Integration of Health & Social Care Services Consultation

In April 2014 the Public Bodies (Scotland) Bill was enacted. Essentially building on Community Health Partnerships, the Act legislates for local authorities and health boards to combine some of their health and social care functions. The intentions, in short, are to create efficiencies, synchronise operational and strategic arrangements and produce better outcomes for people using services.

The Act takes the form of enabling legislation and offers four models of integration:

1. Delegation of functions by the local authority and health board to a body corporate
2. Delegation of functions by the local authority to the health board
3. Delegation of functions by the health board to the local authority
4. Delegation of functions by the local authority to the health board and delegation of health board functions to the local authority   

In Edinburgh the preferred option is to form a ‘body corporate’, in the shape of an Integrated Joint Board. A board of governance will be formed of equal numbers of local authority elected members and non-executive health board members, along with representatives of clinical and allied professions, GPs, Third Sector, carers and service users. None of the last three groups will have voting rights. In Edinburgh the TSI will occupy the place reserved for the Third Sector.

A consultation has been launched on local proposals and papers are available on the CEC website:

The consultation ends on February 20^th.

As many aspects are prescribed in the Act officers from the local authority and health have agreed to attend the EVOC thinkSpace on February 18th to give a presentation on the Scheme of Integration to explain the scope of the consultation, highlight those aspects open to choice and the rationale behind those recommendations.

Of particular interest to the voluntary sector will be

• The delegation of functions, in which health and social services overseen by the Partnership are listed. For example some have a view that the inclusion of housing would be preferable; and the inclusion of accident and emergency comes as a result of considerable debate. A question in this respect: Will the Partnership have the powers to arrive at decisions without recourse to the discrete processes of the respective public bodies? (see section 10.1.9 among others)
• Local arrangements to support preparation of the strategic plan – locally a Strategic Planning Group is proposed with voluntary sector representation, and there is room for negotiation on suitable arrangements.
• Local operational delivery arrangements – the Scheme describes these arrangements with particular reference to performance management and the importance of the role of Chief Officer. Additionally voluntary agencies may wish to seek information on community planning arrangements.
• What are the implications of set aside budgets – could this mean protected/set aside services and functions fare differently from functions not set aside; and by what criteria are decisions regarding set aside budgets arrived at?
• Participation and Engagement – A general outline of commitments to participation with a range of stakeholders, including the voluntary sector, service users and carers, is described. Further work will be developed on this theme and there is a clear opportunity for influence in this respect.
• Data sharing – many agencies have experience of data sharing protocols and requirements, providing a valuable intelligence resource across the voluntary sector. Does this section (Section 12) provide assurance on a particularly complex matter?

The foregoing is very much an edited version of the full consultation document.  There are of course other questions, and coming at a time when survival and sustainability are paramount concerns for voluntary agencies the very short consultation period may have a limiting effect on agency capacity to respond.  EVOC wishes to ensure as many voluntary sector voices as possible are heard and welcomes comments and views to inform a broad based response. 

EVOC is holding a thinkSpace event on Friday February 20^th  8.30-10.30 at 14 Ashley Place, EH6 5PX. 

Please note places are limited and will be allocated on a first come first served basis.  To make a reservation email [email protected].