Commentary: Vicky Irons on integration

Head of Scotland’s integration leaders’ group says there is

Thursday 30th May 2019

Genuine ambition” exists among Scotland’s health and care workers to make a success of health and social care integration and become “world leaders” in the future of health and social care, the new head of a collaborative bringing together Scotland’s integration leadership tells

Vicky Irons, who began as chair of the chief officers’ group of Health & Social Care Scotland in April, says the body, which shares best practice between local government, the Scottish Government and health and social care partnerships (HSCPs), will be publishing a “key milestone” report this summer as it looks to quicken the pace of integration.’s Henry Anderson begins by asking Ms Irons what the leadership group does.

VI: “Health & Social Care Scotland is essentially a collaboration which we set up of the health and care leaders and managers from across all of the Health & Social Care Partnerships (HSCPs) in Scotland. The origins of this began with the chief officers’ network and that was actually established in 2014, during the shadow period leading up to the formal integration of health and social care.

“I think it’s fair to say that it’s developed quite a lot since it now embraces the full breadth of leadership networks…Now it incorporates not just the chief officers’ group but a network of the chairs and vice chairs of each of the IJBs, a network of chief finance officers, a group that brings together all of our strategic planning leads, and then a whole range of what we describe as special interest groups that work on individual priority areas where we want to share best practice.

h&c.s: What will you be doing in your role?

VI: “The role of chair is to provide a key leadership role nationally. Each of the chief officers that form the group are essentially the accountable officers for the services which are delegated to them and outlined in the integration schemes.

“The key role of the individual chief officers and therefore the role of the chair is really to try and develop strength of partnership working and encourage much more integrated working across all partners, so the role of chair has a key link into both Scottish Government and COSLA.

“There’s also an issue about our collective ambition around developing a much more sustainable strategic plan, which can respond to all of the different changes in patterns of demand which we are experiencing at a local level.

“We’ve got a key role as a group and therefore the chair has a key role in providing the profile and leading quite a lot of change and innovation, but also to create a focus amongst the wider public sector for more collaborative behaviour.

h&c.s: How well do you think Scotland’s partnerships are sharing best practice at the moment, given all the pressures on the sector and the need to quicken the pace of integration?

VI: “Certainly one of the early ambitions of the group – because these are quite challenging roles – was to ensure that our main focus should be around sharing best practice.

“Right at the beginning, we started by sharing our individual experiences and identifying some key areas for development.

“As a result of that, we established special interest groups around key areas. So, we have a special interest group around the development of primary care, around public health and a group that looks at the 21st century around the development of technology-enabled care and other things…

“We try to buck the trend when we meet and make sure that we regularly share best practice and performance information, so each time we meet we have a focus on either a particular subject or area where we see interesting developments emerging.

“And recently we’ve been also supported by Healthcare Improvement Scotland and also Scottish Government to host a range of masterclasses. Meaning that if there is an area where one particular partnership is performing really well, what we tend to do is establish what’s basically a web-based masterclass so the other areas can learn from the experience.

“Importantly, because of the link to COSLA and to the Scottish Government, my role is also engaged in the work of the ministerial steering group.

“We were heavily involved in the series of recommendations that stemmed from the Audit Scotland report last year. It’s both the Cabinet Secretary’s priority but also the priority of the ministerial steering group to increase the pace of integration, so we’ve been heavily involved in publishing those recommendations but will also be reviewing all the responses which will be coming from partnerships across Scotland.

“We recently had a development meeting where we set out an ambition to issue a key milestone report later this summer, which will outline the next series of ambitions for health and social care integration in Scotland.

h&c.s: How do the special interest groups work in practice?

“…If I pick the example of what we’ve done around primary care development, we selected a number of chief officers, or representatives of chief officers across Scotland, to work directly with Scottish Government about the development of the new contracts.

“Obviously, the new contract is now in place but we were heavily involved in a series of meetings which were basically setting out the parameters of what a primary care improvement plan should look like.

“We entered into all of the national discussions, really to ensure that changes that were happening in one particular contractual group, i.e. primary care practitioners or general medical practice, would enable greater integration.

“Many of us obviously have worked in health and social care systems for very many years but that open and transparent dialogue that we’ve had with national leads, with Scottish Government leads, it’s been felt to be very mutually beneficial.

h&c.s: what are you really looking forward to in this role in the year ahead?

“First of all, for me the role of chair is both a huge privilege but a huge opportunity in terms of delivering against a set of ambitions.

There’s a few things I’m most looking forward to. First is ensuring that Health & Social Care Scotland can provide the right support to the full breadth of local leadership which I mentioned earlier that enables us all to make the most of integration and the reforms in Scotland. I think there’s no denying that these are really challenging roles, so individual chief officers and other managers and leaders really need the support of a national network.

“Certainly, from a very personal point of view, I’m looking forward to connections with the Scottish Government, COSLA and with other health and social care systems that will help inform the improvements we need to make. Over the last year, we’ve developed quite a lot of links with Australia, New Zealand and lots of European countries, particularly in the development of technology enabled care. We’ve had lots of interest from elsewhere in the UK, so I’m really just looking forward to making the most of these connections.

“There’s something pivotal for me also about realising the ambition that is present in Scotland. I think there is a genuine ambition to use these reforms and almost become world leaders in health and social care modernisation, and I think generally as a group and as chair of the group we’ve got a very valid contribution to make to future strategy, development and reform.

“Last, but by no means least, the biggest opportunity for me here is about making a difference.

My personal experience in this role has shown that many of the changes we have experienced are based on more realistic conversations with the community we represent.

Most of the developments in services are led by frontline teams and they seem to be much more responsive to changing needs rather than some of the traditional systems we’re used to working with. So, if I was to pick one thing I’m really looking forward to – it’s continuing to make a difference.”