Audit Scotland says new health and social care integration boards must shift more cash to community services if they are to succeed
Scotland’s new health and social care authorities must explain how they are going to spend more of their £8 billion budgets on community health services.
A report from public service watchdog the Accounts Commission and Audit Scotland into progress towards the new authorities, which will come into existence in April, highlighted a series of difficulties that could prevent them from radically changing the way health services support Scotland's aging population.
It said budget agreements, governance arrangements and workforce planning could all get in the way of the fundamental changes Scotland needs to make.
There's a real and pressing need for integration authorities to take the lead now and begin strategically shifting resources towards a different, more community-based approach to healthcare
A 75% increase in people living with dementia in Scotland to over 100,000 by 2031 is just one of the looming problems facing health services in Scotland.
Shifting budgets from providing acute hospital services for people who are already in severe need to community based, preventative care at home, is thought to be key to addressing this problem.
The new Integration Authorities (IAs) aim to ensure NHS health services and local authority funded care services work closer.
However, while all 31 IAs are expected to be operational by the 1 April deadline, the report states that significant risks must be addressed if integration is to provide the substantial changes needed to health and social care.
The report states that IAs must set clear targets and timescales to demonstrate how integrated services will deliver care differently, to better meet people's needs.
Douglas Sinclair, chair of the Accounts Commission, said: "Millions of people in Scotland need and rely on health and social care services, and we know that demand is likely to increase in the years to come.
"Integration has the potential to be a powerful instrument for change, and the Scottish Government, NHS boards and councils have done well to get management arrangements in place.
“However, there's a real and pressing need for integration authorities to take the lead now and begin strategically shifting resources towards a different, more community-based approach to healthcare."
As a major deliverer of social care services and preventative community services, the third sector is expected to play a major role in the new authorities.
Ian Welsh, chief executive of the Health and Social Care Alliance Scotland, added: “Whilst we recognise the challenges faced by health and social care partnerships in reconfiguring services and jointly managing budgets, the concern for people who rely on health and social care to claim their right to live well is how disjointed experiences will be avoided.
“In our view, further work is required to create a cultural change in health and social care that benefits from the expertise of people who use the system, and as such strategic planning processes, infrastructural change and staff training must all be geared towards this end.”
