Coming Home implementation: memorandum of understanding

Memorandum of Understanding between the Scottish Government and COSLA: Coming Home Implementation – Dynamic Support Registers

Purpose

To agree that all Integration Authorities will use the Dynamic Support Register.

The Scottish Government and COSLA jointly set out our ambitions to greatly reduce out-of-area residential placements and inappropriate hospital stays with the publication of the Coming Home Implementation Report in February 2022. Our vision is that the human rights of everybody with complex care needs and learning disabilities are respected and protected and they are empowered to live their lives, the same as everyone else. We want and need to see real change where out-of-area residential placements are only made through individual or family choices and people are only in hospital for as long as they require assessment and treatment.

The Scottish Government and COSLA have agreed to implement the five key recommendations from the Coming Home Implementation Report. Key Recommendation 2 specifically refers to developing a Dynamic Support Register as a tool to be used by local areas.

Dynamic Support Register

As we work to implement the Coming Home Implementation Report recommendations, the Dynamic Support Register (“the Register”) will help professionals working with people with complex care needs and learning disabilities to better respond to situations where there is a need for a more intensive level of care management.

The Register is a tool for local areas to improve local case management by complementing local systems and processes to inform local planning and provision. Data from the Register will simultaneously allow local areas to measure their progress against the policy ambitions of Coming Home, as well as providing useful data nationally which is not currently collected.

The Scottish Government and COSLA, together with input from some Integration Authority representatives and family carers have developed a Dynamic Support Register template and operational guidance to aid with its integration into existing operational structures. This has been trialled by a number of local areas across Scotland, and revised following feedback.

The guidance will support local areas to use the Dynamic Support Register template and planning tools.

The Register will, in respect of relevant individuals:

• Aid monitoring, local planning and decision making for those currently in hospital or in out-of-area placements;
• Identify and address risks of breakdown of current support arrangements and admission/re-admission to hospital or out-of-area placement; and,
• Support the development of person-centred and appropriate local community placements.

Principles

The Scottish Government and COSLA will:

• Develop and distribute a template Dynamic Support Register to all Integration Authorities and Lead Agencies.
• Provide guidance to support the integration and consistent use of the Dynamic Support Register across Scotland.
• Support the roll-out of the Dynamic Support Register with national webinars and information sessions for operational staff and local leads.
• Launch and support a Peer Support Network to aid local areas in implementing a Dynamic Support Register and where appropriate, utilise this professional network to further develop and refine the Register.
• Provide ongoing national policy support as we continue to develop and refine the Dynamic Support Register, National Support Panel and Peer Support Network to ensure these national support mechanisms are helpful and provide value.

Each Integration Authority, in partnership with Local Authorities and NHS Boards, will be expected to:

• By July 2023 implement a Dynamic Support Register as a local record of all adults within their funding responsibility who have with complex care needs and a learning disability whose discharge will require significantly higher levels of input and coordination from a range of skilled professionals within health and social care. The Dynamic Support Register will firstly identify, then record all relevant individuals who are currently in hospital, in an out-of-area placement, or who are at risk of breakdown of current support arrangements.
• Appoint a single named lead within each local area who has operational responsibility for ensuring that the Dynamic Support Register is used and maintained.
• Report monitoring data from their Dynamic Support Registers using national reporting mechanisms.
• Ensure storage and use of the Register is fully compliant with local data protection and data sharing mechanisms.

Implementation of these recommendations will require leadership from across Local Government, the NHS and the broader health and social care sector. Scottish Government, COSLA and Integration Authorities will encourage and facilitate senior leaders in these sectors to work together to help shape and deliver sustainable improvement across the sector.

Responsibilities

The work in connection with the Register is to be carried out:

• Within the current statutory framework in Scotland for delivery of health and social care services, particularly the Public Bodies (Joint Working) (Scotland) Act 2014; the Social Work (Scotland) Act 1968; the National Health Service (Scotland) Act 1978 and the Mental Health (Care and Treatment) (Scotland) Act 2003.
• In compliance with the requirements of the Equality Act 2010 and the Human Rights Act 1998, and consistently with relevant international human rights treaty obligations.
• Within the principles set out in the Joint Statement of Intent and Next Steps for Adult Social Care 2022-23.

Signatories

This MoU was signed on 15^th May 2023

Maree Todd MSP Minister for Social Care, Mental Wellbeing and Sport

Councillor Paul Kelly COSLA Health and Social Care Spokesperson