Edinburgh by Numbers 2021, published Jan 2022

EIJB joint strategic needs assessments (JSNA) 2021 – Population and demographics – Edinburgh Health and Social Care Partnership (edinburghhsc.scot)

Alternative methods of payments are available to those who do not wish to use the pre-paid card service.

There are currently 624 cards issued for emergency payments.

EHSCP currently manage approximately 575 Corporate Appointees, with approximately 360 in the community and the remainder within care homes (under 65s).  Eleven of these piloted the Allpay pre-loaded payment card for Corporate appointees

Allpay is not required for those in care homes as the care homes have accounts for the residents and procure what is needed through other processes.

The total number of cards issued is  expected to increase over time as the demographics of Edinburgh continue to change (more people living longer; an increase in the proportion of people over 75; and an increase in those living with chronic conditions and multi-morbidities, for example)

In addition, there has been an increase in legislation over recent years – the Adult Support and Protection (Scotland) Act 2007, Mental Health (Care and Treatment) (Scotland) Act 2003 and the Adults with Incapacity (Scotland) Act 2000. This, along with changes in demographics, has contributed to the growing numbers of compulsory financial interventions being required.

Approximately 61% of service users are over 65 years of age with just less than half being male and slightly more than half female.

Currently, it is estimated that approximately one fifth of service users have a physical disability, one tenth have a learning disability and one tenth have a mental health issue.  A small amount have drug and alcohol issues.

Often the SDS funds are managed and administered by an unpaid carer and there may be a card in the unpaid carers name.

Unpaid carers are also assessed in their own right and in some instances are given a budget to support their needs.  At the moment these payments are made via BACS into their bank accounts or occasionally in cash.

Some services are free of charge, such as personal care for people aged 65 and over and nursing care for those assessed as needing it, but there may be a charge for other services and this is means tested.

Emergency payments are available to those who have been assessed by a Council employee as meeting the criteria for a payment.

A high proportion of the service users will therefore have lower socio-economic status.

The Joint Edinburgh Carers Strategy (currently draft)

Director of Public Health Annual Report

There is widespread data available on equality outcomes for people within these protected characteristic groups, for example,

people with a learning disability do not enjoy the same life chances as others (‘Keys to Life Implementation Framework’, 2019).  They have some of the poorest health of any group in Scotland. They are considerably more likely to die at an early age than the general population – on average 20 years before. Some of the causes of death are potentially preventable.

Caring responsibilities may limit people’s participation in employment, education and other aspects of life. This may impact on the carer’s social status, income, mental and physical health and ability to access services.  The Covid pandemic restrictions brought further challenges for carers’ which exacerbated the impacts of caring on carer’s mental and physical health.

It is estimated that around 60 percent of unpaid carers are women (higher for working age carers) and women are four times as likely to give up paid work due to multiple caring responsibilities and are more likely to be in low-paid, part-time employment than male carers. The responsibility of care has significant ramifications on women’s access to employment, career development and progress, access to training and higher education, as well as on physical and mental health.

The Joint Strategic Needs Assessment (JSNA)  papers provide further information on a range of equality outcomes:

• Population and demographics
• Poverty
• Dementia
• Population health and inequalities in Edinburgh
• Mental Health

The Director of Public Health report highlights a decline in overall population health over the last ten years. The COVID-19 pandemic and the cost-of-living crisis have amplified these negative health trends with particularly deleterious impacts for the most vulnerable members of the Lothian population.

Feedback received from those that work with service users has been extremely positive and it was reported that most service users and workers are very happy with the process.  Feedback noted that the process is user friendly, quick to respond, quick to get money, it can be cancelled if need be, provides transparency and is definitely a better system than previously in place – it is seen as almost indispensable by some.  The Bacs system was clumsy and difficult to operate.  The use of the pre-loaded card is not mandatory and no-one yet has asked to hand back the pre-loaded card and go back to the old system

An emergency Allpay scheme which included Corporate Appointees was piloted over the last couple of years with positive results.  This was introduced to work around Covid19 distancing restrictions. This was successfully implemented and well received by services users, staff and care agencies.

Utilising alternative payment options will also reduce the need to use care at home hours for care agencies to attend local offices to collect cash.

There is an increased demand for this service to grow.

There have been limited issues reported to date with the use of the prepaid card for example, the amount of emergency funds paid both in one transaction and over the lifespan of the prepaid card are restricted.  These have now been extended.