Background information
In order to develop possible options and solutions to the future delivery of services for older adults, we need to be aware of the context we are currently living and working in.
What will shape future services?
- Population
Over the next 10 years, population growth will rise in East Lothian, especially in the over 65 age group. (Estimated population rise over 65 between 2018 to 2028 is 55.8%)
An ageing population means we need to increase our focus on preventing ill health, managing long-term illness, and identifying new ways of working to meet the needs of the growing older population.
With an increasing ageing population we need to identify plans now, to put in place the necessary preparations to meet future needs
- Deprivation
The Scottish Index of Multiple Deprivation (SIMD) is used to assess how deprived an area is.
East Lothian has 8 data zones within the 20% most deprived areas in Scotland.
Deprivtion leads to health inequalities, including lower life expectancy, higher rates of diseas, more long-term illness
We have to take deprivation into account when we are planning for the future.
- Staffing
Health and social care is dealing with a staffing crisis at a national and local level. East Lothian is no exception.
The majority of positions within the care sector are low paid, challenging roles, which directly compete with hospitality, retail, education and cleaning sectors
By 2043, for every 100 people of working age, 49 of them will no longer be working.
To continue delivering services, we have to identify effectives means of recruiting and retaining staff.
- Finance
NHS Lothian and East Lothian Council fund us to deliver health and social care services. Their funds come from Scottish Government. Scottish Government has said that there are significant financial challenges ahead.
Any option that we put forward for services for older people must, be fully costed and analysed to ensure affordability and best value.
We need to do more with less funds.
- Wider issues
There are other things that need to be considered, for example:
- The impact of the proposed National Care Service
- The number of spaces available for community-based services to take place
- How to get people to and from community spaces using public transport.
There are wider issues that ELHSCP does not have control over which may affect the way we can deliver services.
What do we know already?
In 2022, ELHSCP's Provision Change Board extensively engaged with East Lothian communities about Planning for an ageing population.
We asked the public and stakeholders to tell us what they wanted from health and social care services in later life.
Here are the key things people told us:
- People would prefer to stay independently, in their own homes for as long as possible.
- If people needed care, they would prefer to have it at home, or in a homely setting and not go into hospital.
- They wanted more ‘Intermediate Care Services’ - these services are based in the community and help people stay out of hospital or get people home from hospital with minimal delay.
In addition to asking public opinion, research was undertaken into the current provision, and future demand for care home beds and hospital beds. The results of this research identified:
- The hospital bed provision within East Lothian Community Hospital is well managed and there are enough beds available to meet current and any future demand.
- There is still a need for care home provision within East Lothian. It is likely there will be a need to replace 70 care home beds, and provide up to 30 new care home beds to meet demand.
Planning for an ageing popluation engagement 2022
You can review the work and findings of the Provision Change Board, and their engagement sessions in 2022 in the following linked documents: