Annex B: Further sources of information on need and unmet care needs in Scotland

This analysis presents a self-reported measure of unmet need for care, support and help with everyday living amongst older adults in Scotland. This is not precisely the same as social care, although there is likely to be considerable overlap. Amongst other uses, this is important information for strategic planning and policy development for adult social care, especially with limited data on unmet need for social care support.

Below are examples of other data that also give insights on need and unmet need for care / social care support:

People waiting for care assessments or for care arrangements to be put in place

Management information on people requiring a social care assessment and care at home services provide data on the number of people (not just older adults) waiting for an assessment for social care services, the number of people waiting for a care at home package and the number of hours of care people are waiting for.

There are also accredited official statistics on delayed discharges in Scotland. These include people who are awaiting care assessment or for care arrangements to be put in place before they can be discharged from hospital.

We know from our recent additional analysis of HACE 2023-24 that, of people who reported not receiving all the care, support and help with everyday living that they felt they needed, only 16% reported waiting related issues. This emphasises that data on people waiting for social care assessments and care at home services comprise just one particular group amongst others who may experience unmet care needs.

Activities of Daily Living and Instrumental Activities of Daily Living

In England, statistics such as those on social care as part of Health Survey for England 2021 provide a range of detailed information about self-reported unmet social care needs for the older adult population (aged 65 and over), using the framework of need for and receipt of help with specific Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADLs).

In Scotland, the Healthy Ageing in Scotland (HAGIS) Pilot Survey Report provided information from a 2016-17 pilot wave survey of a representative sample of people in Scotland aged 50 and over, from 1057 household interviews, including statistics on ADL and IADL problems (page 56 of the report). 10% of respondents had at least one ADL problem and about 47% of them received care, the nature of such help reported as coming from spouses or partners, with daughters playing an important supportive role. 10% of respondents had at least one IADL problem and 83% received help from others. The study found that being old, female and married made it more likely that there would be informal help with ADL and IADL activities (or these respondents were more likely to report getting help). The study found that people in areas with a high level of deprivation were found more likely to receive help with ADL activities, whereas people from areas of medium deprivation were most likely to receive help with IADL activities. The report highlights that, in addition to informal care, 36% of respondents reported having received paid help in the previous 2 years. As well as the HAGIS pilot wave survey, there are some data available on ADL and IADL difficulties from other surveys such as Understanding Society.

Surveys such as the 2016-17 HAGIS pilot wave survey provide more specific insights on particular types of difficulty with daily living and the help received than in the present study of less prescribed reported need and unmet need for help, care and support for everyday living from a recent, much larger survey sample.

Recorded data on unmet social care needs for particular groups

Further data about unmet needs may be available for particular groups at a sub-national level. For example, the Glasgow Disability Alliance Community Navigator pilot, which received frunding from the Scottish Government, provides support to “disabled people in the Glasgow region to overcome barriers to getting and/or utilising the social care they need, and to support services to remove those barriers”. Data on unmet social care needs amongst the 242 individuals of all ages supported in 2023-24 (not just older adults, as in the current study) were collected and included in the research report (p13). These give valuable insights on unmet needs amongst the particular group supported but are not intended to be a representative sample of the total population in Scotland with unmet needs.