Health and Social Care Integration
The way in which health and social care services are planned and delivered across Scotland was changed by the Public Bodies (Joint Working) (Scotland) Act 2014 . Local authorities and health boards are required by law to work together to plan and deliver adult community health and social care services, including services for older people.
The aim of this reform is to meet the challenges of Scotland’s ageing population by shifting resources to community-based and preventative care at home, or in a homely setting.
To achieve this, the Public Bodies (Joint Working) (Scotland) Act 2014 requires councils and NHS Boards to work together to form new partnerships, known as integration authorities (IAs). The aim is to ensure services are well integrated and that people receive the care they need at the right time, and in the right place.
IAs across Scotland are very different in terms of their size, resources and local context. But all IAs are responsible for the governance, planning and resourcing of social care, primary and community healthcare and unscheduled hospital care for adults. Some areas have also integrated additional services including children’s services, social work, criminal justice services and all acute hospital services. Integration authorities manage the budget for providing all integrated services.
Audit Scotland published a helpful guide ‘What is Integration? A short guide to the integration of health and social care services in Scotland’ in April 2018. This guide summarises some key information on the background of health and social care integration in Scotland, and outlines how IAs are structured and function.
Fife Health and Social Care Partnership
Across Scotland partnerships between Health Board and Local Authorities have been set up to meet this aim and to provide services that support people to live safely at home, with a good quality of life.
In Fife, a vast range of functions previously delivered separately by NHS Fife and Fife Council’s Social Work Services were delegated to Fife’s Health and Social Care Partnership. Integrated services the Partnership is now responsible for include:
- All adult and older people Social Work Services;
- Community Health Services, e.g. District Nursing, Physiotherapy and Mental Health Services;
- Children’s Community Health Services, e.g. Health Visiting;
- Housing Services, which provide support services to vulnerable adults and disability adaptations; and
- the planning of some services provided in hospital, e.g. Medical Care of the Elderly.
The Fife Health and Social Care Partnership works with around 300 organisations across the voluntary and independent sectors and they are a vital part of the Partnership in delivering services. Fife is one of the largest Health and Social Care Partnerships in Scotland, next to Edinburgh and Glasgow, with around 5,000 staff from and a joint budget of around £470 million.
The Health and Social Care Integration Scheme is a legal document setting out how NHS Fife and Fife Council have established integrated partnership arrangements in line with the Public Bodies (Joint Working) Scotland Act 2014. Integration Schemes have been submitted to the Scottish Government by all NHS Boards and Local Authorities.
Fife Health and Social Care Partnership – Strategic Plan
The present iteration of the Fife Health and Social Care Strategic Plan sets out a vision for the transformation of health and social care from 2019-2022. This includes widening the skills of teams, changing the way we commission services, strengthening partnerships and leveraging new technology. This document is the blueprint for change.
Fife Health and Social Care Partnership - Integration Joint Board (IJB)
The Fife Integrated Health and Social Care Partnership has been established as a Body Corporate. This means that it is a separate legal entity from either Fife Council or NHS Fife.
Responsibility for the governance of the Health and Social Care Partnership rests with an Integration Joint Board (IJB), which is responsible for the planning and delivery of Integrated Services. The arrangements for appointing membership of the IJB are such that Fife Council appoints eight voting members from Elected Members of the Council and NHS Fife appoints eight voting members from the Health Board. The Board members appointed by the Partners hold office for a maximum period of three years. The responsibility for nominating the Chair and Vice-Chair alternates between the Parties and appointments to these roles are also made for a period of three years. At present, the Chair role is held by Fife Council and the Vice-Chair by NHS Fife. In addition to the voting members described above, the IJB also comprises of a number of non-voting individuals. These range from professional advisers, representatives from carers and the independent sector to members of the public.
The IJB meets bimonthly in public. On the alternate month the IJB holds a Development Session, which explores specific topics requested by the Board Members. The IJB is supported by three standing governance Committees:
- Audit and Risk Committee
- Clinical and Care Governance Committee
- Finance and Performance Committee
The Senior Leadership Team of the Health and Social Care Partnership is managed by the Director of Health and Social Care, who is jointly responsible to the Chief Executives of Fife Council and NHS Fife for the services delivered by the Partnership. Services are split into three Divisions (East, West and Fife-Wide Divisions), each managed by a Divisional General Managers. The Senior Leadership Team also comprises a Chief Finance Officer, Head of Strategic Planning, Performance and Commissioning, Associate Director of Nursing (Fife wide), Associate Medical Director, Director of Pharmacy, Head of Corporate Services and Communications lead.
Further details on the work of Fife Health and Social Care Partnership can be found at: online