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Where is the thinking on Health and Social Care integration in Scotland?

20 Dec

This is primarily a teaching blog, and I apologise for hi-jacking it today for non-teaching thoughts, but short of starting a new blog for the purpose I can’t think of a better way to ask this question.

I have two major parts to my career: medical education and public health. As a public health consultant, I could be seen as having the short straw of being the lead for Older People, which in turn makes me the lead for Health and Social Care Integration, a process which becomes law in Scotland in 2015, and has many administrative and political hoops between now and then.

I don’t see it as a “short straw” though. After all, being able to play a pivotal role in designing and implementing change that will have an impact on thousands of people, and ensuring that those plans are sustainable in both an ecological and financial sense is an incredibly exciting thing. And although I’m new to this field, I’m surrounded by dedicated and enthusiastic people who really want to see this opportunity maximised and the benefits reaped.

So here is my question: why is it so hard to find any discussion of the topic outside the official documentation? I did my Public Health training in England, where I am aware that they are also working on this topic, yet the political schism between market-driven England and left-leaning Scotland means that there seems to be no appetite to compare and contrast with (even, whisper it, learn from) each other.

Scotland is a small country, I grant you. The community making these changes and decisions is smaller still, and I feel sure that the difference in scale makes dissidence less anonymous. But surely there should be some commentary, some cross-referencing? The total health and social care budget for older people in Scotland is estimated at £4.5 billion – doesn’t that deserve some scrutiny to ensure the changes we make are the right ones?

My plea to you, reader, is to help me find it. I like to be sure I’ve considered as many viewpoints as possible before I make firm decisions, so please, point me at them!

See also: The King’s Fund work on Integrated Care. Which is excellent, but very Anglo-centric.