Scotland integrates care services
Doctors are calling on officials to learn from good practice on the ground as Scotland follows Northern Ireland’s example.
The Scottish Government is moving towards the integration of health and social care services, following on from Northern Ireland’s longstanding example. The process is being implemented through the Public Bodies (Joint Working) (Scotland) Bill, which is expected to take effect from April 2015.
Newly established integrated partnerships will combine the budgets and services of health boards and local authorities’ social care departments, and involve closer working with the private and independent sectors. Scotland has 22 health boards and 32 local authorities.
The Bill was passed by the Scottish Parliament in February and Scottish Health Secretary Alex Neil describing it as a “landmark health and social care reform.”
Neil added: “We should never underestimate how many people rely on health and social care services to lead a healthy, full and happy life. By legislating to integrate health and social care, we are setting out our rightly high and ambitious goal to ensure our public services put people at the centre of their care – not the other way around.”
He highlighted the Midlothian Rapid Response Team as a good existing example of joined-up working. The team works to help people facing a health crisis to stay at home and reduces the amount of time they have to wait in hospital before they can return home.
The British Medical Association has emphasised that the integration process must be clinically driven and person-centred rather than focused on centralised management and structures. The BMA also says that more funding is needed to make integration a success.
“It is acknowledged that doctors are central to the success of good strategic local planning and we want to make sure that their involvement and influence is genuine and meaningful,” BMA Scottish Council Chair Brian Keighley said.
Keighley said that the priority of doctors working both in hospitals and the community was to avoid preventable hospital admissions among frail older people and to remove the barriers that stopped them returning home.
“These barriers are often created by a lack of social care support in the community,” he said. “While the plans to integrate services are welcomed by doctors, they are likely to require additional resources in order to increase capacity in the community and in primary care.”
He said that it was important that NHS boards did not ‘rip up good practice’ but should look instead to local communities and services to see what is working well and where success can be built on and shared.
Keighley added: “A culture change is required within NHS management teams to step back in order to allow clinical leadership from the grass-roots to drive change locally.”
