The current context from a National and Third Sector Perspective

A National Perspective

The integration of Health and Social Care is the largest piece of public service reform ever undertaken in Scotland. The Integration Support team also tries to capture information and intelligence about what is happening on the ground across Scotland. This information is used to inform the content of our programme and to provide feedback to the Scottish Government and other interested parties about the third sector’s experience of integration.

The Third Sector Perspective

Between April and July 2016 the Integration Support Team (then the Third Sector Health and Social Care Support Team)gathered information from the third sector about its experience of integration to date. This information was collated into the Integration Support Team Scoping Report September 2016 (PDF – This link will take you away from our website)

The report we produced as a result of this activity provides information about the challenges from the perspective of:-

  • The Third Sector Interfaces across Scotland who are trying to support and enable the sector’s engagement in the process;
  • The Third sector’s advocates on strategic groups who are working to influence developments; and
  • Third sector organisations who are seeking to contribute to the achievement of the national outcomes.

It is recognised that this report only captures information relating to a specific period in time, therefore the team aims to provide feedback on what it is learning about the evolving landscape on a quarterly basis.

The Integration Key Facts briefing produced by the Integration Support Team (PDF – This link will take you away from our website) also provides a brief overview and analysis of the current context.

Audit Scotland

In December 2015 Audit Scotland undertook an audit of health and social care integration (PDF – This link will take you away from the website). This, the first in a series of planned audits that consider health and social care integration, focused on the potential risks of implementing this scale of public service reform. Another audit is due for 2018.

The Audit Scotland report was predominantly a desktop review of publicly available documents, but did include interviews with six Integration Authorities and a range of other stakeholders.  It also drew on work already carried out by the Care Inspectorate, Healthcare Improvement Scotland and local auditors. The report identifies five core risks and makes a number of recommendations about actions that should be take to address these.

The five core risks identified:-

  • Governance and Accountability
  • Finance
  • Service Redesign
  • Workforce, and
  • Performance Management

The Third Sector Health and Social Care Advisory Group asked Gordon Neill – the Senior Manager from Audit Scotland who led the audit – to deliver two sessions for the third sector to ensure that the sector was aware of the content of the audit, and had an opportunity to interrogate its content and to shape Audit Scotland’s integration work going forward.

Gordon Neill produced a presentation from these sessions providing an overview of the reports content and findings ( PDF – This link will take you away from our website).

Voluntary Health Scotland organised the events under the auspices of the Third Sector Health and Social Care Advisory Group. You can also find a useful capture of discussions: Key Messages from Audit Scotland Health and Social Care Integration Report – January 2016 (PDF – This link will take you away from our website).

Scottish Government

The Scottish Government Health and Social Care Integration Team are based within the Health and Care Directorate.  They have a role to provide strategic support to enable the implementation of health and social care policy across all sectors in addition to analysing progress.

The Scottish Government published a review of the strategic commissioning plans in October 2016 (PDF – This link will take you away from our website). This provides an overview of the content and approach of the plans, and identifies common themes and key areas for further development. The summary of this overview is below:

  • Overall Content and approach – high level
  • Scope of plans – delegated functions
  • Reach and quality of engagement – comprehensive
  • Strategic needs assessment – data, market facilitation plans
  • Strategic Priorities – similar themes
  • Financial planning – challenging
  • Outcomes – focus, SDS, personalisation
  • Localities
  • Workforce and multi-disciplinary teams
  • Primary care
  • Links to acute care and cross partnership working – hosting and lead arrangements
  • Housing – prevention
  • Performance reporting – frameworks
  • Some features of good commissioning