EUROHEALTH

14
Transforming health services
Figure 1: Quantifying the benefits of the IDS-Reablement Service
As of September 2014, 4876 bed days saved
⅓ of hospital patients used the re-ablement service to return to their previous level of independence
65% of these patients required reablement services for up to 6 weeks
Source: Ref 10
of which 40% required a care package in addition to the 6 weeks of support
Since April 2012, ward‐based occupational therapists have assumed 806 direct access assessments
by health workers has reduced the waiting
time for assessments. See Figure 1 for more
quantified gains from this initiative.
Monitoring outcomes
This freed‐up 20% of ward‐based social workers’ workload
now redirected to other in – hospital demands
Given that each social‐worker‐administered assessment costs £158 per unit, the IDS –
reablement service saved the governement a total of £127,348 since 2012
or £54,576 per annum
Waiting times for social worker assessments have decreased from 8 to 4 days
A national framework for measuring the
impact of integrated health and social care
on the health and wellbeing of individuals
is being developed based on a series of
desired outcomes of the Health and Social
Care Integration model. The outcomes
emphasize quality and consistency of
services for individuals, carers, their
families, and those who work in health
and social care. All health boards, local
authorities and integration authorities are
jointly responsible and accountable for
achieving these outcomes. The desired
outcomes are listed in Box 2. Indicators
have been developed and linked to
outcomes in consultation with a wide
range of stakeholders across all sectors,
with significant input from the Convention
of Scottish Local Authorities (COSLA).
They have also been approved by a
Ministerial Steering Group. The indictors
are still being piloted, however, and will
need to be tested before their usefulness
can be assessed both in terms of reporting
and strategic planning. Integration
Authorities will then be required to publish
annual performance reports that monitor
progress on these indicators along with
any information on the local setting that
can help contextualize local performance.
Conclusions
In March 2013, the Scottish Government
launched its 2020 Vision. The vision
aspires to the goal that by 2020 everyone
is able to live longer healthier lives at
home or in a homely setting. Thanks to
the development of the integrated health
and social care system in Scotland the
foundations for achieving that vision
are in place in most Scottish territories.
Interventions ranging from hard regulation
to detailed integration schemes, have
ensured this transformation is tailored to
the specificities of each territory. By 2020,
Scotland will have a health care system
that fully integrates health and social care
and focuses on prevention, anticipation
and supported self-management. Day
care treatment will become the norm
where traditionally individuals have been
hospitalized. Whatever the setting, care
will be provided at the highest standards
of quality and safety, with the person at
the centre of all decisions. The focus will
be on ensuring that people get back to
their home or community environments
as soon as appropriate, with minimal risk
of re-admission’. Scotland’s integrated
health and social care model, is at the
forefront of transformational change
in Europe. Close monitoring of the
implementation and impact of the Scottish
model will be important for scaling up and
knowledge exchange.
Box 2: National health and
wellbeing outcomes
1. People are able to look after and
improve their own health and wellbeing
and live in good health for longer.
2. People, including those with
disabilities or long term conditions, or
who are frail, are able to live, as far as
reasonably practicable, independently
and at home or in a homely setting in
their community.
3. People who use health and social
care services have positive experiences
of those services, and have their dignity
respected.
4. Health and social care services
are centred on helping to maintain or
improve the quality of life of people who
use those services.
5. Health and social care services
contribute to reducing health
inequalities.
6. People who provide unpaid care are
supported to look after their own health
and wellbeing, including to reduce any
negative impact of their caring role on
their own health and well-being.
7. People who use health and social
care services are safe from harm.
8. People who work in health and
social care services feel engaged with
the work they do and are supported to
continuously improve the information,
support, care and treatment they
provide.
9. Resources are used effectively and
efficiently in the provision of health and
social care services.
Source: Ref 11
References
1
Scottish Government. Resources. Available at:
http://www.gov.scot/Topics/Health/Policy/Adult-
Health-SocialCare-Integration/Material
2
Scottish Government. Communications toolkit:
A guide to support the local implementation of Health
and Social Care Integration. Available at: http://
www.gov.scot/Topics/Health/Policy/Adult-Health-
SocialCare-Integration/Material/CommsToolkit
Eurohealth — Vol.22 | No.2 | 2016