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Health and Social Care integration

Oct 2017

The way that Scotland plans and delivers health and social care services in Scotland is changing. Legislation requiring integration of health and social care came into effect in April 2016 and new Integration Authorities now have responsibility for over ₤8 billion of funding for local services which was previously managed separately by NHS Boards and Local Authorities. This is the most significant change to the way we care for and improve the health of our people, in their communities, since the creation of the NHS.

This change reflects the changes happening to our population. We are generally living longer, our health is better thanks to the services we have available and we expect to live fulfilling lives into our old age. These positive changes mean that there is a need to design health and social care services in future to support people who are living with complex needs, many of whom are older. Integration is about making those changes and putting people and not services at the centre of our decisions. It aims to improve services, and to make them seamless and more responsive to the people who use them.

Hospitals provide medical care that cannot be provided anywhere else. However, most of us will need care that can be provided in settings more appropriate to our individual needs and better placed to support our health and wellbeing. Most of us would much rather receive support and care at home or in a homely setting when and if we need it. Integration aims to provide care in this way, built around the needs of the individual. Often this is not about medical needs - it can be about providing support to people to remain part of and connected to their families and communities, allowing people to carry on doing the things they love with a bit of extra help.

31 Integration Authorities across Scotland are planning, innovating and working with health & social care staff, communities and the third and independent sectors to ensure person centred and responsive approaches in the design of care and support locally. By sharing our knowledge and experiences we are finding out what works best for people, delivers best value to our communities and sharing the routes and pathways to those outcomes . Equally we are learning from what doesn't work as well.

Positive changes are already happening. Scotland is leading the way in integrating health & social care in the UK . Scotland should be acknowledged for this vision and commitment and as a nations we should be justifiably proud of that.

The Scottish Government has provided a package of additional investment of almost ₤500 million in transitioning to this new approach to date, including:

  • ₤100 million per year since 2015 on an Integrated Care Fund to shift the balance of care towards prevention and support services to deliver improved outcomes for local communities.
  • ₤30 million per year to support Integration Authorities to reduce delayed discharges, including the development of a range of community based services like Intermediate Care Beds, re-ablement at home and other preventative services.
  • ₤250 million transfer in the 2016/17 budget to support payment of the living wage and health and social care integration
  • ₤107 million of additional investment to be directed to Health and Social Care Partnerships, which will deliver Scottish Government's commitment on the Living Wage and support sustainability in social care

Health & Social Care Integration - Chief Officers

All Partnerships are responsible for adult social care, adult primary health care and unscheduled adult hospital care. Some are also responsible for children's care and criminal justice social work.

Health & Social Care Integration: A Vision

Let us be clear about the objectives of this programme of reform. Scotland wants to ensure that adult health and social care services are firmly integrated around the needs of individuals, their carers and other family members; that the providers of those services are held to account jointly and effectively for improved delivery; that services are underpinned by flexible, sustainable financial mechanisms that give priority to the needs of the people they serve rather than the needs of the organisations through which they are delivered; and that those arrangements are characterised by strong and consistent clinical and professional leadership.

This is the single biggest reform to the way health and social care is delivered in Scotland and the Scottish Government is providing more than £0.5 billion additional funding over three years to help partnerships establish new ways of working.