Edinburgh Napier University

  More older people than ever before can look forward to many years of healthy life after retirement. Reflecting the priority the Scottish Government places on optimising the quality of later life, it has included in the National Performance Framework (NPF) a National Outcome that ‘Our people are able to maintain their independence as they get older and are able to access appropriate support when they need it’ (National Outcome 15).

To help achieve this goal, the Scottish Government launched the Reshaping Care for Older People (RCOP) programme in 2011. The main aim of this programme is to encourage health and social care services to move towards a more preventative approach. This is seen as a way of increasing the proportion of older people who remain active, healthy and independent for longer as well as having potential cost-saving benefits. The programme also recognises the need to address the social inequalities in later life that mean that the length and quality of healthy life expectancy varies markedly between different socio-economic groups.

To support the 32 health and social care partnerships to implement the RCOP programme, a £300 million Change Fund was set aside over a four-year period (2011–15). It is expected that an increasing proportion of funding will be invested in prevention, including anticipatory care, proactive care and support at home. However, it is unclear what a full range of effective preventative services might look like in order to achieve the National Outcome. Having a better understanding of what is required is essential not only for the Change Fund, but also for joint commissioning strategies by local partnerships.

To help to develop a better understanding of what a preventative approach would look like, in 2012 the Scottish Government’s Integration and Reshaping Care policy team and the Joint Improvement Team (JIT)a invited NHS Health Scotland to work with them to develop an outcomes framework for the RCOP strategy. Ultimately, the outcomes framework will be transferred to the JIT website as an online resource that can be further developed and easily updated. The written version of the framework is an interim step.

The remainder of this section sets out the aims of the outcomes framework, the development process, its components, scope and intended uses plus a brief description of the evidence review process. Section 2 describes the current situation being addressed in the framework followed by the vision of change and improvement (section 3). Sections 4 and 5 outline the long-term and medium-term outcomes included in the strategic outcomes model, with section 6 identifying the main external factors that will also effect the achievement of these outcomes. The key groups of older people that a prevention strategy needs to address and reach are outlined in section 7. The final section summarises the evidence for interventions that link the different outcomes in the strategic outcomes model. A separate report describes the four more detailed nested models.