Appendix 2: Policy and Research

East Dunbartonshire HSCP Strategic Plan – 2022 - 2025

Shifting the balance of care has been a priority for national and local government for a number of years. Shifting the balance means moving away
from support being provided in institutional building based settings to the support being delivered in community or home based environments.

East Dunbartonshire Health and Social Care Partnership Strategic Plan (2022 – 2025) realises the main challenges facing the HSCP over the next three years including:

  • Post Pandemic Recovery and Consequences
  • Population and Demographics Changes
  • Financial Constraints and Public Sector Reform

The HSCP’s Strategic Plan lists a number of themes that it intends to concentrate on over a three year period. The themes relevant to this Strategy
include:

  • Empowering People
  • Empowering Communities
  • Prevention and Early Intervention
  • Post Pandemic Renewal

Reshaping Care for Older People

NHS: Reshaping Care for Older People (2011 to 2021) [opens in a new window] recognises that both nationally and locally we have to continue to aim to improve services for older people by shifting the balance of care towards anticipatory care and prevention. It recognises that in order to reshape care for older people we need to adopt:

  • Personalisation: service users and carers must be at the centre of HSCP activities, embracing different cultures, needs and choices.
  • Independence: ensuring that older people are supported to
  • Control: older people make their own decisions about their care and support services live independently in community settings, introducing choice and giving the individual involvement and ownership of any decisions.

Christie Commission on the Future Delivery of Public Services

The Christie Report (June 2011) [opens in a new window]  provides an earlier debate on the future direction of public services whereby it presented a radical roadmap to better public services. Some of the key messages from the Christie Report relevant to this Strategy were:

  • Recognising that effective services must be designed with and for people and communities.
  • Maximising scarce resources by utilising all available resources form the public, private and third sectors, individuals, groups and communities.
  • Work closely with individuals and communities to understand their needs, maximise talents and resources, support self-reliance and build
    resilience.
  • Concentrate the efforts of all services on delivering integrated services that deliver results.
  • Prioritise preventative measures to reduce demand and lessen inequalities.

Independent Review of Adult Social Care in Scotland

The Feeley Report (March 2021) [opens in a new window] highlights that the majority of social care support is given to people in their own houses or in local community settings and that we need to ensure that this community support continues. It suggests that the role that communities play in supporting adults to remain active is extremely important.Community based supports can provide socialisation opportunities, advice, information and breaks for unpaid carers. These community based activities can make a big difference to an older person’s quality of life. “Social connections are important to everyone’s wellbeing” (Feeley, March 2021). Some of the key messages from the Feeley Report relevant to this Strategy were:

  • Social care support should focus on enabling people to stay in their own homes and communities. This will help them to make social connections and to have control over their lives.
  • People must be able to access support at the point they feel they need it, including for advice and signposting to local community-based
    resources and help, and for barriers to this, such as the current eligibility criteria and charging regime, to be fundamentally reformed and
    removed, to allow a greater emphasis on prevention and early intervention.
  • Informal, community based services and supports must be encouraged, supported and funded to respond appropriately to the needs of local citizens, including for preventative and low level support.
  • Investment in alternative social care support models should prioritise approaches that enable people to stay in their own homes and
    communities, to maintain and develop rich social connections and to exercise as much autonomy as possible in decisions about their lives.

National Health and Social Care Strategy for Older People

In May 2022, the Scottish Government published a consultation to seek people’s view in relation to older people’s health and social care service. The
purpose of the consultation is to inform the development of a national integrated health and social care strategy for older people.

The consultation and impending Strategy will focus on four main themes

  • Place and Wellbeing
  • Preventative and Proactive Care
  • Integrated Planned Care
  • Integrated Unscheduled Care

The Scottish Government is seeking people’s views in relation to older people’s health and social care services in order to inform the development of a new integrated health and social care strategy for older people. The consultation is based around the four main themes of:

  • Place and Wellbeing
  • Preventative and Proactive Care
  • Integrated Planned Care
  • Integrated Unscheduled Care

East Dunbartonshire HSCP’s Social Support for Older People Strategy will support the themes focused on ‘Place and Wellbeing’ and ‘Preventative and Proactive Care’.

Self Directed Support

The Social Care (Self Directed Support) (Scotland) Act 2013 implemented in 2014 enabled individuals and their carers to have as much choice and control as they would wish or are capable of in relation to their support. This has seen some changes over the last seven years in the way that some older people have chosen, in relation to the model, to meet their social support needs.

Any individual who has been assessed as eligible for formal social care support will be offered the Self Directed Support options. Some people can manage their support on their own, whilst others need help either from family, friends or
a support organisation.

Self Directed Support Options:

Option 1:

You can choose to receive your individual budget as a payment directly into your bank account. With this money, you can choose to become an employer where you employ your own Personal Assistant (PA) or you can purchase services/ support from an agency or other organisation.

Option 2:

Your individual budget can be held and managed by the HSCP or a third-party organisation and would be used to pay for the support that you have chosen.

Option 3:

With this option discussions will take place with you regarding your individual budget and the support you require to meet your outcomes, but you may have decided that the arrangement regarding who provides this support and when will be made by the HSCP, using their own services or services commissioned from another organisation.

Option 4:

You may choose to use several Self Directed Support options to meet the different parts of your support plan.

Information about Self Directed Support in East Dunbartonshire can be found on our Self Directed Support webpage.

Customer Contributions

East Dunbartonshire Council ‘Charges for Non Residential Services’ Policy means that people in receipt of formal social support may be subject to a customer contribution.

The amount of customer contribution will be dependent upon the older person’s income however those customers in receipt of disability benefits i.e. Attendance Allowance and Personal Independence Payment will usually be eligible to pay the full customer contribution. The contribution levels are reviewed annually.

The customer contribution is applied irrespective of the type of formal social support service that the individual is receiving. However, customer attending a formal day centre based service may also be subject to transport costs and will
also contribute to the provision of a meal at lunchtime.