Health Case Studies Introduction
The Bill provides the framework, which will support improvement of the quality and consistency of health and social care services through the integration of health and social care in Scotland. This framework permits integration of other local authority services with health services. The Scottish Ministers intend to use the framework to integrate adult health and social care services as a minimum, and for statutory partners to decide locally whether to include other functions in their integrated arrangements. The policy ambition for integrating health and social care services is to improve the quality and consistency of services for patients, carers, service users and their families; to provide seamless, joined up quality health and social care services in order to care for people in their homes or a homely setting where it is safe to do so; and to ensure resources are used effectively and efficiently to deliver services that meet the increasing number of people with longer term and often complex needs, many of whom are older.
Enterprising Third Sector organisations are key to this transition and provide a real asset-based approach to transforming the health of people and communities. Furthermore, social enterprises offer additional benefits of community led health and social care services which are sustainable. Social enterprises are often found in areas of poverty, deprivation and ill health and impact on areas of life that help improve the health and well-being of individuals, families and their communities (Health and Social Enterprise Roundtable Policy Context Paper, Second Edition). This is in keeping with The Christie Commission Report on the future delivery of public services, June 2011;
― . . . effective services must be designed with and for people and communities and not delivered top-down for administrative convenience.
― This complexity [in public service delivery in Scotland] is reflected in inadequate strategic coordination between public service organisations that work routinely to different objectives, with separate budgets and processes for accountability.
― Points of authority and control are dispersed widely among varied public bodies, making joint working and reform difficult. Collaboration often relies on the persistence and flexibility of individual front-line workers and leaders.
As we move towards the integration of health and social care, it is important to know where successful partnerships and relationships have been made.
When enacted, the legislation will require Health Boards and Local Authorities to put in place integrated governance arrangements for health and social care. New integrated health and social care partnerships will oversee development and delivery of joint strategic commissioning plans. These will focus on preventative and anticipatory care, and the wellbeing of patients, service users, carers and families, within the context of national outcomes for health and wellbeing that are defined in legislation and integrated budgets for health and social care.
The Guidance for Local Partnerships for the Integrated Care Fund focuses on prevention, early intervention and support for people with complex and multiple conditions, particularly in those areas where multi-morbidity is common in adults under 65, as well as in older people. Multi-morbidity is characterised by complex interactions of co-existing diseases where a medical approach focused on a single disease does not suffice. The current fragmented health care system does not meet the complex needs of multi-morbid patients. Integrated health care models with well-balanced treatment plans tailored towards the needs of the individual person are required.
Working hand in hand with our communities needs to continue and be scaled up if it is to make a real difference. There is evidence that some deprived communities are more resilient to health inequalities than others, with the key difference being higher levels of community cohesion, social and voluntary action.
See full case studies here.