Scottish Government

CHAPTER 1 Introduction

This report gives an overview of collaborative working between health and social work services for older people in Forth Valley. It sets out the strengths and areas of good practice as well as identifying areas where improvements are needed.

It covers the second multi-agency inspection of services for older people. The first was undertaken in Tayside in 2006. A follow up inspection will be carried out one year after the publication of the report, both in Tayside and Forth Valley.

In recent years, the NHS in Scotland and councils have responded to significant challenges and changes. There have been substantial improvements in health, social work and social care services which have delivered better outcomes for people and their carers. But demographic changes, people's rising expectations and advances in medical technology are placing greater demands on agencies to continue improving services for older people.

In all public services there is a shift from top-down, target driven performance management to more self-improving systems built around the needs of individuals. Increasingly, collaborative working between health, social work and social care agencies will make a significant contribution to improved services. Multi-agency inspections support this improvement in several ways. For this reason, they were announced by Malcolm Chisholm, then Minister for Communities, in 2006.

There were significant improvements in the way that this second pilot was undertaken. Data helpfully provided by ISD, the national organisation for health statistics, was used. It promoted discussion with health professionals and managers, particularly about how differences in clinical practice, such as emergency admissions for older people, impacted on outcomes for older people. The data provided support for the direction of travel within Forth Valley towards more community based health services.

A core set of published performance indicators was agreed with the partnerships as the basis for the evaluation of outcomes for older people and their carers, because the National Outcomes were not fully in place. The analysis of health and council performance data enabled the inspection team to undertake considerably fewer fieldwork sessions.

We fully appreciate the co-operation and assistance of the four agencies, NHS Forth Valley, Clackmannanshire, Falkirk and Stirling Councils, which have participated in the second pilot inspection of services for older people. In particular we are grateful to patients, service users, carers, staff and managers who played an active role in the inspection process.