Health and Social Care Integration : Managing the Change

Black, George (2015) Health and Social Care Integration : Managing the Change. [Report]

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    Abstract

    April 2016, arguably the biggest structural change the public sector in Scotland has seen in recent years will come fully into effect. From that date, in most parts of the country, new Integrated Joint Boards will become responsible for a wide range of health and social care services presently provided by Councils and Health Boards. These Integrated Joint Boards will be independent legal entities with full autonomy and capacity to act on their own behalf. The Public Bodies (Joint Working) (Scotland) Act 2014 sets out the legislative framework for integrating health and social care. It sets down the functions which must be delegated by Councils and Health Boards to Integrated Joint Boards, primarily services related to adults and older people. However, Councils and Health Boards may also choose to include other services, for example services covering the health and social care of children, where there is local agreement to do so. As a result, the public sector landscape of the future is likely to be less uniform than it is at present. Although other structural reforms such as the merger of Colleges, or the creation of a single police service and single fire and rescue service, have already taken place, these changes were very much sector specific. The integration of health and social care services stretches across both the local government and health sectors but only covers some of their functions. As a result, the change is much bigger in both scale and complexity. The purpose of this paper is not to examine the operational challenges associated with all structural reforms, such as making appointments, arranging accommodation, organising support services and planning for the integration of ICT systems, albeit they themselves represent a considerable challenge. Instead, this paper seeks to identify the key challenges associated with the integration of health and social care which, to a large extent, will determine the success or otherwise of the reforms.