Adult social care and health to be fused in Scotland

Adult social care and health will be integrated in Scotland in a bid to improve access to care and cut delayed discharges, under plans announced today by public health minister Shona Robison.

Councils and NHS health boards will be expected to set up lead commissioning arrangements, under which one or other body will be responsible for commissioning health and adult care services for designated groups.

“We want to see health and social care for adults delivered in an integrated way by NHS and council social work staff working together to give a seamless service,” said Robison.

The model has been used in England, often to enable councils to commission all learning disability services in an area and for primary care trusts to commission all mental health services, though it has been applied to older people’s services too.

“Evidence from partnerships in England shows more older people can get quicker care packages, cuts in delayed discharges, reduced length of stay in acute hospitals and fewer unplanned emergency admissions to hospital,” Robison said.

The Scottish government has established a lead commissioning implementation group, backed by £2m for 2011-12, to support councils and health boards to take this forward.

The model was backed by Lord Sutherland, who led a review of Scotland’s flagship policy of free personal care in 2008.

“Lead commissioning provides the best and quickest way of achieving an integrated care system, and I believe the Scottish government’s approach is the right one,” he said today.

“It avoids the need for new legislation and wholesale re-organisation, which means improvements can begin to be made straight away.”

Robison and her ministerial colleagues are wedded to the free personal care policy, which has local government leaders and others have criticised on cost grounds.

In an interview with Community Care last year, she said service reform, including closer integration between health and social care, was key to managing increased demand for care at a time of constrained resources.

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