Scotland’s Integration Joint Boards are supposed to be in charge of integrating the work of health boards and councils to improve social care.
I’m not sure you’d know it by attending the monthly meeting of Edinburgh’s IJB last week. A key goal for these bodies is to prevent delayed discharges, the blocking of NHS beds when a well patient can’t return home due to alack of appropriate social care.
On the agenda were a number of apparently worrying items. A report warns plans to dramatically cut bed-blocking by December of this year are well off target, due to problems recruiting staff in the care-at-home sector.
Another report says the board’s financial position is perilous, with spending by the NHS on care services £1m a month more than the £1.2m already expected.. And the figures for the council’s overspend on similar services aren’t even known.
So you might expect questions to be asked by members of the IJB about these issues. The IJB is not directly responsible for ensuring the council or the NHS remain on budget. But any overspend will affect its future work. And questions raised by the bed-blocking report include: why is recruitment in the care at home sector so difficult the city council is having to advertise to help fill the gaps? How big a problem is a lack of affordable housing for care workers? And without new tactics, why should a failing strategy suddenly start working between now and December?
They remained unanswered. Most weren’t asked. Some members of the IJB did express unease. Mike Ash, an NHS Lothian non-executive director warned that just ‘noting’ the bed -blocking report wasn’t enough. “If we don’t get things sorted out it is the IJB that is held responsible,” he said. Others asked mildly what was being done to resolve the financial difficulties are taking place.”
Officials said board members could be assured great effort is going into addressing both concerns. I’ve no reason to doubt it. But one board member said he was struggling to understand how, exactly the IJB was changing the culture and practise to bring about improvements and on this evidence I would have to agree.
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