Health and social care integration is the largest piece of public service reform ever undertaken in Scotland. It is often described as seeking to address the three main challenges facing health and social care:–
- Shifting demography
- The increasing number of people living with multiple, complex, long-term conditions, and
- Ever reducing public funding.
Whilst this is true, the integration agenda also aims to build a system that complements and builds on people’s natural assets and supports them to achieve their aspirations for a good life.
To address these challenges, integration seeks to create a new system that: –
- Is joined-up from the perspective of people who use services,
- Is built around the needs and aspirations of people who use and / or need services,
- Enables investment to be targeted where it is most needed, by making it easier for money to flow between the different parts of the system, and
- Supports whole system redesign in favour of preventative and anticipatory measures.
Among the most significant system changes to enable this transformation are:-
- the creation of a single system for the planning and delivery of the integrated services, and
- new governance arrangements that require the meaningful involvement of a wide range of stakeholders and drive bottom up decision-making.
The Public Bodies (Joint Working) (Scotland) Act 2014 was given Royal Assent on 1st April 2014. This Act, together with its associated statutory instruments, provide the legal framework to enable Health & Social Care integration. Integral to these was a requirement for Local Authorities and Health Boards to develop Integration Schemes by the 1st April 2015 and for the new Integration Authorities to take over responsibility for the planning and delivery of integrated services no later than the 1st April 2016.
All Integration Authorities met these deadlines and ‘went live’ on or before the beginning of April 2016.