The International Centre for Integrated Care, a strategic partnership between the International Foundation for Integrated Care (IFIC), the University of the West of Scotland and the Health and Social Care Alliance Scotland, is the home of IFIC in Scotland. This roundtable continued our cross sector dialogue on hot topics in integrated care. It featured outputs from two collaborative research projects recently undertaken by the University of the West of Scotland and IFIC Scotland partners.
- CLI: Cultures and Leadership for navigating successful change in integrating health and social care
- From strategic intent to procurement of adult social care and support in Scotland
Professor Anne Hendry, Director IFIC Scotland, welcomed 76 participants who had registered for the session. Participants were drawn from healthcare, social care, third sector and independent sector as well as policy colleagues, advocacy partners and representatives from higher education bodies.
Guest Panelists
Professor Stephen Gibb, Chair of Organisation and Human Resource Development, University of the West of Scotland, presented an overview of the CLI project which he led with an interdisciplinary team of researchers from UWS schools of Business & Creative Industries, Health & Life Sciences, and Education and Social Sciences in collaboration with IFIC Scotland and funded by the Scottish Government Directorate for Social Care and National Care Service Development.
Stephen described three project outputs. The first report was a scoping literature review on CLI, followed by a report on insights from 35 cases provided by professionals in advance of an interactive CLI Research and Practice convention. The combined research and experiential evidence informed discussions between 30 people who participated in the convention held in November 2024. You can access the reports through the links below.
Gibb, S., Mashkoor, A., Hendry, A., Webb,A., Rainey, H. (2024) ‘Culture, Leadership, and Integration (CLI) for the National Care Service: The Journey to ‘’We Are The NCS’’, University of West of Scotland. Social Impact Leadership and Management Report 1
Gibb, S., Hendry, A., Rainey, H., Webb, A., Grant, S., Gamble, S., Mashkoor, A., Hendry, C., Craney, A., Carroll, R. (2025) Cultures and Leadership for Integration (CLI): In Health and Social Care: Navigating to Successful Change, CLI Convention Report UWS. Social Impact Leadership and Management Research Group, Report 2.
Gibb, S., Hendry, A., Rainey, H., Webb, A., Grant, S., Gamble, S., Mashkoor, A., Hendry, C., Cultures and Leadership for Integration (CLI): All cases and Contributions, CLI Convention Report UWS. Social Impact Leadership and Management Research Group, Report 2A. 10.5281/zenodo.14918849
The main report sets out
- 7 statements on what we know about CLI in the health and social care context
- Analysis of what we need to know
- Priorities for how to discover more together, here and now and in the longer-term.
These are represented as a compass for navigating journeys to successful change in a complex health and social care landscape
Stephen’s slides can be accessed within the recording. They include a link to an AI tool adapted to enable the evidence for each navigator to be explored. He invited people to make contact if they are interested in participating in an online CPD module that his team has developed.
Connie Hendry, Future Workforce Lead/Unit Head, Scottish Government Directorate for Social Care and National Care Service Development, welcomed the reports and agreed there is a need to explore CLI further to understand what leads to success and contributes to failure in practice. She would like to hear more stories from practice and turn some exemplar experiences into further evidence in future. She looks forward to continuing to work with the UWS team on the proposed CPD and her national team plan to develop a programme of work on cultures and leadership.
Alyson Vale, Business and Operations Director, Abbotsford Care contributed a case study and attended the convention. She supported the findings and recommendations, reflecting that we often underestimate the power of culture and its impact on the workforce. She believes it is important to address this through leadership and thinking creatively, encouraging people to look outside the box.
The second project highlighted in the session was on commissioning adult social care (ASC) in Scotland, conducted on behalf of the Coalition of Care and Support Providers in Scotland with funding from the Scottish Government. The first report, brings together the results of a scoping literature review of published evidence on ethical commissioning, summarising the context for strategic planning, commissioning and procurement of ASC in Scotland. The accompanying study presents the results of qualitative interviews with a sample of national and local stakeholders involved in commissioning and procurement of ASC support and services. Respondents identified ideas for improvement across six themes:
Resolve Ambiguity
Reduce Complexity
Refresh Practice
Rebalance Power and Relationships
Respect Place
Realise Value
You can access the 2 reports and a news article from CCPS here
“Commissioners and providers alike called for simpler processes that enable more collaborative commissioning. There was a strong sense that this need not, and indeed cannot, wait for new legislation or new structures and it was refreshing to hear what can be achieved now with a strong focus on value and outcomes. However, sustainable change requires investment in the social care workforce supported by collaborative leadership, culture and relational practice that respects place and rebalances power.’’
Rachel Cackett, CEO, CCPS agreed that the commissioning and CLI projects amplify each other. She highlighted two quotes that particularly landed with her: ‘get out of the way of people who know what they are doing’ and ‘cede power.’
Rachel expressed increasing concern about the gap between rhetoric and reality on ethical commissioning, reflecting that commissioning and procurement used to be relational, based on knowing both the people who need support and the providers. Now she sees choice and control increasingly being pulled back into the hands of commissioners as processes become more risk adverse in the face of financial pressures facing both commissioners and providers. In a recent survey of CCPS members, two thirds reported they would only break even if they raided their reserves.
Shona Omar Smith, Commissioning Lead, Aberdeen City, and Neil McKechnie Contracts, Commissioning & Quality Assurance Manager, West Dunbartonshire shared Rachel’s view that social care is about relationships. We are commissioning relationships not widgets.
Commissioning should be fair, open and transparent - we need to talk openly and honestly.
Andrew Thomson, Deputy Chief Executive Carr Gomm, spoke about experiencing excellent commissioning practice but also cited the ‘madness’ of closing a service supporting some of the most vulnerable people in society for many years without the users having the opportunity to express their views. Jane Russell, Partnership Manager (Health and Social Care), ACVO, spoke of some harrowing situations for vulnerable people and financial challenges for third sector organisations, as highlighted in a recent ALLIANCE letter to IJBs.
Kerry Ritchie, ALLIANCE Programme Manager, noted people with lived experience often don’t have power or knowledge to challenge on IJBs. You can read the report More than Equal, Valuing and supporting the expert contribution of people with lived experience here
Fraser Smith, Policy Lead (Ethical Commissioning) Scottish Care reflected on commissioning as a key tangible part of culture change. Scottish Care advocates for a more collaborative, participative and ethical commissioning framework, citing themes of ‘Rights’, ‘Respect’ and ‘Redistribution’ to address issues of parity, inequality and problematic relationships. Fraser stressed the importance of a power balance, open communication. transparency and mutual respect to achieve real change. You can read more about Fraser’s work and publications here .
Christina McLaren, Team Leader, Scottish Government Adult Social Care Workforce, advised that the Care Reform (Scotland) Bill has just passed stage 2 and Minister Todd is open to including guidance or legislative change on commissioning at stage 3. Several working groups are looking at current practice and barriers to good practice. Policy officials are considering how non-legislative work can enhance the impact of the Bill – e.g. publishing principles of ethical commissioning and procurement set at a national level, to be delivered locally with supporting guidance and tools. Read more about these non-legislative programmes here.
Final reflections
The extreme black hole has potential to lever more people to do something differently as bunkering down and doing same as usual will not do.
First step is realising ethical commissioning is not a silver bullet. It will be a slow build and needs support from national and local levels of government.
Integration beyond health and social care remains stalled – the entire system needs to be worked on to set integrated care around place. Let’s be messaging more and influencing IJBs and the emerging NCS Advisory board about 5 things:
- Trust & transparency, Open communication across partners and workforce
- Empowered leadership, dispersed models and facilitation.
- Innovation culture, encourage safe, supported experimentation.
- Aligned vision, Use CLI Compass to focus shared outcomes.
- Resilience building, invest in wellbeing & development even during cuts.
We change cultures one conversation and positive experience at a time.
CPD may seem a puny thing but it’s a place to begin many kinds of journey to change.
We need a fresh set of health and wellbeing outcomes that matter to people within a National Performance Framework that values social care
Local boards need to put their money where their mouths are
Let’s take our brave pills…. Move forward with hope and collaboration
The International Centre for Integrated Care
Our Mission
Co-creating a healthier future with individuals and communities by developing courageous and compassionate leaders and practitioners with the knowledge, skills and confidence to design, deliver and evaluate people-centred integrated care.
Check out our webpages to find out more about our partners, work and resources: https://integratedcarefoundation.org/ific-scotland
To receive regular updates and newsletters contact:
Marie Curran: IFICScotland@integratedcarefoundation.org
Or
Professor Anne Hendry anne.hendry@lanarkshire.scot.nhs.uk
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