Key Decisions that Underpin How Individual Integration Authorities Operate
The information below gives you an overview of some of the key decisions that underpin how individual Integration Authorities operate.
Decisions about the Model
The Act placed a duty jointly on the Local Authority and Health Board to establish an “Integration Authority” to deliver nationally agreed outcomes for health and social care (currently nine).
The parties had the option to choose between two models for their Integration Authority: –
- A ‘Lead Agency’, where one of the authorities (NHS or Local Authority) would be responsible for delivering specified integrated functions; or
- A ‘Body Corporate’, whereby a new legal entity would be created to take responsibility for the delivery of the integrated functions, under the direction of a jointly appointed Chief Officer.
All areas except Highland elected to adopt the Body Corporate model and Clackmannanshire and Stirling decided to form a single Body Corporate to service the needs of both areas. This means that there are 30 Integration Joint Boards (IJBs) and 1 Joint Monitoring Committee (Highland) across the 32 Local Authority areas in Scotland.
Decisions about the Delegated Functions
The Act prescribed a minimum set of services which must be delegated to the Integration Authority by both parties – adult social care, adult primary and community health care, and aspects of adult hospital care that offer the best opportunities for service redesign and better outcomes. The legislation also provided Partnerships with local discretion to allow for the inclusion of further functions, such as Criminal Justice Social Work, Housing and Children’s Health and Social Care.
The minimum requirements are:
- Social work services for adults and older people
- Services and support for adults with physical disabilities and learning disabilities
- Mental health services
- Drug and alcohol services
- Adult protection and domestic abuse
- Carers support services
- Community care assessment teams
- Support services
- Care home services
- Adult placement services
- Health improvement services
- Aspects of housing support, including aids and adaptions
- Day services
- Local area co-ordination
- Respite provision
- Occupational therapy services
- Re-ablement services, equipment and telecare
- All community health services previously managed by Community Health Partnerships (CHPs) / Community Health and Care Partnerships (CHCPs)
- Community Hospitals
- AHP outpatient clinics
- Hospital services that most commonly associated with the emergency care pathway (i.e. areas where unplanned admissions dominate)
- A & E
- General medicine;
- Geriatric medicine;
- rehabilitation medicine;
- Respiratory medicine; and
- Learning disability psychiatry
- Palliative care services
- Addiction services
- Mental health services (except secure forensic mental health services).
All areas have also included general health services for children and young people.
You will find information about the additional services that each area has chosen to delegate on our integration arrangements spreadsheets.