Health and Social Care Integration is needed to address the challenges of demographic change.
What are the pressing issues for Scotland’s future? A debate on independence and failure to qualify for successive World Cups might be the answer from the man on the street. However, the message from our politicians is stark: We need urgent and radical reform to ensure public services work together.
The post war baby boom has left us with a long term issue to solve. Scotland‘s population has grown by 5% since 2001 and is also becoming older. Between 2010 and 2035 the number of people of pensionable age will increase by 26% and those aged 75 and over are projected to increase by 82%.
You just have to look at a graph of Scotland’s age distribution from 100 years ago (http://www.guardian.co.uk/news/datablog/2012/dec/17/census-scotland) and compare it with now (http://www.gro-scotland.gov.uk/files2/stats/high-level-summary/j11198/j1119802.htm) to see how powerful this change has been.
Last month the Finance Committee identified a £3billion funding gap for older people’s services by 2016-17. Whilst older people provide a significant level of unpaid care across Scotland, with less money available and a population increasing in number and age, it is clear that this change presents us with a challenge.
Long term financial planning must become embedded within Scotland’s public sector bodies. The evidence presented to the Committee indicated wide variations in long-term financial planning. Health boards in particular feel constrained by annual funding cycles which limit their ability to plan and result in short-term spending decisions. These funding cycles also discourage partnership working between the respective statutory bodies.
The Finance Committee report has set the context in which we head towards integration of Adult Health and Social Care in Scotland. This policy represents a massive opportunity to establish long-term joint strategic commissioning of services to engender better partnership working, increased preventative spend, more effective allocation of finite resources.
It is of central importance that the third sector is embraced as a full and equal partner in commissioning. The Reshaping Care for Older People (RCOP) agenda has laid the groundwork for genuine partnership working and joint commissioning between the NHS, Local Authorities and the Third Sector. For full health and social care integration to succeed the third sector must now be recognised as an indispensable partner around the commissioning table and must be adequately resourced to participate in the process.
You can read a summary of the Finance Committee’s report on demographic change.
Lorne Berkley is the Policy and Research Officer for the Change Fund: Enhancing the Role of the Third Sector Programme. The Programme is being delivered by an ALLIANCE led partnership to build third sector capacity to secure effective engagement in the RCOP agenda.