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Chapter 1: Context and reference to first report
This is the second and final report from the Scottish Executive Health Department's Range and Capacity Review Group
The National Delayed Discharge Action Plan (March 2002) highlighted the need to carry out a range and capacity review of community care services for older people, and led to the establishment of this Range and Capacity Review Group.
The first report of the Group Projections of community care service users, workforce and costs was published on 16 July 2004. This was modelling work that presented 7 scenarios and then, for each of these scenarios, set out statistical projections of the numbers of community care service users and of workforce and cost implications at a Scotland level up to 2019.
It did not set the context for care, nor did it make recommendations about the way forward. We address these matters in this report, working to the remit below.
This report does not provide, as some might have expected, a detailed analysis of the different models that were outlined in the Group's first report. As our work progressed it quickly became apparent that, as a national review group, we could not decide what should happen at local level.
Of the scenarios in our first report, scenario 7 (the joint future model) is the one that fits best with the direction of policy and practice in Scotland. But the way in which a joint future model is delivered in one area will be different from that in another area, because of the mix of existing services (and their inter-action, of which we say more later about a whole systems approach), and the local population and geography.
This report therefore sets out:
- our understanding of the big problems,
- the context in the light of recent, major reports (notably Building a Health Service Fit for the Future (the Kerr Report) , Delivering for Health, Better Outcomes for Older People, and the 21 st Century Social Work Review), and
- a vision for care for the increasing ageing population in years to come.
The report is therefore neither an action plan nor a model of care, but it sets out principles, a vision for care that has to be worked out in detail at local level.
Remit
The Group's remit was -
- to examine evidence of the future health of older people and consider the implications for the provision of care services.
- to investigate the use of existing models of care and the use of other services and support as an alternative to long term residential care.
In fulfilling this remit, the Group sought to articulate and inform the development of a vision for care that provides services for older people as and when they need them. Accordingly the vision needs to:
- be flexible
- respond to changing circumstances, and
- be adaptable to local needs (linking in to local capacity planning at local authority/health board level).
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