Highland Council and NHS Highland have agreed proposed changes that will end their unique model of integration, after almost a decade of partnership working between the council and health board directly.

The changes will see Highland move from the ‘lead agency’ joint working agreement between the council and health board, aligning instead with Scotland’s other integrated health and care boards.

Rather than adopting the template of other integration joint boards directly, the creation of new local care boards is now on the table.

A report from the Highland Council and NHS Highland Joint Monitoring Committee on the proposed changes was heard by a meeting of Highland’s Council last week and will also be considered by the NHS Highland board meeting on 28 January 2025.

The decision to revisit the Highland model came in response to the developing National Care Service Bill – currently paused for scrutiny until 2025 – with NHS Highland chief executive Fiona Davies telling Holyrood’s health and care committee at an evidence session in October that being an outlier has caused challenges in Highland.

Council and health board leaders say they have also agreed to ensure all stakeholders are informed of the plans ‘as they evolve’ and given the opportunity to shape them.

Joint Monitoring Committee Chair, Councillor David Fraser says in the report from his committee that the proposals look to shift care into the community where possible:

“This is an opportunity to explore changes we may make that could benefit the population and communities we serve.

“We need to provide more support to help people receive care in their own homes and communities.”

Highland health and care leaders and councillors have outlined that preparatory work will be undertaken to identify the best future care delivery in Highland.

Recommendations on modifications to the care and governance model currently in place in Highland will then be brought forward alongside to inform the final changes.

NHS Highland’s chief executive, Fiona Davies said the board and council have also agreed to create a strategic steering group representing both the council and the health board to oversee the work needed:

“The steering group will work with all stakeholders, including people receiving care, staff, trade unions, care providers, communities and the third sector.”

“The importance of a skilled and dedicated workforce will remain at the heart of any proposals and staff across Highland Council and NHS Highland will be kept informed and provided opportunities to engage and help to shape plans in due course.”

Ms Davies said once agreed the steering group will be established to oversee the new model and will include representation from the council and both executive and non-executive director representation from NHS Highland.

Highland Council’s Chief Executive, Derek Brown said that a review of adult and children’s social services which is also underway has shown an “appetite” for change:

“Our strategic plans for adult and children’s services already set out in more detail our ambitions and the outcomes we aim to deliver.

“This review has so far indicated an appetite to consider change in our partnership governance to deliver the best outcomes for our staff, our population and the communities we serve.”

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