Our approach

The Public Bodies (Joint Working) (Scotland) Act 2014 sets the legislative framework for integrating adult health and social care.

Integrating health and social care services is important to ensure that people have quick access to the range of services and support they need, that their care feels seamless to them and that they experience good outcomes and high standards of support. This is particularly vital for the increasing numbers of people with multiple, complex, long-term conditions in Scotland.

Since April 2017, the Care Inspectorate and Healthcare Improvement Scotland have had joint statutory responsibility to inspect and support improvement in the strategic planning and commissioning of integrated approaches.

In 2019, the Ministerial Strategic Group (MSG) for Health and Community Care asked us to further develop our joint inspections to focus on how integration impacts on people’s outcomes, to consider the performance of the whole health and social care partnership and to ensure a balanced focus across health and social care provision.

In response to the MSG recommendation, the Care Inspectorate and Healthcare Improvement Scotland have reviewed our joint inspection methodology to answer the following question:

“How effectively is the partnership working together, strategically and operationally, to deliver seamless services that achieve good health and wellbeing outcomes for adults?”

In order to address the question over the broad spectrum of adult health and social care services, we will conduct a rolling programme of themed inspections, looking at how integration of services positively supports people’s experiences and outcomes. It’s important to note that these thematic inspections are not considering the quality of specialist care for each care group but are simply a means of identifying groups of people with similar or shared experiences through which to understand if health and social care integration arrangements are resulting in good outcomes. In this way, we’re looking at integration through the lens of different care groups which, taken together, will in time build a picture of what is happening more broadly in health and social care integration and how this is experienced by people and the outcomes achieved.

The Covid-19 pandemic has meant that joint inspections of adult services have been paused since March 2019, partly as an infection control measure, but also in recognition of the impact that Covid-19 continues to have on health and social care partnerships. The timing for the re-introduction of scrutiny activity will take cognisance of the position of partnerships and services as they transition into and through recovery.

How we do it

Our inspections last for a number of months. We work closely with the partnership to co-ordinate our inspection activities.

We have a range of ways to gather information that will help us to assess how integrated services in the area are helping to improve outcomes for people and their unpaid carers. These include:

  • asking for information from the partnership
  • speaking to people who use health and social care services and their unpaid carers
  • speaking with staff, managers and leaders across the partnership
  • reading people’s records.

We communicate regularly with the partnership and keep them up to date with our findings.

After the inspection, we publish a report about our findings on the Care Inspectorate’s and Healthcare Improvement Scotland’s websites. The report explains what we have found, identifies strengths and points out areas that could be improved. We agree an Improvement plan with the partnership to address those areas.

Getting involved

The voices of people who use health and social care services and of their unpaid carers are at the centre of our inspection. We will use as many opportunities as we can to get people involved and talk to them about their experiences of health and social care services.

We have developed an engagement framework to support all our engagement activity. The framework sets out 12 statements about positive outcomes and experiences that we will speak with people about.

More information

You can find full information about joint adult inspections:

  • The Partnership Guide sets out the inspection process step by step and provides all the information that partnerships need to manage their part in the inspection. 
  • The Quality Indicator Framework (QIF) explains the criteria we use to evaluate quality in our inspections
  • The Engagement Framework provides a set of “I” statements to help us consider the experience of people who use health and social care services and their unpaid carers. It underpins all the engagement with people and unpaid carers that takes place during the inspection. 
  • Our joint inspection reports can be found here.