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The Future Direction of public services
The recommendations set out in Changing Lives set social work services squarely in the context of the whole delivery of public services. Our aspirations, set out in Partnership for a Better Scotland (2003) and amplified in subsequent policy, make it clear that we expect to see a whole system approach to the design and delivery of services that puts the people who use them at the centre and which focuses on prevention rather than crisis management. Changing Lives highlighted these three aspirations in the context of social work very clearly. Our long term goal in setting out the foundations of our change programme is to ensure that services are:
- delivered as part of a whole joined up system;
- personalised to meet the needs of the people who use them and their carers; and
- focused on prevention and early intervention rather than crisis management.
Enabling a whole system approach
The current and future needs and aspirations of individuals, families and communities will only be met if we can bring to bear the expertise and capacity of the whole system. We need to be sure that every part of the system plays its role and properly articulates with every other part. Many of our top priorities, such as improving health, tackling crime and anti-social behaviour, creating an entrepreneurial culture, and regenerating our most deprived communities, cannot simply be 'delivered' by one agency. Public service delivery models need, increasingly, to reflect a more diverse and individualistic society with changing aspirations and expectations.
Integration of services around the needs of groups of users is a central theme in policy across the Executive. The Joint Future approach seeks to integrate health and social care staff. Integrated Community Schools have acted as a catalyst for change in the way schools work with other agencies around the needs of the school population. The creation of Community Justice Authorities will bring together social work, prison service and other local authority services, promoting a more integrated approach to reducing re-offending. At a structural level we have sought to achieve co-terminosity between local authorities and community health partnerships where possible, enabling effective partnership on the ground and creating the opportunity through community planning to develop services around the distinctive needs of local communities.
Nevertheless, despite all of this progress, the review's findings chime with concerns from many other parts of the system. The lack of common boundaries make effective planning difficult. A plethora of plans focuses too much attention on the plan and not enough on making it happen. Different governance and funding streams make joint working unnecessarily difficult, leading to duplication of effort and reporting arrangements don't focus enough on outcomes and thus don't promote whole system working.
We need, therefore, to find new ways of delivering public services to Scotland's most vulnerable people. We've learnt a lot already about what is needed through joint inspection of child protection arrangements. The development of integrated children's service plans and proposals set out in Getting it Right for Every Child, will take this further, requiring new ways and new levels of integrated working. These approaches allow us to concentrate effort and expertise where it is most needed and make the best use of expertise. They are at the heart of our current thinking on public sector reform. The findings of the review will help shape further thinking about how best to fashion the optimal structures and processes for effective delivery of social work services.
Developing personalised services
In Partnership for a Better Scotland (2003), we set out a commitment to ensure that " public services are designed and delivered around the needs of individuals and the communities within which they live". Personalisation of public services, to better match the needs and aspirations of the people who use them, underpins much of current and developing public services policy. It is an entirely positive and unstoppable trend and one which services must embrace through developing greater diversity and flexibility of provision, re-focusing the roles and skills of workers and developing the expertise of the individuals and families who need help.
Personalisation is not a new trend, we can already demonstrate significant reductions in people in institutional care, with individuals far exceeding our expectations of their ability. However, it is clear that the principle of personalisation needs increasingly to be the philosophy on which social work services are founded. In effect that will mean:
- a far greater emphasis on self assessment and self managed care;
- increased recognition of the role of unpaid carers;
- mobilisation of community resources;
- more involvement of people who use services and their carers in designing and developing services;
- increased choice and flexibility in service delivery; and
- the efforts of skilled professionals being increasingly focused on supporting those people who are unable to exercise choice. In particular we need to understand the implications of personalised approaches for those people who are subject to statutory interventions, balancing the tensions between choice and control.
Delivering for Health addresses some similar themes, such as the development of expert service users, the importance of unpaid carers, the need to develop anticipatory care services and the need to streamline access to services.
This creates substantial potential for synergy around implementation. We need to take further the principles of personalisation and try out new applications in the delivery of social work services using the learning to inform wider policy and practice developments across the whole public sector.
Shifting the focus to prevention
For social work to play its proper role in both preventing problems and intervening earlier to address them, it is vital that it is properly connected to other professions and agencies. The intervention triangle set out in Changing Lives emphasises the need to properly articulate and manage these relationships. Getting it Right for Every Child emphasises the need for all agencies to collaborate in supporting children in need. Similarly, Delivering for Health recognises the need for prevention and anticipatory care services and Scotland's Criminal Justice Plan emphasises the need to develop safer stronger communities through reducing re-offending. Successfully delivering all of these policy goals will require social work to contribute to a joined up approach to prevention, ensuring that people get the right help when they need it.
Of course there is still a need to get better at prevention, to understand what works and apply it consistently, to target effort at some of the most persistent problems in society allied with approaches to some of the big issues, for example, tackling poverty and improving parenting skills. We recognise that none of this will be easy, nor will it produce quick results. Service re-design and integrated work with health, education, police and early years will enable joined up approaches to prevention. Over time, our approach to public sector reform and the development of shared outcomes for services will help shift effort towards prevention.
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