Audit Scotland’s latest report on health and social care integration is a clarion call for greater engagement with communities.
The Auditor General for Scotland’s new briefing (this link will take you away from our website) recognises that whilst there has been progress since the publication of the Public Bodies (Joint Working) (Scotland) Act 2014, particularly in reducing delayed discharge and unplanned hospital activity, concerns continue that people’s personal outcomes are not being prioritised.
Back in 2014, the ALLIANCE supported the outcomes focus outlined in the underlying legislation, the Public Bodies (Joint Working) (Scotland) Act 2014, noting that personal outcomes not only have the potential to promote a human rights based approach but also the assets of the individual, and move us beyond the medical/health focused model of support.
An outcomes approach outlines the mission of integration. It is what focuses the approach on compassion, serving the personal values not only of those who use support and services but also staff who work within the health and social care system.
Whilst I welcome the broad recommendations (some of which can be interpreted as applicable to the third sector), for example the need for appropriate leadership capacity; continued pump priming of local integration projects; improving data sharing; and the emphasis on better involvement of communities, I would have liked to have seen specific mention of the third sector and its role. There is the potential to interpret the recommendations as explicitly focused on the relationship between statutory partners, when this only tells part of the story.
Where the third sector are effectively mentioned, we can see the power of their role in supporting people’s outcomes. The British Red Cross (this link will take you away from our website), for example, are commended in the report for their Home from Hospital service – which prioritises support from acute settings back home, achieving what the person wants whilst saving one integrated partnership hundreds of thousands of pounds at the same time. Much more of this type of activity, co-produced and preventative in approach, should be shared and funded across Scotland.
Integration is being hampered by disagreements over governance, according to Audit Scotland, which is leading to a lack of financial planning and adherence to the Act, particularly in reference to moving services from hospitals and into the community. Greater leadership, strategic planning and meaningful engagement are proposed as remedies. A manifesto for change that the ALLIANCE supports.
We believe that it is clear that, whilst there are good examples, there is much more work to be done to share this work and the conditions created by statutory services AND third and independent organisations to make them successful.