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The countdown to health and social care intergration is underway, says Alex MacKinnon, RPS director for Scotland

IN SCOTLAND health and social care integration is on its way to becoming a reality, with all partnerships expected to be fully up and running by April 2015. While budgets, functions and structures are discussed and coming together and joint strategic commissioning plans are agreed with a focus on person-centred care delivered from an ethos of co-production, less clear perhaps is where we are in terms of professional governance, leadership and accountability.

My key challenge to everyone involved is: are we on course for healthcare professionals working together to achieve optimal patient outcomes? Are we creating the opportunities to develop and build relationships across the professions?

The Christie Commission (June 2011) was clear: €Effective services must be designed with and for people and communities €“ not delivered 'top-down' for administrative convenience.€

The Scottish Government has set out principles for integrated health and social care, including: nationally agreed outcomes for health and wellbeing; integrated governance arrangements; integrated budgets; integrated oversight of delivery; strategic planning; and locality planning. That is fine, but my question is: €What about the front line?€

It has been consistently highlighted that health and social care is not about structures, but about our collective values, about how we support everyone to have choice, dignity and control to live an ordinary life.

Cultural changed needed

In our submissions to the integration proposals we highlighted the need for cultural change underpinned by professional leadership, sharing of best practice and leading by example. In short, we need professional and clinical integration €“ system and organisation integration will not be sufficient. Our proposals for moving forward together include:

€¢ Learning together to encourage professions to focus on what they can contribute by looking at the full range of patient needs

€¢ Listening to patients and health and social care colleagues

€¢ Letting go of old ways of working and territory

€¢ Leadership at practice level to achieve professional integration against a backdrop of an increasing number of professionals in increasingly complex systems.

If we are to get it right, then compassion needs to be centrestage with collaboration replacing competitive behaviour between professionals.