Social care cuts

Health and social care services in the Western Isles face £5 million of cuts and savings over the next three years.

Comhairle nan Eilean Siar and NHS Western Isles have joined forces to create a single panel to integrate services - services which aim to work together to give the best care based on a person’s personal circumstances.

The Integrated Joint Board highlights increasing

demand means "we’ve struggled to stay on top of the day-to-day spending that keeps our health and social care system operating."

With an aging population, the council has overspent its budget on providing home care for vulnerable elderly people.

The problem promises to worsen in the future as nearly 22 % of the islands’ 27,400 population are aged over 65 - nearly 14% more than in the decade up to 2011.

By 2037 the Western Isles is projected to have the highest percentage of pensioners in Scotland - some 37% of the islands’ total.

The stark reality is "significant efficiency savings" are required, highlights the board's draft strategic plan which has been published as part of a public consultation

The document says: "The financial outlook for the next three years is very challenging.

"We anticipate that the Integrated Joint Board will have an outline budget of around £57 million for 2016/17, which will require us to make significant efficiency savings.

"We are looking to find savings of £5 million over three years."

The report admits: "This will involve making difficult decisions."

It highlights: "Some of the savings will come from workforce efficiencies like cutting sickness absence, deleting vacant posts or combining management roles.

"Other savings will come from service redesign, including reducing high cost care packages, long-stay mainland placements, and the centralisation of some ancillary services.

"Some services may be removed if they aren’t well used or delivered equitably across all localities."

The Western Isles has the greatest prevalence of obese adults, coronary heart disease and dementia in Scotland.

It also has the highest rate of blocked hospital beds and the third highest rate of alcohol related hospital stays.

Services will look "radically different" into the future.

Demand for services increases as a result of the ageing population while a growing number of people with multiple illnesses require complex care packages, says the consultation document.

The current way of doing things "too often relies on expensive and at times unnecessary hospital treatment when we could be using that resource differently

to support people to live in the community," says the report.

"We now need to reduce our hospital bed capacity and transfer more of our hospital staff into community settings."

A "particularly pronounced challenge" is delayed discharges, where people are stuck in hospital because they are waiting for care packages.

Not only is this very expensive and inefficient, it has a significant human cost, says the report as after just 72 hours in hospital, "older people can begin to experience

functional decline."

The impact is that some 600 people - out of a population of around 26,500 - account for £17.8 million - half the total - of all hospital and community prescribing expenditure in the Western Isles, according to the draft plan.

Supporting people more in the last few months of their life at home or hospices could avoid "unnecessary and distressing" hospital visits.

Health and social care services face £5 million cuts and savings

26 January 2016