5.1 The demographic context

Research question 1 addressed the demographic context in which social care services are being delivered today. Chapter 4 showed that the most obvious factor to effect this service is the volume of people requiring immediate support. Much is written within the literature about the demographic time bomb (Davidson et al, 2007; Razavi and Staab, 2010) and it considers potential policies that might be invoked (Christie Commission, 2011). What is not recognised, however, is that the situation is imminent and is here with us now. Despite demographers and gerontologists writing extensively over the past three decades (Bean 1983; Andersen, 1995; Macunovich, 1999; Bond et al 2001) to predict the demographic challenges, the steps required to offset the demands have failed to materialise. Indeed, if we consider the demographic data in relation to the over 65 population in ten year cycles, a 14% increase is noted between 2000 -2010 [The following two decades show slightly higher increases at 15% and 16% respectively]. This analysis sharpens focus around the baseline data. In terms of determining future service and budgetary provision, these marked increases should provide the focus and understanding to allow meaningful planning of anticipated commitments. The introduction of joint commissioning strategies [A framework for the health and social care partners to assist the development  and fund community services that will deliver the Government’s agenda for better outcomes for older people]  across the health and social care sector clearly makes provision for a population needs assessment and the analysis of any gaps that may arise in service provision. This analysis then becomes a pivotal factor in the determination of future planning and strategy. Indeed, it might be argued, that, had this level of planning taken place throughout the last 15-20 years, the current plight that the public sector organisations find themselves today may have been averted.

The second factor is perhaps less obvious but is equally important. The increased prevalence of individuals living longer with long term conditions is putting significant strain on the public sector resources. Raeside and Kahn (2007) argue that the increase in expenditure in health and social care is directly attributable to the size of the cohort that is dependent upon health and social care services today. The wider concern for LA is that the evidence would suggest (SIMD, 2013) that there is a higher prevalence of long term conditions in areas where there is higher levels of deprivation. LA currently has 55 data zones (out 179) that are in the lowest quintile in Scotland. This then becomes a wider issue for LA in how it begins to tackle the socio-economic problems that underpin the deprivation index. Interestingly, of the 55 data zones identified the one indicator that shows a sign of improvement is the health indicator (SIMD, 2013). In summary, when these two factors are taken together, they represent the very crux of the challenges posed by the ageing population today.