1. Shaping the future of care of older people in Scotland

2. The changing shape of Scotland’s population

3. 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%

4. 9% 24% 41% 61% 84% Calendar year ’07 estimate P Knight Scottish Government

5. Demographic change for population aged 65+ Scotland Potential impact on specialist care services 2007-2031 1-9 hrs Home care 10+ hrs Home care Care Home Cont h/care (hosp) Projection 26% 94% P Knight Scottish Government

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

8. Current service provision by service type

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

10. What this all means for Scotland …  A new 600 bed hospital every 3 years for 20 years  A new 50 bed care home every 2 weeks for 20 years  £2.8 billion investment in sheltered housing to “stand still”  Virtually all school leavers into the care sector by 2030

11. all this will require by 2016 22% increase in health and social care expenditure [extra £1 billion!] while  8% reduction in public expenditure* [* Institute of Fiscal Studies estimate] it just doesn’t add up!

12. The policy response: Shifting the Balance of Care Old Care Model Geared towards acute conditions Hospital centred Episodic care Disjointed care Reactive care Patient as passive recipient Self care infrequent Carers undervalued Low tech New Care Model Geared towards long-term conditions Embedded in communities Team based Continuous care Integrated care Preventative care Patient as partner Self care encouraged and facilitated Carers supported as partners High tech

13. EXAMPLE:TELECARE & DEMENTIA Wristcare Medication Reminder VideoPhone

14. Reshaping Care of Older People Vision and engagement Demographics and funding Care at home Care homes Planning for ageing communities Healthy life expectancy Workforce Care pathways

15. 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

16. 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?

17. Some emerging ideas ……  Better integrated approaches -across health, housing and social care -across paid, unpaid and volunteer care  More anticipatory and preventative care -support to unpaid carers/volunteers - telehealthcare -“contact and connect” support  Better crisis care - appropriate rapid response -24/7 cover - telehealthcare »

18.  Develop and support volunteer and unpaid care -older people as carers -“back-up” for unpaid carers -? Fiscal incentives (reserved matters)  More complex care at home - integrated approaches across acute, primary and social care -telehealthcare  Focus on re-ablement/outcomes/goals -rehabilitation -support to do not services done to -more personal budgets/Self Directed Support