Reshaping Care For Older People - Update Paper

4. CONCLUSION

Since we published the Programme for Change, a hugely encouraging range of activity has taken place - much of it stimulated by the Change Fund, and then driven forward by local areas. It is important, however, that we do not lose sight of the individual in all that we are setting out to achieve.

In line with Christie (2011), a personal outcomes approach supports sustainability by moving the focus away from service led approaches. This requires supporting people to make the move from viewing the delivery of service as the endpoint, to focusing on the purpose of engagement and activity with individuals. When the starting point is clarifying purpose (outcomes), the next stage is identifying how those outcomes might be achieved - this includes considering the role of the person and other resources in their lives, as well as services, consistent with an enabling culture. Increasing profile has been given to personal outcomes in policy in Scotland as illustrated below:

Clearly, Self-Directed Support will have a massive impact on the individual's choice and control, but so too should health & social care integration - with services delivered in a coherent manner, in a way that matters to the citizen, then the goals set out under RCOP will come closer to being realised. Also in line with Christie, work on developing Talking Points has demonstrated the importance of focusing on both quality of life outcomes, which prevent deterioration and delay dependency, and change outcomes, more commonly associated with recovery and rehabilitation.

In conclusion:

• We will use our robust outcomes framework to support service innovation up to 2021
• With our partners, we intend to continue to engage with the public and professionals across the country over the coming months and years ahead.
• We will continue to share learning and evidence of success in shifting the balance of care. We are aware that the public needs this evidence to understand and be reassured about the shift from hospital to community care to improve outcomes for people as well as meet the future demands for health and social care.
• We will develop agreed scenarios to aid the further discussion needed about the economic challenges of an increasingly older population. That will include the hard decisions to be made about role of the citizen and state to create a fair and sustainable model of health and social care for our future.