Social Care Eligibility Criteria And Waiting Times, Scotland, 2020-21

4. Background information

4.1 Data sources

The Scottish Government Quarterly monitoring return was used to compile this Statistics release.

The National standard eligibility criteria and waiting times for personal and nursing care was introduced in 2009-10, and was initially developed for older people following the publication of Lord Sutherland's review, and was extended to all adults with the extension of free personal and nursing care in April 2019. The national standard seeks to deliver the shared commitments agreed by Scottish Ministers and local authority elected members. Eligibility criteria and waiting times for new social care clients completing a community care assessment and new personal care clients is collected annually.

The eligibility criteria and waiting times collection, although collected annually, is part of the longer running (since July 2002) Scottish Government Quarterly Monitoring Return collection on the number of people receiving personal care services at home, the number of self-funders receiving Free Personal Care and Free Nursing Care payments.

The results of the survey data can be accessed via the Social Care Analysis page on the Scottish Government website.

All data in this publication is sourced from the Scottish Government Quarterly Monitoring Return.

In 2019, this survey was updated to collect information on under 65s receiving Free Personal Care following the extension of the policy to people of all ages who are eligible.

4.2 Understanding the statistics in this report

Time period

All information in this Statistics Release is presented for the last quarter of each financial year - from 1 January to 31 March. Information is reported for a rolling ten-year period, which in the case of this release is from 2012 to 2021. However, with the extension of free personal care to under 65's in April 2019, data on 18 to 64 year olds is recorded from 2019 to 2021 only.

Eligibility criteria

In general, care should be taken when comparing the data on 'numbers' and 'proportions' of people completing a community care assessment or beginning a new personal care service. The number/proportion of people recorded is collected for the last 3 months of the financial year and so represents the number of people completing assessments or receiving personal care service delivery from January to March, rather than for the whole financial year. This does not represent the number of people for the full 52 weeks of the year.

Similarly, for the majority of local authorities, only clients assessed as 'critical' or 'substantial' on the eligibility criteria are able to receive care, due to the limitation of financial resources preventing more people from being supported.

Waiting times

As with the Eligibility Criteria data, the information provided for clients waiting times between first contact and completion of a community care assessment, and between completion of a community care assessment to delivery of new personal care service provides a snapshot at the end of the financial year.

The data on number of clients waiting times from completion of a community care assessment to delivery of new personal care service is also used to determine the total numbers of new clients.

4.3 Glossary

Community care assessment - a series of actions, undertaken jointly as far as possible with the person being assessed, which includes identifying the extent and nature of their needs, and the key outcomes they would like to achieve, the extent to which these may be enabled or met by community care services or support, informing the person and/or carer of the conclusion, and, where appropriate, devising a care plan and arranging services.

Delivery of service (date) - the date by which the services set out in the agreed Care and Support Plan are being delivered to the client. The Delivery of Service date is therefore the first date after confirmation of need on which either personal care at home, or personal and nursing care in a care home, or a Direct Payment/ Self Directed Support provided for personal care needs, commences.

First contact (date) - the date on which the potential need for an assessment of social care needs was first notified to the Local Authority, by or on behalf of the client. For clarity, clients are only included in this return if their community care assessment end date or care plan date, is within the monitoring period.

New client - someone who was not receiving services provided or arranged by local authority adult social care services at the time of the contact or referral that triggered the assessment. This does not mean that the person has never been assessed previously or received services in the past. People who receive information or advice or a basic service as a result of screening but without further assessment are excluded from this definition.

Personal care at home - includes intermediate care (e.g. rapid response, crisis care) but, for the purposes of this measure, excludes: telecare, equipment and adaptations, and nursing services provided by the NHS.

Personal care services - includes personal care at home, personal and nursing care in a care home, or a Direct Payment / Self Directed Support provided for personal care needs.

4.4 Limitations of the data

Completeness of data returns is a major limitation of this dataset.

There are three tables in the collection:

• Table 1 of the collection return counts new clients, by age band, of the numbers of older people in each of the eligibility criteria categories following a completed community care assessment.
• Table 2 of the collection return provides the distribution of time intervals from first contact to completion of a community care assessment separately for each of the eligibility criteria categories, for new clients recorded in Table 1.
• Table 3 of the collection return provides the distribution of time intervals from completion of a community care assessment to delivery of a relevant personal care service with the start date in the reporting period, separately for clients in each of the age and eligibility criteria categories. Therefore Table 3 does not count the same cohort of people as Tables 1 and 2.

For all three tables in the return there has been a decline in the number of local authorities that have completed it over time. For tables 1 and 2, there is a decline in completion from 29-30 local authorities in 2012-2014, to 23 in 2020 and 24 in 2021. For Table 3 there is a decline in completion from 27 local authorities in 2013 to 23 in 2020 and 2021, with a low of 20 local authorities in 2016. Tables of data completeness by local authority for each table in the return are detailed in the accompanying dataset.

In addition to the declining numbers of local authorities completing the data return, the local authorities completing the return vary each year. Both of these factors prevents a Scotland level analysis for Eligibility Criteria or Waiting Times. Any trend data contained within this report is for indicative purposes only using the local authorities that have responded every year between 2012 and 2021 and does not represent a national-level trend. Due to the difficulty cited by local authorities in providing the data, we advise caution in drawing further conclusions from the dataset, as different methodologies and recording systems in local authorities have affected data quality and comparability.

Users are advised that trends in the report, or that may be extracted from the dataset, are not of sufficient quality or consistency to support detailed analysis or modelling.

Local authorities provided a range of reasons for this data being of difficulty to provide. These reasons vary by local authority, but include:

• data required for the return is held independently, and so multiple datasets (specifically for those receiving a service) are necessary to complete the return,
• data is not recorded in the correct format or cannot be differentiated e.g. between clients receiving personal and non-personal care services,
• updates to recording systems preventing data delivery,
• data is not held by the local authority for this request.

Public Health Scotland (PHS) are developing plans to capture waiting times data within existing Social Care collections returned to PHS.