The ripples that reach: conversations to enable change

My name’s Alison Taylor: I’m a civil servant in the Scottish Government and I lead the team that’s responsible for integrating health and social care. It’s a challenging, fascinating job, and a huge personal privilege to do it. It’s also unusual because my team and I are not at the sharp end of service delivery, which casts a particular light on the request to write this blog. The ask was for a personal reflection that gives a glimpse into “my” world of health and social care integration, not for a focus on strategy or policy, but something that would describe how the work I do helps to improve people’s lives.

My job, put simply, is all about other people: supporting, sometimes challenging, other people to bring services together in ways that improve care and people’s lives. It’s about enabling, sometimes provoking, a different kind of discussion about the types of service we need to plan for, the skills we need to develop in the workforce, and the way we manage and think about value, opportunity and investment in our public services.                         

The defining characteristic of my job is of course that with my team I provide advice to Ministers on a wide range of subjects that relate to integration: from local implementation of the legislation Parliament passed in 2014, to the detail of delayed discharge statistics, to strategic questions about allocations to integration within the Scottish budget. It would be easy to see this kind of work as distant from the reality of making a difference to people’s lives. I don’t believe that for an instant. We’re fortunate in my team to have really strong relationships with colleagues working at the sharp end locally. It’s our relationships with them that enrich and, I hope they would agree, strengthen the work we do in Government to support integration as a reality that is improving people’s lives. In our professional lives we don’t literally support frail older people to maintain their independence at home, for instance, but we work hard to ensure careful consideration is given to the investment, and the workforce, needed to support the services that do. And personally, of course, we have the same range of experiences as anyone else; we’re working in St Andrew’s House, but we’re not living in a bubble!

Last December, in a speech to colleagues working across health and social care, the First Minister described integration as, “The most significant reform to Scotland’s healthcare system since the NHS was founded [and] ... one of the biggest changes to social work since the 1968 Act ... There is no doubt at all it is a necessary response to quite profound social change.” I am immensely proud of the contribution my team is making to integration, not least because we are not doing any of it on our own, but all of it is part of a much larger effort across Scotland to modernise and improve care. Rightly, satisfyingly and inevitably, integration and my own job are, for me, all about working with other people to improve the way, together, we do things in health and social care.

Alison Taylor is Head of Integration Division, Directorate for Health and Social Care Integration, Scottish Government

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