Health and Social Care Integration Strategic planning and Regional planning Tony Homer JIT Lead, Strategic Commissioning 1 JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, CoSLA, the Third Sector, the Independent Sector and the Housing Sector

Objectives for this session Establish whether RPNs need to understand and be concerned about H&SC integration arrangements Have a better grasp of the likely range of local integration arrangements across the NoS RPN Have a better understanding of some of the key questions and uncertainties about IJB / Lead Agency arrangements and RPN Consider areas for further clarification by the NoS RPN to address future integration arrangements

Key Legislative Requirements The Public Bodies ( Joint Working) (Scotland) Act 2014 requires that the new integrated health and social care partnerships will oversee the development and delivery of Strategic Plans, (Joint Strategic Commissioning Plans), which will have an outcomes focus embedded, and will incorporate a robust financial plan Establish a Strategic Planning Group for the purpose of preparing a Strategic Plan Establish at least 2 locality areas to drive a ‘bottom up’ planning focus Take into account the plans of neighbouring areas and the possible impact of the Plan on other plans and planning activity Publish an annual financial statement, firstly attached to integration authorities strategic plans

Timescales for implementation

Strategic planning – some important features SP concerns the functions and related services falling within the scope of the Integration Authority Care group and individual service planning is already being undertaken in a number of different ways Localities will have a formal planning role which will be a new or strengthened feature There is a strong presumption towards joined up planning, beyond H&SC The SPG will bring a more transparent, strategic determination of priorities, investments and disinvestments across the whole system

IJBs/Lead Agencies – delegated services Some Health Board functions are not permitted for inclusion with integration. These are functions that relate to the provision of education and research facilities of Health Boards, employment of health board staff, and some specific duties such as the registration of health professionals. Tertiary, surgical and trauma aspects of acute care are not required to be included within integrated arrangements. Where these services are provided within a single Health Board area, they may be integrated if there is local agreement to do so. Services provided on a regional or national basis should not be included in integration Other services may be included in integration schemes and children’s services and criminal justice social work are being included in some areas

IJBs/Lead Agencies – planning and operational responsibilities The IJB / Lead Agency is responsible for the planning of integrated services and achieves this through the Strategic Plan. It directs the Parties to deliver or in the case of the Lead Agency delivers services, in accordance with the Strategic Plan. It is expected that the IJB will be operationally responsible for delivery in addition to the planning responsibilities placed upon it by the Act to ensure planning and delivery are fully integrated. Where related but non integrated provision impacts upon investment decisions there is an expectation that joined up planning and delivery arrangements will be agreed with other relevant bodies Issues concerning quality, risk and performance of provision will need to be considered in the context of the integration national performance framework,

Health and Social Care The wider planning landscape 8 HEALTH Local Delivery Plan Clinical Strategy Bed planning Quality Plan Regional Planning SOCIAL CARE LA strategic plan LA service plans SDS Plan (Child Protection Plan) (Integrated Children’s Plan) HOUSING Housing Contribution Statement LHS SHIP LA CORPORATE Finance & budget plans Capital & asset plan SOA Adult Protection Plan Public Protection Plan Procurement strategy STRATEGIC / FINANCIAL PLAN COMMUNITY PLANNING Community Plan Prevention Strategy JSNA Workforce

Ongoing developments The scale and complexity of the required change is substantial – even some of the basics are unclear in some areas The new impetus is towards planning locally to inform strategic priorities. Top down, centrist approaches will not work. Practical arrangements for locality and care group priorities to inform strategic plans will vary from area to area New duties regarding Self Directed Support including delivering more user choice and control is opening up the issue of how best to create and sustain viable social care services that provide a sufficiently personalised offering The Strategic Planning guidance includes a requirement for partnerships to compile a Market Facilitation Plan and to be more transparent about assumptions This is likely to highlight considerations of scale and viability (particularly in rural areas) when deciding how best to plan/deliver care services where these two factors are problematic

Some questions for regional planning / working? Regional planning incorporates a number of different things – networks, short term projects, funded services. How can it best present itself in order to establish a clear locus in the new integrated landscape? By what process does regional planning determine its priorities / work programme and will this need to change in order adequately to exploit the potential offered by integrated arrangements? Policy drivers are opening up consideration of the user as their own commissioner for social care provision. Does this present opportunities/questions for how regional planning and working needs to operate to deliver more seamless care for patients and users? What do RPNs need to know about how IJBs/Lead Agencies will work in order to be able actively to engage with them and ensure its potential contribution is maximised?

Children’s commissioning – additional context A programme provided for partnerships including learning development, improved information & evidence and adaptive change across partner organisations Focussed upon delivering improved outcomes through a co-productive, cross sector approach Using the impetus associated with the Children’s Act to generate momentum and to respond to the pressures associated with providing personlised solutions at a time of austerity In parallel implementing the Doran Review has led to work on a new model of commissioning national resources to supplement local provision for children with ASN This has raised questions about the linkages between local commissioning decisions and the basis for investing in national resources The prospect of developing regional services and supports to facilitate more local models of care at sufficient scale, for this group, has arisen early on in this work