Shelley Gray reflects on this week's NHS Scotland conference and opportunities to shape the future.
Travelling home from the SECC after the recent two-day NHS Scotland Annual Quality Conference I reflected on the shift I’ve seen since the first one I attended only five years ago in 2008. The context was much the same with speakers highlighting our ageing population and impending fall in public finances. This year those challenges feel all the more real as the projected trends become the here and now reality for all of us. We have the added impact too of welfare reform and the prospect of health and social inequalities widening yet further.
In 2008 the ALLIANCE (then the Long Term Conditions Alliance) had just published the Self Management Strategy for Scotland, just secured the £2m a year fund to support activity across Scottish communities and begun to help shape emerging thinking on asset-based approaches and co-production in health and social care. All of this a reflection of the collective history, experience and expertise of our members, the wider third sector and the community-led health movement.
In 2008 though, these ideas still felt peripheral. The NHS Event focused largely on what were then seen as the core issues; delayed discharge, reducing hospital admissions and re-admissions, increasing safety and tackling waiting times. There was some mention of self management, but little if any of co-production, the third sector and health and social care integration. And while those ‘core issues’ remain crucially important, so too is the move towards person centred approaches as the norm, built on co-production at individual, community and national level, all in the context of integrated health and social care. We need a paradigm shift in the way we conceive of health and social care in Scotland and it was heartening at last week’s event that this view was placed firmly centre stage. The high level commitment to this agenda of change is clear too in the newly published Route Map to the 2020 Vision for Health and Social Care. This talks of ‘shifting the balance of power’ to people and communities and supporting their role, skills and assets.
The third sector, along with the voices of people who use support and services will be crucial if we are really to shape a different landscape of health and social care. As legislation to enable integration begins its journey through the Scottish Parliament, it is our sector, and the people who make up our member organisations, who will help widen the debate beyond the structural matters of how the NHS and local authorities can better work together. The third sector delivers over a third of all registered social care services, invests significantly into our health service and is the foundation upon which individuals and communities across Scotland bring their own assets to bear on improving health, wellbeing and quality of life. The importance of the sector’s role in shaping the integration debate, and in enacting its aspirations, cannot be underestimated.
The ALLIANCE will continue to do its part in ensuring this happens. I am delighted that our Chief Executive Ian Welsh has been invited to sit on the Cabinet Secretary’s 2020 Steering Group which will guide us towards the 2020 Vision for Health and Social Care. My colleague Lisa Curtice, working with a range of partners, is leading the dynamic People Powered Health and Wellbeing Programme which will help embed co-production in local areas across Scotland. We have worked with our members and partners to develop our shared thinking on health and social care, building significantly on the self management agenda and reflected in the 12 Propositions for Social Care, Shared Statement on Health and Social Care Integration from Third Sector Organisations, as well as our more recent think piece Being Human. Human rights form the basis for much of our thinking and we are pleased to be part of the group drafting Scotland’s first National Action Plan for Human Rights which will be published in December. We are beginning to explore too the idea of a ‘Health and Social Care Academy’, reflecting the need for a collective space for discussion, debate, development and practical support as we steer our course through the challenges and opportunities ahead. Most crucially, this initiative would have the lived experience of people who use support and services at its heart.
I hope that when we reach the NHS Scotland event in 2020 it will be a national health and social care quality gathering, bringing together people from across the statutory, third and independent sectors and including people who use support and services. Seven years is not a long time in which to bring about transformational change, but we have come a long way in the past five and have much to build on. I hope that by 2020 we will struggle to imagine a health and social care landscape in which co-production and the role of active, empowered citizens is not absolutely central. I look forward to continuing to work with our members to achieve that vision.