Health and social care - strategic plans: statutory guidance

4. Reviewing and producing a strategic plan

An integration authority can include material that it considers relevant in the strategic plan. However, there are two matters that must be covered. A strategic plan must:

• set out the arrangements for carrying out the integration functions, in the geographic area that the integration authority covers, over the period of the plan. The area must be divided into a minimum of two localities for this purpose, and the arrangements for each locality must be set out separately
• set out the way in which the arrangements for carrying out the functions are intended to achieve or contribute towards achieving the national health and wellbeing outcomes

The 2014 Act further sets out detail and considerations in how strategic plans should be produced and reviewed, as outlined throughout the remainder of this guidance.

Annex C provides a high-level checklist to help guide integration authorities.

The Framework for Community Health and Social Care Integrated Services

Integration authorities are advised to draw upon the Framework for Community Health and Social Care Integrated Services in the planning of services and the production of their strategic plan.

Aligned to integration delivery principles and the national health and wellbeing outcomes, the Framework describes the characteristics and components of effective, integrated, sustainable community-based care and support, and the enablers that help to create the right environment for successful delivery of human rights based person-centred care. The Framework supports the improvement of outcomes for people by informing the design and delivery of local services. By encouraging a whole system approach, transformation and improvement planning will be consistent and cohesive, and deliver positive impacts across all of our populations.

Many integration authorities are applying the Framework, or aspects of it, at strategic and at locality level and its use is also advised to inform continuous improvement approaches in service delivery planning and team planning cycles. Actively engaging with people who use services and carers, staff, stakeholders and communities, as a foundation element of the Framework, will be key to successful implementation.

There is opportunity for integration authorities to share their learning, good practice, and approaches in their adoption and implementation of the Framework via their annual performance reporting.

The embedded and emerging good practice online portal has examples of planning, engagement and delivery of services aligned to the Framework. Integration authorities should look to increase the content of this resource by submitting local good practice examples on a regular basis.

What good looks like

Informed by analysis of a range of strategic documents from across the country, Healthcare Improvement Scotland (HIS) has produced a Good Practice Framework for Strategic Planning.

The framework illustrates what good practice looks like across the breadth of activities involved in effective strategic planning, and is accompanied by a self-reflection tool.

4.1 Reviewing a strategic plan (section 37)

It is recognised that all integration authorities must have a strategic plan in place. Integration authorities are required to review their strategic plan at least every three years, and may carry out additional reviews from time to time. In carrying out a review of the strategic plan, integration authorities must consider:

• the national health and wellbeing outcomes
• the integration delivery principles
• the views of the Strategic Planning Group

There should be a clear recording and measurement framework so that there is an ongoing process to assess whether aims are being achieved. Arrangements should also be put in place so that any information relating to risks or significant changes in trends that emerge from the ongoing Joint Strategic Needs Assessment (JSNA) process can be considered and responded to timeously by the integration authority, at any time during the strategic planning cycle.

The health board and local authority are required to provide the integration authority with the information that is reasonably required to carry out the review of the strategic plan. Integration authorities may also wish to refer to the core suite of integration indicators when reviewing their plan, in order to identify areas for improvement. A review may result in the integration authority making any necessary changes by replacing its strategic plan. Flexibility is provided for integration authorities to determine further details of the review process they use.

A strategic plan which is prepared following a review must specify the date on which it takes effect. In preparing a replacement plan, integration authorities must fulfil the statutory requirements for producing a plan, as detailed throughout this guidance.

What good looks like

Good strategic planning ensures that information, evidence and plans are regularly reviewed and performance is measured. To do this, the HIS Good Practice Framework for Strategic Planning advocates for:

• establishing performance measures at the outset
• actively involving supported people and carers in the monitoring of services
• constantly reinventing and stimulating the strategic dialogue – avoiding repeating the same planning processes
• honestly and openly identifying and addressing where there have been barriers or unintended consequences
• having a variety of mechanisms to ensure that learning is spread throughout the partnership and communities of practice

4.2 Considerations in preparing a strategic plan (section 30)

Integration authorities are required to take into account the integration planning and delivery principles, set out in the 2014 Act, and the national health and wellbeing outcomes, set out in the Public Bodies (Joint Working) (National Health and Wellbeing Outcomes) (Scotland) Regulations 2014, when preparing a strategic plan. This is to ensure the principles and national outcomes are at the heart of planning for the population and to embed a person centred approach, alongside anticipatory and preventative care planning.

Each integration authority, when preparing a strategic plan, must take account of any other strategic plan that has been, or is being, prepared which also sets out arrangements for the use of those services, facilities, or resources. Essentially, areas that share resources or services must take account of this in their respective strategic plans. Local areas may plan hospital usage in a neighbouring area so close communication and co-operation is needed.

The strategic plan should ensure correlation with other local priorities, policy direction, service provision and improvement activity as outlined in, for instance:

• Alcohol and Drug Partnership plans
• carer strategies
• children’s services plans
• community plans
• housing and homelessness strategies
• transitional arrangements between children’s and adult services
• Local Outcome Improvement Plans
• NHS health board delivery plans
• NHS health board and integration authority workforce plans
• NHS clinical strategies
• other local corporate plans
• public protection

This informs the development and delivery of a local whole-system approach to drive improved outcomes across a continuum which spans prevention and early help, through to targeted and intensive services and support.

Under the terms of the Local Government in Scotland Act 2003 or, where applicable, the Public Finance and Accountability (Scotland) Act 2000, the implementation of the duty of Best Value applies to integration authorities. That duty is:

• to make arrangements to secure continuous improvement in performance whilst maintaining an appropriate balance between quality and cost; and in making those arrangements and securing that balance
• to have regard to economy, efficiency, effectiveness, the equal opportunities requirements, and to contribute to the achievement of sustainable development

Other local plans may also require demonstration of Best Value in the collective use of local resources across partners. Integration authorities may wish to consider how they might contribute to these wider local planning processes, with opportunities to collaborate, identify cross-sectoral improvement, and create alignment with health and social care planning.

Public Sector Equality Duty (PSED)

The PSED Scottish specific duties requires IJBs to carry out Equality Impact Assessments (EIA) of their strategic plan, and to publish the results. The PSED was created under section 149 of the Equality Act 2010. It requires IJBs, when carrying out their public functions, to have due regard to the need to:

• eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010
• advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it
• foster good relations between persons who share a relevant protected characteristic and persons who do not share it

The ‘relevant protected characteristics’ referred to above are: age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation. The PSED also covers marriage and civil partnerships, with regard to eliminating unlawful discrimination in employment.

The ‘need to have due regard’ should be understood broadly to embrace the full range of IJB activities, including the planning and oversight of service delivery.

The PSED is supported by requirements set out in the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012. The purpose of the specific duties is to enable listed authorities (including IJBs) to better their performance of the PSED. These requirements should be kept under review, as they may be revised over time.

It is important that IJB members are aware of, and consider, the PSED in how they set strategic direction, review performance and ensure good governance. The EIA process (one of the specific duties) should begin at the developmental stage of planning and continue through to implementation, with actual impacts on protected characteristic groups monitored thereafter.

Further information and guidance is available from the Equality and Human Rights Commission.

Children’s Rights

The United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024 (‘the 2024 Act’) makes it unlawful for a public authority, including an IJB, to act in a way which is incompatible with the United Nations Convention on the Rights of the Child (UNCRC) requirements. This will include any IJB functions carried out under a contract or other arrangement with another body. The provisions in the Act will commence on 16 July 2024.

Part 3, section 18 of the 2024 Act also places new and enhanced planning and reporting duties on certain public bodies listed in the Act. Once commenced, section 18 will replace reporting requirements under section 2 of the Children and Young People (Scotland) Act 2014 and require listed authorities to report on the actions taken to comply with the compatibility duty and to secure better or further effect of the rights of children in the previous 3 year period and say what they plan to do in the next reporting period to continue these efforts. Statutory guidance will support listed authorities in fulfilling their duties under this section.

The ‘listed authorities’, at section 19 of the 2024 Act, include any IJB to which functions in relation to persons under 18 years of age are delegated in pursuance of an integration scheme prepared under section 1 or 2 of the Public Bodies (Joint Working) (Scotland) Act 2014.

4.3 Integration delivery principles (section 31)

The integration delivery principles are:

• that the main purpose of services which are provided in pursuance of integration functions is to improve the wellbeing of service-users^[5],
• that, in so far as consistent with the main purpose, those services should be provided in a way which, so far as possible:
  • is integrated from the point of view of service-users
  • takes account of the particular needs of different service-users
  • takes account of the particular needs of service-users in different parts of the area in which the service is being provided
  • takes account of the particular characteristics and circumstances of different service-users
  • respects the rights of service-users
  • takes account of the dignity of service-users
  • takes account of the participation by service-users in the community in which service-users live
  • protects and improves the safety of service-users
  • improves the quality of the service
  • is planned and led locally in a way which is engaged with the community (including in particular service-users, those who look after service-users and those who are involved in the provision of health or social care)
  • best anticipates needs and prevents them arising
  • makes the best use of the available facilities, people and other resources

The integration delivery principles must be taken into account in the preparation of a strategic plan and in the carrying out of functions included in integration arrangements. Integration authorities should also consider ways to demonstrate that the principles have been applied in the delivery of integrated services.

This is to ensure a focus on:

• integrated delivery – including consideration of the needs of different people who use services and different areas
• the dignity of people who use services
• the participation by people who use services in the community in which they live
• protecting and improving the safety of people who use services
• improving the quality of services local planning and leadership
• the anticipation and prevention of need
• the effective use of resources

The Framework for Community Health and Social Care Integrated Services can support integration authorities apply the principles in the planning and delivery of services.

Children’s Services Planning

Integration authorities are key within the collective local leadership of service planning to improve outcomes for babies, children, young people and families, and the development and delivery of each area’s Children’s Services Plan. A number of duties on IJBs are relevant to safeguarding, supporting and promoting child wellbeing, including upholding rights, and tackling child poverty and other inequalities.

Services and professionals within integration authorities are therefore key to effective local partnership approaches to Getting it right for every child; making sure holistic whole family support is available, when it is needed, for as long as it is needed; and driving forward action to help Scotland to #KeepThePromise.

As part of local children’s services planning arrangements set out in part 3 of the Children and Young People (Scotland) Act 2014, various public bodies including IJBs have duties as designated ‘other service providers’. IJBs are required to consider the wellbeing of local children and families in the planning and delivery of services and support.

IJBs will have responsibility for ‘related services’, which are those with an impact on child wellbeing, but not provided to children directly, such as services provided to a parent or carer in relation to their own needs, as part of holistic whole family support. In addition, where integrated, some IJBs have responsibility for the delivery of certain ‘children’s services’.

Local planning, resourcing and delivery of services should also ensure that young people experience a smooth transition in the move from receipt of children’s services to adult services, as well as considering the needs of care experienced young people, where certain entitlements^[6][7][8] extend up to age 26.

Self-Directed Support

Introduced under the Social Care (Self-Directed Support) (Scotland) Act 2013, self-directed support is the primary delivery mechanism of social care support in Scotland. It puts people at the centre of their support by placing a duty on those who deliver it to involve, collaborate with, and support recipients of care to make informed choices.

More information is available in the statutory guidance on implementing self-directed support.

4.4 Strategic Planning Group governance (section 32)

Integration authorities must establish a Strategic Planning Group for the purposes of preparing a strategic plan.

Depending on the model of integration chosen, the group must involve members nominated by the local authority or the health board, or both. This allows the partners who prepared the Integration Scheme, and are party to the integrated arrangements, to be involved in the development of the strategic plan.

In addition, the integration authority is required to involve a range of relevant stakeholders. These groups must include representatives of groups prescribed by the Scottish Ministers in regulations^[9] as having an interest. These are:

• users of health care^[10]
• carers of users of health care
• commercial providers of health care
• non-commercial providers of health care
• health professionals^[11]
• social care professionals^[12]
• users of social care
• carers of users of social care
• commercial providers of social care
• non-commercial providers of social care
• non-commercial providers of social housing
• third sector bodies carrying out activities related to health or social care

The integration authority can include other persons it considers appropriate. The integration authority is to determine the number of members in its Strategic Planning Group and the process for the appointment, replacement and removal of members.

The 2014 Act allows the integration authority to:

• appoint members of the Strategic Planning Group from persons nominated
• remove appointed persons from membership of the group in circumstances it considers appropriate
• appoint members in place of members who resign or are removed from membership of the group

The 2014 Act also provides for members nominated by the local authority and/or health board to be removed from the Strategic Planning Group by the body which nominated them, and replaced with a different nominee. Furthermore, a member of the Strategic Planning Group can resign at any time.

The views of localities must be taken into account with the integration authority required to identify the most appropriate person to represent each locality on the Strategic Planning Group. Local flexibility is allowed, so that an individual can represent more than one locality. The validity of decisions made by a Strategic Planning Group is not affected by any vacancy in its membership. The integration authority is to determine the procedure of the group, and may pay members of the group expenses and allowances. It will be up to each integration authority to decide how the group should operate.

Support and expenses

Integration authorities should provide appropriate levels of support to the people participating in their planning activities. Support may include:

• ensuring documents and papers are as accessible as possible, with consideration of the time provided for people to read papers
• flexibility in the ways that people can engage
• ensuring accessibility needs are met, such as interpreters and accessible meeting venues
• engaging on the best methods of communicating, organising and scheduling meetings
• hosting induction and training sessions to help people participate

These measures will ensure that different groups are able to contribute as fully as possible, which will mean strategic plans take into account a broad range of perspectives and are, in turn, more robust.

Expense policies and related guidance should be clearly communicated to those participating in integration authority governance activities, including participation in the production of a strategic plan. It may be useful to outline guidance during introductory and/or induction sessions.

The Carers Collaborative is a group for carer representatives on IJBs in Scotland. Drawing on their experience as carers, the Carers Collaborative has developed a range of resources, including a template expense policy, which can be used and adapted by integration authorities.

4.5 Preparation of a strategic plan (section 33)

The Strategic Planning Group is required under the 2014 Act to be involved in the development of the strategic plan, assuring the group's engagement in the process from the start.

The key stages are as follows:

1. The integration authority is required to prepare proposals about matters the strategic plan should contain, and seek the views of the Strategic Planning Group on the proposals in order to prepare a first draft of the strategic plan, taking into account the views of the group expressed during the consultation.

2. The integration authority must then seek the views of the Strategic Planning Group on the draft.

3. Taking into consideration the views in response to the consultation on the first draft, the integration authority is required to prepare a second draft of the strategic plan and send a copy of it for comment to the local authority and the health board, as well as representatives of groups prescribed by the Scottish Ministers^[13] and any other persons as the integration authority considers appropriate.

It is imperative that the integration authority shares the draft strategic plan widely and accessibly with those who have an interest in the delivery or receipt of health and social care support within the geographic boundaries of the integration authority. The integration planning principles state that services should be ‘planned and led locally in a way which is engaged with the community’^[14], including those who provide care and those who are involved in the provision of health and social care support.

Wide and diverse engagement will ensure that the strategic plan is not simply controlled by the small number of people on the Strategic Planning Group but rather a shared responsibility by the population that will be affected by its findings. For example, this would include the involvement and engagement of existing representative forums, such as joint planning groups, children’s services planning partnerships, advocacy organisations, lived experience led organisations (such as disabled people’s organisations), locality planning groups and those involved in local community planning. Where possible, effort should be made to identify links to wider planned engagement, in order to streamline and reduce duplication.

Under the Community Empowerment Act (Scotland) 2015, IJBs also have responsibilities for working with local communities to plan and deliver better services which make a real difference to people’s lives. IJBs should consider the links between these responsibilities and their engagement in the production of a strategic plan, and take into account the views, ambitions and priorities of Community Planning Partnerships.

It is important that the integration authority develops an agreed communication and engagement plan at an early stage. Consultation can take place in a variety of ways - written information, public meetings, focus groups, questionnaires and online and interactive discussion forums. Integration authorities should make best efforts to allow groups of people with an interest to participate in a consultation process in order to express an opinion on the draft strategic plan and consider practices to engage underrepresented groups.

This will ensure that any other parties with an interest will have an opportunity to fully understand the direction of travel and to comment on the draft plan. The integration authority is duty bound to take into account the views obtained through consultation on the second draft of the strategic plan when finalising the strategic plan.

To ensure proportionality, the integration authority should consult with people that they can reasonably expect to recognise as representatives of these groups. Integration authorities should consider various methods in engaging their target audience.

Community engagement and participation guidance

Planning with People supports public bodies that plan and deliver health and social care services in Scotland, including integration authorities, to effectively undertake community engagement and participation.

Effective community engagement and the active participation of people is essential to ensure that Scotland’s care services are fit for purpose and lead to better outcomes for people.

The guidance, which is co-owned by the Scottish Government and the Convention of Scottish Local Authorities (COSLA), outlines statutory requirements for public bodies, presents information on community engagement, and promotes good practice.

In addition, HIS has produced operational examples of engaging with communities, including a checklist for involving people with lived experience in service design.

4.6 Involving and engaging partners

While Strategic Planning Groups are required, integration authorities’ engagement should not be constrained by traditional working group approaches. Integration authorities are expected to involve and make best use of local lived experience – such as disabled people’s organisations, carers and advocacy groups – and should seek to innovate with regards to community engagement. There may also be useful opportunities to draw on local participation and engagement networks of children, young people and families through local children’s service planning partners.

Commissioning is crucially about establishing a mature relationship between different partners from across the public, third and independent sectors in a way which will help to achieve the best services for the population. Providers will bring knowledge and experience of their services and the outcomes they are delivering. Every partner has a role to play in commissioning, and it is therefore important that local arrangements promote mature relationships and constructive dialogue. Those involved in the commissioning process will be required to work with a range of partners including the independent and third sector, along with people who use services and their carers to build and implement commissioning priorities. Clinicians, social workers, community learning development officers, housing officers and care professionals in localities also play a key role in ensuring that local needs are understood, and that they inform the overall priorities. They are key to the delivery of improvements in services and support, and in ways of working on the scale that is envisaged in strategic plans.

It is vital that the full extent of the third sector's knowledge, expertise, and information, both in relation to communities and the sector itself, is brought to bear upon commissioning and locality planning in order to achieve the outcomes of health and social care integration. This will require all parties to work with trust and mutual respect.

Third sector interfaces (TSIs) provide a coherent and cohesive voice for local organisations in each of Scotland's 32 local authority areas. They are a key point of intelligence on local third sector organisations and are positioned to identify third sectors issues and perspectives that can feed into both local and national policy. See the TSI contact details.

The housing sector makes a very significant contribution to national outcomes on health and social wellbeing by:

• undertaking effective strategic housing planning
• providing information, advice and advocacy on housing options
• facilitating, or directly providing suitable housing
• providing preventative services such as adaptations and housing support which can obviate or reduce the need for more expensive interventions at a later stage
• building capacity in local communities
• facilitating or providing social care services at home

The integration of health and social care has provided opportunities to strengthen the connections between housing and health and social care, to improve alignment of commissioning, to support the shift to prevention, and to incorporate (and if necessary review) arrangements for housing support and homelessness services.

The role of housing in integration

A housing advice note was published in 2015, which outlines the role of housing in the integration of health and social care and provides guidance on linking strategic plans and local housing strategies. This includes detail on the requirement for a housing contribution statement to form part of the strategic plan.

The Local Housing Strategy: guidance encourages local authorities to recognise the influence housing has on health inequalities and further details how planning activity should align.

In 2021, HIS reviewed how integration authorities approached incorporating housing contribution statements into strategic plans. Learning from this analysis suggests that improvements can be made by:

• increasing accessibility and understanding of the Housing Contribution Statements
• further embedding links between housing and the national health and wellbeing outcomes
• strengthening participation of tenants and residents in the development of plans
• greater evidence sharing across housing and health and social care
• clearly articulating housing challenges, improvements and priorities
• expanding on how the needs of particular groups are met

National strategies and wider planning requirements also continue to outline the importance and recognise the necessity of further embedding links between housing, health and social care. The Scottish Government’s Housing to 2040 sets out a vision for housing in Scotland to 2040 and a route map to get there. The Ending Homelessness Together Action Plan details cross-sectoral action to end homelessness. Children’s services planning duties also include consultation with social landlords, and can include a requirement to set out how housing will contribute to keeping children safe and healthy.

The commitments in these plans underscore the importance of developing integrated, holistic services that draw upon close alignment between the health, social care and housing sectors.

4.7 Provision of information to prepare a strategic plan (section 34)

Health boards and local authorities have a duty to share information with the IJB for the purpose of preparing their strategic plan. Information must be shared if it is information which may be reasonably required for the purpose of preparing a strategic plan.

The integration authority should oversee the production of JSNAs to analyse the needs of local populations and to inform and guide the commissioning of health, wellbeing and social care services within their area. The main goal of a JSNA is to accurately assess the care needs of a local population in order to improve the physical and mental health and wider wellbeing of individuals and communities.

Public support will be vital in taking any redesign forward. It is important that stakeholders have been fully involved in the process, from the start, and not presented with a conclusion. Integration authorities will want to have an agreed and transparent option appraisal process in place, especially to underpin major investment and disinvestment decisions and to consider information available from other JSNAs undertaken in the local area, as well as opportunities to combine JSNA activity to avoid duplication or gaps.

Joint Strategic Needs Assessments

Public Health Scotland has guidance on undertaking a JSNA. This includes prompts on what to consider in the design of a needs assessments, consideration in structuring and defining the scope, and examples of completed assessments.

In assessing local need and producing their strategic plans, integration authorities should consider measures to tackle inequalities. This should take into account the ambitions of national plans such the Women’s Health Plan, which aims to reduce inequalities in health outcomes for women and girls, and the Race Equality Framework (REF) for Scotland (2016-2030), which amongst other things reflects our aim to reduce racialised inequalities – including, specifically, racialised health inequalities both in relation to the physical and mental health of ethnic minority communities in Scotland.

Integration authorities should consider opportunities for JSNAs to act as a collaborative, local resource between partners, such as health boards, local authorities and service providers. This includes alignment with other local JSNAs that may be under development.

Public Health Scotland’s (PHS) Local Intelligence Support Team (LIST), who offer analytical expertise to all 31 integration authorities (to complement health board and local authority analytical capacity), can support the process of preparing Joint Strategic Needs Assessments. LIST staff can also help signpost and source other PHS expertise around meaningful and actionable use of data and intelligence.

Using data

In addition to the national health and wellbeing outcomes and related indicators, wider national outcomes frameworks and national and local data may also helpfully allow integration authorities to establish and evaluate the vision and priorities set out in their strategic plans.

There are a number of published data sets and resources that may assist in the production of strategic plans. While not exhaustive, some of these are listed below:

• Burden of disease: overview – The Scottish Public Health Observatory
• Child Poverty Statistics – Scottish Government
• Core Wellbeing Indicator Set (Children and Young People’s Outcomes Framework) – Scottish Government
• Core Suite of Integration Indicators – PHS
• Equality Evidence Finder – Scottish Government
• Health and Social Care Analysis Statistics – Scottish Government
• Health and Wellbeing Census – local authorities/Scottish Government
• Insights in Social Care: Statistics for Scotland – PHS
• Local Government Benchmarking Framework – Improvement Service
• National Performance Framework – Scottish Government
• Nomis: official census and labour market statistics – Office for National Statistics
• Overview of Poverty – PHS
• Scottish Health Survey – Scottish Government
• Scottish Index of Multiple Deprivation – Scottish Government
• Scottish Social Services Workforce Data – Scottish Social Services Council
• ScotPHO profiles tool – The Scottish Public Health Observatory
• Statistics.gov.scot – Scottish Government
• Statistics and data – National Records of Scotland
• Turas Data Intelligence – NHS Education for Scotland

4.8 Publication of strategic plans (section 35)

Integration authorities have a duty to publish their strategic plans. This can be done in a variety of formats but it will be expected, as a minimum, that these will be made available online. These must be published as soon as practicable after the plan has been finalised.

When publishing their strategic plan, integration authorities must also:

• publish a statement which describes the consultation undertaken
• publish a financial statement
• publish an equality impact assessment and any other relevant impact assessments
• consider producing an implementation plan, or set of implementation plans, outlining how the strategic plan will be delivered (including a procurement plan providing specific detail to direct those responsible for contracting services)

A Market Facilitation Plan should be prepared to complement the strategic plan and support its delivery. A Market Facilitation Plan outlines the approach and provides detail on how integration authorities will engage with the existing and prospective market in order to work together with agencies to put the right services and support in place. Based on a shared understanding of need and demand, market facilitation is the process by which all partners ensure there is sufficient, appropriate range of provision to meet needs and deliver effective outcomes. In December 2021, a Scottish Procurement Policy Note was issued to advise public bodies on steps they can take to embed ethical commissioning and procurement principles into their local practices to support a transition to the National Care Service.

Accessibility

Strategic plans should be accessible to a range of different groups, including supported people, those working in health and social care, wider partners, and the broader local community.

Integration authorities are therefore encouraged to publish an easy read plan alongside their strategic plan. Easy read documents should be published online, alongside strategic plans, in a visible, accessible location.

Integration authorities should also consider the demographics of their local area and, where possible, recognise and support local cultural identity and diversity. This could include specific needs of different age groups, providing translations of strategic plans into languages used by local communities and consideration of language needs in the delivery of services, including Gaelic.

Integration authorities may also wish to consider using diverse forms of publication and engagement to summarise key elements of their plans in alternative, accessible ways, such as through diagrams, videos, or other forms of media. The publication of a strategic plan could be promoted through launch events, dialogue with key partners, or other forms of engagement with local communities.

The Health and Social Care Scotland website hosts key documents from all of Scotland’s integration authorities, including strategic plans and performance reports. This should be kept up to date.

Directions

Section 26 to 28 of the 2014 Act provide for binding directions from the integration authority to a health board and/or local authority. These powers are the mechanism used to action strategic plans.

Directions are the means by which an integration authority tells the health board and local authority what is to be delivered using the integrated budget and for the integration authority to improve the quality and sustainability of care and support, as outlined in its strategic plan.

In the case of an IJB, a direction must be given in respect of every function that has been delegated to the IJB. In a lead agency arrangement, the integration authority may issue directions or may opt to carry out the function itself. In either case, a direction must set out how each integrated function is to be exercised, and identify the budget associated with that.

Read more in the guidance on directions.

4.9 Significant decisions outside of a strategic plan: public involvement (section 36)

Where an integration authority plans on making a decision that would have a significant effect on the provision of an integrated service, beyond the context of the strategic planning cycle, it must seek and have regard to the views of its Strategic Planning Group and take appropriate action to involve and consult the people who use, or may use, the service.

HIS guidance on identifying major service change and Planning with People: community engagement and participation guidance may assist integration authorities identify and consult on significant decisions.

4.10 Requirements on IJBs to prepare a replacement strategic plan (section 38)

The 2014 Act provides for the local authority and the health board, acting jointly, to direct the IJB to prepare a replacement strategic plan where they both agree the current strategic plan prohibits them from carrying out any of their functions or is likely to do so. A direction from both the local authority and the health board requiring the replacement of the strategic plan is binding on the integration authority. In preparing a replacement plan, IJBs must fulfil the statutory requirements for producing a plan, as detailed throughout this guidance.

4.11 Financial planning and annual financial statement (section 39)

The integration authority should draw links between its strategic plan and medium term financial plan, demonstrating how the financial resources available to it will be applied to achieve the outcomes set out in the strategic plan. Further detail on the content of medium term financial plans is available in the finance guidance.

Similarly, workforce planning is a key element in delivering the ambitions set out in strategic plans. Therefore, integration authorities should also consider how workforce planning will enable delivery of its strategic plan.

The integration authority must publish an annual financial statement upon publication of its first strategic plan and each year after that. The financial statement must set out the total resources that the integration authority intends to allocate under the provisions of the strategic plan.

The annual financial statement: advice note provides detail on the production of an annual financial statement.

4.12 Scrutiny (sections 54 to 56)

Sections 54 to 56 of the Public Bodies (Joint Working) (Scotland) Act 2014 amend the Public Services Reform (Scotland) Act 2010 and The National Health Services (Scotland) Act 1978 to extend the remit of the Social Care and Social Work Improvement Scotland (also known as the Care Inspectorate) and HIS to inspect the planning, organisation or co-ordination of the services that health boards and local authorities delegate, as set out within their Integration Schemes, to integration authorities.

These amendments set out the purpose of these inspections that can include:

• reviewing and evaluating the extent to which integrated services are complying with the integration planning and delivery principles and contributing to achieving the national health and wellbeing outcomes
• reviewing and evaluating the extent to which the planning, organisation or co-ordination of integrated services (being social services, services provided under the health service and services provided by an independent healthcare service) are complying with the integration delivery principles and contributing to achieving the national health and wellbeing outcomes.
• reviewing and evaluating the effectiveness of a strategic plan prepared under section 29 of the 2014 Act in complying with the integration delivery principles and contributing to achieving the national health and wellbeing outcomes
• encouraging improvement in the extent to which implementation of a strategic plan prepared under section 29 of the 2014 Act complies with the integration delivery principles and contributes to achieving the national health and wellbeing outcomes
• enabling consideration of the need for any recommendations to be prepared as to any such improvement to be included in the inspection report

HIS and the Care Inspectorate are able to inspect health and social care services for the purpose of reviewing and evaluating how the planning and provision of services is contributing to the achievement of the outcomes. Alongside this, they are able to encourage improvements and make recommendations in relation to the implementation of strategic plans in order to contribute to achieving the outcomes (sections 54 and 55 of the 2014 Act).

The outcomes apply to all integration authorities, and to all persons carrying out integration functions. By reference to the outcomes, the effect of integrated health and care services on the health and wellbeing of individuals can be measured.

Section 56 of the 2014 Act states that HIS and the Care Inspectorate may jointly conduct an inspection into a service provided under an integration scheme or into a local authority, health board or IJB in relation to a strategic plan.