Integration of Adult Health and Social Care VHS Member event, Monday 1 July Grant Hughes, Scottish Government [e-mail]

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Integration of Adult Health and Social Care VHS
Member event, Monday 1 JulyGrant Hughes,
Scottish Governmentgrant.hughes_at_scotland.gsi.gov.
uk
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Vision

• 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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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.

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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

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What are Ministers looking for? Cont.

• Professionally led
• Simplifies existing bodies and structures
• Minimal disruption to staff and services
• Robust public involvement

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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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Progress

• Consultation - May to Sept 2012
• Analysis report - 19 Dec 2012
• Scottish Government response - 13 Feb 2013
• Bill introduced to Parliament - 28 May 2013

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Key points from consultation

• Scope adults
• Local flexibility
• Importance of a minimum position
• Access to robust, shared data
• Importance of ensuring a strong role for local
  professionals

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Key features of legislation

• Nationally agreed outcomes
• Integration plan
• Strategic Plans
• Locality planning
• Integrated budgets

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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

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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

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Governance and Joint Accountability

• 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

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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

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Jointly Accountable Officer (chief officer)
Workforce

• 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

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Locality planning

• 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

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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

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• 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