The active and independent living programme 2016-2020

AILP Ambitions

The six AILP ambitions and the focus on the AHP contribution to prevention and early intervention have been influenced by the engagement process, evidence and current best practice, and policy imperatives.

It is expected that the governance of this programme will be supported through the Ministerial Strategic Group for Health and Community Care and that AILP-related activity will be co-ordinated nationally through the Chief Health Professions Officer's team. Locally, AHP directors and associate directors will work with their executive leads, partners and key strategic leaders across health and social care, third sector and other agencies to develop local implementation plans, reflecting the work in local delivery and integrated joint board plans where appropriate.

Health and wellbeing

AHPs need to prioritise health promotion, prevention and early intervention strategies across all services, underpinned by personal-outcomes approaches and inclusive information.

Stakeholders in the engagement process said they wanted information and resources that allow them to manage their own health without always having to access health and social care services.

AHPs often intervene too late in people's trajectories, resulting in missed opportunities to empower and enable them to make better choices for health and wellbeing. AHPs must be equipped to work within a personal-outcomes framework to support people at a much earlier stage. AHPs need also to engage with people who find it difficult to access self-help information and ensure appropriate services and resources are available to them.

So action will be taken nationally to:

• further develop and scope the AHP contribution to public health
• work with higher education institutions to incorporate personal-outcomes approaches in undergraduate training
• evaluate personal-outcomes and health-promoting approaches
• work with partners across health, social care and the third sector to develop supported self-management information and tools in a range of formats
• use technology to support early intervention, advice and education.

Local systems will be supported and encouraged to:

• encourage awareness of resources available in communities in which AHPs work
• use AHPs' specialist skills and knowledge in promoting health and wellbeing more widely.

Access

People need easily accessible routes to AHP services and information when required.

People want quick access to appropriate AHP services to prevent something minor becoming major. They want to be able to access AHP services outside office hours and be aware of, and know how to access, service and resource options in their area rather than defaulting to other services, such as emergency departments, or out-of-hours or GP services. People still tend to expect a referral from a GP to see an AHP, when in fact many AHPs can accept direct referrals: onward referrals from the AHP to fellow professionals without being routed via a GP or hospital consultant needs to become the norm.

AHPs now need to develop a range of clear access routes and models to successfully address people's needs through earlier interventions and self-management. Most access models deliver in traditional ways, with face-to-face contact being considered the default approach. AHP services have already begun to work on solutions to this by, for instance, exploring technological options (such as web-based access and telephone triage) to improve access to their services and using a request-for-assistance model, which represents the principal of single point of access for the public.

So action will be taken nationally to:

• share the request-for-assistance model across AHP services
• develop information to enable the public to adopt a more proactive role in their health and wellbeing
• analyse patterns of demand and health inequalities nationally
• build on work around information-sharing and IT systems, and maximise telehealthcare
• develop AHP skills to make a culture-shift towards early intervention and prevention
• support a national approach to triage, request-for-assistance models and caseload management across health and social care.

Local systems will be supported and encouraged to:

• introduce clear points of access for local populations to receive appropriate AHP services
• introduce the request-for-assistance model to appropriate services
• review hours of business in identified clinics
• review and streamline processes for intra-professional, inter-professional and cross-agency referrals.

Awareness

The public and other stakeholders need to be aware of AHP services in their local communities.

The public and fellow professionals are not always aware of who AHPs are, what roles they play and the contribution they can make to health and wellbeing. AHPs must make information on their services publicly available in a range of formats.

So action will be taken nationally to:

• promote a consistent AHP public message through linking closely with partners.

Local systems will be supported and encouraged to:

• support AHPs to understand the community in which they work and resources and facilities available to service users
• help AHPs develop the necessary influencing and advocacy skills to promote AHP contributions
• increase awareness of who AHPs are, what services they can provide and how they can be accessed across communities, professions and sectors: this will include connecting with GP services to support distribution of information and how to access AHP services
• ensure AHPs are embedded in local plans.

Partnership-working

AHPs need to think about different ways of working with people who use AHP services.

People have told us they want better communication across sectors. All partners - AHPs, social workers, local authority workers, the wider multi-disciplinary team and volunteers - need to understand what each other does.

AHP practice should be based on partnerships across services and sectors, but AHPs have not always worked effectively with communities and third-sector organisations. They have a long history of supporting people to reach their goals, but how they do this could be clearer.

AHPs working with a broader range of partners will help people access support earlier, and help AHPs target their interventions to those who most need them.

So action will be taken nationally to:

• support AHPs to contribute to strategy and policy development
• extend the range of partnerships across agencies.

Local systems will be supported and encouraged to:

• support AHPs to develop better understanding of each other's roles
• work with partners on improvement projects and programmes
• develop partnerships with community organisations on preventative strategies to address health inequalities
• adopt personal-outcomes approaches to boost partnership-working with service users
• put multi-agency pathways in place.

Research and innovation

AHPs need to deliver excellence through improvement, innovation and research.

AHPs want to be supported to be involved in, and contribute to, new and innovative ways of working though research and better use of technology. Strengthening links with academic partners for undergraduate and postgraduate education will help to better equip the future workforce.

Developing a workforce that is curious and committed to investigating and researching new evidence bases is essential to ensuring AHP practice remains focused on meeting present and future population needs. AHPs need to explore technological opportunities and innovations to transform service delivery.

So action will be taken nationally to:

• work with analytical service colleagues in The Scottish Government to perform national economic analyses and investigations of the health-economic basis of AHP interventions
• develop strong links with academic partners
• strengthen links between improvement science and research
• support and evaluate innovative interventions on meeting personal outcomes.

Local systems will be supported and encouraged to:

• create capacity and infrastructure for staff to access research evidence and develop improvement skills
• employ the practice education workforce across health and social care to support learning and development
• scope opportunities to support clinical-academic careers.

Workforce

AHPs will comprise a competent, skilled and knowledgeable workforce that is flexible and responsive to the needs of the population.

AHPs want a commitment to staff and team development, training and education to prepare the workforce for change. They want to develop extended professional roles to support sustainable multi-disciplinary team-working, explore ways of enhancing skill mix and making better use of support worker roles, and define shared roles and competencies across professions and organisations.

With rising demand on health and social care services, the development of a nationally agreed, evidence-based AHP workforce planning tool should be explored, as set out in the National Workforce Plan. This will make a major contribution to supporting senior managers across health and social care in planning an effective workforce.

So action will be taken nationally to:

• explore an AHP workforce planning tool and workforce prediction tools for skill-mixed AHP services
• develop operational-measures tools to capture current and future ways of working
• explore national frameworks and infrastructure to address professional governance issues
• progress definitions and skill sets to support advanced practice/senior practitioner roles and develop nationally agreed generic competencies to support future pathways through the Transforming Roles programme.

Local systems will be supported and encouraged to:

• develop advanced practice and support worker roles that use nationally agreed definitions, based on service needs and configuration
• scope opportunities for role development across partner organisations
• work with local health and social care partnerships to ensure AHPs are working effectively across health and social care.