Aberdeenshire health bosses are poised to slash spending on care for the elderly in a drastic bid to save millions of pounds.
Cash-strapped chiefs have published a shock “recovery plan” as they scramble to recoup £20m.
They have been spending about £2m more than they can afford every month for the past two years.
NHS Grampian and Aberdeenshire Council’s joint board even admit that cutting some services could result in a “challenge” from the Scottish Government – or the European Commission for Human Rights.
The brutal savings spree, due to be discussed at a major meeting next week, would ultimately result in millions being chopped from care services.
Community hospitals are also being “reviewed” as part of the drive.
What could happen to Aberdeenshire care homes?
The papers reveal the crisis facing the Aberdeenshire Health and Social Care Partnership, the body funded and overseen by NHS Grampian and Aberdeenshire Council.
And they detail the huge savings needed at north-east care homes, as managing the care of older people amounts for the highest area of overspend at £7.4m.
Chiefs explain that there are 38 care homes across the region, catering to an increasing ageing population.
However, only seven of these are “in house”, with venues in Aboyne, Ellon, Fraserburgh, Inverurie, Peterhead, Portsoy and Stonehaven.
Documents state: “With the Aberdeenshire over-70 population projected to increase by over 28% in the next 10 years, changes in demography and complexity of care will continue to significantly impact on our need for residential services and levels of care.
“In addition, the existing physical condition of the estate presents considerable challenges for ensuring buildings remain fit for purpose.”
‘Older people might struggle to form new relationships’
Bosses say the service can “only” save the amount of money needed by cutting down its offering by October.
It is hoped that care providers can be commissioned to fill the gap, with the “majority
of current service packages having to be transferred to another provider”.
The papers add: “This will impact on older people who are the vast majority of current service users.
“The transition may be difficult as new relationships will need to be formed with new carers.”
As the review is just being launched, there are no specific warnings about how each facility could be affected.
What about home carers?
There are 443 publicly-funded carers working across Aberdeenshire, looking after those in need between 7am and 10pm.
A further 53 co-ordinators are employed along with three managers.
There is also the Aberdeenshire Responders for Care at Home (Arch) service – which operates 24/7 with 135 responders, 26 coordinators and three managers.
It was set up as an “emergency response service”, reacting to alarm calls, but has “grown exponentially”.
Staff race out to incidents presenting “immediate and critical risk”, among other issues.
What are the challenges?
The papers state: “The home care and Arch service are undoubtedly of good quality.
“However this comes at significant cost. The service can only meet the savings proposed by a reduction of 70% of what it currently delivers.”
Bosses hope to “reduce the number of unworked hours” where staff are on shift but not providing care.
And they hope to commission other providers to take on a lot of the work.
Why are such measures needed?
It all comes as the AHSCP is set to be over budget by £26.5m in 2024/25.
There are said to be “no reserves” to plug this gap, and a “recovery plan” is being formed to radically rethink future spending.
The papers going before the meeting say the “pensionable age” population is predicted to increase by 28% by 2030.
And the 85+ population is projected to rise by 18.6% by 2030 – “placing additional demand and expectation on the care sector”.
The dossier adds: “A service reset will be necessary to identify sustainable services that meet the demands of Aberdeenshire’s population within the available funding.”
Could community hospitals be hit in Aberdeenshire health cuts?
Another “rapid review” is to be carried out into the region’s community hospitals, to ensure they are “sustainable”.
Aberdeenshire currently has 10 community hospitals. Nine have “active inpatient wards”.
But the documents state: “Many of our hospital buildings are older and will require significant investment over the coming years to ensure their continued viability.
“The scope of the review would be to look at the activity, challenges, strengths
and estate across Aberdeenshire community hospitals.”
This upcoming review would “agree an efficient model”.
And there appears little hope of Insch War Memorial Hospital reopening any time soon.
Local health bosses say “significant capital investment would be required to reopen,
which we do not anticipate receiving”.
What do you think of the plans? Let us know in our comments section below
What else could be slashed in Aberdeenshire health cuts?
Spending on transport services could be cut by £838,391.
The Aberdeenshire Health and Social Care Partnership spends around £1.2million,
per annum, on assisted transport – but the papers stress that this is not a legal requirement.
Any change would affect people who get minibuses to day services, which is about 150 north-east residents.
Activity hubs for older folk in Fraserburgh, Banff and Mintlaw would come under review too.
What costs could go up?
Charges would be raised across the board to bring in an extra £3.3m.
Costs for those who can afford it in very sheltered housing complexes would soar from £482 per week to £775 per week.
And while 71% of people in council care homes pay nothing, those who have the money would see their fees go up from £887 per week to £1,586.
The Aberdeenshire health cuts will be discussed at a meeting on Wednesday, February 19.
Read more:
Conversation