Agenda item 4 - MTFS (Final) Cab 070213 , item 9. PDF 1 MB

Currently an estimated 38,000 older people are living on their own in the county. The number is
projected to rise by about 1,000 a year between 2010 and 2020, and then by 1,300 in the longer
term. Between two-thirds and three quarters of single pensioners will be aged 75+, and among
these 70-80% are women.
Dementia is also an increasingly common condition. In Gloucestershire, there are estimated to be
8,395 people living with dementia. That number is expected to almost double over the next 20
years to 15,151.
As we do not anticipate new investment to meet the needs of our future residents, we have a duty
to plan now in order to build communities who can respond to these changes. In addition to
building capacity, we will need communities who adopt a positive and inclusive approach to people
with disabilities and are not risk adverse. However, this will require a more responsive style of
intervention from statutory services when such risks become unmanageable.
Gloucestershire also has considerable additional pressures in the area of learning disabilities. We
are the third highest region in the country for claims of ‘ordinary residence’. This is fuelled by a
considerable number of placements by other counties into our jurisdiction with resulting claims that
these service users have now become the financial responsibility of Gloucestershire. In addition
the life expectancy for people with learning disabilities continues to add to expected cost
pressures as their care in most cases becomes more expensive based on such things as genetic
dispositions to early onset dementia. Similarly at the young adult end of the spectrum the cases
received from children’s services into adult services demonstrate ever higher levels of need as
heroic medical efforts with premature births lead to people having more profound and multiple
disabilities than seen before and requiring higher levels of costly specialist provision.
Meeting the Challenge 2012/13
We have 14 projects targeted at living within our means and adjusting to meeting demand
differently. Most of these are designed around the implementation of national policy and good
practice – developing a model of reablement, working in multidisciplinary teams, commissioning
differently, listening to our service users and improving the customer journey. Others have
addressed processes – improved recovery of debt.
Achievements in year one of Meeting the Challenge include reducing long term dependency
through improved targeting of our reablement service and developing a partnership approach to
tackling cost pressures from within the independent sector..
In the area of learning disabilities shifting provision to lighter touch front door services such as
Drop In centres has been supplemented with a new focus on employment for people with
disabilities thus increasing independence and reducing costs.
Looking Forward
The proposed budget for 2013/14 requires us to reduce our costs by £9.27m in order to live within
our means.
We intend to achieve financial balance in adult services by:
• fully implementing reablement
• reshaping our assessment and care management model through integration and the
development of multidisciplinary teams
• supporting more people to live independently in the community
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