Integrating adult health and social care in Scotland

Purpose: Separate – and sometimes disjointed – systems of health and social care can no longer adequately meet the needs and expectations of increasing numbers of people who are living into older age, often with multiple, complex, long-term conditions, and who need joined-up, integrated services. The goal for integration of health and social care in Scotland, and therefore for this legislation, is to tackle these challenges, so that the balance of care shifts from institutional care to services provided in the community, and resources follow people‘s needs. Objectives: The Scottish Government introduced the Public Bodies (Joint Working) Scotland Bill to the Scottish Parliament in May 2013. This new legislation will provide the legal framework to support improvements in the quality and consistency of health and social care services by integrating health and social care in Scotland. The Scottish Government’s ambitions for integrating health and social care are: • to improve the quality and consistency of services for patients, carers, service users and their families; • to provide seamless, joined up quality health and social care services in order to care for people in their homes or a homely setting where it is safe to do so; and • to ensure resources are used effectively and efficiently to deliver services that meet the increasing number of people with longer term and often complex needs, many of whom are older. Background: Nationally agreed outcomes will apply across health and social care. Health Boards (which provide primary and secondary health care) and Local Authorities (which provide social care) will be required to establish integrated partnership arrangements. Health and social care functions and budgets will be delegated by the Health Board and Local Authority to the new integrated partnership. Legislation will establish the “minimum scope” of functions and budgets that must be integrated – this will cover adult primary and community health care, social care, and aspects of acute hospital care that offer the best opportunities for service redesign in favour of prevention. Locality planning arrangements will assure strong clinical and professional leadership, and engagement of the third and independent sectors, in strategic service planning. 14th International Conference on Integrated Care, Brussels, April 2-4 2014 International Journal of Integrated Care – Volume 14, 01 October – URN:NBN:NL:UI:10-1-116153– http://www.ijic.org/ Conclusion: The Scottish Government’s approach to this legislation is to focus on ensuring crosssectoral strategic planning to meet the needs of population/care groups. Rather than focussing on re-organising existing structures, the emphasis is on ensuring that strategic planning to support people, particularly those with multiple complex needs, operates with maximum effectiveness across traditional boundaries, and places the patient/service user at the centre of care planning and provision.