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

2. 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

3. 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

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

5. 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

6. 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

7. 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

8. 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. 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

10. 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

11. 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

12. 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

13. 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

14. 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

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

16. 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

17. 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

18. 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”

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

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

21. All for now.....