Summit 19th May 2009 Colin Mair, Chief Executive Improvement Service

  11. Finance & Demand 2009/10 – 2013/14 (% terms)

  12. Budget & Demand Changes (Real Terms) 2009/10 – 2013/14

  13. The Treasury Forecasts • Assumes more than trend rate of economic growth by 2012/13 • We will borrow at least £712 billion across next 5 years (we borrowed in total £500 billion across the last 350 years) • We have not come out of any previous recession (1970’s, 1980’s, 1990’s) in this way • 1.5 million unemployed still assumed

  14. Longer Term (13/14 – 17/18) • Structural gap in public finance opening up – 6.3% national income by 2017/ 18 • Tax rises & spending cuts (25/75 balance) will claw back 50%, remainder to be identified – “2 Parliaments of pain” • If 25/ 75 balance maintained spending will rise 1% real terms per annum maximum across next 20 years

  15. Facing the Challenges - An Outcomes Focus…………..

  16. 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

  17. Growing old- • Not an illness; a state of being • Should we shift our focus?

  18. Current service provision by service type

  19. Current service provision by age group 65-74 75-84 85+ 97% 88% 60%

  20. Some further Considerations • Tenure implications – an equity stake • ‘Young until your dead’ – self image • Economically active • Politically active and influential • Best healthy life expetancy prospects • Pension provision • Older people provide far more care than they receive

  21. Reshaping Care for older people programme Sorry we’re too busy just now

  22. Reshaping Care for older people ….. • Into the Spotlight Conference (Dec 08) • Lord Sutherland Review of Free Personal and Nursing Care (Dec 08) • Ministerial Strategic Group (Dec 08-March 09) • Joint Leadership Summit (May 09) • Engagement from Nov

  23. Reshaping Care for Older People … 8 workstreams • Vision and engagement • Care at home – a mutual care • Care homes • Care pathways • Planning for ageing communities • Workforce • Healthy life expectancy • Demographics and funding

  24. 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 – what’s stopping the spread?

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