Fresh eyes navigating the Integration landscape

Now 3 months in post with the ALLIANCE, Vaughan Jones gives her take on the current status of Health & Social Care Integration in Scotland.

I started with the ALLIANCE feeling that I possessed a reasonable working knowledge and understanding of the Integration of Health and Social Care, but how wrong could I have been! My background is in Mental Health and for many years I worked within the NHS and the Third Sector. I spent the past five years serving as a local Councillor and, in 2015, I was appointed as a member of the newly formed Integrated Joint Board (IJB).

What I have learnt in the past three months with Integration Support is that my knowledge and understanding was very much from the perspective of the Statutory Sector.

One of the things I strongly feel is that, as Development Officers, we need to try and work out innovative ways in which we can enable and encourage the statutory sector to work in partnership with the Third Sector. I think the ALLIANCE has done a great job and continues to do so working to support the Sector. However, it may help if we were able to do more work with the Partnerships.

The Integration landscape is uneven, complex and fragmented. There are inconsistencies throughout the Integrated Authorities with regards to the engagement and inclusion of the Third and Independent Sectors but we have to find creative solutions.

Although Integration could still be regarded as being in its infancy, it should be acknowledged that some progress has been made. Pockets of successful integrated ways of working are occurring across the country and examples of good practice should continue be recognised and highlighted. However, the Third Sector Interfaces and organisations are frustrated by the slow pace of change with many feeling that the Partnerships do not understand the strengths and value that the Sector provide. Despite changes in legislation, there is a lack of parity within this new landscape and power continues to reside with the Statutory Sector.

It is important to understand that all is not a bed of roses for Partnership staff who are stretched to capacity, having to work with increasing demands and workloads. Staff numbers have been drastically reduced because savings are made by not replacing staff when they vacate posts. The focus for staff is trying to maintain and deliver services with reduced budgets. Therefore, thinking about partnership working is not high on their list of priorities. It is my concern that unless the Statutory Sector are able to change their way of working with the Sector, Integration may not succeed without more legislation or resources allocated for this. 

The scale of the challenge cannot be underestimated, but my hope is for a future in which we no longer talk about Integration because the vision of Integration has become a reality, and the people who need and use services are able to live well and feel in control of their lives. By reaching a shared understanding and working together, we can achieve this.

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