Free personal and nursing care, Scotland, 2017-18

2. People receiving Free Personal Care and Free Nursing Care

This section presents the latest available data on the number of people receiving Free Personal Care and Free Nursing Care in a Care Home and people receiving Free Personal Care at home.

2.1 Care Homes

Since 2002, information has been collected on the number of residents aged 65+ supported by Local Authorities in Care Homes. These residents may be mainly funded by their Local Authority or may be self-funders receiving the appropriate weekly payment towards their Care Home fees. All of these residents receive personal care services for free.

Figure 3: Care Home residents, 2008-09 to 2017-18

Figure 3 (above) shows that the number of long-stay residents aged 65+ in Care Homes in Scotland has reduced slightly since the introduction of Free Personal and Nursing Care. In 2008-09 there were around 31,530 older people in Care Homes, which fell to 30,450 in 2017-18.

The number of self-funding Care Home residents who receive FPNC payments, in contrast, has risen slightly over the time period. In 2008-09 there were 9,580 self-funders receiving the FPC payment, which rose to 10,080 in 2017-18. However there was a reduction noted in the last year.

Table 1 (below) shows the proportion of long-stay residents receiving FPC payments has shown little change since 2008-09, rising from 30% to 33%.

Just over three-fifths (61%) of self-funding Care Home residents received the FNC payment in addition to the FPC payment in 2017-18, a figure largely stable since 2008-09. The number of self-funders (all ages) receiving Free Nursing Care has not changed significantly between 2008-09 and 2017-18.

Table 1: Care Home residents, 2008-09 to 2017-18

Year	Self-funders (aged 65+) receiving FPC as % of all long-stay care home residents	% Self-funders (aged 65+) receiving FPC also receiving FNC
2008-09	30%	65%
2009-10	30%	64%
2010-11	31%	63%
2011-12	31%	63%
2012-13	31%	64%
2013-14	32%	62%
2014-15	32%	62%
2015-16	32%	62%
2016-17	34%	64%
2017-18	33%	61%

Source: Community Care Quarterly Key Monitoring Return. Figures up to 2011-12 are yearly averages. From 2012-13, figures are based on the final quarter of the year only. Full figures are available in the accompanying data tables.

2.2 Home Care

Prior to 1st July 2002, people aged 65 and over could be charged for personal care services provided in their own home. Personal care services are now free, although individuals can still be charged for domestic services such as help with shopping or housework, subject to a financial assessment.

Figure 4: Home Care clients, 2008-09 to 2017-18

Figure 4 (above) shows that the number of older people receiving Home Care services in Scotland decreased from 54,720 in 2008-09 to 49,560 in 2017-18, a decrease of 9%. Over the same period, the number of Home Care clients receiving personal care services increased from 44,200 clients to 47,070, an increase of 6.5%.

Table 2 (below) shows the number of hours of personal care provided in Scotland increased from a weekly average of 333,100 hours in 2008-09 to 413,400 in 2017-18, a 24% increase. Overall, the average weekly hours of personal care provided per client has increased from 7.5 hours in 2008-09 to 8.8 hours in 2017-18. The average weekly hours of personal care provided per client has dropped slightly since last year.

Table 2: Home Care clients, 2008-09 to 2017-18

Year	Average weekly hours of Personal Care at home	Average weekly hours of Personal Care at home per person
2008-09	333,100	7.5
2009-10	361,700	7.8
2010-11	371,900	7.9
2011-12	389,000	8.3
2012-13	400,500	8.5
2013-14	409,500	8.6
2014-15	401,600	8.6
2015-16	405,400	8.6
2016-17	405,000	8.9
2017-18	413,400	8.8

Source: Community Care Quarterly Key Monitoring Return 2004-05 to 2008-09, Home Care Census 2009-10 to 2011-12, Social Care Survey 2012-13 to 2016-17, Community Care Quarterly key monitoring return 2017-18.

Average weekly hours (based on last week of final quarter) are rounded to the nearest 100. Full figures are available in the accompanying data tables.

In recent years there has been a shift away from long-term care provided in Care Homes and hospitals towards more care being provided in people's own homes. Figure 5 shows that at the same time there has been an increase in the proportion of clients receiving personal care services. In 2017-18, 95% of all Home Care clients received personal care services compared with 81% in 2008-09.

Figure 5: Change in proportion of all Home Care clients aged 65+ receiving personal care, 2008-09 to 2017-18

2.3 Extension of Free Personal Care to people aged under 65

On 1 April 2019, the Scottish Government extended Free Personal Care to people aged under 65 who are assessed as needing it. This means that people aged under 65 who are found eligible by their Local Authorities as needing personal care at home or in a care home, no longer have to pay for this service.

The Scottish Government has started collecting information as part of the monitoring of the extension of the Free Personal and Nursing Care policy and a separate publication early in 2020 will include the first information on the number of people aged under 65 receiving personal care at home and in care homes, as well as the associated expenditure. This will cover the first 6 months of the extension. Following this, later in 2020, the 2018-19 Free Personal and Nursing Care publication is likely to include more detailed information on people of all ages receiving FPNC.

More information can be found in the Scottish Government's "Guidance on Free Personal and Nursing Care in Scotland for Adults": https://www.sehd.scot.nhs.uk/publications/CC2018_03.pdf.