Transcript Joint Strategic Commissioning

Health and Social Care Integration
Strategic planning and Regional planning
Tony Homer
JIT Lead, Strategic Commissioning
JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, CoSLA, the Third
Sector, the Independent Sector and the Housing Sector
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Objectives for this session
• Establish whether RPNs need to understand and be
concerned about H&SC integration arrangements
• Have a better grasp of the likely range of local integration
arrangements across the NoS RPN
• Have a better understanding of some of the key questions
and uncertainties about IJB / Lead Agency arrangements
and RPN
• Consider areas for further clarification by the NoS RPN to
address future integration arrangements
Key Legislative Requirements
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The Public Bodies ( Joint Working) (Scotland) Act 2014 requires that the new
integrated health and social care partnerships will oversee the development
and delivery of Strategic Plans, (Joint Strategic Commissioning Plans), which
will have an outcomes focus embedded, and will incorporate a robust financial
plan
Establish a Strategic Planning Group for the purpose of preparing a Strategic
Plan
Establish at least 2 locality areas to drive a ‘bottom up’ planning focus
Take into account the plans of neighbouring areas and the possible impact of
the Plan on other plans and planning activity
Publish an annual financial statement, firstly attached to integration authorities
strategic plans
Timescales for implementation
Royal
Assent
APRIL
2014
Consultation on
Regulations and
development of
Guidance
APRIL 2014 –
AUGUST 2014
Regulations and
guidance
complete
NOVEMBER
2014 – FEB
2015
Integration
goes live
locally
APRIL
2015
All integrated
arrangements
must be in place
APRIL 2016
Strategic planning – some
important features
• SP concerns the functions and related services falling within the
scope of the Integration Authority
• Care group and individual service planning is already being
undertaken in a number of different ways
• Localities will have a formal planning role which will be a new or
strengthened feature
• There is a strong presumption towards joined up planning, beyond
H&SC
• The SPG will bring a more transparent, strategic determination of
priorities, investments and disinvestments across the whole system
IJBs/Lead Agencies – delegated services
• Some Health Board functions are not permitted for inclusion with integration.
These are functions that relate to the provision of education and research
facilities of Health Boards, employment of health board staff, and some specific
duties such as the registration of health professionals.
• Tertiary, surgical and trauma aspects of acute care are not required to be
included within integrated arrangements. Where these services are provided
within a single Health Board area, they may be integrated if there is local
agreement to do so.
• Services provided on a regional or national basis should not be included in
integration
• Other services may be included in integration schemes and children’s services
and criminal justice social work are being included in some areas
IJBs/Lead Agencies – planning and operational
responsibilities
• The IJB / Lead Agency is responsible for the planning of integrated services and
achieves this through the Strategic Plan. It directs the Parties to deliver or in
the case of the Lead Agency delivers services, in accordance with the Strategic
Plan.
• It is expected that the IJB will be operationally responsible for delivery in
addition to the planning responsibilities placed upon it by the Act to ensure
planning and delivery are fully integrated.
• Where related but non integrated provision impacts upon investment decisions
there is an expectation that joined up planning and delivery arrangements will
be agreed with other relevant bodies
• Issues concerning quality, risk and performance of provision will need to be
considered in the context of the integration national performance framework,
SOCIAL CARE
Health and Social Care
The wider planning landscape
COMMUNITY PLANNING
Community Plan
Prevention Strategy
HEALTH
Local Delivery Plan
Clinical Strategy
Bed planning
Quality Plan
Regional Planning
STRATEGIC /
FINANCIAL
PLAN
JSNA
Workforce
LA strategic plan
LA service plans
SDS Plan
(Child Protection Plan)
(Integrated Children’s
Plan)
HOUSING
Housing
Contribution
Statement
LHS
SHIP
LA CORPORATE
Finance & budget
plans
Capital & asset plan
SOA
Adult Protection Plan
Public Protection Plan
Procurement strategy
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Ongoing developments
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The scale and complexity of the required change is substantial – even some of the
basics are unclear in some areas
The new impetus is towards planning locally to inform strategic priorities. Top down,
centrist approaches will not work.
Practical arrangements for locality and care group priorities to inform strategic plans
will vary from area to area
New duties regarding Self Directed Support including delivering more user choice and
control is opening up the issue of how best to create and sustain viable social care
services that provide a sufficiently personalised offering
The Strategic Planning guidance includes a requirement for partnerships to compile a
Market Facilitation Plan and to be more transparent about assumptions
This is likely to highlight considerations of scale and viability (particularly in rural areas)
when deciding how best to plan/deliver care services where these two factors are
problematic
Some questions for regional planning / working?
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Regional planning incorporates a number of different things – networks, short term
projects, funded services. How can it best present itself in order to establish a clear
locus in the new integrated landscape?
By what process does regional planning determine its priorities / work programme and
will this need to change in order adequately to exploit the potential offered by
integrated arrangements?
Policy drivers are opening up consideration of the user as their own commissioner for
social care provision. Does this present opportunities/questions for how regional
planning and working needs to operate to deliver more seamless care for patients and
users?
What do RPNs need to know about how IJBs/Lead Agencies will work in order to be
able actively to engage with them and ensure its potential contribution is maximised?
Children’s commissioning – additional context
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A programme provided for partnerships including learning development, improved
information & evidence and adaptive change across partner organisations
Focussed upon delivering improved outcomes through a co-productive, cross sector
approach
Using the impetus associated with the Children’s Act to generate momentum and to
respond to the pressures associated with providing personlised solutions at a time of
austerity
In parallel implementing the Doran Review has led to work on a new model of
commissioning national resources to supplement local provision for children with ASN
This has raised questions about the linkages between local commissioning decisions and
the basis for investing in national resources
The prospect of developing regional services and supports to facilitate more local
models of care at sufficient scale, for this group, has arisen early on in this work