Scottish Community Care Statistics 2002

CHAPTER 7 - EXPENDITURE ON COMMUNITY CARE

Revenue Expenditure by Local Authorities

Tables 7.1 to 7.4 contain expenditure data reported by local authorities in annual local financial returns to the Scottish Executive. This information is published at summary level in the annual publication "Scottish Local Government Financial Statistics". All figures have been adjusted to current prices to remove the effects of inflation.

For definitions under which these data are collected, please refer to the notes in annex A.

Table 7.1 and chart 7.1 present net expenditure on social work services broken down by client group for the years between 1990 and 2002. The categories under which expenditure is recorded were changed between 1994 and 1995, and again between 1997 and 1998. It is therefore difficult to make comparisons, for some categories, over the full 1990 to 2002 period.

Chart 7.1 Net Expenditure on Social Work 1990-2002 (000s)

chart

It is apparent from Chart 1 that net expenditure on social work, as a whole, has steadily increased over the years to reach a level of approximately 1.35 billion in 2001-02. Expenditure on community care has increased at a similar rate to reach a level of approximately 876 million in 2001-02.

Table 7.1: Net Expenditure on Social Work (000s) ^1,2

	1989-90 ³	1990-91	1991-92	1992-93	1993-94	1994-95	1995-96	1996-97	1997-98	1998-99	1999-00	2000-01	2001-02 ⁵
Children ⁴	146,229	166,465	179,996	191,238	218,685	241,142	246,478	254,661	255,391	276,232	291,628	303,850	324,965
All Community Care Client Groups	-	-	-	-	-	236,265	266,220	306,628	245,588	270,607	258,688	282,109	293,699
Older People	268,353	284,188	283,470	291,984	328,185	209,245	226,096	205,460	275,202	283,286	317,161	300,788	316,513
Adults with Mental Health Problems	2,094	2,672	5,603	10,917	17,776	27,866	35,347	39,477	33,201	32,295	30,873	31,512	32,508
Substance Misuse	3,535	3,898	3,893	5,057	6,360	11,184	12,347	10,522	8,915	7,602	8,550	9,196	11,449
Adults with Learning Disabilities	60,759	69,472	73,551	78,991	96,567	99,730	122,297	121,834	128,003	124,247	144,410	147,343	164,685
Physically Disabled Adults	39,525	44,540	49,566	58,006	52,328	56,293	60,488	60,359	46,834	47,157	44,174	50,351	55,439
Services for HIV/AIDS	705	876	1,189	1,174	1,371	1,856	1,840	1,352	1,434	1,473	1,812	1,914	1,683
Total Community Care	374,971	405,646	417,271	446,129	502,587	642,438	724,634	745,632	739,177	466,667	805,669	823,214	875,976
Adult Offenders	3,925	5,203	1,583	1,621	3,046	2,342	4,189	5,533	3,226	5,155	3,991	3,805	3,610
Non Specific Expenditure	189,302	220,861	216,476	226,954	240,116	214,012	234,638	209,361	200,522	170,416	156,594	161,385	147,229
Total Social Work	714,427	798,175	812,160	865,942	964,434	1,099,934	1,209,940	1,215,187	1,198,316	1,218,469	1,257,881	1,292,253	1,351,780

¹ Loan Charges have been excluded for all years.
² Figures have been adjusted to reflect current prices using GDP deflators.
³ In 1990 expenditure excludes Support Services Costs.
⁴ Includes Children's Panels.
⁵ Revenue contributions to capital and support service costs have been apportioned across each service area relative to expenditure on operating costs (including transfer payments) resulting in the Scotland total representing the sum of all 32 authorities.
Source: SE-FCSD Local Government Finance Statistics - LFR3 Return

Net expenditure on community care accounted for 65 per cent of total social work compared to expenditure on children which accounted for 24 per cent and non-specific expenditure which accounted for 11 per cent of the total.

It is difficult to make comparisons between expenditure on client groups within community care because of the changes to the way in which data has been collected over the years. The introduction of the "all community care client groups" category in 1995 has led to an apparent drop in spending on older people and adults with mental health problems. This does not reflect a true reduction in service provision, but simply that this expenditure is being recorded elsewhere.

Table 7.2 presents the same information as table 1 but on a gross expenditure basis. Expenditure over time follows roughly the same pattern as for net expenditure. Gross expenditure on social work was approximately 1.8 billion in 2001-02 and for community care it was 1,230 million.

Table 7.2: Gross Expenditure on Social Work (000s) ^1,2

	1989-90 ³	1990-91	1991-92	1992-93	1993-94	1994-95	1995-96	1996-97	1997-98	1998-99	1999-00	2000-01	2001-02 ⁵
Children ⁴	147,531	167,670	181,567	193,242	219,641	242,929	247,713	256,582	261,276	281,585	299,241	312,471	341,437
All Community Care Client Groups	-	-	-	-	-	252,522	297,745	356,080	301,991	328,101	324,219	354,177	375,223
Older People	313,786	328,835	329,327	338,022	376,838	251,541	270,177	257,100	349,599	370,706	420,230	414,364	446,357
Adults with Mental Health Problems	2,529	3,192	6,170	11,388	18,676	31,266	38,880	46,619	44,150	51,881	59,932	63,634	67,813
Substance Misuse	3,985	3,974	3,995	5,270	6,609	12,857	13,835	12,310	10,651	9,497	10,940	12,631	16,388
Adults with Learning Disabilities	64,537	73,742	77,909	85,840	104,134	112,402	136,328	146,762	157,264	171,754	207,874	229,289	257,721
Physically Disabled Adults	48,453	54,475	59,094	68,388	62,601	66,548	70,958	70,749	51,410	52,553	51,686	59,343	64,244
Services for HIV/AIDS	727	889	1,204	1,186	1,411	2,198	2,534	1,443	2,102	2,1090	2,527	2,469	2,031
Total Community Care	434,017	465,106	477,698	510,094	570,269	729,334	830,457	891,063	917,167	986,681	1,077,408	1,135,906	1,229,777
Adult Offenders	10,336	13,073	22,011	28,877	32,600	36,550	36,601	38,399	37,910	41,026	43,199	45,541	49,959
Non Specific Expenditure	193,657	224,907	220,036	231,127	246,194	232,690	271,538	240,397	234,192	186,988	172,118	179,201	172,560
Total Social Work	785,542	870,756	901,313	963,340	1,068,704	1,241,503	1,386,309	1,426,442	1,450,546	1,496,280	1,591,965	1,673,119	1,793,733

¹Loan Charges have been excluded for all years.
²Figures have been adjusted to reflect current prices using GDP deflators.
³In 1990 expenditure excludes Support Services Costs.
⁴Includes Children's Panels.
⁵Revenue contributions to capital and support service costs have been apportioned across each service area relative to expenditure on operating costs (including transfer payments) resulting in the Scotland total representing the sum of all 32 authorities.
Source: SE-FCSD Local Government Finance Statistics - LFR3 Return

Table 7.3: Net Expenditure on Key Community Care Services (000s) ^1,2

	1989-90 ³	1990-91	1991-92	1992-93	1993-94	1994-95	1995-96	1996-97	1997-98	1998-99	1999-00	2000-01 ¹¹	2001-02 ¹²
SMP for all CC Client Groups	0	0	0	0	0	3,576	12,977	16,650	52,298	67,018	53,375	51,363	50,875
SMP for Older People	0	0	0	0	0	12,617	10,133	15,941	0	0	0	0	0
SMP for People with Learning Disabilities	0	0	0	0	0	3,497	1,762	3,983	0	0	0	0	0
SMP for People with Mental Health Problems	0	0	0	0	0	1,726	1,587	4,728	0	0	0	0	0
SMP for Physically Disabled People	0	0	0	0	0	2,898	2,565	4,583	0	0	0	0	0
SMP for Other Client Groups	0	0	0	0	0	1,046	233	614	0	0	0	0	0
Total Senior Management & Purchasing	0	0	0	0	0	25,361	29,258	46,499	52,298	67,018	53,375	51,363	50,875
Nursing Homes ⁴	0	0	0	0	0	25,283	43,446	97,708	92,604	102,784	124,347	112,573	124,846
Residential Homes - Older People	108,356	114,017	108,465	108,358	134,613	169,551	185,896	154,880	149,959	145,257	139,298	144,573	141,504
Residential Homes - Learning Disabilities ⁵	17,255	19,409	21,438	24,419	28,936	32,477	48,469	49,660	62,201	67,224	80,578	72,854	82,030
Residential Homes - Mental Health Problems ⁵	809	867	750	532	988	1,584	3,665	6,131	6,482	8,113	10,556	9,097	7,054
Residential Homes - Physically Disabled ⁵	4,650	5,438	5,565	7,150	10,256	12,630	13,205	17,146	18,342	19,225	20,899	20,418	22,417
Residential Accommodation - Other ⁶	604	596	665	796	691	1,839	3,476	1,783	1,457	1,867	3,750	4,458	3,799
Total Nursing and Residential Care	131,676	140,327	136,883	141,255	175,484	243,363	298,156	327,308	331,045	344,469	379,428	363,973	381,650
Other Supp'd Accom. - Older People	135	946	389	671	798	1,223	2,457	2,575	0	0	0	0	0
Other Supp'd Accom. - Learning Disabilities	1,087	2,419	3,568	2,736	3,605	2,583	1,373	1,827	0	0	0	0	0
Other Supp'd Accom. - Mental Health Problems	371	519	618	834	746	1,245	-192	810	0	0	0	0	0
Other Supp'd Accom. - Physically Disabled	28	45	760	1,208	891	1,816	614	1,034	0	0	0	0	0
Total Other Supported Accommodation	1,620	3,929	5,334	5,448	6,039	6,867	4,253	6,246	0	0	0	0	0
Day Centres - Older People	10,364	10,545	12,525	16,014	18,948	20,786	22,765	24,023	23,423	27,639	26,096	28,596	31,090
Day Centres - Learning Disabilties	41,274	45,454	46,213	49,204	51,279	52,711	57,866	58,016	56,021	54,856	59,385	55,139	58,293
Day Centres - Mental Health Problems	30	23	47	334	351	1,089	5,167	6,863	7,834	5,951	5,682	4,804	5,171
Day Centres - Physically Disabled	10,809	10,994	11,009	11,586	11,437	13,768	14,002	15,206	15,059	18,991	11,871	12,189	14,103
Day Centres - Other	164	184	148	256	271	664	399	853	748	627	1,672	1,693	2,836
Total Day Care	62,642	67,200	69.941	77,395	82,287	89,019	100,199	104,961	103,085	108,064	104,705	102,421	111,493
Home Care ⁷	121,577	123,784	126,023	128,233	132,681	149,556	154,430	142,846	135,290	141,810	135,890	157,957	172,091
Wardens Sheltered Housing ⁷	18,369	20,695	20,599	19,656	19,694	20,316	18,669	10,470	6,680	6,177	5,764	4,284	3,593
Community Alarms ⁷	4,208	5,188	4,587	4,461	4,961	6,870	7,488	6,965	5,585	5,695	6,473	6,658	5,376
Aids and Adaptations	0	0	0	0	0	16,241	17,145	15,876	16,111	17,450	17,510	20,335	20,870
Occupational Therapy ⁸	3,143	3,683	5,462	7,084	5,414	5,611	5,254	7,267	0	0	0	0	-
Lunch Clubs & Meals on Wheels ⁷	3,901	4,831	4,974	4,773	4,635	5,077	5,660	6,144	5,377	6,208	6,680	6,445	6,250
Community Care Systems	0	0	0	3,277	12,515	3,735	1,152	2,704	0	0	0	0	-
Sheltered Employment ⁹	7,971	10,007	9,862	10,403	10,217	10,868	10,496	9,647	9,763	10,301	9,961	10,051	8,269
Other Community Care	0	0	0	0	0	0	0	0	14,483	15,948	23,035	25,041	26,375
Other Services - Older People ¹²	1,443	4,182	5,908	9,818	11,854	5,067	4,845	8,041	9,216	7,606	27,420	15,046	19,073
Other Services - Learning Disabilities ¹²	1,143	2,190	2,332	2,632	12,747	8,461	12,828	8,348	9,781	2,166	4,447	19,350	24,362
Other Services - Mental Health Problems ¹²	884	1,262	4,188	9,217	15,691	22,222	25,119	20,945	18,885	18,231	14,636	17,611	20,284
Other Services - Physically Disabled ¹²	12,923	14,374	16,908	20,575	14,113	14,313	19,605	12,743	13,434	8,941	11,404	17,744	18,918
Other Services - Other Client Groups	3,471	3,995	4,268	5,179	6,768	9,491	10,078	8,624	8,144	6,581	4,940	4,960	6,497
Total Other Community Care	179,033	194,190	205,113	225,308	251,291	277,828	292,769	260,618	252,750	247,115	268,161	305,456	331,958
Total Community Care	374,971	405,646	417,271	449,406	515,102	642,438	724,634	745,632	739,177	766,667	805,669	823,214	875,975

¹ Loan Charges have been excluded for all years.
² Figures have been adjusted to reflect current prices using GDP deflators.
³ In 1990 expenditure excludes Support Services Costs.
⁴ From 1995 to 1997 figures represent nursing home expenditure for all client groups; from 1998 onwards figures represent nursing home expenditure for older people only.
⁵ From 1998 onwards these figures include expenditure on residential and nursing care.
⁶ This figure may include an element of expenditure on other supported accommodation in addition to expenditure on residential homes.
⁷ From 1990 to 1994 this expenditure was recorded for older people only; from 1995 onwards it is recorded for all community care client groups.
⁸ From 1990 to 1994 this expenditure was recorded for physically disabled people only; from 1995 onwards it is recorded for all community care client groups.
⁹ From 1990 to 1997 this expenditure was recorded for physically disabled people only; from 1998 onwards it is recorded for all community care client groups.
¹⁰ Figures for Total Community Care in 1993 and 1994 differ from those in table 1 due to the inclusion in this table of community care systems. This category is included in Non Specific Expenditure in table 1.
¹¹ Differences in expenditure from 1999-00 to 2000-01 are due to changes in Glasgow City Council's recording practices.
¹² Revenue contributions to capital and support service costs have been apportioned across each service area relative to expenditure on operating costs (including transfer payments) resulting in the Scotland total representing the sum of all 32 authorities.
Source: SE-FCSD Local Government Finance Statistics - LFR3 Return

Table 7.3 illustrates net expenditure for key elements of community care from 1990 to 2002. Expenditure on Senior Management and purchasing increased from 25.4 million (4 per cent of total community care expenditure) in 1995 to 50.9 million (6 per cent of total community care expenditure) in 2002.

Between 1990 and 2002, total expenditure on nursing and residential care increased from 131.7 million to 381.7 million (189 per cent). Nursing and residential care accounted for 35 per cent of total community care expenditure in 1990 and 44 per cent in 2002.

Total net expenditure on day care between 1990 and 2002 has generally followed an upward trend.

Expenditure on home care increased from 122 million in 1990 to approximately 172 million in 2002. Home care accounted for 32 per cent of the community care budget in 1990, reducing to 19 per cent in 2002.

Table 7.4: Net Expenditure on Community Care 2001-02 ^1,2

Local Authority	All Community Care Services		Older People		Adults with Mental Health Problems		Substance Misuse		Adults with Learning Disabilities		Physically Disabled Adults		Services for HIV/Aids		Total Community	Expenditure per 1,000 Pop'n
Local Authority	Expenditure	% of Total	Expenditure	% of Total	Expenditure	% of Total	Expenditure	% of Total	Expenditure	% of Total	Expenditure	% of Total	Expenditure	% of Total	Care	aged 16+
Aberdeen City	14,200	31%	14,643	32%	3,206	7%	753	2%	10,232	22%	3,293	7%	0	0%	46,327	264
Aberdeenshire	8,881	25%	13,219	37%	1,630	5%	498	1%	10,691	30%	1,044	3%	0	0%	35,964	200
Angus	6,591	36%	8,019	43%	405	2%	111	1%	2,115	11%	1,298	7%	0	0%	18,538	211
Argyll & Bute	2,605	17%	7,119	47%	727	5%	156	1%	3,943	26%	443	3%	0	0%	14,992	202
Clackmannanshire	4,441	52%	2,623	31%	234	3%	4	0%	512	6%	731	9%	0	0%	8,544	224
Dumfries & Galloway	12,574	50%	7,857	31%	832	3%	116	0%	3,226	13%	362	1%	0	0%	24,966	208
Dundee City	10,426	38%	9,152	33%	1,045	4%	203	1%	4,814	17%	1,847	7%	188	1%	27,676	233
East Ayrshire	4,974	33%	6,008	40%	501	3%	217	1%	2,893	19%	600	4%	0	0%	15,194	158
East Dunbartonshire	5,635	45%	643	5%	212	2%	99	1%	5,099	41%	883	7%	0	0%	12,571	146
East Lothian	5,053	35%	4,751	33%	568	4%	48	0%	3,135	22%	979	7%	0	0%	14,534	202
East Renfrewshire	2,760	23%	5,535	46%	608	5%	125	1%	2,274	19%	788	7%	0	0%	12,090	171
Edinburgh, City of	28,389	37%	19,380	25%	4,454	6%	904	1%	17,564	23%	5,702	7%	1,229	2%	77,621	206
Eilean Siar	3,502	38%	4,094	44%	463	5%	25	0%	977	11%	177	2%	0	0%	9,236	433
Falkirk	5,303	25%	10,606	49%	1,044	5%	88	0%	2,211	10%	2,245	10%	0	0%	21,497	183
Fife	24,571	42%	20,361	35%	1,561	3%	242	0%	9,613	16%	2,544	4%	63	0%	58,955	208
Glasgow City	38,424	30%	46,835	37%	2,446	2%	3,883	3%	23,531	18%	12,014	9%	172	0%	127,306	269
Highland	7,038	21%	17,895	53%	1,289	4%	470	1%	4,737	14%	2,525	7%	0	0%	33,954	202
Inverclyde	3,826	28%	5,547	41%	694	5%	394	3%	1,785	13%	1,424	10%	0	0%	13,670	202
Midlothian	5,801	40%	3,826	27%	568	4%	49	0%	3,022	21%	1,098	8%	0	0%	14,365	225
Moray	4,309	31%	5,056	37%	451	3%	100	1%	3,126	23%	720	5%	0	0%	13,763	198
North Ayrshire	5,823	31%	7,526	40%	639	3%	448	2%	3,244	17%	906	5%	0	0%	18,586	171
North Lanarkshire	16,164	28%	21,541	38%	2,745	5%	735	1%	13,023	23%	2,840	5%	0	0%	57,048	223
Orkney Islands	1,806	36%	2,288	46%	211	4%	0	0%	467	9%	246	5%	0	0%	5,018	325
Perth & Kinross	6,315	29%	8,003	37%	1,007	5%	334	2%	4,439	21%	1,531	7%	15	0%	21,645	197
Renfrewshire	11,265	39%	10,731	37%	856	3%	465	2%	3,327	11%	2,317	8%	0	0%	28,961	208
Scottish Borders	6,570	36%	6,080	34%	744	4%	144	1%	3,739	21%	856	5%	0	0%	18,134	208
Shetland Islands	2,824	39%	2,147	30%	100	1%	1	0%	1,338	19%	775	11%	0	0%	7,185	417
South Ayrshire	6,031	30%	8,793	44%	461	2%	40	0%	4,015	20%	757	4%	0	0%	20,096	219
South Lanarkshire	20,476	43%	16,630	35%	920	2%	316	1%	7,366	16%	1,430	3%	8	0%	47,144	194
Stirling	6,440	50%	2,974	23%	624	5%	112	1%	1,896	15%	737	6%	0	0%	12,782	184
West Dunbartonshire	5,243	33%	8,361	52%	432	3%	67	0%	1,799	11%	171	1%	0	0%	16,073	215
West Lothian	5,439	25%	8,274	38%	830	4%	304	1%	4,533	21%	2,155	10%	7	0%	21,543	172
Scotland	293,699	34%	316,513	36%	32,508	4%	11,449	1%	164,685	19%	55,439	6%	1,683	0%	875,975	214

¹ Loan Charges have been excluded.
² Revenue contributions to capital and support service costs have been apportioned across each service area relative to expenditure on operating costs (including transfer payments) resulting in the Scotland total representing the sum of all 32 authorities.
Source: SE-FCSD Local Government Finance Statistics - LFR3 Return

Table 7.4 presents the total net expenditure on community care for Scotland in 2002, broken down by local authority.

For Scotland as a whole, the majority of community care expenditure is on older people - 36 per cent in 2002. The second highest share is on services for all community care Services (34 per cent). (The category "All Community Care Services" means "services for all community care client groups which cannot be allocated to a specific client group").

214 was spent on community care per head of population over 16 years of age in Scotland in 2002. This figure ranged from 146 in East Dunbartonshire to 433 in Eilean Siar. Chart 2 illustrates how this rate differs for each local authority.

Chart 7.2 Expenditure on Community Care per Head of Population Aged 16+

chart

Table 7.5: Resource Transfer from Health Boards to Local Authorities (000s)

	1996-97 Outturn	1997-98 Outturn	1998-99 Outturn	1999-00 Outturn	2000-01 Outturn	2001-02 Outturn	*2002-03Plan ^p***
Mental Health	21,993	26,327	31,694	41,208	48,836	52,723	59,071
Learning Disabilities	24,551	30,168	40,074	57,892	72,215	83,359	91,603
Geriatric Long Stay	20,224	29,840	33,376	42,576	46,988	54,959	57,932
Young Physically Disabled	1,117	1,900	3,302	3,583	3,731	3,950	4,794
Resource Transfer ²	68,347	89,804	115,854	145,328	171,769	194,990	213,400
Funding of Other Non-NHS Services	12,772	14,296	17,689	18,711	23,439	39,107	44,615
Resource Transfer Total	81,119	104,100	133,543	164,039	195,208	234,097	258,015

¹ Our understanding is that the Resource Transfer from Health Boards to Local Authorities should be reflected in the LFR3 returns as income and hence in the total gross expenditure.
²In 1995/96 Resource Transfer was given as a total and not split between the service areas, mental health, learning disabilities, geriatric long stay and young chronic sick.
^p Provisional Figures.
Source: SEHD Economics & Statistics Division - Performance Monitoring Returns

Table 7.5 details the resource transfer from health boards to local authorities since 1996-97.

The majority of resource transfer is for people with learning disabilities. This amounted to 83 million 2001-02, 36 per cent of the total. The total amount of resource transfer has increased considerably over time, from 81.1 million in 1996-97 to 234.1 million in 2001-02.

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