The Gathering 23 February 2011
Mike Martin
Partnership Improvement and Outcomes
Division
Doing it right – getting it wrong!!!
WHY we need to ‘Reshape’ Care:
 Sustainability – Rapidly ageing population
– Declining public finances
 Desirability – Promoting independence not dependence
PAUSE FOR THOUGHT:
More of the same will cost an extra £1.1 billion
by 2016 – where will this come from?
Over 1/3 of all money spent on health/social
care for over 65’s is on emergency hospital
admission [£1.4 billion out of £4.5 billion each
year]
89.5% of people over 65 yrs are not in the ‘care
system’ [97% of people between 65-74 yrs]
3,000 people 65 yrs+ receive more than 20hrs
paid care per week
40,000 people 65 years+ provide more than
20hrs unpaid care per week
How do we spend the £4.5 billion …
Other Social Work
Care Homes
£0.2bn
Emergency admissions
£0.6bn
£1.4bn
Home Care
£0.3bn
FHS
£0.4bn
£0.4bn
£0.4bn
£0.8bn
Other Hospital care
Prescribing
Community
Current service provision by service type
People aged 65 and over
hospital est
care home
home care
all others
Current service provision by age group
65-74
75-84
85+
97%
88%
60%
The challenge of change – more HOW
than WHAT?
WHAT:
A new philosophy of care – partnership and coproduction
A shift of focus – enablement, empowerment,
responsibility
A shift of resources – from institution to
community
A conducive infrastructure to promote rather
than prevent integration
HOW
 Build an enduring consensus for the long haul
 Clarity of ambition – what will success look like?
 A decommissioning strategy – will impact on the acute
sector
 A commissioning strategy – coherent service redesign
and development
 Mutually reinforcing national and local strategies
 Building Community Capacity – the ‘spine’ for reshaping care
HOW – THE CHANGE FUND
£70 million for 2011/12 [circa £300 million over
4 yrs]
Subject to Change Plans – developed/agreed
by Council/Health Board/3rd sector/Independent
Sector
To invest in community based provision –
preventative and anticipatory
To impact on Core Budgets to promote decommissioning
To promote effective partnership working
Reshaping Care for Older People – A
Programme for Change 2011-2021
 Publish on 4 March 2011
 Our commitments:

Double proportion of spend on care at home – from 6.7% to
13.5%

Build capacity of community/3rd sector to support/grow
“supported self care”

Change Fund introduced - £300m over 4 yrs

Reduce unnecessary variation – potential to take out 11% of
hospital beds

Reduce bed days for 75+ due to emergency admissions by
10% by 2015

No discharge direct from hospital to care home

All over 75+ to be offered a telecare package based on
assessed need
OVERVIEW: COMMUNITY CAPACITY
AND CO-PRODUCTION
WORKSTREAM
CONTEXT
> DEMOGRAPHY/ECONOMY
> RESHAPING CARE FOR OLDER PEOPLE
> WORKSTREAMS
> CHANGE FUND
> OPPORTUNITIES/CHALLENGES
COMMUNITY CAPACITY AND CO-PRODUCTION
WORKSTREAM (1)
> Values the capacity, skills, knowledge
connections and potential in a
community…sees citizens and
communities as co-producers of health
and well being (and) instead of doing
things for people shares power and helps
a community to do things for itself’
(Improvement and Development Agency, 2010)
COMMUNITY CAPACITY AND CO-PRODUCTION
WORKSTREAM (2)
> Older People are an asset not a burden
> Community capacity building is working with the
voluntary and community sectors to build a
philosophy of care based on co-production
principles and to develop new community driven
models of care provision.
> A partnership between those providing care and
support and those providing it.
COMMUNITY CAPACITY AND CO-PRODUCTION
WORKSTREAM (3)
> Success has as much to do with shifting
attitudes and expectations as it has about
shifting resources, care institutions,
providers and workforces.
> Change Fund/ Change Plan –
Opportunity and Challenge!
OUR ROLE
>
>
>
>
>
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General Support for Partnerships
Developing the Knowledge and Evidence base
Building Networks and Communities of Practice
Sharing Good Practice
Signposting/Developing Guidance
Link to Scottish Government
Contact Details
Scottish Government leads for Community Capacity Building
& Co-production
> Gerry Power
gerry.power@scotland.gsi.gov.uk
0131 244 2374
> Andrew Jackson
andrew.jackson@scotland.gsi.gov.uk
0131 244 5424
Co-production
> Delivering public services in an equal and
reciprocal relationship between professionals,
people using services, their families and their
neighbours. Where activities are co-produced in
this way, both services and neighbourhoods
become far more effective agents of change.
National Endowment for
Science, Technology & the Arts (NESTA)
& New Economics Foundation (NEF)