Since the establishment of the Edinburgh Integration Joint Board and the Health and Social Care Partnership in April 2016, the delivery of health and social care in Edinburgh has understandably being going through a period of transition.
Integration of NHS Lothian and council services can help people get better outcomes by more effectively investing in the right services for each person. However, inevitably, the integration of two large organisations poses many challenges.
Across the UK and Scotland demand for social care services is increasing faster than the resources available to meet that demand. Reducing delays in providing care packages is a top priority for us all and we have undertaken a great deal of work to reduce the numbers of people delayed from being discharged from hospital.
We have moved to locality working, shortened the assessment process, and are working closely with hospital social workers and occupational therapists to reduce delays. We are starting to see results and whilst the rate of delays varies, recently we have seen a sustained downward trajectory of those waiting in hospital for a care package from 215 to 186. However I fully accept this number should be zero.
The IJB performs very well in reducing the number of unplanned admissions to hospital through a variety of work streams include anticipatory care plans and the work of our GPs in addressing health issues at home.
The issues of recruitment and retention of staff is a serious one which we’re working to address. Research on our target job market and discussions on a range of incentives are under way and a full report detailing what actions are being taken to recruit and retain care staff will be going before the IJB later this year.
That said, there is no hiding from the numbers but, at the same time, the statistics quoted for those “waiting on home care” are complex. The packages of care for individuals varies a great deal. Whilst there is a ballpark figure for individuals awaiting assessment, this doesn’t mean they have no current support service in place but that they have requested a further service and are awaiting assessment for that.
Equally, following a highly-critical inspection report from the Care Inspectorate earlier this year, we acknowledge that there are clearly improvements required in terms of performance and budgeting. Following the care inspectorate report a comprehensive action plan was immediately developed and implemented to tackle the issues raised. This is now under review by Michelle Miller, who has been appointed on an interim basis for six months, following the recent departure of the IJB’s Chief Officer.
Michelle, the city’s Head of Safer and Stronger Communities and Chief Social Work Officer, brings a wealth of knowledge, experience and, crucially, a level of continuity which will be important as we continue to work to bring Edinburgh’s health and social care services together. The city’s administration is working flat out with with Michelle on a path for the future while we find a permanent appointment.
Despite these challenges, there is evidence of many positive services being delivered to the people of Edinburgh, and it is really important that we don’t overlook the huge effort and commitment from our staff.
As I said recently in the Council Chamber, we are not trying to brush this under the carpet and are taking this extremely seriously. The welfare of our residents is paramount and we won’t rest until the issue is fundamentally improved and we are meeting the high standards of care that the people of Edinburgh quite rightly expect.
Councillor Adam McVey is leader of Edinburgh City Council