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Scottish Government announces further integration of health and social care

15 December 2011

The moves aim to improve the quality and consistency of care for older people and put an end to the 'cost-shunting' between the NHS and local authorities that too often ends up with older people being delayed in hospital longer than they should be and not getting the best standards of care.

Health Secretary, Nicola Sturgeon confirmed that, following a period of engagement with stakeholders over the summer, the government had decided not to create a new statutory organisation separate from the NHS and local authorities which could create further barriers to integration.

Instead legislation will be introduced to Parliament and will herald a radical reform of Community Health Partnerships.

Key elements of the new system will be:

  • Community Health Partnerships will be replaced by Health and Social Care Partnerships, which will be the joint responsibility of the NHS and local authority, and will work in partnership with the third and independent sectors
  • Partnerships will be accountable to Ministers, leaders of local authorities and the public for delivering new nationally agreed outcomes. These will initially focus on improving older people's care and are set to include measures such as reducing delayed discharges, reducing unplanned admissions to hospital and increasing the number of older people who live in their own home rather than a care home or hospital
  • NHS Boards and local authorities will be required to produce integrated budgets for older people's services to bring an end to the 'cost-shunting' that currently existsThe role of clinicians and social care professionals in the planning of services for older people will be strengthened
  • A smaller proportion of resources - money and staff - will be directed towards institutional care and more resources will be invested in community provision. This will mean creating new or different job opportunities in the community. This is in line with the commitment to support people to stay at home or in another homely setting, as independent as possible, for as long as possible. 

The Health and Social Care Partnerships will be jointly accountable to the NHS and local authorities. The partnerships will also be accountable to the Cabinet Secretary for Health, the leader of the local authority and the public for the delivery of the nationally agreed outcomes which will focus initially on improving older people's care and will be included in the Single Outcome Agreements. A single, jointly appointed, senior accountable officer in each Partnership will ensure that partners' joint objectives are delivered.

Within this broad framework, local leaders can decide upon delivery mechanisms and structures that best suit local needs and priorities. Partnerships can continue to choose to delegate functions, budgets and responsibility for some aspects of service delivery if there is local agreement to do so, as in the type of lead agency arrangement being implemented in Highland.

These reforms will take place within the context of public service reform more widely. "Integration" is about improving people's experience of the whole system of health and social care, and public services more widely. Housing services, for example, play a particularly important role in sustaining the independence and wellbeing of older people.

Carers Scotland will provide further information for carers about these proposals as it becomes available.

To read the full Scottish Government press release about this announcement click here.

 

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