Integrated Care in Scotland
Scotland’s integrated care journey offers rich learning for other systems. Our key documents section – has links to information on the key enablers for integrating health and social care in Scotland and different perspectives on progress and challenges.
The 2011 report of the Christie Commission on the Future Delivery of Public Services in Scotland identified four priorities for reform: service integration at a local level, a greater shift towards prevention, improving outcomes for individuals and addressing health inequalities. The report mobilised cross-party support to integrate healthcare and social care. A perspective paper published in 2016 describes steps taken in creating an enabling environment for integration, including extensive engagement on an ambitious yet simple vision: to ensure better health and well-being outcomes for people at home and in local communities through care and support designed around the individual. This vision builds on the learning from Reshaping Care for Older People, as described in the Canadian Healthcare Quarterly and in the Change Fund Reflecting on Progress report available here.
The Public Bodies (Joint Working) (Scotland) Act 2014 can be accessed here. From April 2015, 31 new integration authorities, often described as Health and Social Care Partnerships (HSCPs), became responsible for planning and commissioning services to meet the needs of their local population. They are governed through Iintegrated Joint Boards who oversee an annual budget of over £9.4 billion to invest in health and social care resources and to make progress against the nine National Health and Wellbeing Outcomes. There is no change to the regulatory framework for professional practice, or established professional accountabilities that are currently in place within the NHS and local government.
Audit Scotland’s report describes the progress and challenges in implementing this complex transformational change across the country. Views on progress from different sectors were gathered by the Health and Social Care Alliance in a collection of personal perspectives. A report by the Ministerial Strategic Group for Health and Community Care describes what needs to be done to enable more progress: Collaborative leadership and building relationships; Integrated finances and financial planning; Effective strategic planning for improvement; Governance and accountability arrangements; Ability and willingness to share information; and Meaningful and sustained engagement. More information about local progress and examples of good practice are available here
Health and Social Care Scotland represents a new social movement that aims to think beyond traditional approaches, creating a culture that supports innovation and reflects the purpose, values, outcomes and ambitions required to meet the needs of Scotland’s population. It relies on collaboration, strong partnership and the spirit of working with communities, and working together to develop positive relationships across systems to enable change to happen and help create a more sustainable compassionate and caring Scotland. Watch the animation of Health and Social Care Scotland’s Statement of intent.
Since April 2018, national Health and Social Care Standards My Support My Life apply across all health and social care provision in Scotland including regulated care settings, social care, early learning and childcare, children’s services, social work, healthcare provision, and community justice.
The new GP contract refocused the role of the GPs as expert medical generalists and describes priorities for service transformation over a three year period. Redesign is informed by the ALLIANCE House of Care programme that promotes health literacy and support for self management, collaborative care planning, and embracing local assets and opportunities for social prescribing. Early learning from House of Care can be accessed here and information on social prescribing and community links workers here.
Self Management and Co-production
A suite of online resources explain the principles and practice of co-production. The ALLIANCE leads My Condition My Life a national campaign and fund to promote support for self management, and partnered in developing action plans on active and healthy ageing and living well with multiple conditions.
Supports for Health Literacy are available here. A series of reports by the Chief Medical Officer on Realistic medicine discuss how to change to a more personalised, collaborative practice and adopt shared decision making. The latest report is available here.
The Integrated Resource Framework provides a perspective of historical patterns of service to support strategic planning and change; and enables a better understanding of costs, activity and variation for different population groups.
a national cross sector group working together to support developments in health and social care, as well as other human services, locally and nationally. The Network is seeking to develop a wider and more consistent understanding of personal outcomes across diverse service settings. Tools and reports can be accessed here.
Data and Analysis
The Local Intelligence Support Team (LIST) team provides on-site expert analytical support to source, link and interpret data and provide local decision makers with meaningful and actionable intelligence to improve outcomes for service users and patients. The Source Tableau Platform is an interactive visualisation tool to understand linked data on local activities, decision making, and planning and performance management. A Data Sharing Agreement specifies who will use the data, who can get access for what purpose, and the process for authorisation and restrictions. More information can be found here.
You as a Collaborative Leader programme was designed for primary care and social care professionals, and middle or senior managers in statutory, third or independent social care organisations who are working to shape, develop and deliver integrated care. This report by the Kings Fund explores how the chief officers of the integration authorities have developed their role in the Scottish health and social care system.
Healthcare Improvement Scotland established their Improvement Hub (ihub) in April 2016 to support those delivering health and social care to redesign and continuously improve services to ensure they meet the changing needs of people in Scotland.
Read more about the range of ihub improvement programmes here.
Public Health Scotland
Launched on 1st April, 2020, Public Health Scotland brings together Health Protection Scotland, Information Services Division and NHS Health Scotland as Scotland’s lead agency for improving and protecting the health and wellbeing of all of Scotland’s people to achieve the vision of a Scotland where everybody thrives. Read more!
This report sets out commitments and planned investment in general practice, primary care, community nursing and wider community workforce over the next 3-5 years to develop multidisciplinary capacity across Scotland in the face of an ageing workforce and anticipated levels of staff turnover.
National Performance Framework
The framework describes the national outcomes and indicators that track progress in achieving the Scottish Government’s purpose and values. They reflect the values and aspirations of people in Scotland, are aligned with the UN Sustainable Development Goals, and will help to track progress in reducing inequality.
Caring Together, The Carers and Young Carers Strategy, has been followed by a Carers Charter, education for professionals on carers as equal partners in care, and by legislation to provide new rights to carers in a number of areas.