20. People told us that they want to be able to live well, and play a full role in making decisions about their care and support. People asked for appropriate advice and support for them and their carers so that they could do this on their own terms.
21. We recognise that many people do not need, or want, to access hospital based services. The actions detailed later in this plan are considered based on a pyramid of support (Figure 1) which defines levels of support and care dependent on the needs and choices of the person living with a neurological condition.
Figure 1: Pyramid of support
22. In the first tier of the pyramid, people living with neurological conditions are self-managing their condition effectively within their communities, with shared decision making, including resources to promote a self-management approach to their care.
23. In the second tier people have a need for access to more generic neurological care and support delivered within the local community (e.g. paid carers from the local authority or a social care provider, personal assistants, social workers, speech or occupational therapy).
24. In the smallest tier are people who require specialist, often condition specific support, frequently available through regional or national services. Such individuals may require complex, highly tailored packages of care and support.
25. People may move between these levels of support, or access all levels at the same time, depending on their needs. Social care delivered in any tier will be accessed through self-directed support, Scotland’s mainstream approach to social care. This ensures that support is personalised, and allows people to take control of their support if they wish to.
26. Scotland’s Health and Social Care Standards set out what standards of care everyone can expect when using health, social care or social work services in Scotland. The standards seek to provide better outcomes for everyone, and we have developed our approach in accordance with the principles of Dignity and Respect, Compassion, Inclusion, Responsive Care and Support, and Wellbeing.