Elderly care costs ‘unsustainable’, says watchdog

Caring for older people in Scotland’s hospitals and care homes at a cost of billions of pounds a year is not sustainable as the elderly population continues to grow, a report warns.

Progress in improving care for older people has been slow. Picture: Donald MacLeod

Audit Scotland said the Scottish Government has estimated that spending on health and social care for over-65s will have to increase from £4.5 billion to £8bn by 2031 unless there are changes to people’s wellbeing and how services are provided.

But their report warned that progress in improving care for older people has so far been slow, with most funding still focused on emergency hospital services and care homes rather than support closer to home.

Concern has been growing about how the NHS and social care services will cope with huge rises in people living to an older age. Projections suggest the percentage of the Scottish population over 65 will increase from 17 per cent to 25 per cent by 2035.

In 2010, the Scottish Government and the Convention of Scottish Local Authorities launched the ten-year Reshaping Care for Older People programme to help cope with the challenges of the ageing population, with a £300 million Change Fund to help drive improvements over four years.

The programme focuses on giving people support to live independently at home and in good health for as long as possible.

But Audit Scotland concluded that overall progress in delivering better services had so far been slow. It also found spending did not appear to be moving away from emergency and residential care and into local initiatives.

And it said the current way that services were delivered was “unsustainable”.

The report said: “To strengthen how services are commissioned, more funding needs to be focused on preventing or delaying ill health and supporting people to stay at home.”

Figures showed that, in 2011-12, almost two-thirds of spending on older people’s care was on hospitals and care homes. This included £1.4bn (30 per cent) on emergency hospital admissions, £847m (19 per cent) on planned and long-stay hospital care, and £637m (14 per cent) on care homes.

Much smaller amounts were spent on services such as community healthcare, home care and general practice.

Audit Scotland said the Scottish Government and other organisations needed to plan how resources would move from hospitals and into the community, as well as look at why spending varies around Scotland.

It said: “There is no clear national monitoring to show whether the policy is being implemented successfully and what impact it is having on older people.”

Auditor General for Scotland, Caroline Gardner, said: “While there has been progress, particularly in bringing bodies together, change has been slow.”

Theresa Fyffe, director of the Royal College of Nursing Scotland, said the report would be worrying reading for the Scottish Government and services trying to improve older people’s services.

“The Change Fund is yet to have any meaningful impact, and there is no shift of care from hospitals to the community,” she said. “What a difference there would be if, for instance, there were more community nurses with advanced practice skills in post who could provide at home the care patients currently receive in hospital.”

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.”