Health and social care integration: spending and performance update

Author: Emma Butcher

PDF Published: Wednesday 26 Jun 2019 (SB 19-44)

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Overview
Report

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Overview
Report
- Executive Summary
- Context
  - Purpose of this briefing
  - History and current policy on health and social care integration in Scotland
  - Integration authority organisation and responsibilities
  - Health and social care integration funding
  - Health and social care integration performance
- Health and social care spending
  - Current health and social care spending
  - Future health and social care spending
  - Integration authority reportedspending
    
    How spending works
    
    Total budget
    
    Proportion of funding from the NHS
    
    Spending by sector
    
    Financial reporting by integration authorities
    
    Set aside budgets
    
    Reported issues with the set aside budget
    
    Data on the set aside budget
    
    Savings
- Health and social care integration performance
  - Reported performance issues
    
    Annual performance reports
    
    Ministerial Strategic Group indicators
  - Reported performance
  - 1. Number of emergency admissions
  - 2. Number of unscheduled hospital bed days
  - 3. Number of accident and emergency admissions
  - 4. Number of delayed discharge bed days
  - 5. Percentage of last six months of life spent in the community
  - 6. Percentage of population residing in non-hospital setting for all people aged 65+
  - Summary of progress
- Ongoing activity and next steps
- Case study: South Lanarkshire
- Annex A: Data sources
- Executive Summary
- Context
- Health and social care spending
- Health and social care integration performance
- Ongoing activity and next steps
- Case study: South Lanarkshire
- Annex A: Data sources
Sources

Image: Figure 1. Map of integration authorities by NHS board in Scotland …

Image: Figure 2. Objectives of health and social care integration …

Image: Figure 3. Health and social care expenditure …

Image: Figure 4. NHS health service total operating costs by sector …

Image: Figure 5. Estimated Scottish Government health and social care savings between 2016/17 and 2023/24 …

Image: Figure 6. Changes in total individual integration authority budgets over time …

Image: Figure 7. The set aside budget in principle …

Image: Figure 8. Change in set aside (as percentage of total budget) from 2017/18 to 2019/20 …

Image: Figure 9. Forecasted savings and shortfall against target for 2018/19 (by Quarter 3 2018/19) …

Image: Figure 10. Emergency admissions by integration authority …

Image: Figure 11. Unscheduled hospital bed days by integration authority …

Image: Figure 12. Total unscheduled hospital bed days across Scotland …

Image: Figure 13. Change in total A&E admissions from 2015/16 to 2018/19 by integration authority …

Image: Figure 14. Delayed discharge bed days per 100 people by integration authority …

Scottish Government. (2014). Public Bodies (Joint Working) (Scotland) Act 2014. Retrieved from http://www.legislation.gov.uk/asp/2014/9/contents/enacted [accessed 21 June 2019]

Scottish Government. (2018, October). Scottish Government Medium Term Health and Social Care Financial Framework. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2018/10/scottish-government-medium-term-health-social-care-financial-framework/documents/00541276-pdf/00541276-pdf/govscot%3Adocument/00541276.pdf [accessed 11 June 2019]

Health and Social Care Alliance Scotland. (2019, May). Health and social care integration: How is it for you? Views from the public sector. Retrieved from https://www.alliance-scotland.org.uk/wp-content/uploads/2019/05/Health-and-Social-Care-Integration-How-is-it-for-you-Views-from-the-Public-Sector.pdf [accessed 23 May 2019]

The King's Fund. (2018, June). Leading across health and social care in Scotland: Learning from chief officers’ experiences, planning next steps. Retrieved from https://www.kingsfund.org.uk/sites/default/files/2018-07/Scottish_officers_full_final.pdf [accessed 15 May 2019]

Health and Sport Committee. (2018, October 29). Looking ahead to the Scottish Government - Health Budget 2019-20: Is the budget delivering the desired outcomes for health and social care in Scotland?. Retrieved from https://www.parliament.scot/S5_HealthandSportCommittee/Reports/HSS052018R9_Budget_2019-20.pdf [accessed 12 June 2019]

Ministerial Strategic Group for Health and Community Care. (2019, February 4). Health and Social Care integration: progress review. Retrieved from https://www.gov.scot/publications/ministerial-strategic-group-health-community-care-review-progress-integration-health-social-care-final-report/ [accessed 28 May 2019]

Pearson, C., & Watson, N. (2018). Implementing health and social care integration in Scotland: Renegotiating new partnerships in changing cultures of care. Health and Social Care in the Community, 26(3). doi: 10.1111/hsc.12537

Damery, S., Flanagan, S., & Combes, G. (2016). Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews. BMJ Open, 6. doi: 10.1136/bmjopen-2016-011952

Lizzy, B. (2012, July 16). Integration of Health and Social Care: International Comparisons. Retrieved from http://www.scottish.parliament.uk/ResearchBriefingsAndFactsheets/Factsheets/SB_12-48.pdf [accessed 19 June 2019]

Robson, K. (2013, August 30). Public Bodies (Joint Working) (Scotland) Bill. Retrieved from http://www.scottish.parliament.uk/ResearchBriefingsAndFactsheets/S4/SB_13-50.pdf [accessed 19 June 2019]

Burgess, L. (2016, August 24). Integration of Health and Social Care. Retrieved from http://www.parliament.scot/ResearchBriefingsAndFactsheets/S5/SB_16-70_Integration_of_Health_and_Social_Care.pdf [accessed 19 June 2019]

Scottish Government. (2015, July 3). Localities Guidance. Retrieved from https://www.gov.scot/publications/localities-guidance/pages/6/ [accessed 21 June 2019]

Scottish Government. (2015). Integration Joint Boards by NHS Health Board. Retrieved from https://www2.gov.scot/Resource/0048/00485238.pdf [accessed 17 May 2019]

Audit Scotland. (2018, November). Health and social care integration Update on progress. Retrieved from http://audit-scotland.gov.uk/uploads/docs/report/2018/nr_181115_health_socialcare_update.pdf [accessed 3 May 2019]

Scottish Government. (2016, March). Directions from Integration Authorities to Health Boards and Local Authorities. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2016/03/good-practice-note-directions-integration-authorities-health-boards-local-authorities/documents/good-practice-note-directions-integration-authorities-health-boards-local-authorities/good-practice-note-directions-integration-authorities-health-boards-local-authorities/govscot%3Adocument/00498164.pdf [accessed 20 June 2019]

ISD. (2018, November 20). Scottish Health Service Costs: Year ended March 2018. Retrieved from https://www.isdscotland.org/Health-Topics/Finance/Publications/2018-11-20/2018-11-20-Costs-Report.pdf [accessed 11 June 2019]

Scottish Government. (2019, February 26). Scottish local government financial statistics, 2017-2018. Retrieved from https://www.gov.scot/publications/scottish-local-government-financial-statistics-2017-18/pages/3/ [accessed 11 June 2019]

Institute for Fiscal Studies. (2018, May 24). Securing the future: funding health and social care to the 2030s. Retrieved from https://www.ifs.org.uk/publications/12994 [accessed 11 June 2019]

National Records of Scotland. (2017, October 26). Projected Population of Scotland (2016-based). Retrieved from https://www.nrscotland.gov.uk/files//statistics/population-projections/2016-based-scot/pop-proj-2016-scot-nat-pop-pro-pub.pdf [accessed 11 June 2019]

Cabinet Secretary for Health and Sport. (2019, June 5). Letter from Jeanne Freeman, Cabinet Secretary for Health and Sport, on 5 June 2019 to Health and Sport Committee. Retrieved from https://www.parliament.scot/S5_HealthandSportCommittee/Inquiries/20190605_Ltr_IN_CabSecHS_pre_budget.pdf [accessed 11 June 2019]

Scottish Government. (2018, September 28). Integration Authority financial monitoring information 2018-2019; Quarter 1. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/transparency-data/2018/11/nhsscotland-and-integration-authorities-consolidated-financial-reporting-2018-2019/documents/integration-authority-financial-monitoring-information-2018-2019/quarter-1-28-september-2018/quarter-1-28-september-2018/govscot%3Adocument/NHSScotland%2Bintegration%2Bauthority%2Bfinancial%2Bmonitoring%2Binformation%252C%2B2018-2019%2Bquarter%2B1%252C%2B28%2BSeptember%2B2018.pdf [accessed 11 June 2019]

Scottish Government. (2019). Personal Communication. [No description].

Health and Sport Committee 21 May 2019 [Draft], Eddie Fraser, contrib. 82, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=12120&c=2179011

Scottish Government. (2018, October). “New deal” for NHS boards. Retrieved from https://news.gov.scot/news/new-deal-for-nhs-boards [accessed 11 June 2019]

Health and Sport Committee 04 June 2019 [Draft], Sandra Ross, contrib. 13, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=12172&c=2183816

Health and Sport Committee 21 May 2019 [Draft], Marie Moy, contrib. 102, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=12120&c=2179031

Cabinet Secretary for Health and Sport. (2019, May 20). Letter from Jeanne Freeman, Cabinet Secretary for Health and Sport. Retrieved from https://www.parliament.scot/S5_HealthandSportCommittee/Inquiries/20190520_Ltr_IN_from_CabSec.pdf [accessed 11 June 2019]

Health and Sport Committee 21 May 2019 [Draft], Eddie Fraser, contrib. 60, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=12120&c=2178989

Scottish Government. (2019, March 29). Integration Authority financial monitoring information 2018-2019; Quarter 3. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/transparency-data/2018/11/nhsscotland-and-integration-authorities-consolidated-financial-reporting-2018-2019/documents/integration-authority-financial-monitoring-information-2018-2019/quarter-3-29-march-2019/quarter-3-29-march-2019/govscot%3Adocument/Quarter%2B3%2B-%2B29%2BMarch%2B2019.pdf [accessed 11 June 2019]

ISD. (2019). Multiple and All Emergency Admissions Interpretation document. Retrieved from https://www.isdscotland.org/Health-Topics/Hospital-Care/Inpatient-and-Day-Case-Activity/Multiple-and-All-Emergency-Admissions-Interpretation.doc?14:59:01 [accessed 11 June 2019]

National Records of Scotlands. (2018, April 19). Mid-2017 population estimates Scotland. Retrieved from https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/mid-year-population-estimates/mid-2017 [accessed 13 June 2019]

Health and Sport Comittee. (2019, June 4). Meeting of the Health and Sport Committee 4th June 2019. Retrieved from http://www.parliament.scot/parliamentarybusiness/report.aspx?r=12172&mode=pdf [accessed 12 June 2019]

National Records of Scotlands. (2019, April 25). Mid-2018 population estimates Scotland. Retrieved from https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/mid-year-population-estimates/mid-2018 [accessed 20 June 2019]

Ministerial Strategic Group for Health and Community Care. (2019, May). Integration Review – Progress Update. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/minutes/2019/06/ministerial-strategic-group-for-health-and-community-care-papers-may-2019/documents/item-3-integration-review-progress-update/item-3-integration-review-progress-update/govscot%3Adocument/Item%2B3%2B-%2BIntegration%2Breview%2Bprogress%2Bupdate.pdf [accessed 20 June 2019]

Leak, P. (2019, May). MSG data review. Retrieved from https://www.gov.scot/binaries/content/documents/govscot/publications/minutes/2019/06/ministerial-strategic-group-for-health-and-community-care-papers-may-2019/documents/item-4-msg-data-review/item-4-msg-data-review/govscot%3Adocument/Item%2B4%2B-%2BMSG%2Bdata%2Breview.pdf [accessed 20 June 2019]

South Lanarkshire IJB, ). (2019). Annual Performance Report 2017/18. Retrieved from https://ihub.scot/media/5604/annual-performance-report-2017-18-south-lanarkshire.pdf [accessed 10 June 2019]

Last Updated: 3/11 3:31pm