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

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

 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:

More Key Messages …. Dementia  Dementia Strategy being developed  5 key areas: oTreatment and managing behaviour oDiagnosis and patient pathways oImproving general service response to dementia oRight and dignity and personalisation oHealth 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

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

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

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

The changing shape of Scotland’s population

Headline Projections: %38% %144% Current numbers of service users – 90,000 by ,000 (25%)

Financial pressures: More of the same results in %(£1.1 billion) %(£3.4 million) At the same time … %-14% reduction in public expenditure

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?

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

Demographic change for population aged 65+ Scotland Potential impact on specialist care services hrs Home care 10+ hrs Home care Care Home Cont h/care (hosp) Projection 26% 94% P Knight Scottish Government

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

The Reshaping Care for Older People Programme  Govt/NHS/COSLA initiative  8 workstreams oVision and engagement oDemographics and funding oCare at home oOut of home care oHealthy ageing oPlanning for ageing communities oComplex care/care pathways oWorkforce  Public launch and extensive engagement programme – March- Summer

Current service provision by service type

Current service provision by age group % 88% 60%

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

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