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Integration: the law, the regulations and the integration

scheme

Jamie Megaw

5 December 2014

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Important terms

• Integration Scheme – describes how NHS Lothian and CEC will respond to the Act and Regulations

• Integration Joint Board – the new organisation legally responsible for strategic planning and setting direction for specific functions

• Strategic Plan – the document and process that sets direction for NHS Lothian and CEC

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Policy developments on Integration

• Joint Futures Group (1999)• Community Care and Health (Scotland) Act 2002• Community Health Partnerships (2004)• Integrated Resource Framework (2008)• Christie Commission (2011)• Public Bodies (Joint Working) (Scotland) Bill (2014)

▪ More than a structural change▪ One health and social care budget▪ Massive shift in power and influence▪ Focus on localities▪ Focus on system of care that an individual requires

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Steps to integration

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Integration Scheme Process

• Regulations laid in parliament Oct/Nov▪ What must, may or must not be delegated▪ What must be described in the Integration Scheme

• Parliamentary process ends Dec

• Prepare Edinburgh Integration Scheme Oct - Dec

• NHS Lothian approve draft Integration Scheme Jan 14th • CEC approve draft Integration Scheme Jan 16th• Consultation (5/6 weeks)• NHS Lothian and CEC approve final Scheme Mar• Send to Scottish Government Mar 31st

• Scottish Government approve June• Integration Joint Board established once the Strategic Plan is written. In shadow

form before then.

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What the integration scheme must cover: • Aims and Outcomes• Choice of Integration

Model• IJB governance

arrangements• NHS and Social Care

functions delegated to the IJB

• Support to prepare the Strategic Plan

• How performance will be provided

• Clinical and Care Governance

• Operational Role of the Chief Officer

• Workforce Development• Financial Management

and Processes• Participation and

Engagement• Information Sharing and

data handling • Complaints• Claims• Risk Management• Dispute Resolution

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Social Care functions that will be delegated

• Residential Care –Older People• Extra Care Housing and Sheltered Housing (Housing Support

provided)• Intermediate Care • Supported Housing-Learning Disability• Rehabilitation-Mental Health• Day Services and Local Area Coordination-LD; Older People; Mental

Health• Care at home services and Reablement –All client groups• Rapid Response• Telecare• Respite services-all client groups• Quality assurance and Contracts• Assessment and Care Management-incl. OT services• Specialist Services-Sensory Impairment, Drugs and Alcohol

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NHS functions that will be delegated

Hospital services (includesassociated services – e.g. AHPs)

• A&E• general medicine • geriatric medicine• rehabilitation medicine • respiratory medicine• psychiatry of learning disability• palliative care• hospital services provided by GPs• mental health services provided in a

hospital with exception of forensic mental health services

• Services relating to an addiction or dependence on any substance.

Community Health Services

• District Nursing• Services relating to an addiction or

dependence on any substance.• Services provided by AHPs• Public dental service• Primary medical services (GP)*• General dental services*• Ophthalmic services*• Pharmaceutical services*• Out-of-Hours primary medical services• Community geriatric medicine• Palliative care• Mental health services• Continence services• Kidney dialysis• Services to promote public health

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