Integration of Adult Health and Social Care

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Integration of Adult Health and Social Care
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What is the problem we are trying to solve?

• Too much variability of health and social care in
  different parts of Scotland, particularly for
  older people.
• No incentive to help get people out of hospital
  quickly and back into a homely setting.
• Much easier to get an older person admitted to
  hospital than to arrange services that would keep
  them at home.

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Projected Demand for Health and Social Care, All
Ages, 2008/09 prices.

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Vision

• Older people are supported to live well at home
  or in the community for as much time as they can
• They have a positive experience of health and
  social care when they need it

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Framework for improvement

• Consistency of approach across Scotland
• Applies in every council and health board area
• Statutory underpinning
• Integrated budget to deliver some acute,
  community and social care services
• Someone clearly accountable for delivering agreed
  outcomes
• Professionally led by clinicians and social
  workers
• Simplifies rather than complicates existing
  bodies and structures and
• Wherever possible, it should be achieved with
  minimal disruption to staff and services.

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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

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Principles of reform

• Nationally agreed outcomes across health and
  social care, focussing in the first instance on
  older peoples services
• Joint accountability via the Chief Executives of
  the Health Board and Local Authority to
  Ministers, Council Leaders and the public for
  delivery of those outcomes
• Integrated budgets
• Strong clinical and professional leadership, and
  engagement of the third sector, in commissioning
  and planning of services

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Framework for integration slide 1

• Legislation
• nationally agreed outcomes
• joint accountability
• integrated budgets across primary care, community
  health and social care, and some of acute care
• locality planning

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Framework for integration slide 2

• CHP committees will be taken off the statute book
  and replaced by Health and Social Care
  Partnerships joint and equal responsibility of
  the NHS and Local Authority
• Jointly appointed senior accountable officer will
  report to the Chief Executives of the NHS and
  Local Authority
• Annual accountability meetings will enable
  accountability to Ministers and Leaders

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Framework for integration slide 3

• Locality service planning groups will strengthen
  the role of clinicians and social care
  professionals
• Fewer resources will in future be directed
  towards institutional care and more resources
  will be directed towards community provision

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Next steps

• Formal consultation
• Detailed work now underway to consider
  practicalities
• Outcomes
• Joint governance and accountability
• Integrated financial management
• Impact on other areas of service
• Workforce and HR issues
• Locality planning
• Improving commissioning skills
• Requirements for OD and leadership development
  work
• Ensuring meaningful engagement of the third and
  independent sectors

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