Free personal and nursing care, Scotland, 2016-17

1. Introduction

Free Personal and Nursing Care (FPNC) was introduced in Scotland on 1st July 2002. Since then:

Care Homes

• care home residents aged 65 and over who are assessed as self-funders can receive a weekly payment towards their personal care
• people of all ages who live in care homes and are assessed as self-funders can receive a weekly payment if they require nursing care
• the remainder of the care home fees for self-funders are paid by the resident
• care home residents who are funded by their Local Authority receive all of their personal care for free

Home Care

• people aged 65 and over can no longer be charged for personal care services provided in their own home. Such individuals can still be charged for certain domestic services but any charge would be subject to a financial assessment

This Statistics Release presents the latest figures (financial year 2016-17) to give a picture of the number of people that benefit from FPNC in Scotland and the amount that local authorities spend on personal care services.

1.1 Number of FPNC Clients

Over 76,000 people in Scotland benefit from Free Personal and Nursing Care, with nearly 31,000 people in Care Homes and around 46,000 people living in their own home. Nearly 10,000 self-funding Care Home residents receive weekly payments for Free Personal Care (ages 65+) and / or Free Nursing Care (all ages).

Figure 1: People receiving FPNC, 2007-08 to 2016-17

1.2 Care Homes

The overall number of older people in Care Homes has reduced slightly over the last ten years, from around 31,730 in 2007-08 to 30,670 in 2016-17.

In 2016-17 there were around 9,870 older people receiving Free Personal Care payments, roughly the same number as in the previous year. These payments are available to self-funding Care Home residents who have assets, including property, worth more than £26,000 (from 7th April 2014). Around a third (32%) of all Care Home residents received FPNC payments in 2016-17.

The remaining Care Home residents are publicly funded and also receive Personal and Nursing Care services for free. These residents contribute towards their Care Home fees from their pensions and any other income they may have. The local authority then funds the balance, which will be greater than the FPNC payments received by self-funding Care Home residents.

Around three-fifths (60%) of people receiving the Free Personal Care payments also received the Free Nursing Care payment in 2016-17, roughly the same as in the previous year.

1.3 Home Care

In 2016-17 there were around 45,780 older people receiving personal care services in their own homes. This number has decreased since last year but represents a long term increase from 42,260 older people in 2007-08. Since July 2002, local authorities in Scotland can no longer charge for these services.

The overall trend of more people receiving personal care services in their own homes reflects two underlying factors: an increasing older population, and a move away from long-term care provided in hospitals and Care Homes towards care being provided in people's own homes for as long as possible.

People receiving personal care services at home received on average 8.8 hours of care per week in 2016-17, slightly higher than in 2015-16. This has increased from an average of 7.1 hours of care per week in 2007-08, which indicates that people receiving care at home have increasing levels of need.

In 2016-17, 94% of older people receiving Home Care services received personal care as part of their care package, compared with 76% in 2007-08.

1.4 Expenditure

Due to differences in recording practice across local authorities, the expenditure figures presented in this report have been adjusted to include estimates for overheads. The figures at Scotland-level are broadly comparable year-on-year, but contain some degree of estimation. For more details on expenditure, see Sections 4.3 – 4.5 of this report.

Figure 2: Estimated Expenditure on FPNC (£ millions), 2007-08 to 2016-17

Source: LFR03 Return / Scottish Government FPNC validation return. Figures presented contain an estimation of overheads

In 2016-17, the amount spent by local authorities on FPNC payments to self-funding Care Home residents totalled £123 million, a decrease from the previous year. Overall, this figure has increased from £104 million in 2007-08 which likely reflects the annual increases in the FPNC payments from April 2008. However, there was no increase in FPNC payments last year which may have contributed to the slight decrease in expenditure. The overall increase in expenditure represents new money arising from the FPNC policy, as prior to its introduction self-funders would have had to pay for all of their care.

In 2016-17 the amount spent by local authorities on providing personal care services to older people in their own home totalled £379 million, an increase on the previous year. Overall, this figure has increased from £267 million in 2007-08. Large increases in expenditure in the years following 2007-08 gradually diminished and recent years show smaller changes.

The increase in expenditure over time is driven by a combination of factors. Firstly, an increasing proportion of older people are cared for at home, rather than in hospital or Care Homes. Secondly, Home Care workers are increasingly providing personal care services rather than domestic services. And lastly, people living at home have increasing levels of need. It should be noted; however, that this is not all new spend arising from the FPNC policy. Prior to 1st July 2002, local authorities had discretion to charge for these services and a variety of charging policies operated across the country. Any charges were subject to a financial assessment which meant that in practice many people received these services for free.