The Scottish Government

« Previous | Contents | Next »

Listen

Executive Summary

This document is also available in PDF format (260k)

Purpose of the Framework

1. The Framework promotes the development and mainstreaming of joint and integrated services, as part of the Joint Future drive for better outcomes for individuals and their carers. Established ways of thinking about services and providing them are changing radically in many parts of Scotland. The Framework demonstrates the exciting changes possible in the shape and nature of modern health, housing, social care and wellbeing services, by developing more joint and integrated services.

2. The Framework sets out the requirements which the local partnerships of NHS Boards and local authorities should meet in developing and delivering joint and integrated services. The three key actions are listed at the end of this Summary. All the actions and timescales are listed in Part 1, Section 10.

3. The Framework should be used as a tool in developing joint and integrated services which assist older people to lead more independent lives and have more personal control over their lifestyles, care and environment. It provides advice and good practice examples. In particular, it signposts the way that joint and integrated services should be provided in the future - in partnership between individuals and their carers, health, housing and social care organisations, in the statutory and independent (both voluntary and private) sectors.

Part 1: Implementing and evaluating joint services

Setting the scene

Scotland has an ageing population. In order to meet the current and future needs of older people for health, housing and social care services, partnerships must plan and deliver services differently. Joint services are essential if sustainable solutions to the complex problems facing local partners, such as the growth in numbers of older people and delayed transfers of care from hospital, are to be achieved.

Older people are clear about the outcomes they want from services. They want:

And they do not particularly mind who provides the service. As their expectations of a better quality of life increase, they and their carers should be involved more effectively in designing and delivering joint services.

What is a joint service?

A joint service is one that has shared decision-making by health, housing and social care partners over one or more of the following:

Joint services offer many advantages over single agency services in helping older people to cope better. They combine the strengths and skills of staff from many different professions and agencies, so they can respond faster and more effectively. And they can be more cost-effective.

But it is not necessary for all health, housing and social care services to be joint - joint services should be put in place wherever it is clear there are or will be benefits for people who use services and their carers.

The Framework is not a review of all joint services or of all joint working in Scotland. Though focused on joint services for older people (including dementia services), the principles and activities apply equally to other community care services, in the same
way as Joint Future does.

Developing joint services together

The Framework builds on three underpinning principles:

Commissioning joint services

Joint services need to be underpinned by effective joint commissioning. In many places, there needs to be a step change to improve joint commissioning. The Framework identifies the critical issues and actions for sound commissioning, such as robust baseline information, joint infrastructure and positive change management.

The development of joint services under this Framework does not necessarily require more resources. For example, service redesign of joint services, by reducing duplication, could lead to more effective use of resources.

The benefits of more integrated working and joint services will be optimised if staff and managers are engaged in the change process, and can see how they personally can deliver better outcomes for older people.

Evaluating joint services

Joint performance management and evaluation, both nationally and locally, is essential to demonstrate better outcomes for individuals and their carers.

The Framework stresses the importance of partnerships building in an evidence base for better outcomes from the start. It offers checklists and measurable criteria which local partnerships can use to assess for themselves the development of joint services. They can also be used by the national quality assurance, inspection and regulatory organisations, such as NHSQIS, Social Work Inspection Agency, the Care Commission, and Audit Scotland.

Part 2: Joint services and the journey of care

Part 2 of the Framework sets out a range of joint services as if travelling along a journey of care. It urges local partnerships to develop more joint services that will meet the increasing needs of older people, as they become more frail or because they have additional needs:

Involving carers

Carers play an essential part in supporting older people in their own homes. There is a wide range of services for carers, often provided in partnership with carers, but joint services, for example joint information strategies and respite, should be more extensively available. Carers highlighted in particular the need for more flexible respite, short breaks and employment support services.

People with additional needs

There are already joint services for younger people and adults who have additional needs such as learning disabilities, mental health needs, physical disabilities, sensory impairment and substance misuse problems. However, local partners need to focus more on the specific needs of older people with additional needs because, other than in the mental health field, few services are designed specifically for them. Developing joint services in these areas should be facilitated by the strong planning and commissioning processes for these care groups (for example Partnership in Practice agreements for people with learning disabilities and the new Mental Health Joint Local Implementation Plans).

The incidence of dementia is increasing. And it is complex to manage. Joint services, by bringing together health, housing and social care knowledge and experience, provide a way to assist individuals and their carers both understand and cope with it. They can also assist in ensuring better outcomes at all stages of the illness.

Monitoring the implementation of joint services

The national partners, the Scottish Executive, COSLA and NHSScotland, will monitor
local partnerships' implementation of the Framework. Through the Joint Performance Information and Assessment Framework ( JPIAF), we will assess partnerships' review of existing and potential joint services to be undertaken by 31 December 2005, and their improved outcomes for people who use services and their carers ( JPIAF Indicator 11, on Local Improvement Targets).

The national quality assurance, inspection and regulatory agencies are also looking at the scope for programmes of joint inspection, which will be particularly appropriate to joint services, and will reduce the burden of regulation and inspection on local partnerships.

Key actions and milestones for developing joint services

The additional supportive actions are set out in Part 1 Section 10.

« Previous | Contents | Next »