Health and Social Care Integration – A further conversation

We asked:

From October to December 2015, we asked if we had the right priorities following our previous engagement activities. Were the targets ambitious enough? Was there enough detail? Was there anything else we should be doing in addition to the projects outlined?

You said:

The work mentioned under the nine Local Objectives does not just relate to the care group given in brackets – it does and should relate to me/us/other users too.

We did:

Strategic Plan updated:

  1. Objectives section extended to include additional examples of work against each objective.
  2. Text added to objectives section to note that although many examples give the name of a particular service or strategy in brackets, all of the objectives relate to all of our client/care groups and we intend that they all benefit from these approaches.
  3. Text added to emphasise that the examples/detail are not exhaustive and this high-level plan will be supported by the implementation of strategies related to specific themes (such as dementia, mental health) and Locality Plans that reflect differing patterns of need across the Borders.

You said:

Mixed feedback regarding the targets referred to in respect of the nine Local Objectives. Mix being:

  • Targets too ambitious
  • Targets not ambitious enough
  • Not enough targets
  • More evidence required for targets and how they link to the objectives

We did:

Further work to be done around performance monitoring.

The targets outlined in the Strategic Plan are a starting point, based on the “Core Suite” List of integration indicators prescribed by the Scottish Government. Further work will be done to develop the Performance Monitoring Framework for the Health and Social Care Partnership.

You said:

The Strategic Plan is not detailed enough with respect to actions, partnership resources, monitoring/evaluation of the work undertaken.

We did:

The Strategic Plan has been developed under the direction of the Integration Joint Board as a high level document (and its high level nature is emphasised in the final version). It is anticipated that related strands of the work in relation to commissioning, implementation and performance monitoring (amongst others) will start to provide additional detail.

You said:

Doubts that everything set out in the Strategic Plan is achievable. For example, how will it all be affordable? It tries to be “everything to everyone”. The partnership needs to be more up-front about what it will deliver and what it can’t. Some contrary views also expressed – don’t cut anything, increase spending on everything!

We did:

This is work that the Partnership needs to consider further over successive months.

You said:

The Plan should make more reference to the Third Sector and other partners, and the partnership should build closer links with the Third Sector.

We did:

Discussions are in progress with Third Sector colleagues to improve links and communications, and work together more closely.

You said:

Communications need to be more joined up. This was particularly in respect of the various health and social care teams/disciplines communicating with each other, the recipient of care and their carer. Suggestions included having a key worker/single main point of contact.

We did:

This is work that the Partnership needs to consider further over successive months.

You said:

Transport issues are a key factor for many patients/clients and/or their carer. Telecomms/telecare may be useful in some instances, but in others connectivity is slow and/or not very accessible to all in our population. Challenges around rurality are a significant concern.

We did:

Integrated Care Fund-funded transport hub project is underway. Partnership to consider further work required in respect of this often-repeated feedback.

You said:

Needs vary across Borders and between towns/rural areas and you need to take account of this.

We did:

Locality Planning work that will be done in 2016 will need to recognise and address this. The Strategic Plan commentary has been extended to outline the partnership’s arrangements for Locality Planning.

You said:

Carers need to be referred to under the list of priorities, have greater recognition and support, and be supported to be more involved.

We did:

Strategic Plan has been updated – with support for carers referenced under the “Planning for Change – Key Priorities” section. Other references to carers – in the Scottish Borders profile and the section on the Local Objectives - have been extended.

You said:

Awareness (e.g. by the primary care/acute care team) of who the carers are is low, and can feel like a tick box exercise.

We did:

This is work that the Partnership needs to consider further over successive months.

You said:

Social isolation/loneliness is a concern for many. A variety of methods are likely to be required to help alleviate this.

We did:

Community Capacity Building work is in progress. Suggest that the Partnership needs to consider this theme further over successive months.