Move to critical-only social care in East Ayrshire scrapped

It had been expected that the East Ayrshire Integration Joint Board (IJB), which oversees the Health and Social Care Partnership (HSCP) on behalf of East Ayrshire Council and NHS Ayrshire and Arran, was going to rubber-stamp a tightening of criteria for adult social care to those with a ‘critical’ need.

But the report instead recommended maintaining the current eligibility threshold for adult social care, allowing people assessed as having both “critical” and “substantial” needs to continue receiving funded support.

The recommendation comes amid ongoing financial pressures facing the East Ayrshire Health and Social Care Partnership and follows several debates in which tightening eligibility criteria had been presented as a potential necessity to help address growing demand and budget challenges.

A move to a “critical-only” model had been under consideration as a way of reducing expenditure by limiting access to publicly funded care to those facing immediate or imminent major risks to their health, wellbeing or independence.

However, officers have now concluded that such a move would create greater problems elsewhere in the system.

The report warns that restricting support to only the most severe cases would likely increase unmet need, place greater pressure on unpaid carers and lead to more people reaching crisis point before receiving help.

The council's services were due to be tightened. (Image: East Ayrshire Council.)

It also argues that any financial savings made through the move could be offset by increased demand on GPs, hospitals, community nursing teams, housing services and voluntary organisations.

“The likely result would be cost displacement rather than true cost reduction,” the report states.

This calls into question the arguments for the tightening of criteria in the rest of Ayrshire and elsewhere in Scotland.

South Ayrshire moved to a critical need focus in 2019, while North Ayrshire, citing financial pressures, changed to a focus on critical need this year.

The East Ayrshire partnership is proposing to keep the existing threshold introduced in 2024, when support was already restricted to people assessed as having critical or substantial needs, with those assessed as having moderate needs no longer routinely eligible for funded care.

The report acknowledges that demand for services continues to rise because of an ageing population, increasing frailty, dementia and other long-term conditions, while the gap between available resources and demand remains a significant strategic risk.

Rather than tightening access further, officers are recommending a stronger focus on ensuring eligibility criteria are applied consistently across teams through enhanced guidance, staff training, supervision and auditing.

The report also highlights concerns about the impact a more restrictive policy could have on unpaid carers, warning that reducing support for people with substantial needs could increase physical, emotional and financial pressures on family members and raise the risk of care arrangements breaking down.