National Home Care Council – 4 February 2010

1. National Home Care Council – 4 February 2010 Mike Martin, Director JIT

2. Key messages from the Minister • Reshaping Care for Older People • The future shape of care at home support

3. Key messages from the Minister: • Home care at the heart of good community care • Huge impact on ‘quality of life’ • Gone through change … more change ahead

4. More Key Messages …. Dementia • Dementia Strategy being developed • 5 key areas: • Treatment and managing behaviour • Diagnosis and patient pathways • Improving general service response to dementia • Right and dignity and personalisation • 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

5. More key messages … End of Life Care at home • ‘Living and Dying Well’ – Scotland’s first national action plan • Achievements to date • Delivery plans in each NHS Board area • Engagement with key stakeholders • Improved visibility and focus • Working group looking at Care at Home and Care Homes

6. Final key messages …. • Joined up strategies and delivery • Big challenges ahead – and we are well placed to meet them • Collaboration between statutory sector, service users/carers/patients/providers and workforce

7. Reshaping Care for Older People: Imperatives: Demographic shifts Financial pressures Policy goals Sustainability

8. The changing shape of Scotland’s population

9. Headline Projections: Current numbers of service users – 90,000 by 2016 + 23,000 (25%)

10. 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

11. 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?

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

13. 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

14. 84% 61% 41% 24% 9% Calendar year ’07 estimate P Knight Scottish Government

15. The Reshaping Care for Older People Programme • Govt/NHS/COSLA initiative • 8 workstreams • Vision and engagement • Demographics and funding • Care at home • Out of home care • Healthy ageing • Planning for ageing communities • Complex care/care pathways • Workforce • Public launch and extensive engagement programme – March-Summer

16. Current service provision by service type

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

18. 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

19. Emerging Proposals Care 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