Scottish Government
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Bill to improve care for ageing population

Caring for our older people at home will be vital to ease the pressure on Scotland’s health and social care services, Health Secretary Alex Neil said yesterday.

Mr Neil was speaking as a new bill designed to ensure that the health and social care systems work together effectively to improve the provision of care in our communities was published.

Recent figures show the proportion of people in Scotland who are aged over 75 will rise by 80 per cent by 2035 and the 2011 census shows us that, for the first time, there are more people in Scotland aged over 65 than there are under 15.

The new Bill will help Scotland cope with these increasing pressures by reducing unnecessary delays that keep older people in hospital longer than needed and increasing the amount of care that can be provided at home.

Health Secretary Alex Neil said: “People in Scotland are living longer, healthier lives – which is good news. But it also means that services need to adapt in order to meet the challenges of a rapidly ageing population.

“That means providing greater levels of care can be provided at home or in a homely setting and ensuring that our older people are not stuck in hospital longer than they need to be.

“The publication of this bill is a major step forward in public service reform, and integrating NHS and local authority budgets will help to reduce these delays.

“Bringing health and social care together in this way improve care for people in communities,  helping to anticipate their needs and reaching them before they need to be admitted to hospital or institutional care.

“Local integrated arrangements between Health Boards and Councils will be able to shape services to best meet the care needs of their local populations.

“This will improve the quality and consistency of care for older people and people with complex care needs.”

The joined up approach is already working well in some areas of Scotland.

The ‘Hospital at Home’ initiative, which has enabled 80 per cent of patients to stay in their home rather than being admitted to hospital, was initially piloted by North Lanarkshire Partnership.

It has been so successful that it is to be adapted for use across Scotland, with NHS boards and their local authority partners trialling similar models.

In Highland a ground breaking Partnership Agreement was signed in March 2012 to successfully establish a lead agency model in Highland.

This involved 1400 Council staff and £89 million transferring to NHS Highland, and 200 NHS staff and £8 million moving to the Council.

This means adult health and social care services are managed though a single budget and a single management system.

Frances Gair (District Manager) in Inverness who transferred across to NHS Highland in April 2012 said: “There been real commitment from all of the staff to make sure we organise our services around our patients and clients. To do this we must all work together. We are beginning to take positive steps and the integrated service is really  taking shape.

“We can see improvements on some of our performance measures but I feel the real success is that we are changing the culture.  What I am seeing is really close working, better communications, reduced duplication and a much more supportive environment for everyone.  All of this is leading to better and more flexible use of resources enabling more people to access services quicker.

Stirling Council and NHS Forth Valley have implemented a reablement service, which provides support to help people to live independently in their own homes, and has seen a 30 per cent reduction in the number of older people in care homes since 2009.

A discharge hub has been established in Hairmyres Hospital to reduce the delays experienced by people who required additional services before they can be discharged home.

It brings together a multidisciplinary and multi-agency team to assess support needs for patients and carers, and arrange for faster and more streamlined discharge.

Since being established it has seen an average reduction of around 20 patients per day who would previously have been in Hairmyres Hospital pending access to home care.

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