Health and social care reform suffering from poor planning

'¨Fragmented leadership and poor planning is crippling attempts to shake-up Scotland's health and social care services, the public spending watchdog has said.

Demands of an ageing population is increasing pressure on NHS. Picture: Katarzyna Bialasiewicz
Demands of an ageing population is increasing pressure on NHS. Picture: Katarzyna Bialasiewicz

Audit Scotland warned today that the current system is “unsustainable” and ambitious changes are not moving quickly enough to cope with soaring numbers of older people with complex health needs, and an ageing GP workforce. A clear plan on how to achieve the Scottish Government’s 2020 vision, where more people will be cared for at home, must be produced by the year end, the report said.

This is the second time the watchdog has spoken out in three months, raising concerns in December over £8 billion plans for health and social care integration due to start from 1 April.

Medics said health and social care services were facing a “perfect storm” due to budget cuts and rising demand.

Auditor General Caroline Gardner said: “An ambitious vision can be a catalyst for change but, without a clear and detailed plan of action, there’s a risk that ambition is overtaken by circumstances. Current health and social care models are unsustainable but with the right services in place, many people could avoid unnecessary admissions to hospital, or be discharged more quickly.”

The health budget decreased by 0.6 per cent in real terms between 2010-11 and 2014-15 to £11.85 billion while overall funding for councils decreased by 5.9 per cent in real terms to £10.8 billion, the report said.

Shifting resources into community services has stalled with hospitals continuing to consume more than half of the available money, warned Theresa Fyffe, Royal College of Nursing Scotland director.

She said: “The whole system is creaking at the seams, with real-time budget cuts and increasing demand creating a perfect storm in health and social care services.

“Transformational change needed to ensure services are sustainable is not happening nearly fast enough.”

Liberal Democrat health spokesman Jim Hume said: “The current system is unsustainable and there is no sign that the SNP recognise the scale of the challenges that we are facing.”

Health secretary Shona Robison said: “We recognise Scotland’s health and social care services are facing new demands – that is exactly why we’re integrating adult health and care so that everyone gets the care they need, in the right place, at the right time.

“We do not believe the report fully takes into account the further £250 million investment we have made in our 2016-17 budget for health and social care partnerships.”