Our latest viewpoint comes from my friend and Colleague Andrew Strong, the ALLIANCE's Assistant Director (Policy and Communications), in response to yesterday's publication of the Scottish Government's Delivery Plan for Health and Social Care.
It’s an analogy which has been used many times but health and social care services in Scotland are at a crossroads. Commentators and policymakers alike have long recognised that we need swift action to increase preventative, community based support or risk further and further spending on crisis management approaches.
The overuse of “the crossroads analogy” should perhaps tell us something – maybe that the rhetoric around prevention and preventative spend just isn’t becoming reality?
Yesterday’s publication of a new Health and Social Care Delivery Plan is a welcome intervention – focusing as it does on the need to shift away from a ‘fix it’ mentality, towards the social model, early intervention and self management. The plan brings together a variety of both existing and new commitments into a timeline of change for health and social care. These changes run from the short term setting of delivery ambitions for delayed discharge to the reduction of smoking levels to less than 5 per cent by 2034.
At a practical level this plan allows us to monitor how purposeful such activity is – and comment on what needs to change where it is not.
But ultimately the decisions being made by integration authorities, Health Boards and councils can, at least on occasion, run in the face of lofty ambitions. Last week’s draft budget committed further investment into social care, but this has been effectively ring fenced for spending on the living wage, removal of war pensions from care charging and implementation of the new Carers Act. These are all valuable and worthwhile investments, but this needs to happen alongside further innovative thinking about how money invested in acute settings can be redirected to support people at home and in their local community. The ALLIANCE’s pre-budget statement set out ten ideas to support such a change.
Relationships between the third sector and statutory services are important here too. But our Third Sector Health and Social Care Support Team recently identified concerns that local partnership working has gone backwards in the last two years and as a result, there are already concerns about whether any change as a result of health and social care integration will be truly transformational, even in the longer term.
As was the case with those that came before it, turning this plan into action will be challenging – and will require people from across sectors to support it and time and effort must be invested in bringing the views of people who use support and services to the table. After all, the risk of not doing so is too great.
Assistant Director (Policy & Communications)
Health and Social Care Alliance Scotland (the ALLIANCE)