The Scottish government is proposing moving approximately 38,000 council workers to the NHS under a radical plan to look after the elderly.
Under the government's plans Shona Robison, Health Minister, said older people could get better treatment with more integrated services. The NHS would take charge of organising home care for patients who need support after leaving hospital. It's also hoped the proposals, to be taken forward by a 'lead commissioning' group with £2m of backing, would save money and cut bed blocking.
"We want to see health and social care for adults delivered in an integrated way by NHS and council social work staff working together to give a seamless service.
"Evidence from partnerships in England shows more older people can get quicker care packages, cuts in delayed discharges, reduced length of stay in acute hospitals and fewer unplanned emergency admissions to hospital".
Let me get this right. Currently some social workers are seconded from the local council to the relevant health board where they assist with problems, such as organising home care or care home places, concerning the hospitalised elderly. What is proposed is that these council staff will now be transferred onto the health board's books. The council will then become 'lead commissioners'.
So all social work services for the elderly will no longer be provided by local authorities. I presume local councils will continue to provide services for those who require home care or is this to be provided by the NHS?
Will the NHS be providing occupational therapy and such other services for those who have been discharged from hospital or will such services then be transferred back to local authorities? As a means of saving money this sounds a non-starter if it is partly duplicating services currently provided by local councils.
It would appear to be an attempt to solve the problems created by handing the care of frail patients backwards and forwards between councils and the health service. But will it? The NHS isn't any better than councils for making speedy decisions and I wonder if this change will improve the service for elderly patients.
The Herald also has some questions although welcomes the proposals in principle. However, the affable Cosla president, Pat Watters, launched a strong attack on the plans, saying that during four years of debating the issue with the minister she had 'at no time raised this idea as the best way forward'.
The government do have Lord Sutherland, who reviewed Scotland's landmark free care for the elderly scheme, on side. "The time for talking is over. It is now time just to get on with it."
I think the time for talking is only beginning. The public need to understand the implications of this plan and I'm already confused. Presently any frail person needing assistance with care contacts their local council. Will this change once these proposals are brought into practice in 2013? Is this proposal partly to redeploy local authority staff and save jobs? I'm strongly in favour of jobs being saved but would be less happy if moving these workers to the already top-heavy administration of the NHS proved to be only a process to balance the books.
I suppose the devil will be in the detail of the proposal and once the Scottish government puts it online then we can all read what the future holds.
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" The NHS would take charge of organising home care for patients"
Oh dear. What could possibly go wrong ? I envisage lots of elderly patients being pushed into hospital side rooms and forgotten about.
I see the SNP/ Lib Dem Fife Council have just voted to privatise all of their care homes. That'll work out well ;)
Have a look at the position in Orkney where the Council and the Health Board have set up a joint body to manage the delivery of adult care under a single management. Basically all OIC's adult services are transferred along with the equivalent NHS staff to give anintegrated service. Home care is there along with occupational therapy and mental health which have long been joint services. It's likely not perfect but it's worth your looking to see what like integration can be.
Confidentiality will go out the window of course. It is already happening for children their families and associated adults.
A single view of every citizen...
just as long as we don't go further down this particular "care pathway".
http://www.dailyrecord.co.uk/news/health-news/2011/02/01/death-row-drug-fed-to-dying-scottish-pensioners-86908-22890605/
It sort of makes sense, my Dad is the middle of this, a major stumbling block on discharge is the comms between the hospital and the LA in getting home care sorted out.
Just don't know if it'll be any better having it under one roof, you'd think so but...
Mmm, need more details really.
With the NHS in England being largely de-constructed in favour of privatisation; does this not show commitment to the social principles by the Scottish government?
Is this, in principle, not to be welcomed, or am I missing something?
Thinking about it RM this won't make a blind bit of difference. All it will do is increase the number of staff in the NHS.
That's similar to what Labour suggest Richard. I should think it may well work in Orkney as it's small enough to be efficient, but the big health boards here are already far too bureaucratic.
I missed that article Sheila. Doesn't it look as if we're going down that path already as LCP is already used in the Scottish NHS.
Pa Broon, I really can't see how much of a difference this will make. I mean with modern communication methods it's just as easy to email someone 20 miles away as it is at the next desk.
What matters is how quickly someone responds to the email. Aye, much more detail. It's all too flimsy.
The principle of keeping health care public is to be welcomed RA and I'm sure it is.
What I can't understand about this is why it's happening. It won't save money and I can't see it being more efficient. Social workers are already seconded to hospitals. Are they going to be more efficient being on the NHS payroll? There's something not quite fitting the spin here.
SR. More tiers of management will be required I suppose. You will have to squeeze through all the mnagers with clipboards to get to see your relative.
RM I've just been reading this in the Herald.
http://www.heraldscotland.com:80/comment/anne-johnstone/navigating-the-maze-of-our-elderly-care-system-1.1083244
If cot sides can no longer be provided for patients who need them, what hope is there?
SR. Can't access that story as I have to register. It must be The Herald preparing for a paywall or something.
I get the latest Labour news from the BBC so don't read The Scotsman or Herald these days anyway.
Jings RM, I haven't registered with the Herald or paid anything and can read it with no problem.
The Scotsman is another matter, but then it's a Labour paper.
It's weird SR. The page is there for about a second then shortens to a few lines of summary and a request to register. Maybe because I copied and pasted your link into it or something.
RM, if you're interested, email me and I'll copy and paste the whole article into my reply. I can't help further because I'm useless with technology as you know.
The email address is in the RH column.
SR. Just been on and managed to read the article thanks. I'm similarly technophobed ;)
Very interesting.
Glad you've read it RM. I believe every word she says because she's going through the 'system'.
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