Health and social care integration marred by ‘significant risks’

Scotland’s integration of health and social care services is being held up by boards which still haven’t produced overall strategic plans, according to a new report by spending watchdog Audit Scotland.

The integration of services is a flagship SNP policy.

The authorities are expected to take over the running of community health and social care services from April next year with a budget of £8bn, but Audit Scotland has said there are “significant risks” in the lack of proper planning.

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These risks include difficulties with agreeing budgets, complex governance arrangements, and workforce planning.

Auditor General Caroline Gardner said: "If these new bodies are achieve the scale and pace of change that's needed, there should be a clear understanding of who is accountable for delivering integrated services, and strategic plans that show how integration authorities will use resources to transform delivery of health and social care."

Dr Miles Mack, chair of the Royal College of General Practitioners in Scotland (RCGP Scotland) said doctors were “deeply concerned” about the launch of the new bodies, and a lack of planning “would have a direct and negative effect on the quality and safety of care patients may expect.”

Mack said the integrated boards had adopted a “top-down” approach.

“Despite efforts from Scottish Government, GPs do not feel engaged by IJBs nor knowledgeable about the oncoming changes to practice. If care is to be provided ‘at home or in a homely setting’ then GPs will clearly be the hub of the system and, to date, they have had little opportunity to develop or influence it.”

Unless GPs are involved in planning, he warned, “patients will suffer”.

Royal College of Nursing (RCN) Scotland Director, Theresa Fyffe, said the principle of the integration of services enjoyed widespread support.

“If the Government is serious about quality of care and scrutiny, it must follow Audit Scotland’s recommendations around governance and accountability, to avoid the mistakes of the past and make sure the public knows how to access the right professional care when and where they need it,” she said.