Seòmar agus comataidhean

The Social Care (Self-directed Support) Act 2013 introduces a range of options for how social care support is delivered and to give individuals the support and information required to enable them to make informed choices. This has opened up support to all individuals requiring social care support.

Of the uptake of self-directed support by client group included in the report, 32% of people have physical difficulties and 10% have learning difficulties, which is in line with the Social Care Survey 2015 as a whole.

Through the Self-directed Support Support in the Right Direction Fund, 13 projects are receiving over £1 million during 2016-2017 to provide support and information to people with learning disabilities.

The Social Care (Self-directed Support) (Scotland) Act 2013 became Scotland’s approach to social care on 1 April 2014. It places firm duties on local authorities to offer a range of options for how social care support is delivered. The Statutory Guidance that accompanies the Act states that all options must be described in full and that all options are equal.

The Self-directed Support, Scotland, 2014-2015 report highlighted data recording issues which the Scottish Government’s analytical services is working with local authorities to improve.

Empowering people to have choice and control of their social care support is a long term cultural and systemic change. Since 2011 the Scottish Government has invested £58.8 million to aid the implementation of self-directed support across Scotland. This has included:

£32 million to local authorities to support system and culture change.

£12.7 million to the Support in the Right Direction Fund to ensure people are supported in setting their personal outcomes and able to make informed decisions (34 organisations received a share of £2.8 million in 2016/17).

£8.6 million to the Innovation Fund to enable third sector social care providers to deliver flexible and creative support and promote culture change through the workforce (21 projects received a share of £1.1m in 2016/17).

£2.8 million to embed self-directed as the approach to social care across the workforce.

£2.7 million on various projects including engagement, evaluation and independent living.

The Scottish Government, COSLA and Social Work Scotland are currently carrying out a survey of local authorities about their implementation. The finding of this will inform a structured improvement programme.

I will meet with representatives from Inclusion Scotland, Independent Living in Scotland, the Glasgow Centre for Inclusive Living, Scottish Independent Living Coalition and the Coalition for Carers in Scotland in the near future to discuss the Shared Ambition for the Future of Social Care Support in Scotland.

The Scottish Government has committed to considering how best to address the issues raised around charges for social care. We have already made significant progress in reviewing the fairness of charging in the social care system.

As a result, from 1 April 2015, no-one in the last six months of a terminal illness should be charged for the social care that they receive at home.

For 2016-17 the Scottish Government provided additional funding of a quarter of a billion pounds for social care. This offer included £6 million to cover changes in the charging thresholds used by local authorities as a first step towards making charging fairer. Local authorities received this additional funding to raise the income threshold at which point people begin to pay charges, and we will seek to make further progress on this, by taking an anti-poverty approach by prioritising support for those on low incomes first, including around how war pensions and guaranteed income payments for veterans are assessed for calculating social care charges.

The Scottish Government is working with COSLA, providers and other partners to deliver a major programme of reform to adult social care. This will consider the commissioning of residential care and the role of new models of care and support in home care. This will enable progress towards our aim to end ‘time and task’ based care and shift to care that focuses on outcomes.

We are currently refreshing the national care standards to help everyone understand what they have a right to expect when they access health and social care services, and are continuing to empower individuals to have choice and control in deciding how their support is delivered, and take ownership of their own health and wellbeing through self-directed support.

The manufacturer’s route to market for Ataluren is through the long standing independent Scottish Medicines Consortium (SMC) process. In April 2016 the SMC decided not to recommend Ataluren for routine use in Scotland because the balance of costs and benefits meant it was not considered to offer value for money. We understand the company will be making a resubmission and would urge them to do so at a fair price to ensure access is as wide as possible. We do think more can be done to build on the progress to date on access to medicines which is why we asked Dr Brian Montgomery to conduct an independent review which will report later in the summer.The initial pilot of the Peer Approved Clinical System for ultra-orphan medicines has been extended to cover all NHS boards. This means that access to licensed ultra-orphan medicines, such as Ataluren, that have not been recommended for use by SMC, can be considered across Scotland through a standard and consistent process. Where such alternative prescribing options are used the Scottish Government’s New Medicines Fund is available to cover the cost.

Access to specialist respiratory support for people with muscular dystrophy and neuromuscular conditions would form part of an individual care package, agreed with relevant healthcare professionals.

Respiratory Managed Clinical Networks across NHS boards work to improve the respiratory health and quality of life of patients; ensuring that they have equitable access to high quality respiratory services.

Tackling the number of delayed discharges is a key priority of this government, and we are working closely with health boards and their local authority partners to address this issue. We are encouraging the continued development of Intermediate Care across Scotland. These services can provide a safe and effective alternative to hospital admission (step-up care), and ensure timely discharge back to the community (step-down care). Providing this type of short-term intensive rehabilitation, or reablement, following a hospital admission can ultimately reduce, or eliminate, the need for longer term packages of care.

Another key solution to delayed discharge is better joint working between health and social care services. To ensure this we have legislated, through the Public Bodies (Joint Working) (Scotland) Act 2014, to bring together local health and social care systems, with the key aim of improving people’s experience of health and care services and the outcomes that services achieve.

We are also providing financial support to all health and social care partnerships in the form of £90 million over three years, specifically to tackle delayed discharge plus an additional £250 million for investment in social care in 2016-17. The funding will help support partnerships achieve the National Integration Indicators, one of which is a commitment to increase the number of people discharged within 72 hours of being ready for discharge.

In answer to enquiries made of NHS boards, as of December 2015 there were a total of 16 hydrotherapy pools across Scotland. All NHS boards provide access to hydrotherapy pools.

The group which met in response to Petition PE1499: ‘Creating Suitable Respite Services for Younger Disabled Adults with Life-Limiting Conditions’ agreed that the immediate focus for this group would be the young adults over the age of 21 who are currently using Children’s Hospice Association Scotland (CHAS) services.

The medium to longer term focus was to generate a range of options that could meet a wider range of needs. To this end the CHAS transition team continues to explore with young disabled adults and others the potential for further collaborative projects which could enable young adults with life limiting conditions to have short breaks outwith a hospice environment.

More recently, as part of the Health and Sport Committee’s inquiry, ‘We need to talk about Palliative Care’ and in the Strategic Framework for Action on Palliative and End of Life Care, I am considering how this area of work can continue to be taken forward.

I will ensure that the relevant interests involved in the stakeholder review group continue to be involved in wider considerations.