1. Imperatives for Change: Shaping the Future of Care Mike Martin - JIT

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. Where to start? Hospital admission

5. HEAT

6. 9% 24% 41% 61% 84% Calendar year ’07 estimate P Knight Scottish Government

7. And in the community at large…

8. 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

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

11. Extracts From: Re-shaping Care for Older People Joint Leadership Summit 19 th May 2009 Colin Mair, Chief Executive Improvement Service

12. Finance & Demand 2009/10 – 2013/14 (% terms)

13. Budget & Demand Changes (Real Terms) 2009/10 – 2013/14

14. 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

15. 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

16. Facing the Challenges - An Outcomes Focus…………..

17. 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

18. Growing old- >Not an illness; a state of being >Should we shift our focus?

19. Current service provision by service type

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

21. 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

22. Sorry we’re too busy just now Reshaping Care for older people programme

23. 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) > Engagementfrom Nov

24. 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

25. 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?