Consultation on the Draft Regulations relating to the Public Bodies (Joint Working) (Scotland) Act 2014 (Set 1 of 2)

ANNEX 4(A)

PROPOSALS FOR NATIONAL HEALTH AND WELLBEING OUTCOMES RELATING TO THE PUBLIC BODIES (JOINT WORKING) (SCOTLAND) ACT 2014

CONSULTATION PAPER

Integration Authorities will have responsibility for the planning and resourcing of a significant proportion of health and social care services across Scotland. It is important that each Integration Authority has a consistent framework against which to plan, report and account for its activities so that the Integration Authority, the Health Board and Local Authority, Scottish Ministers and the public can assess progress made to improve outcomes locally and in different parts of the country.

An outcomes based approach encourages us all to focus on the difference that we make and not just on the inputs or processes over which we have control. The national outcomes for health and wellbeing under the Act need to strike a balance between national prescription and local flexibility. Moving to an outcome-based approach for health and social care will require a shift in culture and practice.

The health and wellbeing outcomes must therefore reflect the experience of people who use services and people in the workforce who are involved in planning and delivering person-centred care.

Scottish Ministers recognise that there must be a clear understanding of the purpose of each outcome, and each national outcome, and its relevant indicators, will be explained and expanded upon in guidance. Measurement of each national health and wellbeing outcome will rely on nationally gathered data to ensure consistency of definition and collection methodology. Indicators in support of the national outcomes are in development.

An outcomes working group of key stakeholders, including the third sector and service-user and carer organisations, and jointly chaired by a Community Health Partnership Director and Social Work Director is established. It was established to develop outcomes relating to health and social care, and associated indicators for tracking progress towards them. The Group has been working with Scottish Government officials to develop the draft outcomes.

The nine draft National Health and Wellbeing Outcomes, including a description of each outcome, is as follows:

Outcome 1: People are able to look after and improve their own health and wellbeing and live in good health for longer.

Policy Background: Integrated health and social care services must be planned for, and delivered, in person-centred ways that enable and support people to look after and improve their own health and wellbeing.

Our aim is to promote action to support a Scotland where people have the information, means, motivation, and opportunity to make the most of their genetic inheritance and to live a healthy life for as long as possible. Integrated health and social care services can influence this by the provision of appropriate information, and by working with individuals to identify how the assets the individual has, or can access in their local family/community, could support people to make those changes to happen.

Outcome 2: People, including those with disabilities, 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.

Policy Background: Successful integration of health and social care services will provide for more people to be cared for and supported at home or in a homely setting. This outcome aims to ensure delivery of community based services, with a focus on prevention and anticipatory care, to mitigate against inappropriate admission to hospital or long term care settings. It recognises that independent living is key to improving health and wellbeing, and responds to Scottish Ministers' commitment to support the reshaping of services to better care for and support the increasing number of people with complex needs in Scotland.

Outcome 3. People who use health and social care services have positive experiences of those services, and have their dignity respected.

Policy Background: It is important that health and social care services take full account of the needs and aspirations of the people who use services. Person centred planning and delivery of services will ensure that people receive the right service at the right time, in the right place, and services are planned for and delivered for the benefit of people who use the service. For people who use care and support services, their experience of those services should be positive, and should be delivered for the person rather than to the person.

Outcome 4. Health and social care services are centred on helping to maintain or improve the quality of life of service users.

Policy Background: There is unwarranted variation and inconsistency in the quality of care and support for people across Scotland. Everyone should receive the same quality of service no matter where they live. It is therefore important that we continue to improve the quality of our care services and address inconsistencies. This national health and wellbeing outcome provides for an on-going focus on continuous improvement in relation to health and social care services.

Outcome 5. Health and social care services contribute to reducing health inequalities.

Policy Background: Health inequalities can be described as the unjust differences in health which occur between groups occupying different positions in society. Health inequalities can occur by gender, income, social class, deprivation, educational status, ethnicity and geography and are the result of systematic and socially modifiable difference, not random variation. This outcome reflects the contributory role that health and social care services have in addressing health inequalities.

Outcome 6. People who provide unpaid care are supported to reduce the potential impact of their caring role on their own health and well-being.

Policy Background: Scottish Ministers recognise the key role played by unpaid carers. This outcome reflects the importance of ensuring that health and social care services are planned and delivered with a strong focus on the wellbeing of unpaid carers.

Outcome 7. People who use health and social care services are safe from harm.

Policy Background: In carrying out their responsibilities under this Act, Health Boards, Local Authorities and Integration Authorities must ensure that the planning and provision of health and social care services protects people from harm.

Outcome 8. People who work in health and social care services are supported to continuously improve the information, support, care and treatment they provide and feel engaged with the work they do.

Policy Background: It is important that the people who work in health and social care services are supported to carry out their vitally important role to a high standard, and that they feel engaged with the work they do and the people for whom they care, in order to improve the care for, and experience of service users.

Outcome 9. Resources are used effectively in the provision of health and social care services, without waste.

Policy Background: Scottish Ministers intend that health and social care services should be integrated from the perspective of the person receiving care. A key policy driver for integration is the growing population of people with multiple complex needs, many - though not all - of whom are older people. Preventative and anticipatory care can play a particularly important role in achieving better outcomes for people with multiple complex needs, helping to avoid or delay admission to institutional care settings and enabling people to stay in their own homes and communities for as long as possible. If people's needs are not anticipated, and opportunities to prevent the need for institutional care are not met, people can find themselves in institutional care too early, and for too long. Not only does this situation represent a poor outcome for the person, it is also a poor use of resources that could be better deployed on other forms of care, for that person and the wider community. Health and social care services must therefore be planned for, and delivered, in ways that make best use of available resource while at the same time optimising outcomes for patients and service users. These considerations must be taken account of by Integration Authorities in fulfilling their legal duty to achieve best value.

These Regulations prescribe these nine National Health and Wellbeing Outcomes under the power conferred by Section 5(1) of the Act.