Partnership Across Boundaries

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Partnership Across Boundaries A Scottish
Perspective Morgan Jamieson
June 2005
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Key Legislation National Health Service and
Community Care Act (1990) - established Trusts
and internal market Health Act
(1999) - abolished fund-holding, halved number
of Trusts National Health Service Reform
(Scotland) Act 2004
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Policy Framework Designed to Care (White Paper)
1997 - end of internal market,
fundholding, contracting - purchaser/provider
became strategic/service - HIPs and
TIPs - Primary Care Trusts introduced - Local
Health Care Cooperatives
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Policy Framework Acute Services Review (CMO
report) 1998 - establishment of Managed
Clinical Networks - create national clinical
quality assurance system (now NHS Quality
Improvement Scotland) it is essential to
build a combined service of child-centred
care.. supports whole heartedly the continued
development of an integrated service for
children..
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Policy Framework Towards a Healthier Scotland
(White Paper) 1999 - focus on public health,
health improvement - commitment to tackle
inequalities - established national
demonstration projects (including Starting
Well) - encouraged joint working with local
authorities
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Policy Framework Our National Health A Plan
for Action, A Plan for Change (Scottish Health
Plan) 2001 - unified NHS Boards (membership
from local authorities, NHS staff and Trust
CEOs) - single Local Health Plan - Performance
Assessment Framework
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National Health Service Reform (Scotland) Act
2004 (preceding White Paper Partnership for
Care) - dissolution of NHS Trusts - establish
ment of Community Health Partnerships - duty to
cooperate in regional planning - duty to
involve public in planning of services - duty
to promote health improvement - provisions
regarding staff governance, equal opportunities
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Community Health Partnerships key building
blocks in the modernisation of the NHS and
joint services with a vital role in partnership,
integration and service design SEHD
Statutory Guidance 2004 CHPs
should - evolve from LHCCs - ensure patients,
carers are involved - establish a substantive
partnership with local authority
services - redesign services locally - integrate
primary and specialist services at
local level - deliver health improvement
agenda locally
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CHPs and Integrated Child Health
Services - Community Child Health
Services - Aspects of CAMHS - School Health
Services - Home Care for Children with complex
needs - Support services for vulnerable
children (including LAAC) - Family support
services - Community maternity services
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CHPs and Integrated Child Health
Services Expected Outcome - children, young
people, parents, carers involved in service
design - more care closer to home - guidelines
for management of common conditions agreed and
implemented - child health improvement promoted
(with specific reference to obesity) - shared
assessments for children with additional
needs - clear funding arrangements for
children with complex needs - coherent child
protection arrangements
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• Community Health Partnerships in Glasgow
• Objectives
• Action on health improvement
• Focus on population health
• Quality, effective, responsive personal care
• Driving externally provided services
• Staff and community influence, engagement,
  ownership
• Influencing and driving other local services
• Credibility with elected members

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Community Health Partnerships in Glasgow

• 9 CHPs
• 5 x Glasgow City
• 4 x other LA
• Joint Accountability
• 1 x Lead CHP for Childrens Services
• Distribution and Management of CCH Services under
  discussion

• DIRECTOR (SW)
• Head of Childrens Services (SW)
• Clinical Director (GP)
• Lead Nurse
• Lead AHP
• Head of Planning
• and Health Improvement

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Local Government Scotland Act 2003 Local
authorities required to - initiate, facilitate
and monitor Community Planning process - estab
lish a Community Planning Partnership (NHS
Boards required to participate) Created context
for Integrated Childrens Service Plans
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• Integrated Childrens Service Plans
• Incorporate pre-existing core statutory and other
  planning
• requirements into a single plan including

• Childrens Service Plans (Children (Scotland/Act
  1995)
• Statement of Education Improvement Objectives and
• progress reports (standards in Schools Act
  2000)
• Child health elements of Local Health Plans,
  Child Health
• Strategies etc
• Youth Justice Strategies

• 3 year plan commencing April 2005
• Enshrine principles of UN Convention on the
  Rights of the
• Child
• Safe Nurtured Healthy Achieving
  Active Respected and
• Responsible Included

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• Additional Drivers
• Health for All Children (Hall 4)
• Integrated Assessment for Children
• Integrated Early Years Strategy Starting
  Together
• Additional Support for Learning

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• Challenges and Risks
• Loss of combined model
• Fragmentation of services
• Balancing of budgets
• Management structures
• Information sharing
• Engagement with Education

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National Framework for Service Change (Kerr
Report) 2005 Key to whole system
development integrated, collaborative and
coordinated working by the NHS and its partners
across the professions, across the traditional
boundaries and across Scotland