The Joint Strategi c Plan for Older People

1. The Joint Strategic Plan for Older People An overview

2. What the Plan is seeking to achieve • Setting out the context, challenges and opportunities for the next 3-5 years • An agreed vision and direction of travel for PYF and beyond • A vehicle for promoting discussion and developing actions across the partnership in order to respond to the needs of older people in the short, medium and long term

3. Some Context • Older people – significant net contributors society and the economy • Including tax payments, spending power, caring responsibilities and volunteering effort they contribute around £40bn more than they receive in state pensions, welfare and health services • Older people are considerable assets

4. Some more context • Rise in longevity brings increases in complex and chronic health conditions • 75% of over 75s will have a long term condition – and this will increase further by 2030 • Demands on health and care systems increase each year in this age group – at the same time available funding is decreasing • We have to think, and act, differently

5. Main challenges • Decreasing levels of public funding • A significant growth in people aged 85 + years • An increase in those living alone and those with complex needs • Increasing workforce challenges • Ruralityof our region • No known, single solution – muti-faceted, complex transformation

6. Main challenges cont’d “The challenge is now not later” In the short term, there will need to be additional resourcing of traditional services to deal with demand and cost pressures.

7. Main challenges cont’d “We must continue to meet the needs of the most vulnerable” In particular those with more complex needs such as dementia and those presenting with challenging behaviours. Particular Challenges in Social Care: • + 13% (115) Care Home beds by 2016 - more than current vacancies - at a cost of £2.9m; +85% (759) by 2031 at a cost of £19.2m • + 15% Care at Home hours by 2016 at a cost of £2.7m; + 74% by 2031 at a cost of £13.3m • Workforce – already use 40% of low paid workforce in the region for care. This will be 50% by 2016 and 101% by 2031.

8. Main challenges cont’d So, “More of the same won’t work” We need to consider alternatives to traditional services such as: • Accommodation with care solutions • Intermediate or “step up step down” care

9. Working towards a sustainable response “We must focus on maintaining people’s independence” • A clear and sustained commitment to re-ablement • Assessing a person’s needs on a regular basis “We must continue to prioritise support for Carers” • Maintaining the caring relationship is a top priority “We all need to adopt a more flexible approach to support” • A personalised approach to support has to be the norm • Community and family supports have a key role • Developing communities to provide practical supports is crucial

10. Working towards a sustainable response cont’d “We need to invest in our workforce” In the short term: • We need additional resources to attract and develop the workforce and respond to cost pressures In the longer-term: • A co-ordinated approach to workforce development

11. Working towards a sustainable response cont’d “We must make the best use of all our resources” • We have already achieved considerable efficiencies. Compared with the Scottish average we have: • Average levels of emergency admission • Very low delayed discharge rates • 30% more care at home than the rest of Scotland • Lower use of care homes • The solution does not lie just with health and social care

12. Working towards a sustainable response cont’d “We must invest in the health and well-being of older people and Carers” We need to support better outcomes for those who will enter the 85+ age group in 5, 10, 15 and 20 years time by: • Providing incentives and opportunities to adopt and maintain healthy lifestyles • Ensuring a greater focus on older people in services which support active ageing and maintaining social networks

13. Working towards a sustainable response cont’d “We must look to the future” This includes: • Making better use of new technologies • Better co-ordination of responses to individuals “We must test new ways of working” • There is no ready made “blueprint” for how we should respond, we need to test alternatives at a more rapid pace.

14. Key priorities for action • Continuing to improve the quality of services, keeping people safe and embedding personalised and person-centred approaches into practice. • Redesigning services within cottage hospitals including increasing bed occupancy and reducing length of stay. • Commencing discussions with care home providers about existing and future care home capacity.

15. Key priorities for action cont’d • Working with Registered Social Landlords (RSLs) to identify opportunities for service redesign of sheltered housing in some locations across the region to provide extra care housing. • Identifying opportunities to develop a range of intermediate “step up step down” care options which could also provide staff to provide outreach into the community for care at home services. • Increasing the range of accommodation options, optimising opportunities for older people to access the full range of equipment and adaptations and increasing the use of technology.

16. Key priorities for action cont’d • Further developing rapid response services and more flexible care at home services which can support GPs to manage an increasing number of people in their own homes and avoid unnecessary admissions to hospital. • Promoting a consistent approach to re-ablement amongst all providers through training and following this up with regular reviews of people’s needs. • Evaluating the “hub” model of integrated working and looking at how this may be extended across the region.

17. Key priorities for action cont’d • Improving the Carer experience by providing increased support and more flexible respite and also supporting Carers when their caring role comes to an end. • Ensuring staff across the partnership have the confidence, competence, skills and shared technology to support Forward Looking Care. • Developing self-supporting communities through making best use of existing assets, including people and developing more opportunities that allow older people to remain engaged with their communities.

18. Key priorities for action cont’d • Taking a co-ordinated approach to securing and developing a well-motivated and appropriately skilled workforce that can respond flexibly to the needs of the older population. •  Taking forward health and social care integration including breaking down technological barriers to joint working and improving data collection and data sharing.

19. PYF workstreams We must ensure thatthe programme: • Take forward the key priorities identified • Take an integrated and consistent approach to balancing: • The requirements of the Acute Services Redevelopment Project – reduced emergency admissions and reduced length of stay • Challenges in social care capacity – particularly in relation to the workforce • Securing sufficient resources for the future health and well-being of older people

20. Keeping Relevant It will be essential that the Joint Strategic Plan is updated on an annual basis to take account of: • Health and social care integration developments • A more detailed Integrated Resource Framework • New data set against baseline data to inform progress and identify new and emerging challenges

21. Questions to take away • What are the key messages from the JSP in in your context / role? • What are the key actions you could take forward from the challenges set? • How will you ensure a focus on this in future work?