Health and Social Care Integration Getting your message across – how to engage effectively with Integration Joint Boards

Overview 32 Local Authorities 32 IJBs 8 Special Boards Brian Montgomery leads Topline of the structural make up of the health and social care environment in Scotland 32 Local Authorities 32 IJBs 8 Special Boards

Why the need for change? People aged 75+account for 8% of the population and use 43% of all bed days in hospital 87% of all bed days for people aged 75+ were for unplanned admissions Over 75s will increase by 65% by 2030 Over 2m have more than one long term condition

Why really £13BN TOTAL NHS BUDGET £1.3BN unplanned admissions £4.6BN spent on older people £1.3BN unplanned admissions

A new way of delivering care Reactive Care Patient as passive Infrequent Self-care Carers Undervalued Low Tech Preventive Care Patient as Partner Self-care encouraged/facilitated Carers supported as Partners High Tech

Ministerial statement “We want those who use health and social care services to get the best care and support, based on their own personal circumstances, and which is focused on what matters most to them.” Shona Robison, Cabinet Secretary for Health, Wellbeing and Sport

Values behind the change Respects the rights, safety of service users Improves the quality of the service Anticipates need, prevents them from arising Makes best use of people and resources Integrated from service users view Planned and led locally Participation of service users Dignity of service users

The objective of Change Improve the health and wellbeing of people who use health and social care A transformational change beyond organisational redesign About the whole person and designing joined-up services Minimise delays in care and people supported to live as independently as possible

9 Health and Wellbeing outcomes To look after/improve own health wellbeing Including disabilities or long-term conditions Users have their dignity respected Improve the quality of life of users To contribute to reducing health inequalities Unpaid carers supported to look after their health People who use services are safe from harm. Those who work in services feel engaged Resources are used effectively

What are IJBs? 31 Integration Joint Boards – copying local authority boundaries Legal entity that binds together Health Board and Local Council in joint arrangement. [Public Bodies Joint Working Act] Joint decision making and accountability and able to make decisions on spend and policy New Governance Board to reflect local stakeholders

IJB powers Minimum Maximum Health Care All primary care All adult care services All addiction services Social Care All adult social care Maximum Health Care All adult care services All addiction services All hospital services Social Care All adult social care Homelessness Criminal Justice

What is the purpose of IJBS? Brings together the planning, resources and operational oversight for adult health and social care functions into single system To ensure services are built around the needs of patients and service users To focus on preventative and anticipatory care in communities To redesign services to develop the above

How the IJB operates Chief Integration Officer responsible for governance and operational management Liaises with Director of Operations in NHS Board on non delegated functions Strategic Commissioning Plan for service plans guided by Strategic Planning group Locality Planning process Guided by professional advisors

How IJB is funded The funds for all social care services transferred to IJB from local authority All funds spent on all health care services be transferred[minimum list] from NHS Board and for other additional services, cost transferred Some IJBs were also given change fund monies Budgets planned on a three year basis and include any presumed NHS uplift

The Glasgow Budget All Adult Care Services City Council All NHS services agreed to delegated Total budget £796.45m £333.53m £1.13bn

How it is governed Councillors [3-5] Non Executive Directors NHS [3-5] Substitutes from above Chief Integration officer Chief Social Wk officer Chief Finance officer Medical/Clinical Lead GP rep Nurse Director/lead Staff reps 3RD Sector rep Service user Carer rep Private sector rep

Challenges IJBS vary in readiness Focus on the immediate Different cultures between NHS/Council Some the key areas still controlled by Councils Targets versus plans Very little in plans about deafness Strategic plans are broad

Opportunities IJBS vary in readiness Role of users and carers voices on the board Social care model strong There is little understanding /awareness of deafness Can offer specific contributions to immediate issues Offer a lead on behalf of “deaf sector”

Position for influence and impact Networks and circles Ambassadors/ Promoters Compelling narrative Navigating the system Unique Proposition

Getting the message across What is it? What is the offer? What are the “wins”? Who are your audiences? Who are your allies?

All for now.....