Scotland has long had a vision that “everyone is able to live longer healthier lives at home, or in a homely setting”. This can be achieved through better integration between both health and social care, and between the different components of the care system, including primary care and acute care.
There have been structural, budgetary and contractual changes to help promote and support these changes:
- Integrated Joint Boards (IJBs) representing health boards and local authorities have been established throughout Scotland – reportedly the most substantial reform to the NHS in a generation.
- It is estimated that at least 60% of health board budgets and 72% of local authority social care budgets will be handed over to the IJBs.
- A new GP contract is about to be implemented. This is designed to shift workload away from GP practices and enable GPs to look after those who really need them.
- GP clusters of 6-8 practices will have oversight and direct involvement in improving the quality of all health and social care services provided to patients registered within their locality.
We will discuss these developments and parallel initiatives in Australia and elsewhere at the Whole of Health Strategies to Improve Patient Flow conference. At this point – and I recognise my thinking may evolve between now and the workshop – I will start with a mapping exercise. This exercise is intended to get a sense as to where participants feel their health systems are in relation to the integration agenda, and then to agree priorities for future work, both in the workshop itself and beyond.
Having established an agenda I would like to introduce you to our Chief Medical Officer’s annual report ‘Realistic Medicine’.
The report has been well received both in Scotland and beyond – 10 million hits and I doubt that everyone of Scotland’s 5 million population has read it. Ben Goldacre, the doctor and author of ‘Bad Science’ who recently toured Australia, greeted it thus:
— ben goldacre (@bengoldacre) January 27, 2016
I thought it would be useful to use some of the key messages in ‘Realistic Medicine’ as design features or principles for considering integration in the Australian context.
These are, of course, my own personal views and not the formal views of the Scottish Government or NHS Scotland. I look forward to discussing them with you. If anyone attending the workshop has any particular issues they would like to explore, please do mention them at time of booking and I am sure we can work them into the session.