SCOTTISH GOVERNMENT REVEALS PROPOSAL TO INTEGRATE HEALTH AND SOCIAL CARE FOR ADULTS
Quicker access to care and staff and reduced delayed discharges are among the benefits of a proposed new plan to integrate health and social care for adults.
Public Health Minister Shona Robison said that in future councils and health boards should work more closely together under a 'lead commissioning' model, in order to provide better services for adults - particularly older people.
The Minister added how the proposals would be taken forward would be fully scrutinised and debated with stakeholders. The first step to beginning discussions is the establishment of a Lead Commissioning Group to take the integration agenda forward.
The Scottish Government's plans are being backed by Lord Sutherland, who carried out Scotland's review of free personal care in 2008.
SNP candidate for the new Banffshire & Buchan Coast constituency Stewart Stevenson MSP has also welcomed the proposals. Commenting, he said:
“I know from my mailbag that the lack of a joined-up approach that delays in discharging elderly patients from hospital into appropriate care arrangements are a major issue for some people.
“This proposal has the potential to ensure that delays in people being discharged from the NHS into the care of local authorities because the local authority has not put together an appropriate care package are minimised, or eliminated.
“At the end of the day, it should be about the quality of life and quality of care that people receive so I welcome anything which will improve the system for my constituents and their families.”
Minister for Public Health Shona Robison said:
"Planning care for increasing numbers of older people in future is one of our biggest national challenges and doing nothing is not an option. There's increasing recognition now that health boards and councils need to work together far more closely. The debate is about how and we believe that lead commissioning is the way forward - a view echoed by no less an expert than Lord Sutherland.
"We want to see health and social care for adults delivered in an integrated way by NHS and council social work staff working together to give a seamless service.
"Evidence from partnerships in England shows more older people can get quicker care packages, cuts in delayed discharges, reduced length of stay in acute hospitals and fewer unplanned emergency admissions to hospital. Pilot work on integration across Scotland has been making progress with this over the last eighteen months and we would now like to see this taken further nationwide.
"We will establish a Lead Commissioning Implementation Group, backed by 2 million pounds for investment over the next financial year, to support partnerships around the country to continue to take the integration agenda forward."
Lord Sutherland, who carried out the Scottish Government's review of free personal care, has backed the use of lead commissioning as a way of improving social care in Scotland.
He said:
"Lead commissioning provides the best and quickest way of achieving an integrated care system, and I believe the Scottish Government's approach is the right one.
"It avoids the need for new legislation and wholesale re-organisation, which means improvements can begin to be made straight away.
"The time for talking is over. It is now time just to get on with it."
Background
Lead commissioning would see health boards and local government contract services from one another to focus on the needs of people rather than from the basis of traditional "supply" responsibilities, i.e. what is a "health" service and what is a "social care" service, cutting through red tape and improving joined-up working. In England, lead commissioning has been used in some places to commission adult social care from the NHS, with local authorities acting as commissioners of services.
The announcement of 2 million pounds to support integration work through the new Lead Commissioning Implementation Group is in addition to the 70 million pound Change Fund announced in the draft Scottish budget to support better integrated older people's services delivered by health boards, councils, and the third and independent Sectors.
Local area partnerships in Scotland will receive:
NHS Board Partnership £m
Grampian 6.763 made up of:
Aberdeen City 2.738
Aberdeenshire 2.837
Moray 1.187
In 2008 roughly 57,000 people worked in social work services in Scotland. Were adult social care to be commissioned from the NHS by local government, approximately 38,500 adult social services staff would transfer to the NHS under lead commissioning.
The Scottish Government estimates that overall around 4.5 billion pounds is spent every year on older people's services across health and social care. Around a third of this - 1.4 billion pounds - of this total goes on unplanned emergency admissions to hospital. Clinicians, care managers and older people themselves tell us this kind of admission to hospital is often distressing and results in poorer outcomes than might have been achieved by a package of primary care and social care in the community - which is what the evidence shows can be achieved via lead commissioning.