Shona Robison urges faster pace of health and social care integration

The Health Secretary has urged councils and NHS boards to speed up the pace of health and social care integration after the public spending watchdog warned four-fifths of Integration Authorities have yet to submit strategic plans five months before they go live.

Shona Robison acknowledged her integration reforms present a significant task but said they must be delivered urgently to help those in need of care.

Nurses and councils said they have been working hard to deliver on the reforms, and urged the Scottish Government to abide by the recommendations of the Accounts Commission/Audit Scotland report which said ministers must do more to support integration.

The Accounts Commission said the Scottish Government must develop a clear performance monitoring system, resolve tensions, publicly report progress on cost-cutting and results, promote leadership development and shared good practice and provide clear and strategic leadership.

Opposition parties said the report couldn't be more damning'', and urged the Scottish Government to urgently review the support it is providing to health boards and councils.

Ms Robison said: Integration is one of the most significant reforms of health and social care since the NHS was established and we do not underestimate the scale of the task.

I'm clear that I expect all local partnerships to be fully prepared for the full integration of services from April next year.

I expect partnerships who aren't making enough progress to up the pace and urgency of change now - so that integration delivers the anticipated benefits for people in their area.

A key part of this is agreeing the shared budget to be controlled by the integration authority - and I would urge local partnerships to focus their efforts on making progress here.

While many partnerships have already made excellent progress in bringing together their health and social care services, we're working closely with those that require additional support.

This includes providing national guidance, tailored leadership support and sharing good practice across Scotland, as well as our significant financial contribution.

Royal College of Nursing (RCN) Scotland director Theresa Fyffe said: Everyone involved in the integration of health and social care... has been working very hard to make it happen.

However, Audit Scotland also identifies major challenges and significant risks still to be resolved by Scottish Government and the new Integration Authorities if, as the report says, integration is to help the move to 'a more sustainable health and social care service, with less reliance on emergency care'.

Many of the issues this report raises reflect what we have been saying over the last two to three years as the legislation progressed through Parliament.''

She added: If the Government is serious about quality of care and scrutiny, it must follow Audit Scotland's recommendations around governance and accountability to avoid the mistakes of the past and make sure the public knows how to access the right professional care when and where they need it.

The health and social care workforce is also critical to the success of integration, yet as this report highlights, few Integration Authorities - with just months to go - have identified a long-term workforce strategy.

This needs to be addressed as a matter of urgency.''

Peter Johnston, health and social care spokesman at council umbrella body Cosla, said: Clearly we need clarity of leadership, accountability and governance between the parent bodies and the IJBs (Integration Joint Boards).

For our part, Cosla are working hard to provide practical support for all of our councillors around the new relationship which exists between local authorities and IJBs.

It is also true that the real success of integration will be in the hands of the workforce delivering health and social care.

Cosla welcomes a recognition that we need to have to plan for an integrated workforce and together face the challenges that shifting the balance of care presents in terms of workforce.''

Scottish Labour's equalities spokeswoman Rhoda Grant said: There are clear concerns that little progress has been made in regard to workforce planning, which will lead to anxiety to both NHS and social care front line staff. The report also highlighted worrying recruitment issues amongst social care staff.

The SNP Government cannot ignore these warnings.''

Conservative health spokesman Jackson Carlaw said: With budget disagreements, staff shortages and some uncertainty about how integration will work in practice, the SNP Government need to be doing better and stepping up to the mark if this is going to work.''

Liberal Democrat health spokesman Jim Hume said: The Auditor General's report couldn't be much more damning.

This report paints a picture of a reform process in utter chaos. The Scottish Government must urgently review the support it is giving local authorities and NHS health boards and Audit Scotland's recommendations must be implemented in full.''

Green MSP Alison Johnstone said: We must ensure that the transition to integrated health and social care is truly focused on patients' welfare, not on cutting back costs.

Without decent, accessible housing and a well-paid care workforce to support families, this transition could leave many patients trapped.

It's crucial that we invest properly in adapting homes to people's needs, and think about accessibility when we build new housing stock too.''

• Local News