ANNEX 4

Circular SWSG7/94 5458 - Community Care - The Housing Dimention

ANNEX 4

HOUSING PLANS AND COMMUNITY CARE PLANS

HOUSING PLANS

1. At strategic level, housing plans are produced by housing authorities, and community care plans by health boards and social work authorities (preferably health boards and social work authorities should produce joint plans with a housing input to ensure housing requirements are quantified). Since addressees for this circular cover all 3 types of body, it may be helpful to summarise the main features of each.

2. A new Housing plans system was introduced in 1993, with the following features:

- The housing plans normally look 5 years ahead, e.g. 1995-96 to 1999-2000 for the 1994 plans. They are due in September. For the 1994 plans, housing authorities have the option of looking only 3 years ahead because of local government reorganisation.

- Housing plans should be strategic in character, and set out priorities, and also key issues which should be addressed in all housing plans (community care, homelessness, houses below the tolerable standard, and condensation and dampness), but housing authorities can develop other key issues for their area based on local needs and priorities. Health and social work agencies will wish to ensure that relevant community care issues are brought to the attention of housing authorities.

- Housing plans, and the capital programmes for future years which they contain, should be realistic, i.e. consistent with the resource planning assumptions issued to each authority for the next 3 years (1995-96 to 1997-98 for 1994 plans); although these assumptions should not be seen as guarantees of Capital Allocations at this level.

- Housing plans must take full account of the linkage between housing investment planning and housing management planning. This linkage is particularly important for community care which consists of a package of housing and services. Under arrangements which have just been introduced, The Scottish Office Environment Department wrote to local housing authorities on 1 July 1994 requesting submission by 30 September 1994 of their first Housing Management Plans, covering the years 1995-1999. Authorities have been asked to describe in these plans the arrangements for their involvement in the assessment, planning, and delivery of community care.

- Authorities submit full housing plans only every 4 years (every 2 years for Glasgow) under a rota system. In 1994 full plans will be submitted by districts within Dumfries and Galloway, and Grampian; and for Clydesdale,

Cumbernauld and Kilsyth, East Kilbride, Hamilton, Monklands, Motherwell and Strathkelvin in Strathclyde Region; and Orkney and Western Isles Islands authorities.

- However, all authorities will submit to the Department every year:

- Capital Programmes, normally for the next 5 years, including details of planned investment in community care. For 1995-96 housing authorities have only been asked to prepare programmes for the next 3 years because of local government reorganisation.

- Annual Policy Statements, which comment on the capital programmes (including changes from the previous years), set quantified output targets for priorities including community care, and review progress against previous targets.

Capital allocations will be issued to authorities in February, ie February 1995 for 1995-96 onward programmes.

3. More detailed guidance on the 1994 housing plans is given in circular Env 9/94, which was sent to housing authorities, and various relevant housing bodies and interested parties. Guidance on housing management plans was given in circular Env 23/94, sent to the same addressees.

COMMUNITY CARE PLANS

4. Regional/Islands Councils are required (and Health Boards expected, where not acting jointly with a local authority) to prepare and publish community care plans. Plans cover a 3 year period and are to be reviewed and rolled forward annually. The first plans covered the period 1992-95.

5. Guidance on community care planning is contained in social work circular SW1/91. The expected content of plans is described in the annex to that circular which is reproduced as the Appendix to this Annex for ease of reference.

6. Community Care Plans serve a number of different purposes at present, which has made for difficulty in their compilation. The tendency to date has been towards plans which are descriptive, rather than dynamic, and philosophical rather than action driven as sought in the guidance. The Scottish Office is therefore reconsidering the terms of the guidance in SW1/91 with a view to focusing on action in support of local service, and national policy, objectives. Plans would, therefore, become more of a management tool. The expectation is that plans will in future focus on specific action to deliver the items in the appendix to this Annex, addressing in particular service and other outputs.

Health Board Community Care Plans

7. Health Boards continue to have the responsibility for the health care aspects of community care. These may include community health services, including primary health care and a range of in-patient, day-patient and out-patient services intended for the community care client groups. Health Boards are expected to continue preparing community care plans. Each health board is, it is understood, currently working with the relevant local authority social work department on a joint plan. The Scottish Office endorses and welcomes this approach. Boards should ensure that they include in their plans, however constructed, the information below.

(a) A summary of planning agreements with the local social work authority.

(b) An indication of the size of the population for which the Board must obtain services including the demographic profile.

(d) Best possible estimates of programme budgets for each care group requiring community care, i.e. a statement of the financial resources (in absolute terms) to be committed to each priority care group for care in the community over a 3 year period together with a broad specification of the quality, range and volume of service expected for the given level of expenditure. Budgets should demonstrate how the Board proposes to fulfil this part of agreements reached with local social work authorities.

As regards the detailed planning of the provision of community care, Boards' Service Provision Plans and the business plans of both NHS Trusts and directly managed units should reflect planned activity in the community and should indicate what manpower, estate, capital and revenue resources are required to provide the required services. In planning the delivery of community services, it is important that NHS providers work closely with family practitioner services, and local authority and other providers of health and social services, to ensure that a continuity of care can be achieved as people's needs change and that appropriate combinations of health and social care are provided when that is needed.

APPENDIX TO ANNEX 4

CONTENT OF COMMUNITY CARE PLANS

1. Community care plans should consist of a general statement followed by separate sections for specific care groups.

Local Social Work Authority Plans

The following information should be included in the general section of plans:

(a) Brief statement of local authority strategic objectives and resource assumptions for next 3 years for (i) total local authority expenditure and (ii) social work expenditure.

(b) Policy statement on community care indicating general principles; key aims and objectives including quantified targets and measures and standards of quality by which the progress of the plan can be measured; priorities for social work in relation to other local authority functions; priorities for community care in relation to other social work functions.

(c) Existing expenditure on each community care group including funding of voluntary and private sector care and related resource assumptions for next 3 years; planned changes in the distribution of expenditure.

(d) A summary of proposals from the (Capital) Financial Plan.

(e) A statement of which agencies, organisations and groups have been consulted in preparing the community care plan and the extent of agreement reached on issues of common concern.

(f) A description of proposals and action on the undernoted subjects which are intended to improve the effectiveness of community care. (In the case of a number of these items a short statement of progress made with a relevant document, eg statement of complaints procedure will be sufficient.)

- arrangements for assessment;

- promotion of consumer choice;

- development of services for people at home;

- practical support for carers, including respite care;

- how the contribution of voluntary and private bodies and volunteers will be stimulated;

- development of purchasing, contracting and budgetary arrangements;

- help for people from minority ethnic groups;

- proposals for care management;

- complaints procedures;

- introduction of inspection units and other measures to safeguard the quality of services;

- how information about services has been provided to service users and their carers; and how their views have been taken into account;

- assessment of future workforce requirements;

- training of staff in new skills;

- how the standards of provision of care will be monitored and evaluated;

- how the information required for planning will be developed.

Care Groups Section

2. For each main care group, local authorities are asked to provide:

(a) A summary of the planning agreement with the Health Board in relation to the care group (if there is no joint plan).

(b) A local strategic statement indicating

- principles underlying community care for that care group;

- key objectives;

- desired service components and standards;

- priorities for development;

- responsibilities of different statutory agencies for commissioning and providing community care services.

(c) An assessment of the numbers of people requiring care and how this will change over time. This should involve analysis of demographic information, social and economic needs indicators and more direct measures of need such as prevalence rates and surveys. Information from other key agencies should be drawn upon. Advice on how to tackle this exercise will be issued early in 1991.

(d) An evaluation of how far current service provision meets identified needs (to be followed by annual assessments of progress as part of the overall assessment of results in reviews of community care plan). This section should include information about the range, volume, quality and outcomes of existing services in each of the relevant sectors.

(e) A set of targets with timetables for the provision of community care services over the next 3 years; specification of responsibility for financing and providing these services; and identification of the resources (including capital funding) committed by local authorities, Health Board and housing bodies in the relevant fields.

Health Board Community Care Plans

3. Health Boards will continue to have responsibility for the health care aspects of community care. These may include community health services in the form of primary health care and a range of in-patient, day-patient and out-patient services intended for the community care groups. Health Boards should work towards developing community care plans which will include the information below. It was recognised that within the timescale of producing the first round of community care plans, Boards would need to base plans on existing information and long-term strategies. Boards have however been asked separately to revise strategic plans and methods of planning to take account of the White Papers "Promoting Better Health", "Working for Patients" and "Caring for People". It is intended that, within the overall strategic planning process, Health Board community care plans should describe in detail Boards' shorter term commitment to community care, and should include the following information:

(a) A summary of the planning agreement with the local social work authority (if there is no joint plan).

(b) An indication of the size of the population for which the Board must obtain services including the demographic profile.

(d) Best possible estimates of programme budgets for each care group requiring community care, ie a statement of the financial resources (in absolute terms) to be committed to each priority care group for care in the community care over a 3 year period together with a broad specification of the quality, range and volume of service expected for the given level of expenditure. Budgets should demonstrate how the Board proposes to fulfil their part of agreements reached with local authorities. While it was recognised that in the first year of community care planning, it would have to be based on limited information about the costs of community care and the levels of activity, in later years, work being carried out on the development of resource management would improve the data-base.

As regards the detailed planning of the provision of community care, Boards' Service Provision Plans and the business plans of both NHS Trusts and directly management units should reflect planned activity in the community and should indicate what manpower, estate, capital and revenue resources are required to provide the required services. In planning the delivery of community services, it is important that NHS providers should work closely with family practitioner services, and local authority and other providers of health and social services, to ensure that a continuity of care can be achieved as people's needs change and that appropriate combinations of health and social care are provided when that is needed.