Services for older people

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Closes 3 Dec 2023


What you need to know: the background context

When planning how East Lothian older people’s services will be delivered, there are a range of factors that need to be taken into consideration, for example:

  • Population growth
    East Lothian has one of the fastest growing local authority populations, especially people aged 65 and over.

  • Deprivation
    Deprivation measures the level of poverty in geographical areas.  East Lothian has 6 wards, which is split into 132 data zones.  8 zones in East Lothian are in the 20% most deprived areas of Scotland.   In more deprived areas, life expectancy is lower, and individuals are more likely to experience more challenging health, social and economic conditions.
  • Staffing
    The health and social care sector is experiencing a staffing crisis.  Some key positions within the care sector are low paid, challenging roles, which directly compete with hospitality, retail, education and cleaning sectors.  Additionally the majority of care staff are over the age of 45 years.  By 2043 for every 100 people working, 49% will no longer be working. 
  • Wider factors out with ELHSCP control
    We also have to consider the potential impact of the proposed National Care Service, the lack of available and suitable building spaces from which to deliver community services, and access issues including transport to help people get to and from activities. 
  • Finances
    East Lothian’s Integration Joint Board receives funds from both NHS Lothian and East Lothian Council to deliver health and social care services. The Scottish Government has already outlined significant financial challenges ahead. East Lothian has already had a funding reduction for 2023-24, which is only likely to continue.

    Any option that is put forward to deliver future services for older people must be carefully costed and analysed to ensure affordability and best value.

Thinking about the bigger picture

This is a big conversation that will have a lasting impact on the shape of older people's services for many years to come. If it doesn't affect you directly now, it almost certainly will in the future.

It is unlikely that services for older people will be able to continue operating as they do at present.   It is important that we are able to work with communities across East Lothian to look at how we can help people to remain as healthy and independent as possible for as long as possible.

There are no easy answers but these are important questions about how we make the best use of our very limited resources to the greatest benefit for older people and their carers across East Lothian.

So, that being said, it's over to you...

Thank you for giving your time, it is much appreciated.

Please complete the survey or just email us your comments at


We will treat everything you tell us in strict confidence.  We will only use the information you give us for this project.  We will follow all the necessary data protection guidance. You can find out more about Data Protection in the UK at Data protection - GOV.UK (


1. What is your name?
2. What is your email address?
3. What is your organisation?
4. What is your interest in older people's services? Please tick as many answers as apply.
5. What Local Area Partnership area do you currently live in?
6. Last year, we carried out the Planning for an Ageing Population engagement to identify what people's priorities and worries were about growing older. (The full feedback report can be accessed within the document library at the following address - The following list identifies key themes that people identified as being important for them. Please tick all the statements that you agree with.
7. Intermediate care services provide support to people either to prevent a hospital stay or to return home from hospital more quickly. This includes things like hospital at home, Physiotherapy, Occupational Therapy, Technology Enabled Care, pain management, and mental health support, all of which helps people retain or regain independence.
8. We know from our engagement last year and from national data that most people would prefer to die at home. However, the number of people being supported to die at home in East Lothian is lower than the Scottish average.
9. There are three hospitals in East Lothian, East Lothian Community Hospital and two older and smaller satellite hospitals, Belhaven in Dunbar, and the Edington in North Berwick. East Lothian Community Hospital in Haddington was opened in 2019 and was specifically designed to support older people. It offers re-ablement services, palliative care, dementia care and a wide range of additional services. Hospital beds within East Lothian Community Hospital are well managed and there are enough beds available to meet current and future foreseeable demand. We need to ensure our hospital services are available to everyone in East Lothian. When considering the future use of Belhaven and the Edington, we need to think about what benefits they offer to people in East Lothian as a whole, and how we ensure the hospital bed provision is sustainable financially and in line with modern health care standards. Please use the box below to give us your thoughts.
10. Care at home supports people with medication and personal care with short visits between one and four times a day. There is a shortage of care at home services which is more acute in some areas of East Lothian than others. Care at home services have difficulty in recruiting people due to low pay and challenging work conditions. Please use the boxes below to share any personal or professional experience of care-at-home services and what works well and not so well.
11. There are currently sufficient care home places in East Lothian, but consideration must be given to future care home provision. Care homes are not equally distributed across East Lothian and the majority of beds are within private care homes, which are located in the more affluent areas of East Lothian. There is no budget to build new care homes and limited budget to fund repairs to partnership managed homes.
12. Minor Injuries Units (MIUs) offer adults and children over 12 months old, advice and treatment for a variety of injuries including strains, sprains, wounds and minor burns, minor bumps to head and face, simple eye injuries and insect bites and stings. Patients presenting with minor injuries and ailments are currently seen within some GP practices, by visiting a local pharmacy or by calling NHS24 on 111 for an appointment to be seen at the minor injuries units at the Royal Infirmary, Western General Hospital or Royal Hospital for Sick Children and Young People. There have been previous suggestions from the public that East Lothian should have its own dedicated Minor Injuries Unit, based at a centralised location. This would be in addition to the minor injuries services in place currently.
13. What does the future of East Lothian older people’s services look like for you and your community? Taking into consideration all of the aspects of this survey, what services do you think should be given priority when planning older people’s services. Please rank the services in order of importance to you 1-7 with 1=most important. Please then use the box below to tell us about any other ideas that you would like to share.