Health and social care Integration Authorities criticised for ‘Tick box approach’ to engagement - Holyrood’s Health and Sport Committee


Engaging with the public and stakeholders must not be a ‘tick box’ exercise for Health and social care Integration Authorities (IAs), says the Scottish Parliament’s Health and Sport Committee.

The warning follows a parliamentary inquiry into the extent to which the public, service users, the third sector and independent sector are being involved effectively in the work of IAs.

In its report published today, the Committee found a lack of consistency in stakeholder engagement across IAs, that are now in their second year of operation across Scotland.

The committee heard evidence from a range of organisations including Alzheimer Scotland, the Coalition of Carers, the Royal College of Physicians and RCN Scotland.

While some areas of good practice were cited on stakeholder engagement, the committee heard concerns over engagement being ‘tokenistic’, ‘overly top down’ and ‘just communicating decisions that had already been made’.

The Committee believes a piecemeal approach to engagement with stakeholders cannot continue, and that meaningful engagement is fundamental to the successful integration of health and social care services.

Health and Sport Committee convener Neil Findlay MSP said:

“We are now two years into the operation of IAs and they are clearly not working as intended. Too often we heard evidence from communities and health professionals saying this is not meaningful engagement, and a tick box approach is being applied.

“This needs to be fixed.

“IAs have to deliver fundamental changes to the way local health and care services are planned and delivered. This requires people in communities not only to understand and support the approach taken but to be involved meaningfully in the process.

“Our Committee believes public engagement could be improved by having a dedicated community development staff member in each IA.

“Our report asks the Scottish Government how it could encourage and support this approach, and we look forward to its response.”


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

During passage of the Act the then Cabinet Secretary for Health and Well-being stated “the third and independent sectors will be embedded in the process as key stakeholders in shaping the redesign of services" .

The Act sought to achieve this vision by placing a duty on integration authorities to ensure stakeholders were fully engaged in the preparation, publication and review of strategic commissioning plans.

Scottish Government guidance on strategic planning states services should be "planned and led locally in a way which is engaged with the community (including those who look after service users and those who are involved in the provision of health and social care)".

The guidance details that the aim is to ensure a wide and diverse engagement results in a strategic commissioning plan that is not simply controlled by the small number of people on the Strategic Planning Group but rather the population that will be affected by its findings.


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