EUROHEALTH

Transforming health services
11
DEVELOPING INTEGRATED
HEALTH AND SOCIAL CARE
MODELS IN SCOTLAND
By: Toni Dedeu
Summary: Across Europe demographic and epidemiological changes
are challenging Member States’ health systems. Scotland is no
exception. The Scottish government is integrating health and social
services to improve their quality and consistency, thereby improving
health outcomes in Scotland. A clear vision, strong political
commitment, extensive partnerships, and a health systems approach
to integrating services have all enabled integration that promotes
strong accountability arrangements, transparent joint planning, and
a clear outcomes framework. The government has provided funds
to facilitate the reform and has established clear communication
mechanisms for managing the transformational change that is needed.
Keywords: Health and Social Care, Integration, Scotland
Toni Dedeu is the Director of the
Agency for Healthcare Quality &
Assessment of Catalonia (AQuAS),
Ministry of Health, Government of
Catalonia, Spain. He was formerly
the Director of Research &
Knowledge Exchange, Digital Health
& Care Institute, Innovation Centre,
University of Edinburgh, Scotland.
Email: tdedeu@gencat.cat
Introduction
The configuration of Scottish society
is changing as are the health and social
care needs of its communities. Over the
next ten years, the number of people in
Scotland aged over 75 is likely to increase
by over 25%. Over the same time period,
it is estimated that nearly two-thirds
of the population will have developed
long-term conditions by the age of 65.
Public services will need to adapt to these
changes and be reconfigured to respond
to these emerging health and social care
needs. Since 1999, successive Scottish
Governments have been exploring ways to
anticipate and tackle these demographic
and epidemiological challenges. The result
has been the transformation of health and
social care services. 1
A step wise and participatory
approach
The transformation has involved several
phases. The transformation began
in 1999, when 79 local health care
cooperatives were established across
Scotland to bring together health and
social care practitioners to deliver a
range of primary and community health
services and promote joint working
with local authorities and the voluntary
sector. In 2000, the Joint Futures Group,
a collection of senior figures from the
National Health Service (NHS) and local
government, recommended that shared
assessment procedures, information
sharing, joint commissioning, and
joint management of services must
be developed throughout the country.
By 2002, the Community Care and
Health (Scotland) Act included powers,
but not duties, for NHS boards and
Eurohealth — Vol.22 | No.2 | 2016