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JOINT FUTURE AGENDA: SHORT LIFE WORKING GROUP ON JOINT PREMISES DEVELOPMENT IN PRIMARY AND COMMUNITY CARE: FINAL REPORT
PART 2 - CONTEXT
4. Community Planning and the Joint Future Agenda
4.1 The Local Government in Scotland Act 2003 provides the over-arching context for partnership working. It places community planning on a firm footing by placing a statutory duty on local authorities to co-ordinate the community planning process and on NHS bodies (and others) to formally participate in it. The Act underpins community planning by placing a statutory duty of best value on local authorities and anticipates its full rollout to other public sector organisations.
4.2 The aim of community planning is to draw together all community interests in an inclusive way to plan services. This process involves not just statutory bodies, service users, carers and the local community but also the wider coalition of service providers to the community. The Joint Future "Next Steps" letter reflects this approach by requiring local partnership arrangements to be more inclusive. Voluntary organisations should be involved in the development of more integrated community care services.
4.3 The Joint Future agenda is likened to "community planning in action" since joint delivery is based on a shared strategic vision. It takes a discrete range of health, housing and social care services and creates, through joint resourcing and joint management, a series of management and financial frameworks that are intended to facilitate the integration of care services.
4.4 We have drawn heavily on this context in our deliberations.
5. Joint Future Agenda - Recent Progress
5.1 The Joint Future Agenda proposed that local partnerships should have in place joint resourcing and joint management arrangements by 1 April 2003. Joint resourcing and joint management brings together the resources (both revenue and capital) of local community care partners in the form of a financial envelope and places these resources under joint management arrangements as a means of promoting and driving service integration. Many partners are progressing these arrangements and are now turning their attention to service modernisation and in turn to the premises that will be required to underpin them.
5.2 The Joint Future Unit's assessment of progress on developing joint resourcing suggests that local partners have made significant progress in identifying revenue resources within their financial envelopes but their attention has only recently focussed on the identification of physical resources i.e. premises.
5.3 Some local partnerships have anticipated the joint working agenda by developing joint premises initiatives driven by customer focus, a shared service vision in a locality, incentive funding, or cost savings. The pattern is patchy and these developments have been largely opportunistic in nature. General feedback (discussed in more detail in chapter 2) suggests significant complexity in getting arrangements off the ground. Short-term drivers such as the Delayed Discharge Action Plan (launched in 2002) also highlight real and perceived obstacles as local partners search for sustainable solutions to service range and capacity issues.
5.4 This presented us with an opportunity to think through the approaches for the systematic inclusion of physical resources within the Local Partnership Agreements and the development of joint services.
6. Community Care & Health Act 2002 - Flexibilities
6.1 During the life of our group, Part 2 of the Community Care and Health (Scotland) Act was enacted (a summary of the key provisions and their impact is set out in Appendix 4). The Act enables local authorities and NHS bodies to make payments towards relevant prescribed functions of each other; delegate functions to one another; and to pool their resources in support of joint services. This significant increase in flexibility enables fuller integration of services, provision of a more seamless response to service users and more effective use of resources.
6.2 These provisions underpin the Joint Future Agenda and promote a range of joint working flexibilities in the organisation; resourcing and management of community care services. The flexibilities enable local partners to transfer capital assets and resources to address immediate needs identified by partners undertaking joint premises developments. These same flexibilities are expected to underpin local partners implementation of their community plans and joint service strategies.
6.3 The Act removes significant barriers to joint working encountered in existing completed developments and facilitates the development of local solutions in a more streamlined way. Our recommendations in this report take into account the anticipated impact of these new general flexibilities, and should in turn, promote new opportunities in the context of premises.
7. Relationship with other Policy Developments
7.1 The timing of this report coincides with the implementation of Community Health Partnerships; the current revision of the Scottish Capital Investment Manual (SCIM); the review of certain relevant sections of the Scottish Public Finance Manual relating to capital; and the forthcoming review of the NHS Property and Transactions Handbook (later in 2003).
7.2 In addition, the upcoming NHS Reform - Miscellaneous Provisions Bill which is due to be go out to consultation in October 2003 provides a vehicle for any primary legislation which may be necessary to underpin appropriate SLWG recommendations. The timing of the Bill fits well with the considerations by the SLWG of the availability of appropriate models for the future delivery of joint premises development, such as LIFT discussed in Part 5 of this report that would require legislative change.
7.3 Looking at the financing of the public sector more generally, the Government is committed to levering in private resources to achieve higher quality public services. Our approach on joint premises follows this course.
7.4 Thus, the development of a flexible approach to the financing of premises sits well with the wider objectives of creating joint services under the Joint Future Agenda, modernising primary care and broadening the scope of financial investment in the public sector.
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