Variation in acute and community service provision of care of the elderly services across Scotland: findings from the Scottish Care of Older People (SCoOP) initial scoping survey

Background 
This scoping survey is a preliminary part of the Scottish Care of Older People (SCoOP) audit programme, which aims to assess specialist service provision for older people with frailty in Scotland, and provide benchmarking data for improving services.

Methods 
The survey was distributed to nominated consultant geriatricians based in 12 of the 14 Scottish health boards who completed data to the ‘best of their knowledge’. Data collected were: consultant and specialty doctor level workforce; days of frailty unit operation; multidisciplinary team discussion frequency; and, physiotherapy and occupational therapy availability. Consultant cover was correlated with population data, and scores for service components used to derive separate acute and community service provision scores.

Results 
Consultant geriatrician availability varies widely across Scottish health boards with a median of 1.45 [range: 0.54–2.40; interquartile range (IQR): 0.71–2.28] full-time equivalent consultant geriatricians per 10,000 people ≥65 years. Variation was also present in the service provision scores [score range 0 (none) to 1.0 (very good)]: for acute services, the median national service provision score was 0.81 (range: 0.50–0.89; IQR: 0.75–0.85) and for community services 0.60 (range: 0.48–0.82; IQR: 0.52–0.65).

Conclusions 
This report clearly demonstrates mismatch between workforce and services in both acute and community settings in the context of the population size. Future surveys will build on this preliminary information to audit service provision for older people at an individual hospital level.