Allowing people to tailor the support they receive to suit their needs is the best way to use our limited resources, says Ricky Henderson
Ensuring that the health and wellbeing of Edinburgh’s half a million residents is protected is not a job that we take lightly.
Edinburgh Council’s Health and Social Care department this year has a budget of just over £203 million to deliver support for people with learning and physical disabilities, older people through care homes, day services and home care, emergency social work, support for mental health, help for carers, and drug and alcohol misuse services.
Working closely with agencies such as NHS Lothian and various charities, third sector organisations and communities we aim to improve health, promote prevention and reduce inequalities. Protecting investment in frontline services for young, old and vulnerable residents is also a Capital Coalition priority.
Of course, demographics are changing and this creates added pressures on how and where to spend, and also, to save. We have an ageing population, with around the same number of pensioners as young people.
In fact, the number of people in Edinburgh aged 85 years and over is expected to increase from around 11,017 in 2012 to 20,816 in 2033, an increase of 89 per cent in around 20 years. While the fact that we are living longer is welcome, this presents added challenges, such as an increase in age-related health conditions and greater need for support services.
Across Scotland, around 90,000 older people receive some kind of care, whether in their own home, a care home or long-term hospital care. If we continue delivering care the way we do right now, an extra 23,000 people will need care by 2016.
The growing pressure caused by this demographic shift on resources is coupled with real terms reductions in the funding available to deliver the services and the challenge is to make sure that everyone who needs help and support, in particular the vulnerable, gets what they need.
One way of making sure that resources are targeted effectively is by changing the way in which they are organised and delivered. Instead of doing things to and for people we are focusing on working more closely with people, supporting them to take more control.
These pressures have led us to increase the amount of community-based care on offer. Our health staff are now aiming to equip people with the tools they need to keep them independent in their own homes, with appropriate support and safety, for as long as possible.
Of course, home care is not always appropriate, or an option. We fund places in either Council-run care homes or in private ones but delayed discharge from hospital is an issue that we are trying to address. Plans to replace ageing facilities with new ones and to offer short-term respite care are being worked on as a priority by our health teams.
Communities already play an active role in supporting their more vulnerable members, and working with them will be a key part in developing more personalised services.
Personalisation focuses on supporting people early on and in a way that is right for them, so that they can stay as healthy, happy and independent as possible, for as long as possible.
One of the ways personalisation can be achieved is through self-directed support. The Scottish Government has introduced new legislation, the Social Care (Self-directed support) (Scotland) Act 2013, to give individuals greater choice and control over the support they receive.
Self-directed support gives each individual more control over the money available to meet their agreed care and support needs.
It allows them to make choices about support based on the things that are important to them. The changes are being introduced in Edinburgh at the moment, with staff being trained in how to deliver the service, and many people already choosing to tailor the way that their care is delivered to them.
Another important change to service delivery is going to be through health and social care integration. Council adult social care services are to be integrated with certain NHS services next year to comply with Scottish Government legislation. The creation of what will be called Health and Social Care Partnerships will lead to a more efficient use of resources and, in turn, an improved service for users.
A lot of work is underway behind the scenes to make sure that the recommendations of this legislation are implemented smoothly and in Edinburgh our partnership has been in place in “shadow” form since November 2012.
It’s certainly a challenging task and by working with other organisations and communities, we will continue to make sure that the needs of residents are met.
• Councillor Ricky Henderson is the convener for health, social care and housing at the City of Edinburgh Council, www.edinburgh.gov.uk