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Integration of Adult Health and Social Care VHS Member event, Monday 1 July Grant Hughes, Scottish Government Vision. People are supported to live well at home or in the community for as much time as they can

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Integration of Adult Health and Social Care VHS Member event, Monday 1 JulyGrant Hughes, Scottish


  • 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

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


  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

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