T HE C IT Y O F E DI NB UR GH COU NC il Kez ia Dugda le MSP The Scottish Parliament Holyr ood Road Edinburgh EH991SP Dear Kezia , Ch an ge Fu nd - Ca rers 27 October 2011 Thank you for your lette r dated 4 Oct ober in r el at ion to sup port for carers as par t of the Chan ge Fun d. The Change Fund has been a welc ome commitment from the Scottish Government to enabl e health and social car e par tne rs to implement loc al plans for making better use of t heir combined resour ces for older people' s ser vic es. Supporting carers has been a key principle of the Change Fund in 2011/12 and I note that this has been str eng thened by the announcemen t as pa rt of the Spe ndi ng Review that at le ast 20% of the Fund should be all ocated to support carers fr om 2012/13. This is not a 20% inc rea se in n ati ona l fun din g, it is s imp ly ask ing par tne rsh ips to ensure tha t the y commit 20% of their overall Cha nge Fund alloca tion to suppo rt car ers . Whi lst the Cha nge Fun d appli es to ol der peopl e, the Spe ndi ng Review mak es fur the r refer enc es to car ers and it is welcomed tha t in 2012 -13, Scotti sh Gov ernment pri ori ties wil l include contin ued fun din g to suppo rt carers and young car er s. The Local Authority will continue to w ork in partn ers hip with Health Boards to help deliver the se pri ori tie s. We awai t cla rif ication by t he Scotti sh Gov ernmen t in r ela tion to t he envelope of funding for this ring-fenced support for carers to imp lement the commit men ts in the Nat ion al Carers and Young Car ers Str ate gy. We also welc ome tha t the Scot tish Gover nment has out lin ed tha t they would ensure carers ' experi enc e and knowle dge is ful ly taken int o account so th at ther e are improvements in the tre atment and care of those who are car ed for . Sup por t to y oung carers and par ent carer s (parents of children with dis abilities) are add res sed wit hin our l oca l carers ' str ate gy and c hil dre n's ser vic e pla ns. Any add iti ona l ser vic e pro vis ion to th ese groups wou ld be consi der ed by t he relev ant commit tees wit hin agr eed bud get s. In response to y our concern that resour ces ava ilable thr oug h the Change Fun d are not being allocat ed to th e third sec tor, I fee l that these con cer ns hav e been tak en on boa rd in Edin bur gh. The Edinbur gh Cha nge Fun d pla n allocates 20% of 20 11/ 12 monies (£1.2m) to C ommunity Capacity and Co-p roduction wor k str eams whi ch is sub stanti all y mor e than other par tne rsh ips , wit h most all oca ting aro und 10% to th is theme. This allocation wil l be made to fun d innovative pro jec ts and mar ks a signif icant commit men t to ch ang e the f ocus of cu rrent mod els of ca re to incl ude more preventative, community bas ed services. Whilst the sh ifting of resource fro m statut ory services to d eve lop ing commun ity cap aci ty is a p ositive move, we need to ens ure tha t we have a rigo rous eva lua tion and evi den ce bas e on whic h to mak e the se decisions and I k now that partnerships are w ork ing to develop the se. ( - ) f i l Q .>----~ l:.,,"VESTOR L~ PEOrLE
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Thank you for your letter dated 4 October in relation to support for carers as part of
the Change Fund.
The Change Fund has been a welcome commitment from the Scottish Government
to enable health and social care partners to implement local plans for making better
use of their combined resources for older people's services. Supporting carers has
been a key principle of the Change Fund in 2011/12 and I note that this has been
strengthened by the announcement as part of the Spending Review that at least 20%
of the Fund should be allocated to support carers from 2012/13. This is not a 20%
increase in national funding, it is simply asking partnerships to ensure that they
commit 20% of their overall Change Fund allocation to support carers.
Whilst the Change Fund applies to older people, the Spending Review makes further
references to carers and it is welcomed that in 2012-13, Scottish Government
priorities will include continued funding to support carers and young carers. TheLocal Authority will continue to work in partnership with Health Boards to help deliver
these priorities. We await clarification by the Scottish Government in relation to the
envelope of funding for this ring-fenced support for carers to implement the
commitments in the National Carers and Young Carers Strategy.
We also welcome that the Scottish Government has outlined that they would ensure
carers' experience and knowledge is fully taken into account so that there are
improvements in the treatment and care of those who are cared for.
Support to young carers and parent carers (parents of children with disabilities) are
addressed within our local carers' strategy and children's service plans. Any
additional service provision to these groups would be considered by the relevant
committees within agreed budgets.
In response to your concern that resources available through the Change Fund are
not being allocated to the third sector, I feel that these concerns have been taken on
board in Edinburgh. The Edinburgh Change Fund plan allocates 20% of 2011/12
monies (£1.2m) to Community Capacity and Co-production work streams which is
substantially more than other partnerships, with most allocating around 10% to this
theme. This allocation will be made to fund innovative projects and marks a
significant commitment to change the focus of current models of care to include more
preventative, community based services. Whilst the shifting of resource from
statutory services to developing community capacity is a positive move, we need toensure that we have a rigorous evaluation and evidence base on which to make
these decisions and I know that partnerships are working to develop these.
The engagement sessions and workshops held to date have highlighted the importance of training,
communication and culture change to support the strategic shift required. This activity will involve all
sectors, including carers.
Information for Older People and their Carers (part of the Training, Development and Cultural
Change theme above)
Communication with older people and their carers and the availability of information about services is
recognised to be an essential element of the Change Fund work. Work will be undertaken to improve
the availability of information and communicating with carers will be a key aspect ofthis work. The
funding for this will come from the allocation to workshop 3 - training, communication and culture
change.
Innovation Fund (£553k)
It is proposed that a significant proportion of the Change Fund budget for Community Capacity
Building and Co-production should be allocated to investment in low-intensity services with high
impact for older people. These services will contribute to the overall Change Fund objectives by
focusing on preventative and anticipatory care, adopting an asset based approach, and usingprinciples of co-production and volunteering. Proposals will be evaluated based on the impact against
key objectives of the Change Fund and this will include support for carers.
Re-ablement Services (£1m)
The home care re-ablement service will be a crucial part of delivering a shift in the balance of care
from institutional to community based settings. It has been agreed to expand the re-ablement service
as part of the Change Fund programme with an initial recruitment of 26 additional staff, to be
considered further as detailed plans develop. Feedback from evaluation of re-ablement services note
the support it can provide to carers, a recent briefi ng by the Social Care Institute for Excellence
reported that "some carers report that re-ablement increased their confidence with their own caring
responsi biliti es" .
Intermediate Carel Community Therapy and Community Nursing services (Um)These services are key to supporting people in the community. Proposals are to increase the capacity
of these services to ensure older people can access the services they need, supporting older people
and their carers.
Home Carel Care at Home (£600k)
This investment is to develop additional capacity for home carel care at home to meet the demand
from shifting the balance of care. Delays. lack of availability or breakdown of home carel care at
home support is a key area of carer stress and providing additional capacity in this area is essential to
supporting older people and their carers at home.
Joint Medication Procedure for Home Care and Care at Home Services (£2251<)
This allocation is to support independent sector care at home providers to implement Council
medication training and procedures. Improvements to medication procedures will increase theconfidence and safety of service users and their carers, and will ensure better co-ordination across in-
house and externally provided home care services.
Medications Review (£60k)
Appropriate, effective medication is essential to enable many older people to stay safely at home.
Improving the review of medication for older people at home will be a benefit to older people and