The way people are being cared for in Scotland is changing and Orkney faces many challenges in response to this in the years ahead.
On the first of April 2016, ‘the Public Bodies the (Joint Working) (Scotland) Act 2014’, came into effect. This established 31 joint working Health and Social Care Partnerships throughout Scotland. In Orkney we have Orkney Health and Social Care.
Orkney has an ageing population. Projected figures from Orkney Health and Care Joint Commissioning Strategy 2012- 2022 suggest that by 2035 the percentage of the population in the islands over 85 will be 17.1% male, 41.9 % female. Now in many respects this is wonderful news showing that people in Orkney have a healthy lifestyle which ensures they will live to a good age.
In other respects,however, it does mean that advance planning is essential not just in caring for an older population but also in staffing. Orkney will need carers.
Anticipatory Care Planning will be vital in the provision of health and care services in Orkney, not just for the elderly but for all people whose needs require care at some level.
What is an Anticipatory Care Plan?
“An Anticipatory Care Plan is a dynamic record that should be developed over time through an evolving conversation, collaborative interactions and shared decision making. It is a summary of Thinking Ahead discussions between the person, those close to them and the practitioner.” (Healthier Scotland)
Over time a person’s needs change and the care delivered must be flexible and responsive to those developments. If this is to be effective it requires all of those involved in the provision of care to engage with the process and central to this is the person, the individual, whose care is being delivered.
“It is a reflective and voluntary process that facilitates discussion with the individual, and often the people who are close to them, to identify their personal values, goals and needs.” (Healthier Scotland)
And it is for all ages.
What about funding?
None of this can happen without adequate funding. The Scottish Government has established a new Scottish Independent Living Fund (ILF) after the scheme was scrapped by the UK Government. It is committed to developing an ILF for new users .
“On top of the £47.2 million a year for support of the scheme’s 2,700 existing Scottish users, a further £5 million a year of new funding will be available.” (A Fairer Scotland for Disabled People – Our Delivery Plan to 2021 for the United Nations Convention on the Rights of Persons with Disabilities Scot Gov)
It is hoped this new fund will be available soon.
A further “£3 million has been committed between 2015-2018 to fund the Active and Independent Living Improvement Programme which finds innovative ways to help disabled people lead healthy lives and stay in their own homes” by the Scottish Government.
In the Scottish Budget 2017 – 18 Derek MacKay, Cabinet Secretary for Finance and the Constitution stated that investment in the NHS remained firmly in place :
“with NHS Board budgets increasing by in excess of £300 million in 2017-18. This will include additional investment of over £100 million to be directed to Integration Authorities, which will deliver our commitment on the Living Wage and support sustainability in the care sector.”
Derek MacKay also pledged to” increase the share of the frontline NHS budget being invested in primary care, community care, social care, and mental health in the coming year, and throughout this Parliament. “
Improving the Standards
The new National Health and Social Care Standards are set to be in place by Spring of 2018. Central to the standards will be human rights, dignity, compassion and wellbeing for all health, social work and social care services across Scotland.
The Scottish Government is committed to:
“invest £107 million in Integration Authorities, to ensure improved outcomes in social care. This builds upon the £250 million included in the 2016‑17 budget for investment in Social Care, along with the £100 million Integrated Care Fund and £30 million delayed discharge fund, bringing the total additional support available for Health and Social Care Integration from the NHS to £487 million”
Orkney Health and Care faces many challenges in the coming years: meeting the needs of a changing population, adapting to new approaches in delivering flexible care, planning for a future workforce and to have the funding to support these changes.
Reporter: Fiona Grahame