The Scottish Government

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Chapter 14: Conclusions and recommendations

We believe this Report is timely. It brings together a wide range of information from a variety of sources, and we believe the Report will be helpful to NHS boards and local authorities throughout Scotland as they develop services to meet the increased number of older people expected in the next 10 and 20 years. It comes in the wake of 2 major framework documents published in 2005:

• Better Outcomes for Older People : A Framework for Joint Services
• Building a Health Service Fit for the Future: A National Framework for Service Change in the NHS in Scotland.

The Executive's response to the latter Delivering for Health made it clear the Executive accepts the National Framework, and set out a clear programme of action for the development of NHSScotland services over the next 10 years.

We recommend

• the vision for care set out in Chapter 7, in line with the principles set out early in that chapter
• that this vision for care in Chapter 7 should be followed by the Scottish Executive, NHS boards and local authorities throughout Scotland as they develop services.
• the Scottish Executive should introduce a telecare grant of £4m a year for 2 years to encourage the introduction of telecare, operating on a challenge basis. (Chapter 7, page 37)
• regardless of whether or not a telecare grant is introduced, local authorities should explore the use of telecare. (Chapter 7, page 37)
• greater priority should be given to, and much wider use made of, equipment and adaptations in line with the recommendations of the Equipment and Adaptations Group. (Chapter 7, pages 37-38)
• consideration should be given to additional investment in improving palliative care services, building on the success of the Gold Standards Framework
  and also from the NHS End of Life Care Programme in England. (Chapter 7, page 40)
• the emphasis in Scotland should continue to be towards enabling people to live as normal a life as possible in their own homes. Where they are unable to do so they should have the right to choose other housing options such as care at home, supported housing, or sheltered or very sheltered housing. (Chapter 7, page 43)
• every community planning partnership should have a forward looking capacity plan as set out in Chapter 8, page 47.
• where they do not already have such plans, such a capacity plan should be prepared. (Chapter 8, page 47)
• all statutory agencies and the independent sector need to work more closely on workforce planning and workforce development in particular identifying new roles, joint training and collaboration on recruitment. (Chapter 9, page 52)
• the Scottish Executive should review the impact of different accountability arrangements surrounding the care and support of older people, and the scope to promote more flexibility and integration in the planning and funding of services for older people. (Chapter 10, page 53)
• We should support the aim to move to more proportionate and targeted regulation, registration and inspection, whilst maintaining standards, allowing more effort to be directed to service provision. (Chapter 11)
• Where the providers of a service are being innovative by offering services in new or flexible ways, the regulatory regime should not work as a disincentive. (Chapter 11, page 58)
• there is a need to keep the definitions of care services within the Regulation of Care (Scotland) Act 2001 under review. (Chapter 11, page 58)
• a whole systems approach is applied at local level from an early stage in implementing Building a Health Service Fit for the Future through Delivering for Health. (Chapter 12, page 59)
• all statutory agencies together with the independent sector need to consider the implications of Building a Health Service Fit for the Future and Delivering for Health for housing and social work, and address the consequential finance issues. (Chapter 12, page 59)

This report sets a direction for community care services in the years ahead, and for development across the interaction with health care services. It is entirely consistent with the 2 Framework documents mentioned above - Better Outcomes for Older People and Building a Health Service Fit for the Future.

Now is the time for action. Our hope is that this Report will help NHS boards and local authorities to develop the services needed in the years ahead for Scotland's ageing population.

23 March 06

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