Renewing Scotland's public services: priorities for reform in response to the Christie Commission

Integrated Local Services

"As a Commission we agree that effective, locally integrated service provision is crucial to the achievement of outcomes, and that local authority-area level partnership is crucial to the development of that integrated service provision. The continued development of local partnership arrangements should therefore be a key element of the public service reform process."
Commission on the Future Delivery of Public Services

Evidence clearly demonstrates that improved outcomes for people and better use of resources can be achieved when local services are planned and delivered through effective place-based partnership and integrated service provision. In many instances, truly preventative approaches are only possible when organisations work together in collaboration and plan budgets jointly.

Many effective solutions to the complex challenges we face - from tackling crime to improving public health - lie locally. The best ideas and most effective solutions will often come from those with the most direct experience of the issues at hand - that is, users of services and frontline workers.

Building on progress achieved in the last four years, we will advance a series of initiatives during this Parliament to sharpen the focus of public services on 'place' as a magnet for partnership and as the basis for stronger community participation in the design and delivery of local services.

We want public service organisations to break through bureaucratic barriers and operate across organisational boundaries to produce integrated services that deliver better value for money and improve the social and economic wellbeing of the nation. We will give people and communities a much stronger voice in the decisions that affect them, responding effectively to their aspirations and concerns.

The type of place-based partnership we envisage will be comprehensive and participative, harnessing the full spectrum of talents and capacities of public bodies, citizens, third sector organisations and local businesses. Our approach will be open, inclusive and responsive and, where appropriate, we will take opportunities to place greater responsibility and control in the hands of citizens and communities.

Renewing Adult Health & Social Care

The Scottish Government is committed to the introduction of an integrated system of health and social care to ensure that older people continue to receive the care, compassion, support and dignity they need and deserve.

Strong evidence suggests that better outcomes for people, better use of resources (money and people's time) and better experience of care and support can all flow from services that are planned and delivered in an effectively integrated way.

Over the next 20 years demography alone could increase expenditure on health and social care by 70 per cent. Reform is necessary to help address this unprecedented challenge.

Our Achievements

Under the broad umbrella of community planning, we have created with our partners strong foundations for the development of place-based partnership across sectors. Examples include, Alcohol and Drug Partnerships, Community Safety Partnerships, Community Health & Care Partnerships and Regional Transport Partnerships.

We have supported the increasing engagement of the third sector in Community Planning Partnerships so that the sector's skills, knowledge and expertise can provide the maximum input to local delivery.

Recent achievements of our partnership approach include:

• Single Outcome Agreements based on an agreed set of national and local outcomes that take account of local priorities for every local authority and their community planning partners since 2008-09;
• a new Change Fund which revolutionised the partnership approach to delivering joined up services across health and social care, providing £70 million across Scotland for investment to support new and improved ways of working and deliver higher quality, more sustainable services;
• the Patients' Right (Scotland) Act 2011 to improve patients' experience of using health services and to support people to become more involved in their health and healthcare;
• the Reshaping Care for Older People programme focussed on improving services across health and social care for older people, including optimising the independence and wellbeing of older people at home or in a homely setting;
• embedding a collaborative culture to underpin the Getting it Right for Every Child ( GIRFEC) approach;
• a new Framework for Local Alcohol and Drug Partnerships that outlines the responsibilities of local partners in improving outcomes for individuals, families and communities affected by alcohol and drugs misuse;
• delivery of the Making Justice Work programme of reform that brings together the Scottish Government, the Crown Office and Procurator Fiscal Service, Scottish Court Service, ACPOS and the Scottish Legal Aid Board on a range of projects to improve the efficiency and effectiveness of the justice system;
• transfer of responsibility for local economic development to local authorities as part of the implementation of the 2007 reform of the enterprise network; and
• housing option and asset management hubs, which cover multiple local authorities and are a forum for sharing best practice, ideas and services.

Our Priorities

Our focus is on outcomes and effective partnerships at a local level to deliver public services that are high quality, continually improving, efficient and responsive to local needs. Community is at the heart of our approach and Community Planning Partnerships will continue to play a significant role in identifying priority local outcomes and leading service integration in their areas through the further development of Single Outcome Agreements.

Our priorities for improving partnership during this Parliament include:

• supporting continuous improvement of Community Planning Partnerships and Single Outcome Agreements as key drivers for partnership working and delivery of outcomes, including building on existing scrutiny activity, reviewing responsibilities of community planning partners in the light of the wider reform agenda;
• developing with the Accounts Commission proposals identifying how external scrutiny can support the delivery of better outcomes at the level of Community Planning Partnerships, through assessing performance and promoting effective practice;
• continuing to provide a Change Fund for NHS Boards and local authorities to invest in partnership to redesign services to support the delivery of new approaches to improved quality and outcomes - worth £80 million in 2012-13;
• integrating health and social care across Scotland to ensure that services are organised around the needs of the individual supported by the continued Change Fund;
• enactment of the Social Care (Self-directed Support) Bill to underpin new models of support, placing greater control and responsibility in the hands of citizens and thereby enhancing people's independence and wellbeing;
• continuing closer joint working between GPs, pharmacists and other community services to improve the service on offer to patients;
• developing a Community Empowerment and Renewal Bill that will significantly improve community participation in the design and delivery of public services, alongside action to build community capacity, recognising the particular needs of communities facing multiple social and economic challenges;
• a legal duty to work together and place the child at the centre of service delivery planning for health boards, councils and other agencies irrespective of bureaucratic boundaries;
• working collaboratively with Scotland's cities and other stakeholders to develop a Cities Strategy that will provide a framework for more effective collaboration and partnership between Government, Scotland's cities and between the public, private and third sectors;
• better alignment of employability and skills interventions between the Scottish Government, Jobcentre Plus, Skills Development Scotland, colleges and local authorities and development of new approaches to employability funding to support this;
• working with local authorities and their community planning partners to support them in the delivery of local economic development services, supporting effective collaboration and seamless assistance to businesses to help them grow; and
• more effective alignment of capital programmes to ensure we maximise the impact of expenditure in supporting delivery of a successful economy.