The recommendations set out in the 2008 report of the Ministerial Task Force on Health Inequalities Equally Well remain pertinent in The Scottish Government’s commitment to addressing the inequalities in health that persist in Scotland.

The Scottish Government has now mainstreamed the Keep Well programme.

Under the Keep Well programme, 40-64 year olds with no previous diagnosis of CVD, living in deprived communities, are invited to attend a health check, typically within their local GP Practice.

As part of the mainstreaming programme, Keep Well has been extended to specific populations, such as carers, homeless people, offenders, gypsy travellers and certain ethnic groups, who evidence suggests are at increased risk of CVD and other health inequalities.

Over 180,000 Keep Well health checks have been delivered across Scotland (between March 2009 and end June 2012).

The Scottish Government uses the following figures in comparing costs of care for older people:

Geriatric long stay hospital bed - £50,700 per annum

Care home with nursing care - £29,400 per annum

Care home excluding nursing - £25,300 per annum

Home care - £7,000 per annum

The actual costs of care for both older people and disabled people will vary depending on the level of assessed needs.

The Scottish Government uses a range of cost estimates from the Scottish Health Service Costs (known as the Costs Book) for planning purposes. This is the official source of published cost information for NHSScotland and is available on the ISD’s website. Detailed health service planning is also carried out locally by NHS boards.

The following table shows the number of emergency admissions to NHS hospitals over the last ten available years for (a) Older people aged 65 and over and (b) children aged 0 to 14. The table also shows the number of emergency admissions as a rate per 1,000 population

Information on patient disability is not routinely collected on central hospital admissions data returns.

Number and rate of Emergency Admissions to NHS Hospitals in Scotland; financial years ending 31 March 2003 to 2012

Source:ISD Scotland SMR01 linked catalogue.

p - provisional

This and further emergency admissions information is published under the Inpatient and Day Case Activity sub-topic of ISD’s Acute Hospital Care publication.

The fund focuses on improving outcomes for older adults, many of whom have long term conditions, complex support needs and disabilities. In line with the Scottish Government's proposals for the integration of adult health and social care, the future Change Fund to 2015 will be explicitly linked to delivery of joint commissioning strategies.

The purpose of the Early Years Change Fund is to support the vision and priorities of the Early Years Taskforce to deliver transformational change in the early years, and redesign of local services may be part of that. Any redesign of services as a result of the Early Years Change Fund will take place at a local level and will be supported by the work of the Early Years Collaborative, launched in October 2012 and of the Early Years Practice Development Team, appointed in November 2012.

The Scottish Government provided an additional £5 million to local authorities during 2005-06 specifically to help reduce waiting lists and support improvements in equipment and adaptation service delivery, choice and quality.

Figures for the total Scottish Government and local authority spend on equipment and adaptations are not held centrally. Funding for social care, which includes the provision of equipment, is provided to local authorities by means of a block grant. It is the responsibility of each local authority to allocate these resources on the basis of local needs and priorities.

Funding for adaptations is dependent on property tenure and is either provided by way of a Private Sector Housing Grant, housing association adaptations funding or, from the local authority housing budget. It is not, therefore possible to quantify the total spend on adaptations across all tenures.

The Adaptations Working Group completed its final reports in November 2012. It has made a number of recommendations on the future organisation and funding of adaptations across all housing tenures. The Minister for Housing and Welfare has agreed that these should be taken forward, and a formal Scottish Government response will be published in early 2013.

The Scottish Government has committed over £500 million to three Change Funds over the three year Spending Review period running between 2012-13 and 2014-15, covering Older People, Early Years and Reducing Reoffending.

The Reshaping Care for Older People Change Fund is allocated to health and social care partnerships via the NHS board, on a formula basis agreed between COSLA and the Scottish Government. £70 million was allocated at the inception of the Fund in 2011-12. A further £80 million was allocated in 2012-13. The following table sets out allocations for both years by NHS boards, and by partnerships within NHS board areas.

The answer to question S4W-10139 on 7 November 2012 sets out the contributions to the Early Years Change Fund by the Scottish Government, NHS and local government, including information held centrally on allocation.

The year 1 tranche of Reducing Reoffending Change Fund grants were issued on
19 October 2012, totalling £1.5 million, for use in 2012-13. Full details of grants for Year one are available on the Scottish Government website at:

http://www.scotland.gov.uk/News/Releases/2012/10/changefund19102012.

All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

The Scottish Government has not commissioned any specific research on the comparative costs of care for older people. However, information on the cost of care in hospitals, care homes and at home is available from a range of official statistical returns.