Integration of Adult Health and Social Care in Scotland Consultation: Scottish Government Response

Foreword

My predecessor as Cabinet Secretary for Health and Wellbeing, Nicola Sturgeon MSP, set out clearly in her foreword to the consultation on integrating adult health and social care her support for this ambitious, necessary and important programme of reform. I wholeheartedly endorse that vision and commitment to improvement, and I want to take this opportunity to affirm my support for the proposals that have now been thoroughly consulted upon.

The shape of Scottish society is changing. The 2011 Census^[1] shows us that, for the first time, our population aged over 65 is greater in number than the population aged under 15. People in Scotland, as in other developed nations, are living longer, healthier lives, and we are benefitting from the great strides that have been made in healthcare and standards of living over recent decades. Such a significant change in our population inevitably brings challenges too, however, which are well recognised and were described in detail in the consultation.

As responses to the consultation make clear, the Scottish Government is not alone in recognising that, as society's needs change, so too must the nature and form of public services. Only by making sure that public services evolve effectively can we ensure that people receive the support they need, and that resources are used to best effect across all population groups, whatever their age or circumstances.

That is why integration of adult health and social care is a key part of the Scottish Government's commitment to public service reform in Scotland, and why what we achieve with this programme of reform matters to everyone in Scotland.

Our population may be getting older, but integration of adult health and social care is about far more than looking after older people better, as important as that is:

• It is about improving outcomes for people who have a range of complex support needs, and for their carers and families as well. Too often in these circumstances people are admitted to hospital, or to a care home, when a package of care and support in the community could deliver better outcomes for them. When that happens, the costs are human and financial, and the consequences are not just personal; they are felt across the whole system and by other people, as resources are tied up inappropriately in care that is not best suited for the individual.
• It is about putting the leadership of clinicians and care professionals at the heart of service delivery for people with health and care support needs.
• Perhaps most ambitiously, it is about establishing a public service landscape in which different public bodies are required to work together, and with their partners in the third and independent sectors, removing unhelpful boundaries and using their combined resources, to achieve maximum benefit for patients, service users, carers and families.

Later this year the Scottish Government will introduce a Bill to the Scottish Parliament to integrate adult health and social care. This response, which has been agreed with my Cabinet colleagues, will give you further insights on my plans for the Bill. We are clear that legislation alone will not be sufficient to achieve our aims in this area, but it will provide the national leadership necessary to create the context within which our ambitions can be achieved.

I am very grateful to everyone who has responded to this consultation, whether via a written reply, or by taking part in the wide-ranging discussions that contributed to the development of the proposals, in the discussions of the proposals that followed publication of the consultation, or in the work that is ongoing to turn the proposals into practical reality.

We have a great deal more to do to make good on our ambitions. I am looking forward to working with you to improve the services we deliver, and the outcomes we achieve, for the benefit of people who use health and social care services and for the improvement of public services generally in Scotland.

ALEX NEIL, MSP
CABINET SECRETARY FOR HEALTH AND WELLBEING