Why is this National Outcome important?
Providing high quality care and support to an ageing population is a fundamental principle of social justice and is an important hallmark of a caring and compassionate society. Collectively we need to give priority to ensuring that older people receive the care, compassion, support and dignity they need and deserve.
This requires us to enhance the role people can play themselves, supported as appropriate to play a fuller part in their own care. We see the importance of giving people as much flexibility as possible in how they manage their care arrangements.
Supporting and caring for older people is not just a health or social work responsibility - we all have a role to play: families, neighbours and communities; providers of services like housing, transport, leisure, community safety, education and arts; and also shops, banks and other commercial enterprises
What will influence this National Outcome?
The simple increase in the number of older people, suggests an increase in need/demand for formal services. Similarly the increase in very old people who tend to have higher care needs, and in the number of people with dementia which is forecast to double by 2031, are further drivers of additional demand for formal care.
Against this we can set more years of healthy life for most people (currently only 10% of all over 65s receive formal continuing health and social care services, though about 40% of all over 85s receive such services).
The reducing ratio of working age people to non-working age people creates a tension in a potentially reducing tax base, relative to expenditure on pensions, and expenditure on health and social care services for an ageing population.
Workforce issues suggest there is likely to be fewer people of working age relative to those who we would expect to be retired; we may also see an increase in the proportion of the workforce engaged in providing publicly funded health and care services.
Social structural changes related to the family; more people living alone, geography; more people living far away from relatives and solidarity; less people actively engaged in mutual support, will all reduce the overall capacity for informal care.
Even success with the current programme of work to maintain people's independence at home or in a homely setting for as long as possible is likely to do no better than slow the requirement for growth in health and social care demand over time.
Increasing public expectation that care and support in old age is the primary responsibility of the state work against the degree to which people are prepared to offer unpaid care to family or others.
Other demographic changes related to family structure may make the context more challenging than the age effect alone; more single people; more people caring for multiple generations; people having to work longer themselves because of changes to work and pensions arrangements.
What is the Government's role?
Scottish Government currently spend approximately £4.5 billion (2008/09) of public funding each year on health and social care for those over 65 years across Scotland. Well over half (60%) of this is spent on providing institutional care in hospitals and care homes with almost one-third spent on emergency admissions to hospital. Less than 7% is spent on home care in spite of our vision that older people should be helped to remain at home or in a homely setting for as long as possible.
Action to shift the balance of care from residential and institutional settings to home and community settings, including work through housing investment to increase availability of appropriate housing.
Reframing activity to promote the idea that older people are an asset and to be valued and engaged as part of civil society through various policy initiatives, media campaigns and age discrimination legislation.
Promoting policies intended to provide better support to those who offer informal care through services such as respite; health checks by GPs for carers; training and support resources.
Changes to who has control over purchasing and commissioning, initially through direct payments and more recently through work on self-directed support.
Significant funding and policy support for the Third Sector as a partner in service delivery and in strategy development.
Approaches which allow for and create a diversity of approach reflecting different needs and capabilities both between individuals and groups and over time, building on the personalisation agenda and approaches such as self-directed support using that as a bridge into personal capability and responsibility and so more than just a different mechanism for resource allocation and management.
Related Strategic Objectives
Healthier
Safer and Stronger
Smarter
Wealthier and Fairer
Greener
Related National Indicators
Improve self-assessed general health
Improve Mental Wellbeing
Reduce premature mortality
Improve end of life care
Improve support for people with care needs
Reduce emergency admissions to hospital
Improve the quality of healthcare experience
Improve people's perceptions about the crime rate in their area
Improve people's perceptions of their neighbourhood