Single Shared Assessment Indicator of Relative Need: Operational Guidance Users Handbook

Guidance to assist implementation of SSA-IoRN


Renaming the Resource Use Measure (RUM) to Single Shared Assessment - Indicator of Relative Need

The Scottish Executive Joint Future Unit have agreed in consultation with representatives from the partnership areas to review the term Resource Use Measure (RUM) in order to more appropriately reflect the fact this is a standardised process which "falls out" of the Single Shared Assessment and provides an indicator of relative need.

In terms of the operational guidance for practitioners and managers which has been developed in partnership with our implementation sites, there are references to the RUM. A decision was made to retain the RUM identity for some material, however, in terms of future implementation and roll out plans from 1 April 2004 we will use the term "Single Shared Assessment - Indicator of Relative Need".

This is a significant milestone in terms of the development and implementation process, which we believe has been driven by the front-line practitioners, who have had a "strong voice" with the Scottish Executive in terms of shaping social policy and implementation plans.


The operational guidance has been produced to assist partnerships implement the SSA-IoRN across Scotland and will provide a useful reference/guide for both practitioners and managers. The Users' Handbook is aimed at practitioners, for use on a day-to-day basis, the Resource Pack provides more detailed information for reference purposes. This guidance will support the implementation process benefiting from the experience gained during the development and initial implementation phase of SSA-IoRN. It covers a range of issues on a broad basis from experience without being too prescriptive. We plan to issue the Users' Handbook in a ring binder file to allow it to be updated as implementation evolves. The Resource Pack will be on CD ROM only and each partnership area will receive 10 copies. The Users' Handbook and Resource Pack will also be available on the Scottish Executive Joint Future Unit (JFU) website from April/May 2004. Any updates to the guidance will be placed on the website only.


Single Shared Assessment (SSA) for older people needs to be in place before the SSA-IoRN can be applied. The SSA is key to providing good quality information on the individual's needs which will enable the practitioner to respond to the specific SSA-IoRN questions.

The SSA-IoRN is a questionnaire comprising 12 questions that draw on the information a practitioner will already have gathered from an individual's assessment of need (SSA). The SSA-IoRN will place people over the age of 65 into groups according to their level of relative need. The development of the SSA-IoRN originated from the Minister for Health and Community Care's response to the Royal Commission on Long Term Care October 2000. Its development was undertaken within the framework of the Joint Future Agenda and is consistent with the principles underpinning joint resourcing, joint management and single shared assessment.


The development process was an interactive process drawing on the expertise of front- line practitioners and managers. Development was undertaken in 2 phases: the first phase involved 4 partnership areas which increased to 9 testing 2 questionnaires. The data was subsequently analysed which resulted in one questionnaire being produced. The second phase involved 29 sites testing the new questionnaire. Following the development phase the Report on the Development of a Resource Use Measure for Scotland (circular CCD 9/2002) and recommendations was presented and accepted by Ministers in August 2002. Incremental implementation across Scotland started in January 2003 within 5 partnership areas; Orkney, Perth and Kinross, East Renfrewshire, South Lanarkshire and Glasgow.

Early Implementation

The 5 sites began implementing the SSA-IoRN within defined geographical patches in January 2003. Work has been ongoing and the SSA Team continue to support these sites. To support implementation a Learning Network was established in June 2003 to bring key people (practitioners, managers, IT representatives) from the early implementation sites together to share knowledge and address implementation issues. Members of the Learning Network have played an integral part in progressing implementation and have informed a number of issues such as the Direct Access paper, rewording of the guidance within the questionnaire, planning uses, Care Assessment Data Summary (previously known as RUM-ICADS), the training framework, the quality assurance framework and the early evaluation work.

Experience from the sites has indicated that some of the key components that will help partnerships implement the SSA-IoRN are:

  • co-located/integrated teams

  • meeting Joint Future Agenda aims/objectives

  • good leadership

  • good support frameworks both locally and nationally


Partnerships will have a range of training plans to cover different areas including induction, specialist on the job training etc. A training framework based on the experience of the 5 partnership areas has been produced to guide implementation in other areas for the phased roll-out. This can be found within the Resource Pack available from the Joint Future Website Copies of the SSA Team's Briefing and Guidance for Implementation and Process Summary are enclosed within this pack.

Quality Assurance (QA):

During early implementation a quality assurance exercise was undertaken within the 5 sites and a report detailing the results are published in the Resource Pack. It was agreed that partnerships would develop local protocols within a Quality Assurance Framework. A Quality Assurance Framework was subsequently developed in partnership with the Learning Network and is available in the Resource Pack.

Direct Access

During early implementation it became apparent that some partnership areas would not be applying the SSA-IoRN to every assessment of older people. Some areas were looking at direct access for certain services without the need for a full assessment. A scoping exercise and report was produced and is published within the Resource Pack.

Planning Uses

The use of SSA-IoRN as a planning tool will develop and evolve during the implementation process. The early implementation sites undertook a consultation exercise to consider initial experiences and potential uses of the SSA-IoRN. Examples from each of the early implementation sites can be found in the Resource Pack. The RUM-ICADS paper also outlined possible uses of the SSA-IoRN.


During implementation close links have been maintained with eCare and SSA developments. IT and information sharing systems will continue to evolve and, with the help of Modernising Government Funding (MGF) more robust IT systems will be in place to help partnerships with SSA and SSA-IoRN. The SSA-IoRN has been incorporated into Carenap. Partnerships who are about to develop or developing their own IT systems should consider incorporating the SSA-IoRN. One partnership who have already done this is South Lanarkshire. They have incorporated SSA-IoRN into their SWiSplus (social work IT system) and are currently incorporating it into PIMs (Health IT system).

Review of Early Implementation

A review on the early implementation of SSA-IoRN within the 5 sites was undertaken by Craigforth Consultancy. The main aim of the work was to review the processes used to implement the SSA-IoRN, highlight what went well, any problems encountered and how the problems were dealt with. The Report and Research Findings are in the process of being published. These will be available through the Scottish Executive publications website (

Further Information

Further information on the Joint Future Agenda generally and/or SSA-IoRN can be obtained at

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