HEALTH and social care integration in Scotland should be made simpler to deliver a more focused system, according to a new report from the Royal College of Physicians of Edinburgh.
The study – Integration in a diverse health and social care system: How effective are Integration Joint Boards? – said the Integration Joint Boards (IJBs), the bodies responsible for such integration, are complex, which can lead to confusion around roles and responsibilities.
It said this could even make accountability unclear, particularly when there is service failure, which could prevent care being delivered in a timely and efficient manner.
The Scottish Government established IJBs to integrate health and care systems across the country, with councils and health boards delegating certain responsibilities to them. But the report said IJBs must understand the needs of their local population for integration to work, and that “staff on the ground” need more support to deliver health and care objectives, which should be underpinned by integrated financial planning and effective leadership.
In a series of recommendations, the college said IJB governance must be made simpler, with leadership focusing on strategic goals and clear guidelines had to be in place “to clarify the roles and responsibilities of IJB board members, and their relationship with the public”.
The purpose and focus of IJBs must be regularly reviewed, said the College, with a common language to ensure that all staff understand the rationale for health and social care integration, and their role in it.
And it saw as essential, a model to develop quality and good practice to improve health and social care standards.
Professor Michael Deighan, who has chaired discussions on the effectiveness of IJBs, said: “I commend this report as it examines the key issues around IJBs, including their effectiveness to date. The report also examines performance and governance arrangements for IJBs, and makes important recommendations for improving governance arrangements, to ensure quality, safe, effective care for patients.”
College president, Professor Derek Bell, added: “Although we would not recommend hardwiring the system and then drastically changing it, because this can be disruptive, many opportunities exist to tweak health and social care in order to improve service delivery. Flexibility is important here. Any changes to the current system must be based on what local data tells us, to make sure that we know our population and can reflect their needs. There is potential in future to share learning and best practice, and to work together to develop a shared learning and problem-solving approach.”
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