Health and social care providers in Edinburgh are to be urged to "abandon the idea" that their job is to assess people to see what services they need.
Elderly and disabled people and those in need of support will instead be given the "Edinburgh offer" of better collaboration with local communities to help them access help to live independently for longer.
The changes are proposed in the new Strategic Plan from the city's health and social care partnership.
The Edinburgh Integration Joint Board (EIJB) said its plan would radically transform the way the city delivers health and social care over the next three years and beyond.
Approved earlier this week, the proposals will deliver an "affordable, sustainable and trusted health and social care system," the IJB said.
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The plan sets out three conversations which staff will have with adults who seek social care. The first will look at what help is available from families and in the local community. The second covers people in crisis and involves staff looking to charity and community support, and asking "what do I have at my disposal, including small amounts of money and using my knowledge of the community, to support you? The third involves looking at sources of funding and the possibility of a personal budget for care.
It aims to address the crisis in social care in the capital which has seen the IJB some £10 million over budget last year, and with some of the worst 'bed blocking' rates in the country. Services for older people in the Edinburgh area have been strongly criticised by the Care Inspectorate in successive reports.
Describing the new strategy as 'ambitious', Ricky Henderson, Vice Chair of the EIJB, said: “Edinburgh’s population is expected to increase faster than any other city in Scotland and with that comes a number of very real challenges. The number of residents who are aged 85+ is expected to more than double over the next 20 years.
"We need to accept that the status quo is unsustainable in the long term and our care systems need to evolve. Our Strategic Plan identifies new ways of delivering care so that we can better meet the current and future needs of Edinburgh citizens and, crucially, work to improve the population’s overall wellbeing.”
He said the ‘Edinburgh Offer’ would provide bespoke support so that age, disability, and health conditions are no longer barriers to living a safe and thriving life. Instead, better collaboration between healthcare providers and local communities will help people to live independently for longer, shifting the balance of care from hospitals to the community.
Judith Proctor, Chief Officer for the EIJB, added: “This is the first step on a long journey which will only work if we improve integration and redesign certain services. Our plans are very ambitious because we need to be bold.
"The conventional approach to care makes people wait for an assessment and is about processes, not people. That’s something I’m passionate about changing. We need to abandon the jargon and work in a way which is much more meaningful for families.”
However many of Edinburgh's community-based services have faced brutal cuts in recent years. One, Pilton Community Health Project, had most of its funding withdrawn - by the IJB - and has since raised £50,000 from the public to keep going, while slashing services and staff.
Ella Simpson, chief executive of the Edinburgh Voluntary Organisations Council, said the project provided exactly the kind of preventive drop in care that the public often want.
She said she did not disagree with anything in the strategy but it was essential the IJB invested in the community services the plan relies on.
She added: "The voluntary and community sector has been involved throughout the development of this plan. The result is a collaborative vision. The hard work starts now as we work together to realise the ambition of the plan.”
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