Slide 1 Free Personal Care – some recent developments David Bell Alison Bowes University of Stirling April 2008

Slide 2 Community Care and Health (Scotland) Act all personal care charges for people cared for in their own home abolished (and nursing care remains free); for those cared for in residential accommodation and who are funding the cost of their care, a free personal care payment of £145 per week; and for those in a nursing home, delivery of free personal and nursing care payment of £210 per week.

Slide 3 Definition of personal care help with personal hygiene, continence management, assistance with eating and mobility, counselling and support services, assistance with medication and simple treatments and personal assistance such as help getting up and going to bed. CC and H (Scotland) Act 2002

Slide 4 Policy Development Most clients happy with policy –particularly where it allows them to stay at home Some groups feel disadvantaged: –those under 65 –those using community care services not related to personal care (UK phenomenon – focus on high levels of need) Policy has widespread support

Slide 5 How Much Has Been Spent? Expenditure on Free Personal and Nursing Care Expenditure - FPNC in Care Homes £72m £81m £87m £91m Expenditure - FPC at home £93m £121m £140m £168m TOTAL EXPENDITURE - FPNC £165m £202m £227m £260m Scottish Government budget is c £25,000 m Personal care is 10-15% of all monies spent on older peoples LTC, including NHS and DWP monies

Slide 6 Increasing Prop of CH Residents Receiving FPC Older people increasingly likely to own housing assets

Slide 7 Increase in FPC at Home and Squeeze on Non-Personal Care Rapid increase in number receiving FPC at home – now levelling off

Slide 8 Diversity - Proportion of Over 65s Receiving FPC at Home by LA

Slide 9 Increase in Supply of FPC at Home by LA

Slide 10 Variation in Weekly Cost by LA

Slide 11 LA Resourcing Are resources allocated by SG to local authorities sufficient to meet local demand for personal care? Money not ring-fenced within LA budget –latitude for variations in delivery?

Slide 12 Observed Increase in Demand and Costs Is not due to demographic change Is not due to changing healthy life expectancy May be partly attributable to unmet need But also to variations in local authority policies/accounting procedures

Slide 13 Unpaid Care No reduction in numbers providing unpaid care But carers may be doing other things Perhaps supplying other forms of care –Added inducement to supply unpaid care may be LA charging policy on non-personal care

Slide 14 Further Developments Hostility between SE and local authorities Main Issue - Funding –Definition of Personal Care –Waiting Lists –Impact of GOAs? Scottish Government has set up enquiry under Lord Sutherland to examine resourcing issues – report due 28 th April