Reshuffle to refocus

As reshuffles in Scotland go, this week’s was pretty dramatic, particularly for those of us in the health and care sector.

So au revoir, Shona Robison. We’ve appreciated all the support you’ve given us at Sue Ryder in our mission to ensure that everyone with a neurological condition lives their lives as fully as possible. You have left a legacy for your successor to build on. Thank you and please take a well-deserved break from frontline politics and look after yourself and your loved ones.

The challenge for our new Health Secretary, Jeane Freeman, is delivery of a range of projects that are started or underway but facing difficulty. There is no doubt that the integration of health and social care services is the right thing to do, but in reality we know there is so much further to go if it’s genuinely going to improve the lives of people across Scotland.

We know that ‘realistic medicine’ – where people are given all the information on their care and treatment options and supported to make their own decisions – is the right way forward, but we know that it is often far from what happens in practice.

And we know the Scottish Government is committed to making sure that by 2021 everyone in Scotland who needs palliative care receives it, but we also know that this is in many ways unmeasurable – and it’s already two and a half years since this aspiration was made public via the Strategic Framework for Action on End of Life Care.

So, as a charity that provides care for people with neurological conditions and for people who are at the end of life, here’s what we the new Health Secretary should focus on:

  • Across all health and social care services – whatever an individual’s condition, situation or circumstances – we must ensure that the person is at the heart of their own care planning and decision making. People must be respected as experts in their own health and wellbeing, and services designed around their needs – we can no longer take a one-size-fits-all approach to services.
  • To support this shift in balance, we must also pay less heed to targets and more heed to personal outcomes. What if being seen by a neurological consultant is not the thing that is going to make a difference to someone’s quality of life, but having home adaptations to continue to live independently is the most important thing? Why measure hospital waiting times in these circumstances? Instead of having a tick-box approach to homecare, aka the regular 15 minute visit, why are providers not empowered to work with the people they support to identify what would make a difference to their day or their week – maybe someone who is virtually housebound would benefit from a trip out with friends much more than they would from rushed care visits? 
  • The new neurological standards for health and social care – the first time health and social care have been joined up in standards this way – must not sit on a shelf. When these are published in 2019, the Scottish Government must commit to making them meaningful: they must measure them and take action to improve care and support wherever it is needed. The postcode lottery must end. 
  • This is one is for the Scottish Government but also all of Scotland’s integration authorities: If the new Neurological Action Plan – due later this year – achieves one thing, it should be that everyone in Scotland with a neurological condition is given the right support at home to live life as fully as possible. Please focus on this. 
  • And last but not least – did you know that under the new Carers’ Act, integration authorities have a duty to signpost people to bereavement support when their loved one dies? No, and I bet you’re not alone. We know from our online community that there are a lot of people out there who are in desperate need of support through this very difficult time. Cabinet Secretary, please make sure people are given the help and support they need.

So that’s a few things to get stuck into – and these things would make a huge difference to a huge number of people. Now we need the Scottish Government’s positive aspirations and commitments to translate to reality on the ground, and we at Sue Ryder are looking forward to playing an active role in this.

Find out more about the work of our Policy and Campaigns team

Elinor Jayne

Policy and Public Affairs Manager (Scotland)

Elinor Jayne