"A wise man proportions his belief to the evidence"

"A wise man proportions his belief to the evidence"

Experiences of Integration in Scotland ADASS Spring Conference Peter McLeod Vice President Association of Directors of Social Work Social Work Services in Scotland SW (Scot) Act 1968 Kilbrandon and integrated care The promotion of social welfare The Childrens Hearing The Chief Social Work Officer 32 local authorities

38,000 council workers facing a switch to NHS 2nd February 2011 ADSWs perspective Achieving the best outcomes for the people who use our services Early intervention Personalised care, power, choice and control for individuals Supporting and empowering communities and carers Seamless pathways of care

Equitable access Local democratic control Evidence based decision making Cost neutral / cost saving, transparent and multi-sectoral reform Promotion of social welfare ADSWs contribution A research literature review commissioned A position paper agreed An engagement commenced ADSWs proposal 9 point plan 1. 2. 3. 4. 5. 6. 7.

8. 7-10 outcomes A nationally agreed dataset Joint strategic commissioning plans Joint commissioning plans based on total LA and NHS adult care spending Joint financial governance Targets for joint commissioning within single outcome agreements Accountability meetings Annual leadership event 9. PSIF self-evaluation to be undertaken by partners Scottish Governments response Another key message that emerged from work over the summer was that wholesale, nationally driven, structural reorganisation of current statutory bodies was not the best way to address the challenges. Evidence shows that that is not

the way to achieve better outcomes for people, and it is therefore not the route that we are choosing. Nicola Sturgeon, Cabinet Secretary Current configurations Social Work Services 11 'Stand Alone departments 5 Social Work and Education 4 Social Work and Housing 2 Social Work, Education and Housing 6 Children's Services 3 Adult social work services, Housing and Community Services

6 Community Health and Care Partnerships 1 Shared Service model What is the problem we are trying to solve? Too much variability of health and social care in different parts of Scotland, particularly for older people. No incentive to help get people out of hospital quickly and back into a homely setting. Much easier to get an older person admitted to hospital than to arrange services that would keep them at home. Projected Demand for Health and Social Care, All Ages, 2008/09 prices. Health and Social Care Demand Projections, mn, 2008/09 prices 15,000 14,000

13,000 Cost mn 12,000 11,000 10,000 9,000 HLE constant 8,000 Change HLE = 0.5 change LE 7,000 Change HLE = Change LE 6,000 5,000 2010

2015 2020 Year 2025 2030 NHS Delayed Discharges Scotland; September 2000 to April 2011. 3000 N u m b e r o f p a tie n ts 2500 Over 6 weeks Under 6 weeks

2000 1500 1000 500 0 Sep 2000 Apr 2001 Oct 2001 Apr 2002

Oct 2002 Apr 2003 Oct 2003 Apr 2004 Oct 2004 Apr 2005 Oct 2005

Apr 2006 Census Oct 2006 Apr 2007 Oct 2007 Apr 2008 Oct 2008

Apr 2009 Oct 2009 Apr 2010 Oct 2010 Apr 2011 Framework for integration Legislation: nationally agreed outcomes joint accountability integrated budgets across primary care, community health and social care, and some of

acute care locality planning Next steps Formal consultation Detailed work now underway to consider practicalities: Joint governance and accountability Integrated financial management

Impact on other areas of service Locality planning Improving commissioning skills Requirements for OD and leadership development work Ensuring meaningful engagement of the third and independent sectors Chief Social Work Adviser workstream Impact on other social work functions Transitions Child, adult and public protection Cross cutting services and support Scoping workforce implications for professional leadership and

support Opportunities for improvement to current service delivery Timetable Local elections 3 May Consultation paper launched end of May Bill to parliament in session 2012/13 Implementation 2014 Context we are operating in A vacuum of information from now until the consultation document is published after the local government elections in May

Congruence with developments in England: The Future Forum Learning from the integrated care pilots Importance of community planning and the single outcome agreement The current agenda and work in this area: Change Fund; joint initiatives we have already established Issues we are concerned about

We need to maintain pressure to ensure services are delivered and outcomes determined at a local level We need to understand more about what a single accountable officer is and how that role will play out We need to understand more about what a Health and Social Care Partnership is We need others to realise the importance of any impact of change on other services within social work and within the wider community planning framework We need to know about the number of partnerships and how they will be governed We will continue to emphasise the crucial role of the CSWO Influencing the debate Meaningful and comprehensive engagement in the consultation

Engagement with our own members Engagement with partners in local authorities, NHS, third and independent sectors Parliamentary engagement Useful and insightful comment on the conclusion drawn from the consultation Dedicated involvement in the drafting of legislation Professional advice Work to limit unintended consequences The future

If you dont know where you are going, any road will get you there Lewis Carroll

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