What You Need to Know

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Service-users and the General Public

Are you a patient or do you care for someone? Find out what integration means to you.

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Staff FAQs

What does integration mean to you as a member of staff?

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The Role of Third Sector Interfaces

This Advice Note sets out the role of the Third Sector Interface organisations in relation to integration activities

About the Health and Social Care Integration Act

1.What is health and social care integration and its principal aim?

The integration of health and social care is the Scottish Government’s ambitious programme of reform to improve services for individuals who use adult health and social care services.

It will result in radical changes to how acute and community health care services, as well as social care services, are planned, funded and delivered in the future. Integration means that the expertise and resources of adult health and social care services will be combined, shared and coordinated and plans made jointly, from the perspective of the service-user.

The principal ambitions of health and social care integration are to:

  • Support the improvement of the quality and consistency of services for patients, carers, service-users and their families.
  • 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.
  • Ensure resources are used effectively and efficiently to deliver services.

 

2. What does the legislation actually mean and how will it work in practice?

The Public Bodies (Joint Working) (Scotland) Act 2014 was granted Royal Assent on 1 April 2014. The legislation sets out how health and social care services for adults will be integrated across Scotland. This means changes to the law which requires Health Boards and Local Authorities to integrate their health and social care services.

There are two models of integration. In the first option, the ‘Body Corporate’ model, the Health Board and Local Authority can delegate the responsibility for planning and resourcing service provision for adult health and social care services to an Integration Joint Board.

In the second option, the ‘Lead Agency’ model, the Health Board or Local Authority takes the lead responsibility for planning, resourcing and delivering integrated health and social care services. The intended result of both models is to provide seamless, joined up, quality health and social care services across Scotland.

 

3. What do these changes mean for the way health and social care services will be delivered in the future?

The Act enables a whole system redesign of health and social care planning and provision, around a system centred on anticipatory and preventative care. It also empowers Integration Authorities to plan across the entire pathway of care to enable the delivery of health and social care services which are seamless and joined up, from the perspective of the service-user.

Integration places a greater focus on prevention and anticipatory care in the community – GPs, social workers, district nurses, etc working together to support people in their own homes.

 

4. What is the structure of the Integration Authorities?

An Integration Authority is the body that is responsible for planning integrated care. It will decide which integrated services will be provided, how they will be funded and what they should look like. They will direct the NHS Board and Local Authority to deliver those services.

More information about the legislative functions that must and may be delegated by Health Boards and Local Authorities are available at:

Health Boards and Local Authorities are currently developing their Integration Scheme which will define the services and functions of their new Integration Authority and how they will be delivered. These Integration Schemes must be submitted to Ministers for approval by 1 April 2015.

 

5. Will integration save money? If so, how will that money be re-invested?

There are many inefficiencies in how we currently allocate and use health and social care resources. These inefficiencies can adversely affect outcomes for people with multiple long-term and complex conditions and are often characterised by disconnects in services provided by Health Boards and Local Authorities. Delayed discharges are a key indicator of this.

While scrutinising the legislation, the Scottish Parliament’s Finance Committee noted that expenditure on health and social care services is projected to increase. This is because of demographic change – more people living for longer – and because more people are living with multiple conditions. The Act removes the barriers that cause these inefficiencies and enables Integration Authorities to maximise the value of their integrated resources in addressing demographic and locality specific challenges over the longer term.

 

6. How will Community Health Partnerships change under integration?

There are currently 34 Community Health Partnerships (CHPs) in Scotland, covering 14 Health Boards and 32 Local Authorities. A CHP is a part of the Health Board responsible for developing and delivering local community health services, in partnership with their Local Authority partners. After April 2015, CHPs will no longer exist and the new Integration Authorities will replace CHPs altogether.

 

7. What will be the main differences between CHPs and Integration Authorities?

There are three main differences between CHPs and Authorities.

  • Joint responsibility
    Existing CHPs are sub-committees of Health Boards, albeit with strong requirements for Local Authority membership. Integration Authorities will be the joint and equal responsibility of the Health Board and the respective Local Authority.
  • Financial  authority
    Currently, CHPs have no delegated financial authority beyond managing Health Board community health budgets. Under integration, the Integration Authority will have financial authority to utilise delegated budgets from the Health Board and Local Authority. This is to achieve maximum benefit of health and wellbeing for local populations and the requirement to demonstrate value for money.
  • Power to make decisions
    Currently, CHPs have to refer some decisions to committees within the statutory partners for approval. The new Integration Authorities will have complete authority over the decisions for the areas that have been delegated to them.

 

8. What are the timescales for integrating health and social care?

By 1 April 2015
Health Boards and Local Authorities must develop and submit their Integration Scheme to Scottish Government Ministers. This must include which model of integration will be used, the functions that are to be delegated and what method of calculating payments to support delivery of delegated functions will be utilised.

By 1 April 2015
Health Boards and Local Authorities must develop a consultation plan. This is to ensure service-users, carers, clinicians and care professionals are involved in the preparation, implementation and monitoring of the strategic plans designed to meet the needs of the local population.

By 1 April 2016
Integration Authorities must develop a Strategic Plan for their area which sets out how they will meet both local and the nationally agreed health and wellbeing outcomes. This will also include the development of Locality Delivery Plans.

 

9. What role does the Third and Independent Sector have in integration?

The Scottish Government recognises the valuable role that is played by the third and independent sectors in providing good quality support to people, working in partnership with other partners.

The Act sets out that strategic planning must be developed with, and take full account of, the views of the third and independent sectors, as well as the statutory partners.

 

10. Will the integration of health and social care require additional investment within care settings to align standards of care with other areas?

All care services are required to meet the National Care Standards. Health and social care integration aims to improve the quality of services across Scotland. Disinvestment and reinvestment will be required to ensure services meet the increasing complex needs of the population.

Integration Documents

Roles, Responsibilities and Membership of the Integration Joint Board

Guidance and advice to supplement the Public Bodies (Joint Working) (Integration Joint Board) (Scotland) Order 2014

Roles, Responsibilities and Membership of the Integration Joint Board IJB Roles, Responsibilities and Membership document cover

Integration Financial Assurance

Advice to Health Boards, Local Authorities and Integration Joint Boards on a process of assurance

Integration Financial assurance Integration Financial assurance Document Front Cover

Housing Advice Note

Statutory Guidance to Integration Authorities, Health Boards and Local Authorities on their responsibilities to involve housing services in the Integration of Health and Social Care.

Housing Advice Note Housing Advice Note document cover

Useful Information

This section contains a range of useful information and links to various guidance, legislation, reports, organisations and resources.

Glossary

This glossary contains some common terms and language to be used when referring to health and social care integration.

Principles of Integration

The principles describe what integrated care is intended to achieve and underpin how services are planned and delivered

National Health and Wellbeing Outcomes

There are nine health and wellbeing outcomes which apply to integrated care. The outcomes provide a national framework for measuring the impact of integrated health and social care on the health and wellbeing of individuals.

Boundaries of Localities

Localities

A Locality is defined as an area that relates to natural communities...