CHSCP - Principles - Social Work Scotland

Duncan MacAulay, Social Work Consultant,
ADSW Partners for Change
Dawn Sherwood, Head of IT and Support Services,
Orkney Islands Council
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Shadow CHSCP - ‘Orkney Health and Care’was established on 1st April 2009
Substantive arrangements from April 2010
Integrated management structure endorsed
February 2011
Not finished yet!
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To determine how OIC and NHS Orkney were
going to work together building on current
arrangements within health and social care
Joint discussions between elected members
and NHS Orkney board to discuss the
principles of possible future partnership
arrangements
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Aspirations
Benefits
Scope
Management/ Delivery Model
Financial Management
Governance
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Council Priorities
 Care for our older & other vulnerable people
 Improved services & facilities through increased joint
working
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Community Planning Priorities
 A healthy caring community with health and social care
services for all who need them
 A community where everyone may live, work, visit and
play safely without fear of risk or harm
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Better community wide integrated management &
governance
 Joint management and service delivery structures
 Reducing bureaucracy and duplication
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More effective planning and commissioning of
services
 Aligned policies and procedures
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Improved and effective integrated service provision
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Improved and more integrated practice
 Addressing service pressures e.g. delayed discharge
 Shifting the “balance of care”
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Retained FOR Orkney WITHIN Orkney
 Services
 Jobs
 Sustainability
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Increase the proportion of people needing
care or support who are able to sustain an
independent quality of life as part of the
community, through effective joint working
 Supported by 16 community care measures:
 To deliver these successfully we must deliver a
“whole systems” model of care through integrated
services
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Achieved through
 Improved access to advice and help
 Improved assessment and decision making
 Faster and more effective delivery of services and
packages of care
 Less risk of errors through reduction in processes
 Maximum opportunity for users and carers to
control/influence the delivery of their care
(personalisation)
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Achieved through
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Greater ownership of objectives and plans
More effective use of resources
Ownership of joint information and data
Better access for public/clear pathways
Better organisation of practice e.g. joint teams
Improved assessment and care management
Improved decision making process
Single Shared Assessment
Director
Joint Appointment
Joint Management
Chief Social Work Officer?
Senior Management
Functional
Service Delivery
Thematic
Financial Management
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 Aligned budgets
 Over/ under-spends
 Funding bids/ Budget monitoring
Governance
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Full Council/NHS Board
OH&C Board
Social Services & Housing Committee
Joint Director
Community Planning Health & Wellbeing Forum
Head of Children &Families,
Criminal Justice and Primary
Care
All Children’s Services including
C&F Social Work
Fostering and Adoption
Residential Child Care
Through Care/After Care
CPC
Criminal Justice
GPs and Nurse Practitioners
Dental Services
Managed Clinical networks
Health Visitors
School Nurses
Maternity Services
Paediatric AHP Services
Head of Health and
Community Care
And CSWO
Adult and Older People’s Services (including
Learning and Physical Disability) including:Adult Social Work including
Emergency Out of Hours
Residential and respite services
including supported accommodation
and extra care housing
Day care
AHP Services including community
services, equipment and adaptations
and Telecare/Responder services *
Mental Health Services including
CAMHS*
Substance Misuse
Home Care and re-ablement
APC
Community Nurses
Intermediate Care
Director of
Nursing,
AHPs and
Midwifery
Lead
Nurse
Clinical
Team
Leads
Lead AHP
Clinical
Team
Leads
Medical
Director
Lead
Midwife
Lead GP
CADO
Chief Social
Work Officer
Principal
Social
Worker Adults
CJ Service
Manager
Principal
Social
Worker Children
Clinical
Team
Leads
Overall – a 25% reduction in
management / senior posts including all
professions and both OIC and NHS
Senior Social
Work
Practitioners
Senior Social
Work
Practitioners
Full Council
NHS Board
OHAC Board
6 x Cllrs
concurrently meeting sub
committees of Council and NHS
OIC Business
5 x NHS Board
Members
NHS
Business
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Shared vision
Strong leadership
Trust
Common desire
Good relationships
Communication
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Fulfilling the full range of functions and
processes of two organisations
simultaneously
Incompatible systems and processes
IT
Co-location
Cultural differences
Change management challenge
Doing it all while also doing all the day job!
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NES – SSSC funded process
Three full day sessions drawing on feedback from
staff and taking an action learning set approach to
support future planning
Noted a great deal of achievement
More work to be done to embed work underway
Greatest pressure / confusion arising from the
change is on Operational Managers / Clinical /
Professional Leads
Some realignment of services is needed
No desire to unpick any of the integration to date
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Issue 1 – clarification of the roles and responsibilities between
operational managers and clinical leads / senior practitioners
and putting structures in place to facilitate effective working
Issue 2 – difficulties in exchange of communication and
definition of roles and responsibilities in complex cases
involving multiple teams
Issue 3 – enabling service specific variation across services /
teams, within the overall standardised framework
Issue 4 – where there is more than one post of the same
nature, enabling staff to take a key lead role in specific
subjects, within the overall standardised remit
Issue 5 – addressing the challenge of workforce planning and
succession planning
Issue 6 – consideration to be given to the alignment of services
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Statutory Social Work services must not be fragmented
if this can be avoided.
The professional social work structure and management
structure should not be reduced further and a review
should be undertaken on the senior management
structure.
Consideration should be given to the arrangements for
the CSWO given that the CSWO’s functions are extensive
and there are now fewer qualified social workers within
the management structure to delegate activities to.
1. Lead Agency – Local
Authority
The model has greatest democratic
accountability. No fragmentation of social
work
2. Body Corporate
Model of least change and still maintains
democratic accountability. Addresses
current governance issues. If all services
are included no fragmentation of social
work
3. Lead Agency – NHS
Council transfers services to NHS but
retains a scrutiny role. Limited democratic
accountability. Possible fragmentation of
social work
4. Joint Lead Agency
Limited perceived merits, duplication of
structures and reduced democratic
accountability. Possible fragmentation of
social work
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Same as in 2008
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Benefits for Service Users
Management and staff arrangements
Professional links
Scope
Finance
Support functions
Organisational links
Governance and democracy