Introduction

Background

The Scottish Government’s Health and Care Experience (HACE) survey asks about people’s experiences of:

• accessing and using their general practice and out of hours services
• aspects of care and support provided by local authorities and other organisations
• caring responsibilities and related support

in the last 12 months.

It is an online and postal survey sent to a random sample of people registered with a general practice in Scotland. The survey is a successor to the GP and Local NHS Services Patient Experience Survey and has been run every two years since 2009.

Following the publication of the national results of the most recent HACE survey (2023-24) in May 2024, and publication of further analysis examining experiences of care and caring in October 2024, there has been interest in additional analysis specifically on the question of unmet need for care, support and help with everyday living.

This analysis of HACE data is the first analysis of reported need and unmet need for "care, support and help with everyday living" amongst the older adult (65+) population. All references to need, receipt of support and unmet need are self-reported measures, indicated through responses to the HACE survey. It builds on previous HACE publications, with a focus on all older adults who do not feel they have the support to meet their everyday living needs. We have outlined both the strengths and limitations of our approach in the Data and Methodology chapter.

What this analysis provides

This analysis presents estimates from the HACE 2023-24 survey of the proportion of the older (65+) Scottish population who reported unmet need for support in the previous 12 months. It also presents estimates of reported need and unmet need by selected demographic, socio-economic and health-related factors, showing how levels, and types, of unmet need vary across different groups.

It is important to note that the HACE survey was not designed to estimate need and unmet need in the overall Scottish population. However, by limiting our sample to older adults (65+), for whom response rates were much higher, and for whom reported incidence of limiting long term conditions were very similar to estimates from Scotland’s Census, we have assessed the analysis usefully provides the best available estimates for current levels of reported need and unmet need in the wider older adult population.  

The factors we have explored are not an exhaustive list. We have only looked at factors that we were aware of being linked to unmet need in the existing literature, and that could be explored using the HACE data. We have excluded a number of equalities characteristics – such as ethnicity, religion and sexuality - from this analysis as the sample sizes for some responses to these characteristics were not sufficiently large to allow for robust analysis.

The HACE national results provides statistics on reported unmet needs amongst people who did not have any support but felt they needed it. However, we also recognize that individuals who did receive some support (whether funded or unfunded) may still have experienced unmet need. This could be because they experienced obstacles in accessing support, and/or that the support they received was not of the right kind, intensity or duration. This report produces estimates of both kinds of reported unmet need in the Scottish population aged 65+: older people who reported not receiving any support despite needing it, and older people who reported receiving some support but still indicated an unmet need. You can read more about the different need groups we have identified in the Data and Methodology section.

Further descriptive information about the group of older adults who reported need and unmet needs can be found in Annex A.

Presentation of data

Many of the estimates we have calculated are discussed in the text or are visualised in graph form. A full set of all the results is available in the accompanying supplementary tables. This includes all the results presented in the graphs.

As the results are estimates calculated from survey data, some of the apparent differences between different groups of people are not statistically significant at the 95% level.  A statistically significant result is one where the difference is sufficiently large that it's very unlikely to be random variation. (For more information please see the section on Significance Testing in the Data and Methodology section.)

Where we describe results for different groups as “similar”, the difference between them is not statistically significant at the 95% level. Where we state a difference between different groups (such as higher, lower, slightly higher) the difference is statistically significant at the 95% level.

We have not included descriptors for all comparisons across different groups in the text. This is to keep the text readable and to focus on presenting the main points.

An Official Statistics in Development Publication for Scotland

These statistics are official statistics in development. Official statistics in development may be new or existing statistics, and will be tested with users, in line with the standards of trustworthiness, quality, and value in the Code of Practice for Statistics.

Over the next 12 months we will engage with relevant users and stakeholders to understand how they are using these statistics, and whether they provide useful insights. If you have any questions or feedback on these statistics, or would like to be involved in this process of improvement please contact us using the details in Tell us what you think.

Scottish Government statistics are regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

More information about Scottish Government statistics is available on the Scottish Government website.