Post on 30-Dec-2015
description
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%
> For the 85+ age group specifically, a 38% rise is projected for 2016
> And, for 2031, the increase is 144%
Where to start?
Hospital admission
Past trend in Emergency Admission Bed Days for people aged 65 and over
2,400,000
2,500,000
2,600,000
2,700,000
2,800,000
2,900,000
1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07
Financial year
no
.of
bed
day
s
HEAT
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
And in the community at large…
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
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
Projected Health and Social care expenditure for Scottish populatiion aged 65+
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2007/08 Actual 2011 2016 2021 2026 2031
£m
NHS Social Work
22%
74%
Extracts From:
Re-shaping Care for Older People Joint Leadership Summit
19th May 2009
Colin Mair, Chief Executive
Improvement Service
Finance & Demand 2009/10 – 2013/14 (% terms)
0
-2.04
-5.78
-9.18
-12.9
0
-2.04
-3.74
-5.44
-7.14
0
-2.04 -2.04 -2.04 -2.04
0
2
4
6
8
-15
-10
-5
0
5
10
2009/10 2010/11 2011/12 2012/13 2013/14
IFS
CPPR
UKTreasuryDemand
Budget & Demand Changes (Real Terms) 2009/10 – 2013/14
-13
-3.8
8.1
-2
-7
-14.5
-9.5
-4.5
0.5
5.5
Budget % Change Budget Cash Change(£Bn)
Demand Growth (%)
IFS
CPPR
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
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
Facing the Challenges
- An Outcomes Focus…………..
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
Growing old-
> Not an illness; a state of being
> Should we shift our focus?
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%
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
Sorry we’re
too busy just
now
Reshaping Care for older people
programme
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
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
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?