Integrating Health and Social Care in Scotland

Alison Taylor Head of Strategy and Delivery Integration of Health and Social Care Vision

• 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

Health Boards - Scotland

• NHS Ayrshire and Arran • NHS Borders • NHS Dumfries and Galloway • NHS Fife • NHS Forth Valley • NHS Grampian • NHS Greater Glasgow and Clyde • NHS Highland • NHS Lothian • NHS Lanarkshire • NHS Orkney • NHS Shetland • NHS Tayside • NHS Western Isles Local Authorities - Scotland

1. Inverclyde 17. Aberdeenshire 2. Renfrewshire 18. Aberdeen 3. West Dunbartonshire 19. Moray 4. East Dunbartonshire 20. Highland 5. Glasgow 21. Western Isles 6. East Renfrewshire 22. Argyll and Bute 7. North Lanarkshire 23. Perth and Kinross 8. Falkirk 24. Stirling 9. West Lothian 25. North Ayrshire 10. Edinburgh 26. East Ayrshire 11. Midlothian 27. South Ayrshire 12. East Lothian 28. Dumfries and Galloway 13. Clackmannanshire 29. 14. Fife 30. Scottish Borders 15. Dundee 31. Orkney 16. Angus 32. Shetland Scottish election, 2011

Scottish National Party 69 Scottish Labour Party 37 Scottish Conservatives 15 Scottish Liberal Democrats 5 Scottish Green Party 2 Other 1 The story so far . . .

• Enabling legislation – Community Care and Health (Scotland) Act 2002 – NHS Reform (Scotland) Act 2004

• 2020 Vision for Health and Social Care

• Reshaping Care for Older People – Change Fund Building blocks for integration

1) A guiding principle:

“. . . effective services must be designed with and for people and communities – not delivered ‘top down’ for administrative convenience” The Christie Commission Report Commission on the future delivery of public services, June 2011

2) A single commissioner and budget for health and social care

3) Legislation: – The Public Bodies (Joint Working) (Scotland) Act 2014 Public Bodies (Joint Working) (Scotland) Act (2014)

• Principles for integrated health and social care

• Nationally agreed outcomes for health and wellbeing

• Integrated governance arrangements for health and social care: delegation to a body corporate or lead agency

• Integrated budgets for health and social care

• Integrated oversight of delivery

• Strategic planning

• Localities Integrated Resources: approximate scale 14.0 Scotland Total =£12.3bn

12.0

10.0 Minimum to be delegated to Integration Authorities =£7.7bn 8.0

£bn

6.0

4.0

2.0

0.0

Hospital Community Health FHS & Prescribing Social Work Minimum scope – hospital services 120.0%

100.0%

80.0%

60.0%

40.0%

20.0%

Proportion unplanned & planned (%)

0.0%

Accident & Emergency & Accident Medicine General Geriatric Medicine Diseases Infectious Obstetrics than Other GP Medicine Palliative Medicine Renal Cardiology Paediatrics Psychiatry General Disability Learning Medicine Respiratory Age Old of Psychiatry Medicine Rehabilitation Gastroenterology Anaesthetics Psychiatry Adolescent & Child Surgery Paediatric Surgery General Neurology Surgery Vascular Orthopaedics and Trauma specialties medical Other Oncology Medical Neurosurgery Haematology Clinical Oncology Medicine & Surgery Oral Throat & Nose Ear, Surgery Plastic Urology Ophthalmology Rheumatology Gynaecology Dermatology Surgery Maxillofacial and Oral Surgery Cardiac Surgery Thoracic Dental Data for integration CHI

SIMD A&E Outpatients Linked Health and Social care file at Inpatients Deaths an individual Day cases service user level Social Care (Activity & Costs) SPARRA Prescribing

Age/gender

Linked File http://blogs.scotland.gov.uk/health-and-social-care-integration