Glossary

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


2020 Vision
The 2020 Vision provides the strategic narrative and context for taking forward the implementation of the Quality Strategy, and the required actions to improve efficiency and achieve financial sustainability. 


Aids and Adaptations
Aids and adaptations can help older and disabled people to live independently in their own homes. They can reduce the risk of falls and other accidents in the home and can also reduce the need for home care or long term admission to a care home. 

A wide variety of aids and equipment is available to help with daily living tasks ranging from simple adapted cutlery, to telecare alarms, specialist seating and beds. Common examples of adaptations include replacing a bath with a level access shower, or making it easier to get in and out of the home by widening doors or constructing a ramp.

Anticipatory Care
Anticipatory Care can take many forms however it is expected to help reduce avoidable and unscheduled acute admissions for people with pre-existing conditions. The purpose of advanced/anticipatory care planning is to support the individual to have greater choice, and control of care preferences through communication across the support team, across agencies and across care settings.


Body Corporate Model
The Body Corporate Model is a model of integration where a Health Board and Local Authority both delegate the responsibility for planning and resourcing service provision for health and social care services to an Integration Joint Board, established as a separate entity.


Chief Officer
Where the body corporate model is adopted, a Chief Officer of the Integration Joint Board will be appointed to provide a single point of management for the integrated budget and integrated service delivery. They are accountable to the Integration Joint Board and to the Chief Executives of their Health Board and Local Authority for the delivery of integrated services.

Choice and control
Choice and control is about shaping services to meet people’s needs, rather than allocating people to fit around services.

Co-production
Co-production is about combining our mutual strengths and capacities so that we can work with one another on an equal basis to achieve positive change.


Delayed Discharges
Delayed Discharges occur when a patient ready for discharge cannot leave hospital because the necessary care, support or accommodation is not available. 

Delegation
Delegation is the process used to integrate functions, by giving responsibility for health and social care functions to a single body.


Health Inequalities
Health inequalities
is the gap which exists between the health of different population groups such as the affluent compared to poorer communities or people with different ethnic backgrounds.

HEAT Targets
The HEAT performance management system sets out the targets and measures against which Health Boards are publicly monitored and evaluated. HEAT is an acronym for Health Improvement, Efficiency and Governance, Access and Treatment. These are the four areas being targeted.


Independent Living
Independent Living means having the same freedom, choice, dignity and control as other citizens at home, at work and in the community. It does not necessarily mean living by yourself or fending for yourself. It means rights to practical assistance and support to participate in society and live an ordinary life.

Independent Sector
The Independent Sector encompasses individuals, employers, and organisations who contribute to needs assessment, design, planning, commissioning and delivery of a broad spectrum of social care services, which are wholly or partially independent of the public sector.

The independent social care sector in Scotland includes care homes, care at home, housing support and day care services. The sector encompasses those traditionally referred to as the ‘private’ sector and the ‘voluntary’ sectors of care provision. It includes organisations of varying types and sizes, amongst them single providers, small and medium sized groups, national providers and not-for-profit voluntary organisations, associations and charities.

Integrated Care
Integrated Care focuses on improving services in relation to access, quality, user satisfaction and efficiency. The aim is to enable better coordinated, joined-up and more continuous care, resulting in improved patient experience whilst achieving greater efficiency and value from health and social care delivery systems.

Integrated Resource Framework
The Integrated Resource Framework (IRF) for Health and Social Care is a framework within which Health Boards and Local Authorities can better understand the patterns of care they provide, particularly to their shared populations of people and service-users.

Integration
Integration is the combination of processes, methods and tools that facilitate integrated care.

Integration Authority
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. It can (and in many cases must) direct the Health Board and Local Authority to deliver those services.

The body that acts as the Integration Authority for a particular area will be determined by reference to the model of integration used in that area.

Integration Functions
The services that Integration Authorities will be responsible for planning are described in the Act as integration functions. The legislation sets out which NHS and social care services must, may and cannot be delegated as part of the integration arrangements.

Integration Joint Board
Where the Body Corporate model is adopted, the NHS Board and Local Authority will create an Integration Joint Board made up of representatives from the Health Board, the Local Authority, the Third and Independent Sectors and those who use health and social care services. The Integration Joint Board, through its Chief Officer, will have the responsibility for the planning, resourcing and the operational oversight of integrated services within the strategic plan.

Integration Scheme
An Integration Scheme is the agreement made between the Health Board and the Local Authority. It sets out the make-up of the Integration Authority and how it will work. The Health Board and the Local Authority must submit their draft Integration Scheme to Scottish Ministers for approval by 1 April 2015. Integration Schemes must be reviewed by the Health Board and Local Authority at least every five years.

Intermediate Care
Intermediate Care services support people to improve their independence and aim to provide a range of enabling, rehabilitative and treatment services in community and residential settings. The term has been defined as a “range of integrated services to promote faster recovery from illness, prevent unnecessary acute hospital admission, support timely discharge and maximise independent living”. (NSF for Older People, DOH, June 2002).


Lead Agency Model
The Lead Agency Model is a model of integration where the Health Board or the Local Authority takes the lead responsibility for planning, resourcing and delivering integrated adult health and social care services.

Locality Planning
Locality Planning is intended to keep the focus of integration on improving care in local communities. It will draw on the knowledge and experience of users of services, carers, staff and the third and independent sectors and provide the route for leadership by local clinicians and professionals from across health and social care – and, particularly, GPs – in planning service provision. Every Local Authority must define at least two localities within its boundaries for the purpose of locality planning.

Long-term Conditions
Long-term Conditions are conditions that last a year or longer, impact on many aspects of a person’s life, and may require ongoing care and support. The definition does not relate to any one condition, care group or age category, so it covers adults and older people as well as children and those with physical and mental health issues.

Common long-term conditions include epilepsy, diabetes, some mental health problems, heart disease, chronic pain, arthritis, inflammatory bowel disease, asthma and chronic obstructive pulmonary disease (COPD).


Market Facilitation
Market Facilitation is a key aspect of the strategic commissioning cycle. Authorities will undertake a range of activities to promote the successful development of services to meet the needs of the local population effectively. These activities should include the development of an accurate picture of local need and markets, published as a Market Facilitation Plan.


National Care Standards
The National Care Standards have been published by Scottish Ministers to help people understand what to expect from a wide range of care services. They are in place to ensure that people get the right quality of care when they need it most.

National Health and Wellbeing Outcomes
The nine national health and wellbeing outcomes provide a national framework for measuring the effect of integrated health and social care services on the health and wellbeing of individuals.


Personalisation
Personalisation means starting with the individual as a person with strengths and preferences who may have a network of support and resources, which may include family and friends. Personalisation reinforces the idea that the individual is best placed to know what they need and how those needs can be best met. It means that people can be responsible for themselves and can make their own decisions about what they require, but that they should also have information and support to enable them to do so.

Person-centred
Person-centred is an approach to working with people which respects and values the uniqueness of the individual and puts the individual’s needs and aspirations firmly at the centre of the process.

Planning and Delivery Principles
The principles that underpin the making of arrangements for integration, and the strategic planning of integrated services, will inform how services are planned and delivered. They explain what people using services and their carers can expect from integrated services and the behaviours and priorities expected of organisations and people planning and delivering care and support.


Quality Ambitions
The three Quality Ambitions of person-centred, safe and effective provide the focus for all our activity to support our aim of delivering the best quality healthcare to the people of Scotland and through this making NHSScotland a world leader in healthcare quality. They explicitly reflect the things people have told us they want and need.

Quality Strategy
The Healthcare Quality Strategy for Scotland is the approach and shared focus for all work to realise the 2020 Vision. It aims to deliver the highest quality healthcare to the people of Scotland to ensure that the NHS, Local Authorities and the Third Sector work together, and with patients, carers and the public, towards a shared goal of world- leading healthcare.


Reablement
Reablement is about giving people the opportunity and the confidence to relearn/regain some of the skills they may have lost as a result of poor health, disability/impairment or entry into hospital or residential care. As well as regaining skill, reablement supports service-users to gain new skills to help them maintain their independence.


Self-Directed Support
Self-directed Support
(SDS) is the new form of social care where the service-user can arrange some or all of their own support. This is instead of receiving services directly from Local Authority social work or equivalent. SDS allows people more flexibility, choice and control over their own care so that they can live more independent lives with the right support.

Self-management
Self-management encourages people with health and social care needs to stay well, learn about their condition and their care and support needs, and remain in control of their own health.

Shadow Integration Board
Interim local Shadow Integration Boards have been set up to manage transitional integration arrangements until integration goes live from April 2015.

Staff Governance (NHSScotland)
Staff Governance is an NHSScotland system of corporate accountability for the fair and effective management of staff. It requires that staff are: well informed; appropriately trained; involved in decisions; treated fairly and consistently; and provided with a continually improving and safe working environment.

Staff Partnership
Staff Partnership describes the process of engaging staff and their representatives at all levels in the early stages of the decision-making process. This enables improved and informed decision making, through achieving and maintaining a positive and stable employee relations culture and gaining commitment, ownership and consensus to decisions through joint problem solving. The emphasis is therefore placed on working collaboratively at all levels and becoming an exemplary employer, both to the benefit of staff but also to the benefit of patient care.

Strategic Commissioning
Strategic Commissioning is a way to describe all the activities involved in:

  • assessing and forecasting needs
  • links investment to agreed desired outcomes
  • planning the nature, range and quality of future services; and
  • working in partnership to put these in place

This is the process that informs the Integration Authorities Strategic Plan.

Strategic Needs Assessment
Strategic Needs Assessments (SNA) analyse the health and care needs of populations to inform and guide commissioning of health, wellbeing and social care services within Local Authority areas. The main goal of a SNA is to accurately assess the health and care needs of a local population in order to improve the physical and mental health and wellbeing of individuals and communities. The SNA will underpin Strategic Plans.

Strategic Plan
The Strategic Plan is at the heart of integration and is intended to be the means by which services are redesigned in an integrated way to improve the quality and coherence of care for people using them. Each Integration Authority must put in place a Strategic Plan (Strategic Commissioning Plan) for functions and budgets under its control. These will be co-produced via a strategic planning group whose members will include representatives of non-statutory partners, service-users and service-user representatives.

Supported Living
Supported Living is an alternative to residential care or living with family members that enables adults with disabilities to live in their own home, with the help they need to be independent. It allows people to choose where they want to live, who they want to live with and how they want to be supported


Third Sector
Third Sector organisations is a term used to describe the range of organisations that are neither public sector nor private sector. It includes voluntary and community organisations (both registered charities and other organisations such as associations, self-help groups and community groups), social enterprises, mutuals and co-operatives. It also includes local intermediary organisations (Third Sector Interfaces), and third sector strategic intermediaries, for example Voluntary Action Scotland (who represent Scotland’s 32 Third Sector Interfaces) and the Health and Social Care Alliance Scotland.

Transformational Leadership
As opposed to the management of the delivery of services, Transformational Leadership relates to the ability to inspire, motivate and engage. These qualities are seen as being particularly important for times when organisations are being challenged by significant external changes.