Health & Social Care Integration - NEW

Published by: Fife Council

  

Q.      What is Integration?

Health and social care integration is a Government-led, legislative change taking place across Scotland. All councils and health boards across the country are involved and will all have formed legal Partnerships by 1 April 2016.

People are living longer with more complex care needs.  Our aging population and the increasing demands for services means our current arrangements for older peoples care are not sustainable.

Over the coming years, GPs, hospitals, health workers, social care staff and others will increasingly work side-by-side to share information and take a much more co-ordinated approach to the way services are delivered.  It is up to each area on how they do this.

Key elements of the new system will be:

  • Community Health Partnerships have been replaced by Health and Social Care Partnerships, which include adult social work services, and are now the joint responsibility of the NHS and local authority, working in an integrated approach with the Third and independent sectors.
  • Partnerships are accountable to Ministers, leaders of local authorities, Health Boards and the public for delivering new nationally agreed outcomes.

In Fife the initial focus is on improving adult and older people's care and Children's Community Services.  The aim will be to:

  • improve the lives and continue to meet the needs of those we serve.
  • prevent and delay ill-health and to support people to live independently in good health in their home for as long as possible.
  • reduce how often and how long people stay in hospital
  • NHS Boards and local authorities are required to produce one integrated budget for all adults and older people's services to bring an end to the 'cost-shunting' that currently exists
  • Focus on local solutions will strengthen the role of clinicians and social care professionals in the planning of services.
  •  A smaller proportion of resources - money and staff - will be directed towards institutional care and more resources will be invested in community provision.
  • This will mean creating new or different job opportunities in the community.

The Change Fund for older people's services is already helping to deliver some of these improvements.

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Q.      How will health and social work in Fife integrate?

National consultation lays out clearly the two models available and describes these as follows:

  • Lead agency model - one partner can delegate some of its functions and resources to the other, which then hosts the service and integrated budget on behalf of the Partnership.
  • New Corporate Body - the Health Board and Council could delegate agreed functions, including agreement on the range of services and amount of resource, to the Integrated Health and Social Care Partnership.

In April 2013, members of NHS Fife Board and Fife Council Executive Committee agreed that an integrated (New Corporate Body) approach was the best way to join up health and social care services in Fife.

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Q.      Which services are being integrated?

Services currently identified for integration include:

  • All adult and older people Social Work Services
  • Community Health Partnership services, eg district nurses, health visitors, mental health
  • Some services provided in hospital, eg medical care of the elderly
  • Children's Community Services provided by NHS Fife - Health Visiting Services
  • Elements of housing services which provide housing  support services to vulnerable adults and disability adaptations

Together, this equate to:

  • around 5,000 staff,
  • a budget of approximately £470million, and;.

Fife being one of the largest Health and Social Care Partnerships in Scotland, next to Edinburgh and Glasgow.

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Q.      What has been the timeline of events?

April 2013

NHS Fife Board and Fife Council Executive Committee approve recommendations for an Integrated approach.

June 2013

Scottish Government put forward the Health and Social Care Bill.  Part 1 of the Bill was published on 18 November 2013.  Part 2 was published on 29 January 2014 and Part 3 was published on 25 February 2014.

June 2013 to April 2015

During 2014, further formal regulations and guidance came from the Scottish Government to support the detail of how the integrated approach will operate.  Fife Council and NHS Fife continue to work in an integrated approach to develop new ways of working, build on existing good practice and develop structures, processes and procedures to support an integrated approach and deliver services wrapped around the individual to meet need.

 

From April 2015

The legislation comes into effect. On the 1 April 2015, our Community Health Partnerships (CHPs) ceased to technically exist as a result of the Scottish Government’s new Act. This made way for the emergence of Health and Social Care Partnerships (HSCPs) across Scotland.

 

1 April 2016

Fife’s Health and Social Care Partnership is established.

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Q.      How has Fife prepared for this change?

 

  • During 2013/2014 a joint Shadow Board was established.  This temporary Board oversaw the changes needed before Legislation came into effect.
  • A series of Consultations have involved patients, service users, staff, partners and the public. 

These are as follows:

  • Strategic Plan for Fife (7th October to 6 January 2016)
  • Integration Scheme Consultation (10 December 2014 to 31 January 2015)
  • Localities Consultation (11 August 2014 to 3 November 2014)

Visit Consultations to find out more.

  • Involving service users, patients, carers, families and partners began from the earliest stage. The Public Reference Group was set up as early as 2012 and since this time, our rolling programme of communications has reached out to the hundreds of patient and service user representatives and partner agencies to glean views and to ensure the voices of the most vulnerable are heard in Fife. Visit the Involving You for more information.
  • In October 2015, the Integration Joint Board for Fife’s Health and Social Care Partnership was legally formed.  The first chair of the Integration Joint Board is Cllr Andrew Rodger appointed on the nomination of Fife Council who will hold office for a period of 12 months. NHS Fife has nominated Alison Rooney as the vice-chair who will also hold office for a period of 12 months.

Fife Council will appoint 8 Councillors and NHS Fife will appoint 8 Board members to be members of the Integration Joint Board. Integration Joint Board members will hold office for a maximum period of 3 years. Visit About Us to find out more.

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Q.      What happened to the previous Health and Social Care Partnership in Fife?

Not all regions had a partnership like this, so in many ways, Fife’s joint working has been leading the way.  But, the previous Health and Social Care Partnership was not set up to support this level of integration.  It had a different scope and remit.

On the 1 April 2015, our Community Health Partnerships (CHPs) ceased to technically exist as a result of the Scottish Government’s new Act.

This made way for the emergence of new Health and Social Care Partnerships (HSCPs) across Scotland.  CHPs formed the backbone of service delivery and over the years delivered innovative and effective services to meet local need.   This foundation is critical to Fife’s success moving forward. 

The employment status of staff did not change as a result and staff continue to be employed by their current employer.  

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Q.      What does the new Partnership and integrated working mean for prioritising how money is spent nationally and locally?

For integration:

  • Central Government spending will reflect the shift from institutional to community-based care, with resources (cash and staff) being directed towards more local facilities.

NHS Boards and Councils are required to produce one, integrated budget.

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Q.      What are the benefits for service users and patients?

Our integrated approach will help to improve services for local communities and meet the aspirations of individuals.  By working together, a combined package of care and support will help keep vulnerable people healthier and independent for longer. Developments undertaken now will set a foundation for further joint services in the future.

By working together, our aim is to:

  • improve the lives and continue to meet the needs of those we serve.
  • prevent and delay ill-health and to support people to live independently in good health in their home for as long as possible.

reduce how often and how long people stay in hospital.

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Q.      How are user of services getting involved?

Involving the public from the start has been vital.  As part of the joint preparation work, a Public Reference Group was formed in 2012.  The group includes a wide range of Fife residents and individuals as well as representatives from existing community organisations such as the Fife Elderly Forum, Alzheimer's Scotland, Age Scotland and the People's Panel.  Current Chairman of the group is Tina Chapman, member of the public and member of the People's Panel and  Vice Chair is Ian Dall, carer and also a member of the People's Panel.

In addition, we involve the public and staff together as we undertake consultations on areas such as defining the localities and communities across which services will be delivered,the re-shaping and transforming of services themselves as well as the development of an improved participate and engage approach with the public, users of services and their families. 

Over the last year we have reached over 4,000 people through the 40 stakeholder channels across the third and voluntary sector and held a series of joint face to face events with which is generating thousands of ideas.  By listening and sharing experiences, the people of Fife are actively informing and shaping the future of services for Fife.

 

In addition, a new Participation and Engagement Network has been formed. 

The Network brings together service user, patient and carer representatives as well as members from the third and independent sector.  Working locally and at a Fife wide level, the Network has a wealth of experience, knowledge and skills. They will be the eyes and ears of the community, ensuring we adhere to the principles and values set out in Fife’s Strategic Plan, our blueprint for change. 

"The Participation and Engagement Network allows the people of Fife to make known their views on the impact of Health and Social Care integration on the services available to them both locally and Fife-wide."  John Stirling, Chairperson, Disabilities Fife

 “The new Partnership and Engagement Strategy has been developed by people who have “hands on” experience alongside the professionals who operate the systems. This will now give us the vehicle which will connect the Health and Social Services with the public who use the services on a daily basis through sickness and disability.”  Carer representative, Peter Hibberd

A copy of the Participation and Engagement Strategy can be found in the Publications section.

 
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Q.      Will there be any change to staff pensions?

All aspects relating to their current pension will remain the same under their current employer ie NHS Fife staff or Fife Council.  There will be no change to pension status.

If in future changes are proposed to existing arrangements, this will be done on a planned and coordinated basis with the full engagement of those involved, in accordance with established policies and procedures.

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Q.      Will there be a change to who staff report to?

Staff will continue to report to their current line manager.

If in future changes are proposed to existing reporting arrangements, this will be done on a planned and coordinated basis with the full engagement of those involved, in accordance with established policies and procedures.

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Q.      How are Trade Unions involved?

NHS Fife and Fife Council are committed to the continued development and maintenance of positive and constructive relationships with Trades Unions and professional organisations involved in Health and Social Care Integration.

Trades Union and professional organisations representative are and will continue to be very much involved in the process of integration.  For example, Senior Staff-side representatives from NHS Fife and Fife Council are members of the Integration Joint Board (IJB) and Workforce Work stream Group (who advise the IJB on workforce issues) and the Strategic Planning Group.

 

A new joint union and staff side partnership forum has been established as part of the new Fife Health and Social Care Partnership.  Representatives from NHS Fife and Fife Council’s Trade Unions and Staff Representatives groups along with senior management have signed a new joint agreement which will see the creation of a forum to forge closer partnership working.  Known as the Local Partnership Forum (LPF), the new group will focus on the key issues facing the workforce in delivering health and social care services.

The LPF does not replace or supersede the role and functions of existing established consultative and integrated approach arrangements within Fife Council and NHS Fife.

 

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Q.      How are the voluntary and independent sector involved?

The voluntary and independent sector play a vital role in the successful integration of servIces and developing new ways of working under the new Partnership .  A proactive approach has been taken in Fife.  All partners have been engaged on Health and Social Care Integration and how NHS Fife and Fife Council are jointly preparing. 

Care Providers from across the voluntary and independent sector as well as members of the public and representative groups have been attending events held by NHS Fife and Fife Council. 

The events generate a lot of lively debate, discussion and raise some challenging questions about how we can all work together to provide care.  Feedback includes:

 "…my views were appreciated and taken on board.”

“At the table everyone listened as well as talked.”

 “Facilitator actively encouraged input from everyone.”

 “Information excellent – going away with food for thought!”

 “ Openess from all concerned”

“The event exceeded expectations”

 “…it’s important we get it right in Fife.”

 

Under the new Partnership, the Independent and third sector service partners will continue to be fully involved the engagement programmes, which will include targeted and tailored events.

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