Integration of Adult Health and
Social Care
VHS Member event, Monday 1 July
Grant Hughes, Scottish Government
grant.hughes@scotland.gsi.gov.uk
Vision
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People are supported to live well at
home or in the community for as much
time as they can
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They have a positive experience of
health and social care when they need it
Why integrate?
• To address variability of health and social care
outcomes in different parts of Scotland,
particularly for frail, older people.
• To make it easier to provide services to help
people stay at home, rather than being admitted
to hospital.
• To make it easier to get people out of hospital
quickly and back into a homely setting.
What are Ministers looking for?
• Consistency of outcomes
• Applies in every council and health
board
• Statutory underpinning
• Integrated budget
• Someone clearly accountable for
delivering agreed outcomes
What are Ministers looking for? Cont.
• Professionally led
• Simplifies existing bodies and
structures
• Minimal disruption to staff and
services
• Robust public involvement
What does the evidence tell us?
• Planning for populations, not delivery
structures
• Pooling resources – money and people
• Embedding GPs, other clinicians and care
professionals in the processes of service
planning, investment and provision
• Very strong local leadership
Progress
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Consultation - May to Sept 2012
Analysis report - 19 Dec 2012
Scottish Government response - 13 Feb
2013
Bill introduced to Parliament - 28 May
2013
Key points from consultation
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Scope: adults
Local flexibility
Importance of a “minimum position”
Access to robust, shared data
Importance of ensuring a strong role for local
professionals
Key features of legislation
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Nationally agreed outcomes
Integration plan
Strategic Plans
Locality planning
Integrated budgets
Principles of Integration
Services should be planned so that they:
•Are integrated from the point of view of recipients
•Take account of the particular needs of different recipients
•Take account of the particular needs of recipients in
different parts of the area in which the service is being
provided
•Are planned and led locally in a way which is engaged
with the community and local professionals
•Best anticipate needs and prevent them arising, and
•Make the best use of the available facilities, people and
other resources
National Outcomes for adult health and
social care and scope
• Focus on a needs based approach
• Do not want to undermine the importance
of local understanding of need, and local
agreement of appropriate local outcomes
and measures
Governance and Joint Accountability
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Need to ensure that statutory partners
are jointly and equally responsible for the
delivery of outcomes
Need to overcome differing
organizational and political priorities
These have the potential to disrupt and
lead to the breakdown of services
Integrated budgets and resourcing
• Budgets and resources will be integrated to
focus attention on the outcome for individual
• A more integrated approach to sharing
information
• Two models for financial integration:
–
–
The Body Corporate
Delegation between partners
Jointly Accountable Officer (chief officer) &
Workforce
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Two workstreams developing proposals: Short
Life Working Group and Strategic Workforce
Development Group
The SLWG is developing the post of the JAO
The SWDG is looking at the longer term issues
of training and organisational development
Locality planning
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Locality arrangements must reflect local needs
and priorities
Professionals must be involved in determining
locality arrangements, not just consulted
Must enable real traction on change and
improvement
Importance of wider community – third sector,
patients, service users and carers
What next?
• Bill Advisory Group
• Working groups:
– Outcomes and measurement
– Governance and accountability
– Integrated resources
– Joint strategic commissioning
– Workforce development and HR
• + further work on locality planning
“Public service providers must be required to work much
more closely in partnership, to integrate service provision
and thus improve the outcomes they achieve. . .
Experience tells us that all institutions and structures resist
change, especially radical change. However, the scale of
the challenge ahead is such that a comprehensive public
service reform process must now be initiated, involving all
stakeholders.”
The Christie Commission Report
Commission on the future delivery of public services, June 2011