A group of MSPs have called for the Scottish Government to put more pressure on the NHS and councils to work together on health and care services
MSPs have called for a “fundamental change” in the way the 31 new bodies created to managed Scotland’s £8 billion health and social care spending operate.
Members of the Scottish Parliament’s health and sport committee have hit out at Scotland’s Health and Social Care Partnerships (HSCPs) after the majority started 2016 without a clear budget plan.
The partnerships were created to force councils and health boards to work together and shift spending from acute services, such as hospital care, to community services that help reduce the number of people who become ill in the first place.
There is no doubt that the delivery of our health and social care needs to undergo fundamental change
Neil Findlay MSP
However, the MSPs who investigated the progress the boards have made since they launched in April this year said delays have impacted on services for vulnerable people.
The committee report into the progress of the partnerships in their first year found they have so far failed to deliver transformational change and there is no evidence of a shift in the balance of care.
MSPs are now calling on the Scottish Government do more to ensure NHS boards set their budgets in alignment with councils.
Convener of the Health and Sport Committee, Neil Findlay MSP, said: “There is no doubt that the delivery of our health and social care needs to undergo fundamental change.
“Along with increased demand on services and financial challenges, it is even more important we ensure these partnerships are working for people in Scotland.
“This is why we’ve made some specific recommendations for areas we think need to be tackled if we are to achieve the promised transformational change.”
The committee also looked at the £250 million given to partnerships to address social care and concluded the late timing of the fund and the initial lack of clarity on how the funding was to be used presented real challenges for partnerships agreeing their budgets.
Ian Welsh, chief executive of the Health and Social Care Alliance Scotland said the partnerships must also pay more attention to community organisations and the users of services.
“The committee’s report is a welcome reminder of the challenges created by health and social care integration as new Partnerships grapple with shared budgets and innovative approaches to delivering support and services,” he said.
“We must reflect, however, that integration is a means to improving the outcomes of people who use supports and services rather than as a structural change. To succeed this must demonstrate a greater focus on prevention, co-production in design and delivery as well as placing more value on the views, experience and expertise of people who use health and social care.”
MSPs also supported the implementation of the living wage for all social care workers and the Scottish Government’s commitment to its provision in future years.
However in a nod to the pressures facing many social care providers, including those working in the third sector, the report stated it is crucial that the financial resources are there to support the delivery of the living wage.
Annie Gunner Logan, chief executive of the Coalition of Care and Support Providers in Scotland, said the report highlights a disparity between the government's estimate of the cost of paying the living wage in social care and the higher amount of resource allocated to it by HSCPs.
"We would suggest that there may be a further disparity, in the sense that the final cost may be greater still than the amount spent by HSCPs," said Gunner Logan. "We know that many providers were not able to secure the full cost of implementation from all the partnerships they work with, and had to absorb it within already tightly-stretched budgets. Some providers are still struggling, at this very late stage, to sign off on agreements.
“In this context, we would be very keen to see a more detailed breakdown of how the totality of the social care fund was deployed by HSCPs: this would help us to reach a better understanding of HSCP priorities.
"We are aware of at least one partnership, for example, that appears to have used the fund to underwrite above-living-wage settlements for its own staff, whilst offering voluntary sector providers very low increases that were largely inadequate to support even the basic living wage rate for staff, never mind employer on-costs.”
The committee report backs this call and ask the Scottish Government to provide more information on how the cost of the living wage will be met in future years.
