Review of targets and indicators for health and social care in Scotland

The current landscape

42. In addition to the priorities of government, local communities have their own concerns, expressed through local democracy when electing Local Councils. Councils play a critical role in the design and delivery of services that contribute to the improvement and maintenance of health and wellbeing. They have an important role in providing opportunities for exercise and recreation. They provide education, social care, housing, and a range of other services which are essential to wellbeing. Economic growth, and particularly growth which is shared equitably, requires a healthy, educated and engaged population. The contribution of the health and social care system to achieving this aim might be defined as ensuring that the people of Scotland live longer, healthier, more fulfilled lives.

43. Health Boards organise and deliver health care in their areas. Together with local authorities, they are embarked on an effort to integrate services. The Public Bodies (Joint Working) (Scotland) Act 2014 established Integration Authorities to plan and deliver services for their area under the management of Integration Joint Boards. Integration Authorities plan and deliver services in partnership with local communities and a range of organisations from the third and independent sectors.

44. As already indicated, coproduction of change is a core principle of designing better indicators of progress. The Third Sector - comprising community groups, voluntary organisations, charities, social enterprises, co-operatives and individual volunteers - has an important role in helping public bodies improve services. These bodies are best able to reflect the experiences of people who come into contact with health and social care and future design of targets and indicators needs to involve the Third Sector fully in the process

45. Government, Local Authorities, Health Boards, Integration Joint Boards and the Third and Independent Sectors must work together to design and deliver services in better ways to deliver the aim of better, healthier, longer lives for the people of Scotland.

46. The remit of this review is to consider the relevance to health and social care of three nationally set groups of targets and indicators. These are the National Performance Framework ( NPF) ^[8] indicators, of which 30 relate directly or indirectly to health and social care, 19 Local Delivery Plan ( LDP) ^[9] Standards and 23 Integration Indicators ^[10] .

47. The National Performance Framework indicators primarily focus on high level outcomes, for example improving self-assessed general health, improving mental wellbeing, reducing premature mortality, reducing poverty. The LDP Standards primarily focus on waiting times for scheduled, unscheduled and mental health; and volumes of intervention activity to support behaviour change – smoking cessation and ABIs. The Integration indicators focus on two broad areas. These are individuals' experience of care and high level indicators of how care is being delivered, for example emergency admissions, delayed discharge, where the last six months of life is being spent.