Matthew reflects on the last year and how it has affected the integration landscape in Scotland.

This time last year, the Integration Support team was hosting a roundtable discussion at the Macdonald Holyrood Hotel in Edinburgh. There was a buzz in the room as people in attendance shared their views on how the Framework for Community Health and Social Care Integrated Services should be implemented.

In the 12 months since, the world has completely changed. COVID-19 has altered the way we all live our lives. And, for us at the ALLIANCE, events like our roundtable discussion last year are now taking place online. Our team have carried out our Engagement Insights series online, hearing from hundreds of people across three events so far. And, in terms of ALLIANCE-wide projects, our annual conference, People at the Centre events and contribution to the recent Independent Review of Adult Social Care in Scotland were all forced to move to online platforms.

The landscape of health and social care integration is also very different now. Following our roundtable discussion last February, our team summarised what people had shared with us in our Third and Independent Sectors as Partners report. This grouped people’s views under:

  • Insights – reflections on the, then current, state of integration;
  • Enablers – existing qualities which would be crucial to the success of the Framework;
  • Roles – the parts the third sector, statutory sector and Scottish Government should all play in order to work together effectively going forward;
  • Support – new approaches and resources required to fulfil the aims of the Framework;
  • And learning – what should be captured by the Framework’s early adopter areas.

The recent Independent Review of Adult Social Care, chaired by Derek Feeley, looks as though it has the potential to shake up the health and social sector in Scotland. It calls on Scotland to shift the paradigm, strengthen the foundations and redesign the system.

Nonetheless, the insights drawn from our Third and Independent Sectors as Partners report are still relevant. It called on all partners’ actions, changes and developments to ‘be undertaken with a human rights based approach.’ A year later, the Feeley report is rightly calling for the same in order to ‘shift the paradigm.’

The new report also recommends a focus on ‘strengthening the foundations’ of the health and social care sector. Third and Independent Sectors as Partners did the same, examining the existing qualities, or enablers, in the sector before then identifying the support that would be required to build upon these strengths.

Finally, the Feeley report recommends that, to ‘redesign the system’ it is ‘vital that we amplify the voice of lived experience at every level in our redesign.’ Although not explicitly highlighted in Third and Independent Sectors as Partners, this is one of the third sector’s real strengths. The ALLIANCE’s Community in Action project has demonstrated the incredible results that are possible when services are informed by the voice of lived experience.

In amongst the turmoil of the last year, there is a lot that the health and social care sector can learn from the third sector’s response to COVID-19. Both the ALLIANCE’s People at the Centre and Community in Action projects have captured a real willingness within the third sector to rally together and support those who have been affected by COVID-19. This behaviour should serve as a blueprint to be followed by other sectors.

One year on from our discussion in Edinburgh, in some senses, a lot has changed and a lot has not. It will be interesting to see what developments emerge as a result of the new Independent Review of Adult Social Care. Regardless, the ALLIANCE’s Integration Support team will continue to engage with those who will be affected by these changes to ensure that they are informed by the voice of lived experience.

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