Adult social care and health to be integrated in Scotland

Adult social care and health will be integrated in Scotland to help tackle delayed discharges from hospital and cost-shunting between councils and the NHS, under plans outlined yesterday by the country’s government.

Councils and NHS boards will be required to set up health and social care partnerships, with pooled budgets, and for which they will be jointly accountably, said health secretary Nicola Sturgeon.

Partnerships will be accountable for a number of national outcomes, including reducing delayed discharges from, and emergency admissions to, hospital, and increasing the number of older people living in their own homes.

The partnerships, which will be introduced through legislation, will replace existing community health partnerships and community health and care partnerships.

“We will tackle the barriers that currently exist within community health partnerships – division of accountability between the NHS and local authorities, insufficient and often unequal delegation of authority, budgets that are not integrated, leading to decisions about older peoples’ care too often being dependent on whose budget is affected, and poor clinical engagement,” said Sturgeon.

“Our reforms will deliver a system that is effectively integrated, leading to better outcomes for older people and better use of resources.”

The proposals reflect plans outlined by the Scottish National Party before this year’s Scottish elections. These – and similar plans from the Labour Party – sparked concern among local government leaders who feared that they would amount to an NHS takeover of local authority social care and would be “expensive, distracting and ineffective”.

However, yesterday’s announcement was broadly welcomed by the Convention of Scottish Local Authorities.

“It is widely known that we need NHS health care to knit together more tightly with local government run social care services and the work that we have been considering with the Scottish government attempts to achieve that,” said Douglas Yates, Cosla’s spokesperson for health and well-being. “While we are still in the early stages of that discussion – with much of the detail still to be ironed out – our view on the general parameters of reform are similar.”

The legislation will specify that a single, jointly appointed officer will be accountable for the partnership’s performance against its objectives.

However, Sturgeon stressed that the plans did not amount to “centrally directed, large-scale structural reorganisation and staff transfer” – the type of change that Cosla feared – and that precise arrangements for partnerships would need to be agreed locally.

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