Georgina discusses how COVID-19 pandemic has illustrated the importance of the principles of health and social care integration.

As a member of the ALLIANCE’s Integration Support team, the aims and principles of health and social care integration (this link will take you away from our website) is a topic which I have reflected on often; I even keep them printed out and pinned to the wall next to my seat in the office. COVID-19 now means that for the foreseeable future I am working from home, surrounded instead by a very different décor. However, it seems to me that the impact of and response to COVID-19 has illustrated the importance of these principles more than that piece of paper ever could.

Every individual in Scotland has now experienced anticipatory and preventative care measures through the introduction of lock down and physical distancing. Each of us has also experienced need differentiation, by the categorisation of the Scottish population into distinct groups relating to their risk of developing severe symptoms should they contract COVID-19. Guidance and advice from the Scottish Government (this link will take you away from our website) and NHS Scotland (this link will take you away from our website) has been developed in a way which is differentiated according to multiple factors, such as health conditions, requirement to work and age.

Enacting these large-scale measures is no mean feat and has exposed the interdependent nature of policy and legislation in Scotland and the role of the public in effectively delivering them. The response to this crisis has clearly shown that the health and wellbeing of the population is not just a health matter, but requires the collaborative support of social care, housing, education and the economy, empowered by a consenting and committed public .

The COVID-19 pandemic is not only illustrating the links between policy areas, but also how these connect with people’s individual circumstances. COVID-19 and the response to it is being shown to exacerbate inequalities, such as the disproportionate impact of the virus on BME communities and the increase in reports of domestic violence resulting from lock down. This highlights the need for integrated health and social care to be truly person centred, where the principles of dignity and humans rights underpin everything and care provision and guidance reflects individual differences. The ALLIANCE’s briefing on draft COVID-19 clinical and ethical guidance  provides observations and recommendations on how the human rights of people who live with long term conditions, disabled people and unpaid carers can be better recognised.

The role of the community, third and independent sectors has also proved invaluable in the response to COVID-19. It highlights the importance of the principle that integrated  health and social care is planned and led by the community. The urgency of the COVID-19 pandemic has created the need for fast adaptation and innovation, a specialism of the third sector, and the ALLIANCE’s Community in Action series is shining a spotlight on this. Even after COVID-19 has peaked and life begins to recover to a new normal, this spirit of innovation and partnership working should be maintained to facilitate the integration of health and social care.

As part of our own adaptation in workplan the Integration Support team is now beginning a new series, Integration Insights, which will delve deeper in to the experiences and themes we encounter through our work to identify and share good practice and support the third sector to influence the direction of integration. After commonly featuring in each of our reports “Third and Independent Sectors as Partners” , “Integration in Action – Six themes of integration” and “We Need to Talk about Integration” the first theme we will focus on is Relationships, exploring the many facets of this key component to collaborative and integrated working.

Never before has the need for effective health and social care integration been illustrated so clearly and experienced so widely, inspiring and driving individuals, communities and organisations in their response. As the pandemic continues, during the recovery period and into the future we must remember the principles of the Public Bodies (Joint Working) (Scotland) Act 2014 and work together as partners to ensure that the right care is given, at the right time, in the right setting.

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