Free Personal and Nursing Care, Scotland, 2023-24

In producing these statistics about FPNC in Scotland, we have tried to make them as accurate as possible. There is more information about how the statistics were produced in the methodology and background information document that accompanies this publication. However, the following factors may affect the accuracy of the Scotland-level totals presented in this publication, and the local authority level data in the accompanying tables.

We aim to engage with local authorities, to explore if data quality can be further improved for future publications.

In the meantime, we recommend the following are kept in mind when considering the statistics presented in this publication and the accompanying tables.

Data supplied by local authorities

As in 2022-23, the underlying data source for these statistics in 2023-24 is data provided to us by Scotland’s 32 local authorities. The data is supplied in a Quarterly Monitoring Return. Please see the data sources section of the methodology and background information document for more information on what data was collected in the Quarterly Monitoring Return in 2023-24.

The Scotland-level totals presented in this report have been calculated by adding together the data for each of Scotland’s 32 local authorities.

Local authorities do their best to ensure that the data they provide in the Quarterly Monitoring Return is correct and accurate. Once we have received the data, Scottish Government also carries out a data validation exercise to further help ensure the data is free from any errors. See the methodology and background information document for more information. 

However, the following factors may impact the accuracy of the data that local authorities provide.

Numbers of clients receiving personal care at home

Some local authorities do not distinguish between personal care at home and Care at Home in general, and class all Care at Home as personal care. Therefore the number and percentage of Care at Home clients reported as receiving personal care in this publication may be higher than the actual underlying position.

Hours of personal care, and spend on personal care, for Care at Home clients

People receiving Care at Home have choice around how they receive their social care. This gives them control over what they receive and how it is paid for. This is known as ‘self-directed support’. There are four options for self-directed support. There is more information about these four options on the Scottish Government’s webpage about the extension of FPC to adults under the age of 65.

Depending on which options their clients receive, and how this is recorded, local authorities may find it difficult to report accurately on the number of hours of personal care provided, or the estimated spend on personal care, to Care at Home clients, in the Quarterly Monitoring Return.

Estimated, missing and revised data

As in previous years, not all local authorities were able to supply a complete set of data in the 2023-24 Quarterly Monitoring Return. The following sub-sections give more information about data that were estimated, missing or revised in 2023-24, and the impact this may have had on the Scotland-level totals presented in this report.

Estimated data

Where possible we have estimated missing values. There is more information on how this was done in the data quality section of the methodology and background information document. Values for some local authorities have now been estimated over multiple years / quarters. Where this is the case, the estimate will have become less reliable over time. 

Where data for one or more local authorities was estimated, the Scotland total presented in this publication is also described as estimated.

The following Scotland totals in 2022-23 and 2023-24 included estimated data. There were fewer estimates made in 2023-24 than in 2022-23.

• Number of long-stay residents aged 65+ supported in Care Homes, 2022-23; one local authority estimated.
• Number of self-funders aged 65+ within Care Homes receiving both FPC and FNC, 2022-23; one local authority estimated.
• Number of self-funders aged 65+ within Care Homes receiving FPC payments only, 2022-23; one local authority estimated.
• Number of Care at Home clients aged 65+ receiving care, 2022-23: two local authorities estimated.
• Number of Care at Home clients aged 65+ receiving care, 2023-24: one local authority estimated.
• Number of Care at Home clients aged 65+ receiving personal care services, 2022-23: three local authorities estimated.
• Number of Care at Home clients aged 65+ receiving personal care services, 2023-24: one local authority estimated.
• Number of hours of personal care services provided to Care at Home clients aged 65+, 2022-23: three local authorities estimated.
• Number of hours of personal care services provided to Care at Home clients aged 65+, 2023-24: two local authorities estimated.
• Estimated annual expenditure on personal care services provided to Care at Home clients aged 65+, 2022-23: one local authority estimated.
• Number of long-stay residents aged 18-64 supported in Care Homes, 2022-23: one local authority estimated.
• Number of self-funders aged 18-64 within Care Homes receiving both FPC and FNC payments, 2022-23: one local authority estimated.
• Number of self-funders aged 18-64 within Care Homes receiving FPC payments only, 2022-23: one local authority estimated.
• Number of Care at Home clients aged 18-64 receiving care, 2022-23: two local authorities estimated.
• Number of Care at Home clients aged 18-64 receiving care, 2023-24: one local authority estimated.
• Number of Care at Home clients aged 18-64 receiving personal care services, 2022-23: two local authorities estimated.
• Number of Care at Home clients aged 18-64 receiving personal care services, 2023-24: one local authority estimated.
• Number of hours of personal care services provided to Care at Home clients aged 18-64, 2022-23: two local authorities estimated.
• Number of hours of personal care services provided to Care at Home clients aged 18-64, 2023-24: one local authority estimated.
• Estimated annual expenditure on personal care services provided to Care at Home clients aged 18-64, 2022-23: one local authority estimated.

Where a percentage has been calculated, if either of the numbers contributing to it are estimates, then the percentage is also an estimate. Estimated percentages are usually referred to as estimates in the text of this publication. The exception is where they are presented as the change between two estimated numbers. In those instances, the percentage is also an estimate, but the word ‘estimate’ in relation to the percentage has sometimes been left out for readability.

All estimated values are marked as such in the accompanying tables.

Annual expenditure on FPNC in care homes in 2023-24 has been estimated, using the number of care home residents receiving FPNC in each quarter, provided to us by local authorities through the Quarterly Monitoring Return. There is more information on how these expenditure estimates are calculated in the data quality section of the accompanying methodology and background information document.

Annual expenditure on free personal care to Care at Home clients in 2023-24 has been estimated. To calculate this estimate, we use expenditure on FPC to Care at Home clients in the final week of each quarter, as provided to us by local authorities through the Quarterly Monitoring Return. For more information on how we have calculated the estimated total annual expenditure from the quarterly data submitted, please see Appendix 2: Collected and calculated variables, in the methodology and background information document accompanying this publication.

Missing data

If a local authority did not return a value in 2023-24, it was not always possible for us to estimate it. Some values for some local authorities were therefore missing. Missing values are marked as [NR], for non-return, in the accompanying tables.

Where values for one or more local authority were missing, the Scotland total reported in this publication (and in the accompanying tables) will be an under-estimate. It is referred to as an estimate in this publication, and marked as an estimate in the accompanying tables. 

These missing data mean the estimated Scotland totals for 2023-24 for the following will be underestimates:

• number of hours of personal care provided to Care at Home clients (both age groups) (tables 7a and 7b in the accompanying tables)
• estimated expenditure on personal care services provided to Care at Home clients (both age groups) (tables 11a and 11b in the accompanying tables).

The following were underestimates (caused by missing data) in 2022-23:

• number of Care at Home clients aged 18-64 receiving personal care (aged 18 to 64) (tables 6a and 6b in the accompanying tables)
• number of hours of personal care provided to Care at Home clients (both age groups) (tables 7a and 7b in the accompanying tables)
• estimated expenditure on personal care services provided to Care at Home clients (both age groups) (tables 11a and 11b in the accompanying tables).

However, note that it is only Scotland total values that will be underestimates. The estimates of average hours per client or average spend per client are not affected by missing data. This is because they are calculated using data only from those local authorities who had returned both the pieces of data necessary for making the calculation.

For example, when calculating the Scottish average for number of hours of personal care delivered to Care at Home clients aged 18 to 64 (section 4; 18 to 64 sub-section). Here, Glasgow City and Scottish Borders’ data on number of clients receiving personal care at home (table 6) was excluded from the calculation, because we had not received data from them on the number of hours of personal care provided (table 7).

To give a sense of the impact of missing data, the estimated percentage of Scotland's population aged 18 and over that lives in each local authority with missing data is indicated next to their names, below. The National Records of Scotland mid-2023 population estimates were used to calculate these percentages.

The missing data for 2023-24 per local authority was:

Fife (estimated 7% of Scotland total 18+ population):

• estimated expenditure on personal care services provided to Care at Home clients (all ages), all quarters of 2023-24. (Table 2d of the Quarterly Monitoring Return; used to estimate tables 11a and 11b in the accompanying tables).

Glasgow City (estimated 12% of Scotland total 18+ population):

• number of hours of personal care provided to Care at Home clients (all ages), all quarters of 2023-24. (Table 2e of the Quarterly Monitoring Return; tables 7a and 7b in the accompanying tables).

Scottish Borders (estimated 2% of Scotland total 18+ population):

• number of hours of personal care provided to Care at Home clients, age 18 to 64, all quarters of 2023-24. (Table 2e of the Quarterly Monitoring Return; tables 7a and 7b in the accompanying tables).
• estimated expenditure on personal care services provided to Care at Home clients (all ages), all quarters of 2023-24. (Table 2d of the Quarterly Monitoring Return; used to estimate tables 11a and 11b in the accompanying tables).

South Ayrshire (estimated 2% of Scotland total 18+ population):

• estimated expenditure on personal care services provided to Care at Home clients (all ages), all quarters of 2023-24. (Table 2d of the Quarterly Monitoring Return; used to estimated tables 11a and 11b in the accompanying tables).

Care should be taken when comparing Scotland totals between years, and between different age groups, as different local authorities may be missing from the Scotland totals being compared. There is information on which values are missing in each year in the relevant publications, which can be accessed from the Free Personal and Nursing Care collections page.

Revised data

During the data validation process, some local authorities also identified errors or updates to their previously submitted 2022-23 Q4 numbers. This has led to some values for 2022-23 being revised in this publication, compared to the 2022-23 publication.

Revised values are marked up in the accompanying tables.

Interpreting changes over time

The statistics presented in this publication – and the accompanying tables – will be influenced by changes in the underlying situation they are describing, and also changes in the data collection and processing methods used. This should be kept in mind when considering changes in the statistics over time, both at annual and (in the accompanying tables) at quarterly level.

Possible reasons for change in the underlying demand for social care support and/or provision are:

• numbers of referrals for social care services, and the waiting times to process these
• changes to the allocation of services and funding, particularly in light of the COVID-19 pandemic for financial year 2020-21
• rising living costs reducing the number of people who meet the self-funding threshold for care homes (thereby reducing the number of self-funders who are considered in this data collection, when looking at numbers of self-funders who receive FPNC payments)
• families changing work patterns to enable them to provide Care at Home for longer
• anxiety about going into a care home because of COVID-19, which may have affected values for years 2019-20 onwards
• when one partner in a relationship enters a care home, the remaining partner is more often choosing to stay in their own home.

The data presented in this report may also be affected by changes in how the data is collected. This can include:

• changes in local authority recording practices, and/or IT infrastructure
• changes to which local authorities can supply data, leading to changes in which values are missing or estimated in Scotland totals. For more on this please see the previous sub-section on estimated, missing and revised data.

Other changes to the data we collect on Free Personal and Nursing care that should be kept in mind when considering changes over time are that:

• Prior to 2018-19, numbers of self-funding care home residents aged 18 to 64 receiving FNC payments were combined with the total number of residents aged 65 and over receiving FNC, and a single total was published for both age groups. Since 2018-19, numbers for the two age groups have been published separately. However, as the number of residents aged 18 to 64 receiving FNC were historically very small, values for those aged 65 and over from 2018-19 onwards are broadly comparable with the ‘all clients’ value from earlier years.
• From 2017-18 onwards, data on numbers of Care at Home clients, numbers of Care at Home clients receiving personal care, and hours of personal care provided, for clients aged 65 and over, have been sourced from the Quarterly Monitoring Return. From 2012-13 to 2016-17, they were sourced from the Social Care Survey. Because of this change of data source, care should be taken if comparing values since 2017-18 with those from years before.
• Before 2021-22, data on expenditure on FPC (in care homes and for Care at Home clients) aged 65 and over, and on FNC, was sourced from the LFR03 return. Since 2021-22, we have used data supplied in the Quarterly Monitoring Return. Data from before 2021-22 is therefore not comparable with data since 2021-22. See ‘expenditure data’ under limitations of data and further background in the methodology and background information document accompanying this publication for more information.

There is more information about how the data we have collected has changed over time in the limitations of data and further background section of the methodology and background information document for this publication.