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

Outline of proposed reforms - what to legislate for?

19. We asked whether the proposed scale of the framework for integration was comprehensive enough.

What we heard

20. There was general consensus that, if the integration agenda is to be community driven, its scope should be widened to include other services beyond health and social care, particularly housing services. In particular, it was felt that early intervention, preventative and anticipatory care could be planned for better and more effectively if a wider range of services were included within the framework for integration.

21. Urban areas in particular were concerned about the future location of homelessness services, especially when this function was part of the Local Authority's social work service. This was usually the case when the Local Authority's housing stock had been transferred to an external body.

The Scottish Government Response

22. We recognise the importance of public, third and independent sector partners working together more effectively, with users and carers, to plan for and provide services that take account of people's broader circumstances.

23. As with whom to legislate for, we do not in general terms want to limit the potential benefits of integration by creating legislation that only applies to certain areas of service planning and provision. At the same time, however, we do not want to undo current arrangements for joint and collaborative working that already function well, and are aware that there is a particular challenge we must address urgently in relation to the interface between health and social care for adults with multiple support needs.

24. We know from examples of well integrated services in Scotland and elsewhere that, where there is good local leadership and commitment to partnership working, strong and effective links are maintained across the wide scope of public service delivery. Integrating adult health and social care in order to address the 'fault line' described in the consultation should not mean that effective working arrangements with other areas of service are diminished or marginalised.

25. It is our intention to legislate to require Health Boards and Local Authorities to integrate health and social care services for all adults, and to leave it to local agreement to decide whether to include other areas of service, such as housing or children's services, within the scope of the integrated arrangement. As we look for the improved outcomes and shift towards community provision previously described, we will expect to see evidence of strong partnership working with other relevant areas of service, and evidence that staff are supported to develop the necessary skills for an effectively integrated health and social care environment.