One year on from integration of health & social care in Scotland

April 1st was the first anniversary of probably the most significant reform of Scotland’s health and social care services since the introduction of the NHS.

It’s now twelve months since the Scottish Government began the process of integrating all Scotland’s health and social care services into 31 local partnerships, giving NHS managers and local councillors joint responsibility for the first time for managing an £8.2 billion budget.

To meet the care needs of Scotland’s ageing population and the increasing numbers of people with complex long-term conditions, a new sustainable system is needed that creates a seamless link between the care provided in hospitals, in homes, in the community, in care homes and in respite centres like Leuchie House.

Leuchie has long been seen as a model of integrated health and social care, linking all aspects of our guests’ and their carers’ needs – physical, emotional, psychological and social – with a focus on preventing ill health through closer working with community health professionals. 

The vision for Scotland’s new integrated system is based on these same person-centred principles, with the emphasis on care where and when people need it.

Achieving effective integration requires a monumental process and culture shift for most partnership areas. Difficult and often controversial decisions need to be made about shifting funding from hospitals to the community.

One year on, Paul Gray, NHS Scotland’s Chief Executive, agrees that “as far as integration is concerned, the future is here, but it’s unevenly distributed.”

The Ayrshire and Arran partnership is often held up as an example of integrated working that other partnerships should replicate. As a Change Management Consultant in my life before Leuchie, I agree their approach has been exemplary. Building on strong existing community health partnerships, two years before the start date they brought in change managers to lead the integration process and back-filled posts so that key staff could be part of the change team.

It’s clear then that while some good practice is coming through both locally and nationally, there is still a long journey ahead to achieve integration across Scotland.

It goes without saying, Leuchie House is ready to play its part.

Mairi O'Keefe, CEO, Leuchie House. Published in The East Lothian Courier, 13 April 2017.