By David Williams

THE sudden departure of Robert McCulloch-Graham, the second chief officer from Edinburgh Health and Social Care Partnership (HSCP) in as many years, is saddening, not least because it gave health and social care integration naysayers the chance to say: “Told you it wouldn’t work.”

But the positive impact HSCPs are having across Scotland can be clearly seen. Hospital bed use is being reduced as people are increasingly cared for at home or closer to home in homely environments.

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Bureaucracy is being reduced as frontline health and social care staff work together and there are significantly increased levels of partnership within communities and with the voluntary sector up and down the country.

Innovative ways of working are being planned and progressed through Integration Joint Boards (IJBs), the governing bodies of HSCPs, to better meet the needs of those who require our services.

Take the decision by Glasgow City IJB to make progress with the development of a safe drug consumption facility for some of the city’s most vulnerable citizens.

In Aberdeenshire the Virtual Community Ward is making a material difference to hospital admissions for older people, when previously it seemed like the only option.

In Moray, short-term tenancies with wrap-around care and support are successfully delivering rehabilitation for frail, older people, helping them go back to their own home after a hospital stay.

There is admittedly a long way to go. That can’t be a surprise when the legislation for health and social integration was described as the biggest change in health care since 1948, when the NHS was created.

Whole-system, nationwide, continuous improvement in health and social care will not occur overnight since the previous planning and operating environment that delivered NHS and social care across 32 council areas was extraordinarily complex.

But we know we are heading in the right direction.While health boards, councils, communities, the voluntary and independent sectors as well as citizens have not always found it easy to work together for the greater good, the establishment of IJBs comes with a requirement to work in partnership with all stakeholders.

IJBs offer an active participation in planning and decision making by all those parties involved in the delivery and receipt of health and social care.

This is a different kind of democratisation of public services that raises the prospect of the kind of social movement that integration of health and social care needs to be if we are to address the challenges facing the health and care system.

The issues of an ageing population, increasing demand on our services, pressures on the workforce and reducing public sector spending are not going away any time soon and, to tackle them all at once takes leadership, resolve and innovation but also a willingness to let go and “do” differently.

The way HSCPs are constituted provides us with the best possible opportunity to take a fresh approach. Unlike a more traditional method often characterised by one public organisation or another being in control, we must work jointly with all involved parties as we seek to design and co-produce the health and social care services of today and tomorrow.

With so many on board, we have the chance to plot a course through the challenges we face.

Unfortunate as recent events have been, chief officers of HSCPs across Scotland, as well as health and care staff within the HSCPs, will not be distracted or diverted by developments in Edinburgh.

David Williams is chairman, chief officers, Health and Social Care Scotland.