Desk Officer:

Telephone: 0131 244 5424

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Circular No: SWSG 21/95

29 December 1995

Heads of Paid Services of Unitary Authorities

Copy to: Directors of Social Work/Chief Social Work Officers of Unitary Councils

Directors of Housing/Chief Housing Officers of Unitary Councils

General Managers of Health Boards

Directors of Social Work, Regional/Islands Councils

Directors of Housing, District Councils and Islands Councils

Chief Executive, Scottish Homes

Director of Education, Unitary Councils

Dear Colleague

COMMUNITY CARE PLANNING: JOINT PLANNING STRUCTURES

Summary

1. The lead responsibility for planning for community care will, with effect from 1 April 1996, transfer from Regional and Islands Councils to the new unitary councils (including the Islands Councils). In preparation for that change this circular invites Chief Executives of unitary councils, together with Directors of Social Work and Chief Social Work Officers, to develop in conjunction with health, housing and other interests, joint planning arrangements for community care. This calls for decisions to be made on:

- the level at which joint planning will proceed;

- the substance of the joint planning structure.

The guidance is directed to all councils but is particularly relevant to unitary councils which were formerly part of larger local government areas.

Action

2. Unitary councils together with existing councils, health boards, housing interests and other relevant local agencies are therefore invited in terms of this circular to determine in the near future, the level at which joint planning is to take place in their area (paragraphs 15 to 20) and the structure for joint planning (paragraphs 21 to 32). The Scottish Office expects that in order to maintain continuity and sustain the different levels of joint planning these decisions should be taken early in 1996 and certainly no later than 28 February 1996. Councils should submit the planning structure they have adopted to SWSG as soon as possible thereafter. There would also be advantage in their publishing the structure locally.

Background

3. As this is the first circular on community care planning to be issued to unitary councils it may be useful to explain something of the background. Care in the community has long been the policy for meeting the needs of vulnerable people. It received additional impetus following the White Paper "Caring for People" and the consequent, phased implementation of the Government's community care reforms, the last and most significant tranche of which was introduced on 1 April 1993. The success of the policy depends on effective inter-agency working and collaboration across the board particularly between social work departments, health boards, housing authorities and Scottish Homes on the planning and delivery of community care services.

4. Under Section 55 of the Social Work (Scotland) Act 1968, local authorities have a statutory duty to prepare community care plans for their area in conjunction with, amongst others, health boards. All such plans are currently joint, i.e. as between the Regional/Islands Council and the Health Board, and we believe it is essential for such plans to continue to be prepared jointly. The Secretary of State has issued Directions that plans will cover a three year period, beginning in 1992 and they are to roll forward annually. Existing Regional/Islands Councils have all drawn up or are close to finalising plans for the period 1995-98.

5. Community care plans are but one of the planning tools for social work services: annual plans are required for criminal justice social work services and the Children’s Scotland (Act) 1995 contains provisions to introduce formal plans in that field. Unitary councils may wish to have regard to these wider elements in determining the management of their planning functions. Within the context of community care, complementary plans are, of course, the housing plans to be drawn up by the new councils, Scottish Homes district plans and local strategic agreements, and the local health strategies of health boards. All the community care dimensions in these plans should be founded in a common set of jointly agreed principles and objectives.

6. The main guidance on community care planning is contained in a number of Scottish Office circulars:

- SWSG1/91 "Community Care Planning" (also issued to Health Boards as SHHD/DGM(1991)1: this sets out the basis for community care planning, the requirements in the legislation on consultation, etc and the original expectations for the content of plans.

- SWSG4/93 "Directions on Consultation": this requires local authorities to state in their plans the process for consultation and requires them to consult organisations representing providers in the independent sector.

- SWSG13/94 "Directions on Purchasing": this directs local authorities to include in their community care plans a statement of their purchasing intentions.

- SW14/94 "Community Care Planning": this amends much of SWSG1/91 (also SHHD/DGM(1991)1) by revising the expected content of plans to make them more of a management tool, focused on intended action in support of strategic objectives. This is the key document on the content of community care plans.

- SWSG7/94 "Community Care - The Housing Dimension": this identifies, amongst other things, the role of housing at the strategic and operational levels and sets out the expectation that housing should be an equal partner in community care planning.

- Env 9/94: Housing Plans, Annual Policy Statements and Annual Policy Proposals

- SWSG letter of 2 February 1995: this invites local authorities in their community care plans for 1998 to disaggregate information on current and prospective services to the areas of unitary authorities.

- A wide range of guidance on community care and joint planning has been issued to the NHS in Scotland. Of particular relevance in this context are that on resource transfer (NHS MEL(1992)55) and the annual Priorities and Planning Guidance issued by the NHS Management Executive which includes as a key strategic objective the promotion of care in the community through, amongst other things, the development of strategies on a joint basis for each care group, including plans for the reprovisioning of long-stay hospital care.

7. The community care policy depends on effective inter agency working at all levels, from the strategic to the operational. In the strategic context, joint planning for community care, particularly as between social work and health, has been in place for many years. Housing is a more recent partner, though the circular "Community Care: The Housing Dimension" seeks to make up for lost ground by according equal status to housing in planning matters. The private and voluntary sectors (including housing associations), users and carers are all stakeholders in this field and their involvement needs to be properly addressed. In all areas except Strathclyde, social work and health currently share the same territorial boundaries, which is reflected in the joint planning structures. In Strathclyde, the structures are effectively at the level of the four Health Boards. Beneath these general boundaries, some areas are developing locality planning approaches (which may be at the level of either local government or convenient administrative divisions). Although this approach is not well developed as yet it has much to commend and is consistent with the thrust of section 23 of the Local Government etc (Scotland) Act 1994 which requires councils to prepare and implement schemes for the decentralisation of their business.

8. The outcome of this guidance should be substantial and effective community care plans. Those for 1995-98 should have set out the broad strategic agenda for community care and particular service and other developments to that end, the essence of which the current planning partners share. Moreover, the plan should be disaggregated to the areas of the new councils. The plans for 1995-98 should therefore provide both a policy and development lead to the new council (see paragraphs 11 and 12, and 35 and 36).

Effects of Local Government Re-organisation

9. Local government re-organisation will bring about considerable changes in structures, boundaries and personnel. While The Scottish Office wishes to minimise as far as possible the demands on local government during this period, our aim is to ensure that inter-agency planning structures for community care are put in place which take account of the new boundaries, and ensure continuity for existing community care services, developments already in train and planning in the longer term. While in some mainland health board areas there will now be a number of social work authorities instead of one as at present the bringing together of housing and social work in a single council will facilitate co-operation between these services; and in some mainland areas health, social work and housing will have the same boundaries for the first time. That said, there are a small number of cases where a new council’s area falls into more than one health board’s area. The implications for these areas are well recognized. They are complex and solutions are not straightforward. The particular circumstances vary somewhat from area to area, as will undoubtedly the management of the respective situations. The Scottish Office will maintain a close interest in the strategic development and delivery of services in these areas. But guidance of a universal nature would not be appropriate, save for it being important for both the councils and boards affected to manage their strategic responsibilities without undue burdens on either side.

10. The community care agenda is vibrant, active and substantial. It is clearly desirable that the progress made so far with the policy is both maintained and built on in the run up to the handover to the new councils. The existing planning systems can clearly act as a bridge to ensure that the impetus is maintained and every effort should be made to that end. The Scottish Office has sought to use community care plans in that regard, as described below.

Preparations for Local Government Re-organisation

11. The Scottish Office sees considerable value in using the current planning systems to ease the transition by requiring current social work authorities to provide their successors with a planning inheritance. The community care plans for 1995-98 prepared by existing Regional and Islands Councils will identify the underlying policies and strategies for the provision of community care in their area. In addition, the guidance issued in February 1995 expects these councils to identify within their plans the levels of current and planned community care services disaggregated to the areas of unitary councils. This should, therefore, provide the unitary councils with a baseline against which to consider the future services for the area. Similarly, we would expect existing housing authorities to make existing housing plans, annual policy statements and housing capital programmes available to the new councils. These councils will, in turn, be asked to prepare in 1995-96 annual policy statements and programmes, but not housing plans for 1996/97 onwards. Statements and housing programmes should cover community care housing in collaboration with Scottish Homes, and in consultation with other housing, health and social work agencies and reflect jointly agreed common principles and objectives. The Scottish Office will look at the range of plans impinging on community care to see if opportunities present themselves for harmonisation of timescales etc.

12. Initially, we would expect unitary councils to focus on planning for community care in the short term, so as to preserve and maintain community care services during the early period of re-organisation. (This recognises, amongst other things, the lengthy lead times required to deliver change.) We expect that unitary councils may, in due course, wish to develop a community care plan of their own for their area, but in the meantime The Scottish Office sees value in their taking on board the plans they inherit and concentrating on protecting the continuity of the community care agenda in concert with their partners in health, housing etc. Maintaining that continuity is imperative: disregarding existing plans, without having in place a viable alternative, is not a reasonable option.

Action for Unitary Councils

13. Under the legislation, the lead agency for community care planning is the social work authority. The new councils will, therefore, inherit that responsibility from the current Regional and Islands Councils. One of the first tasks facing unitary councils, but particularly those with new boundaries, will be to reach decisions in conjunction with their key planning partners on two important areas, as follows:

13.1 The level at which joint strategic planning will proceed.

13.2 The organisation of the joint planning structure.

The current joint planning structures may provide a vehicle for discussion and agreement on these matters.

14. One issue to which particular attention should be devoted is to ensure that housing (through the housing authority and Scottish Homes) is an equal partner in the planning process.

Planning Level

15. Currently, joint planning for community care is at two levels - outside Strathclyde, it is at the coterminous council and health board level (though this may be built up from plans developed at the district or administrative level); and within Strathclyde it is at the level of health board areas, though the process is still led by the council (which has organised its planning staff according to these areas). Unitary councils will therefore have to take a view on what is the most appropriate level for joint planning in their area. The immediately apparent options are:-

15.1 the level of the unitary council (whether or not coterminous with the health board); or

15.2 the level of the appropriate health board (clearly along with other unitary councils); or

15.3 some combination of the 2 approaches above which recognises that for some aspects joint planning at the level of the unitary council may be appropriate, but for others, eg the future balance of long term care, a wider perspective than that of the council’s area is required.

All are compatible with locality planning for smaller areas.

16. At a practical level, the first of these will accord with the territorial responsibilities of unitary councils but in many areas will equate to only part of the area covered by the relevant health board. This would mean the board having to "localise" on planning matters and the development of strategic thinking. However, this level may be too narrow to address key issues at a health board wide level, e.g. the long-stay sector.

17. The second option covers the territory of a health board and would mean in some instances a number of unitary councils grouping together to effect and lead joint planning on a scale larger than their own individual area. In disaggregating areas this would preserve intact at least one of the current planning partners, would facilitate consideration of health board wide issues and may make for easier decisions on resources. This option would mean individual councils working together to look beyond their own boundaries strategically, for which there will be a need in any event, whether achieved by this means or other fora for the purpose. Although we would expect councils to wish to produce a plan for their area it would, however, be open to the planning partners to decide whether they produced a corporate joint plan for the planning area, individual joint plans for the area of the unitary councils based on the wider strategic picture, or some combination of these.

18. The third option is a hybrid which takes the middle ground. It suggests that the level of individual councils may be appropriate for most but not all aspects of joint planning; and that aspects of a supra area nature with a wider perspective may call for planning at a different level. This option would clearly cover the scope of planning needs but would mean meshing 2 separate levels of planning to get a comprehensive perspective for the area.

19. These are matters which unitary councils have to determine locally with their planning partners according to the circumstances of the area. Relevant factors include the size of authority, whether the balance of the community care agenda is heavily localised or more closely related to wider (regional) factors and whether at a practical level authorities and their partners have or can secure reasonably quickly the specialised knowledge of community care planning which is vested in relatively few hands at present. Initially at least there may be advantage for the sake of continuity, in maintaining the present structures or something closely resembling them. This would give the new planning partners an opportunity to come to terms with current strategic developments on an inter-agency basis and give time to consider more fully the way ahead.

20. Whatever the level at which joint planning is struck, it is essential that particularly councils and health boards recognise the need to consider together strategic issues at the council/board level. Boards must not be in a position where the need for health services is addressed in isolation from the needs for parallel community care services, or vice versa from the perspective of councils.

Planning Structure

21. The second decision for unitary councils is to determine the planning structure, irrespective of the level at which joint planning is struck. The legislation places a duty on local authorities to consult a wide number of interests in their area on their community care plans. These include health boards, housing authorities, voluntary organisations representing service users and carers, housing associations, other bodies providing housing or community care services (e.g. in the voluntary and private sectors), and representatives of providers in the private and voluntary sectors. They also require to consult other council departments such as Education (including Community Education), Leisure and Recreation and Transport, etc (which also have strategic responsibilities), and also Colleges of Further Education and, as appropriate, NHS Trusts and GPs. A distinction needs to be drawn, however, between parties who have to be consulted on community care plans and those who should be more directly involved in their preparation because of their strategic planning responsibilities or as representing consumer interests, and would, accordingly, figure more prominently in the joint planning structure. Clearly the latter should be much more focused and considerably fewer in number than the organisations that should be consulted on the community care plan.

22. The joint planning structure is a partnership of key local interests led by the local authority, whose goal is to develop strategic thinking and to implement service developments across the area. The partnership needs to be effective, business like and drive forward the community care agenda, and be representative without being bureaucratic.

23. Key stakeholders in community care who would be expected to figure and be closely involved in joint planning, include:

- Members of the unitary council (social work and housing) and of the health board.

- Chief officers of social work, health and housing.

- Senior officers in other local authority departments, e.g. Education (including Community Education), Transport, Leisure and Recreation, etc and other bodies, eg local Scottish Homes Districts and Colleges of Further Education.

- Representatives of providers in the private and voluntary sectors and of housing associations and voluntary housing bodies.

- Representatives of user and carer interests.

- Voluntary organisations representing individual care groups (who would normally slot in to working groups dealing with their particular client interests).

- NHS Trusts and primary care representatives, as appropriate.

Some of these interests can be drawn together in fora such as a community care forum, a housing forum, etc on which all sectors can be represented and which can put forward collective views to the core planning structure. In the present structures such fora have generally been very effective in providing a conduit for the views they represent and in contributing positively to moving forward the community care agenda.

24. Not all the players above have an equal standing in the community care planning structure. The key partnership is between the strategic and purchasing agencies, ie social work, health boards and housing (including Scottish Homes) which should feature at most and certainly the upper levels of the structure. Other bodies with strategic planning responsibilities, eg council departments, should clearly be involved at the upper levels. Other interests, eg users/carers, providers, etc should feature as appropriate, but the consumer dimension should clearly figure at a high point in the structure. The underpinning value is that representatives of the main interests should have an opportunity through the structure to influence strategic planning at an early stage and to influence the point at which strategic planning recommendations/decisions are reached.

25. The way in which this can occur depends greatly on the structure locally. For example, the presence of an effective community care forum could be an invaluable filter for many of the interests in community care, and the chair of that forum might also be a member of the top level group. Obviously, in other circumstances different arrangements may apply.

26. The present structures and the levels of representation they afford vary considerably from area to area. The voluntary sector, whether through the presence of a forum or otherwise, is regularly represented at the top level. This usually reflects its representative/advocacy role, rather than that of a provider. As regards the latter dimension, the representatives of main providers interests (eg the private and voluntary sector) should be treated equally in that role and should be given equal access to the planning system.

27. The Scottish Office recognises that the agencies with strategic and purchasing functions have particular responsibilities not falling on the representatives of consumers, providers etc. Whether this requires separate levels of involvement in the structure, as has been suggested in some quarters, is a matter for debate. The practice at present and the guidance above suggests otherwise: as said previously, in many areas the top level or levels regularly have non statutory sector inputs.

28. There is therefore no single model of a joint planning structure. Much depends on the particular needs of the area and how they can best be accommodated in an effective working structure. The Scottish Office has, however, identified a number of features which are central to a successful structure, as follows:

- The involvement of members of councils and health boards.

- The engagement of housing’s strategic and purchasing interests as an equal partner with social work and health.

- The explicit commitment to joint planning of Directors of Social Work, Directors of Housing and General Managers of Health Boards.

- Clarity about remits and lines of accountability.

- A permanent focus on strategic developments for the main care groups but with sufficient flexibility to accommodate short-life working groups on specific issues.

- Comparable interests, eg the main providers, should have equal access to the structure.

- Appropriate to the size of the local authority/health board area.

- Getting right the levels of involvement of each set of players so as to ensure that they can feel a sense of ownership of strategic thinking without creating a bureaucracy.

- Providing the opportunity for representatives of the main interests to influence strategic planning decisions.

- Participants in the joint planning structure are enabled to recognise that they are stakeholders.

- Planning is a continuum: the plan should be a vehicle for change and development and not an end in itself. Implementation and monitoring are just as important.

29. The strategic planning structure ought to be based on permanency and consistency. That does not mean that elements within it should not have a short life. We would expect, however, that permanent groups would be formed at member and chief officer level to effect joint planning in the round and at officer level to draw up and implement strategies for individual care groups. At each level we would expect to see representatives of other interests, as identified above.

30. The annex to the circular identifies the key elements in a joint planning structure and how they might come together. It is purely illustrative. At the same time, the relationships are similar to those operating apparently successfully in many areas at present.

31. Critical points are that the remits of each group and the lines of accountability are clear and their level within the structure is appropriate. It also has to be acknowledged and understood that representatives of particular sectoral interests need to recognise that joint planning needs to be focused on strategic issues, and that their contribution should be suitably directed.

32. Present joint planning structures involve a variety of interests of the type described in the preceding paragraphs. While unitary councils serving the same territorial coverage as present Regional and Islands Councils will inherit the previous interests and body of representatives, councils in areas smaller than the current joint planning levels for community care will, if they decide on more localised structures, have to identify and develop these contacts for their own area. This may not be without its difficulties as many organisations, particularly those representing the voluntary and private sectors and users/carers may have established themselves on the basis of the present joint planning structure. In some smaller areas, key elements (e.g. in the provider network) may not exist. An initial task in some areas may therefore be to identify, facilitate and train individuals who will represent agencies and other bodies of opinion in the new, more localised joint planning structure for community care. Some areas have already begun to develop more localised approaches to joint planning which may stand them in good stead in the future.

Monitoring and Review

33. Unitary councils should keep their planning structures under review to ensure that the arrangements continue to meet their objectives and those of the interested parties in their areas.

Planning Skills and Expertise

34. Although community care planning has been in place for some years, the number of individuals in Regional Councils with established experience in this field remains relatively small. Unitary councils, particularly those in areas smaller than the previous levels of joint planning for community care, may not have, initially at least, staff with suitable experience of strategic frameworks or the development of strategic thinking. This may therefore be seen as an early training need. Alternatively, existing Regional Councils may find it helpful to allocate staff with that experience to a particular unitary council or councils to aid them in establishing their own framework.

Community Care Plans

35. Regional and Islands Councils have prepared or are close to completing community care plans for 1995-98. In the normal sequence of events these would be reviewed in April 1996. The advent of local government reorganisation requires that pattern to be adjusted and revised arrangements need to be put in place.

36. Creating a community care plan from scratch is a time consuming exercise taking probably the best part of a year. A pre-requisite, however, is that a planning infrastructure is already in place to develop thinking, to convert that to strategies, devise action plans, etc. Given that particularly in the unitary councils created from larger authorities this infrastructure has not yet begun to be put in place The Scottish Office does not expect these councils to draw up community care plans for the period 1996-99. It would, however, be open to new councils which have the same boundaries as Regional Councils, or other councils if they feel able, to review and adapt with their planning partners the plan for 1995-98, if they so wished. Current thinking is that it is more realistic for the first plans of unitary councils to be for the period 1997-2000, which would be published in April 1997.

Consultation on Plans

37. The legislation requires councils to consult a variety of bodies in their area on their community care plans, as set out at paragraph 21. In the new structure of over 30 councils, service providers in particular may increasingly be located outwith the area of the purchasing council. These organisations which may provide a substantial part of a particular service have just as much right to be aware of the council's strategic thinking as providers within its area. Councils should, therefore, decide which bodies from outside their area (be they in the statutory, voluntary or private sectors) should be included in the list of consultees on their draft community care plans. This is, of course, on top of the existing requirements to consult organisations representing care providers in the independent sector. Councils will also have to decide on the need to consult or be consulted on the plans of other strategic planners (e.g. health boards, housing authorities, other unitary councils and Scottish Homes) from outwith their area and who are obviously not part of the local strategic partnership.

Good Practice

38. The sharing of knowledge and good practice in community care is one of the ways in which progress can be assisted. The Database of Good Practice in Community Care at the Nuffield Centre in Glasgow exists to fulfill that function for all agencies in the community care spectrum (eg health, housing, social work etc), at all levels (eg policy development, planning, management and practice) and for all sectors (eg statutory, voluntary and private). But this is a two-way street in that, in order to supply advice, good practice has to be nominated. The advent of local government reorganisation provides an opportunity both to look at what has gone before and to devise new approaches. The Database already has examples of good practice in community care planning and related matters under the present structure, and would obviously wish to enhance its library of information in these and other aspects of the policy as they emerge. Organisations wishing to contact the Database, either to nominate or seek advice can do so on 0141 330 4554.

Enquiries

39. Any enquiries on the terms of this Circular should be addressed to Mrs Lorna Malcolm, Room 46A, James Craig Walk, Edinburgh, EH1 1DG (telephone 0131 244 5424). [ To holders of the SWSG Circulars and Guidance Package : This circular should be placed in Section F.16 of the volume containing "F : Community Care (Sections 11-20)" circulars. ]

Yours sincerely

GAVIN A ANDERSON JOHN ALDRIDGE DAVID MIDDLETON

Social Work NHS Management Housing Group

Services Group Executive

SOME KEY ELEMENTS IN A JOINT PLANNING STRUCTURE ANNEX

The model below does not prescribe a structure. It provides a map of key elements and options.

----- = Advisory channels —— = Lines of Accountability