GCVS Briefing

Health and Social Care

Integrated Care Fund

This is the first in a series of briefings that will provide updates on the integration of health and social care in Glasgow and the associated Integrated Care Fund.

Introduction

The Public Bodies Joint Working Act placed the integration of health and social care on a legislative footing. The Act provides a framework for health and social care services to work more closely together to ensure joined-up, responsive, person-centred care that meets the needs of Scotland’s people. The following briefing sets out Glasgow’s progress towards integration, structural arrangements, and proposed priorities for the Integrated Care Fund and the involvement of the Third Sector in the process thus far.

Governance Arrangements
As many of you will be aware,Glasgow has now appointed David Williams as the Director Designate of Glasgow’sShadowHealth & Social Care Integration Board (H&SCI). The joint board is now established and the first meeting was held in June, the second in September. Shona Stevens, the CEO of Queens Cross Housing association, has been appointed asthe Third Sector representative on the Integrated Joint Board and will be joined by eight other partners. These are:

Additional representatives will be appointedincrementally; this shall include the Independentsector and services users.

The structures

It is proposed that existing Strategy Groups and Planning Implementation Groups (PIG’s) in the city are maintained and that their roles, remits and compositions are reviewed to take account of Integration.

At present,Third Sector representation on these structures is limited,therefore,in the coming months GCVS and Third Sector Forum members look forward to initiatingconversations with partnersabout the new structures and the possibleformation of forums, with a view to ensuring that the third sector is a) enabled to make an effective contribution at a city and locality level and b)represented at the tables where strategic decisions are taken.

To aid this process, Health and Social Work partners willbe consulting with local Third Sector and Housing organisations. In addition, there will be a meeting of Voluntary Sector Networks to focussolely onThirdSectorrepresentation withinH&SCI.

Integrated Care Fund- Priority areas

Although it has been known for a long time that funding would be available to support H&SCI; it was only on 23rd October that key partners where brought together to have the necessary discussions about the priorities. At this meeting Health and Social Work identified four key priority areas, which are:

Integrated Care pathways: To support the development of an integrated pathway to improve the care of older people in Glasgow. Some of the key characteristic of this model will include; discharges being achieved within 72 hours of FDF, reducing bed days lost, improving outcomes for older people, reducing admission to long-termcare, reducing acute pressure and supporting an increased proportion of older people, including people with LTC’s to return to their own homes

Accommodation strategy: To support the development of the housing with care model focused on [older] people with complex needs, at risk of hospital admission, or admission to long-term care from hospital. Investment from the ICF will form part of a larger financial framework, which will include funding from existing housing support budgets, SHIP investment, telecare budgets and RSLs own contributions.

Anticipatory care: To develop a citywide programme of anticipatory care building upon the experience of various local initiatives, including the Change Fund, to identify and proactively intervene in the care of vulnerable [older] people at risk of being admitted to hospital. Examples include:

  • Enabling district nurses and social workers to engage in anticipatory care planning alongside GPs, including utilising community and personal assets existing on integrated pathway
  • Develop use and access to KIS and ECS
  • Create a single point of access
  • Develop a citywide community respiratory service

Prevention and early intervention:build capacity and reduce the prevalence and level of disability caused by LTC’s and reduce the number of older people requiring hospital admission. The key areas for investment could include:

- Carer support

- Investment in third sector and development of thriving neighbourhoods

- Supplementing of funding for EquipU

- Active and healthy ageing, including providing physical activity programmes

- Building mental health and resilience

In addition to the above priority areas, both the Independent and Third Sector partners flagged up the need forresource to support representative Third Sector organisations (enablers) to continue to build the capacity of the third and independent sector to contribute effectively and to have a strong voice within the structures.

GCVS & Third Sector Forum role

GCVS, in our RCOP role, is focused on usingthe next phase of funding to continue to implement the agreed longer-term strategy of developing a new generation of community services,using asset based approaches to better address the needs of older people. We aim to use the intelligence and learnings gleaned from RCOP to build on the existing contribution of the Third Sector in supporting older people and their carers to live independently at home, for longer.Our strategy is underpinned by what older people, carers and Third Sector organisations told us throughout the extensive consultation on the draft Joint Commissioning Strategy in 2013.

In this transitional year, the Scottish Government awarded Glasgow £809,000 for 2014/15 for Organisational Development support and transitional activity to enable a smooth transition toward integrated services. The Third Sector Forum had hoped that they would have been able to access this fund to support the sector in skilling-up for integration and to reach agreement on how:

  • The expertise and voice of the third sector and services users could be mobilised at a citywide and locality level
  • To further build capacity and technical expertise within the sector to contribute to its potential

Unfortunately, we were not, as a sector, able to access these resources and must now look to the Integrated Care Fundfor 2015/16 to provide resources for the necessary infrastructure, capacity and technical support required.

Despite the desperately short timescale, GCVS and Forum members are consulting as widely as possible with key representative organisations to ensure that as many interests as possible are reflected and that the Third Sector contribution to Health and Social Care Integration is adequately resourced. To support us in this pursuit, we will also beutilising the learnings and the building body of evidence we have gathered throughout our involvement in the RCOP agenda.

Next steps

In the coming weeks, partners will be focusing their attention on meeting the ambitious target of setting up a headline programme for the ICF which will be agreed by the Integrated Board at its meeting on 17th November, with a more detailed programme plan to be submitted to the Scottish Government in December.

Obviously this is a huge task, not least because so many organisations would wish to play in their expertise and secure funding but also to enable partners to make best use of the learnings and evidence from agendas like RCOP to influence the priories of the ICF. In moving forward, we will aim to bring more clarity about the opportunities for the third and independent sectors to input and secure funding.