Health and Social Care Integration Strategic planning and Regional planning

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Health and Social Care Integration Strategic
planning and Regional planning

• Tony Homer
• JIT Lead, Strategic Commissioning

JIT is a strategic improvement partnership
between the Scottish Government, NHS Scotland,
CoSLA, the Third Sector, the Independent Sector
and the Housing Sector
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Objectives for this session

• Establish whether RPNs need to understand and be
  concerned about HSC integration arrangements
• Have a better grasp of the likely range of local
  integration arrangements across the NoS RPN
• Have a better understanding of some of the key
  questions and uncertainties about IJB / Lead
  Agency arrangements and RPN
• Consider areas for further clarification by the
  NoS RPN to address future integration
  arrangements

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Key Legislative Requirements

• The Public Bodies ( Joint Working) (Scotland) Act
  2014 requires that the new integrated health and
  social care partnerships will oversee the
  development and delivery of Strategic Plans,
  (Joint Strategic Commissioning Plans), which will
  have an outcomes focus embedded, and will
  incorporate a robust financial plan
• Establish a Strategic Planning Group for the
  purpose of preparing a Strategic
• Plan
• Establish at least 2 locality areas to drive a
  bottom up planning focus
• Take into account the plans of neighbouring areas
  and the possible impact of
• the Plan on other plans and planning
  activity
• Publish an annual financial statement, firstly
  attached to integration authorities strategic
  plans

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Timescales for implementation
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Strategic planning some important features

• SP concerns the functions and related services
  falling within the scope of the Integration
  Authority
• Care group and individual service planning is
  already being undertaken in a number of different
  ways
• Localities will have a formal planning role which
  will be a new or strengthened feature
• There is a strong presumption towards joined up
  planning, beyond HSC
• The SPG will bring a more transparent, strategic
  determination of priorities, investments and
  disinvestments across the whole system

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IJBs/Lead Agencies delegated services

• Some Health Board functions are not permitted for
  inclusion with integration. These are functions
  that relate to the provision of education and
  research facilities of Health Boards, employment
  of health board staff, and some specific duties
  such as the registration of health professionals.
  
• Tertiary, surgical and trauma aspects of acute
  care are not required to be included within
  integrated arrangements. Where these services are
  provided within a single Health Board area, they
  may be integrated if there is local agreement to
  do so.
• Services provided on a regional or national basis
  should not be included in integration
• Other services may be included in integration
  schemes and childrens services and criminal
  justice social work are being included in some
  areas

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IJBs/Lead Agencies planning and operational
responsibilities

• The IJB / Lead Agency is responsible for the
  planning of integrated services and achieves this
  through the Strategic Plan. It directs the
  Parties to deliver or in the case of the Lead
  Agency delivers services, in accordance with the
  Strategic Plan.
• It is expected that the IJB will be operationally
  responsible for delivery in addition to the
  planning responsibilities placed upon it by the
  Act to ensure planning and delivery are fully
  integrated.
• Where related but non integrated provision
  impacts upon investment decisions there is an
  expectation that joined up planning and delivery
  arrangements will be agreed with other relevant
  bodies
• Issues concerning quality, risk and performance
  of provision will need to be considered in the
  context of the integration national performance
  framework,

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Health and Social Care The wider planning
landscape
SOCIAL CARE LA strategic plan LA service
plans SDS Plan (Child Protection
Plan) (Integrated Childrens Plan) HOUSING Housing
Contribution Statement LHS SHIP LA
CORPORATE Finance budget plans Capital asset
plan SOA Adult Protection Plan Public Protection
Plan Procurement strategy
COMMUNITY PLANNING Community Plan Prevention
Strategy
HEALTH Local Delivery Plan Clinical Strategy Bed
planning Quality Plan Regional Planning
STRATEGIC / FINANCIAL PLAN
JSNA
Workforce
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Ongoing developments

• The scale and complexity of the required change
  is substantial even some of the basics are
  unclear in some areas
• The new impetus is towards planning locally to
  inform strategic priorities. Top down, centrist
  approaches will not work.
• Practical arrangements for locality and care
  group priorities to inform strategic plans will
  vary from area to area
• New duties regarding Self Directed Support
  including delivering more user choice and control
  is opening up the issue of how best to create and
  sustain viable social care services that provide
  a sufficiently personalised offering
• The Strategic Planning guidance includes a
  requirement for partnerships to compile a Market
  Facilitation Plan and to be more transparent
  about assumptions
• This is likely to highlight considerations of
  scale and viability (particularly in rural areas)
  when deciding how best to plan/deliver care
  services where these two factors are problematic

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Some questions for regional planning / working?

• Regional planning incorporates a number of
  different things networks, short term projects,
  funded services. How can it best present itself
  in order to establish a clear locus in the new
  integrated landscape?
• By what process does regional planning determine
  its priorities / work programme and will this
  need to change in order adequately to exploit the
  potential offered by integrated arrangements?
• Policy drivers are opening up consideration of
  the user as their own commissioner for social
  care provision. Does this present
  opportunities/questions for how regional planning
  and working needs to operate to deliver more
  seamless care for patients and users?
• What do RPNs need to know about how IJBs/Lead
  Agencies will work in order to be able actively
  to engage with them and ensure its potential
  contribution is maximised?

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Childrens commissioning additional context

• A programme provided for partnerships including
  learning development, improved information
  evidence and adaptive change across partner
  organisations
• Focussed upon delivering improved outcomes
  through a co-productive, cross sector approach
• Using the impetus associated with the Childrens
  Act to generate momentum and to respond to the
  pressures associated with providing personlised
  solutions at a time of austerity
• In parallel implementing the Doran Review has led
  to work on a new model of commissioning national
  resources to supplement local provision for
  children with ASN
• This has raised questions about the linkages
  between local commissioning decisions and the
  basis for investing in national resources
• The prospect of developing regional services and
  supports to facilitate more local models of care
  at sufficient scale, for this group, has arisen
  early on in this work