1999–2003
2000
Responsibility for adult social care brought together with health under the Scottish Executive Health Department.
Our National Health: A plan for action, a plan for change 2000
Set out ambition for NHS Boards to work with local authority partners around public health improvement
Community Care: A joint future 2000
Established joint operational and strategic planning across agencies, with local authorities (including discharge planning and budgets), NHS boards, and NHS trusts to draw up local partnership agreements.
Community Care and Health Act 2002
Conferred power to transfer specific functions between local authorities and NHS including power to create pooled budgets
2004 – 2009
NHS Reform Act 2004
NHS Trusts were dissolved and community and primary care services entrusted to Community Health Partnerships within NHS Boards, charged with the management of integrated primary care and community health, and charged with strengthening links with social care.
Delivering for Health 2005
Set out a programme for the NHS system to implement the recommendations of a National Framework for Service Change and mapped patient pathways across services.
Better Health, Better Care 2007
Brought oversight and management of the NHS and adult social care within the Cabinet Secretary for Health and Wellbeing, and set out a vision for an integrated NHS based on the principles of mutualism. Introduced an Integrated Resource Framework to support strategic joint commissioning, collaborative contracts and Single Outcome Agreements, revised the HEAT performance framework, and proposed integrated workforce planning cross-sector
Improving the Health and Wellbeing of Long-Term Conditions: A National Action Plan 2009
Followed on from Better Health, Better Care to develop a vision for long-term care conditions reflective of an integrated system through models of care
Reshaping Care for Older People: A programme for Change 2011-2021 (2013)
Developed strategy to improve quality and outcomes of models of care and promoted integrated approaches to supporting older people, for example around care pathways
2010–2014
The Healthcare Quality Strategy for NHS Scotland 2010
Introduced a quality strategy to build on commitments to integrated care in Better Health, Better Care, with the establishment of a Quality Alliance to review indicators of quality across the system, and alignment of Quality Improvement with HEAT targets, and committed to building on existing integrated delivery arrangements and encouraging whole system approach to improvement.
Commission on the Future Delivery of Public Services (Christie Commission) 2011
Recommended urgent reform to public services based on collaborative working, including a new concordat between the Scottish government and local authorities to develop joined-up services, with support from funding arrangements requiring integrated provision; as well as new statutory powers and duties to promote outcomes improvement across all public service bodies with a focus on prevention and health inequalities.
Integrated Resource Framework 2011
Rolled out across four test sites to pilot Health and Social Care Partnership models, with transparent financial mechanisms via explicit mapping by NHS Boards and Local Authorities of patient- and locality-level cost and activity information for health and social care. Allowed money to flow between different care settings to ‘realign’ according to shifts in need.
Public Bodies (Joint Working) Act 2014 (enacted 2016)
Created Integration Joint Boards (and one Lead Agency in the Highlands) for Health and Social Care Partnerships and replacing Community Health Partnerships. IJBs are separate legal entities accountable to local authorities and NHS Boards, with a duty to prepare integration schemes with at minimum include governance and planning for some services. IJBs hold budget responsibility from funds channelled from local authorities (30%) and NHS Boards (70%).
2015–2020
Transformation Funds 2017/8
Provides revenue to support implementation of integration structures, and delivery of integrated services such as delayed discharges.
Joint Progress report between Scottish Government and COSLA on the Integration of Health and Social Care 2019
Made recommendations to strengthen integration including a joint understanding across NHS Boards, Local Authorities and IJBs of their respective financial positions around integration, and more collaborative work across stakeholders.
A National Care Service for Scotland – consultation 2021
Developed following the Independent Review of Adult Social Care and recommends Integration Joint Boards be reformed into Community Health and Social Care Boards funded directly by the Scottish government, with statutory responsibility to oversee the delivery of all community health and social care services.