HEALTH AND SOCIAL CARE INTEGRATION BRIEFING JANUARY 2015
Introducing our Chief Officer for Health and Social Care Integration, Julie White.
“May I take this opportunity to say how much I am looking forward to working with you all on this very challenging and exciting programme of change. Integration is about ensuring that Dumfries and Galloway Council and NHS Dumfries and Galloway work together to improve the experience of people who use Adult health and social care services.”
“In Dumfries and Galloway we have a strong history of good partnership working but we want to make this better. We know that the number of people requiring both health and social care is forecast to rise significantly over the coming years. This is coupled with the challenge of a reduction in our working age population at a time of increased demand for health and social care.
Integration will ensure that we are better placed to meet the predicted changes in demand at a time of facing challenges from a financial and workforce perspective.
“However, this is about much more than just the NHS and adult social care services working closely together. It’s about working with the people who use our services, patients, carers, service users and their families alongside the Third and Independent sector and our local communities to radically reshape the way we deliver health and social care in the 21st Century.
I want to ensure that staff are fully involved with this significant change programme. As a result, this is the first in a series of briefing papers to bring you all up to date with progress. If you would like to be more involved or require further information, please don’t hesitate to contact me or Catherine Withington, Programme Manager for Integration.
Integration – The Story So Far
Since 1 April 2014 health boards and local authorities have been required, by the Public Bodies (Joint Working) (Scotland) Act 2014, to integrate their health and social care services. In Dumfries and Galloway we have chosen to adopt the Body Corporate Model which means we have created a Joint Integration Board which includes representatives from the Council, NHS, trades unions, Third and Independent sectors.
NHS Dumfries and Galloway’s Chief Operating Officer Julie White has been appointed as the Chief Officer for the Joint Integration Board. This board will oversee progress towards integration and ensure that health and social care professionals work together to design, develop and deliver quality, sustainable services resulting in improved outcomes for people who use our services and their Carers. Julie is also responsible for creating a new single management structure. Area
Committees have an important role in the process as they will examine local service delivery and report back to the Board.
How Will We Do The Work?
Catherine Withington is the Integration Programme Manager. She will oversee the work of the seven workstreams we have set up to carry out the various tasks necessary to make integration happen. Each workstream will be led by a member of staff from both the NHS and Council with supporting staff and contributions from trades unions, Third and Independent sectors. They will be responsible for engaging with all relevant stakeholders and will report to the Joint Integration Board.
The workstreams and their outline Terms of Reference are:
1. Governance and Delegations
Develop clear and robust decision-making structures under the corporate body model, for an integration joint board, which will fully reflect the unique and different roles of the NHS and the Local Authority, retaining the respective accountability for resources, outcomes and performance and quality of services.
Health and Social care services in each locality will be accountable to their local community and through to the integration joint board. Develop clear and robust scrutiny structures through Area Committees which recognises full operational delegation and empowered decision-making at a local level.
2. Services Out with Scope of Legislation
Recurring elements of Social Work Services and Health which sit outside the preferred Adult Services model e.g. Integrated Children’s Services and Mental Health Officers must be considered and the development of appropriate decision-making structures is a priority.
3. Strategic Plans
Develop a range of outcomes for integration and integrated services through the preparation of a framework which involves our citizens. This should identify evidence (and any gaps) to assess and measure the delivery of successful integration and improved health and social care services which also support and underpin the requirements of Self Directed Support and Personalisation.
Develop our approach to plan, design and deliver services together, involving all partners effectively – third, public, independent and private – from inception.
Ensure meaningful engagement of local communities, Board members, Elected Members, professional groups, staff groups, all sectors etc. in the design of services in an integrated model is crucial.
Ensure links to other integration work streams and other relevant pieces of work as appropriate.
Consider the range of change initiatives currently underpinning Adult health and social care and refocus this through streamlined decision-making to underpin integration ambitions, maximising capacity and capability to deliver.
Demonstrate compliance with the National Outcomes for Health and Social Care
Revisit and refresh the existing Strategic Commissioning Framework to ensure it complies with most recent guidance and fully supports local integration plans.
Ensure that a Strategic Needs Assessment is undertaken to inform the development of the Strategic Plan.
Ensure ‘strategic fit’ of Strategic Plan with Locality Plans and other recommended documents e.g. Financial Plan/Procurement/Contracting Plan/Market Facilitation Plan/Communication Plan
4. Organisational Development
Design & lead cultural change at an area, locality and organisational level working with the Action Learning Set (ALS) group that will deliver positive integrated services and teams focused on delivering appropriate person centred care. We will do this in a way which is cognisant of, and congruent with the management and operational review work stream, and with a focus on the strategic outcomes of integration set by the Programme Board
Support the development of a comprehensive communications strategy for integration, by feeding in requirements to the overarching Communications Strategy, with particular focus on OD and staff related issues.
5. Management and Operational Review
In our proposed model professional leadership and oversight and practice development will remain with senior professional officers in each organisation. Clear and robust structures will provide for full delegation and empowered decision-making.
Professional leadership and oversight and practice development should remain with senior professional officers in each organisation. Professionals will be freed up to focus on delivery and solutions, learning from experience through, e.g. Joint Future.
Deliver a structure and management arrangements that enable an evidence-based approach to workforce planning based on anticipated demand in the short, medium and long term.
Local commissioning for services required in Area and Community are built and delivered to meet those localised needs.
Health and social care services in each locality will be accountable to their local community and a joint partnership board (D&G Local HSCP).
6. Resources
Identification of Council and NHS budgets to support integration.
Understanding the impact of integration on outcomes and costs and ensure that systems are in place to measure and evaluate both over time.
Modelling current activity and pathways to understand how all resources are currently used in Adult health and social care to be able to assess and evidence the impact of the changes that integration will bring.
7. Information and ICT
To be effective and make the right decisions and avoid duplication requires the right information. Development of our approach and systems to support information sharing, front line staff and support decisions making.
To work collaboratively and in a converging way to make best use of the limited ICT resources in both organisations
Partnership working arrangements with our Trade Unions
Within both the Council and the NHS we value our existing partnership arrangements with our Trades Unions / professional organisations and recognise that they are crucial to our success. Through both our local work, and also at a national level, it is clear that we have more in common between our two organisations than separates us, and so, whilst our organisations may have different arrangements and processes in place, our common ground will ensure that we can positively engage together as we integrate our health and social care services. Partnership work to support integration, involving Trade Unions / Professional Organisations will focus on establishing positive working arrangements across the organisations and the teams involved, and will therefore have a strong development focus for individuals, teams and the wider organisation. The NHS and Council both have recognition agreements in place and remain absolutely committed to those agreements. Terms and conditions of employment will thus remain within each employing authority to manage, as is currently the case.
Locality Teams
Four locality teams have been set up to take responsibility for the delivery of adult health and social care services in each area. These will be managed by a Locality Health and Social Care Manager with a budget and full resources. Each locality team has been asked to develop a Locality Delivery Plan to show how they will deliver integration. These are expected to be developed with input from local communities, Third and Independent sector representatives.
The locality teams are overseen by one senior manager who will also manage a range of region-wide services.
Staff Communication and Engagement
Throughout the process of integration of adult health and social care services we will be working hard to make sure staff are kept up to date with progress. We will work with the locality teams to develop communication and engagement plans and we hope you will work with us.
If you have any questions about integration please contact:
Annandale & Eskdale / John McGoldrick / / 07468 700027Jimmy Marshall / / 01461 207002
Wigtownshire / John McGoldrick / / 07468 700027
Gerry McCabe / / 030 3333 3001
Nithsdale / Alison Solley / / 07736 955164
Colin Lewis / / 01556 505777
Stewartry / Alison Solley / / 07736 955164
Barbara Aitken / / 01556 505777
Head of Care and Support / Kate McLeod / / 01387 271100
Head of Adult Services (SW) / Graham Abrines / / 01387 273626
Primary & Community Care General Manager / Alison Burns / / 01776 707755
Integration Programme Support Manager / Catherine Withington / / 01387 241995