Plans for an unprecedented National Care Service could see the 'disintegration' of the partnership built up in the local care sector according to the body set up to oversee social care in East Ayrshire.
East Ayrshire Integration Joint Board, which oversees the work of the local Health and Social Care Partnership (HSCP) between the council and NHS, is expected to deliver a strong joint response to the Scottish Government's plans for a NHS-like national care service.
The issue was discussed at a meeting of the board on Wednesday.
There has been considerable opposition to the plans in East Ayrshire since the outset, with major concerns that East Ayrshire's positive work will be dismantled and services compromised.
One of the main concerns for those involved is what is seen as a dismissal of the positives that can come from a successful partnership by the Scottish Government.
The HSCP only came into force in 2014, with the put Integration Joint Board in place in 2015.
East Ayrshire Council leader Douglas Reid, who chairs the IJB, said: "We don't deny the reason behind the bill is to improve quality of social work and social care services. That is something we all want.
"We really are disappointed that there is no reflection of where integration has worked well. We know that performance is inconsistent across the country but I didn't hear any leaders from other council areas saying this was the solution.
"For ourselves, integration has worked well and we can see positives we've achieved. This will damage some of the positive strides we have made."
The report to the Integration Joint Board, highlighted a number of areas of concern:
- East Ayrshire HSCP services go beyond requirements and include vital services such as children and young people’s social work and health services; justice social work and health services; and Alcohol and Drug Partnership.
- possible fundamental and unintended consequences for communities and workforce could cause considerable disruption
- a risk of reduction in the quality of services as well as a 'disintegration of mature, strong partnership working and delivery'
- could lead to an erosion of local accountability and democracy
- national ‘one size fits all’ approach would fail to adequately reflect and meet the needs of different areas and populations
- lack of clarity around the finances and expected additional costs
- Ministers will effectively have power to transfer staff and property etc. from councils to a new centralised NCS risking a reluctance to invest in these areas
- adverse impact of national commissioning on local flexibility in procuring services, local employability and third sector local provision.
The draft response stated: "We believe that there are still too many questions and unknown factors for the consultation to be one which is fully informed.
"There is also a significant possibility that any transitional arrangements would risk a reduction in the quality of services currently being delivered, in areas such as East Ayrshire, as well as a disintegration of mature, strong partnership working and delivery models."
The response criticises the lack of opportunity to make improvements within the current system, despite evidence of success in East Ayrshire.
It also highlights the success of EAHSCP in providing early intervention and prevention, including reducing hospital admissions, delayed discharges and increasing support to people in their communities.
The response states: "East Ayrshire has consistently performed well with no delayed discharges locally over a two week period for a number of years.
"Central to this success has been the autonomy to develop local services based on identified local need through community engagement and participation. We are concerned that the National Care Service will erode or eliminate the ability to take this community focused approach to meeting the needs of those we serve."
It also questions how the reform would work to support 'The Promise' - the commitment to ensuring children are 'loved, safe, and respected and realise their full potential', or how the NCS would 'drive quality improvement in care homes, ensuring that quality and standards come before profit'.
The response will also be considered by East Ayrshire Council on August 25.
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