Refreshing the Health and Social Care Alliance Scotland and Scottish Government Partnership Agreement: External Review - Research Findings

Refreshing the Health and Social Care Alliance Scotland and Scottish Government Partnership Agreement: External Review

The ALLIANCE is a national third sector health and social care intermediary funded by the Scottish Government. This independent review of the ALLIANCE aimed to inform the future development of the ALLIANCE's relationship with the Scottish Government. The review mainly gathered and analysed stakeholder views on the impact of the ALLIANCE, its future role, and the strengths and weaknesses of the current working and funding model with the Scottish Government.

Main Findings

• Based on member views, the ALLIANCE is effectively engaging with its members, and has brought about significant impacts for them.
• Representatives from all stakeholder groups spoke of the significant impact the ALLIANCE has had on national policy and legislation - particularly in relation to self management, person centred approaches, and third sector involvement in health and social care.
• The Self Management IMPACT fund - which the ALLIANCE administers on behalf of the Scottish Government - has successfully supported organisations to develop new and existing programmes which focus on self management, and demonstrate the value of these.
• The ALLIANCE's current intermediary role is highly valued - particularly in relation to self management and long-term conditions, and the role of the third sector in health and social care.
• There is support for the ALLIANCE to broadly continue in its current role and deliver similar types of activities - although there are opportunities to clarify its unique role and strategic focus, and the relationship of specific projects and programmes to its strategic priorities.
• There is an ongoing need for intermediaries involved in health and social care to work together. There are opportunities for the Scottish Government to support this at a national level.
• Those with a funding relationship with the ALLIANCE were positive about working with the organisation, and found it flexible, responsive and supportive.
• Sponsorship representatives and the ALLIANCE are supportive of moving towards a more strategic, outcomes focused partnership agreement, and a more streamlined approach to funding.
• Any new partnership agreement should be outcomes focused, support the relationship between the Scottish Government and the ALLIANCE, and provide a useful framework for planning and understanding the impact of funding provided.

Methodology

The review mainly gathered and analysed stakeholder views about the impact of the ALLIANCE, its future role, and the strengths and weaknesses of the current working and funding model with the Scottish Government.

ALLIANCE members were involved through an online survey (with ninety-nine responses) and thirteen telephone interviews. The review also involved face-to-face and telephone interviews or discussion groups with five ALLIANCE staff; two Board members; eleven individuals with a sponsorship relationship with the ALLIANCE (from the Scottish Government and the Joint Improvement Team); and nine representatives from organisations with a strategic policy interest in health and social care.

The Impact of the ALLIANCE

ALLIANCE members who engaged in the review were very positive about the impact of the ALLIANCE. Their feedback suggests the ALLIANCE has effectively communicated policy developments to them, and ensured their views were gathered and heard. Those who had used Hub facilities (office and meeting facilities the ALLIANCE offers its members) were positive about these.

The ALLIANCE carries out a very wide range of activity to support the development of effective policy and legislation. Members, policy stakeholders and sponsorship representatives felt that the ALLIANCE has had a significant impact on the awareness of long-term conditions and self management. They felt it has had a very influential role in shaping policy - particularly in relation to self management, person centred approaches and third sector involvement in health and social care. Stakeholders from all groups were generally very positive about the ALLIANCE's ability to provide a voice for people with lived experience.

The ALLIANCE has also delivered a range of activities to support people who deliver services and those who receive them. They work with other organisations to develop publications, resources, events and direct support programmes.

Member views and existing evaluative evidence indicate that the Self Management IMPACT Fund has had a significant impact on the work of third sector organisations involved in self management. In particular, separate evaluation work commissioned by the ALLIANCE suggests the fund has allowed organisations to develop new and existing programmes, and demonstrate the value of these.

The Role of the ALLIANCE

Members, policy stakeholders and sponsorship representatives clearly felt that the ALLIANCE has had a valuable role as a national intermediary involved in health and social care. In particular, they drew attention to its role in representing the interests of third sector organisations which focus on long-term conditions and people with lived experience.

Stakeholders felt the ALLIANCE had a number of key strengths. In particular, they emphasised its:

• expertise in person centred approaches;
• strong connection with its members;
• ability to provide a strong voice for its members and people with lived experience; and
• its high profile with the Scottish Government and strong focus on health and social care.

Generally, those we spoke with wanted the ALLIANCE to continue in the same role in the future, with many proposing it should continue to deliver broadly the same types of activities it has in recent years. Some stakeholders called for the ALLIANCE to consolidate, and even sharpen its strategic focus and activities.

During the review process, researchers heard of potential challenges for the ALLIANCE. In particular, we at times encountered a lack of understanding of the ALLIANCE's remit and scope. The review highlighted the opportunity to further strengthen and clarify its strategic role and focus, and articulate how specific activities relate to these. Those involved in the review also highlighted the importance of staying connected with what is a diverse membership base, and managing potential conflicts relating to its relationship with the Scottish Government.

Many of those we spoke with were positive about their experience of working with the ALLIANCE. Policy stakeholders and sponsorship representatives emphasised the ongoing need for intermediaries involved in health and social care to work together. The review highlighted that the Scottish Government can potentially support this joint working at a national level.

Sponsorship representatives, policy stakeholders and members felt that the ALLIANCE has an important ongoing role in supporting the delivery of the Scottish Government's 2020 Vision for Health and Social Care. In particular, they wanted to see the ALLIANCE work to ensure that people who access services have a strong voice, and person centred care is put into practice. They also wanted to see the ALLIANCE work with other intermediaries to ensure the role of the third sector in health and social care is further developed. There was support for the ALLIANCE to have an ongoing role in the integration of health and social care, particularly at a national level.

Funding Relationship with the Scottish Government

The ALLIANCE receives a core grant of £700,000 each year from the Scottish Government. It is also funded by the Scottish Government to provide a range of specific projects and activities, and manages the £2 million per year Self Management IMPACT Fund on behalf of the Scottish Government.

Sponsorship representatives had many positive views about working with the ALLIANCE. They spoke of it being a flexible, responsive organisation, which had supported progress in a number of policy areas.

The varied sponsorship approaches and processes with the Scottish Government are complex, and resource intensive to manage. There was broad support for moving towards a new, more strategic partnership agreement between the two organisations, and an associated streamlining of funding and sponsorship processes. It was felt that this would support the ALLIANCE to clarify how different activities relate to its core outcomes, and allow it to plan, monitor and report in a more outcomes focused way.

Recommendations

The review identified a number of recommendations for the ALLIANCE and the Scottish Government including:

• A joint Strategic Partnership Agreement - This would be an accessible, high level document which covers a three year period. This document should set out how the two organisations will work together, outline strategic outcomes for the ALLIANCE, provide a framework for understanding performance and clarify the role and broad activities of the ALLIANCE.
• An annual planning and financial cycle - This would underpin the Strategic Partnership Agreement. This could usefully involve an annual activity plan and associated processes for agreeing and managing funding.
• Consolidating funding - It is recommended that that the Scottish Government explores the opportunities to consolidate individual programme funding streams into the ALLIANCE's core budget, where there is a genuine need for projects or programmes to continue through the life of the Strategic Partnership Agreement.
• Rationalising programme governance, planning and reporting -The Scottish Government should work with the ALLIANCE to rationalise governance, planning and reporting requirements attached to Scottish Government funded core and programme activities. This should improve consistency and clarity, and support more outcomes focused planning and reporting.
• A more strategic approach to developing new projects and programmes - The Scottish Government should continue to develop its approach to commissioning in a strategic way, with the ALLIANCE and others involved in health and social care.

This document, along with full research report of the project, and further information about social and policy research commissioned and published on behalf of the Scottish Government, can be viewed on the Internet at http://www.gov. scot/Topics/Research/About/Social-Research. If you have any further queries about social research, please contact us at socialresearch@scotland.gsi.gov.uk or on 0131 244 2111.