Health and Social Care Review in the Highlands

9th December 2010

A joint meeting of the full membership of The Highland Council and the NHS Highland Board - the first of its kind - will be held next week to consider far-reaching plans to integrate health and social care services in the Highlands.

Both organisations are committed to improving the quality and reducing the cost of services through the creation of new, simpler, organisational arrangements. These plans are designed to streamline service delivery, to ensure it is more responsive, more efficient and more effective.

Councillors and the NHS Highland Board will be asked to progress plans to create single lead agency arrangements for adult community care services and for children's services.

It is proposed that the single lead agency for the delivery of adult community care services should be NHS Highland, and that the single lead agency for the provision of children's services should be The Highland Council.

Detailed planning is recommended, with a view to implementation of these new arrangements in April 2012.

The Highland Council and NHS Highland are already recognised for providing high quality services, and get good evaluations from internal and external reviews. However, both organisations believe they can do even better, and have now developed a new model for service delivery, which will further improve front line services, and help achieve better outcomes for the users of services.

These proposals will:

�reduce bureaucracy,

�ensure front-line services are efficient and cost effective by removing duplication and gaps,

�make sense to the public and to service users, by having a single, lead organisation responsible for the management and organisation of services,

�provide a clear framework for improved leadership and enhanced public accountability.

These changes are significant because they:

�involve far reaching changes in organisational and management arrangements for the two largest employers in the Highland area.

�provide a means of achieving what politicians, professionals, clinicians and the public have been seeking for many years, in both children's and adult services - reduced bureaucracy and a real joined up approach to service delivery.

�represent the most advanced plans in Scotland to achieve these aims.

�demonstrate the significant trust and effective working relationships that have been developed by care and health professionals across Highland Council and NHS Highland.

�will deliver real improvements in services and outcomes for the users of health and social care services in the Highlands.

Garry Coutts, Chairman of NHS Highland, said: "Central and local government have wrestled for too long, with the challenge of bringing health and social care closer together. We all know that is what people want. We all know it delivers better care. The challenge has been how to do it, with reduced bureaucracy. We believe that we have identified the means. The Council provides the universal service for children in schools, and is best placed to manage children's services. The NHS will hold it accountable for the delivery and quality of those services.

"The Health Service however, is the universal service for adults, and the first point of contact when people are ill or have other difficulties. Accordingly, it makes sense that community care services are managed by NHS Highland. The Council will then hold us accountable for these. We have set a tight timescale for the development of an implementation plan, as we are determined to deliver this. But more important than doing it quickly, we intend to do it properly. That is why we are seeking agreement in principle from the Council and Health Board, and we will then bring the details forward over the next few months, with the aim of making the changes in April 2012."

Councillor Michael Foxley, Leader of the Council's Administration, said: "At present, if an elderly person becomes ill or is in need of emergency care out of hours, the most likely outcome is admission to hospital. This is because the community health team do not have easy access to any other resource. It means people can be taken away from their homes at short notice, with no time to put in place any emergency domestic arrangements. Also, once in hospital, it can take time to put measures in place to get people home again.

"If the community health team were part of the same organisation that also provides social care services, there would be a wider range of immediately available options, and the elderly person could be more easily supported at home - which is where people and their families tell us that they would prefer to be. The proposals that we are presenting to the Council and Health Board are therefore practical and straightforward, and will make perfect sense to people. It is a credit to the effective relationships between our two organisations that they are now being brought to this special joint meeting."

The joint meeting will take place in The Highland Council Chamber, Glenurquhart Road, Inverness, at 10 am on Thursday 16 December.