Transcript Integration of Health and Social Care

Integration of Adult Health
and Social Care
What is the problem we are trying to
solve?
• Too much variability of health and social care in
different parts of Scotland, particularly for older
people.
• No incentive to help get people out of hospital
quickly and back into a homely setting.
• Much easier to get an older person admitted to
hospital than to arrange services that would
keep them at home.
Projected Demand for Health and Social Care, All Ages, 2008/09 prices.
Health and Social Care Demand Projections, £ mn, 2008/09 prices
15,000
14,000
13,000
Cost £mn
12,000
11,000
10,000
9,000
HLE constant
8,000
Change HLE = 0.5 change LE
7,000
Change HLE = Change LE
6,000
5,000
2010
2015
2020
Year
2025
2030
NHS Delayed Discharges
Scotland; September 2000 to April 2011.
3000
Number of patients
2500
Over 6 weeks
Under 6 weeks
2000
1500
1000
500
0
Sep Apr
2000 2001
Oct Apr
Oct
Apr
Oct
Apr
Oct Apr
Oct
2001 2002 2002 2003 2003 2004 2004 2005 2005
Apr
Oct Apr
Oct
2006 2006 2007 2007
Census
Apr Oct
Apr
Oct Apr
2008 2008 2009 2009 2010
Oct
Apr
2010 2011
Vision
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Older people are supported to live well at
home or in the community for as much
time as they can
They have a positive experience of
health and social care when they need it
Framework for improvement
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Consistency of approach across Scotland;
Applies in every council and health board area;
Statutory underpinning;
Integrated budget to deliver some acute, community and
social care services;
Someone clearly accountable for delivering agreed
outcomes;
Professionally led by clinicians and social workers;
Simplifies rather than complicates existing bodies and
structures; and
Wherever possible, it should be achieved with minimal
disruption to staff and services.
What does the evidence tell us?
• Planning for populations, not delivery
structures
• Pooling resources – money and people
• Embedding GPs, other clinicians and care
professionals in the processes of service
planning, investment and provision
• Very strong local leadership
Principles of reform
• Nationally agreed outcomes across health and social
care, focussing in the first instance on older people’s
services
• Joint accountability via the Chief Executives of the Health
Board and Local Authority to Ministers, Council Leaders
and the public for delivery of those outcomes
• Integrated budgets
• Strong clinical and professional leadership, and
engagement of the third sector, in commissioning and
planning of services
Framework for integration – slide 1
• Legislation:
– nationally agreed outcomes
– joint accountability
– integrated budgets across primary care,
community health and social care, and some of
acute care
– locality planning
Framework for integration – slide 2
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CHP committees will be taken off the statute book and
replaced by Health and Social Care Partnerships –
joint and equal responsibility of the NHS and Local
Authority
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Jointly appointed senior accountable officer will
report to the Chief Executives of the NHS and Local
Authority
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Annual accountability meetings will enable
accountability to Ministers and Leaders
Framework for integration – slide 3
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Locality service planning groups will strengthen the
role of clinicians and social care professionals
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Fewer resources will in future be directed towards
institutional care and more resources will be directed
towards community provision
Next steps
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Formal consultation
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Detailed work now underway to consider practicalities:
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Outcomes
Joint governance and accountability
Integrated financial management
Impact on other areas of service
Workforce and HR issues
Locality planning
Improving commissioning skills
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Requirements for OD and leadership development work
Ensuring meaningful engagement of the third and
independent sectors