1 Integration: the law, the regulations and the integration scheme Jamie Megaw 5 December 2014

2 Important terms Integration Scheme – describes how NHS Lothian and CEC will respond to the Act and Regulations Integration Joint Board – the new organisation legally responsible for strategic planning and setting direction for specific functions Strategic Plan – the document and process that sets direction for NHS Lothian and CEC

3 Policy developments on Integration Joint Futures Group (1999) Community Care and Health (Scotland) Act 2002 Community Health Partnerships (2004) Integrated Resource Framework (2008) Christie Commission (2011) Public Bodies (Joint Working) (Scotland) Bill (2014) ▪More than a structural change ▪One health and social care budget ▪Massive shift in power and influence ▪Focus on localities ▪Focus on system of care that an individual requires

4 Steps to integration

5 Integration Scheme Process Regulations laid in parliament Oct/Nov ▪What must, may or must not be delegated ▪What must be described in the Integration Scheme Parliamentary process ends Dec Prepare Edinburgh Integration SchemeOct - Dec NHS Lothian approve draft Integration SchemeJan 14th CEC approve draft Integration SchemeJan 16th Consultation (5/6 weeks) NHS Lothian and CEC approve final SchemeMar Send to Scottish GovernmentMar 31 st Scottish Government approve June Integration Joint Board established once the Strategic Plan is written. In shadow form before then.

6 What the integration scheme must cover: Aims and Outcomes Choice of Integration Model IJB governance arrangements NHS and Social Care functions delegated to the IJB Support to prepare the Strategic Plan How performance will be provided Clinical and Care Governance Operational Role of the Chief Officer Workforce Development Financial Management and Processes Participation and Engagement Information Sharing and data handling Complaints Claims Risk Management Dispute Resolution

7 Social Care functions that will be delegated Residential Care –Older People Extra Care Housing and Sheltered Housing (Housing Support provided) Intermediate Care Supported Housing-Learning Disability Rehabilitation-Mental Health Day Services and Local Area Coordination-LD; Older People; Mental Health Care at home services and Reablement –All client groups Rapid Response Telecare Respite services-all client groups Quality assurance and Contracts Assessment and Care Management-incl. OT services Specialist Services-Sensory Impairment, Drugs and Alcohol

8 NHS functions that will be delegated Hospital services (includes associated services – e.g. AHPs) A&E general medicine geriatric medicine rehabilitation medicine respiratory medicine psychiatry of learning disability palliative care hospital services provided by GPs mental health services provided in a hospital with exception of forensic mental health services Services relating to an addiction or dependence on any substance. Community Health Services District Nursing Services relating to an addiction or dependence on any substance. Services provided by AHPs Public dental service Primary medical services (GP)* General dental services* Ophthalmic services* Pharmaceutical services* Out-of-Hours primary medical services Community geriatric medicine Palliative care Mental health services Continence services Kidney dialysis Services to promote public health

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