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Measuring Function/Dependency

Health and Social Care

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Measuring Function/Dependency

Over the last 20 years, ISD have developed a suite of tools to measure dependency and care needs for older people in various settings. All tools characterise dependency/need into a series of groupings. and are designed to provide data for population, not individuals. They also provide a valid and consistent basis for estimating care needs of individuals and have application in population needs assessment and monitoring changes in the balance of care between different settings.


IoRN (Indicator of Relative Need), formerly RUM (Resource Use Measure) was developed in 2002 to categorise individuals' resource implications in a community setting, according to their assessed need, following a Single Shared Assessment. Care needs reflected in the groups include a combination of activities of daily living, personal care and mental health and behavioural issues.

An augmented version of IoRN has been developed for the Care Home Staffing Model. This is an adapted version of IoRN and takes account of the increased dependency of care home residents. Additional questions were added to the IoRN questionnaire and the algorithm was revised to derive 8 new groupings. The Care Home Staffing Project Technical Report Download PDF file [510KB] provides further details.


SHRUGS (Scottish Health Resource Utilisation Groups) and SCRUGS (Scottish Care Resource Utilisation Groups) were developed in the 1990s to characterise dependency in older people in all forms of continuing care, SHRUGS for patients in long stay hospitals and SCRUGS for care home residents. Dependency and care needs reflected in the groups include a combination of eating, toileting, transferring position, special care needs, clinically complex treatments and behavioural difficulties. Annual statistical reports from 1999 to 2009 analysing data from SHRUGS and SCRUGS surveys are available. The collection of SHRUGS and SCRUGS data ceased in October 2009.

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