Scotland's health and social care services are entering a period of unprecedented change. The changes will be underpinned by our vision of enhanced quality, improved efficiency and financial sustainability as we strive to address the challenges of demographic change and rising demands on public services. Our plans for integration of planning and delivery of health and social care services will provide real and tangible benefits for providers and individuals, their families and carers as we strengthen our commitment to person- and family-centred services and enhanced support for carers.
Scotland's approach to meeting the demographic challenges of an increasingly ageing population are set out in Reshaping Care for Older People: a programme for change 2011−2021 (Scottish Government, 2011). This ambitious programme aims to optimise the independence and well-being of older people at home or in a homely setting. To support this, we have committed to establishing an integrated approach to planning and delivering health and social care services that also includes integration within the NHS between primary and secondary care. We are currently consulting on plans for new legislation that will be needed to facilitate integration, including the establishment of Health and Social Care Partnerships (HSCPs) with delegated integrated budgets (Scottish Government, 2012).
The success of this work will rely heavily on strong leadership. Such leadership will be essential to drive innovation and the delivery of high quality, responsive services that are developed around the needs of people who use services and their families. HSCPs will therefore need to ensure that local professional leaders, including allied health professionals (AHPs), play an active role in, and provide leadership for, local commissioning and planning of service provision.
Professional leadership, service realignment and workforce development will all be key to realisation of our aspirations. Achievement will depend largely on AHP leaders, practitioners and people who use services, their families and carers working together and employing strategies to manage demand, prevent dependency and support individuals and their families to live healthy fulfilling lives at home, or in a homely setting, for as long as possible. "Enabling" approaches, including reablement, rehabilitation and supported self-management, will play a central role in underpinning this transformation, which will be realised in the way we support individuals and communities to be strong and resilient. In so doing, we will shift the paradigm away from over-reliance on hospitals and professional interventions from across health and social care.
AHPs are a vital part of this paradigmatic shift. AHPs are expert in rehabilitation at the point of registration and bring a different perspective to the planning and delivery of services. They are uniquely placed to exploit their expertise in "enabling" approaches through providing rehabilitation/reablement approaches and leadership across health and social care as well as driving integrated approaches at the point of care.
While I am aware that AHPs practice across all age groups and specialties, our immediate priorities and challenges undoubtedly have to focus on meeting the growing needs of the older population, those with long-term conditions and people with dementia. AHPs can make an immediate impact on the lives of these individuals and ensure resources are used to best effect by preventing unnecessary admissions to hospital or care, enabling people to live at home for longer, and providing alternative pathways to secondary care referral.
The Scottish Government established the Change Fund to enable health and social care partners to make better use of their combined resources in implementing local plans for older people. It provides bridging finance to facilitate shifts in the balance of care from institutional environments to primary and community settings and enables a refocus on anticipatory care and prevention of unplanned admissions to hospital or long-term care. We have also introduced the Early Years Change Fund, which is designed to support a significant change programme prioritising the early years of children's lives and early intervention. These signal the paradigm shift in action, working "upstream" to ensure older people get the support they need in the communities in which they live and that children get the best possible start in life.
I would encourage chief executives, directors of social work and leaders across health and social care services to utilise AHP expertise to the full as we work to deliver our shared national outcomes, with which the National Delivery Plan for the Allied Health Professions in Scotland has been explicitly aligned. Their professional leadership, together with effective multi-professional team working within the new HSCPs, will be vital to ensuring we experience the full added value integration will bring. I wholeheartedly believe that raising the visibility, accountability and impact of AHPs across health and social care will benefit all concerned.
Much success has already been achieved through the development of AHP strategic leadership in NHSScotland. I now fully expect AHP directors to be given the corporate support they require from across health and social care to strengthen their contribution to the planning and delivery of services, including use of both the Change Fund and the Early Years Change Fund. I also expect AHP directors to bring new solutions to the challenges we face and to drive the development of "enabling" approaches that will help us fully realise our aspirations for Scotland's population.
Michael Matheson, MSP, Minister for Public Health
Email: Angela Worth
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