Cunninghame House Irvine
5 June 2014
Shadow Integration Board
You are requested to attend a meeting of the Shadow Integration Board to be held on Wednesday 11 June 2014 at 10.00 a.m. in the Council Chambers, Cunninghame House, Irvine, to consider the following business.
Business
1. Apologies Invite intimation of apologies for absence.
2. Conflicts of Interest
3. Minutes / Action Note Submit the minutes of the meeting of the Shadow Integration Board held on 1st May 2014 and action note (copy enclosed).
4. Matters Arising
5. Presentation: Family Nurse Partnership Receive presentation by Donna McKee, FNP Lead (copy enclosed).
6. Base Budget for 2014/15 Submit report by the Corporate Director (Finance and Corporate Support) (North Ayrshire Council) on the management of aligned budgets (copy enclosed).
7. CHP Business
7.1 Change Fund Submit report by the Partnership Facilitator (North Ayrshire Council) on the annual Change Fund template submission to the Scottish Government (copy enclosed).
7.2 Minutes of OLG Meeting held on 18 March and 29 April 2014 Submit the minutes of the meetings of the Officers Locality Group (OLG) held 18th March and 29 April 2014 (copies enclosed).
For further information please contact Karen Andrews, Business Support Officer, North Ayrshire Council Social Services on (01294) 317725 or by email to [email protected]
7.3 Minutes from the CHP Forum held on 27 February and 15 May 2014 Submit the minutes of the meetings of the Community Health Partnership Forum held on 27 February and 15 May 2014 (copies enclosed).
8. Director’s Report Submit report by the Director, (North Ayrshire Health and Social Care Partnership) on developments in the North Ayrshire Health & Social Care Partnership (copy enclosed).
9. Expense Policy Submit report by the Head of Service (Development) (Social Services & Health) (North Ayrshire Council) (copy to follow).
10. Developing Health & Social Care Strategic Plan Submit report by the Partnership Facilitator (North Ayrshire Council) the proposed timescale for the first Strategic Plan (copy enclosed).
11. Development of Health & Social Care Sub Structure Submit report by the Partnership Facilitator (North Ayrshire Council) on the development of sub structures (copy enclosed).
12. Organisational Development Support Submit report by the Head of Service (Development) (Social Services & Health) (North Ayrshire Council) on a programme of organisational development support (copy enclosed).
13. Implications of the Children and Young People (Scotland) Act 2014 Submit report by the Chief Social Work Officer (North Ayrshire Council) on the implementation of the Children and Young People (Scotland) Act 2014 (copy enclosed).
14. Social Care (Self Directed Support) (Scotland) Act 2013 Statutory Regulations Submit report by the Senior Manager (Community Care) (North Ayrshire Council) on the implications of the Act (copy enclosed).
15. Consultation on Regulations Relating to the Public Bodies (Joint Working) (Scotland) Act 2014 Submit report by the Head of Service (Development)(Social Services & Health) (North Ayrshire Council) (copy enclosed).
16. Consultation on the Future Model for Community Justice in Scotland Submit report by Criminal Justice Manager (North Ayrshire Council) on the main points arising from the consultation (copy enclosed).
17. Draft Inequalities Strategy Submit report by the Partnership Facilitator on the draft CPP Inequalities Strategy (copy enclosed).
18. Agenda / Dates of Meetings
For further information please contact Karen Andrews, Business Support Officer, North Ayrshire Council Social Services on (01294) 317725 or by email to [email protected]
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Any Other Competent Business
19. Arrest Referral Bail Supervision Service Submit report by the Chief Social Work Officer (North Ayrshire Council) on the proposed extension of the current contract (copy enclosed).
20. Contract Award: Response Monitoring Service Submit report by the Director, (North Ayrshire Health and Social Care Partnership) on the award of the contract (copy enclosed).
21. Date of Next Meeting The next meeting will be held on Thursday 24th July 2014 at 10.00 a.m., in the Council Chambers, Cunninghame House, Irvine.
For further information please contact Karen Andrews, Business Support Officer, North Ayrshire Council Social Services on (01294) 317725 or by email to [email protected]
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Shadow Integration Board
Sederunt
Voting Members
Mr Stephen McKenzie (Chair) NHS Ayrshire & Arran Councillor Anthea Dickson (Vice-Chair) North Ayrshire Council
Dr Carol Davidson NHS Ayrshire & Arran Councillor Ruth Maguire North Ayrshire Council Mr Bob Martin NHS Ayrshire & Arran Dr Janet McKay NHS Ayrshire & Arran Councillor Peter McNamara North Ayrshire Council Councillor Robert Steel North Ayrshire Council
Professional Advisors
Mr Derek Barron Mental Health Advisor Ms Iona Colvin Director North Ayrshire Health & Social Care Partnership Ms Laura Friel Corporate Director - North Ayrshire Council Ms Sheena Gault Chief Social Work Officer- North Ayrshire Council Mr Derek Lindsay Director of Finance NHS Ayrshire and Arran Kerry Gilligan Allied Health Professional Advisor
Stakeholder Representatives
Ranald Mair Independent Sector Representative Mr David Donaghey Staff Representative - NHS Ayrshire and Arran Mr Martin Hunter Service User Representative Ms Louise McDaid Staff Representative - North Ayrshire Council Ms Marie McWaters Carers Representative Mr Jim Nichols Third Sector Representative Ms Sally Powell Carers Representative Ms Fiona Thomson Service User Representative
For further information please contact Karen Andrews, Business Support Officer, North Ayrshire Council Social Services on (01294) 317725 or by email to [email protected]
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NORTH AYRSHIRE SHADOW INTEGRATION BOARD – ACTION NOTE Thursday 1st May 2014, Council Chambers, Cunninghame House, Irvine
Present : Stephen McKenzie (Chair), Janet McKay, Carol Davidson, Bob Martin, Anthea Dickson, Ruth Maguire, Iona Colvin
In Attendance : Derek Barron, Kerry Gilligan, David Donaghey, Laura Friel, Sheena Gault, Martin Hunter, Louise McDaid, Jim Nichols, Sally Powell, Nigel Wanless, Michelle Sutherland, Annie Weir, Eunice Johnston, Karen Andrews.
Apologies : Lisbeth Raeside, Peter McNamara, Robert Steel, Marie McWaters
No. Agenda Item / Summary of Discussion Action Status Officer
1. Implications of Children & Young People (Scotland)(Act) • Director, HSCP to submit a report to Agenda – 11-6-14 Iona Colvin/ the SIB on 11th June 2014 on the Annie Weir implications of the new Bill. 2. Integration of Health and Social Care in North Ayrshire Presentation received by Iona Colvin on progress on • Director, HSCP to provide SIB Ongoing Iona Colvin moving towards integrated health and social care members with regular updates on partnership for North Ayrshire. progress.
3. Reshaping Care – Self Assessment Report on the self-assessment checklist for NHS • The action plan within the report will Ongoing Michelle Boards and local authorities was prepared for the be prioritised and the Sutherland Auditor General and the Accounts Commission. This recommendations will be submitted report will be submitted to NAC Audit Committee on to the SIB for approval. 26th May 2014.
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No. Agenda Item / Summary of Discussion Action Status Officer
4. Minutes of OLG Meeting held on 21st January 2014 Minutes of the OLG meeting were circulated for • Agreed that minutes of all future Ongoing Michelle information. meetings be circulated to SIB Sutherland/ members as soon as they are Committee available. Services 5. Director’s Report Director, HSCP presented her report on the • Proposals for the development Agenda – 11-6-14 Iona Colvin developments in the NAHSCP and progress made to programme for the SIB will be date. Integration Scheme for the SIB needs to be submitted to the next SIB meeting for developed and the content of this will be confirmed on discussion and approval. publication of the legislation. A development programme for SIB members will also be established. 6. Financial Update Corporate Director (Finance & Corporate Support) • Agreed that financial reports for the Agenda – 11-6-14 Laura Friel submitted a report on progress being made in SIB will be developed during developing financial matters for the NAHSCP. The 2014/15. Draft budget report will be local priorities within the report were discussed. presented to the next SIB on 11th June 2014. 10. Mental Health Reference Group Representation from the MH Reference Group on the • Agreed that Director, HSCP meet Ongoing – Iona Colvin SIB was discussed. with the group and report back to the meeting arranged SIB with a proposal for representation. 11. Date of Next Meeting As agreed at Action 9 above, the next SIB meeting Complete has been rearranged and will be held on Wednesday 11th June 2014 at 10.00 a.m., Council Chambers, Cunninghame House, Irvine.
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8 Shadow Integration Board Meeting
Minutes of Meeting held on 1st May 2014
Present :
Stephen McKenzie (Chair) , Voting Member Anthea Dickson, (Vice Chair), Voting Member Janet McKay, Voting Member Carol Davidson, Voting Member Bob Martin, Voting Member Ruth Maguire, Voting Member Iona Colvin, Director, NAHSCP Derek Barron, NHS Ayrshire & Arran Kerry Gilligan, NHS Ayrshire & Arran David Donaghey, NHS Ayrshire & Arran Laura Friel, North Ayrshire Council Sheena Gault, North Ayrshire Council Martin Hunter, Service User Representative Louise McDaid, Staff Representative – North Ayrshire Council Jim Nichols, Third Sector Representative Sally Powell, Carers Representative Nigel Wanless, Independent Sector Representative
In Attendance :
Michelle Sutherland, Partnership Facilitator Annie Weir, North Ayrshire Council Eunice Johnston, NHS Ayrshire & Arran Karen Andrews, North Ayrshire Council
Action By 1. Welcome and Introductions
The Chair welcomed those present and introductions were made.
2. Apologies
Apologies were received from Lisbeth Raeside, Peter McNamara, Robert Steel (North Ayrshire Council), Marie McWaters (Carers Representative).
3. Minutes of Previous Meeting
The minutes of the Transition Integration Board held on 20th March 2014 were approved.
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9 4. Matters Arising
The Director, NAHSCP will submit a report to the Shadow Iona Colvin Integration Board on 12th June 2014 on the implications of the new Children and Young People (Scotland) Bill.
5. Integration of health and Social Care in North Ayrshire
The Board received a presentation by Iona Colvin, Director, North Ayrshire Health and Social Care Partnership in relation to progress on moving towards an integrated health and social care partnership for North Ayrshire. The Director gave a recap of the journey towards integration to date; the scope of services included within the partnership; progress made towards integration; the Ayrshire wide picture; membership of the SIB; senior management structure of the partnership and the emerging partnership priorities and the key activity for 2014/15.
Members asked questions and received clarification in relation to the role of the existing Community Health Partnerships. Iona Colvin confirmed that CHPs will remain until the Joint Integration Board is established. All delegated functions from NHS Ayrshire and Arran to the CHPs will continue and be the responsibility of the SIB until the Joint Integration Board is formed.
The Board noted the presentation and requested that the SIB Iona Colvin receive regular updates from the Director, NAHSCP.
6. CHP Business
6.1 Reshaping Care – Self Assessment
Submitted report by Partnership Facilitator (North Ayrshire Council) on the self-assessment checklist for NHS Boards and Councils, prepared for the Auditor General for Scotland and the Accounts Commission. This will be evaluated over the next six months.
The Partnership Facilitator reported that Allan Gunning, NHS Ayrshire and Arran will develop a paper on Reshaping Care for Older People and the Change Fund. A report on the self assessment will be presented to the NAC Audit Committee on 26th May 2014 for approval.
Members asked questions and received clarification in relation the action plan and the three year joint commissioning plan for older people.
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10 It was agreed that the action plan be prioritised and recommendations submitted to the SIB for approval. Members asked for clarification on the evaluation of the Change Fund as this runs out next year. Decisions will be required on which services will continue to be funded and resources identified to continue this funding.
Work on developing a transparent evaluation process is progressing, led by Allan Gunning, NHS Ayrshire and Arran. This will be submitted to the SIB for approval.
The Director, NAHSCP advised that an integration fund will be available, but this will not be a replacement for the Change Fund.
6.2 Community Services Review Action Plan
Submitted report by Partnership Facilitator on the initial actions from the first Community Services Review Event held with key stakeholders. The detailed action plan included within the report was endorsed.
A further event will be held on 28th May 2014 at 12.30 p.m., Gailes Hotel, Irvine. Members will encourage attendance at this event.
6.3 Minutes of OLG Meeting held on 21st January 2014
Submitted minutes of the meeting of the Officers Local Group Michelle Sutherland meeting held on 21st January 2014. The minutes were noted.
Members asked that minutes of future meetings be circulated to SIB members as soon as they are available. This was agreed.
Director, NAHSCP advised that representation on the OLG will be reviewed once the management structure for the HSCP has been established.
7. Director’s Report
Submitted report by the Director, NAHSCP on developments in the North Ayrshire Health and Social Care Partnership and progress made to date.
Members asked questions and received clarification in relation to:-
• The preparation of an Integration Scheme for the partnership which will set out how integration will operate in North Ayrshire. The content of the integration scheme will be confirmed once the regulations have been published.
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11 • The preparation of the Strategic Plan for the Partnership. • IT and information sharing. Discussions will be required take consideration of the different information systems used both within the Council and within NHS Ayrshire and Arran.
A proposal for a development programme for SIB members will be Iona Colvin submitted to the next SIB meeting for discussion and approval.
8. Financial Update
Submitted reported by the Corporate Director (Finance and Corporate Support) on progress being made in developing financial matters in respect of the North Ayrshire HSCP.
Members asked questions and received clarification in relation to the local priorities identified within the report. These were Financial Advice; Integration Scheme and Strategic Plan and Due Diligence.
Financial reports for the SIB will be developed during 2014/15. Laura Friel Draft budgets will be presented to the SIB at the meeting on 12th June and will be reported quarterly thereafter.
9. Strategic Plan
Submitted report by Partnership Facilitator on the development of the Health and Social Care Strategic Plan. The report set out the proposed direction of travel for the strategic plan including the re- focus of the Community Health Partnership Forum.
The Strategic Plan is critical for the partnership and will be a Michelle Sutherland standing item on the SIB agenda.
A Strategic Planning Group will take this forward and will submit regular reports to the SIB for consideration/approval. It is proposed that the Community Health Partnership Forum assume this role, with augmented membership to include social work services, housing, neighbourhoods and finance. Cllr A Dickson will chair the SPG, in her capacity as Vice Chair of the SIB.
The Chair reiterated the need to be clear about the relationship between the SIB and the Strategic Plan and that the SIB has sustained ownership and investment in the process.
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12 Members asked questions and received clarification in relation to neighbourhood planning. Director, NAHSCP gave an update on :-
• Working to common boundaries. • The needs in each area compiled into Areas of Family Resilience reports.. • Investment in each area mapped. • Audrey Sutton leading on likelihood planning.
10. Programme Risk Register
Submitted report by the Programme Manager, Integration of Health and Social Care, on the strategic risk register. The register highlights the risks which could impact on the development and submission of the Integration Scheme and the creation of the HSCP.
The proposals within the report were agreed and risks should be Annie Weir reported, by exception, to the SIB.
11. Management Proposals – NASCHP
Submitted report by Director, NAHSCP on the management proposals for the partnership.
Members asked questions and received clarification in relation to funding of the management structure. The Director advised that this will be met from existing management arrangements funding.
The report was noted and agreed.
12. Payment to Supported Carers
Submitted report by the Chief Social Work Officer (North Ayrshire Council) on the proposed increase in weekly payments to supported carers.
Members asked questions and received clarification in relation to the reduction in the number of carers, even though there has been a 20% increase in the number of referrals to the Throughcare Team.
CSWO advised that the 20% increase in referrals relates to Throughcare service as a whole, not just the demand for supported carers. The reduction in carers would still meet the needs of the service.
The recommendations within the report were approved. Sheena Gault
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13 13. Carers Legislation – Consultation on Proposals
Submitted report by Senior Manager, Care Management & Review on the consultation response on proposed Carers Legislation.
Members asked questions and received clarification on how young carers fit into the legislation. The Senior Manager confirmed that young carers are represented on the advisory group and were involved in developing the North Ayrshire Carers Strategy.
The consultation response was approved.
14. Improving Children’s Outcomes
Submitted report by Programme Manager (Early Intervention and Prevention) on proposals to participate in a Scottish Government project to improve children’s outcomes.
The project will involve surveys of families with children between 0-8 and undertake wellbeing surveys of children and young people aged 9-11 and 12-16 years. A contribution of £15,000 is requested towards the costs of implementing the project in North Ayrshire. The CPP Children’s Services Strategic Partnership (CSSP) will manage the project.
Members asked questions and received clarification in relation to where the Children’s Services Strategic Partnership fits in relation to the SIB. Director, HSCP advised that the CSSP is a sub group of the Community Planning Partnership and will report to them.
Director, HSCP also advised that the project will assist in the design of interventions to meet the needs of children and look at most effective way of delivering services.
Programme Manager confirmed that officers within NHS Ayrshire & Arran have been consulted in relation to ethical and data confidentiality issues.
The recommendations within the report were agreed. Iona Colvin
15. Any Other Business
15.1 JIT Event – 12 June 2014
Director, NAHSCP advised of an event being hosted by the Scottish Government Joint Improvement Team on 12th June 2014. This event is focused towards SIBs and their members.
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14 It was agreed that if SIB members want to attend the event on 12th Committee June 2014, the SIB meeting planned on that date will be Services rearranged.
15.2 Mental Health Reference Group
Representation from the Mental Health Reference Group on the Iona Colvin SIB was raised. Director, HSCP advised that she will meet with the group and report back to the SIB with a proposal for representation.
16. Date of Next Meeting
The next meeting will be held on Thursday 12th June 2014 at 10.00 a.m., Council Chambers, 3rd Floor, Cunninghame House, Irvine.
The meeting concluded at 12.20 p.m.
Post meeting note : The next meeting has been rearranged to Wednesday 11th June 2014 at 10.00 a.m., Council Chambers, Cunninghame House.
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Family Nurse Partnership in Ayrshire and Arran
June 2014
Our journey so far.....
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What is the FNP Programme?
Evidence based preventive programme through pregnancy until child is aged 2 years
Structured, intensive home visiting programme delivered by Family Nurses
Aims to: - improve pregnancy outcomes - improve child health and development - improve parental economic self sufficiency
18 What is FNP made up of? Programme Materials: Phases Domains Facilitators
Resources: PIPE DANCE
Therapeutic relationship: Registered Nurse/ Midwife Focus on engagement rather than assessment
Strengths based approach:
Motivational interviewing 19 Parallel processing Evidence base....
• Strong rigorous US evidence base developed over 30 years shows that FNP benefits most needy young families in short medium and long term: - Improvements in women’s antenatal health - Reductions in children’s injuries - Fewer subsequent pregnancies - Greater intervals between births - Increases in fathers’ involvement - Increases in employment - Reductions in welfare dependency - Reduced substance use initiation - Improvements in educational readiness • International Review in the Lancet 2009 named FNP as one of only 2 programmes shown to reduce child abuse and neglect
20 Progress to date......
• Team Based in Ayrshire Central Hospital covering 3 CHP areas in Ayrshire and Arran.
• Started recruitment 1 year ago and now complete for 1st cohort (154)*
• Annual Review with FNP National Unit 19th March, delighted with progress, performance feedback and plan moving forward
• Initial learning programme almost complete, continual team, partner site learning ongoing
• Low site attrition and promising early signs in relation to breastfeeding initiation, smoking behaviour changes, father involvement
* 17 clients still to be recruited for one Family Nurse
21 Cont’d......
Meeting performance targets (fidelity goals) - 76% clients offered programme have enrolled - 59% clients enrolled by 16 weeks & 6 days gestation - 100% clients enrolled by 28 weeks & 6 days gestation - 3.3% client have left the programme (target < 20% infancy) Smoking - 21% clients have reduced or stopped smoking - Those who have reduced have made behaviour changes Breast feeding - 37% initiated breastfeeding - 13% breastfeeding at 6 weeks
22 Cont’d......
Birth outcomes - 90% babies full term - 5% babies Low Birth Weight
Education - 75% clients in education - 27% clients in employment
Father Involvement - 52% fathers involved with programme - Average visits attended = 7
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North Ayrshire
3 Towns Irvine Kilwin Arran NW/Largs GV 22 18 10 1 3 15
• Total enrolled = 69 (45%) • Average age = 18 years • 12% clients identified as Vulnerable in Pregnancy (23% Ayrshire) • 7 unborn babies on CPR
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Thank you
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Report on Family Nurse Partnership Programme
Author: Donna McKee FNP Lead Nicola Murphy FNP Supervisor
11th June 2014
Summary NHS Ayrshire and Arran following expression of interest to the Scottish Government in 2012 successfully became part of the third Scottish cohort to locally offer and test the Family Nurse Partnership Programme. The programme commenced client recruitment in February 2013 reaching capacity one year later in February 2014 (154 clients). The current programme is fully funded by Scottish Government until July 2016. Eligibility demand and capacity to respond means that young women are now no longer able to receive this programme and funding from 2016 is uncertain. Client outcomes within the first year are very encouraging with early behaviour and attitude changes in areas such as breast feeding, smoking behaviour changes, father’s involvement and observed mother/baby relationship and responses to cues. A client story is provided to demonstrate the impact of the programme on client and child outcomes. Key Messages:
Ayrshire and Arran are successfully implementing an evidence based programme for first time young parents
Promising early signs of health behaviour change in relation to breast feeding and tobacco use
Family Nurse Partnership is contributing to better outcomes for young parents and their children
Glossary of Terms
FNP Family Nurse Partnership GIRFEC Getting It Right For Every Child
1.0 Family Nurse Partnership Programme
1.1 Background to Family Nurse Partnership Programme Family Nurse Partnership (FNP) is an evidence based preventative programme for first time mothers of 19 years or less. The programme aims to improve pregnancy outcomes, child health and development, and parent’s economic self efficiency and is based on the theories of 27
human ecology, self efficacy and attachment. It offers intensive structured home visiting, delivered by specially trained nurses from early pregnancy until the child is two. The programme works with the strengths of the client and encourages them to fulfil their aspirations for themselves and their child. The Family nurses use programme guidelines, materials and practical activities to work with the mother father and wider family on understanding their baby, making behaviour changes, developing emotionally and building positive relationships. Rigorous evidence developed over 30 years has shown Family Nurse Partnership (FNP) benefits the most in need young families in the short, medium and long term across a wide range of outcomes including. • Improved parenting behaviour • reduced accidental and non-accidental injury/neglect • fewer unplanned subsequent pregnancy • better educational outcomes such as language development • increased father involvement FNP is a licensed programme to protect fidelity, with a monitoring framework reviewing outcomes such as breastfeeding, smoking, birth weight, hospital admissions, infant development and mental health, maternal mental health, subsequent pregnancies, participation in education and employment, referral to other services, enrolment, retention and demographic characteristics.
1.2 FNP Team
The FNP team consist of Programme Sponsor (Nurse Director), Programme Lead (CNM Early Years Service), 7 Family Nurses, 1 FNP Supervisor, and 1 Data Manager, receiving consultative support and supervision from Child Protection and Psychology. The Nursing team are co-located in the Child Health Department at Ayrshire Central Hospital.
1.3 Progress to date
NHS Ayrshire and Arran commenced testing of Family Nurse Partnership Programme in February 2013 and have recently completed recruitment of our first cohort of clients (154). Locality breakdown: North = 69 clients East = 49 clients South = 36 clients
3 Towns Irvine Kilwinning NW/ Largs Arran Garn Valley 22 18 10 3 1 15
The FNP Programme in Ayrshire and Arran is funded by Scottish Government which will continue until July 2016 or until the last child reaches 2 years old.
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FNP licence requirements means that Ayrshire and Arran are unable to offer the programme to current eligible young women of which the demand exceeds capacity and therefore the next steps are to consider sustainability of existing FNP service and expansion to be able to offer the programme to all eligible clients on an ongoing basis.
1.4 Early Outcomes
Client outcomes within the first year are very encouraging with early changes and attitude in areas such as breast feeding, smoking behaviour changes, father’s involvement and observed mother/baby relationship and responses to cues. Some examples are provided in the graphs below:
Breast feeding
Have you breastfed or expressed milk 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Percentage of clients at first Infancy visit Percentage of clients at 6 week post natal (1 week after birth) visit Yes 36% 26% No 64% 74%
(ISD breastfeeding rates 2012/2013 - 15.2% for total population under 20 in Ayrshire and Arran)
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Smoking behaviour at 36 weeks gestation
22 22 26% 26% Stopped smoking Still smoking smoked less
40 48%
Father involvement
Percentage of site visits with father 495 present 43% 654 57% Percentage of site visits without father present
2.0 Client Story
The video clip you will see is an FNP client’s story written by the client and read by her Family Nurse. The client shares how the programme has helped her focus on both her and her child’s health and well being, her future aspirations and how she has gained confidence in her parenting ability.
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Shadow Integration Board th 11 June 2014 Subject: Base Budget for 2014 / 2015
Purpose: To advise members of the North Ayrshire Shadow Integration Board that aligned budgets will be managed by the Director of Health and Social Care. Recommendation: That members of the Shadow Integration Board note the contents of the report.
1. Proposal
1.1 The Health Board and each council agreed to establish a SIB commencing on 1st April 2014. A joint appointment was made for the Director of Health and Social Care and with effect from 1st April 2014 these newly appointed directors will manage budgets delegated by both partners.
1.2 Each partner required to agree the scope of the budgets to be devolved and, in the case of Councils, these will cover older people, physical disabilities, learning disabilities, mental health, addictions and children’s services for social work budgets. For NHS budgets, attached as Appendix 1, is the service configuration summary approved by the NHS Board on 31st March 2014.
1.3 Certain services are best managed on a pan-Ayrshire basis and therefore a lead partnership will manage the following services on behalf of all partners:
• All mental health in-patient services (including those listed in Section C and D of Appendix 1) - North Ayrshire Partnership • Primary care management, NHS Ayrshire Doctors on Call and community dental services (family health services non-cash also included) - East Ayrshire Partnership • Allied health professionals (dietetics, occupational therapy, physiotherapy, podiatry, speech and language therapy) - South Ayrshire Partnership
1.4 Appendix 3 sets out the services provided by Council budgets across the client groups.
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2. Implications
2.1 Appendix 2 sets out the initial partnership budget in 2014-15. The NHS and Council contributions to the budget are separately identified as they are aligned budgets in 2014-15 and any under or overspend falls to the individual partner.
2.2 Within the level one core budgets are included prescribing expenditure for prescriptions written by GPs and dispensed by community pharmacists. This will be identified as indicative budget to individual practices. The payments made for delivery of general medical services (including the Quality and Outcomes Framework) are also shown by individual partnership. Both of the above are cash limited and at this time the non-cash limited budget for fees to pharmacists, opticians and general dental practitioners are not included in partnership budget.
2.3 There will be quarterly financial reports produced to each of the SIBs to indicate spend against these budgets.
3. Consultations
3.1 Consultation on the proposed service configuration was by means of meetings held on 13th February 2014 with senior managers and a Stop Press to all staff dated the same date. Confirmation of the lead partnership agreement for primary care, community dental services and allied health professionals being within the lead partnership was agreed at the Health Integration Steering Group on 29th April 2014 and subsequently notified to all staff via a Stop Press dated 15th May 2014.
4. Conclusion
6.1 To note the 2014-15 aligned budgets managed within the North Ayrshire Health and Social Care Partnerships.
For more information please contact :
Laura Friel, Corporate Director Derek Lindsay, Director for Finance Financial & Corporate Support NHS Ayrshire and Arran North Ayrshire Council
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Appendix 1 Service Configuration Summary
A NHS services which will be based and managed in individual Partnerships from 1 April 2014 • Older People • Community Nursing (District Nursing) • Community Children’s (School Nursing, Health Visiting, Looked after Children’s Service) [non-medical] • Community Mental Health, Addictions and Learning Disabilities (Community Mental Health Teams, Primary Care Mental Health Teams, Elderly, Community Learning Disability Teams, Addictions Community Teams) • All Community Hospitals (Arran, Lady Margaret, Biggart, Girvan, Kirklandside, East Ayrshire Community Hospital, Continuing Care wards at Ayrshire Central Hospital)
B Services which will be managed within the Partnership structure after 1 April 2014 (on an individual or Lead Partnership basis) • Primary Care (pending full analysis of Primary Care funding flows) • Community Dental Services • Community Allied Health Professionals
C Pan-Ayrshire Services which will be based and managed in a Lead Partnership from 1 April 2014 • All Mental Health Inpatients Services • Psychiatric Medical Services, Eating Disorders, Forensic, Crisis Resolution and Home Treatment Team, Liaison (Adult, Elderly Learning Disabilities and Alcohol, Advanced Nurse Practitioner Services)
D Pan-Ayrshire services which will be based and managed in a Lead Partnership from 1 April 2014 subject to a review in 2014-15 to determine optimum arrangements within the partnership structure • Learning Disabilities Assessment and Treatment Services • Child and Adolescent Mental Health Services • Psychology • Prison Service
E Services which will not be in the Partnerships from 1 April 2014 which may need to be reviewed during 2014-15 • NHS ADOC • Child Protection and Vulnerable Children’s Administration Team • Sexual Health • Rainbow House
F Services in the Acute Services Directorate where links to the Partnerships need to be defined and agreed during 2014-15
• Older People (acute aspects) • Neuro Rehabilitation
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• Stroke • Specialist Nursing Notes
1. For the pan-Ayrshire Mental Health Services at C above, it is proposed that North Ayrshire will be the Lead Partnership. Broad principles covering Clinical and Care and Corporate Governance arrangements have been developed for all Lead Partnership arrangements.
2. For the pan-Ayrshire Mental Health Services at D above, it is proposed that North Ayrshire will be the Lead Partnership pending review of arrangements in 2014-15.
3. At present there are a small number of services still under discussion including Family Nurse Partnership, Community Infant Feeding Service and Area Wide Evening Service which will be included in the Partnership structure from 1 April 2014 which may be suitable for a Lead Partnership approach.
4. At present there is a pan-Ayrshire Public Health and Health Improvement Workstream examining the role of the Partnerships in these areas and the way in which this can best be supported. The workstream is led by the Director of Public Health. It is anticipated that recommendations will be made by the end of March 2014. A verbal report on progress will be given at the meeting.
5. Two areas have been identified for wider review (a) Child and Adolescent Mental Health Services as to whether it is best sited in Mental Health or Children’s Services (b) Services for Older People and Elderly Mental Health Services as to whether they are best managed as part of a single service.
34 Appendix 2
Indicative Health & Social Care Partnership Budgets: North
2014/15 Budget 2014/15 Budget 2014/15 Budget Council Health Aligned Objective Summary Gross Income Net Gross Income Net Gross Income Net £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 Level One Core Learning Disabilities 15,789 (4,187) 11,602 497 (6) 491 16,286 (4,193) 12,093 Older people 39,283 (5,670) 33,613 0 0 0 39,283 (5,670) 33,613 Physical Disabilities 4,282 (287) 3,995 0 0 0 4,282 (287) 3,995 Mental Health Community Teams 3,393 (1,256) 2,137 2,160 (46) 2,114 5,553 (1,302) 4,251 Addiction 737 (125) 612 1,700 (9) 1,691 2,437 (134) 2,303 Community Nursing 0 3,483 (80) 3,403 3,483 (80) 3,403 Prescribing 0 27,205 0 27,205 27,205 0 27,205 General Medical Services 0 16,750 0 16,750 16,750 0 16,750 Resource Transfer, Change Fund, Admin, Criminal Justice 4,720 (4,745) (25) 12,367 (58) 12,309 17,087 (4,803) 12,284 Total Level One 68,204 (16,270) 51,934 64,162 (199) 63,963 132,366 (16,469) 115,897 Level Two - Non District General Hospitals Ayrshire Central Continuing Care 0 3,783 0 3,783 3,783 0 3,783 Arran War Memorial Hospital 0 1,504 (4) 1,500 1,504 (4) 1,500 Lady Margaret Hospital 0 592 0 592 592 0 592 Total Level Two 0 0 0 5,879 (4) 5,875 5,879 (4) 5,875 Level Three - Hosted Services Mental Health Services 0 42,718 (834) 41,884 42,718 (834) 41,884 Family Nurse partnership 0 477 (5) 472 477 (5) 472 Total Level Three 0 0 0 43,195 (839) 42,356 43,195 (839) 42,356 Level Four - Children's Services 0 Community Paediatrics 0 521 (105) 416 521 (105) 416 C&F Social Work Services 24,999 (159) 24,840 0 0 0 24,999 (159) 24,840 Health Visiting 0 1,769 (6) 1,763 1,769 (6) 1,763 Total Level Four 24,999 (159) 24,840 2,290 (111) 2,179 27,289 (270) 27,019 Direct Overheads & Support Services 4,782 (277) 4,505 0 4,782 (277) 4,505 Partnership Total 97,985 (16,706) 81,279 115,526 (1,153) 114,373 213,511 (17,859) 195,652
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2014/15 Budget 2014/15 Budget 2014/15 Budget Council Health Aligned Subjective Summary Gross Income Net Gross Income Net Gross Income Net £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 Employee Costs 39,838 39,838 50,224 50,224 90,062 0 90,062 Property Costs 513 513 16 16 529 0 529 Supplies and Services 1,802 1,802 2,896 2,896 4,698 0 4,698 Prescribing Costs 27,205 27,205 27,205 0 27,205 Primary Medical Services 16,750 16,750 16,750 0 16,750 Transport and Plant 580 580 0 580 0 580 Admin Costs 1,450 1,450 2,287 2,287 3,737 0 3,737 Other Agencies & Bodies 51,882 51,882 7,181 7,181 59,063 0 59,063 Transfer Payments 1,673 1,673 8,967 8,967 10,640 0 10,640 Other Expenditure 247 247 0 247 0 247 Capital Expenditure 0 0 0 0 0 Income (16,706) (16,706) (1,153) (1,153) 0 (17,859) (17,859) Partnership Total 97,985 (16,706) 81,279 115,526 (1,153) 114,373 213,511 (17,859) 195,652
36
Breakdown of Services Provided via Council Funding
Older People • Assessment & Enablement and Care Management & Review services including Occupational Therapy input • Provision/Procurement of services for those requiring Care at Home • Provision/Procurement of Residential and Nursing Care Packages – including Respite • Day Care services including Dementia Services • Community Alarms and Telecare services • Admin support
Learning Disabilities • Assessment & Enablement and Care Management & Review services • Procurement of services for those requiring Care at Home/Community Care packages • Procurement of specialist Residential and Nursing Care Packages – including Respite • In-house and purchased Day Care services • Employability services • Local Area Co-ordinator • Admin support
Physical Disabilities • Assessment & Enablement and Care Management & Review services including Occupational Therapy input • Procurement of services for those requiring Care at Home/Community Care Packages • Procurement of Residential and Nursing Care Packages – including Respite • Service-wide small aids and equipment budget • Admin support
Mental Health • Assessment & Enablement and Care Management & Review services • Mental Health Officer Service • Procurement of services for those requiring Care at Home/Community Care packages • Procurement of Residential and Nursing Care Packages – including Respite • Procurement of Day Services • Admin support
Addiction Services • Assessment & Recovery Services • Admin support
37
Criminal Justice Services • Criminal Justice Fieldwork services • North Ayrshire Core Services – Community Payback, Diversion, Probation, Throughcare, DTTO • South West Scotland-wide services – MAPPA, Caledonian, Programme Delivery Team, Women Offenders
Children and Families Services • Assessment, Enablement and Care Management Services - including Occupational Therapy Services • Family placement – including fostering, adoption and kinship care • Provision of Residential placements and procurement of Residential School placements • Young Person Support Team, Youth Crime and Throughcare Services • Early Intervention Projects • Procurement of Community and Residential Placements for Children with Disabilities • Admin Support
Direct Overheads and Support Services • Directorate Costs • Service-wide IT purchasing budget and Carefirst Team • Money Matters, Citizens Advice and Welfare Rights • Service Development, Policy, Planning & Performance and Learning & Development - including service-wide staff training budget. • Procurement and Contract Management
38
Shadow Integration Board 11th June 2014 Subject: Change Fund
Purpose: SIB to approve the annual Change Fund template submission to Scottish Government. SIB to note that the prioritisation of Change Fund monies is being explored by all partners. Recommendation: SIB to: a) Approve annual Change Fund template submission to Scottish Government b) Receive an update on the outcomes of the prioritisation exercise being undertaken by partners by Autumn 2014.
1. Background
1.1 The Reshaping Care for Older People Change Fund is entering its fourth and final year. Each year the Scottish Government provides a template for completion. This template highlights where monies have been spent within the partnership, including the allocation provided directly and indirectly to carers.
1.2 The Change Fund leads, which include our Third Sector and Independent Sector SIB members, review and complete the template with the Adult and Older Peoples Officer Locality Group. This template is attached at Appendix 1.
2. Proposal
2.1 The draft template was submitted to Scottish Government on 30th May 2014 to meet the appropriate Government timescale.
2.2 As in previous years both statutory partners have added monies to the Reshaping Care for Older People agenda. North Ayrshire Council provided for 2014/15 a sum of £152,000 for Telecare call monitoring and £861,000 for Care at Home redesign. In recognition in the shift to prevention a recurrent £150,000 for Telecare equipment and £158,000 to support the response team was also provided. NHS Ayrshire and Arran provided £60,000 for a Carers Information Strategy and £176,000 recurrent resource transfer monies to support our Dementia Support Service.
39
3. Prioritisation Exercise
3.1 The partners are currently undertaking a prioritisation exercise reviewing their current areas of work linked to outcomes; to assess if there is work which can be mainstreamed if monies are available. This is a challenging piece of work and it is hoped that this will be completed by the Autumn.
4. Recommendations
4.1 SIB to approve annual Change Fund template submission to Scottish Government and to receive an update on the outcomes of the prioritisation exercise undertaken by partners by Autumn 2014.
For more information please contact Michelle Sutherland, CHP Facilitator on 01294 317751 or email [email protected] & [email protected]
40
Draft subject to formal sign off by Shadow Integration Board on 11 June 2014
PARTNERSHIP DETAILS Partnership name: North Ayrshire Partnership Contact name(s): Michelle Sutherland Contact telephone 01294 317737 Email: [email protected] Date agreed: To be ratified on 11 June 2014
The content of this template has been agreed as accurate by:
Stephen McKenzie for the NHS Board Cllr. Anthea Dickson for Council
Jim Nichols for the Third Sector Nigel Wanless for the Independent sector
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 1 41 42 ANNEX B – Change Fund 2014/15 Plan Template
1 YEAR CHANGE FUND INVESTMENT PLAN (2014/15)
Indicators of Progress Question Comments Please describe The North Ayrshire Partnership as part of its Joint Commissioning the extent to Strategy has been shifting resource as part of a re-alignment of our which your wider system. The change fund has not facilitated this work Change Fund extensively given its size and the short timescale. activity to-date has changed the The Change Fund has facilitated change in relation to the total spend spend profile of profile in North Ayrshire in the following ways: the total resource The Change Fund itself, which is top sliced from NHS budget, envelope for has been deployed much more extensively to support Older People in community based work across four sectors and with more your area, and emphasis on preventative and anticipatory work and with the whether it has led development of community capacity. to any disinvestment Through the lifetime of the Change Fund, the resources have shifted towards the earlier intervention/prevention work streams and away from institutional care
In 2010/11 two North Ayrshire Council residential homes closed and this money was re-invested in to care at home Reablement services totalling £336,000 per annum in subsequent years.
There have been changes in the spend profile in North Ayrshire Partnership over the last 18 months with the transfer of NHS Rapid Response services from the acute services to community based approach integrating with North Ayrshire Council re-ablement approaches as a new Intermediate Care and Enablement Service (ICES). This totals £167,000 per annum.
In 2011/12 North Ayrshire Partnership also received £176,985 of resource transfer monies from the closure of NHS long stay elderly mental health beds and these monies will be used to mainstream our Dementia Support Service.
In 2013/14 North Ayrshire Council closed a rehabilitation centre and £116,000 was invested recurrently to support community Occupational Therapy posts.
Please describe In North Ayrshire there has been a real emphasis on using the your approach to funding as a catalyst for change. The Change Fund has been determining the invested for different purposes. long term sustainability of For example, some Change Fund has been used to provide
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 2 43 your Change investment funding to change from one model of service Fund provision to another e.g. Re-ablement would be an example of investments. this or for Bridging Finance to allow a change process to take Please provide place e.g. Community Geriatrician Sessions and Community summary Pharmacy sessions as examples. information on any investments Some of the investment has been used to create broader for which clear capacity in terms of skills and knowledge in staff for example, evidence as to Nutrition and Dementia Support and Palliative Care their sustainability programme. is available Some has been used to develop infrastructure for example, Community Equipment Service, Telecare and Telehealth, one off capital and equipment funding to support co-location, or sector leadership such as Scottish Care Development Officer post.
Other funding has been used to pilot and evaluate a new project for example, such as Community Wards.
Other funding has been simply putting in place a development process to shift ‘services’ to community/voluntary sector based approaches such as the footcare service.
Some of the funding has been explicitly aimed at preventative approaches for example, the Invigor8 programme and Falls Trainer.
Other funding has been used to increase of service hours for example, Out of Hours Nursing and Social Care.
Another important component has been to address capacity gaps within pathways because of the increased demand in the system for example, ICES and Winter Care responses.
The Partnership also tested rehabilitation and enablement beds in care homes to assess the impact of this new bed model.
The consequence of this ‘change orientated’ approach is that some of the Change Fund projects identified above do not need material long term funding.
For other component parts we are currently trying to identify the potential post Change Fund demand and identifying resources that could be used to sustain initiative demonstrating real impact. This will include, for example, the Resource Transfer money and monies coming from European programmes for Telehealthcare.
Within the Community Capacity work stream, some interventions have introduced income generation, e.g., such as charging for the footcare service and the post 52 week falls classes. There has been significant work carried out by Third Sector Interface in order to identify other sustainable ways forward for work. Other parts of the
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 3 44 programme are now linked into wider Self-Directed Support approaches and there has been some resource deployed from this in relation to sustainability.
Increasingly, the Community Capacity programme developed for older people has resonance with other work streams for example, Adult Mental Health, addictions and Learning Disability and the future sustainability of this work is being considered within this broader context to build an integrated community service model as we move towards integration. The involvement of our Third Sector interface in supporting all care groups consistently across North Ayrshire has been very helpful.
This approach will also facilitate the work currently being developed on Neighbourhood and Locality Planning.
For acute sector interface work between consultants and GPs; work has commenced to amend consultant contracts in the longer term to sustain this model, recognising the links with communities and partnership working.
The introduction of the national Chronic Medicine Service by our local pharmacists will also support the sustainability of support to paid and unpaid carers in the longer term.
Our component work strands report into a performance management system (Covalent) in order to monitor the individual projects work in terms on inputs and actions, service outputs and short term outcomes. The performance information used by leads is attached at Appendix 1. Our Change Fund Leads meet Project Leads every six months to assess sustainability.
Each project has an associated outcomes model that describes the relationship between the interventions and a larger and longer term outcome.
An example of our work is the Intermediate care team – its results are described below:
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In 2014/15 our allied Health professional and the ICES team will be assessing changes required to disinvest in traditional models to deliver greater community capacity, which can be sustained.
In 2015/16 a further £900,000 will be released from the closure of Elderly Mental Health beds and these monies will be available for the three Ayrshire Partnerships to support mainstreaming of Change Fund Work.
Each of the partnerships have begun discussions on what their priorities might be and an evaluation template is being developed to support partners to prioritise this work. The prioritisation exercise will take account of the recent Audit Scotland report in to Reshaping Care for Older People.
The North Partnership has also volunteered to test both Contribution Analysis and Programme Budget; Marginal Analysis working with JIT
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 6 47 and the Scottish Government but this work has been delayed.
It would be helpful if a single National methodology for quick and easy option appraisal to support identification of sustainability could be identified and agreed for local use.
Please describe The North Ayrshire Partnership had hoped to test both ‘Programme your approach to Budget, Marginal Analysis’ working with the Joint Improvement Team determining the alongside the sites in Tayside and Highland, but this methodology return on was unsuccessful. investment of your Change The North Ayrshire Partnership has also offered to test the Fund Contribution Analysis methodology working with the Scottish investments. Government looking at our falls pathway, but again this work had Please provide limited success. summary information on Our leads have therefore had to rely on the performance data any investments collected by each project on the covalent system, to assess if their for which you investment is having an impact on the agreed outcomes. consider clear evidence is The example below shows a reduction in emergency care home available as to admissions in North Ayrshire and our outcomes at Appendix 1 also the return on highlights that care home residents who have been admitted to investment that hospital stay now stay in for shorter times. they are delivering
Our leads have to assume that this outcome is due to the whole system approach we are taking by providing a care home development lead, development sessions with providers, additional dementia and nutritional training/interventions plus a separate telephone care home line for out of hours clinical advice.
Our Dementia Care Home Liaison Nurses have also been auditing the use of psychoactive medicines and there has been a large increase in the numbers of reviews undertaken.
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 7 48 As stated above the Change Fund projects are performance managed through the covalent system allowing us to assess the programmes across the national pathway areas.
We have good intelligence from both NHS and Council research and planning sources in relation to the overall Reshaping Care metrics but this illustrates complexity, making choice difficult.
Relating the first to the second of these has proved challenging.
Case Studies – increasingly, the use of case studies and patient stories has been seen as better capturing the complexity of and interactions between the constituent elements of our programme and provide a richer perspective on impact.
Some of the Change Fund projects have also been subject to much more extensive evaluation, for example, the Community Ward and Intermediate Care and Enablement Services. The evaluation of the Community Ward, for example, has some basic cost-benefit analysis included to assess the economics and future sustainability of the service.
It would be helpful if a single National methodology for assessing return on investment could be identified and agreed for local use.
Please describe Our entire change fund in North Ayrshire has been focussed on our the value of your early intervention and prevention agenda. The Partnership made Change Fund some key decisions in its first year to ensure the following to support investment in early intervention and prevention approaches: prevention across the entire The building of community capacity using co-production and re-shaping care an assets based approach working with the third sector, pathway. Please carers and independent sector is key to our long term explain the success. rationale that you All of our change fund work had to have a carers support have used to focus. identify relevant Focus on a locality based approaches where partners and investments, in existing teams can work together to support our particular those neighbourhoods. that fall within the Management support and organisational development institutional activities supporting the change fund came from within spectrum existing staff resource to ensure low enabler costs. Improving our partnership understanding of the housing issues older people currently face, particularly our island and rural communities and developing our Older People Housing Strategy which is focussed on prevention and early intervention. Improving our partnership understanding of the inequalities older people currently face in North Ayrshire through the development of a detailed needs assessment. We agreed that the acute pathway would re-designed first to ensure additional funding released to support the prevention pathway and we can now see this in our financial returns.
It is good to see that we have moved our change fund allocation
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 8 49 consistently towards the prevention and anticipatory care pathway, maintaining a low enabler pathway and have reduced our acute pathway.
Our Third Sector Development Workers and Community Connectors on both the Mainland and Arran are focussed on building community capacity to ensure early intervention and prevention using existing community assets in North Ayrshire and the creation of our 20 lunch Clubs is an example of this work. Providing funding directly to community organisations for them to deliver their own programmes is a key prevention approach.
Change Fund 2014/15 – Financial Summary ITEM £ 2013/14 Change Fund year end spend total 2,204,129 2014/15 Change Fund carryover from 2013- 60,686 14 2014/15 Change Fund allocation 1,960,000 2014/15 local resources added to central 1,322,000 Change Fund allocation (LA) 2014/15 local resources added to central 236,985 Change Fund allocation (NHS) 2014/15 other local resources added to central Change Fund allocation (please state) Total 2013/14 Change Fund resources 3,579,671 Total 2014-15 Projected spend 3,579,671 20145-15 Projected under/(over) spend 0
Carers – 2014-15 £ G Projected spend % of total in £s 2014/15 Change Fund allocation Change Fund investment on 239,500 7% direct carer support Change Fund investment on 544,247 23% indirect carer support Total Change Fund investment on 825, 747 30% all carer support
S:\SSPUBLIC\SSHQ\mm4docs\CHP Facilator\CHP Business\Change fund\Change Fund 2014-15\Annex B - 2014-15 investment plan 21052014 Final Draft for Scottish Government.doc 9 50 Appendix 1
RCOP North Ayrshire High Level Indicators - Report for Q4 2013/14
Report Author: Andy Mathie Generated on: 29 May 2014
PI Status Long Term Trends Short Term Trends
Alert Improving Improving
Warning No Change No Change
OK Getting Worse Getting Worse
Unknown
Data Only
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A001a Emergency Margaret Peck; Michelle Kennedy; November inpatient bed day rates for 4,963 4,407 Michelle Sutherland Andy Mathie 2013 people aged 75+ Methods & Sources: Source: ISD Rolling year to end of month (provisional). The target is based on a 12% reduction over 5 years from 2009/10 and 2014/15 and 20% by 2021. Approximately 6 months time lag for data. The monthly HEAT 75+ Management Report is usually published by ISD during the last week of every month This information is released for management purposes only and contain previously unpublished data. Please treat as restricted until general release. In December 2013, NRS released revised mid-year population estimates at health board and local authority level based on the 2011 census. This has resulted in an increase to previously published bed day rates from 2003/04. Revised population estimates have also been released at CHP level for 2011/12. This has resulted in an increase to previous published CHP bed day rates from 2011/12. Benchmarking: Historically, North Ayrshire has had an increasing trend followed by a reduction then again an increase in
11 51 2012/13. There has been a reducing trend in East Ayrshire followed by an increase in last year 2012/13. South Ayrshire has no discernable trend with number of reductions followed by increases, most recent increase in 2012/13. Scotland wide there has been a reducing trend. After period of years where each locality area was below the Scotland annual rate, in 2012/13 each locality was above the Scotland wide rate of 4936. Latest data: Rolling year to end of month December 2012 to November 2013. The target of a 12% reduction for each area is not being met. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. Rate per 1,000 population: Over period December 2012 to November 2013 rates increased across the three local authority areas but figure Scotland wide reduced. Average rates per 1,000 for the three areas were higher than the average rate for Scotland. East Ayrshire had the highest average rate followed by South Ayrshire then North Ayrshire. Latest data (12 months ending November 2013) show that South Ayrshire had the highest rate followed by North Ayrshire then East Ayrshire. Remedial action (where applicable): Following consultation with NHS A&A and Joint Improvement Team staff a range of actions has been suggested to address the high admission rates: o Urgently review and revise the Ayr Hospital bed configuration to match the current demand, informed by a ‘Day of Care’ snapshot survey adapted to identify most appropriate speciality and setting for the inpatients; o Community Ward / ICES specialist team to increase their footprint in Ayr to actively pull out to community and, where possible, bypass Biggart stepdown; o Increase capacity for community pull out through proportionate release of practitioner expertise and resources currently aligned with bed pool at Biggart; o Review data with SAS and ADOC for care home admissions and engage with high referring homes to target care home nurse liaison, ACP and prof – prof decision support; o Each partnership should identify their cluster of practices with highest volume of older emergency referrals, target these hotspots for assertive case management, to raise awareness of alternative community pathways and to lever flow through these community pathways via single point of contact; o Develop urgent Day Hospital access for each locality – building on the model in Girvan and Cumnock; and o Use the associated Community Wards to offer specialist outreach – GPsWI / team, mentored by Consultant and using telehealth to support prof – prof decision support. Note : for each of the above Community Plans are being developed as part of NHS Ayrshire & Arran Local Unscheduled Care Action Plan (LUCAP), ownership for community plans contained within LUCAP.
Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Community Wards (Kathleen McGuire)
12 52 Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A001b Emergency Seek to Margaret Peck; Michelle Kennedy; November inpatient numbers for people 4,723 achieve Michelle Sutherland Andy Mathie 2013 aged 75+ Scottish Trend Methods & Sources: Source: ISD Rolling year to end of month (provisional). Approximately 6 months time lag for data. The monthly HEAT 75+ Management Report is usually published by ISD during the last week of every month This information is released for management purposes only and contain previously unpublished data. Please treat as restricted until general release. No target has been set. In December 2013, NRS released revised mid-year population estimates at health board and local authority level based on the 2011 census. This has resulted in an increase to previously published bed day rates from 2003/04. Revised population estimates have also been released at CHP level for 2011/12. This has resulted in an increase to previous published CHP bed day rates from 2011/12. Benchmarking: Historically, numbers and rates per 1,000 population increased across the three local authority areas and for Scotland. Latest data: Rolling years to end of month December 2012 to November 2013. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. Number: Over December 2012 to November 2013, the number of Emergency admissions increased in North Ayrshire, both East and South Ayrshire experienced a slight decrease. Over same period South Ayrshire had the highest average number followed by North Ayrshire then East Ayrshire. Latest data (12 months ending November 2013) again shows that South Ayrshire had the highest number followed by North Ayrshire then East Ayrshire. Rate per 1,000 population(included to allow comparison): Over December 2012 to November 2013, the Admission rates increased in North Ayrshire, whilst both East and South Ayrshire had slight decreases. Latest data (12 months ending November 2013), average rates per 1,000 for the three areas were higher than the average rate for Scotland (360). East and South Ayrshire had the joint highest average rate (425) whilst North Ayrshire average rate was (395). Remedial action (where applicable): Following consultation with NHS A&A and Joint Improvement Team staff a range of actions has been suggested to address
13 53 the high admission rates: o Urgently review and revise the Ayr Hospital bed configuration to match the current demand, informed by a ‘Day of Care’ snapshot survey adapted to identify most appropriate speciality and setting for the inpatients; o Community Ward / ICES specialist team to increase their footprint in Ayr to actively pull out to community and, where possible, bypass Biggart stepdown; o Increase capacity for community pull out through proportionate release of practitioner expertise and resources currently aligned with bed pool at Biggart; o Review data with SAS and ADOC for care home admissions and engage with high referring homes to target care home nurse liaison, ACP and prof – prof decision support; o Each partnership should identify their cluster of practices with highest volume of older emergency referrals, target these hotspots for assertive case management, to raise awareness of alternative community pathways and to lever flow through these community pathways via single point of contact; o Develop urgent Day Hospital access for each locality – building on the model in Girvan and Cumnock; and o Use the associated Community Wards to offer specialist outreach – GPsWI / team, mentored by Consultant and using telehealth to support prof – prof decision support. Note : For each of the above Community Plans are being developed as part of NHS Ayrshire & Arran Local Unscheduled Care Action Plan (LUCAP), ownership for community plans contained within LUCAP. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Community Wards (Kathleen McGuire) Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
14 54
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A002a Patients whose Margaret Peck; Michelle Kennedy; 0 0 Q4 2013/14 discharge is delayed > 4 weeks Michelle Sutherland Andy Mathie Methods & Sources: Source: ISD Quarterly census data are usually published one month after the quarter end. Target: No people will wait more than 28 days to be discharged from hospital into a more appropriate care setting, once treatment is complete, from April 2013, followed by a 14 day maximum wait from April 2015. Benchmarking: At the last census (January 2014) there were no patients waiting more than 4 weeks across the three local authority areas. Overall Scotland figure at last census (January 2014) detailed 254 patients waiting more than 4 weeks Remedial action (where applicable): Work on-going to prepare for 2 week target. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Care at Home (Helen McArthur) Management Lead: o Helen McArthur, Senior Manager - Community Care o Lorraine Sheridan, Bed Manager
15 55
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow Reduce CF NA A002b Bed-days Margaret Peck; Michelle Kennedy; December 477 Number of Bed Accumulated for people delayed Michelle Sutherland Andy Mathie 2013 days Methods & Sources: Source: ISD Total bed days occupied by delayed discharge patients (Standard and Code 9). Data relates to people aged 75+ years Data only available from April 2012 therefore there is insufficient trend information to allow targets to be set The next update will be published during May 2014. Benchmarking: Monthly data are available from April 2012 to December 2013 (All delayed discharges, patients aged 75+). Over this period, North Ayrshire had the highest average number of bed days followed by East Ayrshire then South Ayrshire. For the period October to December in North Ayrshire there was an increase in October followed by reductions in both November and December 2013. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. December 2013 position showed that South Ayrshire had the highest number followed by North Ayrshire then East Ayrshire. Remedial action (where applicable): Work on-going to prepare for 2 week target. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Bernadette Brown) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Care at Home (Helen McArthur) Management Lead: o Helen McArthur, Senior Manager - Community Care o Lorraine Sheridan, Bed Manager
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A003 Prevalence rates Margaret Peck; Michelle Kennedy; No target has 0.74 2012/13 for diagnosis of dementia Michelle Sutherland Andy Mathie been set Methods & Sources Source: ISD The next update will be published during September 2014. No target has been set. Benchmarking From 2006/07 to 2012/13, South Ayrshire had the highest average prevalence rate followed by East Ayrshire then North Ayrshire. During 2012/13, South Ayrshire had the highest prevalence rate followed by North Ayrshire then East Ayrshire. For the years 2011/12 and 2012/13, prevalence rates in the three local authority areas were higher than the rates for Scotland. Remedial action (where applicable) Dementia Working Group agreed that this existing measure would now be replaced with following new measures; A003a Number of Patients Diagnosed with Dementia A003b Percentage of patients who have been diagnosed with Dementia who have been offered one years post diagnostic support with a named link worker. A003c Percentage of patients who have been diagnosed with Dementia who have accepted offer of one years post diagnostic support with a named link worker. This is in order to address new Heat Target Dementia Post Diagnostic Support (DPDS). Target is to deliver expected rates of dementia diagnosis and by 2015/16 all people newly diagnosed with dementia will be offered a minimum of a year's worth of post diagnostic support coordinated by a link worker, including a person-centred plan in place at the end of the support period. NB. Data set available from April 2014. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Dementia Training (Isabel Marr) o Dementia Care Home Liaison (Isabel Marr) Management Lead: o Isabel Marr, Service Manager, Elderly Mental Health
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A004 Percentage of Debbie Campbell; people aged 65+ who live in Michelle Sutherland Michelle Kennedy; 96.37% 96.4% 2012/13 housing, rather than a care home Andy Mathie or a hospital setting Methods & Sources: The percentage of people aged 65+ living in housing in North Ayrshire during 2012/13 was calculated by North Ayrshire Council and, based on the same methodology; figures have now been calculated by East Ayrshire Council and will be progressed by South Ayrshire Council. Agreed this indicator should now be categorised as "Local Authority" reportable. Scorecard Analysis: The target of 96.40% for 2013/14 is based on previous trend information. There is ongoing dialogue at a national level in relation to relevance of this indicator. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Integrated Care & Enablement Service (Stuart Gaw) o Community Wards (Kathleen McGuire) Management Lead: o Helen McArthur, Senior Manager - Community Care
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A005 Percentage of time Debbie Campbell; in the last 6 months of life spent Margaret Peck; Michelle Kennedy; 93.1% 90.5% 2011/12 at home or in a community Michelle Sutherland Andy Mathie setting Methods & Sources Source: ISD,Table 2: Council area 2012/13 figures will be available August 2014. Target: Maintain between ± 0.1 percentage point per annum Benchmarking From 2008/09 to 2011/12, the percentage increased in North Ayrshire and maintained in East Ayrshire. In South Ayrshire, there was a slight reduction from the 2007/08 position. For Scotland, there was an increasing trend. From 2007/08 to 2011/12, South Ayrshire had the highest average percentage followed by East Ayrshire then North Ayrshire. In 2011/12, the percentages for North and South Ayrshire were higher compared to Scotland. During 2011/12, North Ayrshire had the highest percentage followed by South Ayrshire then East Ayrshire. Remedial action (where applicable) Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Integrated Care & Enablement Service (Stuart Gaw) o Community Wards (Kathleen McGuire) o Mainstream services (incl enablement) Management Lead: o Helen McArthur, Senior Manager - Community Care o Stuart Gaw, Intermediate Care & Enablement Service Manager
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A006a Percentage of Debbie Campbell; Maintain Level Service Users in receipt of Michelle Sutherland Michelle Kennedy; 98% – as per 2011/12 Community Care services feeling Andy Mathie Service Plan safe Methods & Sources: Not applicable. Scorecard Analysis: Change in Supported Self Assessment Questionnaire (SSAQ) paperwork has resulted in data no longer being gathered. Possible replacement information gathering via "talking points". Local authority Performance Officer investigating. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Care at Home (Helen McArthur) o Out of Hours Social Work (Helen McArthur) o LOTs (Mary Francey, Bernadette Brown) Management Lead: o Alan Brown, Senior Manager - Care Management and Review
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A006b1 Percentage of Debbie Campbell; Service Users satisfied with their Michelle Sutherland Michelle Kennedy; 91% No Target 2011/12 involvement in the design of their Andy Mathie care packages Methods & Sources: Not applicable. Scorecard Analysis: Change in Supported Self Assessment Questionnaire (SSAQ) paperwork has resulted in data no longer being gathered. Possible replacement information gathering via "talking points". Local authority Performance Officer investigating. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Care at Home (Helen McArthur) o Out of Hours Social Work (Helen McArthur) o LOTs (Mary Francey, Bernadette Brown) Management Lead: o Alan Brown, Senior Manager - Care Management and Review
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A006b2 Percentage of Debbie Campbell; Carers satisfied with their Michelle Sutherland Michelle Kennedy; 96% No Target 2011/12 involvement in the design of their Andy Mathie care packages Methods & Sources: Not applicable. Scorecard Analysis: Change in Supported Self Assessment Questionnaire (SSAQ) paperwork has resulted in data no longer being gathered. Possible replacement information gathering via "talking points". Local authority Performance Officer investigating. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o 3rd Sector Community Capacity - Elderly Carers Support Worker (Jim Nichols) o Care at Home (Helen McArthur) o LOTs (Mary Francey, Bernadette Brown) Management Lead: o Alan Brown, Senior Manager - Care Management and Review
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A006c Percentage of Debbie Campbell; service users satisfied with Michelle Sutherland Michelle Kennedy; 91% No Target 2011/12 opportunities for social Andy Mathie interaction Methods & Sources: Not applicable. Scorecard Analysis: Change in Supported Self Assessment Questionnaire (SSAQ) paperwork has resulted in data no longer being gathered. Possible replacement information gathering via "talking points". Local authority Performance Officer investigating. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Community Capacity - Lifelong Learning (Pam Crosthwaite) o 3rd Sector Community Capacity - Information and advice (Jim Nichols) o 3rd Sector Community Capacity - Lunch Clubs (Jim Nichols & Tony Fisher) o Care at Home (Helen McArthur)
Management Lead: o Alan Brown, Senior Manager - Care Management and Review
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA A006d Percentage of Debbie Campbell; carers who feel supported and Michelle Sutherland Michelle Kennedy; 86% No Target 2011/12 able to continue in their role as a Andy Mathie carer Methods & Sources: Not applicable. Scorecard Analysis: Change in Supported Self Assessment Questionnaire (SSAQ) paperwork has resulted in data no longer being gathered. Possible replacement information gathering via "talking points". Local authority Performance Officer investigating. Benchmarking: Not applicable. Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o 3rd Sector Community Capacity - Elderly Carers Support Worker (Jim Nichols) o Care at Home (Helen McArthur) o LOTs (Mary Francey, Bernadette Brown)
Management Lead: o Alan Brown, Senior Manager - Care Management and Review
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B001 Proportion of people aged 75 and over living at Margaret Peck; Michelle Kennedy; No target has home who have an Anticipatory No Data 2010/11 Michelle Sutherland Andy Mathie been set Care Plan shared with Out-of- Hours staff Methods & Sources: Not applicable. Scorecard Analysis: Data are not currently available for this measure. Discussions have been ongoing to ascertain an overall Ayrshire wide approach to developing this indicator. Recommendations of paper dated 10 December 2013 to CHP Facilitators accepted that the Anticipatory Care Plan Programme Board (ACPPB) remitted to seek to resolve issues relating to ACPs including provision of robust data in line with Joint Improvement Team methods and sources. Once robust data are available, the B1 measure could also be used to support future performance reporting to the ACPPB. Benchmarking: Not applicable. Remedial Action: ACPPB will lead on taking work forward. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) Management Lead: o Kathleen McGuire, Long Term Conditions Manager o Ann Gow, Assistant Director of Nursing - Primary Care
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B003 Proportion of Debbie Campbell; people aged 75+ with a telecare Michelle Sutherland Michelle Kennedy; 183.32 185 2012/13 package Andy Mathie Methods & Sources: Not applicable. Scorecard Analysis: These data are showing that the proportion of people aged 75+ with a telecare package is 183.3 against a target of 185. The target for 2012/13 is based on previous trend information. Benchmarking: Not applicable. Remedial Action:
Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Care at Home (Helen McArthur) Management Lead: o Julie Thomson, Team Manager - Community Care (Telecare)
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B004 Proportion of Debbie Campbell; service users whose level of No target has Michelle Sutherland Michelle Kennedy; No Data 2013/14 service was reduced after been set Andy Mathie reablement service provided Methods & Sources: Not applicable. Scorecard Analysis: North Ayrshire are in the process of developing their re-ablement information to be able to produce regular reports on the impact of this service. Currently, information produced is not validated. Further, we are still unable to match this data to IoRN scores. It is our understanding that colleagues in South and East Ayrshire are facing similar issues.
Local Authority advise "Introduction of CM2000 scheduling and monitoring system into Care at Home Services will deliver much more robust data on delivery of Reablement services. It will allow us to detail reduction in hours of Care at Home packages and give definitive figures for care packages at end of Reablement service provision. Implementation of system is currently underway and should be complete by June 2014."
Benchmarking: Not applicable.
26 66 Remedial Action: Not applicable. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Care at Home (Helen McArthur) Management Lead: o Kerry Logan, Team Manager, Community Care (Re-ablement)
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow Debbie Campbell; CF NA B005 Respite care for No target has Michelle Sutherland Michelle Kennedy; 119 2011/12 older people per 1000 population been set Andy Mathie Methods & Sources: Not applicable. Scorecard Analysis: These data are showing that 119 people are receiving respite care. Target of 120 proposed based on previous trend information. It is anticipated that reporting against this measure will change due to introduction of Self Directed Support. Benchmarking: Not applicable. Remedial Action:
Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Care at Home (Helen McArthur) Management Lead: o Tony Fisher, Team Manager, Community Care (Dementia and Day Services)
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B006b Rates of 75+ conveyed to Accident & Margaret Peck; Michelle Kennedy; 12.5 Q4 2013/14 Emergency with principal Michelle Sutherland Andy Mathie diagnosis of a fall Methods & Sources: Source: Scottish Ambulance Service Data Warehouse Rates calculated by NHS Ayrshire & Arran Rate per 1,000 based on Scottish Ambulance Service (SAS) data. Note: Data for Q1 to Q3 2012/13 amended by SAS There is usually a one month time lag for quarterly data. At a meeting with the SAS on 4 June 2013, it was established that targets could be set once a national 'See and Treat' pathway for falls was in place. Timescale for this not currently available. Latest request for update forwarded to SAS on 23 May 2014 - response awaited. In interim, provisional target of a year on year decrease suggested. Benchmarking: Rates decreased across the three local authority areas during 2013/14, prior to which rates had been increasing in the three previous years. During 2013/14, South Ayrshire had the highest rate followed by North Ayrshire then East Ayrshire. The latest quarter shows a reduction across the three areas. Remedial action (where applicable): Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Falls Prevention Training Care Homes (Janet Mauchlen) o Falls Prevention Pathways ICES (Laura Halcrow) o INVIGOR8 (KA Leisure, Fiona Comrie)
Management Lead: o Rebekah Wilson, Falls Lead
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B006 Rates of 65+ Provisional conveyed to Accident & Margaret Peck; Michelle Kennedy; 7 year on year Q4 2013/14 Emergency with principal Michelle Sutherland Andy Mathie decrease diagnosis of a fall Methods & Sources: Source: Scottish Ambulance Service Data Warehouse Rates calculated by NHS Ayrshire & Arran Rate per 1,000 based on Scottish Ambulance Service (SAS) data. Note: Data for Q1 to Q3 2012/13 amended by SAS There is usually a one month time lag for quarterly data. At a meeting with the SAS on 4 June 2013, it was established that targets could be set once a national 'See and Treat' pathway for falls was in place. Timescale for this not currently available. Latest request for update forwarded to SAS on 23 May 2014 - response awaited. In interim, provisional target of a year on year decrease suggested. Benchmarking: Rates decreased across the three local authority areas during 2013/14, prior to which rates had been increasing in the three previous years. During 2013/14, South Ayrshire had the highest rate followed by North Ayrshire then East Ayrshire. The latest quarter shows a reduction across the three areas. Remedial action (where applicable): Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Falls Prevention Training Care Homes (Janet Mauchlen) o Falls Prevention Pathways ICES (Laura Halcrow) o INVIGOR8 (Fiona Comrie - KA Leisure)
Management Lead: o Rebekah Wilson, Falls Lead
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA B007 Proportion of frail emergency admissions who Margaret Peck; Michelle Kennedy; No target has No Data 2010/11 access comprehensive geriatric Michelle Sutherland Andy Mathie been set assessment with 24 hours Methods & Sources: Not applicable. Scorecard Analysis: Data are not currently available for this measure. This high level indicator supports the local initiative funded by the Change Fund to 'Develop Specialist Geriatric Services in the Community'. Frail Older Person's Pathway Pilots continuing to run in A&E Departments at Crosshouse and Ayr Hospital until March 2014. There will be a continuous process of qualitative and quantitative evaluation with a 3 and 6 month formal review. Agreed that RCOP/Change Fund Senior Information Analyst is to work actively with the leads of the Frail Elderly pilots to gather the necessary data, based on Methods & Sources for this indicator. Baselines to be provided for the number pre and post elderly pathway.
Agreed if no data, no targets forthcoming look to drop this measure.
Benchmarking: Not applicable. Remedial Action: Not applicable.
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA C001 Per capita weighted Margaret Peck; Michelle Kennedy; No target has cost of accumulated bed days No Data 2010/11 Michelle Sutherland Andy Mathie been set lost to delayed discharge Methods & Sources: Source: ISD & NHS Ayrshire & Arran (Edison system). ISD recently developed a report template to extract the information required for costing. The report was subsequently modified and data should be available in the near future. Christine McGregor, Economic Advisor, Scottish Government previously advised that 12/13 mapping not yet finalised, Andy Mathie tabled information request update with ISD on 23 May 2014. Scorecard Analysis: No target has been set. Benchmarking: Not applicable. Remedial Action (where applicable): Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Integrated Care and Enablement Service (Stuart Gaw) o Community Ward (Kathleen McGuire)
Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA C002 Cost of emergency inpatient bed days for people Margaret Peck; Michelle Kennedy; £2,257,635.00 £2,250,000.00 2011/12 over 75 per 1000 population over Michelle Sutherland Andy Mathie 75 Methods & sources: Source: ISD The figures were calculated by ISD and are recommended by the Scottish Government. They are the cost of emergency inpatient bed days for people aged over 75 per 1,000 population The 2011/12 figure was revised by ISD 5 September 2013. The target for 2011/12 is based on previous trend information. NHS Finance lead to examine the figures and provide background information/caveats No target has been set. There is insufficient trend information to establish quantified targets. Consider setting 'maintain current level target'.
Scotland 2011/12 Cost of emergency bed days for people over 75 = £960,494,664 Number of people over 75 (weighted population) = 426,078 Cost per capita= £2,254
Benchmarking It should be noted that from 2010/11 to 2011/12, cost rates increased in the three local authority areas. During 2011/12, East Ayrshire had the highest cost rate followed by North Ayrshire then South Ayrshire. Remedial action (where applicable)
Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Dementia Care Home Liaison (Isabel Marr) o Care at Home (Helen McArthur) o Integrated Care and Enablement Service (Stuart Gaw) Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA C003 A measure of the balance of care (e.g. split Margaret Peck; Michelle Kennedy; 38% 38% 2011/12 between spend on institutional Michelle Sutherland Andy Mathie and community-based care). Methods & Sources: Source: 2009/10 NHS Ayrshire & Arran IRF. 2010/11 and 2011/12 ISD The % community based care is shown. The target of 39% for 2012/13 is based on previous trend information. Benchmarking: During 2011/12, North Ayrshire had the highest % spend on community based care followed by South Ayrshire and East Ayrshire equally. Over the three years, the percentage increased in East Ayrshire and North Ayrshire . In South Ayrshire, the % remained the same then reduced during 2011/12. The Scotland position for Community based care is 36%. Remedial action (where applicable):
Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 001 Average length of stay for emergency Margaret Peck; Michelle Kennedy; November 12.2 12.7 admissions of over 75 years Michelle Sutherland Andy Mathie 2013 population Methods & Sources: Source: ISD Rolling year to end of month (provisional). Approximately 6 months time lag for data. The monthly HEAT 75+ Management Report is usually published by ISD during the last week of every month This information is released for management purposes only and contain previously unpublished data. Please treat as restricted until general release. Target calculated on basis of trend information for preceding 12 months. In December 2013, NRS released revised mid-year population estimates at health board and local authority level based on the 2011 census. This has resulted in an increase to previously published bed day rates from 2003/04. Revised population estimates have also been released at CHP level for 2011/12. This has resulted in an increase to previous published CHP bed day rates from 2011/12. Benchmarking: Historically, Average Length of Stay (ALS) reduced across the three areas and for Scotland. With ALS lower across each of the three local authority areas compared to Scottish wide figure. Latest data: Rolling years to end of month December 2012 to November 2013. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. ALS were lower across the three local authority areas compared to Scotland. Latest data as at November 2013, show that South and North Ayrshire had the highest ALS (12.2) with East Ayrshire recording 11.8. Remedial action: (where applicable): Remedial action: (where applicable): Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o LOTs (Mary Francey, Bernadette Brown) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Community Wards (Kathleen McGuire) Management Lead: o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 002 Bed days Margaret Peck; Michelle Kennedy; November 57,770 56,575 utilised for over 75 years Michelle Sutherland Andy Mathie 2013 Methods & Sources: Source: ISD Rolling year to end of month (provisional). Approximately 6 months time lag for data. The monthly HEAT 75+ Management Report is usually published by ISD during the last week of every month. This information is released for management purposes only and contain previously unpublished data. Please treat as restricted until general release. Target has been calculated on basis of monthly trend information since April 2012. In December 2013, NRS released revised mid-year population estimates at health board and local authority level based on the 2011 census. This has resulted in an increase to previously published bed day rates from 2003/04. Revised population estimates have also been released at CHP level for 2011/12. This has resulted in an increase to previous published CHP bed day rates from 2011/12. Benchmarking: Historically, there has been a reducing trend in East Ayrshire, however there has been a significant increase in the last financial years (2012/13). North Ayrshire had an increasing trend but there has been a reduction followed by an increase in the last two financial years (2011/12 and 2012/13). South Ayrshire started to see a decreasing trend from 2008/09 but has seen an increase in the last two financial years (2011/12 and 2012/13). For Scotland there was an increasing trend followed by a year on year reduction since 2008/09. Latest data: Rolling years to end of month December 2012 to November 2013. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. Number: The number of bed days has fluctuated in all three local authority areas. This is the same in the Scotland wide figure. Over December 2012 to November 2013, South Ayrshire had the highest average number followed by North Ayrshire, then East Ayrshire. Latest data (12 months ending November 2013) show that South Ayrshire had the highest number followed by North Ayrshire then East Ayrshire. Remedial action (where applicable): Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Integrated Care and Enablement Service (Stuart Gaw), together with Homecare and Out of Hours Services o Community Ward (Kathleen McGuire) o Anticipatory Care Planning (Kathleen McGuire) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Hospital Mainstream Services reference LUCAP
Management Lead:
35 75 o Iona Colvin, Director of Health and Social Care, North Ayrshire Health & Social Care Partnership o Management Structure (to be confirmed), North Ayrshire Health & Social Care Partnership
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 003b Emergency Margaret Peck; Michelle Kennedy; December readmission numbers of over 75 46 30 Michelle Sutherland Andy Mathie 2013 years population within 7 days Methods & Sources: Source: ISD Scorecard Analysis: These monthly data are provisional and amended by ISD. Updated on 24 April 2014 (IR2014-00607) to show the position up to and including December 2013 position. In respect of the yearly position for 2012/13, NHS Ayrshire & Arran's was 1,134 and Scotland 12,065. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted. Target: No national targets provided. Local target calculated on basis of trend information since April 2011 up to and including December 2013. On this basis current target set at 25 for North Ayrshire. Nb will alter and be adjusted pending receipt of further monthly data from ISD. Benchmarking: Number: Historically (since 2003/04) the number of re-admissions increased in each of the 3 localities. Scotland wide there has also been an increasing number. Over April 2011 to December 2013, South Ayrshire had the highest average number followed by North Ayrshire then East Ayrshire. Rate per 1000 population (included to allow comparison): Historically (since 2003/04) the rates increased in each of the 3 localities and Scotland wide also. Average Rates for all 3 localities (South 28.5, East 28.2, North 26.3) are higher than Scotland average rate 25.8. Remedial Action: Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Community Wards (Kathleen McGuire) Management Lead: o Helen McArthur, Senior Manager - Community Care o Stuart Gaw, Intermediate Care & Enablement Service Manager o Kathleen McGuire, Long Term Conditions Manager o Alan Stout, Clinical Manager, Remote and Rural Communities
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 003c Emergency Margaret Peck; Michelle Kennedy; December readmission numbers of over 65 62 52 Michelle Sutherland Andy Mathie 2013 years population within 7 days Methods & Sources: Source: ISD Scorecard Analysis: These monthly data are provisional and amended by ISD. Updated on the 24 April 2014 (IR2014-00607) to show the updated December 2013 position. In respect of the yearly position for 2012/13, NHS Ayrshire & Arran's was 1,922 and Scotland 20,315. For purpose of clarity, last 4 months data is detailed on chart, prior to this point every 4th month value has been charted.
Target: No national targets provided. Local target calculated on basis of trend information since April 2011 up to and including December 2013. On this basis current target set at 52 for North Ayrshire. Nb will alter and be adjusted pending receipt of further monthly data from ISD. Benchmarking: Number: Historically (since 2003/04) the number of re-admissions increased year on year for South and East Ayrshire, North has increased yearly till 2010 then remained almost static. Scotland wide there been an increasing number year on year, though rate of increase has slowed since 2010. Over April 2011 to December 2013, South Ayrshire had the highest average number followed by North Ayrshire then East Ayrshire. Rate per 1000 population (included to allow comparison): Historically (since 2003/04) the rates increased year on year for South and East Ayrshire, rate in North increased yearly to 2010 then has shown a slight decrease. Scotland wide rate increased yearly then rate has remained fairly static since 2010. Average Rates for all 3 localities (East 22.4, South 22.1, North 20.8) are higher than Scotland average rate 20.0.
Remedial Action: Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Anticipatory Care Planning (Kathleen McGuire) o Integrated Care & Enablement Service (Stuart Gaw) o Arran Enhanced Elderly Care Provision Integrated Model (Alan Stout) o Community Wards (Kathleen McGuire) Management Lead: o Helen McArthur, Senior Manager - Community Care o Stuart Gaw, Intermediate Care & Enablement Service Manager
37 77 o Kathleen McGuire, Long Term Conditions Manager o Alan Stout, Clinical Manager, Remote and Rural Communities
Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 005 Admissions Margaret Peck; Michelle Kennedy; No target has No Data 2010/11 from care homes Michelle Sutherland Andy Mathie been set Methods & Sources: RCOP/Change Fund Senior Information Analyst, to provide recommended indicator(s) and data. "All emergency admissions" and "all ages" to be measured. Data Source will be PMS Trakcare. Target : Pending receipt and consideration of above. Scorecard Analysis: Not applicable at present. Benchmarking: Not applicable at present. Remedial Action: Data sets regarding historic admissions from care homes are currently on hold while the ‘address from’ field is developed so it can be ascertained when a patient resided in a care home retrospectively as well as at time of data extract. This is to ensure that admissions for patients admitted historically; before they resided in a care home, are analysed correctly.
Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Dementia Care Home Liaison (Isabel Marr) o Falls Prevention Training Care Homes (Janet Mauchlen) o Anticipatory Care Planning (Kathleen McGuire) Management Lead: o Alan Brown, Senior Manager - Care Management and Review o Mary Francey, Senior Manager, Assessment and Enablement
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Traffic Long Term Short Term PI Code & Short Name Managed By Administered By Current Value Current Target Last Update Light Icon Trend Arrow Trend Arrow CF NA Local 006 Bed days Margaret Peck; Michelle Kennedy; No target has occupied by patients admitted 2,896.14 2010/11 Michelle Sutherland Andy Mathie been set from care homes Methods & Sources: RCOP/Change Fund Senior Information Analyst, to provide recommended indicator(s) and data. "All emergency admissions" and "all ages" to be measured. Data Source will be PMS Trakcare. Target : Pending receipt and consideration of above. Scorecard Analysis: Not applicable at present. Benchmarking: Not applicable at present. Remedial Action: Data sets regarding historic admissions from care homes are currently on hold while the ‘address from’ field is developed so it can be ascertained when a patient resided in a care home retrospectively as well as at time of data extract. This is to ensure that admissions for patients admitted historically; before they resided in a care home, are analysed correctly. Key Drivers (which projects outcomes have greatest impact on High Level Indicators): o Dementia Care Home Liaison (Isabel Marr) o Falls Prevention Training Care Homes (Janet Mauchlen) o Anticipatory Care Planning (Kathleen McGuire) Management Lead: o Alan Brown, Senior Manager - Care Management and Review o Mary Francey, Senior Manager, Assessment and Enablement
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Minutes of the North Ayrshire Community Health Partnership Officers Locality Group
Tuesday 18th March 2014, 10:00am, Conference Room 1, 4th Floor, Cunninghame House, Irvine
Present:
John McCaig Interim Head of Service, Community Care (North Ayrshire Council) Joanne Sharp Health Care Manager (NHS Ayrshire & Arran) Michelle Sutherland CHP Facilitator (NHS Ayrshire & Arran/ North Ayrshire Council) Mary Francey Senior Manager, Community Care (North Ayrshire Council) Maggie Dhinsa Health Promotion Officer (NHS Ayrshire & Arran) Morven Buckby Development Officer (Third Face Interface Arran CVS) Helen McArthur Senior Manager, Community Care (Service Delivery) (North Ayrshire Council) Rab Murray JIT Lead (JIT) Kathleen McCrie LTC & CW Manager (NHS Ayrshire & Arran) Robert McGilvery Divisional Manager, Housing (North Ayrshire Council) Ken Ferguson Assistant Medical Director (NHS Ayrshire & Arran) Linda Boyd Healthcare Manager Mental Health (NHS Ayrshire & Arran) Mary Boyd Clinical Team Leader (NHS Ayrshire & Arran) Nicola Shannan Minute Secretary (North Ayrshire Council)
Apologies:
Kerry Gilligan Head of Profession Occupational Therapy (NHS Ayrshire & Arran) Irene Sinclair Public Heath Practitioner (NHS Ayrshire & Arran) Dale Meller Interim Senior Manager Mental Health/Learning Disabilities (North Ayrshire Council) Craig Stewart Clinical Service Manager (NHS Ayrshire & Arran) Maire Currie Health Care Manager (NHS Ayrshire & Arran) Jim Nichols Third Sector Interface (Arran CVS) Lorne Campbell Business Manager (KA Leisure) Isabel Marr Clinical Service Manager (NHS Ayrshire & Arran) Allan Wilson Community Pharmacist, (NHS Ayrshire & Arran) Kathleen McGuire LTC & CW Manager (NHS Ayrshire & Arran) Marlene McMillan Lead Public Health Practitioner (NHS Ayrshire & Arran) Ann Gow Associate Nurse Director (NHS Ayrshire & Arran) Jacqui McCall Primary Care Manager (NHS Ayrshire & Arran)
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NO ITEM ACTION
1. APOLOGIES/WELCOME/INTRODUCTIONS
John McCaig welcomed all to the meeting and introductions were made. Apologies are noted above.
2. MINUTE OF PREVIOUS MEETING – 21ST JANUARY 2014
The minutes of the last meeting were agreed as accurate.
MATTERS ARISING
Invigor8:
Michelle advised that after discussion at the last meeting she checked the situation on Arran but unfortunately there is no immediate solution. Kathleen asked if there would be an opportunity to use telehealth for support as there is an event next week for the SmartCare implementation. Kathleen will bring further information on telehealthcare to K McG the next meeting.
3. WINTER PLANNING
John advised that there had been discussions in relation to additional resources in North Ayrshire. It was agreed that there is no further update at present.
4. FEEDBACK FROM EVENT ON 14TH FEBRUARY 2014
It was noted that initial key actions have been set for the next 9 – 12 months and that leads need to be identified. There is a follow on session on 28th May 2014 in relation to this. In relation to identifying leads, this can be fed into the SIB, Michelle will put this MS into an action plan as a way to take forward.
5. NHS A & A INTERNAL AUDIT REPORT
Michelle advised that the change fund slippage has been considered. There will be around £100k for a LOT worker in Arran, training for Care Home Managers and dementia support service admin posts. Michelle explained that all the actions in the report will be picked up through the older people and adult sub group.
6. TELECARE
Kathleen advised that Alison Graham has lead responsibility for telehealthcare as agreed at the Strategic Alliance. Kathleen explained that a new group has been convened to take forward National European Projects and there have been 2 stakeholder engagements events to date. The SmartCare project is also currently on- going. Kathleen and Helen are meeting next week in relation to opportunities in North. Mark Halpin and Julie Thomson will be the leads for North Ayrshire Council.
7. CARE HOME REPORT
Michelle explained that this is tabled for information. The intention is to deliver training for care home managers in the next year. Meeting next week regarding this.
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8. FINAL REPORT: CRAFT CAFÉ NA
It was noted that this has now stopped as the project was only funded for 6 months but was successful. It was agreed that Maggie and Morven will take this forward and look MD/MB to see if funding can be sourced elsewhere.
9. SOA ACTION PLAN
Michelle advised that this paper is tabled for information. This has been to the TIB and CPP Board and has been approved.
10. INEQUALITIES STRATEGY
Michelle explained that Iona has been tasked with developing the Inequalities Strategy. Further update will be given at the next meeting.
11. POLICE SCOTLAND
Michelle advised that Police Scotland will be working closely with partners and communities in a new pilot initiative in North Ayrshire called Prevention First. The pilot will started on 3rd February 2014 and will focus on the Irvine and Kilwinning area.
12. COMMUNITY ENGAGEMENT TRAINING
Morven advised that there was agreement at the CPP that the tool should be used across North Ayrshire. Morven explained that 12 people are now trained on ‘Voice’.
13. MENTAL HEALTH & WELLBEING STRATEGY
Maggie Dhinsa was welcomed to the meeting to provide a presentation in relation to the mental health and wellbeing strategy. It was noted that there are a number of potential resource implications and the strategy has not been through all professional committees. Further clarification is required regarding the consultation mechanism.
14. STANDING ITEMS
Integration of Health and Social Care:
TIB papers were provided for information. Joanne advised that in relation to the new partnership there will be interim management procedures in place and she will be the interim senior manager until the new management structure is in place.
15. ANY OTHER BUSINESS
Linda Boyd provided an update and information on the North Ayrshire Community Hospital. The Hospital should be open in Spring 2016. It was noted that staff should be encouraged to attend events in relation to the new hospital.
16. DATE OF NEXT MEETING
Tuesday 29th April 2014 commencing at 10:00am within Conference Room 1,4th Floor, Cunninghame House, Irvine.
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NO ITEM ACTION
1. APOLOGIES/WELCOME/INTRODUCTIONS
Joanne Sharpe welcomed all to the meeting and introductions were made. Apologies are noted above.
2. MINUTE OF PREVIOUS MEETING – 18TH MARCH 2014
It was noted that under point 5 this should read Care at Home managers and not workers.
MATTERS ARISING
There were no matters arising to discuss.
3. CARENA LINK
Isabel McKnight was welcomed to the meeting to provide a presentation in relation to the new website Carena. Kathleen spoke regarding a link with Smartcare. Kathleen to K McG get in touch with Isabel McKnight for further discussion.
4. COMMUNITY REVIEW
The OLG noted the action plan and some actions around the LOT had already commenced. Michelle advised that there is a second event on 28th May. There will be a paper submitted to the SIB this Thursday on the community review and once approved these actions will be placed on covalent. There is a further meeting this week to discuss agenda items for the event on the 28th with OLG chairs and facilitators. Agenda to follow shortly after.
5. CHANGE FUND 2014/15
Michelle explained that the annual submission will be made at the end of May and this will be circulated to leads for comments. Prioritising what should be sustained, is a key challenge and change fund leads will make recommendations to the OLG. It is proposed that this work be completed for end September 2014. There may be some resource allocation monies from bed closures, and Joanne Sharp will explore this further. Change Fund draft template will be sent out for comments and a change fund leads meeting will be arranged to discuss further. Joanne advised that there was a presentation to the NHS CMT and a half day event will be arranged in June to look at the change fund for core funding.
6. JIT
Michelle advised that training has taken place and there is a session on 14th May where Michelle will invite people from Children and Families, addictions, public health and performance staff.
7. RCOP
There was a discussion around indicators and to agree targets as these need to be set. Michelle asked if all leads are in agreement with this which will be taken to the SIB along with the completed change fund assessment. Everyone at the meeting agreed to this approach.
8. LUCAP
Joanne advised that this is the local unscheduled care action plan. This is phased 2 2 86
and it is asking for the NHS to submit this by 16th May 2014. Joanne Edwards, Assistant Director at Ayr Hospital is taking the lead on this. A meeting has taken place to look at last year’s LUCAP and this fits in with last year’s change fund actions that are in place. Shona Johnston will work with Michelle to populate this. Joanne explained that she has emailed Health and Social Care Directors and they are happy with this approach.
9. TELECARE
Kathleen spoke to documents in relation to Telecare. Kathleen advised the following: • The project board is currently in place lead by Dr Alison Graham • In relation to video conferencing, more technology is being looked into • A programme infrastructure has been in place for a year which is supported by a virtual Pan Ayrshire programme office • John Burns, Chief Executive NHS Ayrshire & Arran requested a Pan Ayrshire strategy for Telehealthcare and innovation be developed for consideration by the partnerships which is being looked into at the current time • Virtual approach has been successful, looking at a project manager leadership role • Progress reports will start to come to the OLG meetings in June • Business case will be developed if agreed
10. INEQUALITIES STRATEGY All Michelle explained that the CPP are keen to develop an inequalities strategy. First draft of paper given to everyone for information/discussion. Comments to be sent back to Michelle. Final draft by the end of May 2014.
11. STANDING ITEMS
Integration of Health and Social Care:
Michelle advised that the development of our strategic plan has to be completed by the end of October 2014. The proposed framework was issued and agreed. It is hoped to use the same approach as Reshaping Care for Older People. Engagement and Communications will be the key to success. It was noted that the new structure has started to be shared and the Heads of Service posts will be advertised in May.
12. FOR INFORMATION
Ayrshire & Arran Sensory Locality Plan: All
Paper for information. Any comments to be sent back to Michelle.
13. ANY OTHER BUSINESS
Michelle advised that she attended the first Health and Social Care Partnership Property meeting where discussion took place around the future property needs of the partnership and the possible development of a new headquarters. A further meeting has been arranged for 11th July 2014.
14. DATE OF NEXT MEETING
Tuesday 10th June 2014 commencing at 10:00am within Committee Room 2, 3rd Floor, Cunninghame House, Irvine.
3 87 88 Draft for approval of CHP Forum
Minutes of North Ayrshire CHP Forum held on Thursday 27 February 2014 at 9.30am, Committee Room 1, 3rd Floor, Cunninghame House, Irvine
Mr Stephen McKenzie, NHS Board Member, Chair Present Mr David Bonellie, Area Optical Professional Committee Ms Tricia Chalmers, Independent Sector Representative Councillor Anthea Dickson, North Ayrshire Council, Vice Chair of North Ayrshire Transition Integration Board (NA TIB) Dr Ken Ferguson, Interim GP Representative Ms Kerry Gilligan, Allied Health Professions Representative Mr Martin Gray, Pharmacy Representative Mr Andrew Hale, Health Improvement Officer, North Ayrshire Council Mr Martin Hunter, Public Partnership Forum (PPF) Representative Ms Sandra Monaghan, Public Partnership Forum (PPF) Representative Mr Simon Morrow, Area Dental Professional Committee Mr Jim Nichols, Arran Council for Voluntary Organisations (CVO) Mr Clive Shephard, Confederation of North Ayrshire Community Councils Ms Christine Speedwell, North Ayrshire Carers Centre Dr Maggie Watts, NHS Consultant in Public Health
Ms Iona Colvin, Director of Health and Social Care, North Ayrshire In Health and Social Care Partnership (Items 6, 10) Attendance Ms Kay Boyd, Integrated Children’s Services Ms Michelle Sutherland, CHP Facilitator Mrs Angela O’Mahony, Committee Secretary (minutes)
1. Welcome/introductions
1.1 Stephen McKenzie welcomed everyone to the meeting, in particular, Councillor Anthea Dickson, Vice Chair of NA TIB and Dr Ken Ferguson, interim GP representative.
2. Apologies
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2.1 Apologies for absence were received from Joanne Anderson, Liz Moore, Ross McFarlane, Gordon McKay, Stephen McLaughlin, Ina Paton, Joanne Sharp, Krzysztof Tyczynski and Nigel Wanless.
3. Declaration of Interests
3.1 There were no declarations of interest.
4. Minutes of the last meetings held on 12 September 2013 and 21 November 2013
4.1 The CHP Forum approved the minutes of the meetings held on 12 September and 21 November 2013, subject to the following change being made:
4.2 Draft minutes of meeting on 21 November 2013 – Donald Reid, PPF Representative was present and Martin Hunter, PPF Representative, gave apologies for the meeting.
5. Matters Arising
5.1 Item 6.1, Iona Colvin’s contact details – action complete.
5.2 Item 6.2, CPP Engagement Update – on agenda.
5.3 Item 7.1, Mark Gallagher, Alcohol and Drugs Partnership contact details – action complete.
5.4 Item 8.1, AHP Update – action complete.
5.5 Item 9.1, Neighbourhood Planning Events – Ms Sutherland noted that MS events would be held at the end of March and a report would be submitted thereafter.
Integration
6. Update on Work of the Transition Integration Board (TIB)
6.1 Ms Colvin provided an update on progress being made by the Transition Integration Board (TIB) highlighting the following areas • From April 2014, the Shadow Integration Board (SIB) would assume operational responsibility for services within the NHS and Social Work (including Community Health Partnership business). • Details of NHS and Council services being delegated to the Partnership had been circulated. SG had recently issued Policy
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Statements advising that some other services should be delegated to Partnerships and this was out for consultation. • The TIB on 20 March would consider services to transfer to the HSCP and governance arrangements, for approval by North Ayrshire Council/NHS Board by 31 March. The TIB would also consider membership arrangements for the SIB, including proposals to extend this to include stakeholder representation. • The Public Bodies (Joint Working) (Scotland)(Bill) was on track to received Royal Assent at the end of March 2014. • The CHP Forum would continue to meet and membership would be refreshed to ensure that it is representative. • A Communications strategy is being developed - this will be key in taking forward integration arrangements. • Management arrangements being worked up and these will be considered through NHS/Council partnership process. • Outlined the strategic priorities being developed in partnership to inform Strategic Plan - to be submitted to SG by December 2014. • In June 2014, the Community Planning Partnership would consider proposals to develop an Inequalities Strategy (the HSCP would be part of this overall strategy). • Integration Scheme – partnership discussion would continue until October. • Chief Officer appointed in South Ayrshire, Tim Eltringham, and East Ayrshire would appoint in the near future.
6.3 The CHP Forum noted and made the following comments: • Mr Nichols would discuss proposals for stakeholder representation with Independent Sector colleagues. • Ms Sutherland confirmed in response to a question that arrangements were in place to review community councils and others groups to ensure synergy amongst these groups.
• Dr Ferguson would discuss with the Head of Primary Care KF Development the need to circulate HS stop press updates on Integration to independent contractors.
7. User Engagement
7.1 Stakeholder Representative on TIB
7.2 Ms Colvin outlined proposals for stakeholder representation on the TIB, which would be considered at the TIB meeting in March:
Representative Advisers: • Two staff side representatives (one Council, one NHS). • Public Partnership Forum to represent service users and patients.
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• Carer representative. • TSI to represent independent and voluntary sector – to be monitored as arrangements move forward. Professional Advisers: • Chief Officer. • Medical Director or delegate. • Chief Social Work Officer. • Nursing – being considered at present. • GP/independent contractor – being considered at present.
7.3 Ms Sutherland advised that she was in discussion with PPF, Carer and MS Independent Sector colleagues and that she would be writing formally to invite representation in the near future.
7.4 Mr Nichols would discuss proposals for stakeholder representation with JN Independent Sector colleagues.
7.5 The CHP Forum supported the proposals for stakeholder representation on the TIB/SIB and underlined the need to keep groups updated as arrangements progress.
7.6 Health and Social Care Partnership (HSCP) – Exploring Wider User Engagement
7.7 Ms Sutherland outlined the mapping work and discussion taking place with professional groups, service users, patients/carers, the independent sector and community planning colleagues to support the development of effective user engagement. Mr McKenzie asked members to consider how they felt the CHP Forum should be developed and how members should feed back to/from their groups.
7.8 The CHP Forum discussed communication and the need for all stakeholders to receive updates in relation to integration. Ms Colvin noted that there were a number of issues being worked through in relation to communications. Ms Sutherland encouraged CHP Forum members to get ALL in touch with their suggestions.
8. Professional Lead Updates
8.1 Pharmacy Update (this item was taken after Matters Arising):
• Martin Gray provided a presentation on Prescription for Excellence (PfE), the Scottish Government’s vision for the future of pharmacy over the next 10 years. Mr Gray noted that this would significantly change the way pharmacists work, enabling them to develop their clinical role to provide more patient focused, community based
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pharmacy services. There would be no additional funding to take forward this work but savings would be made as a result of developing the pharmacist’s role. • Mr Gray noted the considerable work that would have to take place to realise this vision. Local workshops were taking place involving hospital and community pharmacy, feedback from which would go to
SG to inform the future approach to taking forward the vision.
• The CHP Forum noted and welcomed this vision which would provide exciting opportunities in relation to integration and developing pharmacists’ skills to provide improved care and support to the public. Mr McKenzie invited Mr Gray to provide another update once work had progressed further.
8.2 Dental Update – Simon Morrow highlighted the following areas: • Good access to NHS dental services - 97% of dentists in NHS A&A are accepting NHS patients. • Sedation services – interviews had recently taken place and a preferred candidate had been identified. • Professional Committee elections were taking place which could mean significant changes to membership. There were some concerns regarding succession planning. • Childsmile Programme – Mr Morrow noted that it was estimated that, as well as the health improvements benefits of this and other oral health programmes, it was estimated that it had saved SG over £1m in treatment costs. • Three dental practices are taking part in the Keep Well project. • Mr Morrow noted that there continued to be challenges in getting dental colleagues involved in discussion about integration.
8.3 Optical Update – David Bonellie highlighted the following areas: • AOPC elections were taking place and there could be a number of changes to the Committee. • Work continues in developing shared care schemes - working particularly well for diabetic retinopathy screening and cataract referrals. Mr Bonellie would provide a fuller update at a future meeting. 8.4 Allied Health Professions Update – Kerry Gilligan highlighted the following areas: • AHP national delivery plan – Ms Gilligan advised that a report would be submitted to the NHS Board on 31 March and this would be shared with the CHP Forum. Ms Gilligan would provide an update on integrated Occupational Therapy work at a future meeting. • 8.5 Public Health – Dr Maggie Watts noted the following areas: • National work (being led by the NHS Board) in relation to provision
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of oral health care in care homes for older people. • Keys to Life – strategy to address health inequalities for people with learning disabilities. SG had asked Boards to implement this strategy. A workshop would take place on 28 February to take work forward. Mr McKenzie noted that Dr Watts would be leaving NHS A&A in the near future and thanked her for her input to the CHP Forum.
8.5 Children’s Services – Mrs Gilmour advised that the NA Inspection report and action plan had been received and the action plan was in the process of being implemented.
Prevention and Early Intervention
9. Asset Based Work
9.1 Mr McHarg provided an update on Asset Based Community Development (ABCD) early years project work in communities in Ardrossan Central and Castlepark to support health improvement and reduce health inequalities with a view to developing models which can be used across North Ayrshire. Mr McHarg outlined the good progress being made in these communities. There had been some changes to staff working on the project. He noted that, to enable mainstreaming/sharing learning and tendering for the final evaluation report, the Project’s completion date would be extended to 31 May 2014.
9.2 The CHP Forum noted and was supportive of the approach outlined in the report.
10. Inequalities Strategy
10.1 Ms Colvin provided an update on progress in developing the CPP’s Inequalities Strategy. Ms Colvin outlined the wide representation on the Programme Board. Six deprived areas have been identified in North Ayrshire and a number of key priority areas agreed. A small working group has been formed to create the Inequalities Framework, which would be presented to the CHP Forum and then to the CPP Board in June 2014 for approval.
10.2 Dr Watts advised that a half day event would take place in March 2014 with a focus on health inequalities and she would provide feedback on the MW outcomes/outputs from this event.
10.3 The CHP Forum noted.
Community Planning Partnership (CPP)
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11. Single Outcome Agreement (SOA) Action Plan
11.1 Ms Sutherland provided an update on the draft SOA Action Plan for 2014- 15, which had been agreed by the TIB last week and would be submitted to the Community Planning Partnership (CPPs) Board next week. The draft plan placed greater emphasis on physical activity and the report’s structure had changed to make it easier to see how resources are being spent, who is leading work and the outcomes being achieved. Ms Sutherland suggested that Covalent reports could be provided on a quarterly basis.
11.2 CHP Forum members noted and discussed the good early intervention work going on in primary schools to encourage healthy eating which it was felt should be extended to secondary schools.
11.3 The CHP Forum discussed the need to carry forward the good work being done on reshaping care for older people following integration. Ms Sutherland advised that, as part of the Community Services Review, a performance framework would be developed to enable services to be scored in the coming months, following which a report would be submitted MS to the CHP Forum.
12. Review of Community Services
12.1 Ms Sutherland provided an update on the joint session held on 12 February 2014 with stakeholders to review NA’s existing adult and older people community service models. A key set of principles and actions would be developed for review at the next OLG and agreement at the CHP Forum MS and TIB. The CHP Forum noted and awaited this report.
13. CPP Community Engagement Training
13.1 The CHP Forum noted.
14. Prevention First
14.1 The CHP Forum noted and requested feedback on progress in taking forward the pilot.
15. Items for information
15.1 PPF Update – Mr Hunter noted that Ms Sutherland had attended the recent PPF meeting to discuss PPF representation on the TIB. A request had been circulated to the PPF Core Group and Mr Hunter would contact Ms Sutherland with nominations. Mr McKenzie underlined the need for further guidance/clarification in relation to the future role/structure of the PPF. The
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CHP Forum noted.
15.2 The CHP Forum noted the following items for information: • PPF Core Group minutes of meetings on 22 October 2013, 3 December 2013 and 4 January 2014. Officer Locality Group (Adult) draft minutes of meetings on 22 October 2013 and 3 December 2013. ICSP draft minutes of meetings on 5 September 2013 and 14 November 2013.
16. Any Other Business
16.1 There was no other business.
17. Date and Time of the Next Meeting Thursday 15 May 2014 at 9.30am, Committee Room 1, 3rd Floor, Cunninghame House, Irvine
Signed (Chair) …………………………………… Date………………………
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Minutes of North Ayrshire CHP Forum held on Thursday, 15 May 2014 at 9.30am, Conference Room 1, Social Services, 4th Floor, Cunninghame House, Irvine
Cllr Anthea Dickson, North Ayrshire Council, Chair Present Mr Stephen McKenzie, NHS Non-Executive Board Member, Chair Mr David Bonellie, Optical Representative Ms Kerry Gilligan, Allied Health Representative Mr Martin Gray, Pharmacy Representative Mr Martin Hunter, Public Partnership Forum ((PPF) Representative Ms Sandra Monaghan, PPF Representative Mr Clive Shepherd, Federation of Community Associations Ms Barbara Hastings, Third Sector Representative Mr Jim Nichols, Arran Council for Voluntary Services Dr John O’Dowd, Public Health Representative Ms Christine Speedwell, North Ayrshire Carers Centre Mr Nigel Wanless, Independent Sector Representative
Mr Andy Pulford, Public Health (Item 14) In Ms Michelle Sutherland, CHP Facilitator Attendance Mrs Angela O’Mahony, Committee Secretary (Minutes)
1. Welcome/Apologies
1.1 Stephen McKenzie welcomed everyone to the meeting. Mr McKenzie noted that, as he chairs the Shadow Integration Board (SIB), it would not be appropriate for him to continue as Chair of the CHP Forum and Councillor Dickson would chair the Forum with immediate effect. Mr McKenzie thanked CHP Forum members for their advice and input at Forum meetings. The CHP Forum welcomed Councillor Dickson to the chair. Councillor Dickson noted that there would be changes moving towards integration and she underlined the importance of having an effective structure in place to allow full engagement and feedback to/from the SIB.
1.2 Apologies for absence were received from Ken Ferguson, Andrew Hale, Liz Moore, Simon Morrow, Gordon McKay and Krzysztof Tyczynski.
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2. Declaration of Interests
2.1 There were no declarations of interest.
3. Draft minutes of the meeting on 27 February 2014
3.1 The CHP Forum approved the minutes of the meeting held on 27 February.
4. Matters Arising
4.1 Item 6.3 – Updates on TIB/SIB – no update available.
4.2 Item 7.4, Stakeholder Representation – Mr Nichols noted that Scottish Care would act as the main Independent Sector representative and that he and Nigel Wanless would work together to ensure effective Independent and Third sector representation. Ms Sutherland noted that discussion is underway to ensure that NHS private providers are also integrated into arrangements.
4.3 Item 14.1, Prevention First – Ms Sutherland would ask the Community MS Safety group to add this item to their agenda.
4.4 All other matters arising were either on the agenda or complete.
Integration
5. Staff Engagement
5.1 Ms Sutherland reported that she had met with the Joint Improvement Team (JIT) to discuss staff engagement, which is a dynamic, constantly evolving process. Ms Sutherland circulated dates for staff information sessions, which she encouraged staff from localities to attend. Further stakeholder events would take place over the summer. Councillor Dickson underlined MS the need to communicate dates widely to maximise attendance from a wide range of staff.
6. Feedback from Shadow Integration Board (SIB)
6.1 Ms Sutherland provided a summary of the Director for Health and Social Care’s (HSC) report to the SIB on 1 May, highlighting the following areas:
• Tim Eltringham would take up the HSC Director post in South Ayrshire in June. • HSCP senior management structure has been developed and
recruitment is underway. This process would be crucial to provide
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the SIB with the necessary infrastructure to take forward integration. • The SIB had discussed the Strategic Plan and considered some papers that would previously have gone to the Council’s Cabinet. • The SIB had agreed a number of priority areas to take forward.
• The SIB meeting had, for the first time, welcomed carers, service
users and additional staff as well as private providers, which was a welcome development. • Communications would be key and Mr Nichols requested that there should be third and independent sector representation within any MS communications team, if this was developed in the future. • Mr McKenzie suggested that headlines could be circulated following SIB meetings to ensure a consistent message. The CHP Forum MS supported this approach.
6.2 The CHP Forum noted.
7. Development of H&SC Strategic Plan
7.1 Michelle Sutherland provided an update on the development of the H&SC Strategic Plan. A report was submitted to the SIB on 1 May. This work has been informed by the JIT advice note produced in February 2014.
7.2 The first set of Scottish Government (SG) regulations was circulated on 12 May with details of areas to be delegated to Integration Joint Boards from the Council and NHS. Further regulations are expected in late May on Joint Commissioning.
8. Development of Strategic Planning Group (SPG) and Membership
8.1 Ms Sutherland advised that SG regulations clearly state that a strategic planning framework should be developed with a strategic planning group (SPG) taking work forward (membership of which is also detailed). The SIB has suggested that, as a number of these representatives currently sit on the CHP Forum, this group should be refocused and its membership extended to take on the role of the SPG in developing the Strategic Plan. The new Community Empowerment Bill/Neighbourhood Planning Bill would also have implications for community councils/neighbourhoods.
8.2 Ms Sutherland sought the CHP Forum’s views on the Forum becoming the Strategic Planning Group (to be chaired by Councillor Dickson) and on initial proposals for the Strategic Plan’s framework.
The CHP Forum made the following comments: • Members welcomed the huge opportunities for engagement. • Welcomed Councillor Dickson as chair • Mr Nichols advised that he would have to consult with third sector
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colleagues and other interested parties in relation to changing the Forum’s role. • Councillor Dickson noted that the Older People’s Change Fund Strategy had provided valuable experience to draw on in taking work forward.
• Forum members suggested that it may be useful to set up a working
group to enable more detailed discussion and ensure that key areas are not missed. • Ms Sutherland noted the discussion taking place at locality level among GPs and Pharmacy staff and the need for all areas to be engaged in services being managed within Lead Partnerships. • Members underlined the need for wider engagement on the joint commissioning process. • Need to support locality planning using an asset based approach. • Strategic Plan needs to give clear direction and identify who will fulfil these roles e.g. strategic and locality planning groups.
• Members noted the group’s changed role as a key broker in
commissioning services.
• SPG workshop-style meetings would encourage wider public involvement in locality planning. • Members questioned whether the membership of the SPG would be mandatory within the regulations or whether there would be some local discretion. • Members should respond individually to the consultation on the regulations to ensure their views are heard. • Councillor Dickson underlined the need to pull together constituent parts through biannual joint SIB/SPG meetings (and older people’s/ children’s services and the alcohol and drug partnership). Councillor MS Dickson suggested that JIT colleagues should attend the next meeting to enable fuller discussion on joint commissioning. • Members underlined the need to work with the Community Planning Partnership in taking forward neighbourhood fora to avoid duplication. Mr Nichols noted that third sector colleagues are currently working with neighbourhood planning/community development colleagues to consider six options and these would be submitted for approval to the Chief Executive and Elected Members late this year.
9. Development of H&SC Substructures
9.1 Ms Sutherland asked the CHP Forum for their views on the development of a substructure to support user, public, stakeholder and staff engagement, taking into account the development of the H&SCP and the Community Empowerment Bill which is also progressing through Parliament. Ms
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Sutherland asked members to discuss the issues raised in this report with ALL colleagues in their areas and feedback comments to her.
CHP Forum members highlighted the following areas:
• Mr Nichols noted that, in addition to the groups shown, there are
public reference groups on Arran and Cumbrae. He questioned
where GP patient groups would fit in. Ms Sutherland would check. MS • Mr Nichols would discuss with carers/social service user carer group JN colleagues. • Members underlined the challenges in representing and being a conduit for wider groups.
10. Review of Community Services
10.1 Ms Sutherland reported that the first successful Community Review Session took place on 11 February 2014, to consider the community services model moving towards integration. A detailed action plan has been drawn up and lead officers met on 18 March to discuss the work required. A further event would take place on 28 May. Evaluation/mainstreaming of the Older People’s Change Fund would run in parallel to this work.
10.2 In response to a question, Ms Sutherland advised that an NHS evaluation tool is being used for this work. Following initial evaluation work on the principles/model there would be dynamic debate with stakeholders.
10.3 Ms Sutherland encouraged Mr O’Dowd to attend the event on 28 May in particular to represent children’s services. JO’D
Prevention and Early Intervention
11. North Ayrshire Inequalities Strategy
11.1 Ms Sutherland reported that the Director of Health and Social Care, Iona Colvin, had been tasked to develop this draft strategy which would affect all areas of the Community Planning Partnership. The draft strategy would focus in particular on worklessness and making North Ayrshire a safer place to live. Actions would be taken forward in partnership to reflect the needs of vulnerable groups and neighbourhoods. The draft strategy would be submitted to the CPP Board in June for approval to undertake wider consultation. Councillor Dickson encouraged members to forward any ALL comments on the draft strategy to Michelle Sutherland . Sandra Monaghan and Clive Shephard left the meeting.
Other Updates
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12. Allied Health Professions (AHP) Local Delivery Plan (LDP)
12.1 Kerry Gilligan provided an update on the AHP LDP and highlighted the following areas:
• 16 workstreams are currently running and these will reduce to three key workstreams (integration, AHP support at front door of acute hospitals to reduce unnecessary admissions, improving IT systems/reducing duplication) from December 2014, as work is mainstreamed into core business. • Occupational Therapy Integration – the first large event for OTs had recently been held in North Ayrshire, which was very well attended. • Ms Gilligan highlighted work that had been done in South Ayrshire in relation to releasing time to care, which has reduced waiting times by 20 weeks and reduced unnecessary steps in the process. • Secondments have taken place between Council and Health staff in North Ayrshire, realised through SG funding.
12.2 The CHP Forum noted.
13. Professional Updates
13.1 Optometry – Mr Bonellie highlighted the following areas:
• Area Optical Professional Committee (AOPC) elections have recently taken place and two new members have joined the AOPC. • Local and national level IT integration is moving ahead quickly and electronic referrals can now be made. • Some progress is being made in relation to electronic payments but there are issues regarding IT requirements. • Discussion is taking place with Ophthalmology colleagues regarding increased delegated care to community optometrists, a national priority within Optometry Scotland. • Mr Bonellie had recently been appointed as Chair of Optometry Scotland. • Mr Bonellie would provide an update at the next meeting on optical involvement in relation to sensory impairment/stroke. • Mr Bonellie reported an issue relating to service provision for deprived groups (e.g. those unable to attend practise) and domiciliary visits.
Councillor Dickson congratulated Mr Bonellie on his chairmanship of Optometry Scotland and looked forward to regular updates.
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13.2 Pharmacy – Martin Gray highlighted the following areas:
• Pharmacy colleagues are considering the Pharmacy locality structure and how this needs to change moving towards integration. The constitutions of the locality groups and Area Pharmaceutical Professional Committee are also under review. • From July 2014, the community pharmacy smoking cessation service would move to a points based system through the pharmacy care record, which would reduce paperwork and simplify the claims process. From July (and following training) non-prescribers in Community Pharmacy would be able to provide some medication to help people stop smoking. • There had been a presentation for all Pharmacy staff on Prescription for Excellence, the national 10 year vision for pharmaceutical services. • The Pharmacy gluten free service has been running for several months and is popular with patients and GPs.
13.3 Public Health – Mr O’Dowd highlighted the following areas:
• Public Health is developing workstreams to look at its roles and responsibilities moving towards integration and sharing its work plan with partners. The Director of Public Health had proposed that a pan-Ayrshire group be set up to pull together issues regarding health information to ensure an effective, consistent approach and reduce duplication. • A Public Health Strategic Plan is being developed and part of this work will be to reinvigorate the joint strategic needs assessment to identify any gaps. The first of two workshops would take place on Monday 19 May with representation from all the Partnerships to frame and prioritise work and set timescales. A second workshop will take place in a month to review progress. • Consideration is being given to refreshing the Children and Young People’s Strategy moving towards integration.
13.4 Third Sector – Barbara Hastings highlighted the following areas:
• Volunteers week would take place on week beginning 2 June. There would be an Oscars event on 2 June for volunteers on the mainland. Ms Hastings would circulate details of all events. • An event had recently taken place with third sector colleagues to seek their views on how they would like to be consulted with and receive feedback. It had been agreed that there should be an annual update event and consideration should be given to having thematic sub-groups.
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• Ms Hastings had taken on the role of third sector lead for community engagement in North Ayrshire which would be a key role in moving forward community engagement. • Ms Hastings noted that training is available on community engagement standards as well as visioning outcomes in community engagement. The CPP Board expects partners to use VOICE for which training is available. • Ms Hastings highlighted initiatives in Fullerton, Irvine and Ardrossan using an asset based approach to reduce health inequalities (funding from various sources). Work is taking place to monitor funding being received by the voluntary sector in North Ayrshire and a Funding Roadshow took place in April
13.5 Independent Sector – Nigel Wanless reported that work mainly focused on integration. He had withdrawn from some pan-Ayrshire commitments to allow him to focus more on work in North Ayrshire. The Care Forum and the Health and Social Care Providers Forum were assisting in acting as a conduit for information and feedback.
13.6 Councillor Dickson thanked colleagues for their informative updates.
14. Draft Mental Health and Wellbeing Strategy
14.1 Andrew Pulford provided an update on the draft (12 year) Mental Health and Wellbeing Strategy which sets out a number of broad priority areas to promote mental health and wellbeing in the general population. The strategy would be taken forward in partnership and would draw on existing work/groups. The draft strategy would be submitted to the NHS Board and Community Planning Partnership (CPP) Board for approval to undertake a three month consultation, following which an action plan would be developed.
14.2 Ms Hastings requested that engagement should take place with third AP sector colleagues once the strategy goes out for wider engagement.
14.3 The CHP Forum noted the strategy.
15. Items for Information:
• PPF Update – Martin Hunter highlighted the following areas: o Iona Colvin attended the most recent PPF Core Group meeting and the group had been supportive of the way forward and the need for change. The next meeting would take place on 20 May. o Andrew Moore, Associate Nurse Director, is looking at all public engagement processes including the PPF network and
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arrangements for future engagement are becoming clearer. o Mr Hunter underlined the PPF as an excellent means of engaging on a locality basis but underlined the challenges in having a network of volunteers willing to help. o The Scottish Health Council is working with ethnic minority groups and other groups to improve engagement. Mr Nichols advised that the third sector is also doing work to address inequalities.
• Adult OLG minutes of meeting on 21 January 2014 – The CHP Forum noted.
16. Any Other Business
16.1 Members suggested that a further meeting should take place at the end of June/early July. Ms Sutherland would look at possible dates and circulate MS/ details to members. AO
17. Date and Time of the Next Meeting Thursday, 28 August 2014 at 9.30am, Committee Room 1, 3rd Floor, Cunninghame House, Irvine.
Signed (Chair) …………………………………… Date………………………
9 105 106 Paper
Actions from NA CHP Forum 15 May 2014
Meeting Item Title and Action Action Owner Timeframe Status Progress Date for completion 15-May-14 Item Update on work of TIB - Dr Ferguson would discuss KFerguson 4.1 with Head of Primary Care Development the need to circulate stop presses on integration to independent Item Prevention First - Ms Sutherland would ask the Msutherland 4.3 community safety group to add this item to their agenda. Item Staff Engagement - Cllr Dickson underlined the need MSutherland 5.1 to communciate dates of staff information sessions as widely as possible. Item Feedback from SIB - Mr Nichols suggested that there MSutherland 6.1 should be a third sector rep on the Communications Team. Item The CHP Forum suggested that headlines should be Msutherland 6.1 circulated following SIB meetings to ensure a consistent message. Item Cllr Dickson suggested that the Joint Improvement Msutherland 8.2 Team should be invited to the next meeting.
Item Development of H&SC Substructure - Members were ALL 9.1 asked to discuss the issues raised in reports with their groups and feed back comments to MS. Item Ms Sutherland would check where GP patient groups Msutherland 9.1 fit into arrangements.
Item Review of Community Services - Ms Sutherland J O'Dowd 10.3 invited Mr O'Dowd to attend event on 28 May to represent children's services. 107 Meeting Item Title and Action Action Owner Timeframe Status Progress Date for completion Item Inequalities Strategy - Members should forward any ALL 11.1 comments to Michelle Sutherland.
Item Mental Health and Wellbeing Strategy - Barbara A Pulford 14.2 Hastings requested that there should be engagement with the third sector. Item Next Meeting - Members requested that a further Msutherland 16.1 meeting should take place end June/early July. A O'Mahony
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Shadow Integration Board th 11 June 2014 Subject: Director’s Report
Purpose: To advise members of the North Ayrshire Shadow Integration Board of developments in the North Ayrshire Health & Social Care Partnership Recommendation: That members of the Shadow Integration Board note progress made to date.
1. Introduction
1.1 This report presents a high level overview for members of the Shadow Integration Board (SIB) of the work undertaken both locally and with the other Ayrshire partnerships towards the establishment of a North Ayrshire Joint Integration Board by 1 April 2015.
2. Current Position
2.1 The Strategic Alliance Integration Sub-Group (SAISG) continues to meet weekly to co-ordinate work across the three local authorities and NHS Ayrshire & Arran. Members of the sub-group also meet regularly with the full Strategic Alliance, the Chief Executives and Directors of Finance.
National Developments
2.2 The Public Bodies (Joint Working) (Scotland) Act provides for Scottish Ministers to put in place a number of Regulations and Orders which give more detail to the provisions of the act. These regulations are based on the policy statements which were published at the second stage of the Bill. The first batch of regulations was published for consultation on 12th May and the consultation will run until 1 August. A second batch was published on 27th May and the consultation on those will run until 18th August. The regulations and the consultation process are the subject of a separate report to the Shadow Integration Board.
2.3 Two key documents are required for the establishment of Health & Social Care Partnerships. The first is the integration scheme, which will set out the delegation to the Integration Joint Board (IJB) and how the IJB will operate. It will contain information regarding the governance arrangements for the IJB, including membership, appointment of the chair, the role of the chief officer, clinical and care governance, performance and financial reporting. We are advised that integration schemes are expected to be submitted in December this year for the approval of Scottish Ministers. Once approved, the integration schemes will be ratified by the Scottish Parliament and the partnerships will then be formally established. The
109 integration scheme is the responsibility of the local authority and the NHS Board to prepare and submit.
The second key document is the strategic plan, which will set out the priorities and outcomes to be delivered by the partnership. This will be prepared by the IJB and approved by the Council and the NHS Board. As the plan has to be submitted by the IJB it cannot be submitted until the IJB has been established in law. The earliest that strategic plans will be submitted is the start of the new financial year.
2.4 The Ayrshire Partnerships continue to be represented on a number of national groups including the Integration Advisory Group whose role is to inform the development of secondary legislation and statutory guidance on integration, as well as to have an overview of the other national groups. Ayrshire is also represented on the Joint Strategic Commissioning Group and the Integrated Resources Advisory Group
Ayrshire Developments
2.5 The delivery of the integration programme plan continues to be overseen by a sub- group of the Strategic Alliance, which meets weekly. The focus of the programme plan is to ensure that the three partnerships are able to deliver schemes of integration to Scottish Government by the end of this year. Workstream leads are now being invited by rotation to this meeting to account for progress made towards the agreed workstream objectives. The programme plan is being reviewed to ensure that it meets the most recent available information on items that will have to be dealt with in the scheme of integration. A status report from the workstreams is attached as an appendix to this report.
2.6 The Ayrshire partnerships have been advised by civil servants of the transitional funding allocated to the three partnerships. The partnerships had requested total funding of £781,000 and were allocated £560,000. This is slightly in excess of the allocation that would have been received had the allocation been calculated using the NRAC formula. It is understood that the total available fund was oversubscribed by some 50%. The amount allocated to the partnerships will be used to fund a range of activities as set out below.
Area of development support Original bid Revised allocation £ £ Programme management 175,000 109,000 OD/Communcations/Locality 175,000 109,000 Legal support 48,000 48,000 Service review 200,000 129,000 Clinician involvement 135,000 135,000 Performance management 48,000 30,000 Total 781,000 560,000
110 2.7 The SAISG recommended to the four chief executives that legal support should be retained as per the bid, as the partners had previously committed to fund a post to provide legal support to all partners to draw up the integration scheme and to ensure that all plans comply with the legislation and regulations. SAISG also recommended that clinician involvement should be retained in full as that will be critical to the success of the partnerships. The other elements were reduced pro- rata.
2.8 In addition to the transitional funding allocation, the Ayrshire Data Sharing Partnership was allocated £98,000 for 2014/15, part of which will be used to close the gap against the original bid. We will also monitor underspend on the Older People’s Change Fund as a potential funding source for bolstering the capacity of the third sector.
North Ayrshire Developments
2.9 Progress has been made towards appointing a senior management team for the partnership. Interviews for Head of Service posts will be held during June and July.
2.10 An outline proposal for organisational development support for the SIB has been developed and is the subject of a separate report.
2.11 Progress is being made locally and with Ayrshire partners on the development of the first strategic plan. Work on a needs assessment is being undertaken with the support of NHS Public Health. The needs assessment will inform the strategic planning priorities of the HSCP and will also link to broader action by the Community Planning Partnership to tackle inequalities.
2.12 Partnerships are required to consult and engage with a wide variety of interest groups in the preparation of the strategic plan. The principal consultation mechanism will be a strategic planning group. The second batch of regulations prescribed membership of strategic planning groups. In North Ayrshire the strategic planning group will be built on the existing CHP forum with additions to achieve a broader and balanced representation that complies with the draft regulation.
2.13 A number of initiatives are in progress to maintain staff engagement with integration. The Partnership Director is delivering a series of face to face introductory briefings at a range of locations across North Ayrshire. An extended management team meeting is being held later in June involving managers from both Health and Social Services. This builds on a series of such meetings in Social Services and will be the first opportunity for managers across the service to meet together to discuss the new partnership.
3. Proposals
3.1 The programme plan continues to be delivered through the identified workstreams. Progress against the plan is subject to scrutiny by the Strategic Alliance and by the Chief Executives of the three Ayrshire councils and NHS Ayrshire and Arran. Members of the SIB are asked to continue their support for this process.
111 4. Implications
Financial Implications
4.1 There are no financial implications arising directly from this report.
Human Resource Implications
4.2 There are no human resource implications arising directly from this report. The human resource implications for each proposal for the Partnership will be considered as they are developed.
Legal Implications
4.3 Work undertaken to prepare for integration will ensure that North Ayrshire Council and NHS Ayrshire & Arran are able to comply with the requirements of the legislation.
Equality Implications
4.4 There are no equality implications.
Environmental Implications
4.5 There are no environmental implications.
Implications for Key Priorities
4.6 The integration of health and social care will contribute to the delivery of the “Healthier North Ayrshire” priority in the 2013 - 2017 Single Outcome Agreement.
5. Consultations
5.1 No specific consultation was required for this report. User and public involvement is a key workstream for the development of the partnership and all significant proposals will be subject to an appropriate level of consultation.
6. Conclusion
6.1 The partners are making good progress in delivering the integration programme plan. Robust programme management arrangements are in place to ensure that key milestones are met.
For more information please contact Iona Colvin, Director, North Ayrshire Health & Social Care Partnership on 01294 317723 or [email protected]
Appendix 1
112 Work Stream Update – May 2014
Work stream Update
Finance Work continues on local implementation of the national Professional Guidance and the key components required for inclusion in the Integration Scheme.
A governance framework has been prepared and assurance sought that the relevant workstreams are addressing the component parts.
Due diligence has been completed for the Partnerships’ budgets for the Shadow year 2014/15, noting that further refinement is required. The current budgets do not reflect the agreement in principle of the transition of Primary Care to the East partnership and Allied Health Professions (AHPs) to the South partnership. There will be on-going changes to budgets e.g. final agreement on efficiency savings, pay award uplifts and Primary Care prescribing budget uplift. The Directors of Finance are preparing papers on the budgets, for submission to the respective Shadow Integration Boards (SIBs).
The group noted the requirement for early consideration of the appointment of the Section 95 Finance Officer to the Integration Joint Board (IJB).
The principles of the funding model continue to evolve and the 2014/15 budget setting process is being used to identify, test and develop these.
ICT This work stream deals with two key areas: Communications & Information ICT Technical Issues- this group has met to standardise terms of Management reference and a technical sub group has been established. This will deal with connectivity issues for Senior Managers working across NHS Ayrshire & Arran and the Councils. There will be a review of ICT infrastructure for Ayrshare to establish whether it can be used for shared data access and to identify issues around Information Governance and Data Sharing.
ICT Requirements/Information Management –a workshop was held on 8 April 2014 with North Ayrshire Council Community Care and legal staff, Health IT, ICES and Dietetics and a local GP to discuss the potential data access requirements in the short, medium and longer term period. An action plan has been developed which will allow the work stream to establish priorities for the shadow year and over the next 5 year period which are expected to be equally applicable across all three partnerships.
The workshop sub group are meeting on 7 May to agree the action plan arising from the feedback at the workshop session and determine the interface with the Data Sharing Partnership.
Legal The workstream continues to review the legal actions required for the development of the Integration Scheme and support for other workstreams. 113 Work stream Update
The workstream is clarifying a number of issues raised by other workstreams including the role of the Monitoring Officer. In addition, it is also considering the requirements of the Freedom of Information (Scotland) Act as it relates to the partnerships.
The workstream is also reviewing the Public Bodies (Joint Working) (Scotland) Act and policy statements. Feedback on the Act will be circulated throughout the workstreams.
Public Health & The draft Regulations on the services which must or may be included Health within partnerships is awaited. Improvement The Public Health Integration Framework, which was developed at the January meeting, will be populated with health information and circulated to the workstream for comment prior to the next meeting of the workstream.
Performance The workstream has agreed (1) a process to define a baseline set of performance measures/indicators for reporting within the SIBs; (2) a plan to provide a populated baseline report and seek feedback on the content of the report; and (3) to consider further the performance framework required in relation to the development of the Strategic Plans and agreement of a timeframe and possible timing of input from the Performance work stream to the development of the Strategic Plans.
A further meeting of the workstream will be held on 7th May where the focus of discussion will be on the existing baseline measures and the link to partnership measures.
Clinical and Care The April meeting reviewed the Action Plan for the activity areas Governance agreed following a workshop held earlier in the year. This created a number of sub-groups which will take forward particular tasks. Sub- Group leads have been asked to ensure that these adhere to the timescales in the Action Plan to maintain momentum, especially over the summer months.
The full workstream will meet again on 13th June to review sub-group progress.
Framework for The draft outline framework for the strategic plan has been prepared Strategic Plan and will be considered by the CHP Forums which, with augmented membership, are developing into the Strategic Planning Groups (SPGs) in each partnership area, as agreed by the Shadow Integration Boards.
Discussion is ongoing with Public Health on the provision of the needs assessment.
Consideration has been given to the content of the first draft of the
114 Work stream Update
pan-Ayrshire element of the plans, which will be discussed by the SPGs.
Currently, each partnership is developing a timetable for development of the partnership content by the end of June and full completion by October.
Work is also ongoing to develop an annual “Planning Cycle” to support the continuing development of the plans to include timescales for the annual update of the needs assessments, development of focused needs assessment, locality planning and the process for engagement, consultation and agreement.
Human This joint workstream for Human Resources and Organisational Resources & Development monitors the work of the component groups. Organisational Development Human Resources (HR) – This group also works on a joint protocol for Management Structure Arrangements.
The group met for the first time in April 2014 and has set the priorities for the next three meetings recognising that a number of actions have already been progressed in relation to the Directors posts (Chief Officer) and now require to be progressed for the next level management structures.
Organisational Development (OD) – the workstream has developed an outline Framework for proposed OD support to the Partnerships and the development requirements for Shadow Integration Board (SIB) members. The OD group supported the Strategic Alliance Integration Sub Group (SAISG) with the OD/Transitional funding bid to the Scottish Government the outcome of which is awaited.
The group has agreed the outline content for Partnership Workforce and OD Strategies to reflect consistency pan-Ayrshire. The sub group recognised the need to establish the remit/extent of the strategies and the need to work with HR colleagues to further develop this.
Communications The Communication work stream has developed a protocol for joint responsibilities in communicating with the media, in and out of hours. per the Integration Scheme Framework. This was forwarded to Strategic Alliance Integration Sub Group for noting.
A master communication schedule has been developed which will require regular updating. This will enable sharing of generic communication across the partnerships to reduce duplication and effort.
The group is currently reviewing website development with a view to a single point of information and has contacted Scottish Government to ascertain if there will be a national digital presence.
Branding ideas are being developed for discussion with Partnership
115 Work stream Update
Directors. User and Public The workstream has developed a generic engagement framework for Involvement how users and the public will be included in delivering the partnership aims and outcomes and this will be included within a paper being developed on the arrangements and operation of the Strategic Planning Groups.
The workstream is liaising with the Communications and OD workstreams to ensure that the Communication Plan and the OD Plan reflect user and public involvement. A joint meeting is planned with the Communications workstream on 28 May 2014.
Corporate & The Strategic Alliance Integration Sub Group has agreed a Other Services methodology for the review of support services. This will include both services managed within Council Social Work departments which are now included within Partnerships and services managed corporately within Councils and the NHS. In the case of the NHS all support services are managed corporately. Work on this area will commence in the early summer when all three Partnership Directors are in post and have identified appropriate resources.
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Shadow Integration Board 11th June 2014 Subject: Developing the Health and Social Care Strategic Plan Purpose: To provide an update on the proposed timescale for the production of the first Strategic Plan and for the SIB to approve the initial draft Strategic Plan Framework.
Recommendation: SIB members to note progress and approve the draft Strategic Plan Framework
1. Background
1.1 At the SIB meeting on the 1st May 2014 the members noted the guidance which requires the Health and Social Care Partnership to develop a Strategic Plan. The SIB noted that a Strategic Plan framework was being developed.
1.2 The SIB also approved the refocus of the CHP Forum in to the Strategic Planning (SPG). The SIB also requested to receive a draft Strategic Plan by Autumn 2014.
1.3 A further set of Health and Social Care Partnership regulations is expected on the 27th of May 2014 about Strategic Planning. This will provide more details around Scottish Government expectations of the Strategic Plan. The implications of these regulations will be brought to the next meeting.
2. Proposals
2.1 An initial Strategic Plan framework is attached at Appendix 1 for the SIBs approval. It is proposed that a 10 year Pan Ayrshire vision for integration services will be developed including a specific North Ayrshire Strategic Plan section.
2.2 This framework has been discussed at the Adult and Older Peoples OLG, Learning Disabilities and Mental Health (LD&MH) Partnership and CHP Forum. There was agreement that this was a good way forward. The draft framework will also be considered at the next Children’s Executive Group and Alcohol and Drug Partnership.
2.3 The LD&MH Partnership also supported the development of a standardised collection template for North Ayrshire Care Groups to collate their key outcomes, priorities and ambitions. The Facilitator is developing this piece of work.
2.4 At the CHP Forum meeting on the 15th May 2014 the members were supportive of the refocus to the Strategic Planning Group. The group had an initial discussion about a proposed membership and the links which require to be developed with
117 localities to ensure effective engagement. These issues will be explored further when there is clarity around the next set of regulations.
3. Proposed Timescales
3.1 An initial draft plan will be available for October 2014 and after consideration by the SIB will progress though the appropriate governance arrangements.
3.2 The detail of this plan will reflect the current planning priorities and the challenges which require further exploration as the Health and Social Care Partnership (H&SCP) moves forward.
3.3 A considerable engagement and consultation process will be undertaken in the coming months with key stakeholders and staff seeking their views on the content of the Strategic Plan.
4. Needs Assessment
4.1 We are currently working with NHS Public Health to develop a needs assessment to support the development of our first strategic plan.
4.2 As we move forward the needs assessment information will be targeted towards H&SC priority areas.
4.3 Whilst the current public health information undoubtedly highlights the health inequalities within North Ayrshire, it is important to acknowledge that actions to address these might not be 'the gift' of the HSCP, as their causes are linked to multiple deprivation and will also require the strategic intervention of the Community Planning Partnership.
4.4 The importance of the needs assessment will therefore be to inform the strategic planning priorities within the HSCP identifying whether and when the approach would benefit from a focus on care groups or more cross-cutting issues e.g. inequalities.
5. Recommendations
5.1 SIB members to note progress and approve the draft Strategic Plan Framework
For more information please contact Michelle Sutherland, CHP Facilitator on 01294 317751 or email [email protected] & [email protected]
Appendix 1
Health and Social Care Partnership draft framework for integrated services
118 Proposed timescale • Agree framework June 2014 • Complete engagement draft content October 2014 • Finalised through governance structures April 2015
Ayrshire and Arran Health and Social Care Partnerships - 10 year vision for integrated services 1. Executive summary
2. Context • Future directions of public services in Scotland
• Christie principles, prevention and early intervention etc. • Principles of co-production, personalisation, (SDS) • Context of time of scarcity • Key drivers summary
• Case for change • What will success look like?
3) How will we do business together? • Vision for Integrated Services • Our Priorities • Summary of governance and accountability of Health and Social Care Partnership • Our principles and values including:
Integration Principles
• to improve wellbeing, • services integrated from the point of view of users, • meet differing user needs; anticipates those needs and prevents them arising • meet differing locality need • planned and led locally • engaged with the community • engaged with local professionals, • makes the best use of the available facilities, people and other resources.
Service Principles
• Engaged with communities • Early intervention and Prevention focussed • Person centred and personalised, • Safe, • outcome focused, • proactive, • flexible responsive and forward looking, • accessible, 119 • resilience building
4) Locality Planning Approach
5) Communication and Engagement
• Community, Stakeholder and user involvement including staff, carers, groups of interest, individuals
6) Future models of care
• Description of ambition (use Diagrams to illustrate)
7) Interface arrangements (diagram)
• CPP • Acute services • Council services – Education and Skills, Housing etc • Commissioned services • Third Sector Interface • Independent Sector
8) Outcomes – How will we know if we have been successful?
• Performance Matrix
• Resource matrix
• Community views
Health and Social Care Partnerships Section – Planning for thematic groups
This to include:
Children and Young People, Adults including disabilities, mental health, learning disabilities; Addictions, Older People, Criminal Justice
• Local Needs • Current models and resources • Future model, including partnership third and independent sectors • How will we deliver change?
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Shadow Integration Board 11th June 2014 Subject: The development of Health and Social Care sub- structures Purpose: To highlight progress on the development of Health and Social Care Partnership (H&SCP) substructures. These structures will support user, public, stakeholder and staff engagement. It is expected that these arrangements will continue to develop over the Shadow year. Recommendation: SIB to note progress and note that additional regulations to be th issued on the 27 May will have an impact on this work.
1. Background
1.1 The Health and Social Care Partnership (H&SCP) requires to develop a dynamic substructure which allows successful engagement of users, public, stakeholders and staff.
1.2 There are many existing engagement groups and mechanisms in North Ayrshire across the NHS, Council, Third and Independent sectors. These have over many years added value in collating the views of local people, staff and other stakeholders on key issues.
1.3 The SIB approved the refocus of the CHP Forum to the Strategic Planning Group (SPG) to support the development of the Strategic Plan. The regulations to be issued on 27th May 2014 will define the relationship between the Strategic Planning Group and the SIB.
2. Emerging Substructures
2.1 The Partnership Facilitator met with the CHP Forum on the 15th of May 2014 and advised that it would be refocused as the Strategic Planning Group for the partnership and would include wider representation from social work, housing and the third sector. The Strategic Planning Group is a consultative and advisory forum with decisions on the Strategic Plan being taken by the Shadow Integration Board. The Vice Chair of the Shadow Integration Board would assume the role of Chair of the Strategic Planning Group. There was also discussion around a proposed membership and links to locality planning, mental health reference group, primary care, advocacy, carers, the acute hospital sector and Community Hospitals. The detailed regulations on Strategic Planning to be issued on 27th May 2014 will inform progress.
121
2.2 At the CHP Forum both our GPs and Pharmacy representatives highlighted that they have locality arrangements and are exploring how these can link to a locality planning approach and the Strategic Planning Group. Dental and optometry arrangements are currently Pan Ayrshire and discussions are now taking place to explore H&SCP support.
2.3 At the meeting held on the 20th May the Public Partnership Forum highlighted that it is very supportive of integration and is keen to explore a merger with the membership of the Social Services User and Carer Group, which unfortunately, has not met for some time. A further meeting with the partnership facilitator is planned to take this forward.
2.4 The Health and Social Care Director, Iona Colvin met the Social Services Staff Reference Group on 21st May 2014 and this group is keen to engage with health colleagues. The group is currently exploring representative members for the Strategic Planning Group.
2.5 A Providers Forum has been developed and our SIB members for the Independent and Third Sector, Nigel Wanless & Jim Nichols, presented on SIB business at the 20th May meeting. Both SIB members are developing their engagement and feedback mechanism with both providers and to the Strategic Planning Group.
2.6 A Staff Partnership Forum (SPF) will also be developed as we move forward.
2.7 An emerging substructure is noted at Appendix 1.
3. Current Position – Locality Planning
3.1 A further set of Health and Social Care Partnership regulations is expected on the 28th of May 2014 about Locality Planning. This will provide more details around Scottish Government expectations of the Locality Planning approach in addition to the JIT guidance note discussed at our last meeting. The implications of these regulations will be considered and brought to our next meeting.
2.2 The Community Empowerment Bill is also progressing and this will have an impact on our Community Planning Partnership (CPP) Neighbourhood Planning approach. This work is being led by the North Ayrshire CPP and the outcome will require consideration by the H&SCP at a later date. It is hoped to create synergy between these emerging arrangements.
2.4 Appendix 2 illustrates how the emerging H&SC substructures might link to localities but this will be clearer once the regulations have been produced.
3. Recommendation
3.1 SIB to note progress and SIB to note progress and note that additional regulations to be issued on the 28th May will have an impact on this work.
For more information please contact Michelle Sutherland, CHP Facilitator on 01294 317751 or email [email protected] & [email protected]
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CONFIDENTIAL – Draft for consideration Health & Social Care Strategic Planning Group
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Appendix 2 - Draft for consideration Health & Social Care – Emerging Locality Planning Approach
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Shadow Integration Board th 11 June 2014 Subject: Organisational Development Support for Shadow Integration Board Purpose: To seek the support of members of the Shadow Integration Board for a programme of organisational development support Recommendation: That members of the Shadow Integration Board agree to support the programme
1. Introduction
1.1 This report sets out proposals for a focused programme of organisational development support for the Shadow Integration Board. This will be the first phase of organisational development activity for the North Ayrshire Health & Social Care Partnership (HSCP).
2. Current Position
2.1 The Shadow Integration Board (SIB) was established to oversee preparations for the creation of the HSCP for North Ayrshire and to have responsibility for services delegated to it by NHS Ayrshire & Arran and North Ayrshire Council. Membership of the SIB was constructed to mirror, as far as was known at the time, the legislative requirements for the Integration Joint Board (IJB) which will succeed the SIB when the HSCP is formally established in law from 1 April 2015.
2.2 The strength of the SIB is its diverse membership, representing statutory, third and independent sectors, together with people who use services and their carers, staff and practitioners. The members of the SIB collectively have a great breadth of experience to bring to support the creation of the HSCP. In order to capitalise on this and to ensure that the SIB operates as effectively as possible it is proposed to develop a short, focused organisational development programme.
3. Proposals
3.1 The aims for the programme are:
• To develop a sense of clarity over the vision and values of the HSCP. • To support the HSCP in developing as an effective, integrated organisation. • To engage SIB members to reflect on the type of organisation they wish to be, exploring the key variables required for such transformational change. • To examine what changes would be required to achieve the desired future strategy.
125 • To develop, from the above, a prioritised OD framework and plan for taking the SIB’s strategy forward.
3.2 As part of the programme, a full day session will be organised for members of the SIB. This session will both initiate the development of the SIB and help to shape future elements of the organisational development programme. It is envisaged this session will be the first of three or four such sessions that will take place during the life of the SIB.
3.3 This programme will run alongside other induction / familiarisation activities such as visits to operational teams and premises and a market-place event, showcasing the wide range of health and social care services for which the SIB is responsible.
3.4 The programme will initially be delivered by an independent contractor, Madeleine O’Brien Associates. This recognises the need for an objective assessment of the needs of the SIB and provides additional organisational development capacity to the Partnership at a time when resources are stretched.
4. Implications
Financial Implications
4.1 The cost of the proposals contained in this report is £4,500. This will be met from existing organisational development budgets.
Human Resource Implications
4.2 There are no human resource implications arising from this report.
Legal Implications
4.3 There are no legal implications arising from this report.
Equality Implications
4.4 There are no equality implications arising from this report.
Environmental Implications
4.5 There are no environmental implications arising from this report.
Implications for Key Priorities
4.6 The integration of health and social care will contribute to the delivery of the “Healthier North Ayrshire” priority in the 2013 - 2017 Single Outcome Agreement.
5. Consultations
5.1 The Chair and Vice-Chair of the SIB were consulted about the proposals in this report.
6. Conclusion
6.1 The proposed programme of organisational development support will help the SIB to develop the capacity to operate as an effective, integrated Board. 126
For more information please contact Iona Colvin, Director, North Ayrshire Health & Social Care Partnership on 01294 317723 or [email protected].
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Shadow Integration Board 11 June 2014 Subject: Implications of the Children and Young People (Scotland) Act 2014 Purpose: The purpose of the report is to advise SIB Members in relation to
the implementation of The Children and Young People (Scotland) Act 2014 and the requirements to develop an implementation plan in line with the Public Bodies (Joint Working) Scotland Bill 2014. Recommendation: It is recommended that the SIB Members (i) Note the ambition and key elements of the Children and Young People’s (Scotland) Act and the work already being undertaken within North Ayrshire. (ii) Requests that further work and analysis is undertaken to ensure the partnership meets its statutory obligations. (iii) Notes the potential financial implications at this stage.
1. Introduction
1.1. The Children and Young People (Scotland) Bill was introduced into Parliament on 17 April 2013 and received Royal Assent on 27 March 2014. The Act makes changes over a wide range of policy areas, from planning children’s services and support for care leavers to provision of early learning and childcare with a particular focus on wellbeing and early intervention. The key proposals of the Act are outlined in Appendix 1 for information and explained more fully below.
1.2. The main policy objectives for the Act are to embed a rights-based approach to children and young people across Scotland and improve how services that look after children and young people such as health, education and social care work together more effectively.
1.3. In terms of children’s rights, the Act includes placing a duty on Ministers to further the rights of children and young people and raise awareness of the United Nations Convention on the Rights of the Child (UNCRC). It places duties on the public sector to create reports every three years to outline the steps they are taking to realise these rights. Part 2 of the Act extends the powers of Scotland’s Commissioner for Children and Young People so the office can undertake investigations in relation to individual children and young people.
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1.4. In order to support children and young people more effectively, it places a duty on public services to work together to ensure that all vulnerable children are given a unified support plan across all services (including adult services) which have a significant impact on our children and young people’s wellbeing. The plans should demonstrate what public authorities are doing to ensure that services are integrated for service users; they make the best use of resources and are meeting their aims to safeguard, support and promote wellbeing, early intervention and prevention.
1.5. The Act enshrines in statute the ambition of Getting it Right for Every Child (GIRFEC). This includes extending the role of the Named Person to every person up to the age of 18. A named person will be from health or educational services and will provide a point of contact for the child and their family, as well as a point to access support for people with concerns about the child’s wellbeing and someone with an overview of the child’s mental, physical and social development.
1.6. The legal responsibilities of the Named Person role fall upon their employing organisation. In practice, it is expected that the ‘named person’ will be a midwife until 10 days after birth, health visitor until school entry, then Head, Deputy Head or guidance teacher depending on the age of the child. The final shape of the legislation will be influenced by regulations set out in secondary legislation and statutory guidance.
1.7. The Act contains measures around early learning and childcare to make sure that children are supported in their early lives. These require local authorities to provide at least 600 hours of “early learning and childcare” to three and four year olds, two-year- olds in families seeking work and to those two year olds who are “looked after” or have a kinship care order under the act.
1.8. In addition, the Act improves services for looked after children and young people and creates a statutory definition of corporate parenting. The Act raises the maximum age when people leaving care can ask for help from a local authority from 21 up to the age of 26. It will extend the role of "continuing care", allowing looked after young people to stay in their existing placement under 21. There remain however, a number of questions about how this will work in practice and whether there will be sufficient resources and capacity in the system.
1.9. The Act focuses on improving services for children who are at risk of becoming looked-after or going into kinship care (cared for by relatives or friends who have agreed to look after a child full-time). The Act defines Kinship Care Orders and what types of assistance can be made available through such Orders. Local authorities will have a duty to provide assistance such as counselling, advice and information on any matter; financial support and any local authority service provided on a subsidised basis.
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1.10. Finally, the Act introduces a range of other important measures. This includes the statutory use of a Scotland-wide Adoption Register and gives Ministers powers to set out what it should contain. It clarifies criteria for school closures, including rural schools, consultation requirements and school closure review panels. It provides clarity on aspects of the Children’s Hearings System and establishes area support teams, including local authority admin and support. It clarifies the appeals process for detaining children in secure accommodation and modifies the circumstances under which children’s legal aid is made available. It provides legal authority for extending free school meals to all P1 to P3 pupils and provides definitions of how wellbeing should be assessed including what are known as SHANARRI measures: Safe; Healthy; Achieving; Nurtured; Active; Respected; Responsible and Included.
1.11. Although most of the provisions will commence from April 2015, the provision for 600 hours of early learning and childcare comes into force in August this year. Within North Ayrshire Council, Education and Skills have developed plans to ensure the 600 hours provision is in place for August 2014. However, there are a number of areas where the impact of the legislation will be determined by forthcoming regulation and guidance.
2. Current Position
2.1. North Ayrshire Health & Social Care Partnership services are well placed to respond to the requirements of the Act, in that it builds on existing good practice already in place across North Ayrshire, for instance the Community Planning Partnerships Early Intervention and Prevention Strategy 2013/17 and the work of the Early Years Collaborative.
2.2. In addition there is already a significant amount of partnership working in North Ayrshire. The Joint Inspection of Services for Children and Young People in North Ayrshire was published on 28th October 2013. The report notes a number of areas of strength, including effective work with young offenders, looked after children and young people, child protection and early years parenting support.
2.3. The report of the Joint Inspection of Services for Children and Young People in North Ayrshire identified 3 main areas for improvement:
• Implement robust and systematic approaches to joint self-evaluation across services for children and young people. • Develop and implement an effective joint commissioning strategy to reflect the community planning partnership’s vision and ambitions. • Continue to improve the joint assessment of risks and needs for individual children and young people.
These areas for improvement are addressed within North Ayrshire's Children's Services Inspection Improvement Plan which is the responsibility of the North Ayrshire Children's Services Strategic Partnership.
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2.4. North Ayrshire Early Intervention and Prevention Strategy 2013/2017 and GIRFEC Development Plan 2014-2015 establish early intervention and prevention and partnership working at its heart. The Children’s Services key strengths highlighted by the inspection report include the recognition that North Ayrshire has “a strong commitment to prevention and intervening early to provide children and young people and their families with the help they need”. In addition they acknowledged that in North Ayrshire there is “strong and successful partnership working to tackle long standing inequalities”. North Ayrshire is therefore well positioned to implement the requirements of the Act. Good practice in terms of information sharing is already in place throughout Ayrshire. AYRshare was developed by NHS Ayrshire & Arran, in partnership with East, North and South Ayrshire Councils. It provides for effective, timely and secure sharing of information between organisations to help address concerns about the well-being and protection of children and young people. It therefore directly supports the information sharing elements of GIRFEC as outlined in the Act.
2.5. In terms of Looked after Children, North Ayrshire Corporate Parenting Strategy for Looked After Children identifies and reinforces collective duties and responsibilities to safeguard, promote and enhance the life opportunities of looked after children and young people. The responsibility for the overview and implementation of this strategy is the North Ayrshire Corporate Parenting Strategy Group who is accountable to the North Ayrshire Children's Services Strategic Partnership.
2.6. Within North Ayrshire there are more looked after children living at home or in kinship care than in most other local authority areas and high levels of kinship care placements (30% compared to the Scottish average of 24% in 2011). Currently there are 251 children and young people in kinship care; this is made up of 165 in Kinship Care and 86 on Residence Orders. This involves Social Services staff in managing greater risk in the community than colleagues in other areas. Given the high level of use of Kinship Care arrangements in North Ayrshire, this may require significant investment in terms of the Act.
3. Proposals
3.1. To clarify and develop an implementation plan in line with timescales for draft regulations and guidance to follow.
3.2. To work with North Ayrshire Children's Services Strategic Partnership to develop a joint Children’s Services Plan. This will be reflected in the North Ayrshire Health and Social Care Partnership Strategic Plan.
3.3. To undertake further analysis of the resource implications for the extension of the “named person”. This will focus around implications for midwives and health visitors where the financial memorandum estimates that there will be on-going costs.
3.4. To undertake further discussion with Education and Skills to establish support for those who leave school at 16. While this group includes those taking up employment or starting college, it also includes a group of very vulnerable young people ‘not in education, employment or training’.
3.5. To undertake an analysis of the resource implications for those with a potential to apply for a kinship care order and individuals who may be eligible for financial assistance. In addition, a review is required of the ability to offer counselling services
132 to a small percentage of families with children at risk of being looked after, should they choose to take this up.
3.6. To review resource implications of extending aftercare for care leavers up to the age of 26, thus increasing the potential population eligible for ‘Aftercare’ support.
4. Implications
4.1. The Scottish Government has made a guarantee to fund the implementation of the Act. In their consultation on the costs associated with the original Bill there was road agreement from local authorities that the early learning and childcare funding was sufficient to meet the requirements.
4.2. However, there were differences of opinion between the Scottish Government, COSLA and local authorities on the cost implications of the other areas of the Bill. Further work is on-going with the Scottish Government, COSLA and local authorities to fully understand the financial implications of the areas of the Act that were contained within the original consultation as well as areas added prior to the Bill being passed. There is therefore a risk that any funding will not cover the costs of implementing the Act.
5. Consultations
5.1. There have been no consultations around the proposals in this paper.
6. Conclusion
6.1. The Children and Young People’s (Scotland) Act is underpinned by the aims and ambitions of Getting it Right for Every Child, as well as strengthening children’s rights, supporting families and Children and young people who are looked after and accommodated. This report highlights both the general ambition of the Act and provides proposals for further work to ensure that the partnership meets the statutory obligations arising from the Children and Young People (Scotland) Act 2014.
For more information please contact Sheena Gault on 01294 317734 or [email protected]
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Appendix 1 - Children and Young People (Scotland) Bill
Key elements of the Bill include:
Part 1 - Rights of Children Strengthen the rights of children and young people by placing a requirement on Ministers and public bodies to “keep under consideration” how they might further the implementation of the United Nations Convention on the Rights of the Child (UNCRC).
Part 2 - Commissioner for Children and Young People in Scotland Reinforces the role of the Commissioner for Children and Young People in Scotland in undertaking investigations into the upholding of rights of children and young people, both as groups and individuals.
Part 3 - Children’s Services Planning Places the requirement of Local Authorities and Health Boards to jointly prepare and publish a Children’s Services Plan, based on wide consultation, for each local authority area every 3 years.
Part 4 - Provision of Named Persons Enshrine in statute the ambition of Getting it Right for Every Child (GIRFEC). This includes providing every person up to the age of 18, a “named person”, appointed by either the health board or local authority, which will be a point of contact and to provide support and advice. Provision is also made for services to share information where there is a concern about a child’s wellbeing.
Part 5 - Child’s Plan The creation of a “Child’s Plan” and an assessment of wellbeing based around nationally agreed outcomes, where the child needs a targeted intervention in order to meet a “wellbeing need”.
Part 6 - Early Learning and Childcare Requiring local authorities to provide at least 600 hours of “early learning and childcare” to three and four year olds and to those two year olds who are “looked after” or have a kinship care order under the Bill.
Part 7 - Corporate Parenting Providing a statutory definition of “corporate parent” in relation to looked after children and applying it to a range of public sector organisations.
Part 8 - Aftercare Extending the obligations of local authorities to provide support to care leavers up to the age of 26.
Part 9 Services In Relation To Children At Risk Of Becoming Looked After, Etc. Providing for local authorities to create counselling services for children at risk of being looked after.
Part 10 - Support for Kinship Care Creating an additional framework for support and recognition of kinship carers of children who are not “looked after” by the local authority.
Part 11 - Adoption Register Creating a statutory adoption register and procedures for school closures.
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Part 12 - Children’s Hearings Reforms in respect of Children’s Hearing arrangements and Secure Care appeals.
Part 13 – General Providing for a statutory definition of wellbeing and requiring it to be used as the basis of assessment as per Part 5.
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Shadow Integration Board th 11 June 2014 Subject: Social Care (Self- directed Support) (Scotland) Act 2013 Statutory Regulations Purpose: To advise the Shadow Integration Board of the implications of the Social Care (Self- directed Support) (Scotland) Act 2013 Statutory Regulations
Recommendation: To note the implications of the Social Care (Self- directed Support) (Scotland) Act 2013 Statutory Regulations and agree to the proposals for implementation.
1. Introduction
1.1 The Social Care (Self Directed Care) (Scotland) Act 2013 was passed for Royal Assent on the 10th January 2013 and was implemented on 1st April 2014.
1.2 The Act is a significant addition in terms of Social Care Legislation and is central to the implementation of the Scottish Self-directed Support Strategy. This Act gives the Council the powers and duty to implement self-directed support. In North Ayrshire these have been delegated to the Health and Social Care Partnership.
1.3 The Act places new statutory duties and powers on local authorities, it repeals some current duties and powers while others remain unchanged; such as Adult Support and Protection (ASP), Child Protection (CP) and Adult with Incapacity Act (AWIA)
1.4 In March 2014 the Scottish Government published the statutory guidance to accompany the Social Care (Self- directed Support) (Scotland) Act 2013 and the new duties and powers which this places on local authorities.
1.5 The duties and powers that will remain unaffected are attached at appendix A
2. Current Position
2.1 Since 2011 Social Services and Health have been preparing for the implementation of the Act. This involved a major change programme and was in line with the North Ayrshire Personalisation Strategy. The result is that the service is in a strong position to meet the challenges this new legislation presents. However, as with any major change there are still potential issues that will test the effectiveness of the processes, and practice and service provision.
2.2 To address these challenges the following measures are in place:
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• Mandatory training in SDS and “Talking Points” outcome focused approach for all staff • Implementation of outcome focused supervision and reflective learning. • To develop a cycle of continuous improvement.( Working Group established Feb 2014) • SDS to be added as standing agenda item at team meetings • Build in dedicated time for staff and team development • Practice forums to be established • Identification of SDS champions to mentor staff • Assessment paperwork and processes in place • Implementation of a Resource Allocation System to identify estimated budget for each SDS option and to facilitate budgetary planning • Review and interpretation of the legislation and statutory regulations
3. Key features of the SDS Act and statutory regulations
3.1 The primary purpose of the SDS Act 2013 is about giving service users more choice and control over how services and support are provided. The Act enables local authorities to make provisions about the way social care services are provided moving from a traditional service led provision to one based on personalisation and designed to meet the outcomes of service users. local authorities have to demonstrate the following principles are part and parcel of practice: involvement, informed choice, collaboration, participation in local community and promotion of dignity.
3.2 The Act provides a new, enhanced duty to offer direct payments and enables local authorities to make provisions about the way social care services are provided. The practical effect of this change is to ensure that two previous service delivery options (the direct payment and arranged services) are replaced by a duty to offer four options, coming under the broad description of options for self-directed support.
3.3 It details four options for self-directed support:
• a direct payment for the individual to arrange their own care and support • the person chooses who they want to provide the support they want and the Council then arranges the care for the person (this is called an Individual Service Fund) • Council arranged services • a combination of the above options
These options need to be offered to all eligible individuals including adults, children affected by disabilities and informal carers.
3.4 The Act prescribes a duty to have regard to the general principles of collaboration and promoting informed choice. These cover taking steps to involve the supported person and their carer fully in both the assessment and selection of their support options and how the support is delivered.
3.5 There is a new duty to take reasonable steps to facilitate the person's dignity and to ensure full participation in the life of the community. This means that that the general principles of participation and dignity should guide and inform the service’s
138 assessment practice, the manner in which it provides services and the manner in which it provides the SDS options to the supported person.
3.6 The 2013 Act provides the authority with a new power to provide support to the informal carer and to provide support which helps the carer to continue in their caring role as long as they wish to do so.
3.7 The authority is placed under a new duty to explain the nature and effect of the 4 options provided under the Act. This means that the authority must:
• explain the level of flexibility and control associated with each option, • provide general guidance and advice on what it means to the individual to have their support arranged on their behalf or to direct their support and • the specific impact for the supported person, i.e. what the different options might mean for the supported person given their own circumstances, assets and circles of support.
3.8 The authority is placed under a duty to provide information about other independent organisations that can provide assistance or information about the options and how to manage the options. There is a similar duty to provide information about organisations and individuals who can provide independent advocacy services.
3.9 There is now a duty to advise the service user of the cost of each option. The development of the resource allocation model allows the identification of an estimated budget based on the needs of the service user which meets this duty. This assists the service user and assessor to plan how their supports will be delivered.
3.10 There is a requirement to ensure all service users are supported in making decisions or managing their support, if the individual does not have capacity in this regard then provision under the Adults with Incapacity Act applies. This equally applies to children whose views, where possible, must be sought and taken account of alongside the individual with parental responsibilities.
3.11 The Act places a duty on the council to develop the social care market to ensure service users are able to exercise a real choices; this includes increasing the range of providers as well as the types of flexible services provided by these providers.
3.12 The regulations also put in place measures to waive charges for services to unpaid carers. The full details and implications will be reported to the Shadow Integration Board at a later date.
3.13 The regulations prescribe changes to direct payments in terms of:
• clarifying who are excluded from receiving a direct payment • how charges should be made against a direct payment • when a local authority may terminate a direct payment • when a local authority may make a direct payment to a person other than the service user • the employment of close relatives as personal assistants
3.14 The regulations also refer to the need or NHS and Social Services to work together in meeting individual outcomes. Where pooled resources and budgets are agreed then consideration will be required to be made as to whether part or all of the budget will
139 apply under SDS legislation. For example if a package is jointly funded the supported person should be offered the support as a SDS option.
4. Proposals
4.1 That the Board note the contents of the SDS Act and statutory regulations and the new powers and duties that they place on a council.
4.2 To put in place clear information and guidance, for service users, their carers and staff to ensure that the statutory duties are understood by all.
4.3 To review and update current policies, procedures and guidance in line with statutory regulations taking advice from legal services, finance and human resources.
4.4 North Ayrshire Council has worked closely with the ADSW in designing, developing and reviewing national training modules on Self-directed Support targeted at social work professionals and other key local authority staff. We have requested that we pilot the support planning training materials.
5. Implications
5.1 The scope and changes brought about by the SDS Act and supporting regulations make it difficult to predict the full implications for service users carers and other stakeholders.
5.2 New duties will shape practice and service delivery which will bring about greater choice and control for service users and carers. There will be a greater transparency in how services are delivered and how resources are deployed and performance of these services will be measured around outcomes for the service user. 5.3 There will be changes in the way we work collaboratively with service users. These are cultural changes for staff, providers and service users. Feedback from the North Ayrshire pathfinder identifies greater levels of satisfaction where service users had increased choice and control. 5.4 The Scottish Government set deadlines for the implementation of self-directed support. The 4 SDS options require to be offered to all new service users from April 2014 and this is in place for existing service users this requires to be offered at the first formal review of the support plan following 2014. There is now no longer any set deadline to achieve this for all service users but there is an expectation it will be completed timeously.
6. Consultations
6.1 A wide ranging consultation process involving service users, service providers and staff has been undertaken to develop the personalisation strategy. This approach will continue with the planned implementation of Self-directed Support over the next three years.
7. Conclusion
7.1 The SDS Act and supporting regulations places new powers and duties on Local Authorities.
140 7.2 The Personalisation Strategy anticipated most of the Act’s provisions and the strategy’s implementation and integration into service redesign means we are well placed to meet the new requirements of the Act and the statutory regulations.
For more information please contact Alan Brown Senior Manager Personalisation on 01294 317794
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What remains in place?" - The duties and powers that will remain unaffected by the 2013 Act
2.1 The following duties and powers are not affected by the introduction of the 2013 Act:
2.2 Duty to safeguard and promote the welfare of children
• The authority retains its duty to safeguard and promote the welfare of children in their area who are in need. This remains a wide-ranging duty, with flexibility for the authority to take a range of steps to safeguard and promote welfare. • The authority retains its duty to promote the upbringing of such children by providing a range and level of services appropriate to the child's needs (Section 22 of the Children (Scotland) Act 1995).
2.3 Duties in relation to children affected by disability (Section 23 of the 1995 Act)
• The authority retains its duty to ensure that services provided under Section 22 of the 1995 Act (services to children in need) are designed to minimise the effect of any disability on disabled children and to minimise the effect on any child who is affected by the disability of any other person in his family. (Section 23 of the 1995 Act) • The authority retains its duty, where requested to do so by the child's parent or guardian, to carry out an assessment of the child or any other person in the child's family to determine the needs of the child. (Section 23 of the 1995 Act) • The authority retains its duty, when assessing the child's needs under Section 23 of the 1995 Act, to take account of the views of the parent or guardian of the child and the views of the carer. (Section 23 of the 1995 Act)
2.4 Carers assessments (carers of disabled children)
• The authority retains its duty to conduct carers’ assessments for carers of disabled children where the carer requests such an assessment and where that carer provides a substantial amount of care on a regular basis.
2.5 Duty to prepare plans for community care services (adults)
• The authority retains its duty to prepare and publish a plan for the provision of community care services in their area (Section 5A of the 1968 Act)
2.6 Duty to appoint chief social worker
• The authority retains its duty to appoint a chief social work officer (Section 3 of the 1968 Act). Registered social workers remain accountable for the exercise of specific statutory functions, as set out in The Role of the Registered Social Worker in Statutory Interventions: Guidance for Local Authorities (Scottish Government: December 2009).
2.7 Power to make arrangements with voluntary and other organisations
• The authority retains its power to make arrangements with voluntary organisations or other persons, including other local authorities, where they are able to assist in the performance of the relevant functions (Section 4 of the 1968 Act).
2.8 Duty to promote social welfare (adults):
• The authority retains its duty to promote social welfare by making available advice, guidance and assistance on such a scale as may be appropriate for their area (Section 12 of the 1968 Act). This remains a wide-ranging duty, with flexibility for the authority to take a range of steps to promote social welfare. The full range of options and additional flexibility provided for under the 2013 Act fall within the scope of "promoting social welfare".
143 2.9 Duty to assess needs (adults):
• The authority retains its duty to conduct an assessment of the adult's needs (Section 12A of the 1968 Act).
2.10 Power to provide emergency assistance in cash (adults)
• The authority retains its power to provide assistance in cash as well as "in kind" in the case of an emergency. This remains a different form of assistance to a direct payment (which is now covered under the 2013 Act).
2.11 Carers assessments (carers of adults):
• The authority retains its duty to comply with all requests for carer's assessments where the carer provides or intends to provide a substantial amount of care on a regular basis (Section 12AA of the 1968 Act). • The authority retains its duty to have regard to the results of the carer's assessment in the assessment of the person cared for, and in making decisions relating to the support to the person cared for. • The authority retains its duty to inform carers who meet the substantial/regular criteria of their right to request a carer's assessment.
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Shadow Integration Board th 11 June 2014 Subject: Consultation on regulations relating to the Public Bodies (Joint Working) (Scotland) Act 2014 Purpose: To advise members content of and consultation on draft regulations relating to the Public Bodies (Joint Working) (Scotland) Act 2014 Recommendation: That members note the publication of the regulations, agree to consider these further at a Shadow Integration Board workshop and to advise NHS Ayrshire & Arran and North Ayrshire Council of any matters which they would wish to inform the responses of the Health Board and the Council to be consultation. 1. Introduction
1.1 The Public Bodies (Joint Working) (Scotland) Act 2014 provides for Scottish Ministers to put in place a number of Regulations and Orders which will provide additional prescription regarding the integration of health and social care. An indication of the likely contents of the Regulations was given in the policy statements that accompanied the passage of the legislation.
2. Current Position
2.1 Scottish Ministers have now published the draft Regulations for consultation in two sets. The first set covers the following matters: • Prescribed information to be included in the Integration Scheme. • Prescribed functions that must be delegated by Local Authorities. • Prescribed functions that may or that must be delegated by a Health Board. • Prescribed National Health and Wellbeing Outcomes. • Interpretation of what is meant by the terms health and social care professionals. • Prescribed functions conferred on a Local Authority Officer.
The consultation on this set of regulations will run until Friday, 1 August 2014.
The second set covers: • Membership, powers and proceedings of integration joint boards. • Groups which must be consulted regarding integration schemes, prescribed consultees for draft strategic plans, prescribed consultees for localities, prescribe consultees for revised integration schemes. • Prescribed membership of strategic planning groups. • Prescribed form and content of performance reports.
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In addition to the above there is a further draft regulation which applies only to partnerships that have chosen the lead agency arrangement for integration in preference to the body corporate model.
The consultation on the second set of regulations runs until Monday, 18th August.
2.2 Both NHS Ayrshire & Arran and North Ayrshire Council will be reviewing the regulations and will respond to the consultation. The Shadow Integration Board may decide how to approach the consultation. The potential options are:
• The Shadow Integration Board could choose to respond to the consultation in its own right. • It could consider the draft regulations and advising the Health Board and the Council of its views as a means of informing the Health Board and the Council’s responses to the consultation. • It could agree simply to keep a watching brief at this stage.
It is recommended that at this stage of the Shadow Integration Board’s development that the second option is the most appropriate. Whichever option is chosen, it is important the members of the Shadow Integration Board develop an understanding of the proposals as in their final form, they will regulate the operation of Integration Joint Boards.
2.3 The draft Regulations are broadly in line with the previously published policy statements. At this stage it is worth drawing members’ attention to a few points which appear to require clarification.
2.3.1 The draft Regulation on functions that must be delegated by a Local Authority includes housing support services. This appears to extend the scope of mandatory delegation beyond aids and adaptions which was the expectation arising from discussions when the policy statements were published. The delegation of all housing support services has significant implications for North Ayrshire Council, specifically for the housing services remaining with the Council. A meeting has been arranged between the Director of the Health & Social Care Partnership, other Council officers and the responsible civil servant to clarify the scope of the proposals.
2.3.2 The Act did not set out the functions that were to be delegated by a Health Board, leaving these to be set out in Regulation. The draft Regulation prescribes that a Health Board must delegate all of its functions relating to adult primary and community health services, along with a proportion of hospital sector provision to support whole system re-design in favour of preventative and anticipatory care in communities. The functions that must be delegated include medical care for urgent or emergency conditions in relevant specialities. This will be set out in statutory guidance to be issued later this year. Work is underway to determine how large hospital budgets would be managed.
2.4 The introductions to the first and second sets of draft Regulations give an overview of the proposals. The introductions are attached as Appendix 1 and 2 to this report.
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3. Proposals
3.1 It is proposed that the SIB holds half day workshop at which it will have the opportunity to consider both sets of draft regulations. The format of the workshop would be brief presentations on the main regulations followed by facilitated discussions. A synopsis of the regulations will be issued to members prior to the workshop. Wednesday, 9th July has been provisionally booked for the workshop.
4. Implications
Financial Implications
4.1 There are no financial implications arising from this report.
Human Resource Implications
4.2 There are no human resource implications arising from this report.
Legal Implications
4.3 The Regulations, in their final form, will impose legal obligations on NHS Ayrshire & Arran, North Ayrshire Council and, when it is established, the North Ayrshire Integration Joint Board.
Equality Implications
4.4 There are no equality implications arising from this report
Environmental Implications
4.5 There are no environmental implications arising from this report.
Implications for Key Priorities
4.6 The integration of health and social care will contribute to the delivery of the “Healthier North Ayrshire” priority in the 2013 - 2017 Single Outcome Agreement.
5. Consultations
5.1 The Chair and the vice Chair of the Shadow Integration Board were consulted on the way in which the Shadow Integration Board might respond to the consultation.
6. Conclusion
6.1 The Regulations give considerably more detail as to how the integration of health and social care will operate. It is important that members develop a good understanding of how these will affect both the work preparatory to the establishment of the formal Health & Social Care Partnership and the future operation of the Partnership.
147 For more information please contact Iona Colvin, Director, North Ayrshire Health & Social Care Partnership on 01294 317723 or [email protected]
148 Appendix 1
Introduction to the draft Regulations – Set 1, published by on 12 May 2014
DRAFT REGULATIONS RELATING TO PUBLIC BODIES (JOINT WORKING) (SCOTLAND) ACT 2014 – SET 1 Public consultation on the first set of draft Regulations to accompany the Public Bodies (Joint Working) (Scotland) Act 2014. Consultation Paper Introduction The Public Bodies (Joint Working) (Scotland) Act 2014 provides a framework to support improvements in the quality and consistency of health and social care services through the integration of health and social care in Scotland. The policy rationale for integrating health and social care services is: to improve the quality and consistency of services for patients, carers, service users and their families; to provide seamless, joined up, high quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and to ensure resources are used effectively and efficiently to deliver services that meet the needs of the increasing number of people with longer term and often complex needs, many of whom are older. Set one of the draft Regulations relating to The Public Bodies (Joint Working) (Scotland) Act 2014 are within this consultation. Their purposes are:
1. Prescribed information to be included in the Integration Scheme Section 1(3)(f) of the Public Bodies (Joint Working) (Scotland) Act 2014 The Integration Scheme is a document to be prepared in respect of each Local Authority area, by the Local Authority and the relevant Health Board. It sets out models of integration that the Health Board and Local Authority have opted to use in practice. It contains the key agreements that have been made between Health Boards and Local Authorities to make integration a success and describes the necessary processes and procedures that will be put in place. Section 1(2) of the Public Bodies (Joint Working) (Scotland) Act 2014 together with sections 2(3) and 2(4), which make provision for the case where there is more than one Local Authority within a Health Board area, requires that Health Boards and Local Authorities prepare an Integration Scheme. Section 1(3)(a-e) of the Public Bodies (Joint Working) (Scotland) Act 2014 sets out the key information that must be included in the Integration Scheme, such as the scope of the functions delegated, the resources delegated and the model of integration chosen. These Regulations sets out the other matters that Scottish Ministers intend to prescribe for inclusion in the Integration Scheme, and information about these matters, which Health Boards and Local Authorities must provide. They include provisions about the following matters:
Local governance arrangements Local operational arrangements Clinical and care governance Workforce Finance Claims management and indemnity arrangements Dispute resolution Stakeholder and public engagement Complaints
149 Data sharing Risk management 2. Prescribed functions that must be delegated by Local Authorities Section 1(7) of the Public Bodies (Joint Working) (Scotland) Act 2014 The policy intention set out within the Public Bodies (Joint Working) (Scotland) Act 2014 is to achieve the integration of adult health and social care functions, while providing local flexibility to integrate further for other specified functions of Local Authorities. Section 1(5) of the Public Bodies (Joint Working) (Scotland) Act 2014 introduces Part 1 of the schedule, which sets out the functions of Local Authorities that may be delegated. Section 1(7) of the Public Bodies (Joint Working) (Scotland) Act 2014 allows Scottish Ministers to prescribe in Regulations those functions that must be delegated by a Local Authority, as they relate to specific services for adults. These Regulations sets out those functions.
3. Prescribed functions that must or may be delegated by Health Boards Section 1(6) &1(8) of the Public Bodies (Joint Working) (Scotland) Act 2014 The Public Bodies (Joint Working) (Scotland) Act 2014 requires Local Authorities and Health Boards to enter into an Integration Scheme, which provides the basis for Health Boards and Local Authorities to plan integrated arrangements for the delivery of adult health and social care services. Section 1(8) of the Public Bodies (Joint Working) (Scotland) Act 2014 allows the functions of a Health Board that must be delegated under an Integration Scheme to be prescribed within Regulations. Section 1(6) of the Public Bodies (Joint Working) (Scotland) Act 2014 allows the functions of a Health Board that may be delegated under an Integration Scheme to be prescribed within Regulations. These Regulations sets out the functions of a Health Board that must be delegated and the functions of a Health Board that may be delegated under an Integration Scheme.
4. Prescribed National Health and Wellbeing Outcomes Section 5(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 Section 5(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 allows Scottish Ministers to prescribe National Health and Wellbeing Outcomes. National Health and Wellbeing Outcomes are high-level statements of purpose which apply to the planning, delivery, review and inspection of the arrangements that are made for the integration of health and social care services. They aim to achieve the improvement in the lives of patients and services users and the quality of service users. These Regulations set out the nine National Health and Wellbeing Outcomes prescribed under Section 5(1) of the Act.
5. Interpretation of what is meant by health and social care professionals Section 68(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 Section 68(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 provides definitions of key terms, which assist with interpretation of the Act. Under this section, the terms “health professionals” and “ social care professionals” are defined as including such groups of persons, engaged in the provision of health and social care respectively, as Scottish Ministers prescribe. These Regulations contain prescribed descriptions of persons who, for the purposes of the Act, are to be within the meaning of the terms health
150 professionals and social care professionals. Sections 5, 12, 16 and 51 require health professionals and social care professionals to be consulted in relation to the National Health and Wellbeing Outcomes and in relation to any proposed staff transfers to take place under the powers in the Act. This Regulation sets out the individuals, or groups, that Scottish Ministers consider to be representative of health professionals and social care professionals and who should therefore be included in any such consultation.
6. Prescribed functions conferred on a Local Authority officer Section 23(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 The policy intention set out within the Public Bodies (Joint Working) (Scotland) Act 2014 is to achieve the integration of adult health and social care functions, while providing local flexibility to integrate further for other specified Local Authority functions. The Act states that Scottish Ministers may, by Regulation, prescribe those functions which Local Authorities must delegate under an Integration Scheme. There are a range of functions, conferred by, or under, the Adult Support and Protection (Scotland) Act 2007 on, specified persons who can be authorised to perform the functions of a “council officer”. These relate to functions of Local Authorities which will require to be delegated.
These Regulations, arising from Section 23(1) of the Act enable functions of a “council officer” to be exercised by suitably qualified employees from any of the bodies which prepared the Integration Scheme. This Regulation sets out which functions, conferred on an officer of a Local Authority, are prescribed.
151 152 Appendix 2
Introduction to the draft Regulations – Set 2, published by on 12 May 2014
DRAFT REGULATIONS AND ORDERS RELATING TO PUBLIC BODIES (JOINT WORKING) (SCOTLAND) ACT 2014 – SET 2 Public consultation on the second set of draft Regulations and Orders to accompany the Public Bodies (Joint Working) (Scotland) Act 2014
Consultation Paper
Introduction The Public Bodies (Joint Working) (Scotland) Act 2014 provides a framework to support improvements in the quality and consistency of health and social care services through the integration of health and social care in Scotland. The policy rationale for integrating health and social care services is: to improve the quality and consistency of services for patients, carers, service users and their families; to provide seamless, joined up, quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and to ensure resources are used effectively and efficiently to deliver services that meet the increasing number of people with longer term and often complex needs, many of whom are older. Set 2 of the draft Regulations and Orders relating to the Public Bodies (Joint Working) (Scotland) Act 2014 are contained within this consultation. Their purposes are:
1. Prescribed groups which must be consulted when preparing Integration Schemes, Section 6(2)(a) of the Public Bodies (Joint Working) (Scotland) Act 2014 Prescribed groups, a representative of which must be sent a copy of the second draft strategic plan and invited to give views, Section 33(6) of the Public Bodies (Joint Working) (Scotland) Act 2014 Prescribed groups who must be consulted on decisions which significantly affect a locality, Section 41(4) of the Public Bodies (Joint Working) (Scotland) Act 2014 Prescribed groups of persons who must be consulted when revising Integration Schemes, Section 46(4)(a) of the Public Bodies (Joint Working) (Scotland) Act 2014 These Regulations prescribe who must be consulted: When preparing Integration Schemes; In the development of the strategic plan; For locality planning; and When revising Integration Schemes.
2. Membership, powers and proceedings of Integration Joint Boards , Section 12(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 The Public Bodies (Joint Working) (Scotland) Act 2014 requires Health Boards and Local Authorities to agree one of four models of integration. One of these models, set out in section 1(4)(a) of the Act, is described as ‘body corporate’ and allows the delegation of functions and budgets from the Health Board and Local Authority to a newly established Integration Joint Board. This draft Order makes provision as to how an Integration Joint Board established under the Public Bodies (Joint Working) (Scotland) Act 2014 is to
153 operate. This includes , who is required to be included in the membership of the board, which members may vote, and other procedures relating to the operation of the board. The Order also makes provision allowing Integration Joint Boards to enter into agreements or contracts which are necessary for them to carry out their duties under the Act. For example, contracts to enable the Integration Joint Board to receive professional advice such as legal or accounting, or when making arrangements in relation to premises, equipment and staff. Section 12(1) of the Act provides for Scottish Ministers to make provision about the membership, proceedings and powers of Integration Joint Boards; the supply of services or facilities to Integration Joint Boards by a Local Authority or Health Board; the establishment of committees by Integration Joint Boards; the operation of committees of Integration Joint Boards; and the delegation of functions conferred upon Integration Joint Boards by an Integration Scheme to the chief officer, any member of its staff or any committee.
3. Establishment, membership and proceedings of joint monitoring committees, Section 17(1) of the Public Bodies (Joint Working) (Scotland) Act 2014. The Public Bodies (Joint Working) (Scotland) Act 2014 requires Health Boards and Local Authorities to agree one of four models of integration. Three of these models are described as ‘lead agency’ and allows the delegation of functions and budgets between the Health Board and Local Authority. Section 1(4)(b)(c)(d) of the Act sets out these three models of delegation as follows: The Health Board may delegate functions and resources to the Local Authority; The Local Authority may delegate functions and resources to the Health Board; or The Health Board and the Local Authority may delegate functions to each other. Section 15(3) of the Act provides that where the Health Board and the Local Authority agree to use one of these models of integration, they are required to jointly establish an integration joint monitoring committee for the purpose of monitoring the carrying out of the integration functions for the Integration Authority area. This draft Order covers the matters that Scottish Ministers intend to prescribe relating to the operation of integration joint monitoring committees. It includes provisions about the following matters: Membership Term of office of members Membership where Integration Scheme is prepared by two or more Local Authorities Appointment of the Chairperson Disqualification Resignation of Members Removal of Members Replacement of Members Expenses of Members Proceedings/Standing Orders
154 4. Prescribed membership of strategic planning group Section 32(2) of the Public Bodies (Joint Working) (Scotland) Act 2014 The Public Bodies (Joint Working) (Scotland) Act 2014 requires each Integration Authority to establish a strategic planning group. Under the Act, the strategic planning group must be consulted during the preparation, review and amendment of the strategic plan. These draft Regulations prescribe the people that must be represented on the group. The group should comprise health and social care professionals, third and independent sector providers, service users and carers, representative groups and housing providers.
5. Prescribed form and content of performance report Section 42(3) of the Public Bodies (Joint Working) (Scotland) Act 2014 Integration Authorities will have responsibility for the planning and resourcing of a significant proportion of health and social care services within Scotland. It is important that the Integration Authority reports and accounts for their activities so that the public are able to assess the progress made to improve outcomes by the Integration Authority that serves them. Section 42(1) of the Public Bodies (Joint Working) (Scotland) Act 2014 requires that each Integration Authority prepare an annual performance report. Section 42(3) of the Public Bodies (Joint Working) (Scotland) Act 2014 gives Scottish Ministers the power to make Regulations that prescribe the form and content of performance reports. The draft Regulations include provisions requiring the performance report to contain information about the following matters: Progress against the national health and wellbeing outcomes; Progress against a suite of key measures and indicators;
Progress against the integration delivery principles with particular reference to strategic and locality planning; An overview of the integrated budget and the proportional changes within it; The flexibility to allow reporting on local outcomes and priorities. And, where a lead agency model of integration is used: Details of any recommendations and associated responses from and to the integration joint monitoring committee.
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Shadow Integration Board th 11 June 2014 Subject: Future Model for Community Justice in Scotland
Purpose: To advise the Board of the main points arising from the above consultation Recommendation: That the Board notes the main changes being suggested in the consultation. That the Shadow Integration Board notes the North Ayrshire response to the questions outlined in this consultation.
1. Introduction
1.1 The Women Offenders Commission and Audit Scotland reports, which were published in 2012, had highlighted flaws and a lack of consistency regarding how community justice was planned and delivered in Scotland through Community Justice Authorities (CJAs). The Scottish Government in response to these reports launched their consultation on community justice redesign in December 2012: Redesigning the Community Justice System – A Consultation on Proposals, and this consultation process ended in April 2013. This consultation provided three options: 1. an Enhanced CJA, which would extend the powers of CJAs; 2. a Local Model, which would build community justice into community planning partnerships (CPPs); 3. and a Single Service Model; which would create a national organisation for community justice and would take Criminal Justice Social Work (CJSW) out of local authority control.
1.2 In their response to this consultation North Ayrshire Council indicated a preference for the Local Model, but highlighted that 32 Community Justice Planning partnerships could create logistical problems of economies of scale and provided details of an amendment to the Local Model that was based on partnerships between local authorities, with links into each local authority’s CPP. This proposal was based on our positive experience of working within a formal CJSW Partnership with East and South Ayrshire for over ten years.
157 1.3 The Scottish Government’s response to this consultation was published in December 2013 and indicated that the “local model” was the preferred option. However, it was noted that none of the proposed models, including the local model, received complete support and therefore a further consultation would take place on the detail of the local model. This new consultation paper: Future Model for Community Justice in Scotland was published in April 2014.
2. Current Position
2.1 In 2003 the Scottish Executive wanted to bring the Scottish Prison Service (SPS) and CJSW together into one organisation titled a: “single agency”. The Scottish Executive undertook a “Reducing Reoffending” consultation on this and feedback received from this consultation was not supportive of the creation of a single agency and indicated that what was required was to bring a range of agencies together with the shared aim of reducing reoffending. This led to the Management of Offenders (Scotland) Act 2005 that established CJAs. The fundamental role of the CJA is to coordinate a strategic partnership approach to reduce re-offending. The South West of Scotland CJA comprises representatives from a range of partners and decision making powers rest with the elected members from the four local authorities.
2.2 The CJA has a strategic planning function and is responsible for the disbursement of the CJSW ring fenced Section 27 Grant. However, it has no operational responsibilities which lie with the local authorities and other partner agencies.
3. Proposals
3.1 The consultation paper’s proposed model will place community justice planning within CPPs. There will be a defined set of partners including local authorities, NHS Board, Police Scotland, the Scottish Prison Service and third sector partners. The consultation paper notes that it is “expected” that the Crown Office and Procurator Fiscal Service, the Scottish Court Service and Victim Support will be involved. The consultation paper states that the Scottish Government will place an additional statutory duty on local authorities and other statutory bodies in the public sector to focus on preventative approaches to reduce reoffending and this is to include a responsibility to work with third sector partners. Section 78 of the consultation paper states: “How local partners work together within CPPs, for the planning and delivery of services for community justice and improving outcomes is at local discretion”. The Scottish Government in conjunction with local government and key partners and stakeholders will produce guidance.
3.2 An issue highlighted in the Women Offender’s Commission and Audit Scotland reports was that there was a lack of accountability in CJAs. The consultation paper notes that each partner within the CPP will be held accountable for its performance through existing CPP governance and accountability arrangements. Partners will be expected to challenge each other on their engagement and delivery. The consultation paper notes that the Scottish Government do not want to duplicate the already established lines of accountability which exist in CPPs.
3.3 As noted in the introduction in our response to the first consultation in April 2013 North Ayrshire highlighted logistical concerns of economies of scale regarding the local model if it resulted in 32 community justice planning partnerships and suggested a partnership model between agreed local authorities could resolve this issue. Discussion with ADSW colleagues indicated that concerns regarding economies of scale had been raised throughout Scotland. The consultation paper notes that local joint partnership arrangements, or joint services delivered across 158 CPP boundaries, can be continued whenever considered appropriate.
3.4 As noted in the introduction the Women Offender’s Commission and audit Scotland reports had highlighted a lack of consistency across Scotland. The Future Model for Community Justice in Scotland most significant addition is the inclusion of a national organisation with the proposed name of Community Justice Improvement Scotland (CJIS). There have been ongoing discussions between the Scottish Government and COSLA regarding the remit and powers of CJIS. The functions of CJIS is to:
• provide leadership for community justice in Scotland; • provide oversight; • advising how resources could be changed to improve outcomes; • and the management of any national services.
The issue of national oversight is a source concern as it could impinge on local accountability and responsibility. CJIS is presented having a bipartisan assurance approach, but it could be suggested that it will be will be weighted towards assuring the Scottish Government. In respect of the management of services the consultation paper highlights services which currently sit at a national level e.g. national training would be managed by CJIS. However, there is no indication that there will be any limit to this and it could be interpreted as the start of a process of national delivery.
3.5 CJIS will have a Board which will be appointed by Scottish Ministers through the public appointment process. The Board will not be involved in the day to day running of CJIS. The Board can have a range of committees with membership from a range of professional agencies. CJIS will have a Chief Executive who will have overall responsibility and oversee the appointment of staff. Staff employed will have a range of skill bases e.g. planning, finance, commissioning, social work adviser. The paper states CJIS will be a relatively small organisation and in addition to Board members CJIS will employ 20 FTE members of staff. However, it states that the Senior Management Team will be the Chief Executive, Director of Operations and Head of Corporate Services & Business Development. Therefore, it does appear that there will be a significant investment in the quality and seniority of the staff in CJIS and it is assumed that with such seniority there will be influential power invested in their roles. The consultation paper suggests the location for CJIS should be Edinburgh or Glasgow.
3.6 CJIS accountability will be through the Chief Executive and the Board to Scottish Ministers to the Scottish Parliament. Scottish Ministers will hold CJIS to account, set a budget, publish a national strategy for community justice, approve CJIS’s strategic plan, approve certain CJIS appointments and consider recommendations made by CJIS.
3.7 In respect of the relationship between CPPs and CJIS the consultation paper notes that as part of CJIS’ “general assurance function” it will provide an overview of local partnership strategic plans and annual reports. CJIS will have the “power to make recommendations” to Scottish Ministers and relevant elected members on areas requiring improvement. CPPs will share plans and annual reports with CJIS to show progress in delivering outcomes. As part of the CJIS’ assurance process they can offer targeted support to assist improvements. The consultation report notes that CJIS can, in certain circumstances, recommend that a “rescue task group” is established to drive improvements but this will be with the agreement of Scottish Ministers and local elected members.
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However, the consultation paper reaffirms that the responsibility for resolving local issues rests with CPPs and that there “should” be no need for CJIS to have direct involvement in the principles of community planning, as existing channels are in place.
3.8 In respect of the transition from CJA responsibility to the proposed new arrangements the consultation paper notes that CJAs will have a key role. CJAs along with Scottish Government are to raise awareness among CPPs of their new responsibilities and will provide training if required. The Scottish Government will establish a change project to facilitate the process of CPPs assuming responsibility. The consultation paper notes that the timing of the changes is uncertain due to the legislative process and “the readiness of partners to take forward the change agenda”, but adds that there is no impediment to commencing the transition process and early work can begin with awareness raising in CPPs. A work-stream will be established for this process and COSLA and CJAs have offered support. CPPs will be invited to establish local partnership arrangements during 2015-16 to come into effect by the end of this year. CPPs will be invited to prepare a plan in conjunction with their CJA for 2016-17, which will shadow the CJA plan. These plans are to be submitted to Scottish Ministers for comment. It is expected that once established CJIS will take on this function. CJAs may remain in place for a short period following the establishment of CJIS to assist transition.
4. Implications
4.1 Financial
The consultation paper states that the current community justice funding process is not fit for purpose and the Scottish Government led Reducing Reoffending 2 programme is addressing this. It is proposed that funding will be from the Scottish Government who will take advice from CJIS. No mention is made of ring fenced Section 27 funding. There will be additional resource implications for CPP’s once they assume responsibility for community justice planning and the consultation paper does not address this.
Human Resource
There will be HR implications for CJAs as they will be disbanded.
5. Consultations
5.1 The Government have launched a series of consultation events across Scotland. In North Ayrshire the salient issues arising from the consultation paper were raised with front-line Criminal Justice Social Work staff on a development day held on May 26th 2014.
160 6. Conclusion
6.1 The consultation report proposal of a local model for community justice built into CPPs is to be welcomed. However, it is important that CPPs have representation from all relevant partners and the consultation paper does not commit the involvement of some particularly significant partners. As noted there could be logistical issues of economies of scale as we move from eight CJAs to a potential 32 CPP community justice planning partnerships. There will also be resource issues when CPPs assume responsibility for community justice and this is not addressed by the consultation.
6.2 The Women Offender’s Commission and Audit Scotland reports highlighted a lack of national consistency and CJIS will have a central role to assure, advise and recommend to address such national issues. Although CJIS will be relatively small it could be suggested that it will have significant power and influence and any CJIS advice or recommendations made to Scottish Ministers will be given considerable weight. This is unsurprising as there would be little point in the Scottish Government creating such a body without investing it with some influential power. Nevertheless, there is the potential of conflict between CPPs and CJIS.
For more information please contact Jim McCrae on 01294 317784 or [email protected]
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ANNEX A
The Future Model of Community Justice in Scotland RESPONDENT INFORMATION FORM Please Note this form must be returned with your response to ensure that we handle your response appropriately
1. Name/Organisation Organisation Name North Ayrshire Council
Title Mr Ms Mrs Miss Dr Please tick as appropriate
Surname McCRAE Forename James
2. Postal Address North Ayrshire Council Social Services and Health 4th Floor West, Cunninghame House Irvine Postcode KA12 8EE Phone 01294 317784 Email
3. Permissions - I am responding as… / Individual Group/Organisation Please tick as appropriate
(a) Do you agree to your response (c) The name and address of your being made available to the organisation will be made public (in Scottish Government available to the public (in the library and/or on the Scottish Scottish Government library Government web site)? and/or on the Scottish Government web site). Please tick as appropriate
Yes No
(b) Where confidentiality is not Are you content for your response requested, we will make your to be made available? responses available to the public on the following basis
Please tick ONE of the Please tick as appropriate following boxes Yes No
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Yes, make my response, name and address all available or
Yes, make my response available, but not my name and address or
Yes, make my response and name available, but not my address
(d) We will share your response internally with other Scottish Government policy teams who may be addressing the issues you discuss. They may wish to contact you again in the future, but we require your permission to do so. Are you content for Scottish Government to contact you again in relation to this consultation exercise? Please tick as appropriate Yes No
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ANNEX B CONSULTATION QUESTIONS
Chapter 2
Question 1: Do you have any general comments on the overview of the new arrangements for community justice?
The overview provides a summary of what is contained elsewhere in the paper. We note that in this section (Section 31) it notes that it is expected that the Crown Office and Procurator Fiscal Service, the Scottish Court Service and Victim Support will be involved. We would suggest that they must be involved rather than expected to be involved.
Chapter 3
Question 2: What are your views on the governance and accountability arrangements?
The governance and accountability arrangements for CPPs and CJIS appear to be clear.
Chapter 4
Question 3: What are your views on the arrangements for local strategic planning and delivery of services for community justice?
As indicated in our response to Question 1 we have concerns regarding appropriate representation through the new local arrangements and this has to be fully addressed by the Scottish Government to ensure that all necessary partners are in attendance. Audit Scotland in its 2011 overview of the Scottish Criminal Justice System highlighted the lack of a systemic approach in Scottish Criminal Justice. It could be reasonably suggested that by not having all relevant agencies involved at a local level through CPPs could undermine this systemic community justice development.
However, we recognise that there may be logistical issues if organisations have to attend 32 such planning partnerships rather than the current 8 CJAs. In our response to the first consultation in April 2013 North Ayrshire suggested a partnership based approach, based on groupings of local authorities. We suggested an all Ayrshire Community Justice Planning Partnership that linked directly into each local authority’s CPP. In Ayrshire this makes sound sense due coterminous boundaries of the three local authorities with one Health Board and two Sheriff Courts. Although the paper notes that such partner arrangements can be continued this could lead to a piecemeal approach which could impact on the development of community justice throughout Scotland.
The additional responsibilities that will be placed on CPPs have not been fully addressed by the consultation paper. The responsibility for community justice will not
3
165 just be a simple add on to current community safety arrangements in CPPs and to undertake this effectively will require additional resources. At the consultation event there was a suggestion that CPPs are already adequately resourced to undertake this function and that any savings generated from disbanding CJAs would be allocated to funding CJIS. Should this be the case we have serious concerns regarding this.
Chapter 5
Question 4: What suggestions do you have on how a national performance framework for community justice in Scotland could operate under the new model?
Outcomes, performance and improvement are dealt with very briefly in the consultation paper. We recognise that as part of RRP2 this is being addressed.
In respect of this performance framework providing assurance to the Scottish Ministers and local government leaders we would suggest that this appears to be weighted towards Scottish Ministers, as local authority leaders will be accountable for performance (as defined in Section 52 of the consultation paper). The challenge will be to develop a performance framework that will deliver clear meaningful outcomes and has a logical transparent evidence process.
Chapter 6
Question 5: What are your views on the functions to be delivered by Community Justice Improvement Scotland?
We would agree that that the provision of national leadership is an important function and we would agree with the bullet points made.
The issue of oversight in respect of performance has the potential to be problematic and through this CJIS could infringe on local accountability and decision making. In recent years there has been a growth in central organisations who oversee local arrangements, rather than the lighter touch promised. There are concerns that CJIS could be an addition to this at a time when greater emphasis should be placed on self-evaluation. Section 69 states that there “should” be no need for CJIS to have direct involvement in the principles of community planning, as existing channels are in place. “Should” suggests that CJIS could be involved?
CJIS’ role in advising Scottish Ministers on how resources are best aligned could be problematic. The local model will allow resources to be aligned where locally it is agreed that they are most needed, there is the potential for disagreement between CPPs, CJIS and ultimately the Scottish Government. We assume that any such advice given by CJIS will be given significant weight by Scottish Ministers.
In respect of the management of services the consultation paper highlights services which currently sit at a national level e.g. national training. However, there is no indication that there will be any limit to this and it could be interpreted as the start of a process of national delivery and any funding could be top sliced from the Section 27 Grant to pay for them. An additional concern is Section 74 which states that if
4
166 local partners choose not to access such nationally commissioned services this will need to be justified, which suggests that that local decision making could be compromised.
Question 6: Does the name “Community Justice Improvement Scotland” adequately reflect the responsibilities of the new national body and the functions?
We believe the name is not appropriate and it suggests that CJIS will has inspection function such as undertaken by the Care Inspectorate. We would suggest that Community Justice Scotland would be sufficient.
Chapter 7
Question 7: Are the skills and competencies in paragraph 105 and referenced in paragraph 106 sufficient to allow the body to fulfil its functions as noted in Chapter 6?
The skills and competencies defined appear to be sufficient.
Question 8: Is the organisational structure shown at Figure 3 and the expected size of the staffing complement sufficient to allow Community Justice Improvement Scotland to fulfil its functions as noted in Chapter 6?
The consultation paper briefly outlines CJIS’ functions but at this stage we are not in a position to provide meaningful comment on the organisational structure and size of the staffing compliment other than noting that there appear to be a significant investment in the seniority of staff in what is proposed to be a relatively small organisation.
Question 9: What other suggestions do you have for the organisational structure for Community Justice Improvement Scotland to allow it to fulfil its functions as noted in chapter 6?
We have no other comments to make regarding CJIS’ organisational structure other than noted above.
Question 10: What are your views on the proposed location for the headquarters of Community Justice Improvement Scotland?
We believe it makes sense to locate CJIS centrally in Glasgow or Edinburgh. We would suggest that Glasgow should be the preferred location as it is easily accessible from most areas in Scotland.
Chapter 8
Question 11: Are the professional areas noted in the list at paragraph 114 appropriate to allow the Board of Community Justice Improvement Scotland to fulfil its functions?
5
167 The professional areas noted generally appear to be appropriate. We note that some Board members could be recruited from organisations responsible for the scrutiny and inspection of public services. We have concerns regarding this as we would expect such services to be at arm’s length.
Chapter 9
Question 12: What are your views on the arrangements for the national Hub for innovation, learning and development?
The national Hub is not addressed in particular detail in the consultation. However, we are generally supportive of such a development.
Chapter 10
Question 13: What are your views on the arrangements in support of the transition process?
We recognise the important role that CJAs will have in transition and welcome the establishment of the change project and specific work-stream to take it forward. The lack of clarity regarding the timing of the transition process is a matter of concern and we note your comments that this is due to uncertainties in the legislative process. However, we do not believe that any significant delay will be due to: “the readiness of partners to take forward the change agenda”, as is suggested in the consultation document.
Chapter 12
Question 14: What impact on equalities do you think the proposals outlined in this paper may have on different sectors of the population?
It is difficult to say at this stage what impact on equalities the proposals will have, although we assume that it will not have a detrimental impact.
Chapter 13
Question 15: What are your views regarding the impact that the proposals in this paper may have on the important contribution to be made by businesses and the third sector?
We are not aware of any impact that the proposals will have on the businesses. However, we note the significant role that the third sector will have in the new arrangements, which can only have a positive impact on them.
6
168
Shadow Integration Board 11th June 2014 Subject: Draft Inequalities Strategy
Purpose: To provide an update on the Draft CPP Inequalities Strategy and seek SIB member comments.
Recommendation: SIB members to provide comments prior to the Inequalities Strategy presentation to the CPP Board
1. Background
1.1 The CPP Board requested that an Inequalities Strategy be developed for the Community Planning Partners to take forward. This is a challenging and complex agenda which requires all key partners, including communities to contribute.
2. Actions
2.1 The Health and Social Care Partnership (H&SCP) Director has held three Inequalities Programme Board meetings with wide representative membership across the CPP and other interested parties e.g. Further Education Colleges.
2.2 The CHP Facilitator undertook a literature search and there are currently no Inequalities Strategies at CPP level in Scotland. Several Scottish NHS Board and English Health Authorities have worked with partners to develop Health Inequalities strategies.
2.3 The CHP Facilitator led a range of partners to develop an initial draft document for comment. This draft was discussed at the Inequalities Programme Board held on 15th May 2014 and some changes have been proposed to the Appendix provided.
2.4 The draft Strategy has also been shared for comment at the Officer Locality Groups, CHP Forum, CPP SMT and other stakeholder meetings.
3. Proposals
3.1 SIB to consider Draft CPP Inequalities Strategy attached at Appendix 1 and provide comments.
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3.2 A draft will be presented to the June CPP Board for approval to begin a three month consultation period with stakeholders.
4. Conclusion
4.1 The draft CPP Inequalities Strategy is provided for comment. An updated draft with SIB comments and the comments provided by the Inequalities Programme Board will go forward to the June CPP Board prior to a three month period of consultation with stakeholders.
For more information please contact Michelle Sutherland, CHP Facilitator on 01294 317751 or email [email protected] & [email protected]
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Appendix 1
North Ayrshire Inequalities Strategy Framework Draft – for discussion
2014-2017
Date of Completion June 2014
Date of Review June 2015
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1. Forward
2. Vision
3. Objectives and Outcomes
4. Needs
5. Priorities
6. Closing Gap
7. Action Planning
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To be developed with CPP Chair.
2. Vision
Our shared vision for Community Planning Partners in North Ayrshire is “North Ayrshire – A Better Life”.
In order to achieve this vision we require to
Reduce local inequalities of outcome
3. Objectives
To reduce local inequalities of outcome we will require to:
Focus Community Planning Partner activities towards reducing inequalities gaps and achieving a faster rate of improvement among disadvantaged neighbourhoods and some population groups
Tackle inequalities in our local neighbourhoods and with the most vulnerable in our communities by implementing proportionate universality and effective targeting
Change and influence mainstream universal services, through effective commissioning, to ensure they are delivered with a scale and intensity proportionate to need across all socioeconomic groups
Link to SOA measures to ensure ‘Golden Thread’ across all CPP priority areas
Focusing on the Causes of Inequalities
The following model from NHS Health Scotland’s Health Inequalities Policy Review for the Scottish Ministerial Taskforce for Health Inequalities, 2013 illustrates the factors, which, when distributed unequally in society result in inequality of outcome, such as individual experiences of employment, learning and access to services. This leads ultimately to inequalities in income, educational outcomes, life opportunities and health and wellbeing across socioeconomic groups.
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What works to address health inequalities?
Although many of these factors can be influenced through the efforts of the Community Planning Partnership, it is also recognised that action on the ‘fundamental causes’ requires action nationally.
North Ayrshire SOA Outcomes
The North Ayrshire SOA has a key set of inequalities focused outcomes.
Children’s health and wellbeing is improved by breaking the cycle of poverty, inequality and poor outcomes
Worklessness is at the Scottish level and there is less inequality within North Ayrshire
North Ayrshire is a safer place to live
However these are the start of the performance journey and require linked to intermediate and specific activities as described in diagram 1:
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Diagram 1 – Performance Framework
NATIONAL PERFORMANCE FRAMEWORK WEALTHIER & SAFER & SMARTER HEALTHIER GREENER FAIRER STRONGER
North Ayrshire CPP Inequalities Vision
North Ayrshire Single Outcome Agreement
4. Needs and Strengths
The following key criteria for focus have been identified:
Reducing inequalities throughout the whole population of North Ayrshire with a scale and focus proportionate to disadvantage and need.
Targeted support to the 5% most deprived as defined by the SIMD
Focusing on reducing the gap between the most and least disadvantaged communities and population groups. Some tools to support this work are:
Top 5% of SIMD as this captures issues of worklessness and employability
S:\SSPUBLIC\SSHQ\mm4docs\Management\Director\MEETINGS\SIB\11-6-14\SIB17 - Appendix 1 - Draft Inequalities Framework.docx 175 A focus on SIMD domains, recognising the need for Community Planning Partners to focus activities towards reducing inequalities gaps and achieving a faster rate of improvement among disadvantaged communities and population groups.
Recognise the challenge that people face when living in isolated rural communities in North Ayrshire
Recognise that some vulnerable population groups may experience discrimination and therefore require more support.
5. Key Success Factors
Children have the best start in life
Access to sustained and good quality employment
Vulnerable individuals have the opportunity to maximise their potential
Communities have a wide range of assets and capabilities to reduce dependency of public services
6. Priority areas of interest
Children and Young • Early Years (including Early Intervention and People Prevention) • Parenting and Family Support • Curriculum for Excellence/Educational Outcomes • Children and Young People’s Health Strategy (including sexual health and mental health) • Vulnerable and disadvantaged children (including Looked After Children, Children, children experiencing homelessness, parental substance misuse and domestic abuse, and children with disabilities) • Improved processes to identify, assess and plan for children at risk • Meaningful employment for young people • Workforce planning
Carers • Focus on young carers • Improvements in health and wellbeing for Carers and
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Adults and older • Income maximisation, particularly for people with People young families • Improve outcomes for people involved in the Criminal Justice particularly women with children • Improving access to work for people affected by mental health and learning disability • Improving outcomes for people involved in the Criminal Justice system leading for a reduction in their reoffending
Communities and • Early intervention and prevention using targeted ‘active Place outreach’ approaches in neighbourhoods • Asset based co-production approaches working with communities and the third sector to develop sustainable empowerment, resilience and greater cohesion • Building capacity of primary care to support deprived communities • Vacant and Derelict Land Strategy to support regeneration opportunities.
Priority Actions
Children and Young • Extend financial advice available from time of People conception and in to the early years (Maternity Services and Early Years Centres) across Health Services including Primary Care, Mental Health and Community Nursing Services • Reduce the number of times Children Services attempt to support children to return to vulnerable families by offering quicker permanent solutions • Improve emotional and mental health of young people to improve their self confidence and self esteem, building their resilience and reducing levels of self- harm. • Develop pathways for children affected by parental addiction issues to positive destinations • Improve educational and care outcomes for Looked After Children
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Adults and older • Explore options to develop a bridging service for those People furthest away from the job market assessing the impact of the ‘Glasgow Works’ with NAC Regeneration Service and Irvine Bay Regeneration Agency • Align Health and Social Services within neighbourhoods in-reaching to Primary Care to provide specialist support to local General Practitioners. • Build a health and wellbeing approach across all CPP Partner services • Build a preventative approach and build integrated service models across partners to support people at earlier stages. • Support individuals on their release from prison into a positive role in the community. • Develop ‘active outreach’ model for priority improvement areas e.g. financial advice family support services, smoking cessation in pregnancy, sexual health services • Reduce impact of fuel poverty by implementing Housing Strategy.
Communities and • Extend and join up asset/co-production work in Place neighbourhoods using the foundations laid by Community Learning and Development & ABCD project. • Introduce traffic calming to improve outcomes for young people • Improving environmental access, play, leisure and green space, promoting active living (NAL) • Deliver Vacant and Derelict Strategy to support regeneration
Community Planning • Develop a joint performance reporting system across Partners the partnership using RIPE Group • CPP partners to implement inequalities self assessment tool • CPP Partners to develop a Equalities Mapping tool showing gaps in practice and neighbourhood inequalities
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7. Identifying the Gaps in Partners Practice
a) CPP Partners – Inequalities self assessment
Partners to undertake a survey of existing levels of inequalities sensitive practice across partnership.
Appendix 1 highlights some proposed questions
b) Inequalities Service Mapping
Partners to identify areas of good inequalities practice, with in each of their service areas.
These examples will be used across the partnership on which to build and commission new work to close inequalities in practice and neighbourhoods.
Those examples shown below of good practice which may be short term require to be mainstream change to support a Health and Wellbeing approach, focussed on early intervention and prevention across all CPP Services: -
Examples provided:
• Early Years Services • Family Nurse Partnership • School meals during the holiday periods for vulnerable families • Money Matters • Keep Well • Vulnerable pregnancy service • Homelessness and Housing support services • Multi-agency Problem Solving group • MADART • Home/school workers • Campus cops • 16+ school co-ordinators to ensure positive destinations • Extensive Outreach services for young people • Activity agreements for young people • Mentor for people in criminal justice system.
S:\SSPUBLIC\SSHQ\mm4docs\Management\Director\MEETINGS\SIB\11-6-14\SIB17 - Appendix 1 - Draft Inequalities Framework.docx 179 • Choose Life whole system approach to reduce suicide • DWP Youth contracts • DWP wage incentives for small businesses to support 18-24 year olds • DWP work choice for people effected by disabilities • Choose Life whole system approach to reduce suicide
Our local college supports inequalities in a number of ways
• Providing access course at all levels • Offering community course to reach those furthest away from the labour market • Through our NHS liaison officer who provides education, training and support on addictions and mental health to students, targeting the most vulnerable • Offering advice and guidance on accessing college and the financial help available • Supporting individual development and support plans • Delivering employability skills
8. Action Planning
The Partnership requires to identify two key actions for the 2014/15 year which will allow the testing of the performance framework and inequalities practice mapping tool.
Action 1 CPP Partners to map inequalities practice
Action 2 CPP Partners to develop inequalities map to neighbourhoods
Action 3
Action 4
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Examples of key questions:
. Are inequalities considered at the outset of policy, strategy and service development? . What tools are employed? . Do you take action to remove negative impacts at the planning stage? . How do you ensure that services being delivered to the whole population will not result in an increase in inequalities by disproportionately benefiting the most affluent? . How do you monitor and evaluate the impact of your service on inequalities? . How do you target those population groups known to experience the greatest barriers e.g. most deprived communities, homeless population, those with a learning disability? Do you offer more intensive support to those groups? . How is action to tackle wider socio-economic determinants of inequalities integrated into practice e.g. do staff enquire about the work and income/benefits status as part of assessments? Do staff signpost/refer to employability/financial inclusion services? . Do spending and investment decisions take account of inequalities and if they do what approach is taken e.g. reducing the gap, targeting the worst off? . How do you work in partnership to ensure a holistic approach e.g. considering housing, transport, community safety? . How do you engage with users and communities? Is this approach underpinned by empowerment and asset and skill development? . How are goods and services procured? Do you include community benefits clauses? Do you consider how procurement practices will support economic development, particularly in the most deprived communities in North Ayrshire? Do you engage social enterprises? . Do employment practices in the organisation support and encourage opportunities for those furthest from the labour market? . How have services changed over the last two years? . How have behaviours of CPP partners changed over the last five years?
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Shadow Integration Board th 11 June 2014 Subject: Arrest Referral Bail Supervision Service
Purpose: The purpose of this report is to seek approval to extend the current contract for the Arrest Referral Bail Supervision service currently delivered by Sacro by one year. Recommendation: The Shadow Integration Board is asked to agree to extend the contract for Arrest Referral Bail Supervision by one year from 1 April 2015 to 31 March 2016.
1. Introduction
1.1 In August 2012, North Ayrshire Council’s Cabinet agreed to the recommendation to approve the award of a three year contract until March 2015 to Sacro (Scotland) to deliver the Arrest Referral Bail Supervision Service with a breakout clause at the end of each financial year and subject to continued funding from the Scottish Government (see appendix 1).
2. Current Position
2.1 North Ayrshire Council has assumed responsibility for this contract but the service is delivered across East, North and South Ayrshire Councils and Dumfries and Galloway Council. Sacro is supported to deliver this contract by a steering group of Criminal Justice Social Work representatives from these four authorities and contract compliance is monitored by North Ayrshire Council.
2.2 To date the service has performed well and either achieved or exceeded requirements of the contract (see appendix 2).
3. Proposals
3.1 The request to extend this contract for a further year is for two reasons;
a) The introduction of Health and Social Care Partnerships b) The on-going review of Community Justice
Both of these national developments are/will bring with them a significant amount of change and at the present time the full implications for Criminal Justice Social Work in North Ayrshire, or indeed across South West Scotland are unknown.
183 4. Implications
4.1 The annual value of the contract is £225,000 however the contract can only be extended subject to continued funding being made available from the Scottish Government. There is no indication that this funding will cease but local authorities will not be advised of their Criminal Justice Social Work budget until December 2014/January 2015. Should funding be discontinued, then the service would also be discontinued.
5. Consultations
5.1 Consultation has been undertaken with representatives of the four local authorities receiving the service, who are all in agreement to extend the contract for a further year.
5.2 Advice has been sought from North Ayrshire Council`s Service Design and Improvement Team as well as the Corporate Procurement Manager.
6. Conclusion
6.1 The next eighteen months will see a significant level of change as Health and Social Care partnerships take over responsibility for a range of services. There are likely to be a number of demands on procurement and the agreement to extend the current service for a further year will ensure that, subject to funding, the Bail Supervision/Arrest Referral Service will continue across the South West Scotland Community Justice Authority Area.
For more information please contact Fiona MacKinnon, Ayrshire Criminal Justice Partnership Manager on 01294 310409 or [email protected]
184 NORTH AYRSHIRE COUNCIL
Agenda Item 20 21 August 2012
Cabinet
Subject: Bail Supervision/ Arrest Referral Service across South West Scotland Community Justice Authority area
Purpose: To advise the Cabinet of the tender exercise for the appointment of a provider organisation to operate a Bail Supervision/ Arrest Referral service on behalf of North Ayrshire Council.
Recommendation: That the Cabinet agrees to award the contract to SACRO for the appointment of a provider organisation to operate the Bail Supervision/ Arrest Referral service on behalf of North Ayrshire Council.
1. Introduction
1.1 At its meeting on 27 March 2012, the Executive agreed to a tender exercise for the appointment of a provider organisation to deliver a Bail Supervision/ Arrest Referral service across South West Scotland Community Justice Authority area, on behalf of North Ayrshire Council.
1.2 A formal contract notice was advertised, in line with the European Procurement Regulations on 17 May 2012 for a contract period of six months with an option to extend the contract on a yearly basis for up to a maximum of two years.
2. Current Position
2.1 The tender document was issued on 17 May 2012 with a closing date of 21 June 2012. At the closing date for applications, three tender submissions were received. All submissions were assessed initially for their capability and capacity to provide the service. Two submissions met the minimum criteria.
2.2 The two submissions which met the criteria were then evaluated in terms of quality of service (60%) and cost (40%). The bias towards quality reflects the importance of ensuring that the successful tender has the necessary expertise to provide the service.
185 2.3 The quality of service element was rated using a scoring framework based on the following criteria:-
Staffing (10%) Policies and Procedures (10%) Outcome for Service Users (10%) Service Outcomes (10%) Quality Processes (10%) Flexibility and Added Duty (10%)
2.4 The tender evaluation panel consisted of five officers from Criminal Justice Social Work, representing the four Local Authorities who will be recipients of the service as well as an officer specialising in addiction services, together with a sixth member, the Planning and Compliance Officer from South West Scotland Community Justice Authority.
2.5 Sacro scored the highest against the evaluation criteria. The completed evaluation matrix is detailed in Table 1.
TENDERER QUALITY PRICE OVERALL RANK SCORE SACRO 60% 39.73% 99.73% 1 APEX 51.69% 40% 91.69% 2
3. Proposals
3.1 It is proposed that the Cabinet award the contract to SACRO to operate the Bail Supervision/ Arrest Referral service across South West Scotland area on behalf of North Ayrshire Council.
4. Implications
Financial Implications
4.1 The value of the contract per annum will be approximately £225,000.
Human Resource Implications
4.2 Provisions do not apply to the transfer of employees. The current provider of the Bail Supervision service across the three Ayrshire's Sacro will deliver the Bail Supervision/ Arrest Referral service across South West Scotland Community Justice Authority.
186 Legal Implications
4.3 The procurement exercise has been undertaken in accordance with the Council's Standing Orders and European Procurement Procedures.
Equality Implications
4.4 The equality credentials of the service providers have formed part of the evaluation process.
Environmental Implications
4.5 There are no environmental implications.
Implications for Key Priorities
4.6 The continued provision of a Bail Supervision service and re-introduction of an Arrest Referral service (in Ayrshire) will contribute to the achievement of the following Single Outcome Agreement outcomes:
The harmful effect of alcohol and drug misuse are reduced (6c). Levels of crime and anti-social behaviour are reduced and crimes being detected have increased (9b).
Community Benefit Implications
4.7 The appointed provider will potentially recruit from the local community thus offering employment opportunities.
5. Consultations
5.1 Consultation previously took place with Senior Social Work Managers across Ayrshire and Dumfries and Galloway and with the Chief Officer of South West Scotland Community Justice Authority.
5.2 The tender exercise has been undertaken in consultations with the Councils Legal Services and the Planning and Commissioning Team, Social Services and Health.
187 6. Conclusion
6.1 The tender exercise has identified Sacro as the preferred provider organisation. The award of the contract to Sacro will allow the further development of the Bail Supervision Service in Ayrshire extending it into Dumfries and Galloway and the creation of an Arrest Referral service across South West Scotland Community Justice Authority area.
IONA COLVIN Corporate Director (Social Services and Health)
Reference : For further information please contact Fiona MacKinnon, Social Services Manager on telephone number 01294 318755 Background Papers Tender documentation
188 Contract Management Assessment (October 2013 – March 2014)
Sacro Bail Supervision/Arrest Referral (CMN -77)
Outcomes – Bail Supervision Outcomes -Arrest Referral Quality Service Cost Provider Assessment Does Not Meet Expectations Exceeds Expectations Meets Expectations Meets Expectations Meets Expectations CMO Assessment Exceeds Expectations Exceeds Expectations Exceeds Expectations Meets Expectations Meets Expectations
PAGE SECTION COMMENT Summary Page Complete Outcomes (page 3) Key Contract Information Complete Self Assessment Complete Quality (page 4) Key Contract Information Complete Self Assessment Complete Service (page 5) Key Contract Information Incomplete - staffing section Self Assessment Listening & Learning – indicators should still be completed to reflect process in place Financial Key Contract Information Complete Information (page 6) Self Assessment Complete Evidence Submitted:
Bail Supervision – 3 month review form, Pre Programme Questionnaire – Alcohol Education Programme, Information for Questionnaire – Arrest Referral (Viewpoint), Information for Questionnaire – Bail Supervision (Viewpoint), Homes Matrix, Homes Matrix Spreadsheet – Bail Supervision, Matrix Action Plan, Monitoring Notes, Outcome Monitoring Tool (Initial/Review/Exit), Sacro – Performance and Development Reviews, Compliments, Suggestions and Complaints Policy, Training Spreadsheet
CMO Analysis:
No issues identified.
Monitoring Status:
Provider to remain on low monitoring status
189
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190
Shadow Integration Board 11th June 2014 Subject: Contract Award – Response Monitoring Service
Purpose: To advise the Shadow Integration Board of the exercise of emergency powers by the Chief Executive of North Ayrshire Council in relation to the award of the contract for the Response Monitoring Service.
Recommendation: That members note the contents of this report.
1. Introduction
1.1 In terms of North Ayrshire Council’s Scheme of Delegation emergency items relating to Council Business on the Shadow Integration Board can be determined by the Chief Executive of North Ayrshire Council
2. Current Position
2.1 In terms of North Ayrshire Council’s Scheme of Delegation emergency items relating to Council Business on the Shadow Integration Board can be determined by the Chief Executive of North Ayrshire Council subject to reporting to the Cabinet thereafter. The extract from the Scheme of Delegation reads:
“Take such measures as may be required in emergency situations, or in the case of urgency, subject to advising the appropriate portfolio holder, where possible and reporting to the Executive as soon as possible thereafter, on any items for which the Executive or other Committee approval would normally be necessary. Where such measures involve the Council in incurring expenditure, the Chief Executive and Corporate Director (Finance and (Infrastructure) should be advised and a report submitted to the Executive as soon as possible thereafter.”
References to the Executive in the extract above should be read as referring to the Cabinet.
2.2 An emergency situation arose where it was necessary for the continuation of services to award a contract for the North Ayrshire Response Monitoring Service. This service currently provides support to approximately 3,500 service users in North Ayrshire, receiving alarm calls, recording and recalling sufficient information to enable assistance to be provided for each service user in any instance.
191
As a result of structure changes and internal budgets South Ayrshire Council, which previously provided this service, applied the termination clause under the terms of the Service Level Agreement and the service will cease to operate no later than 31 August 2014. In addition South Ayrshire Council has applied a 34% increase in charges with effect from 1 April 2014. Due to the restricted timescale and risk to service users it was not possible to tender this requirement, therefore a negotiated approach was taken and three options pursued. An options appraisal was undertaken and Cordia Care Services identified as the new proposed service provider.
2.3 The Chief Executive of North Ayrshire Council exercised her emergency powers in relation to the contract award as there was not a meeting of the Shadow Integration Board to which a report could be taken. The Chief Executive subsequently reported to Cabinet as required by the Scheme of Delegation.
2.4 The full report is now brought to the Shadow Integration Board to advise the Board on the exercise of the North Ayrshire Council Chief Executive’s emergency powers. This is attached as Appendix 1.
3. Proposals
3.1 The Shadow Integration Board is asked to note the exercise of the emergency powers of North Ayrshire Council’s Chief Executive.
3.2 The Board may wish to consider whether the current cycle of meetings is of sufficient frequency to allow it to take decisions on operational matters.
4. Implications
Financial Implications
4.1 The cost of the contract will be met from existing budgets.
Human Resource Implications
4.2 There are no human resource implications arising from this report.
Legal Implications
4.3 There are no legal implications arising from this report.
Equality Implications
4.4 There are no equality implications arising from this report
Environmental Implications
4.5 There are no environmental implications arising from this report.
Implications for Key Priorities
192 4.6 The integration of health and social care will contribute to the delivery of the “Healthier North Ayrshire” priority in the 2013 - 2017 Single Outcome Agreement.
5. Consultations
5.1 The Head of Democratic and Administration Services in North Ayrshire Council was consulted on the contents of this report and provided advice regarding the Council’s Scheme of Delegation.
6. Conclusion
6.1 The award of the response monitoring contract will ensure the continuation of services to vulnerable residents in North Ayrshire.
For more information please contact Iona Colvin, Director, North Ayrshire Health & Social Care Partnership on 01294 317723 or [email protected]
193 194 NORTH AYRSHIRE COUNCIL
Agenda Item 6 May 2014
Cabinet
Subject: Provision of a Response Monitoring System
Purpose: To advise the Cabinet of the outcome of the Options Appraisal to appoint a provider for the Response Monitoring Service.
Recommendation: That the Cabinet agrees to award the contract for the appointment of a provider organisation to provide the Response Monitoring Service for individuals who require the service within North Ayrshire.
1. Introduction
1.1 The North Ayrshire Council Response Monitoring Service (RMS) is currently provided by SAMS - South Ayrshire Council Response Monitoring Service. The service is provided 24 hours a day, 7 days a week and 52 weeks a year. The service receives alarm calls from north ayrshire residents and is capable of recording and recalling sufficient information to enable assistance to be provided for each service user in any instance.
2. Current Position
2.1 South Ayrshire Council (SAC) has provided the Response Monitoring Service since 1993. As a result of structure changes and internal budgets South Ayrshire Council has applied the termination clause under the terms of the Service Level Agreement and the service will cease to operate no later than 31 August 2014. The service currently provides support to approximately 3,500 service users in north ayrshire.
2.2 In addition South Ayrshire Council has applied a 34% increase in charges with effect from 1st April 2014. This equates to an increase from £43 to £78 per alarm per annum. The NAC Social Services and Health budget of £98k makes budget provision for only £28 per alarm at the current level of service. A pressure bid of £152k was approved for one year only and although this meets the increased costs from South Ayrshire Council the migration of the service to an alternative provider will incur additional costs as outlined in Appendix 2. There are additional set-up, capital and migration of service users costs which result in a shortfall of approximately £46k for this year and £103k for 2015/16 should the award of contract be approved. The shortfall of £46k for 2014/15 will be met from the additional monies to the Social Services Care at Home base budget and will have an
195 implication for the savings targets which the service will need to address. The shortfall for 2015/16 will be identified from the review of the Telecare Service which sits within the Care at Home Service Review.
3. Proposals
3.1 Due to the restricted timescale and risk to service users it was not possible to tender this requirement, therefore a negotiated approach was taken and three options pursued:
1. In house provision 2. East Ayrshire Council provision 3. Cordia Services provision
An options appraisal has been undertaken and a new proposed service provider has been identified. The options appraisal has identified Cordia Care Services as the new preferred provider. A copy of the options appraisal has been attached to the report as Appendix 1.
3.2 Service migration would commence immediately after approval to contract, with the new service being fully operational by 01 September 2014.
4. Implications
Financial Implications
4.1 The current budget for the response service is not sufficient to deliver the service and a budget variance report has been attached to this briefing note as Appendix 2.
Additional budget requirement 2014/15 £ 45,932 Additional budget requirement 2015/16 £103,200
Human Resource Implications
4.2 None
Legal Implications
4.3 Permission to contract is sought by applying the exemption in accordance with NAC's Standing Orders Relating to Contracts at point 4.1.4: "Any contract for the supply of goods or materials or for the provision of services or for the execution of works which in the opinion of any Chief Officer are urgently required for the prevention of damage to life or property".
196 Equality Implications
4.4 None
Environmental Implications
4.5 None
Implications for Key Priorities
4.6 The proposal is in keeping with the key priorities within the North Ayrshire Single Outcome Agreement:
A healthier North Ayrshire A safe and secure North Ayrshire and within the Council Plan of 'supporting vulnerable people'.
Community Benefit Implications
4.7 This service will provide high quality services to the local communities.
5. Consultations
5.1 Social Services and Health has consulted with Legal Services and Corporate Procurement throughout this process and both are supportive of this approach.
6. Conclusion
6.1 The Response Monitoring Service is vital in supporting vulnerable people within their communities. The options appraisal has identified Cordia Care Services as the preferred provider organisation.
6.2 The award of the contract to Cordia Care Services will allow the process of migration to be undertaken with immediate effect to minimise risk to a significant number of vulnerable people.
IONA COLVIN Corporate Director (Social Services and Health)
Reference : IMcK/NS For further information please contact Isabel McKnight, Manager (Service Development) on 01294 317750. Background Papers 2
197 198 Appendix 1
Department: Social Services and Health
Report to: Head of Service Community Care
Date: Monday 28th April 2014
Subject: Sourcing a Response Monitoring Service for the Community Alarm Service in North Ayrshire
Purpose: OPTIONS APPRAISAL & CONCLUDING REPORT
1.0 INTRODUCTION
1.1 This report marks the conclusion of a sourcing exercise to procure a Response Monitoring Service to support the community alarm service in North Ayrshire.
1.2 The report consists of:
• A description of the current provision and the challenges of the decommissioning process • Exemption to contract • A statement of the criteria to be used to assess the options • A summary of the options available • An analysis of each option • Recommendations • Action Plan
2.0 CURRENT POSITION
2.1 Telecare in recent years has been recognised by central and local government as an increasingly important support service within the community care system. Clear links have been established through the Telecare Development Programme to telecare’s positive role in achieving key national objectives such as earlier hospital discharge and helping people to remain in their own homes rather than being admitted into long stay establishments.
Therefore, the monitoring service is imperative in supporting Service Users, by allowing the Service Users to maintain a reasonable quality of life. The Service contributes to making the Service Users feel supported by promoting the ability to remain independent in their place of residence.
2.2 The monitoring service is currently provided by South Ayrshire Council’s Response Monitoring Service (RMS) 24-hours a day, 7 days a week, and 52 weeks a year. The RMS receives alarm calls from North Ayrshire residents. The RMS is capable of recording and recalling sufficient information to enable assistance to be provided for each Service User in any instance.
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2.3 SAC has applied the termination clause under the terms of the SLA and the service will cease to operate no later than 31st Aug 2014. It is the council’s intention to identify new provision no later than 30th April 2014.
On completion of the options appraisal and the new provision identified, contractual arrangements will be determined with the migration of the service taking immediate effect.
Budget provision has been insufficient to support the service from the current provider from outset.
3.0 EXEMPTION FROM THE PROVISION OF THE COUNCILS STANDING ORDERS
3.1 Due to the extremely tight timescale it isn’t possible to tender this requirement and exemption is requested from from the councils standing orders see 4.1.4:
“Any contract for the supply of goods or materials or for the provision of services or for the execution of works which in the opinion of any Chief Officer, are urgently required for the prevention of damage to life or property.”
4.0 CRITERIA USED TO EVALUATE THE OPTIONS
4.1 Following a review of the current situation, it has been possible to generate 3 options for consideration as follows:
• Option 1: In-House provision • Option 2: Purchase the Service from East Ayrshire Council • Option 3: Purchase the service from an external provider- Cordia Services LLP
4.2 Following a review of the materials produced to date and consultation of key stakeholders, the following criteria was used to evaluate each of the above options:
1) Risk: What degree of risk is involved in the option? Can the safety of users be fully secured?
2) Timescale: How long will it take to deliver this option? Can the option be delivered within the timescale?
3) Capital Cost: Will this option be costly to implement?
4) Revenue Cost: Will this option be provided within budget?
5) Ease of Management of the contract: What demands will this option place upon the provider and NAC?
6) Deliverability: How easy will it be to deliver the overall project?
7) Community Services: Will this option maintain and extend the quality and range of services
and options available to citizens within local community?
8) Future needs: To what extent will this option support future demand and potential changes?
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4.3 Each criterion is assessed using the following scale with the current situation forming the frame of reference:
• 3 = Exceeds requirements • 2 = Meets requirements • 1= Partially meets requirements 0= Not meet the minimal requirements
Each option takes the form of a narrative, describing the option in question then assessment in accordance with the criteria listed above, followed by a scoring.
5.0 Options Evaluation
5.1 OPTION 1: In-house provision
1) Risk: What degree of risk is involved in the option? Can the safety of users be fully secured? A robust risk management process is required to migrate the service with minimal disruption to any user: Response: unable to commit: Score = 0
2) Timescale: How long will it take to deliver this option? Can the option be delivered within the timescale? The transition of the service must be completed within a 4 month period: Response: unable to provide within the timescale: Score = 0
No further considerations were scored on Option 1 as the minimum requirement on 1) Risk and 2) Timescale could not be met.
5.2 Option 1 Summary of Response to request for Bid
Departmental discussions took place between, HR and Social Services &Health senior managers to determine the capacity to deliver the service by the Customers Services team within the council. The Customer services manager advised that at this time the Council does not have current capacity or expertise to deliver the service within the tight timescale and without risk to service users. Consideration should be given to conduct a scoping exercise to determine the longer term arrangements in delivering the service in – house.
5.3 OPTION 2: Purchase the Service from East Ayrshire Council
1) Risk: What degree of risk is involved in the option? Can the safety of users be fully secured? A robust risk management process is required to migrate the service with minimal disruption to any user: Response: unable to commit: Score = 0
2) Timescale: How long will it take to deliver this option? Can the option be delivered within the timescale? The transition of the service must be completed within a 4 month period: Response: unable to provide within the timescale: Score = 0
No further considerations were scored on Option 2 as the minimum requirement on 1) Risk and 2) Timescale could not be met.
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5.4 Option 2 Summary of Response to request for Bid
Senior managers from North Ayrshire Council met with East Ayrshire Council to determine the capacity to deliver the service by the Community Alarm Service within East Ayrshire. Senior management within East Ayrshire advised that at this time they as a council were in the process of strategic change within the service and that they could not support the requirements within the timescale and without risk to service users. Consideration should be given to conduct a further scoping exercise to determine the longer term arrangements in delivering the service in partnership with East Ayrshire Council.
5.5 OPTION 3: Purchase the service from an external provider- Cordia Services LLP
1) Risk: What degree of risk is involved in the option? Can the safety of users be fully secured? A robust risk management process is required to migrate the service with minimal disruption to any user.
Response: The Cordia Community Alarm and Telecare Service already provides support to over 9000 service users. The migration activity will be secured by ensuring a dedicating team from Cordia will work with Tunstall to minimise risk. Score = 2
2) Timescale: How long will it take to deliver this option? Can the option be delivered within the timescale? The transition of the service must be completed within a 4 month period.
Response: The project can be delivered safely within the timescale. Score = 2
3) Capital Cost: Will this option be costly to implement? All start up or capital investment should be considered.
Response: one off set up charge of £5,000 and an estimated £18,000 capital charge. Score =2
4) Revenue Cost: Will this option be provided within budget? A cost per user should be determined.
Response: £182,000 per year for a 2 year period (Approx. £52 per user per annum) (10% parameters before increase/reduction applied) Score =0*
5) Ease of Management of the contract: What demands will this option place upon the provider and NAC? A robust Implementation plan is required to satisfy the demands of the service.
Response: A robust implementation plan has been submitted. Score =2
6) Deliverability: How easy will it be to deliver the overall project? A specification that outlines how the service will be delivered should be submitted.
Response: A robust service specification has been submitted. Score= 2
7) Community Services: Will this option maintain and extend the quality and range of services and options available to citizens within local community? What outcomes will be achieved and how will they be evidenced.
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Response: The provider has submitted a clear business continuity plan, is a member of TSA and can provide a reporting suite of KPI activity. Score = 3
8) Future needs: To what extent will this option support future demand and potential changes? Potential future developments should be outlined.
Response: The proposal submitted outlines the capabilities of the current service and the technical capacity to develop the current service provided within North Ayrshire further. Score = 3
5.6 Option 3 Summary of Response to request for Bid
Senior managers from North Ayrshire Council met with Cordia to determine the capacity to deliver the service by them as an external provider, Cordia (Services) LLP. A comprehensive proposal and implementation plan were submitted by Cordia that meets the minimum requirements of the service, with the *exception of the budget, and minimises risk to service users.
6.0 CONCLUSIONS AND RECOMMENDATIONS
6.1 In accordance with the criteria as applied above, the Scoring for each bid is as follows:
Option 1: Deliver the service In-house
Option 1 score = 0
Summary: Unable to meet the minimum Requirements
Option 2: Purchase the Service from East Ayrshire Council
Option 2 Score = 0
Summary: Unable to meet the minimum Requirements
Option 3: Purchase the service from an external provider- Cordia
Option 3 Score = 16
Summary: Cordia can meet the timescale and all of the minimum requirements with the exception of the budget costs.
6.2 Recommendations
It is the recommendation that Budget is made available to support Option 3.
The outcome from the Options Appraisal is a recommendation that Social Services and Health enter into a contract with Cordia for a 2 year period, with the option to extend for a further 2 periods of 12 months, with budget made available to meet the cost of the service over the said period.
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7.0 ACTION PLAN
7.1 Preferred option identified: April 2014
Refer to point 6 within the Index
7.2 Firm estimate of costs: April 2014
Year 1 Year 2 Total Start Up Costs £5,000 £5,000 Capital Costs £9,000 £9,000 £18,000 Revenue Costs £182,000 £182,000 £364,000 Total £196,000 £191,000 £387,000
Please Note : Year 1 : 1st September 2014 – 31st August 2015 Year 2 : 1st September 2015 – 31st August 2016
7.3 Contractual arrangements secured: May 2014
Corporate Procurement will progress.
7.4 Implementation plan for new provision: April 2014
Provided By Cordia (Services ) LLP April 2014
7.6 Decommissioning plan agreed: May2014
Decommissioning plan will be formalised between South Ayrshire Council & North Ayrshire Council, on acceptance of the Proposal.
Options Appraisal, proposed by:
Isabel McKnight, Service Development Manager, Social Services & Health
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Budget Variance Report
Budget 2014/15 Budget 2015/16
Budget Allocation £98,000 Budget Allocation £98,000 Pressure Bid Allocation £152,000 Pressure Bid Allocation £0
Total £250,000 Total £98,000
Costs 2014/15 Costs 2015/16
SAMS £109,375 SAMS £0 BT £10,200 BT £10,200 Set up (Cordia) £5,000 Set up (Cordia) £0 Capital (Cordia) £9,000 Capital (Cordia) £9,000 Revenue (Cordia) £106,166 Revenue (Cordia) £182,000 Tunstull £40,000 Tunstull NAC Staff £16,191 NAC Staff
Total £295,932 Total £201,200
Budget Variance 2014/15 -£45,932 Budget Variance 2015/16 -£103,200
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