Frequently Asked Questions
A. Integration of health and social care is the Scottish Government’s ambitious programme of reform to improve services for people who use health and social care services. Integration will ensure that health and social care provision across Scotland is joined-up and seamless, especially for people with long term conditions and disabilities, many of whom are older people. On April 1 2016 NHS Orkney and Orkney Islands Council will form a new legal entity called an Integrated Joint Board (IJB). We will continue to call this Orkney Health and Care (OHAC), rather than develop another new brand in a bid to avoid confusion. This builds on excellent work that has been done since 2011 when OHAC was first launched. Many people will already be benefiting from integrated services for example, the Intermediate Care Team, Family Support Workers, the Single Point of Referral.
A. The Public Bodies (Joint Working) (Scotland) Act 2014 requires all local councils and NHS bodies to form a new Health and Social Care Board or Partnership. In Orkney it will build on the very effective integrated work we already have in place and give us real opportunities to change the way we get things done, so that people get an even better service.
A. A summary of the services that will be covered by the IJB is shown below.
- Social work services for adults including older people, children and families.
- Social work and social care services for people with learning disabilities, physical disabilities and/or sensory impairment.
- Mental health services including child and adolescent services.
- Social work services to the criminal justice system.
- Home care, care homes and day centres.
- Telehealth and telecare services.
- Services to support carers.
- General practitioner (GP) and general medical services.
- Dental health services.
- Community pharmacy services.
- General ophthalmic services.
- Community nursing.
- Mental health services including child and adolescent services.
- Community allied health professional services, i.e. physiotherapy, occupational therapy, dietetics and speech and language therapy.
- School health services and child health visitors.
- Maternity services.
- Drug and alcohol services.
- Community access to outpatient and diagnostic services.
Also a background note has been developed by The Scottish Government to provide further information on the legislation that sets out the scope of the health and social care functions to be included in integration. It describes which health and social care functions must and may be integrated under the legislation, to improve outcomes for people using health and social care services. A link to the document on the Scottish Government website is available from the 'Related Sites' section of this page.
A. Caroline Sinclair has been appointed as Chief Officer and is operationally responsible to the Chief Executives of NHS Orkney (Cathie Cowan) and Orkney Islands Council (Alistair Buchan). The Chief Officer will also be responsible to the Integration Joint Board (IJB) a separate legal entity whose membership is largely prescribed by Scottish Government and comprises an equal number of voting members from Orkney Islands Council and NHS Orkney. The IJB will be responsible for developing a Strategic Commissioning Plan that will set out the priorities over the next three years (2016-2019) in delivering health and social care services that have been delegated to them. The Scottish Government has set out nine key indicators known as the health and wellbeing outcomes which the IJB will be monitored against. A link to the web page on the Scottish Government website is available from the 'Related Sites' section of this page.
A joint Shadow Board has been established. This temporary Board oversees the changes needed before Legislation comes into effect in April 2016.
Membership is made up from three voting members of NHS Orkney Board and three councillors of Orkney Council, along with non-voting representatives from professional groups, the Voluntary Sector care providers and service user groups and carers. Their involvement helps shape and inform decisions.
Staff are working on a number of key areas to support the preparations for the IJB ‘going live’ on 1 April 2016. These are:
- Integrated budgets and financial planning.
- Communications and consultation.
- Workforce and organisational development.
- Governance and accountability.
- Strategic Planning.
- Information management and technology.
There is also a senior group of managers and executives from NHS Orkney and the Council supporting the move towards integration called the Integrated Programme Board. This group currently oversees the work undertaken by the groups listed above and reports to the shadow board on progress.
A. At present, all services will remain as they are. Over time, there may be changes to services in order to best meet the needs of the People of Orkney. However, any change to services will include a process of consulting people and providing information.
A. Well this is a good question! Given Orkney Health and Care was set up in 2011, the Council and NHS Orkney already have in place some things that contribute to improved ways of working and joined up services. However, the new legislation means that we have to take things a step further and delegate budgets and decision making processes to a new and separate independent legal body. Also, Orkney Health and Care are not currently responsible for all the services that will be covered by these new changes. Therefore some people may not notice a difference, where services are already provided jointly under Orkney Health and Care, and that is hopefully a good thing! But some people may notice a difference in the future as services that are not currently provided jointly, are re-designed and improved in line with your needs and views.
Services in the future should look completely seamless, from your point of view. No gaps, no fuss, no duplication – just an excellent, high quality service.
A. No, definitely not. If we work together and avoid duplication of effort we will be able to get better value for money and use our resources to better effect. We do have challenges ahead in meeting increased levels of demand for services like the rest of the country and integration should help us to achieve that.
Q9. Orkney is made up of many different areas with different needs, what are you going to do about this?
A. Places or ‘localities’ as we know them, are at the heart of integration and will become the ‘engine room’, driving changes and improvements. Orkney is a unique place, with lots of different communities often in remote locations, which means needs can be very different between one place and the next and often for very small numbers of people. We will work with the professionals who work in these locations, and the people who live there, to see how we could work differently to deliver efficient services.
In order to get our planning under way, we are going to concentrate on two ‘localities’ – one will be the Orkney Mainland but with a focus on East and West, the second will be the Isles Network of Care. Over time though we will listen to what people want, what you want, and we may need to change our approach in order to meet local needs and wishes. We want you to be part of this, to help us make the right decisions. Getting involved in the consultation on the strategic plan will be an important opportunity for people to share their thoughts and opinions with us on this and other matters.
Not all regions have an existing partnership like this, so in many ways, Orkney’s joint working has been leading the way. But, the current Health and Social Care Partnership (OHAC) was not set up to support this level of integration. It has a different scope and remit.
On the 1 April 2016, our joint working arrangements through OHAC will cease to technically exist as a result of the Scottish Government’s new Act. This will make way for the emergence of the new Integrated arrangements we have been preparing for.
The employment status of staff does not change as a result and staff will continue to be employed by their current employer.
A. Yes, of course. Through our work over many years, we have always involved our communities to ensure that their voice is heard, they are at the heart of what we do and help us make the right decisions. The Scottish Government does require us to involve and engage with our communities, but we would want to do it anyway! There will be lots of opportunities for people to say what they think, share their ideas, tell us what their fears are and what doesn’t work for them, but also what they think is good and their ideas for change. Remember, your voice does count.
We will be looking at various opportunities for people to get involved leading up to April 2016 so watch this space. In the meantime you can email us your thoughts.