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NHS Orkney and council tensions stall health reform

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The integration of health and social care in Orkney is struggling because of tensions between the NHS and local authority, says Accounts Commission

Plans to improve health services in Orkney are in trouble because of tensions between the local authority and health board, a watchdog has said.

A report from the Accounts Commission and the Auditor General for Scotland says it is extremely disappointed at poor progress towards the integration of health and social care services in the area.

Changes to health services in local areas are being rolled out across the country as a result of new Scottish laws that call for health boards, local authorities and the third sector to work in partnership.

The move aims to ensure a shift in the focus of health services from acute hospital care to preventative services within the community.

However, despite good examples of island bodies working well together, the Orkney Community Planning Partnership (CPP), which is made up of representatives of all sectors, is not following these examples, the report says. It states all partners need urgently to agree priorities and align resources to deliver them.

In its findings, the commission said: "We note with serious concern that tensions between Orkney Islands Council and NHS Orkney have held back progress in community planning. It is imperative that those two bodies address and resolve issues between them.

"But we emphasise that all partners need to fulfil their responsibilities to work together to fulfil the CPP's objectives. It is the responsibility of each partner, and of the CPP, to fulfil its obligations and to ensure improved outcomes for the people of Orkney."

The CPP steering group had identified three priorities but still not agreed how and when to take them forward. The report found it is not using Orkney's scale and agility to best effect.

An overly complex structure makes it difficult for partners to contribute effectively and only just over half of last year's targets were met.

This comes despite a strong track record from the CPP in involving the voluntary sector to support communities living on the outer isles.

Douglas Sinclair, chair of the Accounts Commission, said: "Community planning is not delivering what it should for the people of Orkney. The partnership is aware of some of the areas in which it needs to improve, but has been slow to implement necessary changes and improvements."

"There is substantial potential for it to build on vibrant community engagement and the strength of the voluntary sector to deliver better services. But this needs effective leadership from the top to make it happen."

Orkney MSP Liam McArthur said the partnership needs to learn from the report.

“The findings are very disappointing,” he said. “Orkney has always prided itself on the way we pull together as a community to deliver for those living and working in the islands. Indeed, the Accounts Commission has commented on the vibrancy of community spirit and strength of voluntary sector in Orkney.”

Sally Inkster, chief executive of Orkney Housing Association and chair of the partnership liaison groups, said: “Many of the recommendations made are in line with improvements already planned for the way community planning is delivered in Orkney.”