Integration of Adult Health and Social Care in Scotland: Consultation on Proposals

Annex A: draft national outcomes for adult health and social care

A.1. Over recent years, a significant amount of work has gone into establishing outcomes and related measures for health and community/social care. With the commitment to establish an integrated approach to planning and delivering health and social care, the Scottish Government, COSLA and other key stakeholders have agreed to develop a set of shared outcomes and related indicators/measures that will underpin the delivery of the national outcomes, which form the National Performance Framework. The National Performance Framework enables partners to jointly drive and track progress towards delivery of agreed outcomes through better integration, supported by the development of Single Outcome Agreements.

Health and Social Care Quality Measurement Framework

A.2. The diagram illustrates how various sets of outcomes and indicators/measures relate to each other. It does not represent a governance structure. The three levels of measurement are defined as follows:

Level 1 - high- level outcomes used to drive health and social care quality nationally over time, where progress is reported nationally by a small set of selected national indicators;

Level 2 - publicly accountable indicators and targets for Health Boards, Community Planning Partnerships and Health and Social Care Partnerships used to drive short to medium term improvement and agreed to impact significantly and positively on the level 1 outcomes; and

Level 3 - extensive range of indicators/measures used for local improvement and performance management, including core sets of specific indicators for national programmes.

Health and Social Care Quality Outcomes

A.3. Health and social care quality outcomes are high-level statements of what health and social care partners are attempting to achieve though integration and ultimately through the pursuit of quality improvement across health and social care. It is important to be explicit about these outcomes so that people can understand what they are working towards, maximise their contribution and have a clear understanding of the indicators that will be used to measure progress.

A.4. It is intended that the proposed full set of health and social care quality outcomes will eventually replace the six Quality Outcomes, which have been developed through the implementation of the Healthcare Quality Strategy - i.e. they are not intended to form an additional set of outcomes. They are also intended to be integrated and aligned within the National Performance Framework and be included in all Single Outcome Agreements.

A.5. Following a period of extensive engagement, seven proposed health and care integration outcomes have been developed to specifically reflect the outcomes, which are expected to be improved through the integration of health and social care. In order to reflect the wider priorities of health and social care, beyond those directly affected by the integration agenda, and before these outcomes can replace the current set developed through the healthcare quality strategy, further refinement will be required after consultation.

A.6. A suite of indicators and measures for integration of adult health and social care is under development. These include measures from all three levels of the proposed Health and Social Care Quality Outcomes Framework. Development of outcomes and measures will continue over time as integration takes effect across health and social care.

Health and Care Integration Outcomes

1. Healthier living

Individuals and communities are able and motivated to look after and improve their health and wellbeing, resulting in more people living in good health for longer, with reduced health inequalities.

2. Independent living

People with disabilities, long term conditions or who become frail are able to live as safely and independently as possible in the community, and have control over their care and support.

3. Positive experiences and outcomes

People have positive experiences of health, social care and support services, which help to maintain or improve their quality of life.

4. Carers are supported

People who provide unpaid care to others are supported and able to maintain their own health and wellbeing.

5. Services are safe

People using health, social care and support services are safe- guarded from harm and have their dignity and human rights respected.

6. Engaged workforce

People who work in health and social care services are positive about their role and supported to improve the care and treatment they provide.

7. Effective resource use

The most effective use is made of resources across health and social care services, avoiding waste and unnecessary variation.