Orkney Health and Care

NHS Orkney and Orkney Islands Council formally established a partnership arrangement in 2010 which we called Orkney Health and Care. Orkney Health and Care brought together Local Authority/Council and NHS responsibilities into an integrated management and governance arrangement with each parent body (NHS Orkney and Orkney Islands Council) continuing to retain individual organisational accountability for statutory functions, resources and employment issues.

Much has happened since 2010 including a shift in the health and care policy landscape, new initiatives, new local ambitions and importantly a deeper understanding of what our communities want from us. NHS Orkney and Orkney Islands Council remain committed to delivering joined-up care and services closer to home and support the new arrangements to establish a new Integration Joint Board.

New Arrangements

The new policy landscape requires Councils and NHS Boards Councils to integrate adult health and social care services. But also allows them to integrate other social care services, such as children’s health, social care services, and criminal justice social work functions – in Orkney we have agreed to include children and criminal justice social work functions. Our new ‘Integration Joint Board’ to be known as Orkney Health and Care became operationally from 1 April 2016, this Board is a separate legal entity and is responsible for planning, commissioning and overseeing the performance of functions delegated to it and for those services delivered by NHS Orkney Orkney Islands Council.

Diagram 1 outlines the relationship between the new Board with both Scottish Government and locally with NHS Orkney and Orkney Islands Council. Council and NHS staff working in this arrangement will continue to be employed by either NHS Orkney or Orkney Islands Council.

Diagram 1 (Audit Scotland - Health and Social Care Integration, December 2015)

Diagram 1 (Audit Scotland - Health and Social Care Integration, December 2015)

To help support our arrangement a Chief Officer, Stephen Brown has been appointed to NHS Orkney, and is seconded to the Orkney Integration Joint Board, but remains accountable to both NHS Orkney and the Council. Stephen will have a dual role and will be accountable to Orkney Integration Joint Board for the responsibilities placed on it by legislation and Orkney’s approved Integration Scheme. Caroline will also be accountable to the NHS Board and Council for any operational responsibility for integrated services, as set out in the Orkney’s Integration Scheme. The Chief Executives of the Council and NHS board are responsible for line managing the Chief Officer to ensure that their accountability for the delivery of services is properly discharged.

In addition a Chief Finance Officer has been appointed Peter Thomas, under the terms of Section 95 of the Local Government (Scotland) Act 1973, has formal responsibilities for the financial affairs of the Orkney Integration Joint Board and whilst the Board does not employ any staff it will have planning and commissioning responsibilities that will require good financial governance arrangements to be in place.

Budgets allocations from NHS Orkney and Orkney Islands Council for delegated functions have already been agreed and these have been transferred to the new Board to plan and commission future services that will deliver improvements in each of the Governments nine national health and well being outcomes.

Localities

In agreeing to establish an Integration Joint Board we are required to establish at least two localities. The Orkney Integration Joint Board in moving forward agreed that Orkney will have two localities: the Mainland which will be subdivided into the West and East Mainland and the Isles.

Localities will play a key role in strategic planning and our local GPs and other health and care professionals, along with service users and carers will through the Strategic Planning Group have an influential voice in determining how this Board plans and commissions services that deliver improvements in the nine health and wellbeing outcomes set by Scottish Government.

Strategic Planning Group (SPG)

In Orkney we have ensured that the SPG has a wide membership including people and their unpaid carers who use health and care services, health and social care professionals, third sector bodies carrying out actives related to health and social care, commercial and non commercial providers of health and social care including housing and people who can represent the interests of each localities.

The Orkney Integration Joint Board will seek the views of the SPG to inform the proposals that are contained within its Strategic Plan. The SPG will also play a key role in the annual review of the Strategic Plan. NHS Orkney and Orkney Islands Council will provide support for strategic planning through their respective strategic planning and corporate service support systems.

In addition, both the Council and NHS Board will inform the Orkney Integration Joint Board where they intend to make a change to service provision which may have an impact on the delivery of the Strategic Plan. This Plan will be reviewed to fit with Council and NHS Board planning cycles so that we begin to better align our activities within a wider community planning context.