PETER KNIGHTHead of Service for Integration Support

ISD Scotland

Indicator of Relative Need

ioRNStandard measure of functional needs &

independence

Principles of integration of health and social care, include:

o Best anticipate needs and prevent them arising

o Take account of the particular needs of different service-users

o Take account of the particular characteristics and

circumstances of different service-users

➢ SHRUGS (circa 1990)

➢ SCRUGS (circa 1999)

➢ RUM/ioRN (circa 2002)

➢ ioRN for care homes (circa 2008)

➢ ioRN2 for the community

ISD Scotland’s ‘Family tree’

for routine

measurement of functional

need/status

Components of the ioRN2

• Standard questions & answer options

• ioRN2 Algorithm

Supported by:

• Training pack (being finalised now)

• Practitioner user resource pack

• Guidance

• Other resources on request

Community ioRN questions 5Minutes

Community ioRN:completion follows an outcome-focussed assessment

Personal themes

• Mobility, transferring and eating

• Personal Care & Food Prep’n

• Mental well-being, behaviour and risk

www.isdscotland.org/IoRN2

Features of ioRN2 data

Person-centred

Standardised & consistent

Collectable by health and

social care

Shareable information

Generates aggregate info

10

0

0.5

1

1.5

2

2.5

3

3.5

4

ADL

Q4 Washing handsand face

Q7 Dressing

Q5 Complete wash

Q6 Wash hairQ8 Main meal

Q9 Light snack

Q10 Hot drink

Mental well being /Behaviour

Example 1 - initial and review for ADL, personal care and food and drink questions (Q4 to Q10) and mental well being.

initial

Note : ADL consists of:1) eating a meal2) mobilising an transferring3) using the toilet

11

0

0.5

1

1.5

2

2.5

3

3.5

4

ADL

Q4 Washing handsand face

Q7 Dressing

Q5 Complete wash

Q6 Wash hairQ8 Main meal

Q9 Light snack

Q10 Hot drink

Mental well being /Behaviour

Example 1 - initial and review for ADL, personal care and food and drink questions (Q4 to Q10) and mental well being.

initial

review

Note : ADL consists of:1) eating a meal2) mobilising an transferring3) using the toilet

Percentage distribution of ioRN groups by named team

0

5

10

15

20

25

30

35

40

A1 A2 A3 B1 B2 B3 C+E D F H I

% o

f to

tal (

N=6

93

)

ioRN2 group

Change in ioRN group: all teamssample are people who have two ioRN groups

Initial

0

5

10

15

20

25

30

35

40

A1 A2 A3 B1 B2 B3 C+E D F H I

% o

f to

tal (

N=6

93

)

ioRN2 group

Change in ioRN group: all teamssample are people who have two ioRN groups

Initial

Second

Based on insight gained from an assessment

Person-centred information

Collectable across health,

social care and housing

Complements information on personal outcomes

Provides information for a wide range of purposes

Useful to practitioners...and to

management

About me

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A1+A2 A3 B1 B2 B3 C + E D F + G + H I

ioRN Group

Estimated hours per week of informal care given by carers: cumulative percentages by ioRN Group; Clackmannanshire

data

35+ hrs

20 - 34 hrs

5 - 19 hrs

1 - 4 hrs

Common Tool, Common Language: Supporting Integration

ioRN2 development report (July 2017)‘Outcomes Count’With a Foreword by Scotland’s Chief Nursing Officer, Chief Social Work Adviser (to the SG), and Chief Health Professions Officer

https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2017-07-25/2017-07-25-IORN2-Report.pdf?40417116881

Or check webpage: http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Dependency-Relative-Needs/In-the-Community/