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

Professionally led locality planning and commissioning of services

103. We asked you for your views on how best to establish effective locality planning arrangements in communities.

What we heard

104. Respondents were in general very positive about the principle of establishing locality planning arrangements for the commissioning of services designed to meet the needs of local communities.

105. Most respondents felt that the best way to make locality planning work would be to allow local development and implementation of arrangements with local leaders and stakeholders.

106. There was agreement with our proposal to include within legislation a duty on Health and Social Care Partnerships to work with stakeholders to develop locality planning arrangements, but we have heard a consistent message that this duty should be stronger than suggested. The duty on Health and Social Care Partnerships should be to 'engage with and involve', rather than merely to 'consult' local professionals, across extended multi-disciplinary health and social care teams and the third and independent sectors, regarding how best to put in place local arrangements for planning service provision.

107. Respondents expressed the view that, in order to encourage active participation of clinicians and social care professionals in planning service provision, they would need to have a clear understanding of the requirements of their localities. Some respondents also added that Health and Social Care Partnerships should be strengthened by setting up joint professional and stakeholder advisory input to contribute to the development of joint strategic commissioning plans. It was suggested that structured support for stakeholder involvement would be required.

108. Opinions were split regarding locality planning being organised around clusters of GP practices. Whilst many supported this approach in principle, many respondents supported locality planning being developed at the level of 'natural communities'. There was also a consistent view that the size of localities should be determined locally. There was a mixed view of the level of devolved responsibility for decision-making to localities. The strongest proponents of devolved decision-making came from professional membership organisations, Local Authorities and public representative bodies.

The Scottish Government Response

109. We believe that the success of locality planning arrangements will be absolutely central to the success of these proposals in the round. The criticality of this part of the proposals also presents a challenge. We believe that locality planning, by definition, can only work effectively if its arrangements are agreed and implemented locally. At the same time, it is important to us to make sure that we achieve some degree of consistency in terms of improved outcomes via locality planning.

110. We also believe that locality planning offers a particularly significant and important opportunity for the effective involvement and leadership of non-statutory partners in the delivery of services in the third and independent sectors, and for representatives of patients, people who use services, and carers.

111. These are high expectations for an aspect of the proposals over which we believe the role for centrally directed arrangements should be kept to a minimum, and they bring particular challenges for the creation of effective legislation.

112. It is therefore our intention, as respondents have suggested, to legislate for a duty on Health and Social Care Partnerships to 'engage with and involve', rather than merely to 'consult' local professionals, across extended multi-disciplinary health and social care teams, the third and independent sectors, and for representatives of patients, people who use services, and carers regarding how best to put in place local arrangements for planning service provision.

113. Beyond that requirement, we do not intend to legislate for the specific form or nature of locality planning arrangements, preferring to leave that to guidance and local determination.

114. However, we think there is an important role for central government in helping different Partnerships learn from one another about different approaches to locality planning and we will look for ways to support that flow and exchange of knowledge and experience.

115. We also believe that it is important to ensure that other arrangements are in place between central government and professionals - for example, development and implementation of the more Scottish GP contract. This and other initiatives support and encourage our aspirations for locality planning, and we will continue to work on these in partnership with stakeholders.