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

EXECUTIVE SUMMARY

About this report

This report sets out the findings from an independent review of the ALLIANCE, and aims to inform the future development of the ALLIANCE’s relationship with the Scottish Government. The review has 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.

The review involved an initial analysis of existing monitoring and evaluation material provided by the ALLIANCE. ALLIANCE members were involved through an online survey (which received ninety-nine responses) and thirteen telephone interviews. We also carried out interviews with: five ALLIANCE staff members; two Board members; eleven individuals with a sponsorship responsibility for 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 successfully ensured their views were gathered and heard. Those who had used Hub facilities provided by the ALLIANCE were positive about these.

The ALLIANCE carries out a very wide range of activity to support the development of policy and legislation relating to aspects of health and social care. Members, policy stakeholders and sponsorship representatives felt that the ALLIANCE had 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 of long-term conditions.

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 enabled organisations to develop new and existing programmes, and demonstrate the value of these.

The Role of the ALLIANCE

During the review 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 that the ALLIANCE had a number of key strengths. In particular: its expertise in person centred approaches; its strong connection with its members; its ability to provide a strong voice for its members and people with lived experience; its high profile with the Scottish Government; and its strong focus on health and social care.

During the research, we at times encountered a lack of understanding of the ALLIANCE’s remit and scope. Stakeholders highlighted potential risks and concerns that the ALLIANCE may wish to consider – mainly related to the breadth of activities it undertakes, its connection to its membership as it grows in size, and (real or perceived) conflicts relating to its funding relationship with the Scottish Government. The authors of this report concluded that these were mainly issues for the ALLIANCE to be mindful of in the future, as it continues to develop. The authors also believe that some of these concerns could be overcome through further communicating how specific programmes and projects relate to its overarching role and strategic focus.

Generally, stakeholders wanted the ALLIANCE to continue in broadly 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.

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 role in supporting the delivery of the Government’s 2020 Vision for Health and Social Care in the future. 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 wanted to see the ALLIANCE continue to work with other intermediaries involved in health and social care to ensure the role of the third sector in health and social care is further developed. There was also support for the ALLIANCE to have an ongoing role in the integration of health and social care.

Funding Relationship with the Scottish Government

The ALLIANCE receives a core grant of £700,000 each year from the Scottish Government. In addition, it is currently funded to provide a range of specific projects and activities. During 2013-14 this project income totalled £2,474,218. The ALLIANCE also 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 currently in place 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 current 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

This report sets out 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 we suggest 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. The report recommends this will involve an annual activity plan and associated processes for agreeing and managing funding.

• Consolidating funding – The report recommends 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 – It is recommended that the Scottish Government works with the ALLIANCE to rationalise the programme and core governance, planning and reporting requirements attached to funding. This should improve consistency and clarity, and support more outcomes-focused 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 potentially other organisations.