£300m Change Fund failing to reshape care

 HEALTH funds need to move from hospitals to communities much faster if Scotland is to stave off the rising cost of care for older people, Audit Scotland has said.

Continuing to plough in billions of pounds into hospitals and care homes is unsustainable according to a new report from the financial watchdog.

The cost of caring for Scotland’s aging population will increase from £4.5 billion to £8bn by 2031 if radical changes are not introduced much faster.

A review of the first three years of the Scottish Government’s ten-year Reshaping Care for Older People (RCOP) plan has found that the £300m Change Fund is not enough to shift health funding from expensive treatments in hospitals to community services.

By 2035, a quarter of Scotland’s population will be aged 65 or over, up from 17% in 2010.  Politicians believe moving funding  to preventative health services that help people live independently at home for longer is the only way to ensure the public purse can cope with rising health costs.                   

However, emergency hospital admissions for over 65s cost the NHS £1.4bn in 2011/12, a third of all cash spent on care for older people. At the same time just £439m was spent on community healthcare and £395m on homecare, according to Audit Scotland.

Older people’s charity Age Scotland said there is an urgent need for change.

Brian Sloan, chief executive, said: “We have an ageing population, and that is to be celebrated. It is a challenge we can rise to, but it requires a fundamental shift in how we deliver health and social care.

“Most importantly, we need greater national and local leadership to drive through this change with more urgency.

“This has to start with a proper monitoring system so we know precisely how money is being spent around the country and what is working and what isn’t. Without this we’ll continue to see the patchy, slow progress which Audit Scotland has highlighted.”

Audit Scotland found while the Change Fund has brought together the NHS, councils and the third sector it has created only small-scale initiatives.

Making up just 1.5% of all spending on older people, Change Fund initiatives are not always monitored and it is not clear how successful projects will be developed or expanded, the report said.

Auditor general for Scotland Caroline Gardner said: “Reshaping the care Scotland’s older people receive is crucial to helping people live long, healthy and independent lives, and to making sure services can provide the care and support needed.

“The Scottish Government is three years into the 10-year programme. Our report makes recommendations aimed at helping accelerate change, particularly given the growing pressure on services and the integration of health and social care.

“In particular, we want to see better information for making decisions and assessing impact, and the government and its partners to be clearer about how to move resources from institutions, like hospitals, to community-based services.”

The Scottish Government’s Public Bodies Bill, which is expected to be passed in parliament later this month, aims to require NHS boards and councils to work more closely together in the delivery of care in future.

Third sector bodies, however, have expressed concerns the bill may not encourage enough investment in third-sector run community services.

In response to Audit Scotland’s report, a Scottish Government spokesperson said: “The Scottish Government is absolutely committed to ensuring that our older population get the support they need to stay in their own homes for as long as possible