Free Personal And Nursing Care, Scotland, 2020-21

Expenditure on Free Personal and Nursing Care

This section presents the total net expenditure from 2011-12 to 2020-21 on Free Personal and Nursing Care for people in a Care Home or people receiving a care at home service. Net expenditure figures have been adjusted to account for overhead costs and differences in recording practice between Local Authorities.

This means that net expenditure figures in this publication contain some degree of estimation, but are broadly comparable year-on-year at Scotland-level. Expenditure estimates presented in this section include estimates of overhead costs. Please see the Limitations section of this publication for further information.

Please note that expenditure on FNC in Care Homes includes self-funders aged between 18 and 64, in addition to self-funders aged 65 and over.

Care Homes

Expenditure data on Free Personal and Nursing Care in this section relate to self-funders aged 65 and over (FPC) and self-funders aged 18 and over (FNC) in Care Homes only, who previously would have paid for all of their care. The data allows us to determine the additional cost to Local Authorities following the implementation of this policy, with regards to Care Homes.

In 2020-21, net expenditure by Local Authorities on FPNC payments to self-funding Care Home residents (aged 65 and over and aged 18 to 64 for FNC payments) totalled around £127 million, a decrease from from £142 million in 2019-20. This is, however, a long-term increase from £107 million in 2011-12, likely reflecting annual increases in the FPNC payments, which are detailed below in Table 1.

As a proportion of all net expenditure on Care Homes for older people, the £127 million spent on FPNC payments in 2020-21 was equal to 20%, or one fifth, of the £637 million spent on Care Homes for older people in that financial year. This is a larger proportion than in 2011-12 (17%).

Local Authorities spent around £99 million (78% of expenditure on FPNC in Care Homes) on FPC payments in 2020-21, and around £27 million (22%) on FNC in Care Homes. The proportion spent on FPC and FNC payments has remained consistent over time: in 2011-12, £84 million (78%) was spent on FPC in Care Homes, and £23 million (22%) on FNC in Care Homes.

Estimated net expenditure (£ thousands) on FPC in Care Homes (age 65 and over), FNC in Care Homes (all ages), and non-FPNC expenditure on Care Homes for older people (65 and over), including overhead costs, Scotland, 2011-12 to 2020-21

Notes: Please note that total net expenditure on Care Homes for older adults was not included in 2019-20 LFR03 returns, and been omitted from this publication. Figures for expenditure on FPC and FNC in care homes are available for 2019-20, as shown in Figure 3.

Please also note that expenditure on FNC in Care Homes includes self-funders aged between 18 and 64 in addition to self-funders aged 65 and over.

Figures contain estimates for overhead costs.

For context, total net Local Authority expenditure on Care Homes for older people in 2020-21 was £637 million, compared to £596 million in 2018-19 (the most recent previous year for which this data is available, please see Data Sources section). Expenditure in 2020-21 is an overall increase from the £625 million spent in 2011-12.

Full data, both with and without estimated overhead costs, are available in the accompanying tables.

Care at Home

In 2020-21, the estimated amount spent by Local Authorities on providing personal care services to older people in their own home was £433 million, an increase from £424 million in 2019-20. Since 2011-12, this figure has increased by 25% from £347 million.

Proportionately, expenditure on personal care services for older people was 89% of all Care at Home expenditure for those aged 65 and over in 2020-21: an increase from 87% in 2019-20 and from 87% in 2011-12.

Expenditure on personal care services at home (£ thousands) and other Care at Home expenditure (£ thousands), Scotland, 2011-12 to 2020-21

Notes: Figures in this chart contain estimates for overhead costs.

For context, total Care at Home expenditure in 2020-21, £488 million, is consistent with £488 million in 2019-20 and represents an overall increase from £398 million in 2011-12.

The increase in expenditure over time may be driven by a combination of factors:

• An increasing proportion of older people are cared for at home, rather than in hospital or Care Homes.
• Care at Home workers are increasingly providing personal care services rather than domestic services.
• People living at home have increasing levels of need.
• Increasing cost of providing care at home services.

Full data are available in the accompanying tables.