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Highland Health and Social Care integration performs well

7th September 2017

The integrated health and social care partnership between NHS Highland and The Highland Council performed significantly better or matched national averages in Scotland in eight out of 12 benchmark performance areas, according to a report.

The first-ever annual performance report on the North Highland Health and Social Care Partnership (NHHSCP) was stipulated by the Scottish Government this year in order to help gauge and compare the progress of integration of all the health board and council services across Scotland.

Cllr Alasdair Christie, chair of The Highland Council's People Committee welcomed the publication of the first report, saying: "It is now four years since The Highland Council and NHS Highland took forward an integration of health and social care in a formal partnership. This report provides a useful marker setting out achievements against outcomes and importantly highlighting areas requiring a greater focus."

Jan Baird, NHS Highland's director of adult care, said: "The report provides the opportunity to reflect on the year and to celebrate the achievements delivered as well as some of the challenges still to be overcome. It is also a chance to highlight new ways of working across sectors which focus on maximising the benefits of integration."

NHS Highland and the Highland Council were the first in Scotland to integrate the health and social care services after signing a ‘lead agency’ partnership agreement in 2012.

Unique to Highland, this ‘lead agency’ means NHS Highland reports to the council in relation to adult care and the council reports to the NHS Highland board on children and families.

Although the Scottish Government included nine national outcome benchmarks in its guidance, the NHHSCP reported on 12 benchmark areas.

In these 12 areas, the NHHSCP showed significant improved performance in indicators in five sections and met national averages in three benchmark areas.

However, the report showed that the partnership could improve in four areas as the scores recorded were below national averages. NHS Highland has planned programme of quality improvement work to improve experiences of care, reduce reliance on institutional care and create more choice for people in end of life care. Recent improvement work in Caithness and Sutherland has significantly improved both in better care experience and better use of resources.

On the financial side, the NHHSCP’s revenue position for the financial year (April to Mar 2017) showed a total overspend against budgets of some £2.7m, with some unit overspends being offset against underspends in other areas.

The Inner Moray Firth Operational Unit (IMFOU) reported an overspend of £9.8m. This was due to overspends within Raigmore Hospital and is made up of £6.2m of recovery plan actions that did not materialise recurrently in previous years, and other pressures mainly within the surgical directorate, including a net spend of £2m on improving waiting times.

The report showed North & West Highland had an overspend of £5.7m primarily due to Out of Hours (£1m) medical locums (£2.5m) unachieved savings (£2m) and other pressures including care packages and vacant practice costs.

However, these were offset by an underspend in Central areas.

Specifically on the integrated children’s services, the outcomes focus on ensuring children and young people are safe, healthy, achieving, nurture, active, respected and responsible and included.

The indicators for Outcome 1: “Our children have the best start in life”, show improvement in the majority of measures during the last year, which includes breastfeeding rates across Highland achieving the 36 per cent target for the first time during the year, significantly above the national benchmark of 30.3 per cent.

Much of the data collected over the last four years shows significant improvement in the wellbeing of the most vulnerable children in Highland. Levels of numeracy and literacy in children is 83.7 per cent against a national benchmark of 78 per cent.

Head of children’s services, Sandra Campbell, said: “The integration of health and social care services for children is now fully embedded in Highland and this is reflected in improved performance as this report illustrates.”

Full report at -


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