Below is the response that East Lothian Health Network has submitted to the Scottish Executive’s consultation on Integrating Adult Health and Social Care services.
The Network decided it should only concentrate on two of the areas up for discussion: on public participation and devolvement of responsibility & decision making from the partnerships to ‘locality planning groups’. This long posting only includes responses that cover these areas, contains some jargon, and is not the full response.
Members of the network were encouraged to submit their own views especially where they wanted to comment on other areas, for example, the fact the Community Health Partnerships will be disbanded as part of the proposals.
Public Participation
With the demise of the Community Health Partnership (CHP) and by implication the PPF, the way in which public involvement might be supported is unclear not only in the context of adult services but equally for children’s services.
The current role of the Public Partnership Forum (PPF) includes networking with other health and care agencies and as such the PPF receive invitations to participate in a variety of consultations, working groups within the NHS as well as third sector and social care. The absence of the PPF might have a detrimental effect on the development and facilitating of engagement with stakeholders be they members of the public or service providers.
The hierarchy proposed in the consultation for the executive committee does not give the public (lay) representatives a measure of influence which would generally be expected in terms of good governance and accountability. The resulting unexpected consequence might be failure to maintain the confidence of the public.
Proposal for a replacement for a PPF:
Please note that the term partnership refers to the proposed health and social care partnership. A possible model could be that of an independent consumer group:
- a core group sitting outside of the partnership but supported by either the government or the partnership in terms of finance and resourcing.
The public need to have confidence that any consultation or engagement is appropriately targeted and uses a suitable variety of methods – focus groups, internet, surveys, special interest groups. They need to be confident that any response is treated confidentially, and will not affect their package of care adversely.
An advocacy service to enable harder to reach groups could be embedded within the New Forum to further enable engagement. A representative from this new forum would be invited to sit on any eventual planning group of the partnership to present the independent views of the forum for consideration.
A concern to be addressed is that of communication – when ideas and suggestions are fed up to the decision makers, there needs to be a mechanism for feed back, ensuring transparency and accountability of the decision making process.
The partnership itself needs to ensure that its membership (executives and non executives) engage with their service users and have a robust programme of engagement with and reporting back to the service users.
Devolvement of responsibility & decision making from the partnerships to locality planning groups
We acknowledge the importance of local Health and Social Care professionals being able to feed into the planning of services and there needs to be a mechanism for them to do this.
We are concerned that any one local group for example GP surgeries would not have the capacity (technical, management, financial and procurement experience/expertise of service delivery) to plan locality Health and Social Care services.
Local planning groups would be better used in providing input into the development of essential local services which feed into the (6) National Outcomes rather than being responsible for service delivery.
Composition of locality groups may well depend on where they are in Scotland and what issues the region face – the concentration/spread of population, rurality, population demographics, distances to services, transport infrastructure, industry. Membership should include representatives from local health professionals, social work agencies, voluntary and carers agencies, public representatives and allied services such as the Ambulance Service.
