A new ALLIANCE report looks at progress, challenges and aspirations for the future of health and social care.

The ALLIANCE Integration Support programme has published a report reflecting on the process of health and social care integration from 2014 to 2024.

The Public Bodies (Joint Working) (Scotland) Act was passed by the Scottish Parliament in 2014 to set in motion structural changes that would enable joined-up, collaborative working across health and social care. By bringing together health and social care, the goal is to ensure that people get the support, care and treatment they need, when they need it – person centred care, at the right time and in the right place.

We wanted to paint a picture of what integration looks like at this moment in time from the perspective of the third sector and people with lived experience of accessing health and social care support. To do this, we brought together ALLIANCE members and IJB Lived Experience representatives to hear from them about what has been working well and where there is room for improvement.

Ten years on, there has been some progress. But there have also been many challenges and barriers to integration. For example, there has been a broad cultural shift toward valuing the voices of people with lived experience, but there is still a long way to go to achieve meaningful involvement in practice and even further for true co-production. While the third sector’s contribution to integration is widely celebrated, third sector organisations are yet to be treated as equal partners, particularly in regard to their strategic role in health and social care.

The report identifies challenges and barriers that need to be addressed to support the third sector, people with lived experience, and unpaid carers, to become true partners in care, including funding, commissioning processes, and organisational systems and cultures. It also highlights priority areas for improvement such as developing integrated care records, addressing inconsistent support for unpaid carers and ensuring inclusive communication across health and social care.

The report concludes with a vision for the future of integrated health and social care that promotes, protects and upholds everyone’s right to live well with dignity and respect, underpinned by the Health and Social Care Academy’s Five Ambitions for the Future of Health and Care.

Our vision for the future:

  • Health and social care support that is integrated, person-led and human-rights based, leading to positive experiences and outcomes for all. Integrated planning happening at all levels, supported by a national vision and strategy. And decisions guided by human rights principles and standards.
  • People are partners in care. They are actively involved in planning, delivering, evaluating and improving health and care services, supported by strong participation mechanisms locally and nationally.
  • People experience health and social care support that is person centred and seamless. Everyone has access to the information they need, in a format that is right for them. People are empowered to have control over their information and care planning.
  • All partners in health and social care are meaningfully and equally involved in strategic and operational planning, including the third sector, people with lived experience and unpaid carers. The third sector is empowered as an equal partner, through Fair Funding, outcomes-based commissioning, and organisational attitudes and processes.

Read and download the full report below.


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