PERTH and KINROSS COUNCIL COMMUNITY SAFETY COMMITTEE 1 MARCH 2017 3(I)

Securing the future • Improving services • Enhancing quality of life • Making the best use of public resources

Council Building 2 High Street Perth PH1 5PH

Wednesday, 31 May 2017

A Meeting of the Housing and Communities Committee will be held in the Council Chamber, 2 High Street, Perth, PH1 5PH on Wednesday, 31 May 2017 at 10:30 .

Note: The Convener will ask the Committee to agree to vary the order of business to take Items P1 and P2 (exempt business) following Item 2 on the agenda at the commencement of the meeting at 10.30am. Following this, the meeting will reconvene in public at 11.10am to consider the business from Item 3 onwards on the agenda.

If you have any queries please contact Committee Services on (01738) 475000 or email [email protected] .

BERNADETTE MALONE Chief Executive

Those attending the meeting are requested to ensure that all mobile phones and other communication devices are in silent mode.

Members: Councillor Peter Barrett (Convener) Councillor Harry Coates (Vice-Convener) Councillor Chris Ahern Councillor Alasdair Bailey Councillor Bob Brawn Councillor Eric Drysdale Councillor Tom Gray Councillor David Illingworth Councillor Michael Jamieson Councillor Roz McCall Councillor Sheila McCole Councillor Tom McEwan Councillor Beth Pover

Page 1 of 234 Page 2 of 234 Housing and Communities Committee

Wednesday, 31 May 2017

AGENDA

MEMBERS ARE REMINDED OF THEIR OBLIGATION TO DECLARE ANY FINANCIAL OR NON-FINANCIAL INTEREST WHICH THEY MAY HAVE IN ANY ITEM ON THIS AGENDA IN ACCORDANCE WITH THE COUNCILLORS’ CODE OF CONDUCT.

1 WELCOME AND APOLOGIE S

2 DECLARATIONS OF INTE REST

3 MINUTES

(i) MINUTE OF MEETING OF THE COMMUNITY SAFETY 7 - 10 COMMITTEE OF 1 MARCH 2017

(ii) MINUTE OF MEETING OF THE HOUSING AND HEAL TH 11 - 14 COMMITTEE OF 29 MARCH 2017

4 PERTH AND KINROSS CO MMUNITY PLANNING PAR TNERSHIP - PERTH AND KINROSS INTEGRATION JOINT BOARD

(i) MINUTE OF MEETING OF THE PERTH AND KINROS S 15 - 20 INTEGRATION JOINT BOARD OF 3 FEBRUARY 2017

(ii) THE PERTH AND KINROS S INTEGRATION JOINT BOARD - 24 21 - 22 MARCH 2017 By Chief Officer - Health and Social Care Partnership (copy herewith 17/192)

5 APPOINTMENT OF MEMBE RS TO THE EXECUTIVE SUB - COMMITTEE The Committee is requested to appoint five members to the Executive Sub-Committee.

6 SCOTTISH FIRE AND RE SCUE SERVICE - LOCAL SCRUTINY 23 - 44 AND ENGAGEMENT PERTH AND KINROSS – QUARTERLY PERFORMANCE REPORT – 1 JANUARY TO 31 MARCH 2017 Report by Local Senior Officer Colin Grieve, Scottish Fire and Rescue Service (copy herewith 17/193)

Page 3 of 234 7 POLICE SCOTLAND – LOCAL SCRUTINY AND E NGAGEMENT

(i) PERTH AND KINROSS LO CAL POLICING PERFORM ANCE 45 - 62 RESULTS – 1 APRIL 2016 TO 31 MARCH 2017 Report by Divisional Commander Paul Anderson, Police Scotland ‘D’ Division (Tayside) (copy herewith 17/194)

(ii) LOCAL POLICE PLAN 20 17 -20 63 - 88 Report by Executive Director (Housing and Community Safety) (copy herewith 17/195)

8 COMMUNITY JUSTICE IN PERTH AND KINROSS 89 - 128 Report by Executive Director (Housing and Community Safety) (copy herewith 17/196)

9 JOINT PUBLIC HEALTH PROTECTION PLAN 129 - 178 Report by Director (Environment) (copy herewith 17/197)

10 HOUSING AND COMMUNIT Y CARE COMPLAINTS AN D 179 - 192 CUSTOMER FEEDBACK Report by Executive Director (Housing and Community Safety) (copy herewith 17/198)

11 PERTH AND KINROSS TE NANT PARTICIPATION S TRATEGY 193 - 200 2014-17 AND SURE TEAM PROGRESS REPORT Report by Executive Director (Housing and Community Safety) (copy herewith 17/199)

Note: Suzie Burt, Team Leader, Housing and Community Care and the SURE Team will deliver a short presentation on the report.

12 AUTISM ACTION PLAN S TRATEGY UPDATE 201 - 232 Report by Executive Director (Housing and Community Safety) (copy herewith 17/200)

IT IS RECOMMENDED THAT THE PUBLIC AND PRESS SHOULD BE EXCLUDED DURING CONSIDERATION OF THE FOLLOWING ITEM(S) IN ORDER TO AVOID THE DISCLOSURE OF INFORMATION WHICH IS EXEMPT IN TERMS OF SCHEDULE 7A TO THE LOCAL GOVERNMENT (SCOTLAND) ACT 1973

P1 SCOTTISH FIRE AND RE SCUE SERVICE – LOCAL SCRUTINY AND ENGAGEMENT – OPERATIONAL UPDATE FOR PERTH AND KINROSS Verbal Report by Local Senior Officer Colin Grieve, Scottish Fire and Rescue Service (Perth and Kinross)

P2 POLICE SCOTLAND – LOCAL SCRUTINY AND E NGAGEMENT – OPERATIONAL UPDATE FOR PERTH AND KINROSS Verbal Reports by Chief Superintendent Paul Anderson and Chief Inspector Ian Scott, Police Scotland ‘D’ Division (Tayside)

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Page 6 of 234 PERTH AND KINROSS COUNCIL COMMUNITY SAFETY COMMITTEE 1 MARCH 2017 3(i)

COMMUNITY SAFETY COMMITTEE

Minute of Meeting of the Community Safety Committee held in the Council Chambers, Ground Floor, Council Building, 2 High Street, Perth, PH1 5PH on Wednesday, 1 March 2017 at 2.00pm.

Present: Councillors D Pover, E Maclachlan, H Anderson, K Baird (substituting for Councillor A Stewart), R Brock, Cowan (substituting for Councillor H Stewart), T Gray (substituting for Councillor M Williamson), G Laing, A MacLellan, A Munro, C Shiers and L Simpson.

In attendance: B Atkinson, Acting Executive Director (Housing and Social Work); C Johnston and J Irons, (both Housing and Community Care); C Flynn and L Brown (both Corporate and Democratic Services); Divisional Commander P Anderson, Superintendent S Mentes and Area Commander M Pettigrew (all Police Scotland); Local Senior Officer C Grieve and Group Manager B McLintock (both Scottish Fire and Rescue Service); E Osborne, MAPPA Co-ordinator.

Apologies for Absence: Councillors J Giacopazzi, A Stewart, H Stewart and M Williamson.

Councillor Pover, Convener, Presiding.

134. WELCOME

The Convener welcomed all those present to the meeting. Apologies for absence and substitutions were noted as above.

In terms of Standing Order 13 the Committee agreed that the meeting be recorded for use as part of the elected member development programme following the Local Government Elections in May 2017.

135. DECLARATIONS OF INTEREST

There were no Declarations of Interest made in terms of the Councillors’ Code of Conduct.

136. MINUTE OF PREVIOUS MEETING

The minute of meeting of the Community Safety Committee of 18 January 2017 (Arts. 39-48) was submitted, approved as a correct record and authorised for signature.

137. TAYSIDE MAPPA (MULTI-AGENCY PUBLIC PROTECTION ARRANGEMENTS) ANNUAL REPORT 2015/16

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/90) introducing the Tayside Multi-Agency Public Protection arrangements (MAPPA) report for 2015-16. E Osborne, MAPPA Coordinator, spoke to the report.

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Resolved: The Tayside MAPPA Annual Report for 2015-2016, as appended to Report 17/90 be noted.

138. POLICE AND FIRE REFORM: LOCAL SCRUTINY AND ENGAGEMENT

(i) Scottish Fire and Rescue Service Quarterly Performance Report – 1 October to 31 December 2016

There was submitted a revised report by Area Manager Grieve, Local Senior Officer, Scottish Fire and Rescue Service (17/91) on the performance of the SFRS, against the priorities, performance indicators and targets detailed within the Local Fire and Rescue Plan for Perth and Kinross for the third quarter, 1 October to 31 December 2016, and detailing a number of local community engagement and operational activities undertaken within the reporting period.

In response to a question from Councillor Simpson for more information on the recruitment of retained firefighters, Group Manager McLintock confirmed that there had been 4 national recruitment drives in the last 12 months. Area Manager Grieve reported changes had been made to the recruitment process. If there was no vacancy in the local area the applicant’s details were retained and the Service could contact them again should a vacancy arise. In response to a further question from Councillor Simpson, Area Manager Grieve confirmed that training was undertaken at the training facility in Perth, however, staff could also undertake their training at the SFRS facility in Port Lethen, Aberdeenshire or at the National Training Centre in Glasgow.

Resolved: The performance of the Scottish Fire and Rescue Service in Perth and Kinross area for the third quarter, 1 October to 31 December 2016, as detailed in Report 17/91 be noted.

(ii) Perth and Kinross Local Policing Area Performance Results – 1 April to 31 December 2016

There was submitted a report by Chief Superintendent P Anderson Police Scotland ‘D’ Division (Tayside) (17/92), on the performance of Police Scotland against the local policing priorities for the Perth and Kinross area as set out in the Local Policing Plan for the period 1 April to 31 December 2016, and detailing a number of community engagement and operational activities undertaken within the reporting period.

Councillor Simpson noted with concern that road policing officers had issued warnings to 96 drivers during the Police Scotland campaign “Get Ready for Winter” and that of 22 trucks stopped during a national Truck and Bus campaign officers had detected 13 offences and 3 prohibitions had been issued. Area Commander Pettigrew reassured the Committee that a warning would not been issued to a driver if a road policing officer considered a more serious offence had been committed.

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Councillor Shiers voiced concern regarding the lack of emphasis on rural crime and rural issues within the Scottish Police Authority consultation document on a 10 Year Strategy for Policing. In response the Convener gave a commitment to raise the matter with Nicola Marchant, the Community Safety Committee’s link member on the Scottish Police Authority at his next meeting with her and to circulate a note of the outcome of the meeting to the members of the Committee.

Resolved: The performance of Police Scotland against the local policing priorities for the Perth and Kinross area as detailed in Report 17/92 be noted.

139. VALEDICTORY

The Convener announced that Colin Johnston, Head of Adult Social Work and Social Care, was shortly to retire from the Council. On behalf of the Committee the Convener paid tribute to Colin’s long service to Social Work in Perth and Kinross, in particular his extensive experience in Adult Social Work Services and his involvement in developing Community Safety Services in Perth and Kinross and the new Community Justice arrangements. He wished Colin a long and happy retirement and presented him with a civic gift on behalf of the Council. Colin Johnston responded in appropriate terms.

IT IS RECOMMENDED THAT THE PUBLIC AND PRESSS SHOULD BE EXCLUDED DURING CONSIDERATION OF THE FOLLOWING ITEMS IN ORDER TO AVOID THE DISCLOSURE OF INFORMATION WHICH IS EXEMPT IN TERMS OF SCHEDULED 7A TO THE LOCAL GOVERNMENT (SCOTLAND) ACT 1973

140. SCOTTISH FIRE AND RESCUE SERVICE – LOCAL SCRUTINY AND ENGAGEMENT – OPERATIONAL UPDATE FOR PERTH AND KINROSS

The Committee received and noted a verbal report from Area Manager Grieve of the Scottish Fire and Rescue Service on information which was not to be made publically available.

141. POLICE SCOTLAND – LOCAL SCRUTINY AND ENGAGEMENT – OPERATIONAL UPDATE FOR PERTH AND KINROSS

The Committee received and noted a verbal report from Divisional Commander Anderson of Police Scotland “D” Division (Tayside) on information which was not to be made publically available.

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Page 10 of 234 PERTH AND KINROSS COUNCIL HOUSING AND HEALTH COMMITTEE 29 MARCH 2017 3(ii)

HOUSING AND HEALTH COMMITTEE

Minute of meeting of the Housing and Health Committee held in the Council Chambers, 2 High Street, Perth on Wednesday 29 March 2017 10.00am.

Present: Councillors D Doogan, K Howie, H Anderson, K Baird (substituting for Councillor H Stewart), P Barrett, I Campbell, D Cuthbert, J Flynn, E Maclachlan, D Melloy, W Robertson, G Walker and M Williamson.

In Attendance: B Atkinson, Director (Housing and Social Work); J Beverley, L Cameron, S Coyle, M Dow, C Mailer, R Pollok and A White (all Housing and Community Care); C Flynn, L Potter and A Taylor (all Corporate and Democratic Services).

Also in Attendance: C Stewart and D Wilkie (Tenants’ Representatives).

Apology for Absence: Councillor H Stewart.

Councillor D Doogan, Convener, Presiding.

The Convener led the discussion for Arts. (175-178 and 182-185) and the Vice- Convener for Arts. (179-180).

175. WELCOME AND APOLOGIES/SUBSTITUTES

The Convener welcomed all those present to the meeting. An apology and substitute was noted as above.

In terms of Standing Order 13 the Committee agreed that the meeting be recorded for use as part of the elected member development programme following the Local Government Elections in May 2017.

176. DECLARATIONS OF INTEREST

There were no Declarations of Interest made in terms of the Councillors’ Code of Conduct.

177. MINUTE

The minute of the meeting of the Housing and Health Committee of 25 January 2015 (Arts. 49-57) was submitted, approved as a correct record and authorised for signature.

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178. PERTH AND KINROSS COMMUNITY PLANNING PARTNERSHIP – PERTH AND KINROSS INTEGRATION JOINT BOARD

(i) Minute of meeting of the Perth and Kinross Integration Joint Board of 4 November 2016

The minute of meeting of the Perth and Kinross Integration Joint Board of 4 November 2016 was submitted and noted.

(ii) Briefing Paper by Chief Officer Health and Social Care Partnership

There was submitted and noted a briefing paper by the Chief Officer Health and Social Care Partnership (17/121), providing an update on the recent business and decisions of the Health and Social Care Integration Joint Board (IJB) following their meeting on 3 February 2017.

B Atkinson, Acting Executive Director (Housing and Community Safety) was present to answers members’ questions.

179. CARE AND REPAIR SERVICES

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/122), (1) providing an update on the recent changes to Care and Repair Services in Perth and Kinross, detailing future developments which will help support people to remain in their homes; and (2) seeking the endorsement of the initiatives and new developments being implemented through the new contract with Caledonia Housing Association.

Resolved: The initiatives and new developments being implemented through the new contract with Caledonia Housing Association as set out in Report 17/122, be endorsed.

180. HOARDING PROTOCOL AND PROCEDURE

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/123), (1) seeking approval of the application of a new ‘Hoarding’ Protocol developed with Key partners, the Protocol, the first of its kind in Scotland, will ensure a person-centred and effective response to people with Hoarding difficulties; and (2) highlighting Housing’s role in the process with staff training and awareness raising and the delivery of appropriate and sensitive support to tenants.

Resolved: (i) The innovative work to develop this multi-agency protocol, the first of its kind in Scotland, be noted.

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(ii) The application of the ‘Hoarding’ Protocol as detailed in the Appendix to Report 17/123 for use across Perth and Kinross’s housing services be approved.

181. HOME ENERGY EFFICIENCY WORKS

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/124), (1) summarising the progress in providing energy efficiency measures to households in Perth and Kinross during 2016/17; (2) outlining proposals for the continuation of further energy saving initiatives and improvements in 2017/18 and; (3) seeking endorsement of the actions taken to secure ECO funding from SSE for the 2017/18 programme.

Resolved: (i) The range of energy saving measures carried out as part of the Council’s plan to improve energy efficiency and achieve compliance with the EESSH by December 2020, be noted. (ii) The actions already taken to secure ECO funding from SSE for the 2017/18 programme, be endorsed. (iii) The Committee thanked John Cruickshank, Housing and Community Care for his diligence.

182. PERTH AND KINROSS HEALTH INEQUALITIES STRATEGY

There was submitted a report by Acting Executive Director (Housing and Community Safety) (17/125) providing an update on the outcomes of the consultation exercise on the draft Health Inequalities Strategy and presenting an updated strategy for approval.

Resolved: (i) The revised Health Inequalities plan for Perth and Kinross, as detailed in the Appendix to Report 17/125, be approved. (ii) An update report be submitted to Committee in twelve months.

183. RENT ARREARS – CASH COLLECTION WITHIN LOCALITIES

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/126) seeking approval to make the temporary arrangements in place to collect payments in local housing offices and tenants’ homes permanent as a way of supporting and reducing the Council’s rent arrears.

Resolved: The proposal to accept cash payments for Council rents in local housing teams and tenants’ homes on a permanent basis, following the success of the pilot, be approved.

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184. HOUSING ESTATE-BASED INITIATIVES

There was submitted a report by the Acting Executive Director (Housing and Community Safety) (17/127) providing an update on the progress and ongoing development of Estates Based Initiatives which continue to engage and empower local tenants to identify and deliver improvements within local communities and advising of the plans currently in place for 2017/18.

A video presentation on some of the work already carried out under the Estate Based Initiatives was shown to the Committee.

Resolved: (i) The excellent progress to date in delivering this project and the wider educational and employment opportunities delivered through initiatives such as Community Payback Team and social enterprise opportunities, be noted. (ii) The plans currently in place for 2017/18, as detailed in Report 17/127, be noted.

185. VALEDICTORY

This being the last meeting of the Committee before the Local Government Elections on 4 May 2017, the Convener thanked all Elected Members of the Committee for their contribution over the last five years and also expressed his appreciation to the Tenants Federation Representatives and all Housing and Community Care staff. The Convener further advised that Councillors Gordon Walker, John Flynn, Heather Stewart and Vice-Convener Kate Howie had intimated they would be retiring. He expressed his thanks to all of them for their contribution to the work of the Committee over many years and wish them all well for their future.

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Page 14 of 234 4(i) PERTH AND KINROSS INTEGRATION JOINT BOARD

Minute of Meeting of the Perth and Kinross Integration Joint Board held in the Council Chambers, Ground Floor, Council Building, 2 High Street, Perth on Friday 3 February 2017 at 10.30am.

Present: Councillor D Doogan, Perth and Kinross Council (Chair) Councillor I Campbell, Perth and Kinross Council Councillor K Howie, Perth and Kinross Council S Tunstall-James, Tayside NHS Board B Atkinson, Chief Social Work Officer, Perth and Kinross Council R Packham, Chief Officer J Smith, Chief Finance Officer Dr M Martindale, Independent Contractor J Foulis, NHS Tayside (from Item 6 onwards) Dr A Noble, External Advisor to Board F Fraser, Staff Representative, Perth and Kinross Council (substituting for G Mackie) A Drummond, Staff Representative, NHS Tayside (up to and including Item 7) H MacKinnon, PKAVS (Third Sector Interface) A Gourlay, Service User Public Partner B Campbell, Carer Public Partner

In Attendance: B Malone, Chief Executive, Perth and Kinross Council; S Hendry, G Taylor, L Cameron and C Johnston (all Perth and Kinross Council); V Aitken, E Devine and H Dougall (all NHS Tayside); M Summers, Substitute Service User Public Partner; S Cole, Substitute Carer Public Partner.

Apologies: Councillor P Barrett, L Dunion, S Hay, J Golden, Dr D Walker, G Mackie and A Davidson.

Councillor Doogan, Chair.

1. WELCOME AND INTRODUCTIONS

Councillor Doogan welcomed all those present to the meeting and apologies were noted as above.

Councillor Doogan informed the Board that Colin Johnston, Joint Head of Community Care, Perth and Kinross Council would retiring on 31 March 2017. The Board passed on its best wishes to Colin for the future and thanked him for all his hard work particularly in the area of health and social care integration.

2. DECLARATIONS OF INTEREST

There were no Declarations of Interest made in terms of the Perth and Kinross Integration Joint Board Code of Conduct.

Page 15 of 234 3. MINUTE OF PREVIOUS MEETING

The minute of meeting of the Perth and Kinross Integration Joint Board of 4 November 2016 was submitted and approved as a correct record, subject to the following amendment:

The record of members present be amended to read M Summers (substituting for B Campbell), and the record of in attendance be amended to read S Cole.

4. ACTION POINT UPDATE There was submitted and noted the action point update for the Integration Joint Board as at 3 February 2017 (G/17/13). In relation to Action Point 51, R Packham agreed to seek a further update in relation to a map to be provided for patients who are attending Out of Hours at Kings Cross Hospital, Dundee and also the availability of vending machines for public use. 5. MATTERS ARISING (i) Recording of Dissent (Item P2 refers)

It was agreed that a post meeting note would be added to the minute of the meeting of 4 November 2016 confirming that all of the public partners present at the meeting wished their dissent to be noted in relation to this item of business.

6. CHIEF OFFICER UPDATE

There was submitted a report by the Chief Officer (G/17/14) providing an overview and update of work across the Health and Social Care Partnership.

Resolved: Progress be noted on governance and operational matters and on the range of projects described under the following Strategic Planning Themes:

• Prevention and Early Intervention; • Person Centred Health, Care and Support; • Work Together with Communities; • Addressing Inequality, Inequity and Promoting Healthy Living; • Making the Best Use of Available Facilities, People and Resources.

7. FINANCIAL UPDATE 2016/17

There was submitted a report by the Chief Finance Officer (G/17/15) providing an update on the financial position of Perth and Kinross Integration Joint Board, and an update on the development funding directly available to the Partnership to effect change.

Page 16 of 234 Resolved: (i) The year end forecast overspend for the Integration Joint Board of £303,000, as detailed in the report, be noted; (ii) The in year commitments against the development funding that is available to the Partnership, and the need to carry this forward to support change projects, as detailed in the report, be noted.

8. AUDIT AND PERFORMANCE COMMITTEE

8.1 ESTABLISHMENT OF AUDIT AND PERFORMANCE COMMITTEE

There was submitted a report by the Chair of the Audit and Performance Committee (G/17/16) that sought approval of the amended Terms of Reference for the Audit and Performance Committee of the Integration Joint Board.

Resolved: The amended terms of reference, attached as Appendix 1 to Report G/17/16, be agreed.

8.2 AUDIT AND PERFORMANCE COMMITTEE ACTION NOTE OF MEETING – 17 JANUARY 2017

There was submitted a report by the Chair of the Audit and Performance Committee (G/17/17) updating members on the outcomes of the Audit and Performance Committee meeting held on 17 January 2017.

Resolved: (i) The detailed actions in Appendix 1 of Report G/17/17 be noted; (ii) The matters of note from the Audit and Performance Committee of 17 January 2017 be noted.

8.3 DRAFT MINUTE OF MEETING OF THE AUDIT AND PERFORMANCE COMMITTEE OF THE PERTH AND KINROSS INTEGRATION JOINT BOARD

There was submitted and noted the draft minute of the meeting of the Audit and Performance Committee of 17 January 2017.

9. PERFORMANCE REPORT ON KEY ELEMENTS OF THE STRATEGIC COMMISSIONING PLAN

There was submitted a report by the Chief Officer (G/17/18) providing a high level summary of key elements of the strategic commissioning plan including progress in achieving the nine national outcomes for health and social care.

Resolved: (i) The contents of Report G/17/18 be noted: (ii) The Chief Officer to prepare the Annual Performance Report for consideration at the meeting of the Board in June 2017.

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10. STRATEGIC COMMISSIONING PLAN - UPDATE

There was submitted a report by the Chief Officer (G/17/19) providing an update on key actions within the Strategic Commissioning Plan 2016-2019, as part of the regular progress reports to the Board.

Resolved: (i) The contents of Report G/17/19 and the progress in meeting the 2016/17 priority actions as set out in Appendix 1 be noted; (ii) The Chief Officer be requested to bring further updates to the Board meeting in March 2017.

11. PRESCRIBING MANAGEMENT IN PERTH AND KINROSS

There was submitted a report by the Chief Officer (G/17/20) updating the Board on the NHS Tayside led Programme of Work to deliver GP Prescribing efficiency savings in 2016/17 along with the Perth and Kinross Health and Social Care Partnership Work Plan being developed to ensure all possible opportunities are explored in relation to quality, safe and cost effective prescribing.

Resolved: (i) The NHS Tayside Prescribing Management Group 2016/17 Work Stream Initiatives, the progress made to date in delivering anticipated efficiency savings, and the significant forecast in-year shortfall, be noted; (ii) The further priority initiatives that the NHS Tayside Prescribing Management Group have identified as at December 2016 to accelerate the level of savings delivery in 2016/17 be noted; (iii) The progress made to date in developing a local Perth and Kinross Prescribing Action Plan that aims to both support the NHS Tayside priority initiatives as well as identify local actions and initiatives that will be required to ensure that the level of savings delivered across Perth and Kinross over the next three years delivers a more effective and sustainable prescribing position be noted; (iv) It be noted that further discussions would be required to establish clear lines of accountability and responsibility for savings targets and delivery of savings plans thereon.

12. ADULT SUPPORT AND PROTECTION BIENNIAL REPORT 2014-16

There was submitted a report by the Director (Housing and Social Work), Perth and Kinross Council (G/17/21) providing a summary of the Adult Support and Protection Biennial Report that covered the period 1 April 2014 – 31 March 2016.

Resolved: The contents of the report be noted and it be agreed that a development session be arranged for members in the future.

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13. ACCOUNTS COMMISSION REPORT INTO SOCIAL WORK IN SCOTLAND

There was submitted a report by the Chief Social Work Officer, Perth and Kinross Council (G/17/22) that provided the Board with the findings of the recent Accounts Commission examination of how effectively Councils across Scotland are planning to address the financial and demographic pressures facing Social Work Services. The report also considered the position in Perth and Kinross and the progress that was being made against recommendations contained within the report.

Resolved: The contents of the report be noted and the Chief Social Work Officer be instructed to report to the Integration Joint Board in 12 months time on the progress against the recommendations.

14. MEETING DATES 2017

Monday 27 February (Proposed Special Meeting – TBC) Friday 24 March Friday 16 June Friday 18 August Friday 13 October Friday 15 December

All meetings to take place at the Perth and Kinross Council Offices, 2 High Street, Perth. Board Meetings to begin at 10.30am with Development Sessions beginning at 9.00am as required.

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Page 20 of 234 4(ii) (17/192) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Briefing on the Health and Social Care Integration Joint Board (IJB)

Report by Chief Officer - Health and Social Care Partnership

PURPOSE OF REPORT This report updates Committee on the recent business and decisions of the Health and Social Care Integration Joint Board (IJB) following their meeting on 24 March 2017.

1. BACKGROUND/MAIN ISSUES

1.1 The Perth and Kinross Health and Social Care Integration Joint Board’s most recent meeting was held on 24th March and the following reports were submitted for approval and noting:-

• Chief Officer update – the Chief officer provided an update on:

o Patient flow across Perth and Kinross o Staffing pressures in Perth Royal Infirmary (PRI) o Crieff Ward 1 o Developing public engagement o Dalweem community health and care facility o Addressing inequality, inequity and promoting healthy living o Contingency planning for mental health services o Mental Health Service Redesign Transformation Programme (MHSRT) o Various operational matters

• Financial update at August 2016 – the Chief Finance Officer presented a report with the updated forecast financial position of the Perth and Kinross Integration Joint Board for the year to 31 March 2017. The Board noted that the year-end forecast overspend was £1.19M.

• 2017/18 Budget – the Chief Finance Officer presented a report setting out progress in agreeing the 2017/18 budget requisition for Perth and Kinross Council and NHS Tayside, seeking approval from the Integration Joint Board to the Budget Requisition to Perth and Kinross Council.

The Board approved the budget requisition and noted that, although the draft budget proposition from NHS Tayside for Core Hospital, Community and Other hosted services were sufficient, no final proposition had been made due to ongoing discussions. It therefore wasn’t possible for the Chief Finance Officer to recommend final approval. It was also noted that, at this stage, the Chief Finance Officer couldn’t recommend approval of the budget proposition from NHS Tayside for GP Prescribing and Inpatient

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Mental Health Services. The Chief Officer and Chief Finance Officer were asked to work with NHS Tayside to develop a three year financial plan that ensures financial sustainability.

• Proposed Reserves Policy – the Chief Finance Officer set out a proposed Reserves Policy for IJB approval.

• General Practitioner (GP) prescribing and locality engagement – the Clinical Director asked the IJB to approve a three year GP engagement plan focused on sustainable prescribing and the wider transformation of care. The Board agreed the investment of £312k per annum from Partnership Development funding for three years, subject to annual review by the Board; and the Clinical Director is to provide quarterly progress reports, linked to the three year Prescribing Improvement Plan.

• Update report on key elements of performance of the Strategic Commissioning Plan – the Chief Officer submitted a report providing an update on key actions within the Strategic Commissioning Plan 2016- 2019 as part of the regular progress reports to the Board. The report summarised and linked the plan to the national Health and Social Care

2. The Chair asked for an update following recent media coverage of staff shortages at Perth Royal Infirmary. Officers highlighted significant challenges locally and nationally in recruiting staff and the consultation underway to address these. A report is to be submitted to the next Board meeting as part of the Joint Workforce and Organisational Development Strategy on addressing workforce planning issues.

3. CONCLUSION

3.1 The above provides a brief overview of the business conducted at the Health and Social Care Integration Joint Board held on 24 March 2017. The next meeting of the Board is on 30 th June 2017.

Author Name Contact Lorna Cameron, Interim Director Housing [email protected] and Communities

Approved Name Designation Date Rob Packham Chief Officer Health and Social Care 22 Ma y 201 7 Partnership

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(17/193)

PERTH AND KINROSS COUNCIL HOUSING AND COMMUNITIES COMMITTEE

31 MAY 2017

Report by Area Manager Colin Grieve, Local Senior Officer, Scottish Fire and Rescue Service

SUBJECT: FIRE AND RESCUE QUARTERLY PERFORMANCE REPORT

1 JANUARY TO 31 MARCH 2017

Abstract The Reports contain performance information relating to the Fourth quarter (January - March) of 2016-17 on the performance of the Scottish Fire and Rescue Service in support of Member scrutiny of local service delivery.

1 PURPOSE OF THE REPORT

To provide information for the Committee regarding the performance of the Scottish Fire and Rescue Service, against the priorities, performance indicators and targets detailed within the Local Fire and Rescue Plan for Perth and Kinross 2014-17, to facilitate local scrutiny.

2 RECOMMENDATIONS

It is recommended that members:

Note, scrutinise and question the content of this report.

3 FINANCIAL IMPLICATIONS

None.

4 PERFORMANCE

4.1 A performance management framework has been developed to facilitate the monitoring of performance against the agreed priorities and outcomes ensuring effective targeting of resources and the principles of Best Value are met.

4.2 The Local Fire and Rescue Plan for Perth & Kinross 2014-17 was approved by the Community Safety Committee on the 21 st of May 2014.

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4.3 The priorities and outcomes contained within the Local Fire and Rescue Plan reflect ‘place’ and the contribution of Scottish Fire and Rescue Service to the Perth and Kinross Community Plan and Single Outcome Agreement 2013-16 and Community Planning Partnership.

4.4 In summary the following priorities and targets are detailed within the plan:

• Priority 1 – Local Risk Management and Preparedness

• Priority 2 – Reduction of Accidental Dwelling Fires

• Priority 3 – Reduction in Fire Casualties and Fatalities

• Priority 4 – Reduction of Deliberate Fire Setting

• Priority 5 – Reduction of Fires in Non Domestic Properties

• Priority 6 – Reduction in Casualties from Non Fire Emergencies

• Priority 7 – Reduction of Unwanted Fire Alarm Signals

4.5 Appendix 1 attached to this report provides a detailed breakdown and analysis of all data collected during the reporting periods. A performance summary and scorecard is detailed on page 1 of the reports. In addition further sections are included to provide Members with an overview of a range of notable incidents and events undertaken by the local personnel/stations in support of prevention activities and preparation for emergency response.

4.6 Appendix 2 attached to this report provides an overview of the nine month performance against all performance indicators for the Perth & Kinross area.

5 EQUALITY IMPACT ASSESSMENT

5.1 Not applicable.

6 ENVIRONMENTAL ISSUES

6.1 There are no environmental issues arising as a consequence of this report.

7 SUMMARY

7.1 The attached report updates members regarding significant community safety engagement activities and operational matters; and gives context to the performance of the Scottish Fire and Rescue Service in the Perth and Kinross area.

Area Manager Colin Grieve Local Senior Officer Perth & Kinross, Angus and Dundee Fire and Rescue Headquarters Blackness Road, Dundee DD1 5PA

Page 24 of 234

QUARTERLY PERFORMANCE REPORT FOR PERTH & KINROSS

Quarter 4: 201 6-201 7 (1 st January – 31 st March)

0 Page 25 of 234

Performance Summary

This report contains a review of the local performance of the Scottish Fire and Rescue Service (SFRS) against the seven agreed priorities as detailed in the Local Fire and Rescue Plan for Perth & Kinross 2014-17. The SFRS continues to deliver a range of services to improve the safety of our local communities. These will directly contribute to the four strategic aims of the SFRS:

• Improved safety of our communities and staff • More equitable access to fire and rescue services • Develop a culture of continuous improvement

Performance Scorecard

We measure how well we are meeting our priorities using a number of key performance indicators. The main indicators are detailed below with further ones broken down under each priority contained within pages 2-14 of this report:

Quarterly Year to Q4 Q4 Q4 Q4 Q4 Q4 Q4 Main Compari Date Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar 5 Year Indicators son RAG RAG 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 Aver Rating Rating Accidental 36 28 27 36 34 31 32 dwelling fires Fire casualties 7 11 14 13 8 2 9 and fatalities Deliberate 42 33 23 16 19 24 27 Fire Setting Non domestic 14 21 17 16 12 14 16 property fires Special 101 106 73 77 120 66 95 Service – All False Alarms 339 293 311 296 299 261 308 – All

Key

Red 10% more than previous result or local target not met (worse than)

Amber Up to 9% more than previous result or local target not met (worse than)

Green Equal to or better than previous result / or local target met (better than)

Note:

• Quarterly comparison Red, Amber or Green (RAG) Rating = the reporting period compared to the average of the five previous quarterly reporting periods. • Year to Date RAG Rating = the cumulative total of all quarterly performance in current year compared to the 5 year average for the same period in previous years. • The statistics featured throughout this report are provisional until the year end.

1 Page 26 of 234 PRIORITY 1: Local Risk Management and Preparedness

We are committed to the safety of our Firefighters and Community by ensuring that we have a competent workforce equipped with the essential knowledge and skills, so they can undertake their role in an efficient, effective and safe manner. We have therefore identified core skills which have been deemed as critical to maintaining competence and ensuring the safety of firefighters and our communities at incidents. These skills, as well as other attributes, are maintained and delivered through a three year maintenance and development programme, which is delivered locally and nationally.

Personnel who cannot demonstrate competence in all areas are required to complete a development programme at the earliest opportunity. Examples of the ongoing training conducted during the fourth quarter 2016/17 were Incident Command, Breathing Apparatus, Safe Working at Height, hazardous materials and Domestic Fires.

All station based operational personnel continue to visit premises within their station area so efforts are focused on premises which constitute a significant life, heritable or firefighter risk enhancing their awareness of associated risks and hazards that may be encountered in these buildings, and if required taking effective actions in dealing with incidents in the premises. During the fourth quarter 2016/17, this included visiting residential Care Homes and Hi-Rise buildings. Pre-planning and exercising has continued for a number of subject areas with personnel attending multi-agency meetings to ensure that appropriate fire safety and emergency response contingency measures are in place as part of a proactive approach to preparedness.

Crews also continue to conduct routine water hydrant inspections as it is important to check that there is access to and adequate provision of water supplies within the area should crews require them in the event of an incident. This also provides the opportunity for crews to familiarise themselves with the locations of hydrants in relation to the risks in their area and link-in other activities, such as conducting Home Safety Visits.

We currently have 70 Wholetime, 128 Retained and 22 Volunteer operational (station based) personnel working in Perth & Kinross to provide an emergency response capability, supported by a team of seven managers. There is on-going recruitment for retained and volunteer firefighters in the Perth & Kinross area. Support will be provided to any potential candidates to assist them in the recruitment process.

Notable Incident/Event Water Rescue Training

Given the number of water related incidents we continue to attend across Perth & Kinross and wider in partnership with other agencies. Local Crews and Managers, along with partner agencies, will continue to attend multi-agency debriefs from incidents to ensure on-going learning with this type of incident.

Crews from Perth Community Fire Station have intensified their Swift Water Rescue training activities through visits Loch Tay to carry out boat handling operations which have included; boat maneuvering, 2 boat operations, capsize drills and casualty pick up techniques.

Swift Water Rescue training has continued on the river Tay and other local water locations where crews practice line throwing procedure, passive and aggressive swimming techniques combined with Rope work to support water rescues .

2 Page 27 of 234 PRIORITY 2: Reduction of Accidental Dwelling Fires

The reduction of Accidental Dwelling Fires (ADF) remains a key focus for SFRS, and our partners, in Perth & Kinross and nationally as part of our ‘Join Scotland’s Fight Against Fire’ campaign.

There were 31 ADF during this reporting period which was an decrease of 3 (9%) from the same reporting period last year, a slight decrease on the five year average, and a decrease of 7 (18%) from the last quarter. The number of ADF attended is 7% of all incidents in the reporting period.

Of the 31 premises 17 (55%) had a smoke detector fitted whilst 15 (88%) of the houses that had detectors fitted operated to give early warning of a fire. These incidents were attributed to a range of causes with 13 (42%) cooking related which continues to be the most significant cause. Other than cooking no identifiable trend emerges. Of the 31 incidents 1 (3%) confirmed involved drugs/Alcohol. All of these fires recorded 28 (90%) resulted in minor fire related damage.

The cornerstone of this safer communities is preventative community safety work undertaken jointly through PKC Partnership - Safer Communities Wardens, SFRS Community Safety Engagement staff, Police Scotland and PKAVS Community Safety Volunteers etc. The partnership team continually review and develop to ensure that the most appropriate community knowledge, experience and resources are available for the communities of Perth & Kinross.

Year to date there were a total of 2,031 HFSV’s carried out across the twelve ward areas of which a number were partnership Home Safety Visits which led to further onward referrals to additional partner agencies to help support the most vulnerable within our community.

Within Perth & Kinross we will continue to work with our partners to ensure we positively contribute to driving down the risk to our communities and Staff by analysis of our operational activities and targeting those most at risk and vulnerable particularly around unintentional harm in the home. These targeted approaches will continue to develop and improve as we move forward.

Notable Incident/Event Montague house 11 th January Crews on two fire appliances from Perth City attended a fire in a boiler house attached to Montague house near Balbeggie around 9am.

Crews went to work quickly when on scene to prevent any further fire spread to the property itself and bring the fire under control. Thanks to their quick actions the fire damage was minimized. This fire resulted in minor damage to the property as a consequence of fire spread from the boiler house which was extensively damaged by fire.

Firefighters remained in attendance for a further two hours cutting away affected areas to ensure the building was in a safe condition whilst also giving home safety advice.

Page 28 of 234 Priority 2: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Key Key Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar 5 year Performance Performance Trend 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 average Indicator Indicator All accidental 2b(i) 36 28 27 36 34 31 32 dwelling fires

Accidental Dwelling Fires - 4th Quarter

40 36 36 34 35 31 32 30 28 27 25 20 15 10 5 0 4th Q 4th Q 4th Q 4th Q 4th Q 4th Q 5 year 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 average

% Accidental Dwelling Fires - 4th Quarter All Accidental Dwelling Fires 7%

All Other Incidents 93%

Accidental Dwelling Fires by Time of Day - 4th Quarter 7 6 5 4 3 2 1 0 00:00 - 02:00 - 04:00 - 06:00 - 08:00 - 10:00 - 12:00 - 14:00 - 16:00 - 18:00 - 20:00 - 22:00 - 02:00 04:00 06:00 08:00 10:00 12:00 14:00 16:00 18:00 20:00 22:00 00:00

Page 29 of 234 PRIORITY 3: Reduction in Fire Casualties and Fatalities

There were no Fire Fatalities in the reporting period.

A Fire casualty recording relates to any person who has received any form of first aid treatment or medical attention at the scene of an incident regardless of the nature of the injury. This could range from a person receiving a precautionary check at the scene of an incident to removal to hospital for severe smoke inhalation.

In total there were 2 casualties reported which is a significant decrease of 6 (75%) within Perth & Kinross compared to the same quarter last year, a significant decrease on last quarter of 5, and a decrease of 8 (80%) on the 5 year average of 10. The casualties were from one incident as a result of a dwelling fire where both received first aid on scene suffering from the effects of smoke inhalation. The casualties were both female in the age range of 20-29 and the fire cause was accidental as a result of cooking.

In every case where a casualty is recorded, a case study is instigated to identify any on-going needs, inform other agencies and if appropriate, initiate a multi-agency case conference. In addition to this, a Post Domestic Incident Response (PDIR) visit is carried out after every domestic fire. This involves contacting the owner / occupier of the property affected and neighbouring residents to offer a HFSV in the immediate aftermath of the incident.

The SFRS vision is to have no fire fatalities/casualties throughout Scotland and we are striving to achieve this through partnership working with Perth & Kinross Council, Police Scotland, National Health Service, PKAVs, Housing Associations, local landlords and others. This joint working will continue to develop and implement risk reduction strategies. Crews regularly visit houses and provide free Home Safety Visits. These are instrumental in helping to reduce the number of fire fatalities/casualties through early detection/intervention and contributing to safer communities.

Notable Incident/Event Fire in a flat – St Catherine’s Square, Perth

Perth Crews attended a Flat fire on 10 th March around 3am at St Catherine’s square in Perth City. The scene was fairly chaotic on arrival given the time of the morning.

The Firefighters in attendance quickly dealt with a fire in the living room area of a ground floor flat, whilst giving safety advice to other residents. Thanks to the initial actions of Firefighters no one was seriously injured, two persona were treated for smoke inhalation on scene by Firefighters and then Paramedics.

Firefighters gave initial Home safety advice whilst Community safety officers visited St Catherine’s square the following day to provide additional home safety advice to residents of this residential area to ensure the risk of type of incident is minimised.

Page 30 of 234 Priority 3: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Jan- Jan- Jan- Jan- Jan- Jan- Key Key Mar Mar Mar Mar Mar Mar 5 year Performance Performance Trend 2011 2012 2013 2014 2015 2016 average Indicator Indicator /12 /13 /14 /15 /16 /17

All fatal fire 3a(i) 1 0 casualties 0 0 0 0 0

Non-fatal fire casualties excl. 3a(ii) 6 11 11 11 4 2 9 precautionary check-ups Non-fatal fire casualties incl. 3a(iii) 6 10 precautionary 11 14 13 8 2 check-ups

Fires Involving Casualties and Fatalities - 4th Quarter

16 14 14 13

12 11 10 10 8 8 7

4 2 2

0 4th Q 2011-12 4th Q 2012-13 4th Q 2013-14 4th Q 2014-15 4th Q 2015-16 4th Q 2016-17 5 year average

Page 31 of 234 PRIORITY 4: Reduction of Deliberate Fire Setting

All deliberate fires There was a significant decrease of 10 (33%) in the number of deliberate fires within Perth & Kinross during this reporting period with 20 incidents of this type being experienced in comparison to 30 for the same quarter last year. This is 29% below the 5 year average of 28 deliberate fire incidents. This is decrease (17%) compared with quarter three 2016/17 with 24.

Deliberate primary fires There were 5 deliberate primary fires for the reporting period which is a slight decrease of 2 (29%) for the same quarter last year with 7. This reflects a significant decrease (50%) on the 5 year average of 10 whilst showing the same decrease (50%) on last quarter which reported 10 deliberate primary fires. Two of these were in a secure facility, 2 were outdoor fires and 1 dwelling (flat) fire.

Deliberate secondary fires There were 15 deliberate secondary fires such as rubbish, grassland, etc., which shows a significant reduction (35%) compared to 23 for the same quarter last year. This is a slight increase compared to Q3 2016/17 with 14, which was in line with our longer term vision of reducing fires and fire- setting behaviour of this type in Perth & Kinross which is a welcomed reduction. There were 5 (36%) secondary fires relating to refuse fires which reflects a slight decrease on the same period last year with 6 incidents. 10 (71%) of these incidents were outdoor related; Grass/woodland/crops etc. There was no specific trend noted with the number of secondary fires.

There was no other identifiable trends during this reporting period and incident monitoring and review by SFRS Managers will continue with actions taken through our partnership meetings and other local initiatives as appropriate. This is intended to further reduce these types of fire and continually improve the safety of our communities.

As a result of the excellent partnership work undertaken within the ward areas of Perth and Kinross we are fortunate to have a low number of deliberate fires which account for 5% of all Incidents. We will continue to work with our partner agencies and with groups within the community to help maintain and improve the reduction in deliberate fires.

Notable Incident/Event

No notable incident/event in the reporting period

Page 32 of 234

Priority 4: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Key Key Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar 5 year Performance Performance 2011 2012 2013 2014 2015 2016 average Trend Indicator Indicator /12 /13 /14 /15 /16 /17 All deliberate 1b 11 10 primary fires 2 6 11 7 5

All deliberate 1b(ii) other building 0 0 6 8 6 2 4 fires All deliberate 1c 32 18 secondary fires 16 8 13 23 15

All Deliberate Fires - 4th Quarter 50 45 43 40 35 30 30 28 24 25 20 20 18 14 15 10 5 0 4th Q 2011-12 4th Q 2012/13 4th Q 2013/14 4th Q 2014/15 4th Q 2015/16 4th Q 2016/17 5 year average

% Deliberate Fires - 4th Quarter All Deliberate Fires 5%

All Other Incidents 95%

Page 33 of 234 PRIORITY 5: Reduction of Fires in Non-Domestic Properties

The number of fires in non-domestic premises within the Perth & Kinross area reports a slight decrease from 14 last year to 13 this year for the corresponding reporting period. This figure is a decrease (24%) the 5 year average of 17. The 13 incidents recorded occurred in premises ranging from industrial/offices (5) to hotel/motel (2). The number of non-domestic fires accounts for 3% of all incidents attended in Quarter 4.

The primary cause of the majority of incidents was overheating/faulty equipment (6), with other causes being recorded as careless handling/materials too close to heat source (2). Of the 14 incidents 10 were accidental fires.

These fires can often have a serious impact on our local business sector and wider economy, as a fire within companies’ premises often results in significant monetary loss and in the worst cases, loss of employment for staff. Our Fire Safety Enforcement Officers (FSEO’s) will continue to provide support to local businesses to enable suitable legislative fire safety guidance and enforcement to be undertaken. This includes post-fire audits following each incident.

In relation to our statutory legislative fire safety requirements, our FSEOs personnel conduct audits of specific types of non-domestic properties (‘relevant premises’) to ensure they comply with the fire safety requirements of the Fire (Scotland) Act 2005 (‘the Act’). Relevant premises audited in Perth and Kinross include: Care Homes; Hospitals; Houses of Multiple Occupation (HMO’s); Hotels and High/ Very High risk premises identified during previous audits.

Of the 13 non-domestic property fires reported during the fourth quarter 2016/17, 10 were relevant premises. These were therefore subject to post fire audits by our FSEOs to ascertain how the premises were being managed and if the Act was complied with. This may require further actions to ensure the premises is compliant whilst also providing the appropriate level of support and advice for the owner/occupier.

Notable Incident/Event Fishers Hotel Pitlochry 1st January 05.30hrs Around 50 firefighters tackled a ‘well alight’ fire in the roof space at Fishers Hotel. This proved an extremely challenging incident for everyone involved due to the fact the Hotel was at full capacity, being Hogmanay together with the sub-zero temperatures outside.

The quick actions taken by Hotel staff to evacuate all guests to a nearby Hotel were praised. The initial attack on the fire and response from the Scottish Fire and Rescue Service (SFRS) contained this to an area of the top floor bringing it swiftly under control with no injuries sustained. Additional appliances were requested from across the Scotland including a specialist aerial platform from Kirkcaldy.

As a result the Hotel was able to re-open just days after the fire. This was due to the efforts made in what was an effective multi- agency response as well as the community of Pitlochry. As it is such an important landmark and place to reside for people when visiting the local community this was a great success fo r all. 9

Page 34 of 234 Priority 5: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Key Key Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar 5 year Performance Performance 2011 2012 2013 2014 2015 2016 Trend average Indicator Indicator /12 /13 /14 /15 /16 /17 All accidental 2b(ii) other building 18 10 8 13 14 11 13 fires All deliberate

1b(ii) other building 0 0 6 8 6 2 4 fires

All Fires in Non-Domestic Properties - 4th Quarter

0 4th Q 4th Q 4th Q 4th Q 4th Q 4th Q 5 year 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 average

% All Fires in Non-Domestic Properties - 4th Quarter

All Fires in Non- Domestic Properties 3%

All Other Incidents 97%

Page 35 of 234 PRIORITY 6: Reduction in Casualties from Non Fire Emergencies

There were 62 non-fire emergencies reported during the fourth quarter of 2016/17. This is a decrease of 43% non-fire emergencies when compared to the second quarter last year with 109, and a decrease of 18% (14) when compared to the five year average for that quarter of 76 . The total number of non-fire emergencies to the end of 2016/17 is 276 which reflects a decrease (13%) compared to the 5 year average (316 ) for the same period in previous years. There were a total of 21 casualties (3 fatal) from special service incidents. This type of incident accounts for 15% of all incidents attended this quarter.

Road Traffic Collisions (RTC) There were 15 RTC’s during the fourth quarter 2016/17, which is a decrease of 10 (40%) RTC’s when compared to the same quarter last year (25), and a decrease of 5 (25%) RTC’s when compared to the five year average (20) for the fourth quarter. The total number of RTC’s to the end of 2016/17 is 86 which is a slight decrease on the 5 year average (89) for the same period in previous years. The 15 RTC’s attended accounted for 0 fatalities and 8 casualties.

Flooding There were 2 flooding incidents during the fourth quarter 2016/17, which is a significant reduction on the same quarter last year as a result of severe weather storms.

Rescue/Extrication There were 3 rescue/extrication services during the fourth quarter 2016/17, which equates when compared to the same quarter last year and when compared to the five year average (3).

Special Service – Other There were 42 incidents this quarter, a decrease of 18% on the same quarter for 2015/16 (51), and a slight increase of 10% compared with the five year average of 38. There were 27 (65%) of these incidents where crews attended in support of our other blue light agencies to medical type responses. This type of special service call will continue to be supported by the SFRS in the future as we continue to develop mutual cross emergency service support to ensure we safeguard our communities’ wellbeing.

Notable Incident/Event Building Collapse, Atholl Street Perth 29 th March

Crews from Perth attended a partial building collapse with one female casualty trapped who had fallen approximately 12-14 feet causing injuries. Fire service evacuated a number of buildings while working to shore up the basement to ensure a safe work area allow Paramedics access to the casualty. This was an arduous and challenging rescue, of a physical and technical nature utilising equipment from the heavy rescue asset located at Perth and Urban Search and Rescue from Dundee.

The casualty was removed from the building by the SFRS and handed over to SAS personnel. SFRS remained for the rest of the day to effect shoring up operations to make the building safe in support of colleagues from Local Authority Building Standards .

Page 36 of 234

Priority 6: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Key Key Jan- Jan- Jan- Jan- Jan- Jan- Mar Mar Mar Mar Mar Mar 5 year Performance Performance Trend 2011 2012 2013 2014 2015 2016 average Indicator Indicator /12 /13 /14 /15 /16 /17 Road Traffic 5a Collisions 23 22 23 13 19 15 20 (RTCs) 5b Flooding 1 2 22 10 36 2 15

5c Extrication 3 4 3 3 3 3 3 38 5d Others 36 29 32 44 51 41

All Special Service Incidents - 4th Quarter

120 109

100 80 76 80 70 63 59 62 60

0 4th Q 4th Q 4th Q 4th Q 4th Q 4th Q 5 year 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 average

% All Special Service Incidents - 4th Quarter

All Special Service Incidents 15%

All Other Incidents 85%

Page 37 of 234 PRIORITY 7: Reduction of Unwanted Fire Alarm Signals

There was a decrease in the overall number of Unwanted Fire Alarm Signals (UFAS) experienced (251) in comparison to previous year (268) and this figure remains below the 5 year average of 259. This figure is in line with the gradual longer term reduction in UFAS incidents which should be considered alongside the increased level of detectors within premises as being a positive trend. There was no significant pattern or trend identified in these incidents and actions were initiated as deemed necessary by Local Managers and FSEO’s to offer guidance and support to premises striving to reduce the number of alarm activations.

It should also be noted that approximately 50% of these calls occurred in domestic premises (e.g. Sheltered Housing Complexes) where we encourage the installation of Tele-care services such as PKC’s Community Alarms Service which are targeted at people identified as being at risk of unintentional harm in their homes. A number of UFAS incidents recorded from these premises are as a result of cooking activities that could potentially result in a fire affecting people that are at higher risk of harm, possibly due to age, health and / or mobility issues.

The main contributor of UFAS continues to be the high number of calls that are received from larger premises with similar high numbers of detector heads and more complex systems such as Sheltered Housing Complexes, Hospitals, Hotels, Care Homes and Prison establishments thereby increasing the chance of unwanted activations.

On scene investigations by responding crews into the activations continue to be undertaken in an attempt to understand the reasons for these activations and encourage duty holders to be proactive in the reduction of UFAS. Our experience informs us that there is generally a responsible attitude towards reducing these incidents by duty holders in the area. All UFAS calls are being monitored and analysed for emerging trends and trigger points. With the assistance of the duty holders of these premises, and the knowledge and expertise of the local firefighters, we are actively addressing any issues to help reduce the number of unwanted fire calls in the Perth & Kinross area. All UFAS calls are monitored within monthly performance reports where trend analysis and actions are undertaken relevant to the findings by local Station Managers with the support of FSEO’s.

Looking ahead, changes in the way we implement our UFAS Policy and Procedures at non- sleeping risk premises will allow us to tailor a more appopriate level of response to automatic fire alarm calls from such premises in the future, with the aim of reducing the number of unnecessary blue light journeys.

Notable Incident/Event

No notable incident/event in the reporting period

Page 38 of 234 Priority 7: Key Performance Indicators and Statistics – 4th Quarter 2016/17

Key Key Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar Jan-Mar 5 year Performance Performance 2011 2012 2013 2014 2015 2016 average Trend Indicator Indicator /12 /13 /14 /15 /16 /17 False Alarm: 10a 262 243 241 283 268 251 259 All False Alarm: 10b 61 48 Good Intent 46 37 42 56 50 False Alarm: 10c 15 10 Malicious 5 8 7 15 4

All UFAS Incidents - 4th Quarter 290 283 280

268 270 262 259 260 251 250 243 241 240

230

220 4th Q 4th Q 4th Q 4th Q 4th Q 4th Q 5 year 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 average

% All UFAS - 4th Quarter

All Other Incidents 41%

All UFAS Incidents 59%

Page 39 of 234 Glossary of Terms

Accidental: Caused by accident or carelessness. Includes fires which accidentally get out of control.

Casualty : consists of persons requiring medical treatment including first aid given at the scene of the incident and also those sent to hospital or advised to see a doctor for a check-up or observation (whether or not they actually do). People sent to hospital or advised to see a doctor as a precaution, having no obvious injury, are recorded as ‘precautionary check-ups’. Casualty figures do not include fatalities.

Deliberate : covers fires where deliberate ignition is suspected.

Unwanted Fire Alarm Signal (UFAS) : is defined as an event in which the Fire and Rescue Service believes they are called to a reportable fire and then find there is no such incident. These can be Malicious, of Good Intent or caused by faults/unsuitable equipment within the alarm system.

Fatality : a casualty whose death is attributed to a fire is counted as a fatality even if the death occurred later. Fatalities associated with Other Incidents can include attendance to assist Police or Ambulance colleagues when a person has been found who has committed suicide, for example. Often there is little we can do as a Service to influence this particular figure.

Primary Fires: includes all fires in buildings, vehicles and most outdoor structures or any fire involving casualties, rescues or fire attended by five or more pumping appliances.

Secondary Fires: These cover the majority of outdoor fires including grassland and refuse fires unless they involve casualties or rescues, property loss or if five or more appliances attend. They include fires in derelict buildings but not chimney fires.

Tayside Local Resilience Partnership: Local resilience partnerships (LRP’s) are multi-agency partnerships made up of representatives from local public services, the emergency services, local authorities, the NHS, the Scottish Environmental Protection Agency and others. These agencies are known as Category 1 Responders, as defined by the Civil Contingencies Act. They are supported by organisations, known as Category 2 responders, such as public utility companies etc. and have a responsibility to co-operate with other Category 1 organisations and to share relevant information with the LRP. LRPs also work with other partners in the military and voluntary sectors who provide a valuable contribution to LRP work in emergency preparedness. The LRPs aim to plan and prepare for localised incidents and catastrophic emergencies. They work to identify potential risks and produce emergency plans to either prevent or mitigate the impact of any incident on their local communities.

KEY:

Reduction against 5 year average

Maintained

Increase against 5 year average

Page 40 of 234 NOTE: The statistics featured throughout this report are provisional until the year end.

Page 41 of 234

Page 42 of 234 Perth & Kinross Year to Date Performance Summary – 1st April 2016 – 31st March 2017

Year to Apr Mar Apr Mar Apr Mar Apr Mar Apr Mar Apr Mar 5 Year Key Performance Indicator Date RAG 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 Average Rating

All deliberate primary fires 53 31 34 32 32 33 36 (1b) All deliberate other building 9 13 17 19 16 8 15 fires (1b(ii)) All deliberate secondary fires 131 83 78 60 88 78 88 (1c) All accidental dwelling fires 112 114 97 124 120 136 114 (2b(i)) All accidental other building 63 55 41 51 58 63 54 fires (2b(ii)) All fatal fire casualties (3a(i)) 0 1 0 0 0 1 0

Non-fatal fire casualties excl. precautionary check-ups 24 25 37 22 21 22 26 (3a(ii)) Non-fatal fire casualties incl. precautionary check-ups 25 29 46 28 33 31 32 (3a(iii)) Special Service Road Traffic 77 106 75 94 91 86 89 Collisions (RTCs) (5a) Special Service Flooding (5b) 42 57 43 27 104 19 55

Special Service Extrication 13 16 16 17 14 15 15 (5c) Special Service Others (5d) 207 142 145 121 173 154 158

False Alarm: All (10a) 1196 1141 1163 1222 1151 1106 1176

False Alarm: Good Intent (10b) 240 201 172 192 173 172 196 False Alarm: Malicious (10c) 45 34 48 28 40 29 29

Key

Red 10% more than previous result or local target not met (worse than)

Amber Up to 9% more than previous result or local target not met (worse than)

Green Equal to or better than previous result / or local target met (better than)

Note  Year to Date RAG Rating = The cumulative total of all quarterly performance in current year compared to comparable period of all quarterly performance in previous 5 years

PLEASE NOTE: The statistics featured throughout this report are provisional until the year end. 1

Page 43 of 234

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7(i) (17/194)

PERTH AND KINROSS COUNCIL

Housing and Communities Committee – 31 May 2017

PERTH AND KINROSS LOCAL POLICING AREA PERFORMANCE RESULTS 1st April 2016 to 31st March 2017

Report by Chief Superintendent Paul Anderson Police Scotland ‘D’ Division (Tayside)

1. RECOMMENDATION

1.1 It is recommended that members note and scrutinise this operational report.

2. BACKGROUND

2.1 The purpose of this report (Appendix A) is to provide information to the Committee regarding the performance of Police Scotland against performance indicators that will facilitate local scrutiny.

2.2 Appendix A will provide context to the information provided in relation to performance and give information on some of the work which has taken place within Perth and Kinross Local Policing Area.

2.3 The data provided in this report is for information purposes to allow Board Members to conduct their scrutiny responsibilities.

3. PERFORMANCE

3.3 Performance Indicators detailed in Appendix A are subdivided into the following priorities within this report which are the Local Policing Priorities as identified in the 3 year Local Policing Plan.

• Serious and Organised Crime • Public Protection and Safety • Road Safety • Major Events and Planning • Theft, Housebreaking and Scams

Page 45 of 234

3.4 Appendix A will also provide updates on:

• Antisocial Behaviour • Community Engagement

Please note that an updated report containing 5 year averages and Multi Member Ward information will be available and distributed prior to the Committee meeting on 14 th June 2017.

4. FINANCIAL IMPLICATIONS

4.1. There are no financial implications as a result of this report.

5. STAFFING IMPLICATIONS

5.1 There are no staffing issues as a result of this report.

6. ENVIRONMENTAL ISSUES

6.1 This report does not have any impact on the environment.

7. SUMMARY

7.1 The attached report updates members regarding significant operational matters and gives context to the performance of the local policing area.

8. COMPLIANCE

Is the proposal; (a) Human Rights Act 1998 compliant? YES (b) Equality & Diversity compliant? YES

Page 46 of 234 NOT PROTECTIVELY MARKED

PERTH & KINROSS COUNCIL

Community Safety Committee

Report by Chief Superintendent Paul Anderson (Quarter ending 31st March 2017)

NOT PROTECTIVELY MARKED 1

Page 47 of 234 NOT PROTECTIVELY MARKED

Contents

Background to this Report page 3

Executive Summary of Performance page 4

Local Policing Priority Updates: Serious and Organised Crime pages 5-6 Public Protection and Safety pages 6-8 Road Safety pages 9-10 Antisocial Behaviour pages 11-12 Major Events and Planning pages 12-13 Theft, Housebreaking and Scams pages 13-15 Community Engagement pages 15-16

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BACKGROUND TO THIS REPORT

As from April 2013, the Police and Fire Reform (Scotland) Act 2012 has required Police Scotland to produce and publish a Local Policing Plan (LPP) for each local authority area. The LPP clearly sets out the policing priorities for Perth and Kinross.

Performance in relation to the identified policing priorities is monitored and reviewed internally on a weekly basis. Quarterly reports are produced to allow scrutiny by Perth and Kinross Council Community Safety Committee. This report covers the period from 1st April 2016 to 31st March 2017.

Data provided in this report is for information purposes to allow Board Members to conduct their scrutiny responsibilities.

This report will make reference to crime groupings. Groups 1-4 refer to an amalgamation of four crime groups. They are Group 1, consisting of violent crime; Group 2 covering sexual offences; Group 3 covers a wide range of crimes of dishonesty; and Group 4 includes vandalism, fire-raising and malicious mischief.

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EXECUTIVE SUMMARY OF PERFORMANCE

The reporting year under review has once again seen Perth & Kinross at the centre of Policing in Scotland. With my officers and staff supporting over 200 events across the area. These ranged from ETAPE Caledonia, a large Pitlochry based cycling event, to Comrie Flambé, and included The Enchanted Forest, Rewind Music Festival, Perth Round Table Bonfire & Fireworks display, Tayside Classic Motor Show, Loch Leven Half Marathon and Kinross Farmers’ Market to name but a few. In addition to these a number of Scottish Premier League football matches, Race meetings and Royal visits and political events.

Working closely with residents, communities and partners is at the heart of our locality based policing model and has enabled us to gather intelligence and report, to the Procurator Fiscal, 116 cases of persons involved in the supply, production and cultivation of controlled drugs.

Page 5 of this report explains our Group 1 to 4 crime classifications and I am delighted that the work done by my staff and officers has contributed to a reduction of over 400 reported crimes during the year. Whilst the statistics are positive, the reality means that we have 400 less victims of crime compared to the previous year.

Serious and Organised crime blights communities across the length and breadth of Scotland, and Perth and Kinross is no different. As a national policing service we utilise a range of assets, strategies and resources to target those living off the proceeds of crime, and during the year we have seized cash, restrained assets and sought expedited referrals to the value of almost £1.4 million.

Road safety continues to be an important issue in Perth & Kinross and local officers work with road policing colleagues and partners throughout the year in order to educate motorists and raise awareness and when appropriate carry out enforcement activity. During the year under review we contributed to 4 campaigns linked to the carriage of dangerous goods, 3 bus and truck campaigns, 2 drink driving campaigns, a month long motorcycle safety initiative and 2 operations linked to foreign national offenders utilising the road network.

Other positives areas of performance include: - 150 fewer common assaults Nearly 200 fewer domestic abuse crimes. And a 130 fewer homes being broken into.

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Serious and Organised Crime

Tackling Serious and Organised Crime Groups (SOCGs) in Perth and Kinross remains a key priority.

Within this quarter we have continued to focus our activity on drug possession, supply, production and cultivation as well as continuing our partnership working with HMP Perth to tackle illegal activity within the Prison Estate and can report some notable successes.

For the period under review there have been 13 offences detected in respect of persons being concerned in the supply of controlled drugs. Of the 13 cases there were 9 incidents at HMP Perth. In addition, there were 4 other cases reported to the procurator Fiscal in respect of individuals being in possession of drugs with the intent to supply.

Following intelligence received about males suspected of dealing drugs to school children a number of search warrants were obtained in order to search various premises in Perth. On 27 January 2017, a 21 year old male was arrested for various drugs offences.

On 22 February 2017, premises were broken into at Aberuthven and 2 vehicles stolen. Enquiries revealed that this incident linked in with other crimes throughout the Tayside, Forth Valley and Fife areas. On 29 March a number of premises were searched in these areas and a 27 year old male was arrested.

On 9 March 2017, a fire was reported at Whyte Place, Milnathort, during a search of the premises a cannabis cultivation was discovered. A search warrant was obtained for the premises and a 46 year old male arrested.

We remain committed to tackling the supply of controlled drugs across Perth and Kinross and seek the support of the community to provide information with regards to individuals actively dealing in their respective communities.

During this period, a gang, of seven men, that caused explosions at cash machines across Scotland and England has been jailed for a total of 92 years.

The group stole more than £550,000 and caused more than £160,000 worth of damage in attacks on 13 commercial premises, targeting those with ATMs.

In a raid at the Co-op in Carnoustie in February 2016, they sawed through the roller-shutter doors, dragged the ATM out using a Land Rover Defender and winch, and escaped with £16,000.

They were apprehended following a joint cross border Police investigation.

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Serious and Organised Crime

5 year Apr 2015- Apr 2016- % Change average Mar 2016 Mar 2017 from last year 25 Number of detections for drugs supply, 95 116 22.1% production, cultivation.

Number of Detection for Drugs Supply, Production and Cultivation YTD Apr 2015-Mar 2016 YTD Apr 2016-Mar 2017

YTD Apr 2015 -Mar YTD Apr 2016 2016-Mar Public Protection and95 Safety 2017

Keeping People Safe is a116 key priority for the Police Service of Scotland.

Reducing violence is a key priority for Police Scotland and as a result we continue to deploy our officers into key locations to prevent, deter and detect violent crimes.

Centre Safe deployments within Perth city’s centre have continued to focus on the night time economy. Officers are deployed with the latest up to date intelligence and carry out licensing checks and proactive patrols within the town centre. Engagement meetings are also held with licensees within Perth to identify and target any issues and to aim for continuous improvement in making a night out in Perth as safe as it possibly can be as well as prioritizing our contribution to the Purple Flag award.

We work closely with our partners who include street pastors and community wardens to provide support and assist vulnerable people within our community.

In this quarter there were 26 Serious Assaults reported within the LPA. 23 of these have been detected. This figure includes 5 serious assaults which took place in Perth Prison.

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There have been 4 robberies reported within the Quarter, 2 of which were detected. All four robberies occurred within Perth city and do not appear to be connected.

On 25th February a murder occurred in Dunnock Park, Perth. This was a domestic incident and a 36 year old female was arrested. The female was remanded in custody. As this investigation is sub judice no other information can be passed at this time.

Our partnership approach for tackling the causes of missing persons continues and follow up interviews with the individual is tasked to a variety of partners to ensure that the individual’s needs are met and signposted for further intervention.

The Community Hub assisted Sandy Robertson, Safer Communities (MAPPA liaison) to develop a screening process to enhance the Environmental Risk Assessment process already carried out by the Offender Management Unit. Whilst the ERA identifies potential risks and vulnerabilities of the residents at the relevant time there remains the issue of persons subsequently moving into the area. Whilst Perth and Kinross Council cannot influence privately owned properties the Community Hub can screen potential tenants who are to be allocated in the proximity of offender’s addresses.

Discussions are under way with Women’s Aid to develop a similar system to address the issue of known domestic perpetrators being located in the vicinity of Women’s Aid properties.

Public Protection and Safety

5 year Apr 2015– Apr 2016- % change average Mar 2016 Mar 2017 from last year 1 Total Number Group 1: Crimes of Violence 120 168 40.0%

2 Murder 1 2 100.0%

3 Attempted Murder 3 1 -66.7%

4 Culpable Homicide (common law) - 0 0 -

5 Culpable Homicide (other) - 0 2 -

6 Serious Assault detection rate 95.3% 84.8% -10.5

7 Serious Assault 85 105 23.5%

8 Robbery detection rate 91.7% 58.8% -32.9%

9 Robbery 12 17 41.7%

10 Petty (Common) Assault detection rate 85.6% 77.6% -8.0%

11 Petty (common) Assault 1105 946 -14.4%

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13 Number of Domestic Abuse incidents reported to - 1213 1171 -3.5% the Police 14 Total crimes and offences in Domestic Abuse - 889 690 -22.4% incidents

15 Percentage of Domestic incidents that result in a - 51.4% 41.2% -10.2% crime being recorded 16 Total crimes and offences in Domestic Abuse - 87.3% 72.9% -14.4% incidents detection rate 17 Total detections for Domestic Bail offences - 64 32 -50.0%

18 95% of initial Domestic Abuse Bail Checks are - - 96.8% - conducted within 24hrs 19 Hate crime and offences detection rate - 93.5% 75.0% -18.5%

33 Number of Group 2: Crimes of Indecency 274 308 12.4%

34 Group 2 crimes detection rate 84.3% 69.5% -14.8%

35 Rape detection rate 80.4% 66.7% -13.7%

April 2016 – April 2016 – Mar Mar 2017 2017 (Positive) 20 Number of Stop and Searches conducted (total) 842 407 21 Number of Statutory Stop and Searches conducted 830 406 22 Number of Consensual Stop and Searches conducted 12 1 23 Number of Consensual Stop and Searches refused 0 - 24 Number of seizures made 37 -

Total No of Group 1 Hate Crime and Offences Crimes - Crimes of - Detection Rate

Violence YTD Apr 2015 - Mar 2016 YTD Apr 2015-Mar 2016 YTD Apr 2016 - Mar 2017 YTD Apr 2016-Mar 2017

YTD Apr YTD Apr 2015- YTD Apr YTD Apr 2016- Mar 2016 - 2015 - Mar Mar 2017, 2016 Mar 2016, 2017 75.0% 120 93.5% 168

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Road Safety

The strategic priority for road safety is keeping people safe on the roads of Perth and Kinross.

The officer who holds the post of Rural Crime Liaison Officer for Roads Policing continues to offer support to those affected as well as providing security advice. This has led to frequent cross border Kinross-shire/Fife evening/night road checks with Fife DRPU. Roads Policing continue to maintain their commitment to local priorities and we continue to operate a Road Crime Patrol car, the purpose of which is to augment our efforts in targeting criminals using the road network.

Tragically there have been two fatalities over the reporting period. On 3rd January an 80 year old female stepped into the path of an oncoming vehicle on the A94 Perth to Coupar Angus Road near to Scone. Then on 16th February a 50 year old male suffered from a medical matter whilst driving on the A85 in Methven which resulted in his vehicle colliding with a hedge.

Between 13th and 17th February a National Police Chiefs Council Truck and Bus Campaign ran within the area, this was carried out in partnership with DVSA, SEPA and the Department of Work and Pensions. 27 vehicles were stopped with 6 of these vehicles issued with immediate prohibitions and 25 other offences detected.

Between 20th and 24th February a carriage of dangerous goods operation was run along with DVSA, 5 carriage of dangerous goods controlled vehicles were stopped and checks carried out which resulted in 2 prohibitions for overloading and 1 for general condition. 10 additional offences were also detected.

In addition there have also been operations carried out for vehicles with no insurance and also for drivers utilising mobile telephones which coincided in the increase of penalty for offences of this type.

Two persons have also been reported for Culpable Homicide in relation to road traffic accidents which occurred on the A9 at Luncarty and at Coupar Angus.

Road Traffic Statistics

5 year Apr 2015– Apr 2016- % Change Average Mar 2016 Mar 2017 from last year N/A People Killed - 6 10 66.7% N/A People Seriously Injured - 32 37 15.6% N/A People Slightly Injured - 114 112 -1.8%

N/A Children (aged<16) Killed - 1 1 0.0%

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N/A Children (aged<16) Seriously Injured - 4 3 -25.0% 36 Dangerous driving 103 72 -30.1%

37 Speeding 1749 1377 -21.3%

38 Disqualified driving 51 56 9.8%

39 Driving Licence 265 237 -10.6%

40 Insurance 617 601 -2.6%

41 Seat Belts 87 69 -20.7%

42 Mobile Phone 334 250 -25.1%

People Seriously Injured People Slightly Injured YTD Apr 2015 - Mar 2016 YTD Apr 2015 - Mar 2016 YTD Apr 2016 - Mar 2017 YTD Apr 2016 - Mar 2017

YTD Apr YTD Apr YTD Apr 2015 - YTD Apr 2016 - 2016 - Mar 2015 - Mar Mar 2016 Mar 2017 2017 32 2016 37 112 114

Mobile Phone Children (aged<16) Seriously Injured YTD Apr 2015 - Mar 2016 YTD Apr 2016 - Mar 2017 YTD Apr 2015 - Mar 2016 YTD Apr 2016 - Mar 2017

YTD Apr YTD Apr YTD Apr 2016 - 2015 - 2016 - YTD Apr Mar Mar Mar 2015 - 2017 2016 2017 Mar 250 334 3 2016 4

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Antisocial Behaviour

Antisocial behaviour and its impact on communities remains a priority for Police Scotland. Working closely with our council and housing partners at the hub we continue to make early interventions where householders are identified as being involved in anti-social behaviour and have a range of measures in place to stop it and improve the quality of life for those previously affected.

Police have recently received a number of reports regarding antisocial behaviour taking place near to the North and South Inches in Perth. These incidents appear to involve a large number of youths. A multi-agency partnership meeting has been held to discuss methods to target the problems and also diversionary methods that can be used.

Community officers in Perth are carrying out regular patrols in these areas and have already established the identities of some of the youths involved. The Community Officers are also being assisted by officers from the National Violence Reduction Team during the Easter school holiday period, a number of offences have already been detected and reported and it is hoped that the instances of Antisocial behaviour will decrease.

Officers within the Community Hub have also been working alongside the Street Pastors to discuss and trial a scheme where by school pastors can be used to help target any antisocial behaviour by youths when out with school. This work is ongoing and it is hoped that a trial can be arranged in the near future.

Community Wardens along with the PSYV have carried out patrols identifying areas where graffiti is prevalent. The graffiti has been recorded and our partners Perth and Kinross Council Safer Communities team have arranged for the graffiti to be removed from the affected areas.

Officers within the community hub regularly hold meetings with the Safer Communities and partner agencies to discuss any emerging issues and ensure that they are appropriately addressed and support put in place for the persons concerned. This highlights issues at an early stage with the aim of measures being put in place to prevent any escalation.

Local residents are encouraged to report any incidents at the time to Police Scotland via 101 or if in an emergency 999. Correspondence can also be sent to [email protected]. Perth and Kinross Council Safer Communities Team can also be contacted on 01738 476173.

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Antisocial Behaviour

5 year Apr 2015 – Apr 2016 – % Change average Mar 2016 Mar 2017 from last year 12 Number of complaints regarding disorder - 3924 4900 24.9% 30 Vandalism & Malicious Mischief detection rate 29.3% 28.1% -1.2%

31 Vandalism & Malicious Mischief 948 754 -20.5% 32 Number of detections for Consuming Alcohol in a - 18 12 -33.3% designated place (where appropriate byelaws exist)

Vandalism and Malicious Vandalism and Malicious Mischief Mischief Detection Rate YTD Apr 2015 - Mar 2016 YTD Apr 2015 - Mar 2016 YTD Apr 2016 - Mar 2017 YTD Apr 2016 - Mar 2017

YTD Apr YTD Apr YTD Apr YTD Apr 2016 - 2015 - 2016 - 2015 - Mar Mar Mar Mar 2017 2016 2017 2016 754 948 28.1% 29.3%

Major Events and Planning

For the period under review there have been major events that have happened that had an impact on local policing resources.

On the night of Saturday 4th February an Operation Frankie was carried out targeting drug issues in the town centre licensed premises. A number of persons were searched as a result of the operation however no controlled drugs were recovered.

On 25th February a murder occurred in Dunnock Park, Perth. This was a domestic incident and a 36 year old female was arrested and remanded in custody. This placed significant demands on local policing resources to assist the specialist departments that were in attendance. Over the same period a number of other significant enquiries were on-going in other areas of D Division with resources being supplied from other areas of Police Scotland to assist.

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There have been two significant missing persons enquiries commenced for the reporting period.

Other significant incidents for the reporting period include on the 31st January a report of an 88 year old male being reported missing and his vehicle being recovered near the River Tay and also on 18th March when a 25 year old male was seen to enter the River Tay at the Queens Bridge. Both these incidents resulted in significant resources being deployed from both local and national areas with assistance also being received from specialist officers in Police Scotland, the Scottish Fire and Rescue Service, Mountain Rescue Team, Coastguard, RNLI and Air Support from Police Scotland and the Coastguard. At present enquiries remain on-going to trace the males.

On 5th February St Johnstone had a home fixture against Celtic. Several officers were deployed to the fixture as well as an amended traffic management plan that was agreed between the club and Police Scotland.

On 11th February St Johnstone had a fixture against Partick Thistle, as well as deploying resources to the fixture officers were also involved in policing a march by a significant number of the Fair City Unity supporters group who were celebrating a year of the group and walked from the city centre to the ground, this operation passed without incident.

On 23rd February Police Scotland hosted the second Rural Crime Partnership event at Bankfoot Church Centre. The event was attended by local farmers and supported by the NFU and the SGA. Guest speakers provided local farmers with crime prevention advice and educational inputs on coursing.

Inspector Chase attended a meeting with the National Park to discuss the forthcoming season with visitors to Loch Earn. Operation Ironworks is the partnership approach to policing the National Park incorporating Park Rangers, Police Scotland and the local community. Additional funding has been secured to police Loch Earn for the forthcoming season.

On 11th March, St Johnstone had a home fixture against local rivals Dundee. Officers were deployed to the fixture both inside and outside the stadium.

Theft, Housebreaking and Scams

Theft, housebreakings and scams continue to be a divisional priority and as such officers are tasked on a daily basis with deterrence patrols based on the latest intelligence. It is encouraging that crimes of housebreakings are continuing to show a significant reduction year on year.

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These figures are encouraging and we are also pleased to report some notable results in terms of detected incidents for the reporting period.

A 36 year old female was charged in January with a housebreaking which occurred in Blairgowrie and £700 of property stolen. The female was also responsible for a number of other thefts in Blairgowrie, including the theft of bank cards and jewellery. The case is waiting to proceed at court.

On 16 January 2017 a house was broken in Kinross and a wallet containing £385 was taken. A 25 year old male was arrested a number of other theft were also linked to him. He has been reported to the procurator Fiscal.

On 9 March 2017 police arrested a female who had committed a number of Fraud and thefts in Auchterarder. The female was wanted throughout the UK in relation to similar crimes which she had committed. Enquiry by local officer also established that the female had entered illegally into the country and she is now in the process of being deported

On 10 March 2017 two males targeted a vulnerable 90 year old female. The victim was distracted by one of the culprits whilst the other stole the victim’s purse containing cash and bank cards. Enquiries carried out revealed the identity of the males and they were arrested. The males appeared at court and are currently remanded awaiting trial.

Officers from our Community have been involved in an Initiative along with Santander to offer advice and assistance to customers. They have also attended an Inner Link meeting where they have given a talk to the group regarding issues including doorstep crime, internet safety, fraud prevention and bogus callers.

Housebreaking and Theft by Shoplifting

5 year Apr 2015– Apr 2016- % Change average Mar 2016 Mar 2017 from last year 26 Theft by housebreaking (including attempts) 28.2% 23.9% -4.3% detection rate 27 Theft by housebreaking (including attempts) 309 176 -43.0% 28 Theft by shoplifting detection rate 78.4% 75.6% -2.8% 29 Theft by shoplifting 532 529 -0.6%

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Theft by Housebreaking Theft by Shoplifting (including attempts) Detection Rate YTD Apr 2015 - Mar 2016 YTD Apr 2015 - Mar 2016 YTD Apr 2016 - Mar 2017 YTD Apr 2016 - Mar 2017 YTD Apr 2016 - YTD Apr YTD Apr Mar YTD Apr 2016 - 2015 - 2017 2015 - Mar Mar 176 Mar 2017, 2016, 2016 75.6% 78.4% 309

Community Engagement

Engaging with the community is a priority for Perth and Kinross LPA. This reporting period has seen the implementation of the new community policing model for the area with newly formed teams of dedicated Community Sergeants and Constables for each area with the LPA.

The LPA Commander is supported by three Locality Inspectors with Inspector Gordon Thomson based in North Perthshire, Inspector Jon Anton based in Perth City and Inspector Kevin Chase based in South Perthshire. Each Police Station has a dedicated Community Team that report to a Locality Sergeant.

The officers now have allocated areas and have met with many of the local councillors. There is an officer allocated to each Secondary School in the area and they are now making regular visits to the schools, the intelligence dividend for this has already been apparent with a male who was reported to be targeting school children and selling controlled drugs being traced and found in possession of a quantity of controlled drugs.

The local authority of Perth and Kinross, has so far accepted 7 families relocated from Syria under the Home Office refugee relocation scheme. Officers from the Community Hub continue to work with partnership agencies to ensure the families are integrating in the community and to share any issues or difficulties they may have encountered.

Officers from the Community Hub have also attended at Perth College where they have given a talk to foreign language students with regards to the Scots Law and their rights. They have also formed part of the group that are meeting to discuss and push forward the improvement and upgrade of the existing CCTV system within NOT PROTECTIVELY MARKED 15

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Perth and Kinross.

A meeting has been held with officers from the local Authorities Trading Standards Department and agreement reached to hold monthly liaison meetings to ensure that the appropriate information is being shared. This will enable a joint approach to identify victims and ensure they are supported, it will also allow offenders to be identified and targeted by the correct agency. The liaison meeting will be attended by Community wardens who can assist in supporting victims and patrolling the areas where repeat victims have been identified.

This reporting period has also seen the release of quarter 3 of the Your View Counts survey, this shows that the top 5 local priorities are Antisocial Behaviour/Disorder, Drug Dealing, Homes being broken into, Violent Crime and Child Abuse including Child Sexual Exploitation. 44% of the public are reassured to see the police in their areas whilst the majority believe that crime levels have remained the same. 56.9% of persons who completed the survey and have had contact with the police are satisfied with the response they have received, this is a slightly higher figure than the previous quarter.

Contact Details Divisional Commander - Chief Superintendent Paul Anderson D Division HQ West Bell Street, Dundee

Area Commander - Chief Inspector Ian Scott Perth & Kinross Local Policing Area (LPA) HQ Barrack Street, Perth

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Page 62 of 234 7(ii) (17/195) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Local Police Plan 2017-20

Executive Director (Housing & Community Safety)

PURPOSE OF REPORT

This report presents the Local Police Plan 2017-20 and provides members with an opportunity to comment on the main priorities and objectives.

1. BACKGROUND/MAIN ISSUES

1.1 The Police and Fire Reform (Scotland) Act 2012 introduced the new statutory arrangements for policing in Scotland. The relevant chapters are :-

• Chapter 4 of the Act (Principles, Priorities, Objectives and Plans) states:- ‘..the main purpose of policing is to improve the safety and well-being of persons, localities and communities in Scotland..’

• Chapter 7 of the Act (Local Policing) explains the role of the Local Authority Partnership in working with the Police on local policing, including the Local Police Plan. It is attached as Appendix 2.

1.2 The Local Police Plan (2017-2020) is designed to reflect local priorities and objectives, which contribute to the delivery of successful outcomes, identified through local community planning, where Police Scotland are active and essential partners.

1.3 It also has to reflect national Police Scotland strategies and priorities including for example, the Scottish Government’s five year” Strategic Police Priorities”, published in 2016 and the recently published, for consultaion, 10 Year strategy for Policing in Scotland “2026 Serving a Changing Scotland”. In addition the Chief Constable also publishes an Annual Police Plan which sets out immediate priorities. These documents describe internal and external direction and should, if they are to be effective, set a consistent approach without constraining local discretion and leadership.

2. LOCAL POLICE PLAN

2.1 The Plan identifies future challenges, most of which are familiar to the local authority, as partners. These include:-

• Increasing prevalence of vulnerability in a number of ways

Page 63 of 234 • Recent increases in recorded crime, particularly in domestic abuse • Impact of public sector reform on service delivery, including public expectations of the Police and other public services • Challenges presented by the growth of cyber crime • Threat of terrorism and serious organised crime

2.2 None of these challenges can be addressed by the Police alone and emphasise the importance of responding to these challenges through strong partnership working between the Police and community partners, including the local authority.

The draft Local Police Plan 2017-20 sets out objectives:-

• Putting victims at the heart of what we do • Tackling crime and anti-social behaviour • Protecting vulnerable people • Maintaining public safety

These objectives can also only be achieved through close partnership working between the Police and community partners and through engagement with the communities they serve.

3. CONCLUSION AND RECOMMENDATION(S)

3.1 The Local Police Plan is an important document in setting out the challenges for the Police in Perth and Kinross and how they will respond to these through the setting and delivery of their objectives over the next three years. The local authority has a key role in working with the Police to identify and work together to achieve improved outcomes for individuals and communities in Perth and Kinross.

It is recommended that Committee approve the Local Police Plan 2017 – 2020.

Author Name Designation Contact Details Nicola Rogerson Service Manager [email protected] 01738 475000

Approved Name Designation Date Bill Atkinson Executive Director (Housing and 23 May 2017 Community Safety)

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Page 65 of 234 ANNEX

1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

Strategic Implications Yes/ None Community Plan/Single Outcome Agreement Yes Corporate Plan Yes Resource Implications Financial None Workforce None Asset Management (land, property, IST) None Assessments Equality Impact Assessment None Strategic Environmental Assessment None Sustainability (community, economic, environmental) None Legal and Governance None Risk None Consultation Internal Yes External Yes Communication Communications Plan None

1. Strategic Implications

Community Plan/Single Outcome Agreement

1.1 The Local Police Plan plays an important specific role in:-

(v) Creating a safe and sustainable place for future generations

But policing plays a role in the other objectives also. Police Scritiny holds the police to account and must ensure the service contributes to the Community Planning Partnerships.

Corporate Plan

1.2 The Police have a key role to play in delivering all 5 elements of the Corporate Plan:-

(i) Giving every child the best start in life (ii) Developing educated, responsible and informed citizens (iii) Promoting a prosperous, inclusive and sustainable economy (iv) Supporting people to lead independent, healthy and active lives (v) Creating a safe and sustainable place for future generations

Police Scrutiny holds the police to account and must be seen to be effective.

Page 66 of 234 2. Resource Implications

Financial

2.1 None

Workforce

2.2 None

Asset Management (land, property, IT)

2.3 None

3. Assessments

Equality Impact Assessment

3.1 This section should reflect that the proposals have been considered under the Corporate Equalities Impact Assessment process (EqIA) with the following outcome:

(i) Assessed as not relevant for the purposes of EqIA

A EiA should be completed by Police Scotland. The Local Authority may be asked to contribute to this.

Strategic Environmental Assessment

3.2 No further action is required as it does not qualify as a PPS as defined by the Act and is therefore exempt.

Sustainability

3.3 Not relevant

Legal and Governance

3.4 This is a draft Police Plan – Legal and Governance will be consulted as part of the consultation.

Risk

3.5 No specific new risks

4. Consultation

Internal

Page 67 of 234 4.1 Community Safety, Chair Community Safety Committee (past)

External

4.2 Not applicable.

5. Communication

5.1 The Police Plan should be publicised by Police Scotland once approved by the Council.

2. BACKGROUND PAPERS

The Police and Fire Reform (Scotland) Act 2012 10 Year Strategy for Policing in Scotland – 2026 Serving a Changing Scotland Strategic Police Priorities Annual Police Plan 2016

3. APPENDICES

Appendix 1 - Chapter 7 The Police and Fire Reform (Scotland) Act 2012 Appendix 2 - Local Policing Plan

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APPENDIX 1 CHAPTER 7 LOCAL POLICING

44. Local policing

(1) The chief constable must ensure that there are adequate arrangements in place for the policing of each local authority area (and any adjacent territorial waters).

(2) For each local authority area, the chief constable must, after consulting the local authority, designate a constable as local commander.

(3) A constable may be designated as local commander in relation to more than one local authority area.

45. Local authority role in policing

(1) A local commander must involve the local authority in the setting of priorities and objectives for the policing of its area.

(2) A local authority may monitor and provide feedback to the local commander on the policing of its area, and (in particular) may provide to the local commander:-

(a) its views on any matter concerning or connected to the policing of its area (b) any recommendations for the improvement of the policing of its area that it thinks fit

(3) A local authority may specify policing measures that it wishes the local commander to include in a local policing plan.

(4) A local authority may provide feedback by reference to any local police plan in force for the area.

(5) A local commander must provide to the local authority such:-

(a) reports on the carrying out of police functions in its area (including by reference to any local policing plan in force for the area) (b) statistical information on complaints made about the Police Service in, or the policing of its area (c) other information about the policing of its area as the local authority may reasonably require

(6) A local commander may refer a requirement under subsection (5) to the chief constable if the local commander considers that complying with the requirement would or might prejudice:-

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(a) the carrying out of any operation by the Police Service (b) the prosecution of offenders

(7) A requirement referred under subsection (6) has effect only if it is confirmed by the chief constable.

46. Duty to participate in community planning

(1) In section 16(1) of the Local Government in Scotland Act 2003 (asp 1) (duty to participate in community planning:-

(a) paragraph (c) is repealed (b) in paragraph (e), for “a police force” substitute “the Police Service of Scotland”

(2) The chief constable must delegate the carrying out of the chief constable’s functions under section 16(1)(e) of the Local Government in Scotland Act 2003 in each local authority area to the local commander for that area.

(3) Subsection (2) does not affect:-

(a) the chief constable’s responsibility for the carrying out of the delegated functions (b) the chief constable’s ability to carry out the delegated functions

47. Local police plans

(1) As soon as is reasonably practicable after the first strategic police plan is approved under section 34, a local commander must prepare and submit a local police plan to the relevant local authority for approval.

(2) A local police plan is a plan which:-

(a) sets out the main priorities and objectives for the policing of the local authority’s area (b) explains the reasons for selecting each of those priorities and objectives (c) sets out the proposed arrangements for the policing of the local authority’s area (and how those arrangements are expected to achieve the main priorities and objectives) (d) where reasonably practicable, identifies outcomes by reference to which the achievement of those priorities and objectives may be measured (e) describes how those priorities, objectives and arrangements are expected to contribute to the delivery of any other relevant local outcomes which are identified by community planning

Page 70 of 234 (f) includes any other information connected with the policing of the local authority’s area which the local commander considers relevant

(3) In preparing a local police plan, the local commander must:-

(a) have regard to the most recently approved strategic police plan (b) consult;-

(i) the joint central committee of the Police Federation for Scotland (ii) such persons as appear to the local commander to be representative of (iii) senior officers (iv) such persons as appear to the local commander to be representative of (v) superintendents (including chief superintendents) (vi) such persons as appear to the local commander to be representative of (vii) police staff (viii) such other persons as the local commander considers appropriate

(4) If the local authority approves a local police plan submitted to it, the local commander must publish it in such form and manner as the Authority may specify.

(5) The local commander must review the local police plan if:-

(a) a new strategic police plan is approved under section 34 (b) the plan is not replaced under subsection (6) or modified under subsection (9) during the period of 3 years beginning with the date of publication of the plan.

(6) Following a review under subsection (5)(a), the local commander may prepare and submit a replacement plan to the local authority for approval.

(7) Following a review under subsection (5)(b), the local commander must prepare and submit a replacement plan to the local authority for approval.

(8) Subsections (3) to (5) apply in relation to a replacement local police plan as they apply in relation to the plan being replaced.

(9) The local commander and the local authority may agree to modify an approved local police plan at any time.

(10) Subsections (3) to (5) apply in relation to a modified local police plan as they apply inrelation to the plan being modified.

(11) In this section “community planning” means the community planning processes

Page 71 of 234 described in Part 2 of the Local Government in Scotland Act 2003 (asp 1).

Page 72 of 234 APPENDIX 2 APPENDIX 2

Page 73 of 234 Page

1. Introduction - About Perth and Kinross 3

2. Future Challenges 3

3. Policing in Perth and Kinross 4

4. Police Objectives 5

4.1 Putting Victims At The Heart Of What We Do 6

4.2 Tackling Crime And Anti-Social Behaviour 7

4.3 Protecting Vulnerable People 8

4.4 Maintaining Public Safety 9

5. Accountability 10

6. Want To Know More 11

7. Structure Perth and Kinross Local Policing Area 12

7.1 Local Contact Details 13

Page 74 of 234

1. Introduction – About Perth and Kinross

The people and the communities in Perth and Kinross are served by uniformed officers dealing with a wide range of policing issues, including anti social behaviour, road safety, criminality including homes being broken into, road crime, bogus callers, scams and rural crime. Through to vulnerability including, missing people, children and young persons at risk and those involved in the misuse of drugs and alcohol. In addition local officers attend sporting events, community led festivals and celebrations from Rewind and the Scottish Game Fair at Scone Palace and the International Horse Trials at Blair Atholl.

2. Future Challenges

• Increasing and changing demands on police time due to social care issues, for example, those dealing with mental ill health or alcohol, drug and substance misuse challenges;

• The increasing prevalence of vulnerability through domestic abuse, child sexual exploitation, modern slavery, human trafficking, child neglect, sexual abuse, prostitution, hate crime, missing people and mental ill health;

• Recent increases in recorded crime including victim-based crime in particular domestic abuse;

• Public sector reform and the resulting impact to service delivery by the police service and partners;

• Challenges presented by the growth and complexity of fraud, cyber crime, criminal innovation and cyber enabled crime, increasingly through the use of smart devices;

• Understanding public expectations and the need to develop opportunities for all those who live, work and those who visit Perth and Kinross, to express their views on policing and crime and contribute too public safety;

• Introduction of new and changes to existing legislation; and

• The threat of terrorism and serious organised crime and their impact on community cohesion.

Page 75 of 234

3. Policing in Perth and Kinross

Locality policing is designed to ensure local police work with local people, the community and other public and third sector services to ensure the most vulnerable are protected and to contribute towards building stronger communities.

A legislative framework through the Police and Fire Reform Act 2012 and Community Empowerment Act 2015 place a statutory obligation on the Police and other public sector bodies to work together.

Having taken account of the Scottish Government National Performance Framework and the Police Scotland Strategic Intentions, we aim to:

• Adopt a sustainable operating model to deliver local policing with partners and our communities with a focus on making a positive difference in our communities;

• Utilise evidenced based policing to prevent crime and anti-social behaviour;

• Recognise and deal with vulnerability, working with others to ensure that vulnerable people and victims are safe and supported in their communities;

• Encourage and respond to feedback from the public through your view counts, customer satisfaction surveys and independent critical friends including the National Independent Strategic Advisory Board (NISAG); and

• Ensure commitment to equality and diversity, promoting respect and cohesion within communities, creating an environment that allows communities to participate and flourish.

In Perth and Kinross the Local Area Commander, a Chief Inspector has responsibility for the overview of the operating model and delivery of local policing on a day to day basis. They will have access to uniformed officers, detectives and road policing officers, who are responsible for patrolling, investigating local crime, gathering intelligence, attending and supporting local events, working with local communities and responding to their concerns. They are supported by volunteers such as special constables and police scotland youth volunteers and will work in conjunction with community wardens and street pastors.

Page 76 of 234 In addition the Perth and Kinross co located Community Safety Hub will continue to build upon its effectiveness through improved working with local people, partner agencies and third sector organisations. By focusing on local problem-solving they will work with others to prevent offending and reduce reoffending, to in time reduce the costs and demand for services, with the aim of protecting the people and places most at risk.

Their local activities will be supported and complemented by specialist teams with expertise in areas such as serious crime, search, community resilience, event planning, counter-terrorism, forensic investigation, communications, armed police and public order who operate not only across Perth and Kinross but, where appropriate, nationally and internationally.

4. Police Objectives

Putting victims at the heart of what we do

Integrity, Tackling Protecting Fairness crime and vulnerable anti-social people and Respect behaviour

Maintaining public safety

Page 77 of 234 These objectives lie at the heart of the Perth and Kinross local policing plan and are built around our values of Integrity, Fairness and Respect. By working with local people and the community we will work towards better outcomes for people and communities.

The objectives have been formulated after listening to the views of people through consultation with the public, key statutory and third sector organisations across Perth and Kinross and have been developed in conjunction with the Local Outcome Improvement Plan which will strive to reduce inequalities, improve community safety and public protection.

Policing is complex, it is not possible, to specify every public concern in this plan, or all the activities undertaken by Police, partners and other agencies in Perth and Kinross, therefore the plan will focus on what we know and what you and partners have told us. By working with partners we need to determine how best to make an impact, whilst remaining flexible, in order to take account of issues that are specific to particular places whilst responding to changing circumstances.

4.1 Putting victims at the heart of what we do Working with local people, partner and third sector agencies to:

• Be open, responsive and accountable to victims, witnesses and communities, giving them an effective voice and working to develop new ways to meet their needs, such as a better understanding of cultural and diversity requirements;

• Ensure that victims, witnesses and communities get the help and support they need, when they need it from the most relevant agencies;

• Build confidence amongst victims and witnesses to report their experiences by providing and promoting accessible services; and

• We will take steps to support and protect victims and where possible protect them from repeat victimisation, intimidation or retaliation.

The How

Prevention – Through on going education and engagement we will raise the awareness of crimes including bogus callers, scams, on line sexual exploitation and distribution of indecent images. We will work with others to raise awareness of Safe Places and Internet Safety.

Intelligence / Intervention – When appropriate we will share information with partners and promote awareness of the Disclosure Scheme Domestic Abuse Scotland 'Claires Law' and third party reporting mechanisms and we will gather and develop intelligence and use it to tackle and highlight emerging threats and trends.

Page 78 of 234 Communication – To support victims we will consider where and when to interview and where appropriate, deploy specialist officers such as Sexual Offence Liaison Officers and Domestic Abuse Liaison Officers. We will work closely with partners and use Joint Investigative Interview trained officers for serious crimes linked to children and young people. We will make use of Appropriate Adults and Interpreter Services when required and will deal with your concerns and when necessary raise these with partners including Crown Office and Procurator Fiscal Service.

Enforcement – We will target repeat perpetrators and when appropriate utilise the Domestic Abuse Investigation Unit, Offender Management Unit, Divisional Rape Investigation Unit, Public Protection Unit, CID and national resources including the Domestic Abuse Task Force and National Child Abuse Investigation Unit.

Page 79 of 234 4.2 Tackling crime and anti-social behaviour Working with local people, partner and third sector agencies to:

• Prevent, reduce and solve crime and anti-social behaviour;

• Focus on the specific offences and offenders that cause the greatest harm;

• Reduce offending and re-offending by understanding and addressing factors that can lead to and aggravate criminal behaviour;

• Work to reduce the impact of crimes and behaviours that cause greatest harm to communities and individuals; and

• Identify, understand and tackle emerging threats.

The How

Prevention – We will work collaboratively to educate, inform and guide people towards positive alternatives to criminality, through education and training initiatives, such as 'Safe Drive Stay Alive', 'Mentors in Violence' and 'Safe Taysiders'.

Intelligence / Intervention – We will seek and gather information and intelligence and when appropriate, share this with partners to ensure early and effective intervention. We will be visible in our communities and support victims through the criminal justice process.

Communication – Through the Community Safety Hub, when appropriate, we will share information to identify vulnerability and by working with others reduce threat, risk and harm to individuals and communities.

Enforcement – Where appropriate, we will seek alternatives to criminalisation using a variety of options such as anti social behaviour orders, fixed penalty notices, police recorded warnings and when proportionate utilise diversionary activities.

Page 80 of 234

4.3 Protecting vulnerable people Working with local people, partner and third sector agencies to:

• Recognise and identify the factors that can lead to individuals and groups being at risk of becoming victims;

• Identify, protect and support individuals and groups at greatest risk;

• Improve our investigations into missing people and enhance our support to individuals and families; and

• We will make it easier for victims of crime to get help and support.

The How

In Perth and Kinross we will focus upon domestic abuse, child sexual exploitation, other sexual offences including the distribution of indecent images, those suffering from poor health (including mental ill health), hate crime, child sexual abuse, missing people and those affected by drug, substance or alcohol misuse and financial harm.

Prevention – When appropriate we will share information with partners to reduce the volume and frequency of looked after young persons and those suffering mental ill health going missing. As Corporate Parents we pledge to listen to young people and through the Childrens' Services Plan continue to embed the Getting It Right For Every Child (GIRFEC) approach in Perth and Kinross. We will contribute and play a key part in a range of public protection partnerships including Alcohol and Drugs Partnership, to seek solutions, ensure continuous improvement and support joint problem solving.

Intelligence / Intervention – Work with other agencies including DVLA, Immigration Enforcement, HMRC, Trading Standards and the Gangmasters Licensing Authority to support local and national initiatives to disrupt criminal activity.

Communication - Raise awareness of scams, reporting through education and media, including social media, and by increasing awareness of 3rd party reporting to make it easier for individuals to report crime.

Enforcement - We will seek to use all criminal justice measures at our disposal, including taking people into custody, using banning orders, exclusion orders, robust police undertaking conditions, seek relevant bail conditions, including curfews and use perpetrator management plans and anti social behaviour legislation.

Page 81 of 234

4.4 Maintaining public safety Working with local people, partner and third sector agencies to:

• Prevent, reduce and solve serious crime;

• Identify and deal with the problems caused by organised crime groups, ensuring that local people are aware of the impacts on their community;

• Contribute fully to the CONTEST strategy in respect of terrorism locally, across the region, nationally and internationally;

• Manage civil emergencies, major incidents, natural disasters, major events such as large public gatherings and protect the roads and public spaces of Perth and Kinross;

• Identify, understand and contribute to tackling emerging threats to safety, such as cyber enabled crime;and

• Through education and enforcement maximise safety on the road network for all users.

The How

Prevention – Through the Perth and Kinross Resilience Planning Group we will ensure that the response to civil emergencies and major events is comprehensive, coordinated and effective, testing contingency plans where appropriate and working with others to bring together key agencies through Tayside Local Resilience Partnership.

Intelligence / Intervention – Use intelligence and work in partnership with other law enforcement agencies to disrupt criminal enterprises and seize criminal assets and carry out intelligence led operations.

Communication – Establish and maintain services through the promotion of a mature approach to partnership working.

Page 82 of 234 Enforcement – From analysis and community concerns, target those using the road network for criminality. Execute search warrants for property, drugs and proceeds of crime.

5 Accountability

• Ensure that policing services are accessible and responsive to the needs of the community. When using police powers, ensure that they are used fairly and proportionately and people are treated with dignity and respect and that our staff are aware of Equality, Diversity, Human Rights and our Code of Ethics and our Values;

• Care for the well-being of police officers, police staff, special constables and volunteers, acknowledging the impact of increasing pressure on resources and the extraordinary and ever changing challenges they face. This includes supporting staff to ensure they receive due recognition for the personal sacrifices they make to protect society and help to keep people safe; and

• Strengthen the openness, integrity and accountability of policing by maintaining the effectiveness of the complaints system, ensuring that concerns and or complaints are addressed robustly with sensitivity and transparency .

Our Aim

Community Safety and Public Protection Committee

Page 83 of 234 The Divisional Commander for Tayside Division supported by the Perth and Kinross Local Area Commander will attend the Community Safety Committee and be held to account by the Committee in respect of policing in Perth and Kinross.

Going Forward

Police Scotland has launched a project to look at how we will deliver policing in the future. The current focus is around how services will be delivered and prioritised whilst ensuring that the Police Scotland workforce has the necessary skills and capabilities, and that both are supported by good information and technology, to meet future demands. To have your say go to ' Your View Counts' (http://www.scotland.police.uk/about-us/decisionmaking/public-consultation/localpolicing-consultation 6. Want To Know More

Page 84 of 234

Community Empowerment Act ( http://www.gov.scot/Topics/People/engage/CommunityEmpowermentBillFAQs )

Police and Fire Reform Act (http://www.legislation.gov.uk/asp/2012/8/enacted )

Community Justice Scotland Act ( http://www.gov.scot/Resource/0048/00486212.pdf )

Police Scotland (http://www.scotland.police.uk )

7. Structure Perth and Kinross Local Policing Area

Perth & Kinross Area Commander

Community Hub

Community Team Community Team Community Team Serving Serving Serving Perth North Perthshire South Perthshire

Localities in Perth and Kinross have been identified by taking cognisance of partnership, communities and demand for policing. Each locality will have a Locality Plan which will detail how staff and officers in Perth and Kinross will deliver on the objectives laid out in this plan and will focus upon the key issues and concerns specific to the individual localities / areas.

Further information regarding the areas covered by each locality and their plans can be found Link ( http://www.scotland.police.uk )

Page 85 of 234

7.1 Local Contact Details

Telephone Number 101 – for all non emergencies / 999 – In case of an Emergency

Details on how to use Text Relay can be found at; (http://www.scotland.police.uk/contact-us/british-sign-language )

You can email us or via Contact Us: (http://www.scotland.police.uk/contact-us/contact-us-form ) this option should not be used to report crime.

Have your say about policing in your area, 'Your View Counts' : (http://www.scotland.police.uk/about-us/decisionmaking/public- consultation/localpolicing-consultation )

Your local Community Teams can be contacted via group email addresses to discuss non urgent local policing issues or concerns. It is not a mechanism for reporting crime.

[email protected]

Page 86 of 234 [email protected]

[email protected]

You can provide information about a crime or criminal activity anonymously - Crime Stoppers 0800 555 111 http://www.crimestoppers-uk.org

Follow us on Facebook, Twitter , For Police Scotland Youth Volunteers, Recruitment, Police Constables and Special Constables : http://www.scotland.poice.uk/recruitment/

Page 87 of 234

Page 88 of 234 8 (17/196) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Community Justice in Perth and Kinross

Report by Executive Director (Housing and Community Safety)

PURPOSE OF REPORT

This report provides an update for the Committee in respect of the ongoing redesign of Community Justice in Perth and Kinross and on the recent publication of reconviction rates by Scottish Government.

1. BACKGROUND/MAIN ISSUES

1.1 The Community Justice (Scotland) Act 2016 was passed by the Scottish Parliament last year. The purpose of the Act is to establish a new model for the local governance and delivery of Community Justice in Scotland.

1.2 The Act dissolved Community Justice Authorities (CJAs) with effect from 1 April 2017 and replaced them with Community Justice Partnerships in each of the 32 local authority areas in Scotland.

1.3 The Act defines Community Justice and who the Statutory Partners are. It requires the Statutory Partners to:-

• focus on improving community justice outcomes locally • publish a community justice outcomes improvement plan • publish a Participation Statement on their engagement with third sector and communities as part of the community justice planning process • review plans periodically • take account of the National Strategy for Community Justice when developing their plan and the Local Outcomes Improvement Plan (LOIP) when developing their own plan • annually report progress against the plan using the national outcomes for community justice outlined in the National Performance Framework

1.4 The statutory partners for community justice as outlined in the Act are:-

• Chief Constable of Police Scotland • Health Boards • Integration Joint Boards for Health and Social Care • Local Authorities • Scottish Courts and Tribunals Service

Page 89 of 234 • Scottish Fire and Rescue Service • Scottish Ministers (i.e. Scottish Prison Service, Crown Office & Procurator Fiscal Service) • Skills Development Scotland

1.5 At its meeting on 24 February 2016 the Council approved the establishment of a shadow Community Justice Partnership to ensure the development of the necessary arrangements for the changeover from CJAs to the local Community Justice Partnership in 2017 ( Report No.16/73).

1.6 Whilst the Act states that Community Justice Partnerships are only answerable to the statutory partners own governance arrangements, the Perth and Kinross Community Planning Partnership has agreed that the Community Justice Partnership should be part of the local community planning process and will report through it. Most Community Justice Partnerships in Scotland are being positioned in local Community Planning Partnerships and the Scottish Government considers this to be best practice.

1.7 On 24 November 2016 the Cabinet Secretary for Justice launched the National Community Justice Strategy and the Outcomes and Improvement Framework for Community Justice.

1.8 These documents are available at :- http://www.gov.scot/Publications/2016/11/5600

2. NATIONAL COMMUNITY JUSTICE STRATEGY

2.1 The National Strategy provides a vision for community justice in Scotland - ‘Scotland is a safer, fairer and more inclusive nation where we:-

• Prevent and reduce further offending by addressing its underlying causes • Safely and effectively manage and support those who have committed offences to help them reintegrate into the community and realise their potential for the benefit of all citizens’

Page 90 of 234 2.2 The Strategy has seven outcomes which are show in the diagram below:-

Structural Person-centric Outcomes Outcomes What we deliver as partners Changes to Users

Communities improve their understanding and participation Life chances are improved in community justice through needs, including health, financial inclusion, housing and safety being addressed.

Partners plan and deliver services in a more strategic and collaborative way People develop positive relationships and more opportunities to participate and Effective interventions are contribute though education, delivered to prevent and reduce employment and leisure activities the risk of further offending

People have better access to the Individuals resilience and capacity services they require, including for change and self-management welfare, health and wellbeing, are enhanced housing and employability

2.3 In addition there are four priorities identified in the National Strategy:-

• Improved community understanding and participation • Strategic planning and partnership working • Effective use of evidence-based interventions • Equal access to services

2.4 The National Strategy is set for a five-year period but can be refreshed by Scottish Ministers at any time. Statutory partners must give due consideration to the strategy when preparing their community justice plans.

3. RECONVICTION RATES

3.1 The National Community Justice Strategy includes reducing offending as one of its seven outcomes. Reducing reoffending remains one of the 12 priority areas for action in the Scottish Government’s Justice Strategy. Reconviction rates continue to be used as a key measure of progress in achieving this

Page 91 of 234 reduction. Reducing reconviction rates is therefore one of the Scottish Government’s National Indicators in the National Performance Framework.

3.2 In May 2017, the Scottish Government published its annual reconviction rate data. The data concerned the 2014-15 cohort of offenders and their rates of reconviction within a follow-up period of one year after their original conviction.

3.3 The reconviction rate data is published in relation to Local Authority Groups, rather than Local Authorities. Local Authority Groups are approximate areas based on where the courts of the offender’s index convictions are located, including High Courts. As some sheriff court boundaries include more than one Local Authority area, there are 25 Local Authority Groups. The Scottish Government data measures reconviction rates using two measures of reconviction. These are ‘reconviction rate’ and ‘average number of reconvictions per offender.’

3.4 However, it is acknowledged that this measure is not sensitive enough to detect individual-level progress as a result of interventions and programmes which may have been successful in reducing the number of reconvictions, but not complete desistance from crime by an offender. Therefore, a second measure of reconviction, ‘average number of reconvictions per offender’ is also used.

3.5 The ‘average number of reconvictions per offender’ is a measure of the number of times offenders in a cohort who were given a non-custodial sentence or were discharged from custody were reconvicted within one year from the date of their index conviction. For example, if the average number of reconvictions per offender was 0.50, this would mean that on average, offenders have half a reconviction in the one year follow up period. As this measure is an average, this figure will include some offenders who have no reconvictions and some offenders who have multiple convictions.

3.6 There were 1092 offenders in the 2014-15 Perth and Kinross cohort who were discharged from custody or given a non-custodial sentence and who were reconvicted within one year of their index conviction, giving a reconviction rate of 21.5%. This means that just over one-fifth of offenders whose index convictions were located in Perth and Kinross were reconvicted at least once in the year following their index conviction.

3.7 The average of number of reconvictions for Perth and Kinross for the same offender cohort is 0.34. This means that on average, offenders had one-third of a reconviction in the one year follow-up period. As this measure is an average, this figure includes some offenders who had no reconvictions in the one year follow-up period and some offenders who had multiple reconvictions.

3.8 The reconviction rate and the average number of reconvictions per offender for Scotland are both at their lowest for 18 years. Since 2005-06, the reconviction rate for Scotland has fallen by 4.3 percentage points, from 32.5% to 28.2% and the average number of reconvictions per offender has fallen by

Page 92 of 234 0.10, from 0.60 to 0.50. The rates of reconviction in Perth and Kinross are also at their lowest for 18 years and are now consistently lower than the rates for Scotland. For Perth and Kinross, the reconviction rate has fallen 12.1 percentage points since 2005-06, from 33.6% to 21.5% and the average number of reconvictions has fallen by 0.30, from 0.64 to 0.34.

40 35 30 25 20 15 Scotland 10 P&K Reconviction (%) Rate 5 0

Offender cohort

Figure 2. Reconviction rate 2005-06 to 2014-15 for Perth and Kinross Local Authority group and Scotland

3.9 As Perth and Kinross has a relatively small number of offenders and reconvictions, small changes in the number of offenders or number of reconvictions can lead to changes in measures of reconviction. However, as Figure 2 highlights, the overall trend for Perth and Kinross since 2005-06 is one of a reducing reconviction rate and average number of reconvictions.

3.10 Reconviction data is often used to rank Local Authority Groups according to their performance. Using this approach, data for the 2014-15 cohort of offenders sees Perth and Kinross ranked as the 4 th best performing Local Authority Group of the 25. This suggests that differences between Local Authority Groups are the result of variations in practice. However, this approach is misleading as it fails to account for differences between Local Authority Groups that are attributable to the characteristics of offenders, such as the number of previous offences, sentence length, gender and age. A more sophisticated analysis of the data using a technique that takes account of these differences in characteristics suggests that differences between reconviction rates for Local Authority Groups are primarily attributable to the characteristics of offenders rather than differences in performance between the groups.

4. OUTCOMES, PERFORMANCE AND IMPROVEMENT FRAMEWORK

4.1 Measuring reconviction rates alone do not provide an insightful indication of performance. Therefore, a Community Justice Outcomes, Performance and

Page 93 of 234 Improvement (OPI) Framework has been introduced. The OPI is intended to provide community justice partners and Community Justice Scotland with opportunities to measure progress, drive improvement, offer consistency and transparency and link decisions and actions to analysis of need and what works, leading to increased efficiency and effectiveness. It is not intended as a simple performance management tool but as a means to provide community justice partners with the information they need to focus efforts on the improvements that matter to their local areas. It is intended to allow community justice partners and Community Justice Scotland to report on achievements as well as identify issues and blockages and evaluate the impact of services on personalised outcomes.

4.2 The OPI identifies:-

• 31 Improvement Actions for the 4 Priorities • 6 Principles (3 Quality Ambitions – 3 Quality Principles) • 27 common indicators

5. COMMUNITY JUSTICE SCOTLAND

5.1 A new body, Community Justice Scotland came into being on 1 April 2017. It will work closely with statutory community justice partners, the third sector and a range of other parties to provide support and leadership for community justice. The body will bring enhanced opportunities for innovation through the establishment of a Hub for the promotion of Learning and Development. It will also provide assurance to Scottish Ministers and Local Government Leaders on the delivery of improved outcomes for community justice and provide improvement support as required.

5.2 Community Justice Scotland is required to publish an annual report on performance in relation to National Community Justice Outcomes. As part of this Community Justice Scotland may make improvement recommendations to the statutory partners at any time. The statutory partners will be required to take account of these when they review their own performance against their plan and report on progress achieved or where progress is still to be achieved.

6. LOCAL ARRANGEMENTS

6.1 A Shadow Perth and Kinross Community Justice Partnership, under the chairmanship of ex-Councillor Archie MacLellan, was established in 2016 to develop the Community Justice Outcomes Improvement Plan.

6.2 In addition to the statutory partners Perth and Kinross Association of Voluntary Service (PKAVS) was co-opted as a member of the partnership. Discussions are being held with groups representing victims and people with lived experience of the community justice system to also be co-opted.

6.3 To assist in its completion of the plan there were a number of activities which took place:-

Page 94 of 234 • Gaps Analysis • Self-Evaluation with Statutory Partners • Community Consultation • Consultation with the Third Sector

6.4 From the discussion in respect of the information from the gaps analysis and the self-evaluations carried out by the partners the following priority areas were identified:-

• Employment • Housing • Health (including mental health and substance misuse) • Victims • Women who offend • Family Relationships • Males who offend

6.5 The Shadow Partnership developed a Community Justice Outcomes Improvement Plan which is attached at Appendix 1.

6.6 Improvement actions in the plan have been linked to the 7 outcomes required by the national strategy and the indicators from the OPI Framework.

6.7 The Community Justice Partnership will meet in its established form on 16 June 2017.

6.8 Whilst the Tayside Community Justice Authority has been dissolved there are still close links with community justice colleagues in Dundee, Angus and Fife. A series of meetings have been programmed to ensure that good practice can be shared and, where appropriate, joint services commissioned.

7. CONCLUSION AND RECOMMENDATION(S)

7.1 The new model for Community Justice, underpinned by the Community Justice (Scotland) Act 2016, will transform the community justice landscape to bring a local perspective to community justice. It will provide opportunities for services and communities to work together to improve the overall outcomes for those who are or have been in the criminal justice system.

7.2 It is recommended that the Committee:-

I. Note the contents of this report II. Endorse the Perth and Kinross Community Justice Outcomes Improvement Plan

Page 95 of 234 Author(s)

Name Designation Contact Details John Irons Community Justice Co- [email protected] ordinator 01738 475000

Charlie Cranmer Community Justice [email protected] Improvement Team Leader 01738 475000

Approved Name Designation Date Bill Atkinson Interim Executive Director 19 May 2017 (Housing & Community Safety)

Page 96 of 234 ANNEX

1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

The undernoted table should be completed for all reports. Where the answer is ‘yes’, the relevant section(s) should also be completed. Where the answer is ‘no’, the relevant section(s) should be marked ‘not available (n/a)’.

Strategic Implications Yes / None Community Plan / Single Outcome Agreement Yes Corporate Plan Yes Resource Implications Financial None Workforce None Asset Management (land, property, IST) None Assessments Equality Impact Assessment None Strategic Environmental Assessment None Sustainability (community, economic, environmental) None Legal and Governance None Risk None Consultation Internal None External None Communication Communications Plan None

1. Strategic Implications

Community Plan / Single Outcome Agreement

1.1 The recommendation in this report will assist in the delivery of both the Perth and Kinross Community Plan and Single Outcome Agreement in respect of the following local outcomes:

(i) Developing educated, responsible and informed citizens (iii) Promoting a prosperous, inclusive and sustainable economy (iv) Supporting people to lead independent, healthy and active lives (v) Creating a safe and sustainable place for future generations

Corporate Plan

1.2 The Councils Corporate Plan 2013 – 2018 lays out five strategic objectives which provide clear strategic direction, inform decisions at a corporate and service level and shape resources allocation. The relevant strategic objectives in respect of this report are as follows:

Page 97 of 234 (ii) Developing educated, responsible and informed citizens; (iii) Promoting a prosperous, inclusive and sustainable economy; (iv) Supporting people to lead independent, healthy and active lives; and (v) Creating a safe and sustainable place for future generations.

2. Resource Implications

Financial

2.1 This report contains no proposals which would have a financial impact on the Council.

Workforce

2.2 There are no workforce implications arising from this report.

Asset Management (land, property, IT)

2.3 There are no Asset management implications arising from this report.

3. Assessments

Equality Impact Assessment

3.1 Under the Equality Act 2010, the Council is required to eliminate discrimination, advance equality of opportunity, and foster good relations between equality groups. Carrying out Equality Impact Assessments for plans and policies allows the Council to demonstrate that it is meeting these duties.

This section should reflect that the proposals have been considered under the Corporate Equalities Impact Assessment process (EqIA) with the following outcome:

(i) Assessed as not relevant for the purposes of EqIA

Strategic Environmental Assessment

3.2 The Environmental Assessment (Scotland) Act 2005 places a duty on the Council to identify and assess the environmental consequences of its proposals. However, no action is required as the Act does not apply to the matters presented in this report. This is because the Committee are requested to note the contents of the report only and the Committee are not being requested to approve, adopt or agree to an action or to set the framework for future decisions.

Sustainability

3.3 There are no issues in respect of sustainability from the proposals in this report.

Page 98 of 234 Legal and Governance

3.4 This report contains no proposals which would have a legal or governance impact on the Council.

Risk

There are no issues in respect of risk from the proposals in this report.

4. Consultation

Internal

4.1 None.

External

4.2 None.

5. Communication

5.1 There are no communication issues in respect of the proposals in this report.

2. BACKGROUND PAPERS

2.1 None.

3. APPENDICES

3.1 Appendix I – Perth and Kinross Community Justice Improvement Plan

Page 99 of 234 PERTH AND KINROSS COMMUNITY JUSTICE PARTNERSHIP

OUTCOMES IMPROVEMENT PLAN 2017 - 2020

Page 100 of 234 BACKGROUND

The Scottish Government’s Vision for Community Justice -

Scotland is a safer, fairer and more inclusive nation where we:-

The delivery of Community Justice services in Perth and Kinross has a strong history of success.

The Community Justice (Scotland) Act 2016 was passed by the Scottish Parliament last year. The purpose of the Act is to establish a new model for the governance and delivery of Community Justice in Scotland.

The Act dissolves Community Justice Authorities (CJAs) with effect from 1 April 2017 and replaces them with Community Justice Partnerships in each of the 32 local authority areas in Scotland.

The Act defines Community Justice and who the Statutory Partners are. It requires the Statutory Partners to:-

The statutory partners for community justice as outlined in the Act are:-

• Chief Constable of Police Scotland • Health Boards • Integration Joint Boards for Health and Social Care • Local Authorities • Scottish Courts and Tribunals Service • Scottish Fire and Rescue Service • Scottish Ministers (i.e. Scottish Prison Service, Crown Office & Procurator Fiscal Service) • Skills Development Scotland

Page 101 of 234 Whilst the Act states that Community Justice Partnerships are only answerable to the statutory partners own governance arrangements, the Perth and Kinross Community Planning Partnership has agreed that the Community Justice Partnership should be part of the local community planning process and will report to it.

On 24 November 2016 the Cabinet Secretary for Justice launched the National Community Justice Strategy. In addition two other documents:-

• Guidance for Community Justice Partners • Outcomes and Improvement Framework for Community Justice were published

NATIONAL COMMUNITY JUSTICE STRATEGY

The National Strategy provides a vision for community justice in Scotland - ‘Scotland is a safer, fairer and more inclusive nation where we:-

Community Justice is defined in the draft Strategy as:-

‘the collection of individuals, agencies and services that work together to support, manage and supervise people who have committed offences, from the point of arrest, through prosecution, community disposal or custody and alternatives to these, until they are reintegrated into the community. Local communities and the third sector are a vital part of this process which aims to prevent and reduce further offending and the harm that it causes, to promote desistance, social inclusion, and citizenship’.

Page 102 of 234 The Strategy will has seven outcomes which are show in the diagram below:-

Structural Person-centric Outcomes Outcomes What we deliver as partners Changes to Users

Communities improve their understanding and participation Life chances are improved in community justice through needs, including health, financial inclusion, housing and safety being addressed.

In addition there are four priorities identified in the National Strategy:-

Improved community understanding and participation – this section is focussed on increasing awareness of community justice issues to improve understanding and reduce stigma; as well as strengthening participation in the planning, delivery and evaluation of community justice services and policy.

Strategic planning and partnership working – the new model for community justice requires a wide range of statutory and non-statutory partners to work together to improve community justice outcomes. This section of the strategy focuses on how to ensure these partners work together effectively, that there is a strong leadership at national and local level, resources are used strategically, and that there is a well-trained and effective community justice workforce.

Effective use of evidence-based interventions – this section recommends improvement actions to ensure the delivery of effective, evidence-based

Page 103 of 234 interventions at all appropriate points in the community justice system, as well as adopting a person-centred approach, tailored to meet the differing demands of specific groups and focused on getting people into support.

Equal access to services – this section is focused on ways to make equal access to services a reality and to ensure that people who have committed offences and their families have equal access to the services that will help them to desist from offending such as health, housing and welfare.

The National Strategy is set for a five-year period but can be refreshed by Scottish Ministers at any time. Statutory partners must give due consideration to the strategy when preparing their community justice plans.

GUIDANCE FOR LOCAL PARTNERSHIPS

This guidance specifies who the statutory partners are and outlines their roles in relation to the new model for community justice. It is intended to provide support and advice to the statutory partners in the development of their community justice outcomes improvement plan for the local authority area as required by the Act as well as to wider community justice partners and stakeholders.

The guidance also outlines the requirements for a publication of a Participation Statement as part of the plan approach. It can be published as part of the plan or separate to the plan. The Participation Statement will allow the statutory partners to identify how they have consulted and engaged with the third sector involved in community justice and relevant local community bodies in the preparation of the plan.

One of the key building blocks of the new model is collaborative working. The statutory partners must work together to prepare, publish and annually report on the plan for the local authority area in relation to the performance framework and national strategy for community justice. It also reinforces the statutory partners’ joint responsibility for the preparation, implementation and review of the plan.

OUTCOMES, PERFORMANCE AND IMPROVEMENT FRAMEWORK

The Outcomes, Performance and Improvement (OPI) Framework is intended to provide community justice partners and Community Justice Scotland with opportunities to measure progress, drive improvement, offer consistency and transparency and link decisions and actions to analysis of need and what works, leading to increased efficiency and effectiveness. It is not intended as a simple performance management tool but as a means to provide community justice partners with the information they need to focus efforts on the improvements that matter to their local areas. It is intended to allow community justice partners and Community Justice Scotland to report on achievements as well as identify issues and blockages and evaluate the impact of services on personalised outcomes.

Page 104 of 234

The OPI identifies:-

• 31 Improvement Actions for the 4 Priorities • 6 Principles (3 Quality Ambitions – 3 Quality Principles) • 27 common indicators

Key to the development of the 27 common indicators has been striking the correct balance to ensure that statutory Community Justice Partners demonstrate the achievement of outcomes to communities and their lines of accountability. In addition, there will be assurance provided across Scotland by Community Justice Scotland while ensuring that this does not become a major data collection exercise.

The following types of indicator have been developed:-

Quantitative : those which require statistical data and analysis. If something is defined as a common indicator here, it must be measured consistently and robustly across local areas. We also need to be clear that some measures will be contextual due to issues of attribution.

Change and impact: affords the opportunity to show activity that has been carried out, what this has meant for the local area, the impact of the activity, the resultant change, user and community views; leading to the sharing of good practice. Undertaking the activity is not an end in itself but a precursor to achieving an improved outcome. Partners should consider and measure the improvement, the movement for the service or individual, the impact and the change for people and communities brought about as a result of the activity. The ‘5 Step Approach to Evaluation’ explains this in more depth.

Contextual information : contextual drivers, including those of demand, to guide planning rather than direct indicators of performance.

The starting point is that all indicators must be used. However, where statutory Community Justice Partners for an area collectively identify that a particular indicator is not relevant for them at that point in time, they must specify their reasons for this conclusion in their Community Justice Outcomes Improvement Plan.

Where Partners choose not to report on a common indicator the partners must specify in their plan why they feel it does not apply in their area. Partners may also indicate that they will not report on a common indicator on the ground that it is irrelevant for their area.

Partners may identify additional locally determined outcomes (and associated indicators), targets and initiatives as they consider appropriate based on the profile and needs of the local area.

Page 105 of 234 When providing evidence against the indicators, there must be examples of both good practice and examples where lessons can be learned to effect improvement.

COMMUNITY JUSTICE SCOTLAND

A new body, Community Justice Scotland has been established. It will work closely with statutory community justice partners, the third sector and a range of other parties to provide support and leadership for community justice. The body will bring enhanced opportunities for innovation through the establishment of a Hub for the promotion of Learning and Development. It will also provide assurance to Scottish Ministers and Local Government Leaders on the delivery of improved outcomes for community justice and provide improvement support as required.

GOVERNANCE

Perth & Kinross Community Plan/Single Outcome Agreement 2013- 2023 clearly describes how the Community Planning Partnership will achieve our shared ambition for excellence.

The plan sets out five strategic objectives:-

• Giving every child the best start in life • Developing educated, responsible and informed citizens • Promoting a prosperous, inclusive and sustainable economy • Supporting people to lead independent, healthy and active lives • Creating a safe and sustainable place for future generations

It further states the following ambition:-

“Ensuring that Perth and Kinross is a place where everyone enjoys a pleasant and safe environment is important to the wellbeing of communities. Everyone has the right to live in safe and secure environment, where they feel protected and able to go about their business without fear of crime. Action to prevent and reduce crime and anti-social behaviour, accident prevention and protecting children and vulnerable adults are vital to the wellbeing of our communities. In addition to safety, our communities benefit from having a beautiful natural environment around them which is one of the most significant assets of Perth and Kinross, and we have a responsibility to protect and enhance it. We also have a duty to act locally in making a positive contribution towards the wider environment by reducing the effects of climate change.”

The reduction of inequality is in inherent part of the Plan/SOA.

Community Justice in Perth and Kinross is set within the established Community Planning arrangements and will report through them.

A Community Justice Partnership has been established chaired by an elected member of the Council in the first instance. All eight statutory partners are

Page 106 of 234 represented around the table. In addition to the statutory partners Perth and Kinross Association of Voluntary Service (PKAVS) have been co-opted as a member of the shadow partnership. Discussions are being held with groups representing victims and people with lived experience of the community justice system to also be co-opted. This group will work alongside and with the established Community Safety Partnership as many of their aims and objectives are shared.

KEY FACTS Perth and Kinross – Community Justice Area Profile

General Information The population of Perth and Kinross in 2015 was 149,930. This is an increase of 0.7% from the previous year. The population of Perth and Kinross is expected to grow. By 2039, the population is projected to be 167,087. This is an increase of 12.2% when compared with 2014.

The population of Perth and Kinross is older than the national average. Those aged 60 and over make up 28.9% of the population compared with 24.2% in Scotland. By 2039, the age group that is projected show the largest increases is the 75 and over age group. This mirrors projections for Scotland as a whole.

Data from the 2011 National Census shows that the majority of the population of Perth and Kinross were identified as White Scottish (81.8%). Another 11.3% were identified as either White-British or White-Irish resulting in a British white population of 93.9%.

Perth and Kinross is divided into 5 localities, each with their own Locality Action Partnership and Locality Action Plan. The localities are Eastern Perthshire (Carse of Gowrie, Strathmore, Blairgowrie and the Glens), Highland and Strathtay, Strathearn and Strathallan, Perth City, and Kinross- shire and Almond & Earn. Crime Picture

Recorded crime

2010 - 2011 - 2013 - 2014 - Crime Group 2012-13 11 12 14 15 Group 1: Non-sexual crimes of 162 140 141 127 90 violence 114 Group 2: Sexual Crimes 105 169 209 261

Group 3: Crimes of dishonesty 2887 2727 2615 2360 2478 Group 4: Fire-raising, 1225 1060 980 852 830 vandalism etc Group 5: Other crimes 1254 1288 1108 1382 1249 Group 1-5: Total crimes 5642 5320 5013 4930 4908 Group 6: Miscellaneous 3,844 2,795 2,983 3,075 2,526 Offences Group 7: Motor offences N/A N/A N/A 6,640 3,142

Page 107 of 234

There has been an overall reduction in recorded crime by 15% in Perth and Kinross over the past 5 years since 2010-11. Crimes of dishonesty account for half (50.5%) of all recorded crime in Perth and Kinross with other crimes including breach of the peace the second most common (25.5%) recorded crime type. Crimes of fire-raising, vandalism etc account for 16.9% of all crimes in Perth and Kinross. Sexual crimes account for 5.3% of crimes and non-sexual crimes of violence account for the remaining 1.8% of all crimes.

Despite the general overall reduction in recorded crime, this reduction is not consistent across all crime types over the same period. For example, while crimes of fire-raising, vandalism etc have shown consistent year-on-year reductions, sexual crimes have increased on a year-on-year basis.

During the same time period the picture for Scotland overall is one of a consistent, year-on-year reduction in crime, falling by 21% since 2010-11. As with Perth and Kinross, crimes of dishonesty are the most common crime type (49.5%) while non-sexual crimes of violence are the least common (2.5%). Similar to Perth and Kinross, sex crimes have showing a year-on-year increase while crimes of fire-raising, vandalism etc are showing consistent year-on-year reductions.

Domestic Abuse Incidents

2010 -11 2011 -12 2012 -13 2013 -14 2014 -15 PKC 1060 1162 1236 1351 1529 Scotland 55698 59847 60080 58439 59882

Specific incidents recorded by the Police also have consistent patterns across both Perth and Kinross and Scotland as a whole. For example, in Perth and Kinross incidents of domestic abuse are showing a year-on-year increase, from 1060 in 2010-11 to 1529 in 2014-15 whereas in Scotland they have increased from 55698 to 59882 over the same time period. In contrast, incidents of racist abuse show a more variable pattern. Between 2010-11 and 2013-14, incidents in Perth and Kinross initially decreased but have subsequently risen from 81 in 2012-13 to 89 in 2013-14. Across Scotland, incidents initially increased then fell but increased again between 2012-13 and 2013-14. Convictions

Main CJA crime or 2010-11 2011-12 2012-13 2013-14 2014-15 offence All crimes Tayside & 9,669 9,689 8,747 9,093 9,605 offences Scotland 115,575 108,388 101,015 105,626 106,507

Page 108 of 234 Main crime or offence – 2010 - 2012 - 2011-12 2013-14 2014-15 Tayside data 11 13 Group 1: Non-sexual crimes 125 186 119 111 123 of violence Group 2: Sexual crimes 58 68 58 65 84

Group 3: Crimes of 1,967 2,033 1,540 1,355 1,272 dishonesty Group 4: Fire-raising, 310 291 214 235 227 vandalism etc Group 5: Other crimes 1,767 1,810 1,539 1,348 1,553

Conviction data at Tayside CJA level has followed a similar pattern to the Scotland-wide data since 2010-11. This has seen the number of convictions for all crimes and offences initially decrease until 2012-13 and then increase from 2013-14. This pattern is not consistent across all crime types however. For example, Crimes of Dishonesty initially increased but have then fallen consistently since 2012-13 whereas Fire-raising, vandalism etc. initially fell, then rose in 2013-14 but fell again in 2014-15. Sentencing

Main crime Community Monetary Absolute CJA Custody RLO DTTO Admonish or offence Order Penalty Discharge Tayside All 1,260 1525 5,222 129 11 1,201 51 crimes & 658 Scotland 13,957 16,809 56,843 1,172 538 16,418 offences

Main crime or offence Community Monetary Absolute Custody RLO DTTO Admonish - Order Penalty Discharge Tayside CJA Group 1: Non- sexual crimes 62 36 6 11 0 7 0 of violence Group 2: Sexual 0 27 44 7 2 0 4 crimes

Group 3: Crimes of 531 256 244 26 9 198 8 dishone sty Group 4: Fire- raising, 44 61 93 2 0 27 0 vandalis m etc Group 5: Other 362 353 492 31 2 302 11 crimes

Page 109 of 234 Sentencing data highlights that a monetary penalty was the most common sentencing option when all crimes and offences are considered together. This is the same for both Tayside CJA and Scotland as a whole. New Custodial Sentences

Over 2 Over 3 Over 6 years 4 Main Average Up to 3 months months to years CJA crime or length of months to 6 to 2 less and offence sentence months years than over 4 years All crimes Tayside & 451 580 351 59 17 228 offences Scotland 4,092 5,225 3,587 616 394 285

Average Over 3 Over 6 Over 2 length Main crime or Up to 3 months months years to 4 years offence - of months to 6 to 2 less than and over Tayside CJA sentenc months years 4 years e Group 1: Non- sexual crimes - 5 38 15 3 653 of violence Group 2: Sexual crimes - 5 11 3 8 876

Group 3: Crimes of 175 240 102 12 2 181 dishonesty Group 4: Fire- raising, 12 19 11 1 - 185 vandalism etc Group 5: Other crimes 141 124 73 21 3 222

There are some small differences in the length of custodial sentences that Tayside offenders receive when compared with Scotland are a whole. For example, 31% of Tayside offenders received sentences of up to 3 months in 2014-15. This is compared with 29% of offenders across Scotland. In addition, 40% of Tayside offenders received sentences of between 3 and 6 months whereas 37% of offenders across Scotland received the same lengths of sentence. When considering the main crimes types for Tayside in 2014-15, as would be expected, sexual crimes received the longest average length of sentence with crimes of dishonesty receiving the shortest. The most common sentence for Group 5: Other crimes were sentences of up to 3 months.

Page 110 of 234 Prison Population – June 2013

Imprisonment Men Women All rate per 100,000 population Perth and 159 5 164 133 Kinross Scotland 7,446 437 7,883 179

Figures from 2013 show that the imprisonment rate per 100,000 for Perth and Kinross is lower than the rate for Scotland. Community Payback Orders 2014-15

Local authority Orders per Individuals per area / Number of Number of 10,000 10,000 community Orders Individuals population (1) population (1) justice area

Perth and 454 43.9 381 36.8 Kinross Scotland 19,016 49.7 16,302 42.6

In 2014-15, Perth and Kinross had 454 new Community Payback Orders for 381 individuals. The number of orders made as measured by orders per 10,000 of the population was lower than the number issued in Scotland.

Reconvictions 2013-14

Local Number of offenders Authority Number of offenders Reconviction Rate convicted Group Perth and 912 220 24.1 Kinross Scotland 42,193 11,939 28.3

Local Number of offenders Authority Number of offenders Reconviction Rate convicted Group Perth and 912 376 0.41 Kinross Scotland 42,193 21,570 0.51

There were 912 offenders in the 2013-14 Perth and Kinross cohort who were reconvicted within one year of their index conviction giving a reconviction rate of 24.1%. Perth and Kinross had the 6th best performance for the average number of reconvictions per offender of the 25 areas with 0.41. This figure was 0.10 below the Scotland figure of 0.51 and was the lowest when

Page 111 of 234 compared with the other Tayside LAs. Since 2005-6 performance has steadily improved in Perth and Kinross with a drop in average reconvictions per offender of 0.23. Nationally, the figure has fallen by 0.09.

Perth and Kinross figures were in the top 5 best performing local authority groups for:-

• male offenders • offenders aged 21-25 • offenders aged 26-30 • offenders aged 40+

The lowest performing measures for Perth and Kinross were offenders aged under 21 and crimes of dishonesty which were 14 th and 13 th respectively. Perth and Kinross also has the 7 th best overall average number of reconvictions when compared with the other 24 Local Authority Groups. Perth and Kinross figures were in the top 5 best performing local authority groups for:-

• offenders aged 21-25 • offenders who were given a custodial sentence

The lowest performing measures for Perth and Kinross were offenders aged 31-40 and crimes of dishonesty which were 13 th and 14 th respectively. The reconviction rate and the average number of reconvictions per offender for Scotland are both at their lowest for 17 years. In Perth and Kinross, the reconviction rate has fallen 8.5 percentage points since 2004-05, from 32.6% to 24.1%. Similarly, the average number of reconvictions has fallen by 0.25, from 0.66 to 0.41. Both the reconviction rate and average number of reconvictions have risen slightly for the 2013-14 cohort of offenders by 0.6 percentage points and 0.03 respectively, when compared with the data for the 2012-13 cohort of offenders. While there has been a decrease of 33 in the number of offenders reconvicted since 2012-13, there has been a slight rise in both measures of reconviction. This is attributable to an increase of 20 in the number of reconvictions for the 2013-014 offender cohort. As Perth and Kinross has a relatively small number of offenders and reconvictions, small changes in the number of offenders or number of reconvictions can lead to changes in measures of reconviction. However, the overall trend for Perth and Kinross since 2004-05 is one of a reducing reconviction rate and average number of reconvictions.

Page 112 of 234 Client Profile

A snapshot of clients who are subject to community-based orders highlights that the majority are based in Perth City (Wards 10,11, and 12), are male and aged between 21 and 35.

Location of clients with CJS Community Number of % of total Orders (February 2017) clients Carse of Gowrie, Strathmore, Blairgowrie and 89 19.7% the Glens (Wards 1,2,3) Highland and Strathtay (Wards 4,5) 24 5.3% Strathearn and Strathallan (Wards 6,7) 39 8.6% Kinross-shire and Almond & Earn (Wards 8,9) 24 5.3% Perth City (Wards 10,11,12) 276 60.9% Other LA 1 0.3% England 1 0.3% Total 454 100%

Percentage of Gender Number of clients clients

Male 360 79.3%

Female 94 20.7%

Age Range Male Female 16-17 9 (2.5%) 3 (3.2%) 18-20 38 (10.6%) 12 (12.8%) 21-25 57 (15.8%) 11 (11.7%) 26-30 60 (16.7%) 13 (13.8%) 31-35 60 (16.7%) 10 (10.6%) 36-40 38 (10.6%) 8 (8.5%) 41-45 32 (8.9%) 10 (10.6%) 46-50 23 (6.4%) 14 (14.9%) 51-55 20 (5.6%) 7 (7.5%) 56-60 9 (2.5%) 3 (3.2%) 61+ 13(3.6%) 2 (2.1%) Missing 1 (0.3%) 1 (1.1%) Total 360 94

Analysis of employment information for clients who had a Criminal Justice Social Work Report written about them in 2015-16 highlights that the majority of clients are not employed or not economically active with only 30.9% of clients in employment.

Page 113 of 234

Government Employed/ Unemployed/ Full time sponsored Self- Economically Other Total education training employed inactive scheme

4 (0.7%) 191 (30.9%) 0 408 (65.9%) 16 (2.6%) 619

PRIORITY AREAS

From the discussion in respect of the information from the gaps analysis and the self-evaluations carried out by the partners the following priority areas have been identified and why:

Employment There is a complex interplay between employment, offending and reoffending. Evidence points towards employment status affecting and being influenced by offending. It has also been found to affect other factors linked to offending and reoffending, particularly accommodation and drug and alcohol misuse. Studies have shown that the extent and frequency of offending diminish when offenders gain employment, and offenders with stable and quality employment are less likely to reoffend.

Housing Offenders with accommodation problems have been found to be more likely to reoffend. Access to stable accommodation is important in enabling ex- offenders to access employment and training opportunities, which in turn support their rehabilitation. Accommodation needs can also impact on family relationships and the chances of successful reintegration into the community on release from prison, which are important in reducing reoffending.

Health (including mental health and substance misuse) There are well established links between drug misuse and offending, with a particularly strong link between the use of opiates and acquisitive offending. Problematic alcohol consumption is associated with crime, particularly heavy or binge drinking and violent crime. However the links between alcohol, crime and reoffending are complex: other mediating factors, for example personality disorder, childhood experiences of violence and social/normal norms are likely to play a role in the relationship between alcohol misuses and violent crime.

Victims Discussions with the voluntary sector groups who support victims and witnesses through the criminal justice system have revealed weaknesses in communicating with them during the process which has led to further stress and worry.

Page 114 of 234 Women who offend The Commission on Women Offenders (Angiolini) report in 2012 clearly outlined the reasoning for looking at women who repeatedly offend in a different way from men. It stated “For women who have been repeatedly convicted of committing lower level offences, their offending is often the result of significant underlying issues, such as drug or alcohol addiction and mental health problems, that could be better addressed in the community. Her Majesty’s Inspectorate of Prisons (HMIP) reported in 2007 that 80 per cent of women in Cornton Vale had mental health problems. In another study, 60 per cent of women prisoners said they had been under the influence of drugs at the time of offence. Women offenders themselves are often victims of severe and repeated physical and sexual abuse. The children of women prisoners are also adversely affected. Approximately 30 per cent of children with imprisoned parents will develop physical and mental health problems, and there is a higher risk of these children also ending up in prison. Short-term prison sentences have little or no impact on reoffending, with 70 per cent of women offenders who received a prison sentence of three months or less reconvicted of an offence within two years. Prison is also more expensive than community disposals.”

Family Relationships Strong and supportive family and intimate relationships are widely considered important factors in desistance from crime. Prisoners receiving family visits have been found less likely to reoffend and more likely to have employment or training or accommodation arranged for their release than prisoners who received no family visits.

Males who offend Males make up the vast majority of the offending population. With the increasing use of community sentences there is a requirement for new and innovative approaches to the delivery of these sentences. Learning from the work carried out with women who offend the potential for the increased use of mentors has been identified.

HOW WE WILL DELIVER OUR IMPROVEMENT PLAN

In delivering this improvement plan our ambition is not about a single strand of work or necessarily about commissioning a new series of projects. Indeed, much of the work is already underway. It is about making sure the different components of change work together to deliver the joint community planning/community justice outcomes which will improve the quality of life for our citizens especially those who suffer from inequality of service and opportunity.

Whilst there is a significant amount of good practice being carried out by our partners daily, we will look across Scotland and beyond to find good evidence based practice and ideas that can be used to improve our delivery of Community Justice.

Page 115 of 234 This plan is a “living” document. It is to be used to inform and guide the work of the Community Justice Partnership and to hold it to account. Areas of it will be reviewed at every meeting of the Partnership during the year and the whole plan will be subject to a major review at least once a year.

Page 116 of 234 Community Justice Outcome 1 Communities improve their understanding and participation in community justice

Community Justice Indicators

Activities carried out to engage with ‘communities’ as well as other relevant constituencies Consultation with communities as part of community justice planning and service provision Participation in community justice, such as co-production and joint delivery. Level of community awareness of/satisfaction with work undertaken as part of a CPO Evidence from questions to be used in local surveys/citizens panels etc. Perceptions of the local crime rate

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 1/ 1 Develop and implement a communications plan to better inform all communities about the work PKAVS / 30 September being carried out as part of community justice reform and receive their views and ideas. This will Community 2017 include the use of stakeholder events and traditional and social media options to access all Justice Co- areas of our communities ordinator

1/2 Engage with voluntary and community groups on a regular basis to ensure the continual PKAVS / Ongoing exchange of information and views Community Justice Co- ordinator

1/3 Encourage communities to be more involved in community justice by engaging with them and PKAVS / 30 September with the help of the voluntary sector, develop the potential for volunteers to be part of our service Community 2017 delivery Justice Co- ordinator

1/ 4 Continue to survey those who request and receive input from the unpaid work teams to establish Community Ongoing its value to communities Safety Team, PKC

Page 117 of 234 1/ 5 Work with communities to understand the reality of crime in their areas by developing Police Ongoing engagement opportunities and communication routes with them Scotland 1/ 6 Recognising that there are issues within the of the criminal justice system which have a Victim 31 March 2018 significant impact on the victims of crime we will work with them and organisations supporting Support / them to improve their journey through the community justice system Community Justice Coordinator 1/7 Support the continued strengthening of client involvement in the management of the One-stop Community 30 September Women’s Learning Service (OWLS) by actively encouraging and supporting them to take part Safety 2017 Team, PKC

Page 118 of 234 Community Justice Outcome 2

Partners plan and deliver services in a more strategic and collaborative way

Community Justice Indicators 2.1 Services are planned for and delivered in a strategic and collaborative way 2.2 Partners have leveraged resource for community justice 2.3 Development of community justice workforce to work effectively across organisational/professional/ geographical boundaries 2.4 Partners illustrate effective engagement and collaborative partnership working with the authorities responsible for the delivery of MAPPA

Outcome Improvement Action

Improvement Improve ment Action Lead Completion Action No. Agency Date 2/1 Arrange further self-evaluation/development days to ensure that partners understand their role in Community 30 September the new Community Justice system Justice 2017 Coordinator / Scottish Fire & Rescue 2/2 Ensure that partners and third sector colleagues have a good understanding of each other’s PKAVS / 30 September businesses and clarity around their roles and available resources by organising opportunities for Community 2017 joint training/briefing sessions Justice Co- ordinator

2/3 Ensure clear lines of communication and development of joint working between the Community Community 30 September Justice Partnership and other Community Planning Groups by organising joint meetings/briefing Justice Co- 2017 sessions ordinator

2/4 Continue to develop the Police Scotland/Perth and Kinross Council Community Safety Hub Community 30 September based within the Criminal Justice Office so that the opportunities for cross service working can Safety 2017 continue to be improved Team, PKC /

Page 119 of 234 Police Scotland 2/5 Review and ensure the implementation of the Short Term Prisoner Protocol to improve the Community 30 September outcomes for people released from prison Justice Co- 2017 ordinator / Scottish Prison Service

2/6 Position Police Scotland local Offender Management Unit within the Council’s Criminal Justice Community 30 September Office to improve direct lines of communication and partnership working in respect of the Safety 2017 management of serious and violent offenders Team, PKC / Police Scotland 2/7 Explore the potential for further partnership engagement between the Public Protection Team Community 30 September and other support networks (employability, mental health, and health improvement substance Safety 2017 misuse) to deliver better services for clients Team, PKC / NHS / IJB / PKAVS

2/ 8 Explore the potential for further partnership engagement between the Unpaid Work Team, other Community 30 September support networks (employability, mental health, and health improvement substance misuse) and Safety 2017 the existing social enterprises at the Westbank Site, Perth to deliver better services for clients Team, PKC 2/ 9 Ensure that there is a robust monitoring and evaluation process for all projects and activities Community 30 September delivered by the Partnership to ensure the best outcomes for clients and communities. Safety 2017 Team, PKC

Page 120 of 234 Community Justice Outcome 3 People have better access to the services they require, including welfare, health and wellbeing, housing and employability

Community Justice Indicators 3.1 Partners have identified and are overcoming structural barriers for people accessing services 3.2 Existence of joint-working arrangements such as processes/protocols to ensure access to services to address underlying needs

3.3 Initiatives to facilitate access to services 3.4 Speed of access to mental health services 3.5 Speed of access to drug and alcohol services 3.6 % of people released from a custodial sentence: • registered with a GP; • have suitable accommodation; • have had a benefits eligibility check.

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 3/1 Review information sharing and protocols and processes between partners to identify and Community 30 September remove barriers for people accessing all the services they require Justice Co- 2017 ordinator

3/2 Ensure the provision of a nurse at One-stop Women’s Learning Service (OWLS) for women who Community 30 September have offended to increase their ability to access medical services Safety 2017 Team, PKC / IJB 3/3 Examine the issues caused through the introduction of Universal Credit in Perth and Kinross and Community 30 September where possible determine actions to mitigate these concerns Justice Co- 2017 ordinator

3/4 Research the barriers which reduce the ability of people with convictions to access appropriate Community 30 September accommodation in the public or private sector and determine actions to mitigate these issues Justice Co- 2017

Page 121 of 234 ordinator

3/5 Research the barriers which reduce the ability of people with convictions to access appropriate IJB / P&K 31 March 2018 mental health care and drug and alcohol services and work with partners and the third sector to ADP address any issues found 3/ 6 Develop opportunities for work experience placements for people with convictions by changing Community 30 September attitudes amongst employers Justice Co- 2017 ordinator / Scottish Prison Service / APEX

3/ 7 Promote existing employment support services to service users Community 30 September Justice Co- 2017 ordinator / Scottish Prison Service / APEX

3/ 8 Review the processes between Youth Justice and Criminal Justice services to ensure that the Community 30 September Whole System Approach is continued into the adult system Safety 2017 Service and Education and Children’s Services, PKC 3/ 9 Review the services for people coming out of prison to ensure that they meet their needs and Community 31 March 2018 are delivered timeously Safety Service PKC / Scottish Prison Service

Page 122 of 234 3/10 Develop links with providers of parenting services to enable people who are subject to the Community 31 March 2018 criminal justice system to build and develop strong, positive family relationships and engage with Safety parenting support, both in the community and secure establishments Service PKC / Scottish Prison Service 3/11 Work with partners to examine the possibility of not deregistering people sentenced to short Scottish 31 March 2018 periods of imprisonment with their GP’s therefore removing the need to reregister on release Prison Service / IJB

Page 123 of 234 Community Justice Outcome 4 Effective interventions are delivered to prevent and reduce the risk of further offending

Community Justice Indicators 4.1 Targeted interventions have been tailored for and with an individual and had a successful impact on their risk of further offending. 4.2 Use of "other activities requirement" in Community Payback Orders (CPOs) 4.3 Effective risk management for public protection 4.4 Quality of CPOs and DTTOs 4.5 Reduced use of custodial sentences and remand: • Balance between community sentences relative to short custodial sentences under 1 year; • Proportion of people appearing from custody who are remanded. 4.6 The delivery of interventions targeted at problem drug and alcohol use 4.7 Numbers of police recorded warnings, police diversion, fiscal measures, fiscal diversion, supervised bail, community sentences (including CPOs, DTTOs and RLOs) 4.8 Number of short-term sentences under 1 year.

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 4/1 Develop and expand the work being carried out by the joint Community Safety Hub staff who Police 30 September identify individuals at risk of reoffending and work with partners to reduce these risks Scotland / 2017 Community Safety Service PKC 4/2 Carry out an evaluation of the One-stop Women’s Learning Service (OWLS) to ensure that it is Community 30 September meeting the needs of its client group and use this information to determine its future activities Safety 2017 and opening hours Service PKC 4/3 Expand the “other Activities” part of CPO’s in partnership with the third sector to deliver training Community 31 March 2018 to improve the employment chances of clients. Training will include health and safety, manual Safety handling, food hygiene, fire awareness, first aid/CPR and building and writing a CV. In addition Service PKC (not included in the CPO hours) the ability to take part in a health related fitness activity will be / PKAVS offered

Page 124 of 234 4/4 Explore the possibility of developing with the third sector a mentoring service for men that would Community 30 September continue to provide support for clients after the completion of the CPO to reduce the risk of Safety 2017 reoffending Service PKC 4/5 Explore the possibility of providing health checks for male clients engaging with the Public Community 31 March 2018 Protection Team and others participating in unpaid work in an effort to increase their all-round Safety health and wellbeing Service PKC / IJB 4/6 To ensure the best value from the expansion of electronic monitoring develop a group to explore Community 30 September the opportunities that come from it Safety 2017 Service PKC 4/7 Carry out a review of the delivery of unpaid work as part of a CPO to ensure that it delivers best Community 30 September value Safety 2017 Service PKC 4/8 Review the delivery of DTTO’s to ensure that they deliver best value Community 31 March 201 8 Safety Service PKC

Page 125 of 234 Community Justice Outcome 5 Life chances are improved through needs, including health, financial inclusion, housing and safety being addressed

Community Justice Indicator 5.1 Individual have made progress against the outcome

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 5/1 The Criminal Justice Public Protection Team will develop and implement a new recording Community 1 April 2017 system which will indicate a client’s progress in respect of issues including education, Safety employment and attitude to offending. Service PKC 5/2 Encourage partners to record and where appropriate share information about clients in relation Community 30 September to needs, including health, financial inclusion, housing and safety Safety 2017 Service PKC 5/3 Develop a process to bring this information together for analysis Community 30 September Safety 2017 Service PKC

Page 126 of 234 Community Justice Outcome 6 People develop positive relationships and more opportunities to participate and contribute through education, employment and leisure activities

Community Justice Indicator 6.1 Individual have made progress against the outcome

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 6/1 Encourage partners to record and where appropriate share information about clients in relation Community 30 September to needs, including health, financial inclusion, housing and safety Justice 2017 Coordinator 6/2 Develop a process to bring this information together for analysis Community 30 September Justice 2017 Coordinator

Page 127 of 234 Community Justice Outcome 7 Individual’s resilience and capacity for change and self-management are enhanced

Community Justice Indicator 7.1 Individual have made progress against the outcome

Outcome Improvement Action

Improvement Improvement Action Lead Completion Action No. Agency Date 7/1 Encourage partners to record and where appropriate share information about clients in relation Community 30 September to their clients resilience and capacity for change and self-management Justice 2017 Coordinator 7/2 Develop a process to bring this information together for analysis Community 30 September Justice 2017 Coordinator

Page 128 of 234 9 (17/197) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Joint Public Health Protection Plan . Report by the Director (Environment)

As part of its duties under the Public Health etc (Scotland) Act 2008, NHS Tayside has prepared a final draft Joint Public Health Protection Plan for 2017 - 2019, in consultation with Angus, Dundee City and Perth and Kinross Councils. This Plan provides an overview of health protection priorities, provision and preparedness within Tayside.

The Committee is asked to approve the contents of the plan and working with NHS Tayside, to address the local priorities identified within the plan.

1. BACKGROUND / MAIN ISSUES

1.1 The Public Health (Scotland) Act 2008 (The Act) introduced several improvements in legislative controls to secure public health protection in Scotland. The overall implications of the Act were previously reported to the Community Safety Committee on 27 May 2009 (Report number 09/257 refers). Perth and Kinross Council has a statutory duty under the Act to make provision, or secure that provision is made, for the public health protection of its communities from infectious diseases, contamination and other hazards which constitute a danger to health. “Public health protection” includes the prevention of, control of, and the provision of a public health response to such hazards.

1.2 These health protection controls are implemented within the Council, primarily by the Environment Service. This is through the activities of the Regulatory Services Team by statutory inspection and sampling programmes, with reactive responses to emerging public health incidents on a risk based approach, in consultation and in partnership with NHS Tayside

1.3 Tayside Health Board also has a statutory duty under the Act to make provision for the public health protection of its communities from infectious diseases, contamination and other hazards which constitute a danger to health.

1.4 Tayside Health Board is also required by the Act to prepare a Joint Public Health Protection Plan (JPHPP), in consultation with the relevant local authorities within its area. This plan provides an overview of health protection priorities, provision and preparedness within their area. JPHPPs must be formally signed off by NHS Boards and the relevant local authority Committees, and must be reviewed every two years

Page 129 of 234 2

1.5 The preparation of the revised draft Tayside JPHPP 2017 - 2019 was led by the Public Health team of NHS Tayside. The review team also consisted of representatives of Angus Council and Dundee City Councils. Perth and Kinross Council’s representative was Robert Lyle, Regulatory Services Manager.

2. PROPOSALS

2.1 The final draft of the Plan is provided in Appendix 1. The Plan reaffirms the comprehensive public protection arrangements which exist within Tayside and recommends a number of actions to be delivered jointly between health protection partners across Tayside. The key future actions for Perth and Kinross Council in relation to the agreed priorities for 2017- 2019 are:

• Share learning from leisure pool incidents to reduce swimming pool related infection. • Implementation of Cleaner Air for Scotland Strategy in Tayside. • Reviewing and revising existing protocols and emergency plans in accordance with the schedule at Appendix B of the JPHPP.

2.2 The final draft Plan (Appendix 1) was approved at the meeting of NHS Clinical and Care Governance Committee on 9 February 201, subject to formal ratification by the three participating Councils

2.3 On approval by all partners, the final plan will be publicised by the organisations involved, and a more detailed action plan will be prepared to take forward the key activities arising from the agreed priorities. In accordance with the requirements of the Act, the plan will be subject to review and revision.

3. CONCLUSION AND RECOMMENDATION

3.1 The plan allows the Council the opportunity to have comprehensive public protection arrangements delivered in partnership with our health protection partners across Tayside. This provides a commitment on behalf of the Council to work with NHS Tayside, Dundee City and Angus Councils to address the agreed priorities identified in the Joint Public Health Protection Plan as contained in Appendix 1.

3.2 It is recommended the Committee approve the contents of the Joint Public Health Protection Plan.

Page 130 of 234 3

Author Name Designation Contact Details Robert Lyle Regulatory Services 01738 475000 Manager [email protected]

Approved Nam e Designation Date Barbara Renton Director (Environment) 9 May 2017

Page 131 of 234 4

ANNEX

1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

Strategic Implications Yes / None Community Plan / Single Outcome Agreement Yes Corporate Plan Yes Resource Implications Financial None Workforce None Asset Management (land, property, IST) None Assessments Equality Impact Assessment Yes Strategic Environmental Assessment None Sustainability (community, economic, environmental) None Legal and Governance None Risk None Consultation Internal None External None Communication Communications Plan None

1. Strategic Implications

Community Plan / Single Outcome Agreement

1.1 This section should set out how the proposals relate to the delivery of the Perth and Kinross Community Plan / Single Outcome Agreement in terms of the following priorities:

Corporate Plan

1.2 This section should set out how the proposals relate to the achievement of the Council’s Corporate Plan Priorities:

(i) Giving every child the best start in life; (ii) Developing educated, responsible and informed citizens; (iii) Promoting a prosperous, inclusive and sustainable economy; (iv) Supporting people to lead independent, healthy and active lives; and (v) Creating a safe and sustainable place for future generations.

Page 132 of 234 5

2. Resource Implications

Financial

2.1 There are no financial implications arising from this report as out of hours cover for public health incidents is contained within the existing service budget.

Workforce

2.2 There are no workforce implications arising from this report as the health protection arrangements detailed in the report are provided as core duties by Regulatory Services staff.

Asset Management (land, property, IT)

2.3 There are no asset management implications arising from this report.

3. Assessments

Equality Impact Assessment

3.2 This section should reflect that the proposals have been considered under the Corporate Equalities Impact Assessment process (EqIA) with the following outcome:

(i) Assessed as not relevant for the purposes of EqIA

Strategic Environmental Assessment

3.3 The Environmental Assessment (Scotland) Act 2005 places a duty on the Council to identify and assess the environmental consequences of its proposals.

3.4 The proposals have been considered under the Act and no further action is required as it does not qualify as a PPS as defined by the Act and is therefore exempt.

Page 133 of 234 6

Sustainability

3.5 Under the provisions of the Local Government in Scotland Act 2003 the Council has to discharge its duties in a way which contributes to the achievement of sustainable development. Under the Climate Change (Scotland) Act 2009 the Council also has a duty relating to climate change and, in exercising its functions must act:

• In the way best calculated to delivery of the Act’s emissions reduction targets; • In the way best calculated to deliver any statutory adaptation programmes; and • In a way that it considers most sustainable.

3.6 There are no sustainability implications arising out of this report

Legal and Governance

3.7 There are no Legal and Governance implications as a result of this report.

Risk

3.8 There are no risks associated with the proposals addressed in the report.

4. Consultation

Internal

4.1 No other Council services have been consulted , in the development of the proposals and the preparation of the report.

External

4.2 The Joint Public Health Protection Plan has been produced collaboratively with NHS Tayside, Angus Council and Dundee City Council.

5. Communication

5.1 None.

2. BACKGROUND PAPERS

2.1 None.

3. APPENDICES

3.1 Appendix 1 - Final Draft Tayside Joint Public Health Protection Plan 2017 – 2019.

Page 134 of 234 APPENDIX 1

Tayside

Joint Public Health Protection Plan

2017-2019

Page 135 of 234 Table of Contents Introduction ...... 4 Executive summary...... 6 1.0 Overview of NHS Tayside and its three Local Authorities ...... 7 2.0 Health protection: National and local priorities ...... 18 2.1 National priorities ...... 18 2.2 Specific features of areas of Tayside associated with health protection risk...... 20 Angus ...... 20 Dundee...... 21 Perth & Kinross...... 22 2.3 Health protection priorities and activities in Tayside...... 22 Local authority activities...... 23 2.4 Local priorities for health protection work in Tayside for 2017-19...... 24 3.0 Health Protection Resources and Operational Arrangements...... 25 3.1 NHS Tayside Health Protection Team staffing ...... 25 3.2 Roles and responsibilities ...... 25 3.3 Tayside Local Authorities’ staffing...... 27 3.4 Tayside Scientific Services ...... 27 3.5 Tayside Local Authorities Out of Hours Arrangements...... 27 3.6 Tayside staffing for delivery of the health protection function ...... 28 3.7 Maintaining knowledge and skills...... 28 3.8 Capacity and resilience...... 29 3.9 Information Technology and Communications Technology ...... 29 4.0 Health Protection: planning infrastructure ...... 30 4.1 Health Protection Plans ...... 30 4.2 Local authority health protection plans...... 30 4.3 Joint working arrangements...... 32 5.0 Delivering the health protection function in Tayside 2014-2016 ...... 33 5.1 Notifiable diseases and organisms...... 33 5.2 Significant Incidents and Outbreaks 2014-2016...... 34 5.3 Healthcare associated Infections ...... 35 5.4 Vaccine preventable diseases and immunisation programmes ...... 36 5.5 Planning for emergencies, including potential pandemic of influenza...... 37 6.0 Mutual aid arrangements...... 37 7.0 Health protection: public involvement and stakeholder feedback ...... 37 8.0 Progress during 2014-16 ...... 38 9.0 Recommendations for 2017-19...... 39

2017-19 Tayside Joint Public Health Protection Plan 2

Page 136 of 234 Appendix A: Reporting of Health protection incidents and outbreaks...... 41 Appendix B: Programme for review and exercise of plans...... 42

2017-19 Tayside Joint Public Health Protection Plan 3

Page 137 of 234 Introduction Inequalities play an important role in the epidemiology of infectious diseases, and illness caused by environmental hazards. In Scotland infectious diseases and environmental hazards disproportionately affect marginalised populations and can be linked to upstream determinants such as low socio economic status and migration, which can lead to downstream risk factors such as tobacco, alcohol and drug use, poor living conditions, limited social networks and difficulty in accessing services.

The function of health protection services is to take action and provide leadership, expert guidance and support to prevent and manage risks to the health of the public from infectious diseases and environmental hazards.

There are three key elements in the delivery of this function:

 Risk identification  Risk management  Risk communication

Like many public health services in Scotland, health protection services rely on coordinated strategic efforts between various organisations. The introduction of the Public Health etc (Scotland) Act 2008 updates and replaces legislation dating from as far back as 1897, directing this health protection effort. Public Health legislation places statutory roles on those who provide the health protection service; defining Competent Persons for the delivery of functions in relation to premises (led by the Local Authority) and persons (Lead by the NHS Board). Statutory duties and responsibilities include the surveillance and public health management of notifiable diseases, organisms and health risk states, and monitoring, control and management of environmental health hazards. In delivering these functions, Competent Persons have significant powers to require, or seek the Sherriff to enforce, restrictions on businesses and individuals, including for example closure of premises, decontamination, and quarantine of individuals.

The importance of this Act is further supported by the development of the Scottish Health Protection Network, production of the 2015 Review of Public Health in Scotland report and subsequent ongoing Shared Services Review. This seeks to provide a clear basis for future work that will strengthen and re-focus all aspects of the public health function in Scotland. There is also the need for strategic resilience within public health to sustain the capacity and the relationships within health protection to manage outbreaks and public health incidents. These skills and competencies need to be maintained and the capability to escalate and sustain a response needs to be assured.

The importance of this integration of effort is as great today as it has always been. The Public Health Act of 2008 required the development of Joint Public Health Protection Plans, setting out the arrangements in local areas for delivery of the Health Protection function. I am pleased to present Tayside’s third JPHPP for the period 2017-2019, which has been written jointly by NHS Tayside, Angus Council, Dundee City Council and Perth and Kinross Council.

The plan provides an overview of health protection priorities, provision and preparedness within Tayside.

The plan describes how the Board and the Local Authorities deal with a range of health protection topics and outlines areas we have identified that require further work.

2017-19 Tayside Joint Public Health Protection Plan 4

Page 138 of 234 What the recent past demonstrates is that the health protection function is subject to sporadic and often unpredictable challenges. An overarching aim of this plan is for Tayside’s health protection function to be robust to manage unforeseeable events; ensuring there is sufficient capacity and resilience within Tayside is essential to this aim. A decline in core health protection resources within any party to this plan could affect the overall capacity within Tayside to react effectively to incidents.

Dr Drew Walker Director of Public Health NHS Tayside

January 2017

2017-19 Tayside Joint Public Health Protection Plan 5

Page 139 of 234 Executive summary NHS Boards have a health protection function mostly relating to the control of infectious diseases and diseases arising from contact with substances hazardous to health. A significant proportion of the health protection function of boards relates to statutory duties. Other aspects of the function are the co-ordination of immunisation programmes, and working to reduce the burden of infectious disease in the community.

It is NHS Tayside’s Health Protection Team’s vision to take action and provide leadership, expert guidance and support to prevent and manage risks to the health of the public from infectious diseases and environmental hazards. Similarly, local authorities have a health protection function, which is predominantly delivered through local authority environmental health services. In practice, health board and local authority functions are co-ordinated to ensure that the health of people in Tayside is protected as effectively as possible from the range of infectious and environmental hazards to health.

The Public Health etc (Scotland) Act 2008 (hereafter referred to as ‘The Act’) consolidates and updates public health legislation relating to ‘protecting public health from infectious diseases, contamination or other such hazards, which constitute a danger to human health.’ Part 1 of the Act requires each health board area to develop a Joint Public Health Protection Plan (JPHPP) to provide an overview of health protection (infectious disease and environmental health) priorities, provision and preparedness.

The importance of this Act is further supported by the development of the Scottish Health Protection Network, production of the 2015 Review of Public Health in Scotland report and subsequent ongoing Shared Services Review. This seeks to provide a clear basis for future work that will strengthen and re-focus the public health function in Scotland. There is also the need for strategic resilience within public health to sustain the capacity and the relationships within health protection to manage outbreaks and public health incidents. The skills and competencies need to be maintained and the capability to escalate and sustain a response needs to be assured.

In cognisance of this Tayside’s JPHPP for 2017-19 has been written jointly by NHS Tayside, Angus Council, Dundee City Council and Perth and Kinross Council and will be renewed every two years. The JPHPP provides an overview of the geography and demography of Tayside and identifies health protection risks associated with these specific features. The plan describes health protection activities in Tayside and the resources with which the health protection function is delivered.

The JPHPP recommends a number of actions to be delivered jointly between health protection partners across Tayside, in response to the following agreed priorities for 2017-19:

 Progress recommendations from the Health Protection Team away day in January 2016 to improve and develop longer term strategic team vision, cohesion and priorities.  Share learning from leisure pool incidents to reduce swimming pool related infection  Implementation of Cleaner Air for Scotland Strategy in Tayside  BBV focus on prevention  Migrant health  Scottish Health Protection Network GIZ priorities  On-going resilience for Health Protection Team  Reviewing and revising existing protocols and emergency plans in accordance with the schedule at Appendix B

2017-19 Tayside Joint Public Health Protection Plan 6

Page 140 of 234 1.0 Overview of NHS Tayside and its three Local Authorities

Tayside Population Estimates In 2015, the estimated total population of Tayside was 415,0401. The NHS Board is coterminous with the three local authority areas of Angus, Dundee City and Perth & Kinross, covering in total 7,527 sq km with mixed urban and highly rural population distribution (Table 1). Tayside’s population accounts for approximately 7.7% of the Scottish population.

Table 1. NHS Tayside: Land Area, Population and Density, 30 June 2015 Estimated Population Areai Densityii Administrative Area 30 June 2015 (sq km) (Persons per sq km) Tayside 415,040 7,527 55 Angus 116,900 2,182 54 Dundee City 148,210 60 2,477 Perth & Kinross 149,930 5,286 28 Source: NRS Mid Year Populations Estimates, June 30th 2015 (2011 Census Based) - NHST Populations Table 9 Notes: i. Land areas were derived from Standard Area Measurements produced by the Office for National Statistics in December 2015. Figures may not add exactly because of rounding. ii. Persons per sq km calculated using actual, not rounded areas.

In 2015, the overall gender distribution (all ages) within Tayside was 48.6% male and 51.4% female, however the gender proportions very much depend on the age band under consideration, as displayed in Figure 1.

Figure 1. NHS Tayside: Population Distribution by Age and Gender, 2015

Source: NRS Mid Year Populations Estimates, June 30th 2015 (2011 Census Based)

As the population ages, the male to female ratio becomes more apparent, especially within the elderly population, with more females surviving in the older age groups. In 2015, for those 65+ years, there were 45% males and 55% females, these proportions become 41% and 59% respectively for those aged 75+ years.

1 NRS (formerly GRO(S)) - Mid-year population estimates, 2015 (2011 Census Based) 2017-19 Tayside Joint Public Health Protection Plan 7

Page 141 of 234 While all three Tayside local authority areas are fairly similar in terms of age and gender distribution, due to Dundee’s large student population, this Tayside local area has a greater proportion of 20-24 year olds year-on-year than its other Tayside counterparts. In 2015, this age group represented 10.2% of the Dundee population, compared with 5.4% of the population in Angus and 5.6% Perth & Kinross.

As the Tayside population ages, a slight difference across the local authority areas emerges. In 2015, those aged 60+ years accounted for 28.9% of the population within Angus and 28.8% in Perth & Kinross; a slightly higher proportion than across the Dundee City area (22.5%).

The 2015 mid-year population (415,040 persons) demonstrated an increase in 1,240 individuals (0.3% increase) from the 20142 estimate (413,800 persons).

Tayside Population Projections3

National Records of Scotland (NRS) estimate that the population of NHS Tayside will increase by 14.1% to 469,606 in 2037 (based on 2012 population projection figures). The 2012 based projections predict that across Tayside’s local authority areas, the population will increase in both Dundee City (+15.6% to 170,811) and Perth & Kinross (+24.2% to 183,468), while remaining fairly similar in Angus (-0.8% to 115,327).

In general, Tayside’s population is ageing, particularly with increases in the population aged 65 and over. While those aged 65 and over account for 19.5% (80,350) of the 2012 population, this age group is anticipated to increase to representing 25.4% (119,513) of the population in 2037. The 85+ band is expected to make the largest increase by 2037. The population of this age band is anticipated to increase by 139.7% (24,801) in Tayside as a whole, 165.8% (8,050) in Angus, 85.3% (6,100) in Dundee City and 164.5% (10,651) in Perth and Kinross.

While the overall population across Tayside is predicted to increase by 2037, there are differences within the age bands. Between 2012 and 2037, the 45-64 age group is expected to decrease across Tayside (-6.7%), as well as within Angus (-22.1%) and Perth & Kinross (-7.1%). In addition, Angus is also projected to show population decreases in all age groups below 44 years of age.

These changes are summarised in Figure 2 which presents the projected percentage changes in the population by age group between 2012 - 2037.

2 2015 – Revised 2011 (2011 Census Re-Based) population estimate 3 Population projections can be useful for planning and providing services, however they have limitations and should be viewed with some caution and are continually updated. 2017-19 Tayside Joint Public Health Protection Plan 8

Page 142 of 234 Figure 2. Projected Percentages in the Population by Age Group, 2012-2037

Source: NRS Population Projections, 2012 Based (January 2016)

Projected population estimates predict that the male proportion of the population will increase over the coming years. In 2012, 43.7% of the Tayside population aged 65 and over were male, compared with the projected 45.3% in 2037. This proportion change may potentially be a factor to consider when planning service needs in the community.

The age and gender structure of the populations for the three Tayside local authority areas are shown in Figure 3.1 – 3.3, comparing 2012 estimates with the 2037 projection figures.

Figure 3. The Population Profile of the Three Tayside Local Area, Population Estimate 2012 & Projected Population 2037 (2012 based)

Figure 3.1 Angus Profile

2017-19 Tayside Joint Public Health Protection Plan 9

Page 143 of 234 Figure 3.2 Dundee City Profile

Figure 3.3 Perth & Kinross Profile

Fig 3..1 - 3.3 Source: NRS Mid-Year Population Estimates [2012] & Population Projections [2037] (January 2016)

Tayside Deprivation (SIMD)

Health and deprivation are linked on various levels. People from deprived areas have higher incidence and prevalence of all the major diseases, have higher mortality rates and show higher rates of health damaging behaviours, such as smoking and poor nutrition. Patterns of higher access to primary care but lower access to secondary care tend to be demonstrated by those living in deprived areas. Access to screening is lower and there is higher likelihood of late presentation with disease among people in deprived areas.

Scottish Index of Multiple Deprivation (SIMD 2012)4: The Scottish Index of Multiple Deprivation (SIMD) is the Scottish Government's official tool as an area-based measure of deprivation. The SIMD categorises Scotland into 6,505 small areas (data zones), each containing around 350 households (average 800 people living in each). The Index provides a relative ranking for each data zone, from 1 (most deprived) to 6,505 (least deprived). This results in a comprehensive picture of relative area deprivation across

4 SIMD is regularly updated, most currently available measure being SIMD 2012. SIMD identifies deprived areas, not deprived individuals, not everyone living in a deprived area is deprived, and not all deprived people live in deprived areas. 2017-19 Tayside Joint Public Health Protection Plan 10

Page 144 of 234 Scotland and can be used to target policies and resources at the places with greatest need.

Table 2 summarises the SIMD 2012 for Tayside’s three local authorities5. The table shows that Dundee City has the largest proportion of data zones in every deprived category, both in terms of Local and National Share compared with its other Tayside counterparts.

Table 2. SIMD 2012: Local and National Share of Data Zones in the Most Deprived 5%, 10%, 15% & 20% by Local Authority Area Local Authority Level of Dundee Perth & Deprivation Data Angus City Kinross Scotland 5% Most Deprived No. of Data zones 0 19 2 325 Local Sharei (%) 0.0 10.6 1.1 5.0 National Shareii (%) 0.0 5.8 0.6 100.0 10% Most Deprived No. of Data zones 2 36 2 651 Local Share i (%) 1.4 20.1 1.1 10.0 National Shareii (%) 0.3 5.5 0.3 100.0 15% Most Deprived No. of Data zones 3 55 6 976 Local Sharei (%) 2.1 30.7 3.4 15.0 National Shareii (%) 0.3 5.6 0.6 100.0 20% Most Deprived No. of Data zones 9 69 11 1301 Local Sharei (%) 6.3 38.5 6.3 20.0 National Shareii (%) 0.7 5.3 0.8 100.0 Total Number of Data Zones 142 179 175 6,505 Source: SIMD 2012, Tables 2.1a-2.1d &Table 2.2a-2.2d, Scottish Government Website (January 2016) Notes: i. ‘The ‘Local Share’ is the proportion of an area’s data zones that fall into the 15% most deprived in Scotland. This measure is not influenced by the size of an area and so picks out areas with concentrations of deprived data zones whether these areas are big or small. Example: An area consists of 300 data zones, 30 data zones fall into the 15% most deprived category, and the local share is 10% (30/300). ii. The ‘National Share’ is the proportion of the most deprived data zones in Scotland that are found in a particular area e.g. local authority. The 15% most deprived in Scotland that fall in a particular Local Authority area. This measure is heavily influenced by the size of an area since bigger areas will have more data zones and so are more likely to have more data zones in the 15% most deprived than smaller areas. Example: 976 data zones are in the 15% most deprived areas in Scotland. If an area was built up of 300 data zones and 30 of its data zones were in the 15% most deprived, then its national share would be 3% (30/976).

5 Community Health Partnership (CHP) numbers and local/national share percentages equal to Tayside local authority level. 2017-19 Tayside Joint Public Health Protection Plan 11

Page 145 of 234 Local Authority National Shares: 57.0% of Scotland's 15% most deprived (976) data zones are located in five local authorities: Glasgow (29.6%), North Lanarkshire (10.2%), Fife (5.9%), Dundee City (5.6%; 55 data zones), and Edinburgh (5.5%). These five local authorities contain 37% of Scotland's population.

In SIMD 2012, 3 (0.3%) of the 976 data zones in the 15% most deprived data zones in Scotland were found in Angus. A further 6 (0.6%) data zones were found in Perth & Kinross in terms of National Share.

Local Authority Local Shares: The five local authorities with the largest local share of Scotland's 15% most deprived data zones are Glasgow (41.6%), Inverclyde (40.0%), Dundee (30.7%; 55 data zones), West Dunbartonshire (26.3%), and North Ayrshire (25.7%). These are the same five local authorities as in SIMD 2009.

In SIMD 2012, 3 (2.1%) of Angus’s 142 data zones were found in the 15% most deprived data zones in Scotland, in comparison 6 (3.4%) of Perth & Kinross’s 175 data zones were found in the 15% most deprived data zones in Scotland.

Health Boards: Tayside Health Board had 64 data zones in the 15% most deprived, 12.9% of the Local Share and 6.6% of the National Share. This can be compared with the Scottish Health Board, ‘Greater Glasgow & Clyde’ with the largest proportion of their data zones in the 15% most deprived in both Local and National Shares of 30.1% and 45.4% respectively.

Most Deprived: The most deprived data zone in Angus in the overall SIMD 2012 was S01000626, found in the Intermediate Zone of ‘Arbroath Warddykes’. With a rank of 509, it is amongst the 10% most deprived areas in Scotland.

Amongst the 5% most deprived areas in Scotland are the two most deprived data zones in each of Dundee City and Perth & Kinross. In the overall SIMD 2012, the most deprived data zone in Dundee City was S01001253 (Intermediate Zone - Whitfield), a rank of 54, while in Perth & Kinross the most deprived data zone was S01005075 (Intermediate Zone - Muirton), with a rank of 137.

SIMD Health Domain: The health domain within SIMD identifies areas with a higher than expected level of ill-health or mortality for the age-sex profile of the population using a set list of indicators6,7.

Table 3 summarises the Local and National Shares of SIMD 2012 for the distribution of the 15% most deprived data zones in the health domain for Tayside three local authority areas.

6 a. Standardised Mortality Ratio b. Hospital episodes related to alcohol use c. Hospital episodes related to drug use d. Comparative Illness Factor e. Emergency admissions to hospital f. Proportion of population being prescribed drugs for anxiety, depression or psychosis g. Proportion of live singleton births of low birth weight 7 The indicators used are the same as for SIMD 2009, however there has been a change to the methodology for three of the health indicators; SIMD 2012 now uses continuous inpatient stays (CISs) to count the total number of stays in NHS hospitals. As a result of the change, caution should be used when interpreting change between the SIMD 2009 and SIMD 2012 health domains, as they are not directly comparable.

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Page 146 of 234 Table 3. Local and National Share of Data Zones in the 15% Most Deprived on the Health Domain in SIMD 2012, for Tayside’s Local Authorities 15% MOST DEPRIVED DATA ZONES HEALTH DOMAIN / SIMD 2012 National Share Local Share Tayside Total Data No. Percent Total Data No. Percent Local Authority Zones Data Zones (%) Zones Data Zones (%) Angus 1 0.1 142 1 0.7 976 Dundee City 35 3.6 179 35 19.6 (Scotland) Perth & Kinross 8 0.8 175 8 4.6 Source: SIMD 2012 – Local Authority Individual Reports, Scottish Government Website (January 2016) i) Angus Health Doman: The most health deprived data zone in Angus in SIMD 2012 is S01000620, found in the Intermediate Zone of ‘Arbroath Warddykes’, ranked at 777, it is amongst the 15% most health deprived areas in Scotland. ii) Dundee Health Domain: The most health deprived data zone in Dundee City in SIMD 2012 is S01001200, found in the Intermediate Zone of ‘Linlathen and Midcraigie’, ranked as 128, it is amongst the 5% most health deprived areas in Scotland. iii) Perth & Kinross Health Domain: The most health deprived data zone in Perth & Kinross in SIMD 2012 is S01005075, found in the Intermediate Zone of ‘Muirton’ and ranked as 201, it is amongst the 5% most health deprived areas in Scotland.

SIMD 2012: Tayside Population Estimates as at June 30th, 2014

Figures 4.1, 4.2 and 4.3 show the population structure of each Tayside CHP by SIMD 2012 quintile. The charts show that Dundee City has the largest deprived population (Quintile 1) across Tayside’s three local authority areas for both males and females.In comparison, both Angus and Perth & Kinross have their largest population portion within quintile 4, representing a more affluent (less deprived) male and female population.

Figure 4. Tayside Population Estimates 2014 (as at June 30th) by SIMD 2012 Quintile:

Figure 4.1 Angus Population Estimates by SIMD 2012 Quintile (as at 30th June 2014)

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Page 147 of 234 Figure 4.2 Dundee Population Estimates by SIMD 2012 Quintile (as at 30th June 2014)

Figure 4.3 Perth and Kinross Population Estimates by SIMD 2012 Quintile (as at 30th June 2014)

Fig 4.1 - 4.3 Source: NRS - Small Area Population Estimates (2014, Based on 2001 Data Zones) & SIMD 2012 - Scottish Government (January 2016) Note: Small area populations estimates for 2015 have not been published yet (June 2016)

Ethnic Population

Over the last decade between the 2001 Census and 2011 Census, the non-white ethnic population within Tayside has increased by over 5,500 individuals to 13,294 (7,495 in 2001). The proportion of the total Tayside population, accounted for by this non-white ethnic population group, increased from 1.9% to 3.2% over the last decade.

Table 4 summarises the 2011 census figures for Tayside’s ethnic groups, showing that at the time of the census, 'Asian' (inc. Scottish & British) recorded the largest non-white ethnic population group within Tayside (2.1% of the Tayside population; N = 8,611), followed in proportion by the 'African' (0.4% of the Tayside population; N = 1,527), and then both the 'Other -' and 'Mixed/Multiple -' ethnic population groups (0.3% of the Tayside population each; N = 1,241 & 1,420 respectively).

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Page 148 of 234 Table 4. Tayside's Ethnic Population Groups (Census 2011) Ethnic Groups (Census 2011)

c i

b r n c n h o i

s a r t i n i n t o i h E s All Non-

a r r t e c A h e o e B E s s l

a n , s

d White b i p p r d p e t a n n k i b t t u u i e t e i c c a a l

Administrative All i r Ethnic i o i o o h x h r a i u t r r a Area People s c s f l Groups W A S A A C B O G M M G Tayside 409,709 396,415 8,611 1,527 495 1,241 1,420 13,294 96.8% 2.1% 0.4% 0.1% 0.3% 0.3% 3.2% Angus 115,978 114,468 921 125 75 125 264 1,510 98.7% 0.8% 0.1% 0.1% 0.1% 0.2% 1.3% Dundee 147,268 138,460 5,838 1,170 269 846 685 8,808 94.0% 4.0% 0.8% 0.2% 0.6% 0.5% 6.0% Perth & Kinross 146,652 143,676 1,852 232 151 270 471 2,976 98.0% 1.3% 0.2% 0.1% 0.2% 0.3% 2.0% Source: Census 2011 (www.scotlandscensus.gov.uk) Release 2A, Table KS201SC "Ethnic Group by Health Board and Council Area" Notes a. Encompasses: White: Scottish; White: Other British; White: Irish; White: Gypsy/Traveller; White: Polish; White: Other White b. Encompasses: Pakistani, Pakistani Scottish or Pakistani British; Indian, Indian Scottish or Indian British; Bangladeshi, Bangladeshi Scottish or Bangladeshi British; Chinese, Chinese Scottish or Chinese British; Other Asian c. Encompasses: African, African Scottish or African British; Other African d. Encompasses: Caribbean, Caribbean Scottish or Caribbean British; Black, Black Scottish or Black British; Other Caribbean or Black e. Encompasses: Arab, Arab Scottish or Arab British; Other ethnic group

All three of Tayside's council areas have recorded increases in their non-white ethnic population groups between the 2011 and previous census. As displayed in Table 4, of Tayside's three council areas, Dundee City recorded the highest proportion of non-white ethnic groups within its own council area population (6.0% of the Dundee population; N = 8,808). Dundee City's non-white ethnic population accounted for 66.3% of Tayside's total non-white ethnic population, the largest contribution of Tayside's three council areas.

Life Expectancy

‘Life Expectancy’ (LE) at birth is a common measure of mortality, useful in comparing the 'health' of one country to another. It is an estimate of the average number of years a newborn infant is expected to live if current mortality rates continue to apply. Between males and females, and among different geographical and socio-economic groups, there can be considerable variations. All figures should be viewed as providing a general indication of LE, rather than precise and robust figures.

The expectation of life at birth in Scotland has improved greatly over the last 30 years and improvements in life expectancy at birth are projected to continue. Women continue to live longer than men; however the gap has been closing over more recent years.

While both Scottish male and female life expectancy has continued to increase to 77.05 years for males and 81.06 years for females (2012-2014 based), these figures remain below the UK average of 79.07 years and 82.81 years respectively. Therefore the Scottish population can expect to live shorter lives than the rest of the UK by more a year. Table 5 shows that Scottish LE is the lowest of its UK counterparts when comparing the current 2012-14 based figures.

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Page 149 of 234 Table 5. Life Expectancy at Birth (in years) by UK Area of Residence, (2012-14 based) Area of Residence Males (Years) Females (Years) UK (All) 79.07 82.81 England 79.35 83.05 Wales 78.40 82.29 Northern Ireland 78.25 82.28 Scotland 77.05 81.06 Source: National Life Tables, United Kingdom, 2012-2014, Office of National Statistics (January 2016)

The continued increases in life expectancy can be attributed to the improvements in mortality at older age. Scotland’s lower life expectancy can be associated with higher levels of alcohol consumption, a greater smoking prevalence and higher levels of cardiovascular diseases in Scotland compared to the other constituent countries of the UK8. The current life expectancy at birth for Tayside males is 77.8 years and 81.7 years for females (2012-2014 based). These figures are very slightly higher than the Scottish life expectancy estimates for both genders as summarised in Figure 5, which displays the life expectancy for Tayside males and females by local authority.

Figure 5. Life Expectancy at Birth (in Years) by Area of Residence (2012-14 based)

Source: Life Expectancy, National Records of Scotland (NRS) and National Statistics (January 2016)

There are variations in life expectancy across Tayside’s local authority areas: - Both males and females in Angus and Perth & Kinross have higher life expectancies than the Scottish average. The latter displaying the highest life expectancy of the three local Tayside areas. - Dundee City males and females have the lowest life expectancy compared with both its Tayside counterparts and the Scottish estimates. - Dundee City males are expected to live 4.2 years less than those in Perth and Kinross, with a corresponding difference of 2.8 years less in females.

Table 6 summarises the latest available LE figures by deprivation and displays the variations in the life expectancy at birth for the most deprived (MD) areas and least deprived (LD) areas across Tayside three local areas. As expected those living in most deprived areas have a lower life expectation than those who live in more affluent areas.

8 Office of National Statistics: Scottish Health Survey - UK comparisons: The Scottish Government, 2010. 2017-19 Tayside Joint Public Health Protection Plan 16

Page 150 of 234 Table 6. Expectation of Life at Birth for Tayside Council Area by Split Level of Deprivation, for the period 2009-2013 Deprivation Expectation of Life at Birth MD = most deprived 15% Male Female LD = least deprived 85% (Years) (Years) Angus LD 79.2 81.6 Angus MD 73.6 78.7 Angus (2009-2013) 78.3 81.2 Dundee City LD 75.4 80.2 Dundee City MD 69.9 75.3 Dundee City (2009-2013) 74.6 79.4 Perth & Kinross LD 79.9 83.0 Perth & Kinross MD 74.8 79.9 Perth & Kinross (2009 - 2013) 79.2 82.6 Source: Life Expectancy by Deprivation (2009-2013), National Records of Scotland [NRS}; (January 2016)

Adult Overseas Nationals Registered Within Tayside

National Insurance Number (NINo)9 Allocations to Adult Overseas Nationals entering the UK statistics are based on adult overseas (non-UK) nationals registering for a new National Insurance number for the purposes of work, benefits or tax credits and provide an indication of the number of new arrivals coming to a particular area.

In 2015/16, the majority of overseas nationals within Tayside were registered within Perth & Kinross, accounting for 51.9% (N=2,774) of Tayside overseas national population. In comparison, the overseas national individuals in Dundee City accounted for 24.8% (N=1,352) and in Angus 24.3% (N=1,327), of Tayside’s total overseas nationals population.

The 2015/16 proportions of Tayside’s three local authorities NINo allocations in terms of nationality recorded in that year shows that the majority of non-UK nationals registered are from Romania (29.7% of the total Tayside NINo allocations10). There is some variation between the three Tayside local authority areas in terms of country of origin of their NINo allocations. Within both Angus and Perth & Kinross, the majority of their allocations were from Romania, 47.9% (N=636) and 30.6% (N=851) of their total NINo allocations respectively. In comparison with Dundee’s allocations, those of Romanian origin represented only 9.8% (N=227) of their non-UK population; the majority of the Dundee allocations were from Poland, representing 19.9% (N=270) of the Dundee allocations.

Urban Rural Classification

The ‘Scottish Government Urban Rural Classification11 provides a standard definition of rural areas across Scotland, distinguishing between urban, rural and remote areas across Scotland.

9 Produced by the Department for Work and Pensions (DWP) Statistics 10 Collective total of Tayside’s three local authority areas. A Tayside figure is not available from DWP. 11 Large Urban Area: Settlements of over 125,000 people. Other Urban Areas: Settlements of 10,000 to 125,000 people. Remote Rural: Areas: Settlements of less than 3,000 people and with a drive time of between 30 and 60 minutes to a settlement of 10,000 or more. Accessible Rural: Settlements of less than 3,000 people and within 30 minutes drive of a settlement of 10,000 or more.

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Page 151 of 234 Across Tayside during 2013/14, the largest proportion of the population (38.3%) resided within ‘large urban areas’ with a further 26.6% living within ‘other urban areas’. In comparison, 5.2% of the Tayside population were living in ‘remote rural areas’, with a further 19.1% residing in ‘accessible rural areas’.

Within Dundee, 99.5% of the population were classified as living in ‘large urban areas’, while across Angus the majority of the population (53.6%) resided within ‘other urban areas’. In comparison, in Perth & Kinross the majority of the population comprised of a combination of both those living in ‘Other Urban Areas’ and ‘Accessible Rural’, accounting for 31.9% and 32.6% of the Perth & Kinross population respectively.

Homelessness

Under the Homeless Persons legislation, housing authorities have statutory duties to assist those who are homeless or threatened with homelessness, which include providing accommodation in certain circumstances. Local authorities are required to assess each application.

During 2014/15, of Tayside’s three local authority areas, Dundee City had 1,102 applications under the Homeless Person’s Legislation, compared with Angus (597 applications) and Perth & Kinross (680 applications).

Within Tayside over the last eight years there has been a decline in the number of homeless applications. Between 2013/14 and 2014/15, Perth and Kinross recorded the greatest decrease in the number of homeless applications, a reduction of 8.4%. In comparison, Angus and Dundee have showed a reduction to a lesser degree, a decrease in the number of applications by 3.2% and 0.3% respectively. This is a substantial slowing of the rate of reduction from homeless applications compared to previous years (2012/13 reduction in Perth and Kinross was 34%for example).

2.0 Health protection: National and local priorities

2.1 National priorities

In the Chief Medical Officer for Scotland annual report for 2012 key challenges and priorities in relation to communicable diseases were identified and these have remained largely unchanged:

 Gastro intestinal and foodborne infections: The global food industry maintains complex transnational foods chains which are hard to regulate and can contribute to local and international incidents and food fraud and crime. Campylobacter is the most common form of foodborne illness in Scotland (a situation which is similar to the UK and most of the developed world). Out of an estimated total of around one million cases of foodborne disease each year in the UK, Campylobacter is considered to be responsible for around 460,000 cases, 22,000 hospitalisations and 110 deaths, and 80% of infections are estimated to be foodborne. Recent research published in 2015 found that 73% of fresh whole chickens on retail sale in the UK are contaminated with Campylobacter. http://www.foodstandards.gov.scot/food-safety-standards/foodborne- illness/campylobacter  Travel and international health: In 2014 there were an estimated 3.9 million journeys made by travellers from Scotland, an increase of 6% from 2013. Imported and emerging gastrointestinal, viral and vector borne infections, such as dengue and chikungunya, present an ever increasing burden and threat. The 2017-19 Tayside Joint Public Health Protection Plan 18

Page 152 of 234 global scale of situations such as the Ebola outbreak at the end of 2013 and currently Zika virus, illustrate this.

 Environmental factors: Environmental factors are estimated to account for 14% of the UK's disease burden and 23% of worldwide deaths (ref. WHO 2009. Country profiles of the burden of disease – United Kingdom http://www.who.int/quantifying_ehimpacts/national/countryprofile/unitedkingdom.p df, WHO 2006. Preventing Disease Through Healthy Environments http://www.who.int/quantifying_ehimpacts/publications/preventingdisease.pdf ) The main environmental concern for Tayside is the risk to health from air pollution. Traffic is a major contributor to air pollution and data from 2014 show that in Tayside there were 3 sites in Dundee and 2 sites in Perth where air pollution levels exceeded the UK Air Quality Objectives (Ref.SG 2014. Scottish Air Quality Databases, http://www.scottishairquality.co.uk/assets/documents/technical%20reports/SAQD _annual_report_2014_Issue_1.pdf ). The Health Protection Team are collaborating with Dundee City Council, and Perth & Kinross Council in support of the implementation of the national strategy to improve air quality (Ref. SG, 2015 Cleaner Air for Scotland – Road to a Healthier Future http://www.scottishairquality.co.uk/news/index?id=513 ).There are both national (Ref. SG. Air Quality in Scotland http://cleartheair.scottishairquality.co.uk/) and local initiatives to improve air quality and encourage active transport (Ref. DCC, 2011. Air Quality Action Plan (AQAP) for NO2 and PM10 https://www.dundeecity.gov.uk/air-quality/air-quality-dundee-background; Perth and Kinross, 2009. Action on Air http://www.pkcairquality.org.uk/action-on-air/ ).  Emerging and re-emerging infections: Zoonoses (infectious diseases that can be transmitted from animal to humans), account for 61% of all human infections including established infections such as Campylobacter, Salmonella, Cryptosporidia, VTEC/Ecoli O157; and, potentially emerging problems such as Hepatitis E, Hantavirus, Lyme disease, Avian Influenza and rabies; Antimicrobial resistance such as carbapenemase producing Enterobacteriaceae is recognised by the European Centre for Disease Control as a significant threat to public health in Europe; Epidemic infections - 2012 saw the re-emergence of pertussis infection, plus, the largest outbreak Scotland has ever seen of Legionnaires disease; Pandemic infections - in 2012 a further 32 cases and 20 deaths brought the global total of cases of avian influenza A(H5N1) to 610 with 360 deaths.  Resilience and emergency preparedness: Scotland needs to predict and respond to established and emerging global health threats posed by infectious diseases, environmental hazards, natural disasters and bioterrorism. Delivery of effective Health Protection services requires development of the workforce, standards, protocols and governance structures to maintain quality, and, preparation for major disruptive challenges involves clear emergency planning. Tayside agencies have been collaborating in the review and exercising of Pandemic Flu Plans. The response procedures for flu provide the basis for responding to a range of other emerging diseases such as MERS CoV, Ebola and Zika virus.

Trends and changes in relation to vaccine preventable diseases, Hepatitis C and HIV, Tuberculosis, Legionnaires’ disease, Healthcare Associated Infection and Antimicrobial resistance are also highlighted as priorities.

Recommendations from the CMO report in relation to control of communicable diseases were:

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Page 153 of 234  To become technologically smarter particularly around surveillance (e.g. TB, Anti- Microbial Resistance), communication of risk (e.g. Travel, Lyme disease, Legionella) and in linking case and outbreak management to national guidance and quality assurance. This will involve close integration of human and animal information sources and expertise, within the broader context of trade, travel and the environment.  To develop and implement national programmes and multiagency action plans such as the extended immunisation programme, the Sexual Health and Blood Borne Virus Framework, A TB Action Plan for Scotland, the VTEC/E Coli 0157 Action Plan, and the Scottish Antimicrobial Action Plan.  To maintain the capacity and resilience to deliver quality assured services for Scotland that are flexible enough to deal with all kinds of disruptive challenges, from infectious disease outbreaks to terrorist attacks or flooding. This requires the development of innovative approaches which promote priority setting, linkages between policy areas, effective governance, quality assurance and collaborative working between statutory agencies, the private sector, the voluntary sector and communities.

Source: Annual Report of the Chief medical officer 2012-Population Health and Improvement Science. Dec 2013 http://www.scotland.gov.uk/Publications/2013/12/7881/6

2.2 Specific features of areas of Tayside associated with health protection risk

The geography of Tayside results in certain risks associated with particular features of the local area. The community risk register lists a number of health risks for which a response is required across the Category 1 responders in Tayside e.g. Pandemic Influenza. Tayside also hosts a number of (Control of Major Accident Hazards) COMAH sites and major pipelines (Shell and BP). Plans are in place to address these risks, but these plans require regular review to take account of learning from actual incidents and exercises.

Local authorities have a major role in health protection mainly discharged through their environmental health (EH) services. Within each of the three Councils there is a common set of core functions carried out by all the EH services. However, there can be significant variations between Councils in the range of activities carried out by their EH services for the following reasons:

 Many other Council functions have an underlying health protection purpose and as a result may be allocated to the EH function in one Council but not in another.  Specific features within the different local authority areas may produce particular demands (e.g. major facilities or events).  The demands and expectations within different communities also shape EH service delivery.

These factors are outlined below for each Council area:

Angus There are many rural communities in Angus including a significant population of migrant workers, in common with Perth & Kinross. The standard of residential accommodation for these workers has been a concern especially where caravans are used. The coastal

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Page 154 of 234 location of Angus carries particular significance for health protection because of its harbour at Montrose. Shell and BP Onshore Pipeline Systems are located in Angus.

Again in common with Perth & Kinross, Angus regularly hosts a number of major outdoor events, including ‘The Open’ golf tournament and Angus has a thriving tourist industry. Campsites throughout the area may be associated with, for example, E.coli O157 risk from the use of livestock fields.

Other health protection risks and challenges relate to:  The potential for chemical and biological contamination of private water supplies – affecting permanent and temporary residents of the area  Montrose harbour – port health issues e.g. ammonium sulphate storage  The health of migrant workers – the issues are described extensively in publications relating to this area  Agricultural and rural exposure to environmental pathogens resulting in a range of infectious diseases e.g., Cryptosporidium, E.coli O157, Lyme disease  Wastewater Treatment Works at Hatton, including pumping stations  Local hazards and nuisances e.g. large populations of gulls in urban areas  A large number of individual wind turbines with potential nuisance/health effects  A number of premises using biomass boilers which, although contributing greatly towards reducing carbon dioxide emissions, can also produce particulate matter as a product of combustion, if insufficient filtration incorporated into plant design

Dundee Dundee is a wholly urban area with a relatively high population density and high levels of deprivation. It has the biggest percentage of flatted property per head of population in Scotland, which results in a wide range of environmental health problems requiring resolution.

The city's industrial legacy means that there are many former industrial sites zoned for development. Screening for contaminated land with a view to remediation is a major Environmental Health function.

Dundee, like a number of other local authorities has a range of measures in place to improve its air quality since it has air quality targets for PM10 and NO2 which are not being met in the city centre and around major arterial routes. The city is listed by Audit Scotland as one of fourteen Scottish Councils which have air quality problems.

Dundee City Council is the Port Authority for the city's seaport and Riverside Airport, with both facilities accommodating international traffic.

Dundee’s large number of temporary residents includes students from across the UK and international locations. Infectious diseases common to other areas of the world can therefore present in temporary residents. A good example of this is the small but significant number of cases of Tuberculosis infection that occur amongst temporary residents.

Being a regional centre it has a relatively high number of workplaces and commercial activities requiring regulation.

Dundee has one lower tier Control of Major Accident Hazards (COMAH) site.

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Page 155 of 234 Perth & Kinross There are many rural communities in Perth & Kinross. The working and residential environments are associated with an increased exposure to farm and wild animals, soil and untreated water sources. Agricultural and rural exposure to environmental pathogens may result in a range of infectious diseases e.g., Cryptosporidium, E.coli O157, Lyme disease.

Amongst the agricultural workers of Perth & Kinross there are a large number of migrant workers and travellers. The specific health needs of these groups are well described in the scientific literature. In relation to health protection, specific health needs result from the infection risk associated with poor standards of accommodation, transient use of primary health care services and imported infections.

Potential exists for the chemical and biological contamination of private water supplies affecting permanent and temporary residents of the area. An estimated 7,175 people are exposed annually to the risk of infectious diseases including E.coli O157 and Cryptosporidium resulting from private water sources.

There are a number of COMAH sites throughout Perth & Kinross. Port health related issues are relevant to Perth harbour.

The thriving tourist industry of Perth & Kinross results in many visitors to the area. These visitors may develop infections typically associated with holiday populations e.g. Norovirus.

2.3 Health protection priorities and activities in Tayside

NHS Tayside’s health protection activities The broad functions of the NHS Tayside Health Protection Team are as follows:  Surveillance, prevention and control of communicable diseases and environmental hazards;  Provision of specialist advice and support to primary care, hospitals, and other relevant organisations such as care homes and nurseries, to support effective delivery of health protection locally;  Investigation and management of a full range of health protection incidents (including single cases and outbreaks of diseases such as meningococcal meningitis, tuberculosis, food poisoning and environmental release of chemical, biological or radiological agents);  Co-ordinating and contributing to planned, preventive programmes including routine and selective immunisations, emergency and resilience planning, and public information and education initiatives;  The conduct of clinical audit, research, teaching and contributing to and undertaking continuous professional development relating to health protection.

Topic areas include:  Immunisation and vaccine preventable diseases;  Blood borne viruses;  Respiratory infections (including TB and pandemic influenza planning);  Gastrointestinal and waterborne infections;  Infection control in non-NHS community settings;  Port health;  Environmental health;  Resilience Planning

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Page 156 of 234 Local authority activities The main areas of local health protection activities carried out by Environmental Health and other professionals within local authorities are outlined below. Many are requirements of statute, in order to protect the health of individuals living in working in or visiting our communities.  Effective enforcement of housing, (including caravans) public health and pollution control legislation to reduce the effects on health of poor housing standards, statutory nuisances poor air quality, unwholesome drinking water, contaminated recreational waters or other hazards  Dealing with pest infestations, including the provision of pest control services  Controlling environmental noise/ antisocial behaviour noise  Identification, investigation and control of contaminated land  Identification, investigation and action to reduce air pollution  Pandemic flu operational planning particularly in the context of business continuity in respect of the maintenance of critical Local Authority services  Risk assessment, sampling and improvement of private water supplies to protect users from the risk of waterborne infections or diseases  Effective enforcement of health and safety at work legislation to protect workers and those affected by work activities  Effective enforcement of food safety legislation using inspection and sampling programmes to protect consumers from unsafe food supplies  Inspections of ships and aircraft to protect crew and passengers, as well as potential communicable disease affecting local population  Effective response to any notified diseases or food poisoning cases to identify and limit the spread of infection where necessary  Minimising the risk of exposure to environmental incivilities such as dog fouling, illicit tipping and graffiti  Minimising the risk of environmental tobacco smoke/ secondary exposure through inspection and the enforcement of smoke free legislation  Regulation of sales of under age products e.g. tobacco, alcohol  Ensuring that tobacco and smoking related products are not displayed openly in retail premises  Regulation of alcohol sales through licensing standards legislation – including enforcement, education and awareness raising work  Domestic refuse collection and recycling services  Disposal of human remains where no relatives, or other persons, are in a position to do so.

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Page 157 of 234 2.4 Local priorities for health protection work in Tayside for 2017-19 Priority area Actions Progress recommendations from the Health Protection Team away day in Agree and implement shared team: January 2016 to improve and develop longer term strategic team vision,  Vision statement cohesion and priorities.  Workplan  Performance management framework  New staff induction  Mandatory training Share learning from leisure pool incidents to reduce swimming pool Establish swimming pool convention related infection and improve public and pool operator understanding of roles, responsibilities and risks Implementation of Cleaner Air for Scotland Strategy in Tayside Work with Local Authorities to promote active transport and reduce air pollution across Tayside. BBV focus on prevention Work with BBV MCN on development of key emerging prevention issues including:  PrEP  Foil provision  Chemsex  People involved in commercial sexual activity Migrant health Ascertain as clear a picture as possible of the local migrant population and their priorities and needs in relation to health protection. Consider and explore specific service developments to address these areas. Scottish Health Protection Network GIZ priorities Implement local actions emerging from SHPN GIZ sub-groups relating to:  Campylobacter  Giardia  VTEC  Hepatitis E virus  Lyme disease On-going resilience for Health Protection Team Contribute to local and national discussion regarding Shared Services Review for Public Health Explore development of joint out of hours CPH/M rota with NHS Fife Reviewing and revising existing protocols and emergency plans in See Appendix B accordance with the schedule at Appendix B

Page 158 of 234 3.0 Health Protection Resources and Operational Arrangements

3.1 NHS Tayside Health Protection Team staffing

The NHS Tayside health protection function is continuously operational 24/7. In hours (Monday to Friday, 9am to 5pm) a small multidisciplinary team operates to deliver the full range of services. Out of hours the service is covered by an on call team where a single Consultant in Public Health / Medicine (CPH/M) is always available on call and at times there is additionally a Speciality Registrar on call. A voluntary out of hours agreement is informally in place with a small number of nursing and administrative staff.

Table 1 Monday to Friday (In Hours) Health Protection Team Designation WTE Consultants in Public Health / Medicine (Health Protection) 2.4 Specialist Nurses (Health Protection) 3.0 Personal Assistants 2 Surveillance/Notification Assistants 1.5

The Consultants in Public Health / Medicine (Health Protection) are supported by 5 additional generic Consultants in Public Health / Medicine for the purposes of 24/7 on call provision.

Table 2 Out of Hours Health Protection Team Designation Periods covered Consultants in Public Health / Medicine 24/7 evenings and weekends Speciality Registrars in Public Health Evenings & weekends for 3 days per week only Specialist Nurses (Health Protection) None Personal Assistants None

A Consultant in Public Health Pharmacy provides ad hoc input on health protection issues when required. The Health Protection Team also benefits from access to the Public Health Officer Team who provide research, evaluation and database management expertise.

NHS Tayside Competent Persons Eight Consultants in Public Health / Medicine are designated as NHS Competent Persons under the provisions of the Public Health etc (Scotland) Act 2008.

3.2 Roles and responsibilities

Consultants in Public Health / Medicine (CPH/M) The CPH/M role is:  Surveillance: Monitoring the health of the population and the hazards and exposures affecting it  Investigation: Investigating why and how people fall ill because of exposure to hazards and what can be done to prevent this  Risk assessment: Estimating the probability of the health of a community being damaged from exposure to a hazard  Risk management: Putting in measures that reduce the risk of exposure to hazards and the impact they have on health

Page 159 of 234  Risk communication: Informing the public and other stakeholders about the risks to their health and what the individually or collectively can do to reduce these.  Co-ordination: Leading and contributing to time-limited and ongoing planned, proactive programmes and activities, including statutory services, to protect population health.

The CsPH/M provide public health advice to other professionals, to patients and relatives, staff and the public from an NHS base, home or other agency site. A CPH/M leads the management and coordination of the public health incident response, in liaison with local NHS senior management, and others e.g. other NHS Board areas, Health Protection Scotland, Scottish Government and other national agencies. A CPH/M convenes an incident/outbreak management team on the basis of clinical judgement in order to ensure protection of the public health. CsPH/M participate in local emergency planning arrangements including Regional Resilience Partnerships (RRP) and Scientific and Technical Advisory cell (STAC) arrangements when required.

Specialist Nurses (Health Protection) The Specialist Nurses also provide public health advice to a wide range of other professionals, to patients and relatives, staff and the public from an NHS base, home or other agency. This includes on health protection issues including communicable diseases, infection control, immunisation and environmental health, implementing the public health response in relation to health protection incidents and leading strategically on the control of communicable disease through agreed projects and in relation to broad policy areas in Tayside.

The Specialist Nurses take a lead role in the initial investigation of confirmed, probable and possible single cases of communicable disease and infection (e.g. meningococcal disease, measles) and in the local control of specific outbreaks (i.e. gastro intestinal infections in care homes). The Specialist Nurses also take a lead role in providing advice and information and training to NHS professionals, local authority, private and voluntary organisations, educational establishments and the general public on health protection issues including communicable disease, environmental health, infection control and immunisation. The Specialist Nurses are members of and participate in regional and national health protection networks/groups.

Surveillance Notification Assistants The Surveillance Notification Assistants receive verbal, written and statutory notifications of infectious diseases, record these in appropriate databases, and produce local returns on notifications through national systems for monitoring of disease trends.

Health Protection Administrative and Clerical Staff The health protection administrative and clerical members of staff provide a comprehensive administrative and secretarial support service to CsPH/M and other professional staff within the Directorate of Public Health. This includes assisting staff in managing their working day and acting as the identified contact point for all callers to the office, by telephone or in person, dealing with non-clinical enquiries, resolving difficulties and advising on the proper channels of communication to ensure that they minimise inappropriate interruptions whilst maintaining the continuity of the needs of staff and outside agencies.

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Page 160 of 234 3.3 Tayside Local Authorities’ staffing

Angus Council Angus Council has 15.2 whole time equivalent (WTE) competent persons as designated under the Public Health etc (Scotland) Act 2008. In addition 1.6 (WTE) food safety officers, two technical officers, a Dog Warden and an Animal Health Inspector contribute to public health protection functions.

Dundee City Council The planned provisional staffing complement for the period of this Health Protection Plan includes 17.3 WTE Environmental Health Officers (EHOs) including 3 managers (meeting the definition of competent persons under the Public Health etc (Scotland) Act 2008).

There are a further 21 WTE staff who contribute to public health protection functions, including; Food Safety Officers, Pest/Animal Control Technicians and Licensing Standards Officers.

Perth & Kinross Council Perth and Kinross has 9.0 WTE competent persons as designated under the Public Health etc. (Scotland) Act 2008. In addition there are a further 22.0 WTE officers who contribute to public health protection functions.

3.4 Tayside Scientific Services This laboratory is part of Dundee City Council and provides comprehensive scientific services to the Tayside Local Authorities, private business and government agencies. It does not interface with the general public, but provides a support service to local authority functions such as Environmental Health and Trading Standards. Their services include analysis and examination of air quality, contaminated land, and microbiological and chemical examination of food and water supplies. The work of the lab contributes greatly to the work of the Local Authorities within Tayside NHS area both in day-to-day terms and in outbreak or major incident situations.

3.5 Tayside Local Authorities Out of Hours Arrangements Each local authority has an out of hours facility, which holds contact details for key staff. This information is held by:  NHS Tayside Health Protection Team  Emergency Planning- contact lists are kept by all senior officials  Food Standards Agency- Food Alert Contact Team

In only one area of Tayside are officers on a formal on-call rota. In the other two areas, the contact list system relies on officers identified on the list being available if contacted. To facilitate availability, contact lists contain the names of a number of officers for each local authority area.

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Page 161 of 234 3.6 Tayside staffing for delivery of the health protection function

Covering CPH/M total 24/7 availability for on call

In recent years the CPH/M on call availability has been variable as the rota has been subject to periodic changes in total generic CPH/M availability. At any one time the total availability for on call can vary from that expected in line with occurring vacancies and absence.

Employing Designation WTE body 2010-12 2012-14 2014-16 2017-19 NHS CPH/M total 6.7 6.7 7.3 7.5 Tayside generic availability for 24/7 on-call Specialist nurses 3 3 3 3 (health protection) Angus Environmental 30 28 TBC 21 (Not Council health staff (all 24-28 expected WTE) grades) Dundee Environmental 47 40 40 38.3 City health staff (all Council grades) Perth and Environmental 37.9 31.9 31.0 31.0 Kinross health staff (all Council grades)

3.7 Maintaining knowledge and skills

NHS Tayside All consultant staff are required to maintain their skills and professional registration, and to record continuing professional development (CPD) activities and undergo annual appraisal, in keeping with current General Medical Council (GMC) and UK Public Health Register (UKPHR) guidelines.

Speciality Registrars are required to undergo annual assessment of progress with training in order to ensure that skills are being developed appropriately.

The Specialist Nurses (Health Protection) are required to maintain their skills and professional registration and to record continuing professional development (CPD) activities and undergo annual appraisal, in keeping with the current Nursing and Midwifery Council (NMC) guidelines.

Local Authorities Local Authority professionals all have an Employee Review and Development process, or equivalent, on an annual basis. There is ongoing training ensuring that staff have the necessary skills and competencies on a wide range of public health and environment matters, including health protection. In addition, officers regularly attend national Liaison Groups on matters of food, health & safety, pollution, public health, housing, smoking and port health.

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Page 162 of 234 3.8 Capacity and resilience

Capacity can be defined as having sufficient resources and capability in an organisation with responsibility for Health Protection to enable them to discharge their remit, including the response to increasing pressures on their services12.

Resilience is about the sustainability of a response over a period of time (e.g. 48 hours)12. For example a complex disease outbreak may require the core investigatory team to work intensively for long hours over many days. To cope with this pressure therefore it may be necessary to operate a shift or rota system. Sufficient capacity to do so is therefore required. This means that staff called in from other functions to support the response will have to be trained and prepared in advance for this role.

Maintaining and building capacity and resilience depends on adequate resources being available. A decline in core health protection resources within any party to this plan could affect the overall capacity within Tayside to react effectively to incidents. It is essential that all parties maintain and develop plans to ensure that there is sufficient health protection capacity, including the ability to effectively react to incidents. This includes maintaining and reviewing existing business continuity plans.

3.9 Information Technology and Communications Technology

NHS Tayside NHS Tayside uses the following systems to support the health protection function. All these systems are available during office hours, and many can be accessed on call and can be used in an outbreak or incident.

NHS Tayside Information Technology and Use communications technology BT (British Telecom) landline, mobile phones, on call Day-to-day (including on call) pagers and 3 sets of teleconferencing equipment communications and teleconferencing Access to video-conferencing facilities off-site Video-conferencing including teaching Microsoft packages including Word, Excel, used on Communications, data collection including desktop and laptop computers outbreak management, filing, presentations. Laptops (with email, internet) Internet Investigations, communications, research. CHI (Community Health Index) Patient demographic data HPZone Notifications of Infectious Diseases reported to Health Protection Scotland Disease notification local database Record of notifications ECOSS (Electronic Communication of Surveillance in Reporting mechanism for notifiable and Scotland) reportable organisms ESMI (Enhanced Surveillance of Mycobacterial National surveillance database for TB Infections in Scotland) Information board Can be written on and used in an incident or as a teaching or presentation facility. Television Enables staff to keep up-to-date with media Mobile phones including MTPAS messages and communications during an incident or outbreak.

12 Definitions sourced from Health Protection Scotland (personal communication, March 2010) 2017-19 Tayside Joint Public Health Protection Plan 29

Page 163 of 234 IT (Information Technology) and Communications Technology available to Local Authorities in Tayside

Each Local Authority has access to the following: 1. Emergency Planning centres and facilities 2. Geographical Information System (GIS) 3. Civica IT system linked to Address Gazeteer. The capacity of this system provides: a. database for all premises within EH jurisdiction b. handling of all service requests including communicable diseases c. planning of inspection programmes d. sampling database (e.g. food samples) e. production of data reports f. mail merge g. multi access points in Council premises including emergency planning centre 4. All staff equipped with mobile phones and cameras 5. All staff equipped with PC and internet access

4.0 Health Protection: planning infrastructure

Joint plans for the Tayside local resilience partnership and regional resilience grouping are held on Scriptstore: http://civilcontingencies.dundeecity.gov.uk/

Parts of this site are password protected.

4.1 Health Protection Plans A number of health protection plans have been produced for Tayside (Appendix B). These require to be regularly updated and exercised.

4.2 Local authority health protection plans

Single Outcome Agreements and the service planning process The Scottish Government and local government share an ambition to see Scotland's public services working together with private and voluntary sector partners, to improve the quality of life and opportunities in life for people across Scotland.

This shared ambition is pursued through Single Outcome Agreements in a drive towards better outcomes. These agreements between the Scottish Government, local authorities and Community Planning Partnerships (CPPs) set out how each will work in the future towards improving outcomes for the local people in a way that reflects local circumstances and priorities, within the context of the Government’s National Outcomes and Purpose.

The Scottish Government's priorities, to be reflected in SOAs, can be summarised as follows:

 Wealthier and Fairer Scotland  Healthier Scotland  Safe and Stronger Scotland  Smarter Scotland  A Greener Scotland

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Page 164 of 234 In Tayside each Council has signed Single Outcome Agreements (SOAs). In the case of Dundee City Council this was made through the vehicle of the multi agency Dundee Partnership. The SOA for Dundee describes how Dundee City Council, Scottish Enterprise Tayside, NHS Tayside, Tayside Police, academic institutions and representatives of the private, community and voluntary sectors have all agreed to work together to make Dundee a better place.

Perth and Kinross Council’s Planning Partnership (NHS Tayside, Perth College, Perth and Kinross Association of Voluntary Organisations, Perth and Kinross Council, Police Scotland, Scottish Enterprise and Scottish Fire and Rescue Service) approved the Community Plan / Single Outcome Agreement 2013 – 2023 in June 2013 setting five strategic objectives:

 Giving every child the best start in life  Developing educated, responsible and informed citizens  Promoting a prosperous, inclusive and sustainable economy  Supporting people to lead independent, healthy and active lives  Creating a safe and sustainable place for future generations

Each Council also produces Council Plans linked to SOAs. Individual service plans link with these higher-level strategic objectives providing a clear link between these and service delivery. This is illustrated in Figure 6.

Local authorities have a wide range of plans which connect with health protection. The strongest links are contained in the respective departmental service delivery plans for environmental health.

Figure 6. Local Authority Planning Links

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Page 165 of 234 4.3 Joint working arrangements

Gastro-Intestinal Liaison Group This Group has a remit to ensure that the main stakeholders responsible for health protection take a consistent approach in the reporting, investigation, monitoring and control of notifiable infectious disease across Tayside. Membership includes NHS Tayside, the three Local Authorities and Tayside Scientific Services.

Joint Tayside and Fife Water Group This group has a remit to ensure that NHS Tayside working in partnership with other statutory organisations fulfils its responsibility to take appropriate action in protecting and informing the public on the risks associated with public and private water supplies and blue-green algae (BGA) (Cyanobacteria). Membership includes NHS Tayside, the three Local Authorities, SEPA and Scottish Water. The group produces a monitoring and action plan for BGA on an annual basis setting out the arrangements in place to control the risks associated with BGA in water supplies.

Communicable Diseases - National Pregnancy Screening Programme The programme offers screening to all pregnant women for HIV, rubella, syphilis and hepatitis B. Screening, diagnosis and treatment, and follow up are required to be in line with NHS QIS Pregnancy and Newborn Screening Clinical Standards (October 2005) and relevant Managed Clinical Network (MCN) standards.

Women’s Health/Microbiology Liaison Group A multidisciplinary group with representation from midwifery, obstetrics, microbiology, virology and public health meet regularly to discuss a range of issues relating to communicable diseases in pregnancy. The group also discusses issues on pregnancy screening for communicable diseases, when relevant.

Other groups that support and promote the work of health protection include Tayside Immunisation Steering Group, the NHS Tayside Seasonal Influenza Vaccination Strategic Governance Group,

Tayside Blood Borne Virus and Sexual Health Managed Care Network (BBVSHMCN) http://www.bbvmcntayside.scot.nhs.uk/

This is a multi agency accredited managed care network charged with implementing and monitoring delivery of the Scottish Sexual Health and BBV Framework 2011-15 (http://www.scotland.gov.uk/Publications/2011/08/24085708/0), the Hepatitis C Action Plan (http://www.scotland.gov.uk/Publications/2008/05/13103055/0) and the HIV Action plan (http://www.scotland.gov.uk/Resource/Doc/293178/0090440.pdf). Representation includes NHS Tayside, Voluntary Sector agencies, and Local Authorities. Subgroups take forward specific areas of work in relation to Prevention, Hepatitis, HIV, Sexual Health and Audit.

Tayside Immunisation Strategy Group

This group co-ordinates delivery in Tayside of all national vaccination programmes, involving NHS pharmacy, admin, finance, community and school nursing, in liaison with local education authorities.

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Page 166 of 234 5.0 Delivering the health protection function in Tayside 2014-2016

5.1 Notifiable diseases and organisms

Under the Public Health etc (Scotland) Act 2008 there is a list of diseases that registered medical practitioners have a statutory duty to notify to their public health department based on reasonable clinical suspicion. There is also a list of largely corresponding organisms that diagnostic laboratories also have a statutory duty to notify to public health. The Health Protection Team is now routinely using the national electronic HP Zone database system to manage all notifications. The table below shows all notifications whether directly from diagnostic laboratories or medical practitioners. Confirmed cases are all the notifications that were subsequently confirmed ie not all clinically notified cases are subsequently be confirmed by laboratory testing. The numbers apply to Tayside residents and refer to individual disease/organism notifications not individual people.

Table 1: Diseases / organism notified / confirmed to Public Health in 2014 – 2015 and 2015 – 2016 Disease / 01/04/2014 - 31/03/2015 01/04/2015 - 31/03/2016 organism Notifications Confirmed Notifications Confirmed Anthrax <5 0 <5 0 Campylobacter 696 696 549 549 Clostridium difficile 8 8 11 11 Clostridium 0 0 <5 <5 perfringens E.coli / VTEC 35 29 15 15 Cryptosporidium 50 48 50 50 Diphtheria <5 0 0 0 Giardia 11 11 17 17 Hepatitis A <5 <5 <5 <5 Hepatitis B 39 39 28 28 Hepatitis E 20 20 27 27 iGAS 25 24 33 32 Influenza virus 13 12 10 10 Legionella 6 5 9 5 Listeria 0 0 <5 <5 Measles <5 0 7 0 Meningococcal 10 <5 20 14 disease Mumps 54 20 137 91 Novel Coronavirus <5 0 <5 0 2012 Paratyphoid <5 <5 0 0 Pertussis 126 55 197 107 Psittacosis <5 <5 <5 0 Rubella 0 0 <5 <5 Salmonella 50 50 59 59 Severe Acute <5 0 0 0 Respiratory Syndrome (SARS)

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Page 167 of 234 Shigella 6 5 6 5 Tuberculosis (all) 41 21 28 15 Typhoid 0 0 <5 0 West Nile fever <5 <5 0 0 Yellow Fever <5 <5 <5 <5 Source: HP Zone

5.2 Significant Incidents and Outbreaks 2014-2016 In any one year, a number of incidents and outbreaks occur. These vary in severity and in the degree to which new lessons are learned about how services can better respond in the future. Early lessons can be learned during ongoing 'hot reviews' as an incident develops or at the close of an incident. ‘Hot reviews’ enable matters to be dealt with, which do not require the in depth study needed to produce a report. Very often such lessons can be very valuable if captured fresh and often concern issues such as communication. This can be useful when final reporting of such incidents is delayed, for example due to outstanding legal considerations. For the purpose of the JPHPP, significant incidents and outbreaks refer only to those for which an Incident Management Team (IMT) meeting was required. In 2014-2016 there were 13 such significant incidents or outbreaks managed through multiagency IMT led by the Health Protection Team. Of these, 3 involved respiratory pathogens and 7 involved gastrointestinal pathogens.

Respiratory and Vaccine-preventable Communicable Diseases TB cases again required significant investigative and control effort, including close collaboration with other NHS and external services. This has been necessary to manage the risks associated with individual patients’ non-adherence to treatment and where there has been potential for widespread transmission in specific healthcare and educational settings. In response to previous progress reports in relation to the TB Action Plan for Scotland regular multidisciplinary team meetings have been re- established and participation in a regional programme of retrospective review of TB case management (“TB Cohort Review”) has commenced. Regular audit of contact tracing was put in place and discussions are on-going towards targeted preventative and case finding activity amongst higher risk populations.

Outbreaks of influenza in care homes have been much fewer and less impactful in 2014- 2016 compared to the previous period. Those that have occurred have generally been well managed. Education and advice provided by Health Protection Team staff on visits and remotely has served to support care homes in managing the impact on their staff and resources. In turn this has limited the impact on primary care, hospitals, out of hours NHS, and social care services.

A rare instance of multiple cases of meningococcal infection being associated with a specific (non-healthcare) community setting necessitated a substantial and detailed health protection response. This involved co-ordinated communication and rapid provision for exposed individuals of protective antibiotics followed by two doses of a specific vaccine. Feedback from those affected and from other agencies which provided support was that the management had been effective and well co-ordinated. Useful lessons were learnt regarding preparedness and documenting of communications.

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Page 168 of 234 Communicable Gastro-intestinal Diseases

The NHS Tayside Health Protection Team and staff from the three local council environmental services work closely to investigate cases and outbreaks of infection associated with potentially food or water-borne organisms. The Health Protection Team provides ongoing surveillance of all reported cases of gastroenteritis. Surveillance includes identifying any possible links between cases, determining possible cause and quantifying incidence rates. Information gathered by Environmental Health Officers during interviews with cases of gastrointestinal disease forms a vital part of the epidemiological surveillance function.

During 2014-16 there were many outbreaks and cases of food and water borne infection. These peaked, as usual, in late summer and were frequently the result of infection imported from overseas when patients returned from their summer holidays. There were 12 outbreaks associated with more local transmission commonly through leisure and recreational settings.

Not reflected in the figures for notifiable diseases and organisms, however, are the many outbreaks of norovirus managed by the Health Protection Team. During 2014- 2016 there were 37 such incidents. These are most commonly associated with community care settings and therefore, as with outbreaks of acute respiratory illness, do impact significantly on other health and social care services. Collaborative working between NHS Infection Control and Prevention services, Local Authorities, private providers and public health is essential to provide a full response to these risks. A member of the HPT has recently completed a Masters degree dissertation on the subject of managing such outbreaks involving a survey of local care homes and will be working to disseminate the findings.

E coli O157 and other Verotoxigenic E coli (VTEC) continue to feature in significant incidents. These pathogens are of particular public health importance because of their ease of transmission and the risk of serious lifelong morbidity from complications such as Haemolytic Uraemic syndrome (HUS). Throughout 2014-16, NHS Tayside and Local Authority colleagues will be working with other agencies to implement the VTEC Action Plan for Scotland.

Environmental incidents

2014-16 the HPT collaborated with Tayside local authorities in the investigation and management of 6 air pollution reports, 8 chemical issues, 3 cancer cluster enquiries, 3 waste related concerns, and 2 windfarm complaints. Throughout 2014-16 the HPT continued to review and provide advice on private and public water supply reports. In addition the HPT collaborated with partner agencies in the investigation of a number of cryptosporidium incidents including an outbreak associated with Arbroath Pool in Angus. Recommendations from the review of pool-related incidents are taken forward through the Tayside Pool Convention.

5.3 Healthcare associated Infections NHS Tayside continues to carry out surveillance of healthcare associated infections in line with guidance from the Chief Medical Officer.

Emerging challenges include carbapenemase-producing enterobacteriaceae (CPE), especially amongst people who have received healthcare outside the UK.

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Page 169 of 234 Outbreaks of Multidrug resistant Acinetobacter have also been reported in Scotland, affecting in particular patients in HDU and ITU.

5.4 Vaccine preventable diseases and immunisation programmes

Childhood immunisation programme

Uptake rates for well-established vaccinations including diphtheria, tetanus, polio, pertussis, Haemophilus influenza type B, meningococcal group C and pneumococcal vaccines in children up to 24 months in NHS Tayside all continue to be above 95%, as does the uptake of MMR (Measles, Mumps, Rubella) by the age of 6 years. In addition to maintaining these attainments major changes in the national childhood vaccination programme introduced in 2013 have subsequently been fully implemented throughout 2014-16.

Meningococcal disease

In October 2015 Men B was introduced into the childhood programme for any child born after the 1st July 2015. Babies born on or after 1 May are being offered the vaccine as part of a one off catch-up campaign. All children will now receive Men B vaccine at 2, 4 and 12 months of age. Since 2009, there has been a year-on-year increase in the number of cases of Men W disease in the UK. Therefore in 2015/16, all young people aged 14-18 were offered Men ACWY vaccine, as well as new university entrants. This was part of a catch-up programme. Subsequently, all S3 pupils will be offered the Men ACWY vaccine as part of the routine childhood programme, in place of the Men C booster previously offered to the same age cohort.

Seasonal Influenza An annual flu vaccine is offered annually from October onwards for everyone aged 65 and over, pregnant women, everyone with serious health condition, including those with obesity and all health care workers. The established at risk groups include:  At risk 6 months to 65 years  Pregnant women  Household contacts of people with compromised immune systems  Over 65’s  Frontline health and social care workers

The nasal flu vaccine is also offered to all primary school children, as well as children aged 2-5 years who are not yet in primary school. Children in secondary school are not currently included in the programme. However, children of all ages with a serious health condition will still be offered the flu vaccine from 6 months of age.

Varicella Zoster vaccination

This is a new vaccination programme that will offer Varicella Zoster vaccine to people aged 70 to 79 years. The first phase of the campaign commenced in September 2013, targeting 70 and 79 year olds, and is being progressively rolled out to other age cohorts between age 70-79.

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Page 170 of 234 5.5 Planning for emergencies, including potential pandemic of influenza NHS Tayside and Local Authority colleagues have been engaged in implementing the changes in Emergency Planning structures across Scotland. Tayside is an active member of the North of Scotland Regional Resilience Partnership alongside Grampian and Highlands and Island health board areas. The Local Resilience Partnership arrangements will continue to address local issues while regionally work is underway to review plans and share good practice

Embedding these new arrangements and exercising emergency response plans within the new structures was an important element of health protection work throughout 2014- 2016

The Commonwealth Games in July/August 2014, with shooting events being hosted in Angus, and the Ryder Cup in Perth and Kinross in September 2014 provided an opportunity to strengthen multiagency planning and response. This was tested during a norovirus outbreak at the accommodation of the Games participants. Rapid identification of cases and improved hygiene procedures meant that none of the participants were affected by the virus.

6.0 Mutual aid arrangements A Mutual Aid Agreement (MAA) is defined as an agreement between organisations, within the same sectors and across boundaries, to provide assistance and additional resources during an emergency which may go beyond the resources of an individual organisation13.

A MAA for the three Local Authorities is in place and was agreed through the Tayside Strategic Co-ordinating Group (Tayside SCG).

Joint working arrangements between the various agencies in Tayside are in place through the Tayside Local Resilience Planning structure. Police Scotland, Fire and Rescue Scotland, Scottish Ambulance Service and NHS Tayside have formal mutual aid arrangements within their sector of operation.

Regulation 3 of the Civil Contingencies Act (CCA) 2004 (Contingency Planning) (Scotland) Regulations 2005 provides that Category 1 responders, which have functions exercisable in a particular police area in Scotland, must co-operate with each other in connection with the performance of their duties under section 2(1) of the CCA.

7.0 Health protection: public involvement and stakeholder feedback NHS Tayside has a long and established network of public partners who participate in a wide variety of engagement activities around development and improvement of NHS services. One of their key roles is their involvement in the Healthcare Associated Infection Public Partnership Group (PPGs) network. Members regularly meet with professionals around infection control issues and contribute to development of strategic and communication plans. PPGs also conduct hand hygiene and cleaning audits. They share information, for example on hand hygiene awareness-raising with the wider public at information stands both within and outwith NHS premises and also seek public views and opinions on services.

13 Definition sourced from Preparing Scotland (section 7) http://www.scotland.gov.uk/Resource/Doc/94471/0022783.pdf

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Page 171 of 234 PPGs also contribute to discussion and debate on an individual issue basis.

Governance of the Joint Public Health Protection Plan is through the NHS Tayside Improvement and Quality Committee which has a Public Partnership Group representative as a member and as such is able to comment on their content.

The Health Protection Team invests on-going time in developing its intranet site, which includes the facility to raise health protection queries via a dedicated e-mail link. The public facing NHS Tayside internet site also makes all relevant content available and members of the public and other stakeholders are able to feedback comments to the HPT via these sites.

Through the NHS Tayside Public Partnership Forum, the Health Protection Team will be engaging in further discussions with public partners to discuss the role of Health Protection in Tayside.

The Health Protection Team will make all incident management reports available on the intranet and internet (Appendix A), unless the IMT agrees that this is not appropriate for any particular incident.

8.0 Progress during 2014-16 Below are topics that were identified for further work during 2014-16:

1. Ensuring joint working arrangements to deliver an effective response (including out of hours), which is consistent with the provisions of the Public Health etc (Scotland) Act 2008  Local authorities to formalise and implement a robust on-call arrangement for appropriate personnel where it is not yet provided Each LA has now provided out-of-hours contact details

2. Reviewing, revising and exercising existing protocols and emergency plans in accordance with the schedule at appendix B These plans have been reviewed and exercised

3. Maximise opportunities for joint learning:  Provide opportunities for joint CPD Monthly CPD sessions are now provided in which HPT, PH, microbiology, infection control, occupational health, emergency planning and LA colleagues are invited to participate

 Share learning from participation in the WINCL project investigating norovirus transmission The publication of this research has been shared and disseminated

4. Learning from the incidents that have recently occurred in Tayside and elsewhere  Hot debriefs of incidents This is now standard practice

 Make available incident management reports These are prepared and submitted to relevant agencies for noting and taking forward recommendations where appropriate 5. Joint working to implement national plans and policies: 2017-19 Tayside Joint Public Health Protection Plan 38

Page 172 of 234  Identify joint actions to implement the VTEC action plan Relevant actions are being implemented on an on-going basis as they are further developed by national working groups eg the new revised surveillance form is now in use

 Implementing the TB Action Plan for Scotland Implementation is ongoing, focusing on the key recommendations of the second phase of the TB Action Plan for Scotland, which launched in summer 2016. Work is underway, commencing with an exploration of available data in order to develop an assessment of needs and options appraisal for the establishment of a system offering accessible TB screening and testing to members of new entrant (migrant) and other higher-risk populations in Tayside, involving partners in NHS primary and secondary care services, education authorities and the voluntary sector.

 Continue to implement the new national immunisation programmes Men B and Men ACWY are now integrated as part of the routine childhood immunisation programme. Changes to HPV and Men C programmes continue to be implemented during 2016

 Implement HP Zone within the national programme for roll-out of the system, ensuring partners are kept informed of and involved in changes in ways of working and communicating HP Zone is now fully and routinely used by all members of the HPT. On-going cpd opportunities are available for all team members to further develop their skills and HPT fully participates in the national user group

 Engage with Regional Resilience Partnerships This is now in place

9.0 Recommendations for 2017-19

 Progress recommendations from the Health Protection Team away day in January 2016 to improve and develop longer term strategic team vision, cohesion and priorities  Share learning from leisure pool incidents to reduce swimming pool related infection  Implementation of Cleaner Air for Scotland Strategy in Tayside  BBV focus on prevention  Migrant health  Scottish Health Protection Network GIZ priorities  On-going resilience for Health Protection Team  Reviewing and revising existing protocols and emergency plans in accordance with the schedule at Appendix B.

Tayside’s Joint Public Health Protection Plan is a public document and is available to members of the public on NHS Tayside’s Directorate of Public Health website at www.taysidepublichealth.com and on request from:

Directorate of Public Health NHS Tayside King’s Cross Clepington Road 2017-19 Tayside Joint Public Health Protection Plan 39

Page 173 of 234 Dundee DD3 8EA

Telephone: 01382 596987 Fax: 01382 596985 E-mail: [email protected]

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Page 174 of 234 Appendix A: Reporting of Health protection incidents and outbreaks

It is good practice for a full report to be prepared and agreed by the IMT and made available to appropriate agencies. There should also be a presumption in favour of public access to incident reports. The report should consider the effectiveness of the investigation and management measures taken as well as describing the incident. Where appropriate it should contain targeted recommendations.

National guidance is provided in the document -“Management of Public Health Incidents Guidance on the Roles and Responsibilities of NHS led Incident Management Teams revised in October 2011. http://www.scotland.gov.uk/Publications/2011/11/09091844/0. This national guidance is reflected locally in the Tayside Health Protection Major Incident Response Plan.

Reporting of public health incidents and outbreaks should be in the format of an SBAR (Situation, Background, Assessment, Recommendations) report, or a formal Incident report and Minimum Dataset as recommended by Scottish Government and the Health Protection Network (Management of public health incidents: Guidance on the roles and responsibilities of NHS led Incident Management Teams. 2011.)

It may be necessary to delay or limit the circulation of the report pending legal action. Legal advice should be sought in such cases. In situations where pending or ongoing legal or enforcement action makes it impossible to produce a report within the designated timescale, this should be notified to the relevant governance and oversight committees. Consideration should be given to producing a brief ‘lessons learned’ statement, if necessary with input from organisational legal advisers.

Reports should be completed within 3 months of the closure of the incident/outbreak.

IMT reports and incident SBARs will be presented to the NHS Tayside Public Health Clinical Governance committee for assurance that processes are in place to disseminate learning and to ensure plans are in place for any internal improvement work. The Chair of the IMT or PAG will be responsible for ensuring all further actions identified in the report for NHS Tayside Public Health / Health Protection are completed.

Completion of actions and recommendations by other agencies, including Local Authority partners should be monitored through committee(s) of the individual agencies involved.

Summaries of incidents/outbreaks and agreed actions will be presented to NHS Tayside Clinical Quality Forum, which then reports to NHS Tayside Improvement and Quality Committee (Board governance committee). This reporting will form part of the annual Health Protection report to I&Q.

Summaries and key learning points from incident and outbreak reports will be presented within other reports, such as the Director of Public Health’s Annual Report.

IMT reports and incident SBARs will generally be placed on the NHS Tayside intranet Health Protection website, and on the NHS Tayside Public Health internet site for public access. These reports would also be made available through FOI requests or in less formal engagements with members of the public or other interested parties. So that it can be placed in the public domain, the report should not contain any commercially sensitive or person identifiable information.

2017-19 Tayside Joint Public Health Protection Plan 41

Page 175 of 234 Appendix B: Programme for review and exercise of plans Name of plan Description Last review Due review Lead person Last Due for Lead person exercised exercise NHS Tayside health protection manual Departmental guidance for public n/a TM/DC/JH/LD n/a n/a n/a health management of individual cases, incidents and outbreaks NHS Tayside health protection major 08/15 08/17 JH 26/03/14 11/16 JH The objectives of this plan are to incident response plan ensure prompt action to:  Recognize a major incident or outbreak of food poisoning or communicable disease with serious consequences for the population of Tayside;  Define its important epidemiological characteristics and aetiology; Stop its further spread;  Prevent its recurrence;  Maintain satisfactory communication with external agencies with a legitimate interest in the outbreak. Public Health resilience and business Sets out the procedures to be 03/15 03/16 LM ? ? LM continuity plan followed in the event of a loss of facilities, staff or communications. NHS Tayside pandemic influenza 11/15 11/17 JH 09/15 09/17 JH The objectives for the NHS Tayside preparedness response plan Plan are to:  Reduce the impact of the influenza pandemic on morbidity and mortality in Tayside, through delivery of appropriate and timely disease prevention,

Page 176 of 234 and the organisation of NHS care;  Make provision for the appropriate NHS care of large numbers of ill people and dying people in Tayside;  Provide accurate, timely and authoritative advice and information to professionals, the public and the media. Blue Green algae monitoring and action An annual plan has been produced 03/15 03/16 JH n/a n/a JH plan each year since 2001 by NHS Tayside in partnership with all three local authority departments of environmental health, Scottish Water, SEPA and Dundee University. The plan sets out inspection and monitoring frequencies for water bodies at risk of developing algal blooms and details multi-agency actions in various scenarios relating to cyanobacteria and is reviewed each year. Scottish waterborne hazard plan 10/13 12/15 SW/HPS 04/14 11/16 JH This Plan was developed as a multi- agency approach to the management of waterborne hazards within Scotland, and is led by Scottish Water with involvement of NHS Boards, Local Authority and Environmental Health and Emergency Planning Departments and Health Protection Scotland. It 2017-19 Tayside Joint Public Health Protection Plan 43

Page 177 of 234 provides guidance for dealing specifically with waterborne hazards to enable a consistent approach to be adopted by staff in all the relevant agencies across Scotland, and is updated nationally every year. STAC Plan A Science and Technical Advice 05/14 12/15 JH 01/16 01/18 JH Cell (STAC) is a group with expert knowledge whose role is to advise the North of Scotland Regional Resilience Group (NSRRG), Tactical LRP or any part of the formal response during an incident, including a declared Major Incident. The fundamental role of the STAC is to:  Undertake a risk assessment;  Advise on risk management measures required;  Advise on risk communication A comprehensive list of plans for each of Tayside’s Local Authorities can be accessed via the following hyperlinks: Angus Council http://www.angus.org.uk/documents.cfm Dundee City Council http://www.dundeecity.gov.uk/cplanning/plans/ Perth & Kinross Council http://www.pkc.gov.uk/Council+and+government/Community+planning+-+working+in+partnership/

2017-19 Tayside Joint Public Health Protection Plan 44

Page 178 of 234 Joint Public Health Protection Plan

List of Abbreviations

Abbreviation Clarification NHS National Health Service JPHPP Joint Public Health Protection Plan BBV Blood Borne Virus GIZ Gastrointestinal Zoonosis NRS National Records of Scotland SIMD Scottish Index of Multiple Deprivation CHP Community Health Partnership LE Life Expectancy MD Most Deprived LD Least Deprived NINo National Insurance Number MERS COV Middle East Respiratory Syndrome Coronavirus HIV Human Immunodeficiency Virus CMO Chief Medical Officer VTEC/E-COLI 0157 Vero Cytotoxin-Producing Escherichia Coli COMAH Control of Major Accident Hazards EH Environmental Health

PM10 Particulate Matter of 10 Microns or Smaller

NO2 Nitrogen Dioxide BBV MCN Blood Borne Virus Managed Care Network PrEP Pre-Exposure Prophylaxis SHPN Scottish Health Protection Network CPHM Consultant in Public Health Medicine RRP Regional Resilience Partnerships STAC Scientific and Technical Advisory Cell WTE Whole Time Equivalent EHO Environmental Health Officer GMC General Medical Council NMC Nursing and Midwifery Council

Page 179 of 234 CHI Community Health Index HPZONE Health Protection Zone ECOSS Enhanced Surveillance of Mycobacterial Infections in Scotland MTPAS Mobile Telecommunication Privileged Access Scheme CCP Community Planning Partnership SOA Single Outcome Agreement BGA Blue Green Algae SEPA Scottish Environmental Protection Agency QIS Quality Improvement Scotland MCN Managed Clinical Network BBVSHMCN Blood Borne Virus and Sexual Health Managed Care Network HPT Health Protection Team MMR Measles, Mumps, Rubella MEN B Meningococcal B Vaccine MEN ACWY Meningococcal ACWY Vaccine MEN C Meningococcal C Conjugate Vaccine MAA Mutual Aid Agreement SCG Strategic Co-ordinating Group CCG Civil Contingencies Act PPG Public Partnership Group CPD Continuous Professional Development WINCL Where is Norovirus Control Lost Study IMT Incident Management Team SBAR Situation, Background, Assessment, Recommend Action PAG Problem Action Group I&Q Improvement and Quality NSRRG North of Scotland Regional Resilience Group

Page 180 of 234 10 (17/198) PERTH AND KINROSS COUNCIL

Housing and Communities Committee 31 May 2017 Scrutiny Committee 21 June 2017

Housing and Community Care Complaints and Customer Feedback

Executive Director (Housing and Community Safety)

PURPOSE OF REPORT This report details the complaints received between 1 April 2016 and 31 March 2017 across Housing and Community Care. It includes information on the number of Stage 1 and Stage 2 complaints received and some examples of feedback from customer satisfaction surveys. It also summarises actions taken to improve services as a result of customer feedback.

1. BACKGROUND/MAIN ISSUES

1.1 In Perth and Kinross we value what people tell us about our services by way of complaints and other customer feedback. We use the information to support learning and improve services. We are committed to providing high quality services, however we do accept that sometimes things can go wrong, and when they do, we aim to resolve things quickly.

1.2 The Council has a statutory responsibility to establish and maintain a formal procedure for receiving and considering complaints by, or on behalf of, people who use services. This is enshrined in social work legislation as well as government guidance which asks local authorities to report annually on the complaints investigated and the outcomes of these. Across housing, community care and community safety, the service also reports on non-social work areas, including those relating to finance, local taxes and business support. This statutory requirement ceases for the reporting year 2017-18 due to the introduction of the new model Social Work Complaints Handling Procedure.

1.3 Procedures have been amended to reflect national requirements and recent charges introduced across Scotland from April 2017. All complaints will now be included in the Council’s Annual Complaints Performance Report in accordance with the requirements of the Scottish Public Services Ombudsman. Changes are also being made to align NHS complaints and social work complaints to support services and improvements within the Perth and Kinross Health and Social Care Partnership.

2. PROGRESS SINCE LAST REPORT

2.1 The previous report presented to Housing and Health Committee on 25 th of January 2017(Report No 9 17/35) covered the 18 month period from April 2015 to September 2016. This report overlaps, but now aligns to a financial year reporting cycle and annual report. Progress has been made on the improvement actions highlighted in the previous report and are noted below.

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2.2 The Customer Liaison Team supports the Quality Assurance Group for Social Work and the Complaints Scrutiny Group for housing which allows a consistent approach to scrutinising and learning from complaints.

2.3 The Customer Liaison Team have a full programme of staff training to all community care staff and will closely monitor performance and provide any further training as required. The Team is continuing to explore closer joint working with health colleagues and how information is shared and services improved.

3. ANALYSIS OF COMPLAINTS

3.1 This section summarises the types of complaints reported in the past year and the improvements introduced. Services have been undergoing significant transformational change to improve and alter the way they are delivered to meet rising demand, public expectation and challenging financial times for public services. This has a bearing on the number and type of complaints the service receives.

Table 1: No Complaints received 2015/16 2016/17 Social work services Stage 1 46 65 Stage 2 13 20 Non social work services Stage 1 406 521 Stage 2 26 50

3.2 The table above shows that the majority of complaints about Social Work and non social work services were resolved at the first point of contact by frontline services.

3.3 Complaint Numbers in Context

Although the numbers of complaints recorded has increased, they are low compared to the number of service users, but still an important source of feedback about services.

Table 2: Complaints in relation to total service users/tenants

Service Number of Number of or Number Number Complaints & % Complaints & % Team 2015/16 2016 -17 2015 -16 2016 -17 Comm 10,681 10,652 46 (0.43%)*FLR 65 Care (users) (users) 13 20

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(0.12%)**Invest 169 (0.7%) *FLR 267 Housing 24,401 21,606 9 (0.04%) Repairs (repairs) (repairs) 17 **Invest 118 (1.6%) Area 148 7,457 7,467 *FLR Housing (houses) (houses) 4 (0.08%) Teams 23 **Invest

*FLR Front Line Resolution (Stage 1) ** Investigation (Stage 2)

3.4 Social Work Complaints (Community Care)

The figures show that complaints for this reporting year are higher than last year. In the reporting year, 65 complaints were dealt with by frontline staff, with a smaller number being investigated (20) at stage 2. Of the 20 stage 2 complaints, 3 (18%) were upheld. The main areas of complaint related to learning disabilities, Perth City team and care at home services. The reasons were primarily due to provision of services.

Of the 20 investigations:-

• Service Provision (including quality and reduction of services) represents the largest reason for complaints, but we also received complaints in relation to staff conduct/attitude • Complaints are evenly spread across a number of teams with no specific team highlighted • All 20 complainants (100%) received an acknowledgement within the target time set of 5 working days • 12 (67%) of complainants received their detailed response within the target time set of 28 days or where an extension had been agreed. 2 complaints were withdrawn before the final response was sent • Five Complaints Review Committees were held in the reporting period

3.5 Other Service Complaints (Non Social Work Complaints)

The majority of complaints about housing, finance and business support services were also resolved at the first point of contact by frontline services. Between 1 April 2016 and 31 March 2017 there were 521 complaints which were dealt with and resolved by frontline services and 50 complaints which were investigated under stage 2. Of those investigated:-

• Housing Repairs had the largest number of the 50 stage 2 complaints, followed by some of the Area Teams, which reflects the volume of services provided in these areas • The main reason for the complaints was provision of services or issues with employees

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• 48 (96%) received their acknowledgements within the target time of 3 working days • 37 (79%) of the complainants received their response within the target time of 20 working days. Where responses were delayed, complainants were given information about a new target date

The increase in complaints from last year may be a reflection of the considerable amount of training carried out across the service to emphasise the importance of recording accurately complaints activity.

3.6 Key Improvement Areas

Working with management teams improvement actions have been implemented and include:-

• Staff have been reminded of the Customer Service Standards and their responsibilities with regard to returning calls and correspondence • Improved process for calculating charges for services and improved the information given to service users and their families • Reiterated the importance to staff and contractors of wearing and carrying ID badges • Through our Repairs Transformation Project we are looking at ways to improve communication with tenants about the status of their repairs • Staff have been challenged about inappropriate parking of Council vehicles • Improved signage and reviewed how we deal with customers at one rural office

3.7 Themes and Lessons Learned

• Poor customer care and communication are a key element of many of the complaints we deal with • Issues around charging for services in Community Care, especially the delay in sending out invoices had caused a spike in complaints activity within Finance and Support Services, however the improvement actions have resulted in a reduction of these type of complaints • Failure to communicate clearly or timeously with customers often causes complaints and can result in them escalating, often out of proportion to the initial problem • Complaints handling is not consistent across the three areas of the service, although with the change to the Social Work process there are opportunities to share good practice now across the service • In the second half of the year we received no complaints concerning parking or use of ID badges indicating that practice had improved in this area after being raised as an issue of concern

3.8 In addition to improvements undertaken with individual teams and services, a number of actions have been introduced to help support and improve how we handle complaints and improve the customer experience.

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These include:-

• Ensuing all improvement actions relating to specific complaints are completed • Working to fully introduce and embed the new Social Work procedure • Working with Health colleagues on “joint” complaints • Monitoring improvement actions across the service and where appropriate share the learning • Monitoring decisions made by the SPSO concerning other public bodies and share the learning where appropriate

4. Customer Satisfaction

We regularly gather information from people about the services they receive, some of which is summarised in the table below.

4.1 Housing Services

Indicators *2013 -15 **2015 -17 % of tenants satisfied with Perth and Kinross Council as 84.5 85% a landlord % of tenants who have had a repair completed in the last 90.43% 90% year satisfied with the service they received % of Gypsy/Travellers satisfied with the N/A 69% management of our Gypsy/ Travellers site % of tenants who think the rent for their property 84% 85% represents good value for money? % of tenants satisfied are you with the quality of their 85% 85% home?

*Source: Tenant Satisfaction survey April 2013. 7,300 surveys sent out, 858 returned (response rate 11.75%)

**Source: Tenant Satisfaction survey April 2016. 7,400 surveys sent out, 1,536 returned (response rate 20%)

4.2 Housing Services satisfaction levels remained similar across all indicators. Some initiatives introduced as a result of feedback included the introduction of Take the Lead project with the Environment Services to re-inforce messages about dog–fouling and a Tenant Welcome Pack to enhance the experience of new tenants moving into their home.

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4.3 Adult Social Work and Social Care

Specific Area of Service Adult Social Work and *2016 **2017 Social Care % of service users who agreed that they were 90.1% 86.7% satisfied with the overall service they received % of service users who agreed that they were 84.9% 80.1% supported to live as independently as possible % of service users who agreed that they received a 87.5% 85.8% high quality service % of service users who agreed that they can rely on 85.4% 80.6% the services that they receive % of service users who agreed they were treated with N/A 89% dignity and respect % of service users who agreed they were treated with N/A 86.3% compassion and understanding

*Source: Community Care survey May-June 2016. Sample size 900 service users, of whom 242 responded (Response rate 26.9%)

** Source: Adult Social Work and Social Care survey April-May 2017. Sample size 1,200 service users of whom 344 responded (Response rate 28.6%)

4.4 In response to this feedback the Community Care Management Team have undertaken a number of improvement actions including:-

• Discussions with Care at Home providers about their quality and contractual arrangements • Followed up with respondents who have highlighted areas of concern around their support to ensure that these were addressed and alternatives steps put in place • Reviewed communication and information about charging and how this would be embedded in the outcome focussed assessment/review process

Staff are in the process of identifying improvement actions based on this year’s survey concluded in May 2017.

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5. Conclusion and recommendations

5.1 This report summarises the Social Work and other service complaints received during 2016/17.

5.2 The Committee is asked to:-

(i) Note the contents of this report and the impact that feedback from customers has had on improving services. (ii) Note the improvement actions noted to support and improve how we handle complaints and improve the customer experience.

5.3 The Committee is asked to refer this report to the Scrutiny Committee for their consideration.

Author Name Designation Contact Details Joy Mayglothling Team Leader [email protected] Customer Liaison 01738 475000

Approved Name Designation Date Bill Atkinson Executive Director Housing & 3 May 2017 Community Safety

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ANNEX

1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

Strategic Implications Yes/ None Community Plan/Single Outcome Agreement None Corporate Plan Yes Resource Implications Financial None Workforce None Asset Management (land, property, IST) None Assessments Equality Impact Assessment None Strategic Environmental Assessment None Sustainability (community, economic, environmental) None Legal and Governance None Risk None Consultation Internal Yews External None Communication Communications Plan None

1. Strategic Implications

Community Plan/Single Outcome Agreement

1.1 The Perth and Kinross Community Plan/Single Outcome Agreement 2013- 2023 and Perth and Kinross Council Corporate plan 2013-18 have five outcomes which provide clear strategic direction, inform decisions at a corporate and service level and shape resources allocation. All are relevant to this report.

Corporate Plan

As above

2. Resource Implications

Financial

2.1 None

Workforce

2.2 None

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Asset Management (land, property, IT)

2.3 None

3. Assessments

Equality Impact Assessment

3.2 The proposals have been considered under the Corporate Equalities Impact Assessment process (EqIA) with the following outcome:

(i) Assessed as not relevant for the purposes of EqIA

Strategic Environmental Assessment

3.3 The Environmental Assessment (Scotland) Act 2005 places a duty on the Council to identify and assess the environmental consequences of its proposals. However, no action is required as the Act does not apply to the matter presented in this report. The matters presented in this report were considered under the Environmental Assessment (Scotland) Act 2005 and no further action is required as it does not qualify as a PPS as defined by the Act and is therefore exempt.

Sustainability

3.4 None

Legal and Governance

3.5 The Head of Legal & Governance Services has been consulted and there are no direct legal implications of this report.

Risk

3.6 The Housing and Community Care Senior Management Team regularly reviews complaints and identifies areas for action.

4. Consultation

Internal

4.1 The Heads of Finance and Legal & Governance Services have been consulted on this report.

External

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4.2 The Tenant Committee Reporting Panel was consulted on the report. They commented that the ‘report emphasises the need for complaints to be dealt with and recorded in a clear and previse way.’

5. Communication

5.1 None

2. BACKGROUND PAPERS

None

3. APPENDICES

Detailed complaints monitoring

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Appendix 1

Community Care Stage 2 - 1 April 2015 – 31 st March 2017

Table 1: Complaints Activity and Performance Number No. & % No. & % No. & % progressing Number of ack by responded No. & % satisfied to Stage 2 target to by upheld with Complaints complaints date target date response Review Committee 13 10 (77%) 7 (64%) 4 (36%) 11 (100%) 0 (2015/16) 20 20 12 (71%) 3 (18%) 11 (55%) 3* (2016/17) (100%)

* In addition to the 3 CRCs escalated from Stage 2 there were an additional 2 CRCs that we were directed to hold as a result of decisions from the SPSO.

Table 2: Teams Involved

Number of Number of Team Concerned Stage 2 Stage 2 (2015/16) (2016/17) SW Perth City 2 5 Learning Disabilities 0 5 Care at Home 0 2 Finance Charging 1 2 SW Access Team 1 2 Community Mental Health 1 1 Team SW South/Finance 1 1 Charging AHT North/ Safer 2 0 Communities Community Mental Health 1 1 Team SW North 1 0 Hospital Discharge Team 1 0 SW South 0 1 Occupational Therapy 1 0 SW Perth City/ Finance 0 1 Charging AHT South/ Safer 1 0 Communities SW North/Care at Home 1 0 Total 13 20

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Table 3: What was the focus of the complaints?

Service Policy and Employee Communication Other Equal provision procedure 2015/16 2 8 0 3 0 0 2016/17 2 16 0 2 0 0

Community Care Complaints dealt with at Stage 1

In addition to the complaints dealt with at stage 2, between April 2016 and Mar 2017 we had 65 complaints that were dealt with at stage 1 primarily by the teams themselves and sometimes by the Customer Liaison Team. Between April 2016 and Sep 2016 we had 32 complaints dealt with at Stage 1.

The main area dealing with complaints informally was the Care at Home Service and the Learning Disability Team, which is understandable due to the immediate and personal nature of these services and the large number of service users and carers involved. The other area identified, which was reflected in the formal complaints data, concerned staff conduct / attitude and service users feeling that they received a poor quality or reduced service. Many of these issues were dealt with to the complainants’ satisfaction when a member of staff made prompt contact and clarified the situation and also made an apology, where this was required.

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Appendix 2

Complaints dealt with under Corporate Complaints Procedure, which comprise Housing and Finance and Support Services.

Table 1: Complaints Activity and Performance

No. & % No. & % No. & % of Number of Stage ack by responded to by complaints 2 complaints target date target date upheld 26 (2015-16) 25 (95%) 13 (50%) 19 (73%) 50 (2016-17) 48 (96%) 37 (74%) 23 (46%)

Table 2: Teams involved

Number of Number of Team Concerned Stage 2 Stage 2 (2015/16) (2016/17) Housing Repairs and Imp 8 9 Area Team North 2 9 HAC Housing Access 2 4 Area Team Letham 0 5 Area Team City 0 6 Area Team South 1 3 Local Taxes 4 1 Area Housing Team 0 3 Letham Repairs Finance Charging 3 1 Benefits 0 1 HAC Homeless 1 0 Welfare Rights 0 0 Scottish Welfare Fund 0 1 Housing 0 1 CSC/HRIS 0 2 Area Housing Team City/ 1 1 HRIS Area Housing Team 1 0 North/Benefits Area Housing Team 1 0 North/HRIS Customer Service Centre 2 0 Area Housing Team City 0 1 Repairs Housing 0 1 Area Housing Team North 0 1 Repairs Safer Communities 0 1 Total 26 50

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Table 3: What was the focus of the complaints?

Service Policy and Employee Communication Other Equal provision procedure 2015/16 3* 21 0 3* 0 0 2016/17 5 44 0 1 0 0

* Covers more than one category

Complaints dealt with at Stage 1

In addition to the complaints dealt with by way of Investigation Stage 2 the new model CHP expects staff to deal with complaints raised with them by way of Front Line Resolution (Stage1).

In 2016-17 staff in Housing and Finance and Support Services dealt with 521 stage 1 complaints and in the. Of these complaints raised at stage 1 the numbers escalating to Investigation are very small indicating that staff are dealing with these complaints well and more importantly to the customer’s satisfaction.

Page 194 of 234 11 (17/199) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Perth and Kinross Tenant Participation Strategy 2014-17 and SURE Team Progress Report

Executive Director (Housing and Community Safety)

PURPOSE OF REPORT

The purpose of this report is to update Committee on the progress in achieving the Tenant Participation Strategy aims and the Scottish Social Housing Charter Participation Outcome. The report also highlights the recent work of the Service User Review and Development (SURE) Team.

1. BACKGROUND/MAIN ISSUES

1.1 Section 53 (1) of the Housing (Scotland) Act 2001 places a duty on local authorities and Registered Social Landlords (RSLs) to prepare a tenant participation strategy which includes an assessment of resources required and a statement of the resources to be made available. The Strategy must demonstrate how, as a landlord, the Council intends to communicate with, and listen to, tenants and residents.

1.2 In addition the introduction of the Scottish Social Housing Charter through the Housing (Scotland) Act 2010 requires Perth and Kinross Council (PKC) to report to the Scottish Regulator annually on the achievement of the Charter Outcomes. These include those relating to tenants.

1.3 While the involvement of tenants and others is central to achieving all of the Scottish Social Housing Charter Outcomes, the Tenant Participation Strategy focuses on the achievement of Charter Outcome 3: Participation - Social landlords manage their businesses so that tenants and other customers find it easy to participate in and influence their landlord’s decisions at a level they feel comfortable with. The outcome describes what landlords should achieve by meeting their statutory duties on tenant participation, covering the ways in which social landlords gather and take into account the views and priorities of their tenants; how they shape their services to reflect these views; and how they help tenants and other customers to become more involved.

1.4 The Perth and Kinross Tenant Participation Strategy 2014-17 was approved by Housing and Health Committee on 12 March 2014 (Report 4/113) and identified 5 high level outcomes to be achieved through an action plan, including the further development of Service User Review and Evaluation (SURE) Team. The 5 outcomes are:-

• Develop a range of opportunities for people to get involved, which reflect local circumstances and allow people to participate effectively

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• Build and develop an agreed programme of scrutiny activities with people who use our services • Ensure all tenants, staff and all other people who use our services, will be given access to adequate levels of training and support that will enable them to participate more effectively • Continuously develop ways of improving communication and information sharing to meet the needs of all • Regularly monitor and review this strategy to ensure it continues to be effective

2.0 PROGRESS OF THE SURE TEAM 2016/17

2.1 The Service User Review and Evaluation (SURE) Team is currently made of 6 dedicated tenant volunteers who work tirelessly to support improvement of Housing Services. They carry out in depth research in the agreed area of service to be scrutinised, involving conducting surveys, interviews with staff and tenants, benchmarking and study visits. They meet regularly with the support of an Independent Tenant Advisor and they have received local and national recognition for the work they have undertaken. 2.2 In the last year the SURE Team completed 2 scrutiny activities, reviewing Housing Services’ management of their Anti-Social Behaviour policies and our Tenant Participation activities.

2.3 The team concluded the review of Anti-Social Behaviour policies with presentation to the Housing Management Team (HMT) and the Team Leader of the Safer Communities Team, offering recommendations for improvement and closer working opportunities. They interviewed housing staff, community wardens and tenants, as well as visiting Dundee, to observe other practices.

2.4 HMT and the Safer Communities Team considered the findings and then Reported back to the SURE team with an improvement action plan based on their recommendations. HMT also explained why, in some circumstances they were unable to accept some of their recommendations at that point. Some of the recommendation actions taken so far include:-

• Revising our Anti-Social Behaviour procedures • Increasing co-location of Safer Communities staff with Housing Services • Agreeing a definition of routine and serious anti-social behaviour and response and resolution target timescales with tenants • Introducing Take the Lead, a dog fouling reduction initiative, across all our estates • Enhancing our Northgate System to allow housing staff to record antisocial behaviour complaints and our performance against our locally agreed targets • Progressing reporting online and mobile working

2.5 The SURE Team's scrutiny Tenant Participation (TP) activities took an in- depth look at the activities offered by the Council, and how easy it was for

Page 196 of 234 tenants to get involved and influence their housing services. They chose to look at tenant participation because the Council's three-year TP Strategy is due for review and updating. The SURE Team wanted to know how effective the Strategy has been and what it has achieved in the last three years.

2.6 The SURE Team also looked at the TP Strategies of other Councils: Aberdeen City, Aberdeenshire and North Ayrshire Council, to compare their approach. Three staff from the Customer and Community Engagement team and Area Housing Co-Coordinators from three of the four Housing Management Areas were interviewed during the scrutiny exercise. The report can be viewed at http://www.pkc.gov.uk/media/39232/SURE-Team-report-on- tenant-participation/pdf/Final_TP_Scrutiny_Report_16-1-17

2.7 All of the 24 recommendations for developing and improving tenant involvement were accepted by the Housing Management Team and these will form the basis of the Council’s next Tenant Participation Strategy, which will be written by SURE Team. Consultation on the findings and the development of the strategy has begun with the wider tenant body, and the new strategy will be presented to Housing and Communities Committee later in 2017 for approval and implementation in 2018-2021.

2.8 The SURE Team also has a critical role in the development of the Annual Performance Report to tenants. They contribute to this report by assessing the performance of Housing Service’s achievement of the 16 Scottish Social Housing Charter Outcomes. Their comments and validation of 2015/2016 were included in the report, which was circulated to all tenants in October 2016.

2.9 The detailed information and well researched work of the SURE Team has been recognised and acknowledged by tenants, who have regular feedback from them through the Tenant Participation Forum, presentations at our Tenant Conferences and updates on their own page on the Council’s website. They won the Gold award for Customer Focus at the Council’s 2016 Securing the Future Awards and they have been recently short listed as a finalist in a national excellence award for tenant led scrutiny. Our work in the development of tenant led scrutiny has also been highlighted as good practice in the Chartered Institute of Housing’s publication ‘Developing effective tenant scrutiny good practice guide.

3. OVERALL TENANT STRATEGY PROGRESS ACHIEVED IN 2016/17

3.1 Good progress has also been made in the achievement of the five Tenant Participation Action Plan outcomes and below are some of the key highlights of 2016/17.

3.2 The 2 year Rent Restructure Review has concluded and the new model of rent calculation implemented in April 2017. At the heart of this process was the Rent Restructure Review Tenant Working Group who scrutinised and considered very complex information as part of the rent restructuring process and in doing so had significant influence on decisions taken by the Council

Page 197 of 234 and raised awareness of the project with all Council tenants. The input from the group helped across all areas of wider tenant engagement, especially in reviewing communication and helping design surveys, issued to all 7,400 tenants.

3.3 Tenant involvement in the Estate Based Initiatives has been a critical success factor of this work. In the last 2 years over 200 tenants have been involved in identifying and prioritising over 80 local projects. We have had excellent feedback from them about the results and this work enables tenants to get involved at very local level in things that are important to them in terms of improving the environment and community safety.

3.4 In the last year we have reviewed our rent consultation process with the Tenant Participation Forum and made good progress in increasing the number of people involved in the discussion about rent setting. The last rent consultation survey sent out in 2016, along with the tenant satisfaction survey, resulted in 20% (1536) of tenants responding. The results were fed back at the Tenant Summer Conference and the Winter Forum and through On the House Magazine and ideas have been developed to improve the process for 2016/17.

3.5 We continue to make sure that our homeless people and prospective tenants have opportunities to participate. We actively enabled them to be involved in the Home First Review and their thoughts and opinions shaped the transformation of this service. Engagement activities in St Catherine Square have led to the development of Community Flat which has a full activity programme for residents and the Homeless Voice Association continues to hold weekly drop in session in the evening and has expanded the Boxing Project.

3.6 A key development in 2016 was the work with Glasgow University to deliver Activate, an introductory course on Community Development as part of the Resident Academy Programme. In total 22 tenants and staff took part in the course, including some tenants from the Letham area who are working to develop a Community Well Being Hub for their community. They used the course to help undertake research to successfully support their work. The group won the Gold Award at the Council’s 2017 securing the Future Awards in the ‘Working with Communities’ category and have been recently shortlisted for a national excellence award for Community Development.

3.7 Listening to tenants we delivered and instigated a Digital Inclusion Project to help tenants get the skills and confidence they need to become digitally included. This project will continue until March 2018 but is already making a positive impact on the lives of tenants. By March 2017, 23 people had received highly personalised digital inclusion support and now have the core skills to meet the Government’s definition of being digitally included and being safe online. They have told us of the major benefits this support has given them with some now actively getting involved in tenant participation activities through the tenant e-Panel. Staff have also benefitted from this project, with 56 taking part in Digital Awareness Training.

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3.8 In relation to involving more tenants we have exceeded the 10% target agreed with tenants to increase the number of people we communicate with through our ‘interested persons’ list and through social media. Our ‘interested persons’ list has 700 people registered, compared with 251 in March 2016. Our followers on Twitter has risen from 1,080 in March 2016 to 1,712 and our friends on Facebook has increased from 517 to 1,321 in the last year. We will review the target set for increasing the numbers we communicate with through these channels with Tenant Participation Monitoring Group in 2017. We have continued to deliver our On the House newsletter to every tenant twice a year and the Quality Panel have presented the Customer Approved stamp on publications, standard letters and our webpages.

3.9 An indicator of the success of this work has seen tenant satisfaction levels in opportunities to participate in decision making rise from 62% in 2013 to 74% in May 2016.

3.10 We have also experienced rises in satisfaction levels in relation to communication rising to 82.5% in May 2016 from 80% in 2013 and staff from the Customer and Community Engagement Team won national recognition by winning the Scottish Government’s sponsored National Tenant Participation Champion Award presented at the Tenant Information Service Conference in June 2016. Underpinning the success of this work is the hard work and commitment of the tenant volunteers and we cannot under estimate the value of this input in helping us achieve the tenant participation outcomes, the Scottish Social Housing Charter and improvements to services for tenants.

4. CONCLUSION AND RECOMMENDATIONS

4.1 The report evidences the very positive impact and summarises the work and activities undertaken in 2016/17 to achieve the Scottish Social Housing Charter Participation Outcomes and evidences the very positive impact of tenant involvement in scrutinising services and influencing decisions about housing services. This report also highlights some particularly inspiring work by tenants which has been recognised by local and national awards.

4.2 It is recommended that Housing and Communities Committee:-

(i) Note the progress in achieving the Tenant Participation Strategy aims and the Scottish Social Housing Charter Participation Outcomes.

(ii) Approve the prioritising of tenant participation activities and resources to continue support for existing activities relating to Estate Based Initiatives, Digital Inclusion and the implementation of the recommendations of the SURE Team’s scrutiny of tenant participation activities.

(iii) Notes that the new Tenant Participation Strategy will be presented for Committee approval later in 2017.

Page 199 of 234 Author Name Designation Contact Details Suzie Burt Team Leader , Customer and [email protected] Community Engagement Team 01738 475000

Approved Name Designation Date Bill Atkinson Executive Director Housing and Community Safety 9 May 2017

Page 200 of 234 ANNEX

1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

Strategic Implications Yes / None Community Plan / Single Outcome Agreement Yes Corporate Plan Yes Resource Implications Financial None Workforce None Asset Management (land, property, IST) None Assessments Equality Impact Assessment Yes Strategic Environmental Assessment None Sustainability (community, economic, environmental) None Legal and Governance Yes Risk None Consultation Internal Yes External Yes Communication Communications Plan None

1. Strategic Implications

Community Plan / Single Outcome Agreement

1.1 This report supports the delivery of the outcomes of the Community Plan/Single Outcome Agreement.

Corporate Plan

1.2 This report supports the delivery of the outcomes of the Corporate Plan.

2. Resource Implications

Financial

2.1 Head of Finance and supported has been consulted on the proposals in this report. The costs of the activities outlined in this report has been contained within the Tenant Participation budget of £101,000 2016/17

3. Assessments

Equality Impact Assessment

Page 201 of 234 This section should reflect that the proposals have been considered under the Corporate Equalities Impact Assessment process (EqIA) with the following outcome:-

(i) Services that are the focus of this report provide positive outcomes through care, support and assistance to range of clients.

Strategic Environmental Assessment

3.2 The Environmental Assessment (Scotland) Act 2005 places a duty on the Council to identify and assess the environmental consequences of its proposals.

No further action is required as it does not qualify as a PPS as defined by the Act and is therefore exempt.

Legal and Governance

3.3 The Head of Legal and Governance Services has been consulted and there are no direct legal implications in this report.

4. Consultation

Internal

4.1 The SURE Team have been consulted on this report, however due to timescales, we were unable to present the report to the Tenant Committee Report Panel, prior to Committee.

5. Communication

5.1 None

2. BACKGROUND PAPERS

None

3. APPENDICES

None

Page 202 of 234 12 (17/200) PERTH AND KINROSS COUNCIL

Housing and Communities Committee

31 May 2017

Autism Action Plan and Strategy Update

Report by Executive Director (Housing and Community Safety)

PURPOSE OF REPORT

The purpose of this report is to update Committee on the work currently being undertaken in relation to the updated Autism Strategy.

1. BACKGROUND/MAIN ISSUES

1.1 The National Records of Scotland project the 2017 population for Perth and Kinross as 154,101. If we use the estimated prevalence of 90 per 10,000 as detailed in the Scottish Strategy for Autism there would be an estimated 1,390 people across the age span with an Autistic Spectrum Condition (ASC) in Perth and Kinross.

1.2 The ‘Additional Support for Learning and Young Carers Report to Parliament’ (2013) states that in Perth and Kinross there are 4,596 (recorded) children and young people in education who have additional support needs and our recording systems details 350 (recorded) children and young people with an autism spectrum condition.

1.3 Autism has been the subject of a number of seminal papers and initiatives including:

1.3.1 The Same as You document 2000 recommended that Scottish Autism, National Autistic Society (NAS), Health Boards and Local Authorities should develop a National Network for people with an ASC. http://www.gov.scot/resource/doc/1095/0001661.pdf

1.3.2 In 2001, the then Public Health Institute of Scotland (PHIS, now NHS Health Scotland) was commissioned by Scottish Ministers to carry out a needs assessment of services for people with Autism Spectrum Conditions (ASC) in Scotland. The report, published in February 2002, identified a patchwork of services and made 32 recommendations that set out what ideal services should look like. http://www.gov.scot/Resource/Doc/94715/0022799.PDF

1.3.3 The Scottish Strategy for Autism: Local Report from the National Mapping Project (2013). http://www.autismstrategyscotland.org.uk/news/autism- mapping-project-individual-reports-for-local-authorities.html

Page 203 of 234 1.3.4 The Keys to Life: Improving quality of life for people with learning disabilities (2013). http://www.gov.scot/Publications/2013/06/1123

1.3.5 NICE Pathway – Autism Spectrum Quality Standards (2014) https://www.nice.org.uk/guidance/qs51

1.3.6 New SIGN Guidelines 2016: Assessment, diagnosis and clinical interventions for children and young people with Autism Spectrum Conditions (ASC). http://www.sign.ac.uk/pdf/SIGN145.pdf

1.4 In 2010, a draft autism strategy was consulted on widely and, in 2011 The Scottish Strategy for Autism was launched by the Scottish Government. http://www.gov.scot/Resource/Doc/361896/0122366.pdf

• The Strategy set out a 10 year agenda for change that addresses the entire autism spectrum and the whole lifespan of people living with ASC in Scotland which will give individuals on the autism spectrum a meaningful and satisfying life built on: people being given the care and support they need in a way which promotes their independence and emotional well-being and respects their dignity • People being supported to have choice and control over their lives so that they are able to have the same chosen level of privacy as other citizens • Services being personalised and based on the identified needs and wishes of the individual • People being supported to feel safe and secure without being over- protected; people having the opportunity to achieve all they can • People having equal access to information assessment and service • Agencies should work to redress inequalities and challenge discrimination

1.5 In December 2015 the Scottish Government Care, Support and Rights Division, recently reframed the Scottish Strategy for Autism into four outcomes. These outcomes align with the four strategy goals. There is no change in the Strategy’s priorities; it simply reframes the Strategy to align it with current national Scottish Government priorities.

1.5.1 Strategic Outcome 1

A Healthy Life: People with autism enjoy the highest attainable standard of living, health and family life and have timely access to diagnostic assessment and integrated support services.

Perth and Kinross have a wide variety of assessment and diagnostic teams available to those with Autism, their families and carers as detailed in Appendix 1. Notably the Adult Learning Disability team and Tayside Adult Autism Consultancy Team (TAACT) have developed a high level of skill, clear pathways and are highly regarded by those who have and do use their service. TAACT offer appointments at the One Stop Shop (which is an Autism specific day opportunities centre run by Autism Initiatives). This has improved

Page 204 of 234 access. There are also a range of activities available to people with autism through the One Stop Shop and other organisations such as Live Active Leisure and St Johnstone in the Community.

Moving forward we want to ensure that a standard autism diagnostic pathway based on national guidance is developed ensuring children receive a high standard of care regardless of where or whom they are seen by in Tayside. Child and Adolescent Mental Health Services (CAMHS) are investing in more non-medical staff to be able to diagnose autism, to relieve internal bottlenecks.

In order to sustain support for familes pre and post diagnosis we are looking to secure ongoing funding for the appropriate autism third sector partner.

1.5.2 Strategic Outcome 2

Choice and Control: People with autism are treated with dignity and respect and services are able to identify their needs and are responsive to meet those needs.

Within Perth and Kinross we have kept abreast of the most up to date good practice guidance as detailed in Appendix 1. We employed an Autism Lead Officer who has continually kept us as an authority up to date with what is an ever changing area of guidance.

Both our third sector autism specific partners adhere to this guidance and those focussing their work based on children apply Getting it Right For Every Child (GIRFEC) and Safe, Healthy, Active, Nurtured, Achieving, Respected, Responsible and Included (SHANNARI) principles to their practice.

Everyone who is assessed by Social Work in Perth and Kinross, who meet the eligibility criteria, is offered support via all four of the Self Directed Support options. This helps ensure people have choice and control over their support.

Moving forward we will continue to apply best practice, guided by national health, education and social care guidelines and ensure any work moving forward is enhanced by:

• Providing appropriate training for our staff • Providing specific support mechanisms for engaging in the workplace • Joined up working with our colleagues in health, social care, education and the third sector • By addressing funding gaps we aim to create more sustainable autism specific services that more effectively meet the needs of this complex group of individuals • Continuing to embed Self Directed Support

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1.5.3 Strategic Outcome 3 Independence: People with autism are able to live independently in the community with equal access to all aspects of society. Services have the capacity and awareness to ensure that people are met with recognition and understanding.

Within Perth and Kinross we are particularly fortunate to have two autism specific third sector organisations providing whole life support, as detailed in Appendix 1. This has allowed those with autism to access areas of the community that would have been otherwise impossible. By understanding the unique needs of this community they have increased awareness within Perth and Kinross by providing a wide variety of learning opportunities and an open door policy to anyone keen to learn more about autism and its impact.

Within Perth and Kinross Council we have continually invested in training in this area of work and have access to specialism from our dedicated Outreach Teachers, Educational Psychlogy and Autism Lead Officer.

Perth and Kinross have invested a small amount of funding in Technology Enabled Care and are keen to evidence the impact of this on this particular client group.

There is a specialist supported living complex in Bridge of Earn for people with Autism and there is a proposal for another development in Perth and Kinross. Numerous supports are available across the statutory and independent sectors to assist people with autism to live in mainstream housing.

Moving forward we would like to provide more experiential learning opportunities for staff across services.

We are looking improve joint working mechanisms and accurately assess the skills of those expected to make these interventions work in a different context.

We will be looking to provide long term models of (whole life) support. We aim to increase the skills of these individuals to ensure they have access to the same things you and I do, to be employed, to access education, to have their own home to have a social life/relationships.

1.5.4 Strategic Outcome 4

Active Citizenship: People with autism are able to participate in all aspects of community and society by successfully transitioning from school into meaningful educational or employment opportunities.

Perth and Kinross council have developed several projects as detailed in Appendix 1, that specifically focus on the needs of those with Additional Support Needs including Autism:

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• The Transitions Team who work with those requiring a more enhanced and involved transition from Secondary school • The Building Family Support service who provide residential short breaks, family support, outreach work and independent living skills development • Ease the Move project, an autism specific transition project jointly run by Adult Social Work and Social Care and Perth Autism Support. • ASC Work Experience coordinator a post, focussing on post school employment opportunities • ASC Modern Apprentice Scheme, developed by the Autism lead officer working closely with our Human Resources team and both third sector autism charities

Moving forward we aim to get better at providing the information required to help families prepare, particularly when a young person with moderate or complex support requirements is facing the very difficult transition into the adult care system. We believe that a combination of early intervention and a good quality transition will radically alter the experience many with autism experience and as a consequence reduce the strain and stress felt by families and reduce cost to statutory services in later life.

1.6 The work as detailed in the original autism action plan has influenced the production of an updated Perth and Kinross Autism Strategy 2017 (see appendix 1), that aligns itself with the Scottish Government’s Outcomes Approach as outlined above.

2. PROPOSALS

2.1 Key priorities for 2017/18 will include:

• Carrying out a full review of autism services within Perth and Kinross • Develop a single whole life autism support model • Look to secure ongoing funding for our autism specific third sector partners to assist with the implementation of the above model • Geographically expand the Ease the Move project (unique autism specific transition service, working with our more complex young people who are unable to access existing service provision) • Further develop the autism work experience coordinator post (enabling young people within school to access work experience opportunities that would otherwise be unavailable. The intention being to increase the age range able to access this support and feed into our existing Autism MA scheme • Enhance local provision within mental health services for those with autism. By ensuring a consistency of knowledge across the staff group and by ensuring the support mechanism around the individual and their family are appropriate and that there is an understanding of the unique presentation and issues that autism may present

Page 207 of 234 • Roll out Brain in Hand, smartphone app that provides 24/7 support to those with autism and extreme levels of anxiety (ten individuals) • Work with Community Safety to create autism specific community interventions that aim to reduce numbers entering the prison system and support those with an ASC on exiting

3. CONCLUSION AND RECOMMENDATIONS

3.1 To conclude we are continuing to develop and improve support for people with autism within Perth and Kinross and by carrying out the aforementioned review we will, with full consultation of the relevant stakeholders, find more effective and sustainable mechanisms with which to fulfil our commitment to this client group, their families and carers.

3.1 It is recommended that the committee:

(i) Note the content of the report. (ii) Agree the continuing implementation of the action plan and strategy in line with the National Scottish Autism Strategy 2011-2021.

3.2 Every effort has been made to ensure that the local strategy document is fully co-produced and the action plan consulted upon, this will be an ongoing process.

Author Name Designation Contact Details Zoe Robertson Lead Officer Autism PKC [email protected] 01738 475000

Approved Name Designation Date Bill Atkinson Interim Executive Director Housing & 11.05.17 Community Safety

Page 208 of 234 ANNEX 1. IMPLICATIONS, ASSESSMENTS, CONSULTATION AND COMMUNICATION

Strategic Implications Yes / None Community Plan / Single Outcome Agreement Yes Corporate Plan Yes Resource Implications Financial Yes Workforce Yes Asset Management (land, property, IST) None Assessments Equality Impact Assessment Yes Strategic Environmental Assessment None Sustainability (community, economic, environmental) Yes Legal and Governance None Risk None Consultation Internal Yes External Yes Communication Yes Communications Plan

1. Strategic Implications

Community Plan / Single Outcome Agreement

1.1 The proposals relate to the delivery of all the Perth and Kinross Community Plan/Single Outcome Agreement priorities:

Corporate Plan

1.2 As above

1.3 The report also links to the Education & Children’s Services Policy Framework in respect of the following key policy area:

• Inclusion and Equality

Page 209 of 234 2. Resource Implications

Financial

2.1 In order to ensure the continuation of the ASD Coordinator post (Grade TL10) funding should be part shared initially by Education and Children Services and Housing and Community Safety initially.

Workforce

2.2 As above.

Asset Management (land, property, IT)

2.3 There are no expected asset management or information technology implications arising from this report.

3. Assessments

Equality Impact Assessment

The Local Autism Strategy has been considered under the Corporate Equalities Impact Assessment process (EqIA), and it has been concluded that the ten year strategy will impact positively on the agenda for Housing and Community Safety and Education and Children’s Services.

Strategic Environmental Assessment

3.2 The Environmental Assessment (Scotland) Act 2005 places a duty on the Council to identify and assess the environmental consequences of its proposals. Pre-screening has identified that the PPS will have no or minimal environmental effects, it is therefore exempt and the SEA Gateway has been notified.

This was evidenced by the pre-screening assessment using the Integrated Appraisal Toolkit.

Page 210 of 234 Sustainability

3.3 Following an assessment using the Integrated Appraisal Toolkit, it has been determined that the proposal is likely to contribute positively to the following corporate sustainable development principles:

• SDP1 Low levels of crime and anti-social behaviour with visible, effective and community-friendly policing • SDP6 Well-maintained, local, user-friendly open spaces with facilities for everyone • SDP10 Healthy living is actively promoted and the provision of preventative health services maximised • SDP11 Equitable access to high quality, integrated local health care and social services (particularly for those who are excluded or vulnerable) • SDP12 A wide range of local jobs and training opportunities for all • SDP16 Accessible and appropriate transport services and communication linking people to jobs, schools, health and other services (e.g. public transport facilities, telecommunications) • SDP17 Well-educated people from well-performing local schools, further and higher education and training for lifelong learning • SDP18 Friendly, co-operative and helpful behaviour in neighbourhoods • SDP19 A mutual tolerance, respect and engagement among people from different cultures, background and beliefs • SDP20 A sense of civic values, responsibility and pride • SDP22 Creating a sense of place (e.g. a place with a positive ‘feeling’ for people, and local distinctiveness) • SDP23 A sense of community identity and belonging • SDP24 Strong, inclusive, community and voluntary sector • SDP25 Strategic, visionary, representative, accountable governance systems that enable inclusive, active and effective participation by individuals and organisations • SDP26 All people are socially included and have similar life opportunities • SDP27 Opportunities for cultural, leisure, community, sport and other activities • SDP28 Continuous improvement through effective delivery, monitoring and feedback at all levels • SDP29 Accessible, affordable public, community, voluntary and private services (e.g. retail, food, commercial, utilities)

Legal and Governance

3.4 None

3.5 None

Page 211 of 234 Risk

3.6 Delivery of The Local Autism Strategy will support effective controls of the following Corporate Risks: Protect vulnerable children and families.

4. Consultation

Internal

4.1 In writing the new draft autism strategy representatives from Education and Children Services and Housing and Community Safety were fully consulted.

External

4.2 In writing the new draft autism strategy representatives from Perth Autism Support, Autism Initiatives, NHS and parents/carers and service users were fully consulted.

5. Communication

5.1 In order to implement the proposals, information will be shared with representatives from ECS, HCC, NHS, Perth Autism Support, Autism Initiatives, PKAVS and parents/carers and service users.

2. BACKGROUND PAPERS

Same as You 2000 PHIS A needs assessment of services for people with autism spectrum disorders 2001 Sign Guidelines 2016 NICE Quality Standards January 2014 The Scottish Strategy for Autism 2011 The Scottish Strategy for Autism: Local Report from the National Mapping Project Scottish Strategy for Autism (Easy Read Version)

3. APPENDICES

Perth & Kinross Draft Autism Strategy

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Perth & Kinross Autism Strategy 2016 - 2021

PERTH & KINROSS AUTISM STRATEGY The purpose of this strategy and associated action plan is to set the strategic direction for improving outcomes for people with Autism and their families/carers across the lifespan in Perth & Kinross. The content of the strategy and action plan is based on a mapping out of existing service provision and identifying priority areas for action reflecting local need to inform future shaping and co-ordination of services. Specific and measurable actions have been recommended in the action plan, on the basis of evidence, parental/carer/user consultation and a localised mapping analysis. What words do people prefer to use to describe people on the autism spectrum? The language we use is important because it embodies and can therefore help change attitudes towards autism. http://www.autism.org.uk/about/what-is/describing.aspx recent research (NAS 2015) confirmed that there is no single term that everyone prefers. However, they suggest a shift towards more positive and assertive language, particularly among autistic communities where autism is seen as integral to the person. In light of this Perth and Kinross council are not using the term disorder and using the broad descriptor of Autism Spectrum Condition, and as being autistic for adults and on the autism spectrum for children.

WHAT IS AUTISM? There is no one answer to this question because the way autism impacts on each individual are unique. No two people are exactly the same. Autism is a difference in the way a person thinks, perceives and therefore understands the world and others. This results in difficulties or differences in communication, social interaction, and thinking and in sensitivity of the senses. Therefore autism poses many challenges that are often multi-faceted and complex, requiring a range of services and sectors to work together and clearly understand and ensure that individual needs are properly assessed and addressed.

BACKGROUND In 2010, a draft autism strategy was consulted on widely, and the development and creation of the new Scottish Autism Strategy (2011) http://www.gov.scot/Resource/Doc/361926/0122373.pdf for Autism was identified as being vital to ensuring that progress is made across Scotland in delivering quality services. Its 26 recommendations (see appendix) are far-reaching and will impact upon all professions, across all disciplines involved in the provision of public services. The Strategy sets out a 10 year agenda for change that addresses the entire autism spectrum and the whole lifespan of people living with ASC in Scotland which will give individuals on the autism spectrum a meaningful and satisfying life built on:

• people being given the care and support they need in a way which promotes their independence and emotional well-being and respects their dignity ; • people being supported to have choice and control over their lives so that they are able to have the same chosen level of privacy as other citizens ; • services being personalised and based on the identified needs and wishes of the individual; • people being supported to feel safe and secure without being over-protected; • people having the opportunity to achieve all they can;

Page 213 of 234

SCOPE AND STRUCTURE OF THE STRATEGY

In December 2015, the Scottish Government developed its ‘ Scottish Strategy for Autism Outcomes Approach: Priorities 2015-2017 ’ document. This specifies four Strategic Outcomes (SOs) with a descriptor of what requires to be done to achieve each of the outcomes. The Scottish Government have advised us to consider and site the 26 recommendations within a broader framework, for the purpose of being clearer about intended outcomes that can result from the implementation of the Scottish Strategy for Autism at a local level. The introduction of national health and wellbeing outcomes, along with the integration of health and social care, will bring changes to how services for people with Autism and others will be planned and developed and the national strategy has been reframed to align with the four priority outcomes whilst remaining linked to the original Scottish Autism Strategies whole-life journey goals (see appendix 1).

STRATEGIC OUTCOMES 2015 -17:

A Healthy Life : People with autism enjoy the highest attainable standard of living, health and family life and have timely access to diagnostic assessment and integrated support services. Linked goal - Improve access to integrated service provision across the multi-dimensional aspects of autism.

Choice and Control : People with autism are treated with dignity and respect and services are able to identify their needs and are responsive to meet those needs. Linked goal - Consistent adoption of good practice guidance in key areas of education, health and social care across local authority areas.

Independence : People with autism are able to live independently in the community with equal access to all aspects of society. Services have the capacity and awareness to ensure that people are met with recognition and understanding. Linked goal - Capacity and awareness building in mainstream services to ensure people are met with recognition and understanding of autism’.

Active Citizenship : People with autism are able to participate in all aspects of community and society by successfully transitioning from school into meaningful educational or employment opportunities. Linked goal - Improve access to appropriate transition planning across the lifespan.

PERTH AND KINROSS HEALTH AND SOCIAL CARE PARTNERSHIP

Health and Social Care changed in April 2016 health and social care services are now provided through the Perth and Kinross Health and Social Care Partnership. In Perth and Kinross, we recognise that people who are ill, vulnerable or have disabilities, often need support from a number of services to enable them to live as independently as possible and to prevent unnecessary stays in hospital or in residential care. Autism in acknowledged as presenting a rising demand and placing a pressure on services within the Perth and Kinross Health and Social Care Strategic Commissioning Plan 2016-19. http://www.pkc.gov.uk/CHttpHandler.ashx?id=36538&p=0 “Prevalence of Autism is likely to be higher than we are currently aware and increased rates of diagnosis for young people will impact on adult services”.

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Perth and Kinross Health and Social Care Partnership recognise the distinctive needs of different areas of Perth and Kinross and the need to take account this in planning our services. We value the diversity of the communities of Perth and Kinross and will work with them to make sure we have an integrated health and social care system that is inclusive and accessible. We will work together to make sure people are supported to lead as independent, healthy and active lives as possible in their own homes. Children and young people’s services are not formally included in the Health and Social Care Partnership and we will continue to work collaboratively with the Children, Young People and Families Partnership to meet the needs of the whole community.

Our commitment to the Public Service Reform agenda is articulated in our Community Plan/Single Outcome Agreement 2013-2023 http://localapps.pkc.gov.uk/internet/flashmag/Community%20plan%202013/index.html . This sets out a vision of a confident and ambitious Perth and Kinross, to which everyone can contribute and in which all can share. Through our strategic objectives we aim to maximise the opportunities available to people to achieve their potential, at every life stage and there are cross cutting themes that will underpin the work of the Health and Social Care partnership.

The framework of the Scottish Autism Strategy (2011), along with Perth & Kinross’s Community Planning Partnership – Community Plan (2013 - 2023) has guided the preparation of this strategy. This will ensure that the expectations of the strategy remain the focus of development and improvement of services for people with autism, whilst linking with the values and priorities of the local community plan, which sets out 5 strategic objectives for Perth and Kinross: • Giving every child the best start in life • Developing educated, responsible and informed citizens • Promoting a prosperous, inclusive and sustainable economy • Supporting people to lead independent, healthy and active lives • Creating a safe and sustainable place for future generations

This strategy and associated action plan includes reference to both adults and children and whilst there are some common themes across all age groups, the legislative and organisational context is quite distinct for adults and children’s services. Therefore the report acknowledges the importance of several key documents and areas of guidance that are applicable to the entire autism spectrum and the whole lifespan of people living with ASC in Scotland (see appendix 2).

The National strategy is in its fifth year of implementation, however Perth & Kinross’s action plan was not written until 2014 and although that may appear delayed we were in fact more prompt in producing this document than many other areas, as a consequence our action plan was written to align with the original Scottish Government guidance, since then and as detailed previously the National Strategy has altered its approach and therefore we as an authority have decided to consult once more and re draft our original document, to ensure congruence with the National direction. We have consulted the local autism community, we asked those with an ASC their families and carers to comment on the four outcomes as identified by the Scottish Government, the feedback we have received will direct our future work and ensure that we as an authority are basing our plans on the needs of this group by ensuring autistic individuals, their families and carers remain an active participant in service development and improvement for those with an autism spectrum condition within Perth & Kinross. In relation to each outcome we will detail: • What we will do • Why we need to do this • What we have achieved • What we will do next

Page 215 of 234

STRATEGIC OUTCOME - A HEALTHY LIFE – PEOPLE WITH AUTISM ENJOY THE HIGHEST 1 ATTAINABLE STANDARD OF LIVING, HEALTH AND FAMILY LIFE AND HAVE TIMELY ACCESS TO DIAGNOSTIC ASSESSMENT AND INTEGRATED SUPPORT SERVICES.

WHAT WE WILL DO

Improve access to integrated service provision across the multi-dimensional aspects of autism. WHY WE NEED TO DO THIS

For people with autism getting an assessment of autism is the first step to accessing services they need to meet their personal outcomes. WHAT WE HAVE ACHIEVED:

CAMHS : - Child and Adult Mental Health Services. NHS Tayside CAMHS provides specialist assessment and treatment for children and young people aged up to 18 years who have or are suspected to have mental health difficulties. They work as part of a multi-disciplinary team of Child & Adolescent Psychiatrists, Clinical Psychologists, and Clinical Associates in Applied Psychology, Family Therapists, Specialist Nurses, Psychotherapists, Occupational Therapists, Primary Mental Health Workers, Social Workers, Speech & Language Therapists and administration staff. They also work in partnership with other agencies that provide health, social care and education services. Their aim is to ensure that they deliver the best or most appropriate services possible to meet the particular mental health needs of the child or young person. A small amount of outreach is also provided to Community Paediatrics to support diagnosis of autism in pre- schoolers.

Since December 2015, Tayside CAMHS has achieved the Scottish Government standard of 90% of referrals accessing treatment within 18 weeks of referral. More efficient and patient centred processes have been put in place to try to ensure that children and their families have the opportunity to work with a clinician who has the right skills to help them from the start of their journey through CAMHS. However, many children will still experience a lengthy wait following initial assessment and care before a diagnosis can be confirmed or excluded by an autism specialist.

CHILD DEVELOPMENT TEAM : - Primarily provides assessment for pre-five children, you can be referred to this team via a variety of sources, they are a multi-disciplinary team with a substantial amount of expertise and time spent working with children who have an ASC. Parent to Parent support parents of children undergoing assessment for ASC/ADHD offering emotional support while the child is waiting to be assessed. For children displaying challenging behaviour the support worker will help parents to implement boundaries and strategies.

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Parent to Parent will accompany parents to assessment and feedback visits if required and if a diagnosis is given will help parent access other appropriate provisions. 11 ADULT LEARNING DISABILITY TEAM :- Comprises of a multidisciplinary team and is based at Murray Royal Hospital, Perth including: Psychiatrists, Learning Disability Nurses, Psychologists, Physiotherapist, Occupational Therapists, Speech & Language Therapists, Dietitians, Music Therapist and Art Therapist. This team accept referrals for those with autism as long as they have a comorbid Learning Disability. Included within this service are the Learning Disability Intensive Support Service (LDISS) who offer an assessment and treatment service for Adults who have a Learning Disability and who may also have associated health needs in relation to a variety of issues e.g. Mental Health, Epilepsy, Autism, Exhibiting behaviours which can be challenging, this can be either at LDISS or in a community setting which meets their needs e.g. their own home.

They offer a person-centred flexible approach to healthcare, encouraging individuals to achieve their potential in an environment which is safe and therapeutic and offer support, education and advice to clients, their families / carers and to partner agencies e.g. behaviour support plans. The learning disability team and pathway is very clear and works well, they offer autism specialism and are highly regarded.

CMHTs: - Community Mental Health Teams. People with autism are provided with diagnostic assessment from their local CMHT and/or from the Specialist Team. Interface relationships continue to mature and most referrals are discussed together to ensure that the correct service is providing the diagnostic assessment. There is a clear increase in joint working with individuals to ensure both diagnostic assessment and integrated community mental health support. People are provided with information regarding No3 this support is displayed within our waiting areas.

TAACT : - The Tayside Adult Autism Consultation Team were set up in January 2014 and received recurring funding in September 2015, they are a multi-disciplinary team comprising of (psychology, occupational therapy, SALT and nursing input) with a psychiatrist joining the team imminently. They have provided a much needed diagnostic and consultancy service; they have worked with 202 referrals since February 2015 and tend to diagnose the more complex cases of autism that present. Notably their number are comprised of approximately 50% females, which is interesting given the established male/female ratio 1:4 and would indicate a better understanding of how autistic women present.

PERTH AUTISM SUPPORT:- Perth Autism Support, support over 550 families throughout Perth & Kinross, taking a full family approach to their support they promote the highest attainable standard of living, health and family life which families can access not only when they have received a diagnosis of autism but throughout the assessment period.

AUTISM INITIATIVES: - Number 3 supports individuals aged 16 and over to navigate the diagnostic process. From pre-diagnostic information about autism and what the assessment process is to supporting the individual to attend their GP, to seek a referral then if needed supporting the person to attend assessment appointments with the relevant service (Adult LD Team, Community Mental Health Team or Tayside Adult Autism Consultation Team). Follow up appointments are essential to help the individual to understand the process at all stages. Post diagnostic support is provided in the form of 1:1 appointments with individuals and family if required and through the “Late Diagnosis Group”, an 8 session course specifically designed to support individuals understanding of their diagnosis. Number 3 have

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supported more than 20 adults to navigate through the diagnostic process with a further 38 being referred to our service for post diagnostic 1 support following an adult diagnosis. Number 3 is an integral part of the diagnostic pathway for adults living in Perth & Kinross. WHAT WE WILL DO NEXT?

We are working to improve joint working methods with our colleagues in health CAMHS, Child Development Team, CMHTs and TAACT to ensure individuals and their carers/families find the diagnostic process before, during and after as efficient and stress free as possible. Additionally we want to ensure that all parties involved contribute to the assessment process in an appropriate and constructive manner with the aim of ensuring we have an accurate picture of the young person’s presentation and that the views and perspectives of families, carers and professionals are equally respected.

CAMHs: A number of factors have led to children still facing a lengthy (although improved) waiting time for diagnosis of autism, including internal bottlenecks resulting from the huge numbers of children seen during the drive to reduce the waiting time for accessing CAMHS, year on year increases in demand for CAMHS; and a local and national shortage of child psychiatrists. To address this problem, CAMHS are developing a standard autism diagnostic pathway based on national guidance so that children receive a high standard of care regardless of where in Tayside CAMHS they are seen, or which clinician they are seen by.

CAMHS is also working with Community Paediatrics to find more efficient ways to work across both services, making best use of skills, and avoiding duplication of work. In addition, CAMHS is investing in training more non-medical staff to be able to diagnose autism. CAMHS is developing links with the Tayside Adult Autism Consultation Team (TAACT) to promote successful transitions between child and adult mental health autism services when young adults need this. CAMHS recognises the need for all agencies to work together for the benefit of children and their families, and will be contributing to multi-agency planning for autism services in Perth, Dundee and Angus localities going forward.

TAACT : - Have developed a new pathway that should make the referral process clearer and therefore efficient.

Referral can come from CMHT - if a specialist consultation is felt necessary. Referral can be made to the team if the individual has a complex differential diagnosis, previous trauma, schizophrenia, OCD but with the understanding that the CMHT have screened the individual. Referral can be made by a GP straight to the TAACT team if the individual presents with no previous or current comorbid mental health issues and believes they may have an ASC. Additionally the team provide flexible post diagnostic support, looking at what the individual’s autism means for them individually and strategies for moving forward. They provide training and support to other teams including psychology, criminal justice services, social work teams and the CMHTs.

PERTH AUTISM SUPPORT & AUTISM INITIATIVES: Their priority is to ensure that we secure ongoing funding to sustain and allow us to deliver services continuously to our families throughout Perth & Kinross.

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1 FEMALE PRESENTATION OF AUTISM : - A recurring theme in our consultation across all age ranges is a lack of specialism and understanding of a female presentation of autism. We seek to improve this by:

Providing a range of resources including front line training and a dedicated section on our Perth Autism website www.autism- perth.org.uk PAS have run a joint event with the Curly Hair Project www.thegirlwiththecurlyhair.co.uk and will continue to work closely with them. The Scottish Women’s Autism Network (SWAN) has a local group which is run at Autism Initiatives. The TAACT specialise in diagnosing women with autism.

Timely identification and subsequent formal diagnosis of autism are surely the most basic of building blocks for an effective and cost effective autism strategy. In an ideal world, identification of needs should be sufficient for action to be taken, but in practice a diagnosis is often required to access support and services. Identification and diagnosis open the door to assessment of an individual’s needs for support, and of how their personal strengths and preferences might affect what should be done. CONSULTATION FEEDBACK IN RESPONSE TO OUTCOME 1:

“Reduced waiting time needed at CAMHS for access to Drs and assessments”.

“Living with autism is exhausting and the last things people want are complicated procedures, lots of reading and forms to fill out. It would be better to have one point of call for everything, and possibly to be referred on to an agency/support group who can help from there”.

“Advice and support post diagnosis particularly with entrenched behaviours needed”.

“Options for parents/carers to access overnight respite even if this involves a cost”.

“Family life can be put under severe strain without adequate respite care being available. It shouldn't take crisis point to happen before help is available”.

If it wasn't for my referral to Perth Autism Support via Parent to Parent I dread to think where we would be relying on the state.

“Important to have plenty support”.

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CHOICE AND CONTROL – PEOPLE WITH AUTISM ARE TREATED WITH DIGNITY AND RESPECT 2 AND SERVICES ARE ABLE TO IDENTIFY THEIR NEEDS AND ARE RESPONSIVE TO MEET THOSE NEEDS.

WHAT WE WILL DO Consistent adoption of good practice guidance in key areas of education, health and social care across local authority areas.

WHY WE NEED TO DO THIS

People with autism tell us that they experience variation in access and how services respond to their needs. Professionals must be able to understand autism and develop services that are responsive to the needs of people with autism. WHAT WE HAVE ACHIEVED:

The National Institute of Health and Care Excellence (NICE) have produced materials to support diagnosis and multi-agency assessment, as well as recommendations for commissioning support. All diagnostic services within Perth & Kinross apply the same quality standards as required by NICE. Staff will have, or be supervised by staff who have specific knowledge and skills outlined in the Scotland Autism Training Framework. These standards are reinforced in the NES Autism Training Framework and Menu of Interventions document . http://www.gov.scot/Resource/0043/00438221.pdf , these documents have been circulated and all diagnostic teams made aware of this work and up to date research on reducing waiting times, PUBLISHED BY Autism Achieve Alliance. http://www.autismnetworkscotland.org.uk/files/2014/11/AAA-ASD-Waiting-for-Assessment-Executive-Summary.pdf

PERTH AUTISM SUPPORT : Support just under 200 young people on a weekly basis; they work on an individual basis with each child identifying needs and developing plans for each young person taking in to consideration their thoughts and views using the SHANARRI indicators to keep this in line with other support services. Their individual plans look at the young person’s life as a whole and not just their time within PAS services. Their service is flexible to the needs of each young person and they can tailor and adapt groups as appropriate. Through their family support and school liaison team’s information is shared with families and education colleagues to allow a streamlined, consistent approach to the support of every young person who accesses their services.

AUTISM INITIATIVES : - Number 3 provides a complete ‘One Stop Shop’ service for individuals with an ASC where communication and interaction can be the biggest barrier to accessing support. Individuals with an ASC can build a relationship with a team of staff who has a specialist understanding of their condition that is able to support them and their families with any difficulties and challenges in their lives.

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Number 3 offers a safe haven for adults with an ASC, available on an as required basis, meaning individuals can access support when they need it with all aspects of life. The main areas of support provided are with benefits, housing, employment, relationships, life skills and mental wellbeing. The Number 3 service provides direct support and also enables adults with autism to access services elsewhere effectively by 2 supporting communication between the individual with autism, their families and other services. Number 3 employees use their knowledge, understanding and experiences of autism and appropriate guidance (SIGN, NICE, Menu of Interventions) to bridge the gap between individuals with autism and mainstream services. Number 3 is used by 247 adults with autism (178 male and 69 female).

PERTH & KINROSS COUNCIL: - Perth & Kinross Council promotes learning for everyone and works to keep our vulnerable residents safe and protected, the priorities for Education & Children's Services are: Raising achievement for all; Supporting vulnerable children and families; Improving the quality of life for individuals and communities; and Enabling the delivery of high quality public services

Working in partnership with Angus and Dundee City Councils, NHS Tayside and colleagues from the independent school sector, we have developed a shared format for a single Child’s Plan as well as multi-agency guidance to support their effective creation. This format is being used to coordinate plans for all children and young people who need one, including children and young people who are looked after or are in need of protection. The specific focus of our Child’s Plan meetings is now to improve outcomes for children, young people and families. The plan format gathers information about progress made, identifies what needs to be different and better, and details the actions we will put in place to make those improvements. Use of the agreed Child’s Plan format is leading to fewer meetings for families and a greater focus on partnership working as we meet the needs of the children, young people and families we serve.

In addition to the multi-agency guidance, education specific guidance has been produced and training in the use of the Child’s Plan format has been rolled out to all relevant staff in Education Services. The Tayside Child’s Plan format and guidance will be evaluated and reviewed by June 2017. Getting It Right for Every Child (GIRFEC) approaches, including use of the Wellbeing Wheel and the Child’s Plan format, are well embedded across our schools and centres. In most schools children, young people, parents and staff are developing a shared understanding of wellbeing. With the publication of How Good Is Our School? We have further strengthened the focus of schools on wellbeing and equality and this is helping to ensure that all our children and young people have appropriate opportunities to develop as successful learners and confident individuals.

Housing and Community Care: Housing & Community Care provides housing services and services for older people and vulnerable adults. We help people, wherever possible, to live independently within their own homes. We support communities across Perth and Kinross by working to reduce re-offending and increase public safety and protection. We match support to people's need, so provide support such as home care, day care and residential services, respite or advocacy.

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With specificity to autism we employed an autism coordinator who has ensured through the production of our action plan and strategy and ongoing joint working with relevant partners that we are focussing our work on the recommendations of the Scottish Autism Strategy and have 2 ensured our work is aligned with all relevant National Developments of particular note: The Principles of Good Transition 3 (The Autism Supplement) The NES Training Framework Menu of Interventions New Autism Outcomes and Priorities Approach 2015-17

WHAT WE WILL DO NEXT?

Autistic people often express the wish for greater autonomy - more choice in the opportunities available to them and greater control over decisions that affect their lives – but empowerment may be pointless unless there are effective supports and structures in place for some people, these structures are influenced by good practice guidance. We will continue to apply best practice, guided by national health, education and social care guidelines and hence ensure any work moving forward is enriched by:

Providing appropriate training for our staff Providing specific support mechanisms for engaging in the workplace Providing enhanced transition (as detailed in outcome 4) By working in a truly joined up manner with our colleagues in health, social care, education and the third sector. By addressing funding gaps we aim to create more sustainable autism specific services that more effectively meet the needs of this complex group of individuals.

Our Ease the Move project as detailed in Outcome 4 is a good example of how we have already started to move forward in our thinking around how we provide Autism specific services and encapsulates all of the above mentioned working methods.

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CONSULTATION FEEDBACK IN RESPONSE TO OUTCOME 2:

2 “Better communication from CAMHS”.

“These services must employ people who truly understand the nature of autism though, and be able to be flexible enough to accommodate individual needs, as all autistic people have different characteristics. I see very few professionals who truly seem to understand my child's condition - indeed, some people who have not been 'trained' can be more empathetic”.

“More training for school staff in supporting young people on the spectrum”.

“I agree we have a very positive experience so far”.

“When you get access to a service people are increasingly respectful, however getting access to services to identify needs is very difficult as services are stretched to the limit and have very long waiting times”.

“There needs to be a council wide subtle way of communicating that a person has autism at every reception desk for example (Dr surgery/hospital /council leisure facility etc.) so that information can be passed over easily about what may help them”.

“The staff make me feel that being ‘Different’ is not a bad thing, they make you feel as though you have a purpose in the world.” (No3) “Number 3 rescued me from a very low point in my life and has helped turn my life around”

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INDEPENDENCE – PEOPLE WITH AUTISM ARE ABLE TO LIVE INDEPENDENTLY IN THE 3 COMMUNITY WITH EQUAL ACCESS TO ALL ASPECTS OF SOCIETY. SERVICES HAVE THE CAPACITY AND AWARENESS TO ENSURE THAT PEOPLE ARE MET WITH RECOGNITION AND UNDERSTANDING.

WHAT WE WILL DO

Capacity and awareness building in mainstream services to ensure people are met with recognition and understanding of autism WHY WE NEED TO DO THIS? People with autism experience barriers accessing community facilities. Having the right support and knowledgeable workforce to deliver services are important aspects on an independent life.

WHAT WE HAVE ACHIEVED Education and Children Services :- The creation of the additional posts of Outreach Teacher has allowed the outreach service to be enhanced with one teacher focussing primarily on primary schools and the other focussing on secondary schools they have provided a wide array of practical resources that are being put in place to support teachers, young people and their families.

The Outreach Teacher post has built up a wealth of materials for teachers, training courses and worksheets to help build knowledge and skills. The teacher also provides telephone support in respect of individual children. The Outreach Teacher has also been in close contact with parents, and has helped to build their knowledge and capacity or support them when things are not going well. This has required good interpersonal skills and the Outreach Teacher has been able to mediate where their school finds a child’s behaviour particularly challenging. This activity was reported to reduce exclusion of children and young people from school, thus reducing stress and distress for children, young people and their families as well as helping to prevent children being placed in specialist or residential provision. The Outreach teacher post has also worked to change cultures and influence thinking within schools about children with Additional Support Needs.

The Educational Psychology Service provides consultation with key school professionals for 365 children and young people. The focus of these consultations included anger, aggression, bereavement and loss, transition, wellbeing and sexualised behaviours. The most commonly reported immediate impact was consultees feeling that they had a plan to meet their need.

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Housing and Community care and Education services recruited an autism coordinator in August 2013, who wrote our original action plan and newest updated version. Since then the coordinator has actioned many of the areas of need as identified by the original plan, has accessed Scottish Autism Development Funding to create two bespoke autism specific transition services for young people between the ages 3 of 16 and 25 and has created an Autism specific modern apprentice scheme supported by Perth Autism Support and Autism Initiatives No3. Worked jointly with a parent to create an Autism Perth Website and run a wide array of courses including autism awareness, how to manage behaviour and cognitive affective training. In addition the coordinator provides one to one support and consultation for those with an Autism Spectrum Condition and their families/carers, whether it is in the family home or in a work environment, the coordinator provides appropriate strategies and support enabling the individual to work or just be safe in the community.

The coordinator is a member of Autism Strategy Lead Officers Collaborative and sits on the Scottish Government Working Group two looking at the Goal: Access to appropriate transition planning across the lifespan and as a consequence is up to date with national developments and able to translate and apply them to a local context.

Many autistic people have a strong interest in technologies that has been linked to clarity in demands (and absence of social demands), immediate, predictable and repeatable responses, use of visual cues, and diminished sensory stimuli. Technologies may be used to support functional skills such as interventions aiming to improve activities of daily living, social participation, communication skills, spatial and temporal planning and recognition of emotions.

Perth & Kinross council are investing a small amount of funding in Brain in Hand (BiH) smart web-based software that helps users achieve greater independence, manage mood problems and reduce reliance on support. It synchronises with a smartphone app so it is always available and simple to use. It is based on well-established therapeutic principles such as CBT, solution focused therapy, and recovery based rehabilitation allowing the learning from these approaches to be turned into a set of patient centred strategies.

Brain in Hand enables the service user access to: Instant access to pre-planned coping strategies A diary to structure their time and “recipes” for difficult to remember tasks A monitor to track anxiety levels A system for users to request support if things don’t go to plan A secure website where they can review their use and identify new issues.

We are proposing a 10 user program that we believe would provide Perth and Kinross Council with large enough cohort of service users to demonstrate how this would deliver both improved outcomes for a much larger number of service users across many different services such as older peoples services, Children and young people services as well as reducing costs in the delivery of existing support services. Outcomes that BIH have already seen within other deployments are: Enabling service users to live more independently. Reinforcing other adaptations and programmes already on offer by encouraging the outputs to be utilized within Brain in Hand Providing support to travel training. Reducing sleeping and waking night support.

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PERTH AUTISM SUPPORT : “Our ethos at Perth Autism Support is not that our children require autism specific services for the rest of their lives but to ensure that we can develop communication and social skills within an autism friendly environment at the pace that is right for each young person which in turn we would hope means that when they move into adult services there will be less reliance on service and that they 3 will be able to achieve any goal they wish to strive for in life and be an active and independent member of the community with less barriers faced when accessing mainstream services, based on the idea that early intervention is key to better longer term outcomes for our young people. Although our groups are fun they are very structure based working on some of the challenges the young people are facing but in a fun, non-confrontational “real” way”. PAS spend a lot of time raising autism awareness in the community and this includes delivering training to our colleagues in both Perth & Kinross Council and NHS Tayside. This also includes the wider community remit of supporting organisations who may be working with our young people in other settings and with employers in the area who are working with our Employment Co-ordinator to deliver Modern Apprenticeships or work experience opportunities. They provide a wide array of learning opportunities locally and nationally with the aim of providing autism specific training that meets the needs of professional, carers/families and individuals on the autism spectrum.

Autism Initiatives launched the Perth and Kinross One Stop Shop (No3 ) in 2013 which is for people aged 16+ living in Perth & Kinross with autism. No 3 is a free, person-centred support service for adults with an autism spectrum disorder (ASD) living in the Perth & Kinross region. It offers a wide range of advice, information, activities and support services. The work No3 do is focussed on positive mental wellbeing, not only for adults with ASC but for their families and those close to them. They provide an all-round service including but not exclusive to pre diagnostic information, attendance to and advocacy at appointments, post diagnostic support, problem solving and life skills support, relationship issues and self-awareness. They aim to provide a safe autistic space where people can build their self-esteem, sense of self and appropriate strategies with the support of knowledgeable staff and others in a similar position.

SALT & OT: - Speech and language therapy and occupational therapy staff within paediatrics and adults (Mental health and Learning disability) have been integral to training in relation to various elements of autism. They have worked jointly with the third sector to provide flexible, autism specific learning opportunities, for professionals, carers and individuals on the autism spectrum. Both these services are highly valued and their ongoing contribution has meant that jointly Perth & Kinross are able to offer high quality, up to date autism specific training.

WHAT WE WILL DO NEXT We are keen to develop more experiential learning opportunities for professionals within schools and community care. The local authority, the NHS, PAS and No3 currently provide a wide range of training opportunities and there is no doubt that this learning is valuable but how it is applied to practice is something we could improve on.

A growing body of research suggests that we should be linking strategies for intervention with the settings in which we hope interventions ultimately will be used. Specialist interventions that work in a clinical environment don’t work in community settings, for them to be successful we need improve joint working mechanisms and accurately assess the skills of those expected to make these interventions work in a different context.

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This will help facilitate the successful adoption, implementation, and maintenance of interventions that have already been developed, and to develop new interventions in collaboration with communities to ensure that the interventions meet the community’s needs and capabilities, thereby increasing the likelihood of successful diffusion”. Dingfelder and Mandell 2010. With public sector resources so very stretched, actions 3 need to be affordable. Effective interventions and support are needed and will continue to be needed at all stages of life, whether these are remediating the effects of earlier poor care or not. These issues mean that a cradle to grave model of support could be most effective.

Perth & Kinross are currently looking at possible long term models of support, were we to go down a whole life route we would want a provider that recognizes the need for early intervention, ensuring individuals are supported from childhood into adulthood, in turn lessening costs and pressure on adult services, support should be provided as a preventative measure and not when irreversible damage has been done and families find themselves in a crisis situation. They should truly understand the nature of autism and what makes a meaningful difference. We should not be aiming to just keep people safe, or to find somewhere for people to go each day with no real outcome other than just filling time. We should be aiming to increase the skills of these individuals to ensure they have access to the same things you and I do, to be employed, to access education, to have their own home to have a social life/relationships. These are all entirely possible for a large proportion of this population and should be where we aim to work, thus improving outcomes not only for the individual but their families and society as a whole.

CONSULTATION FEEDBACK IN RESPONSE TO OUTCOME 3:

“Access to appropriate support at every stage of life”.

“This is an admirable goal, but needs the community to fully understand the complex nature of autism (and its many associated variations) in order to work. This kind of work is already being undertaken by the NAS, but it is a huge undertaking, and much publicity is still needed. In the end it benefits the community as much as it does the ASD person, as it broadens their understanding and tolerance of social behaviours”.

“More supported living options for young people transferring from children's services to adult services”.

“Education and awareness to everyone. Supermarkets, chemist, retailers because everyone can do something to help even if it's giving someone a kind words to a stressed out mother dealing with a meltdown in a supermarket”.

“Well where do I start? Number 3 has helped me enormously. If it was not for the staff at Number 3 I would still be living a reclusive life by not going out or meeting new people. They have also helped me get a flat so that I can live independently as I can.”

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CITIZENSHIP – PEOPLE WITH AUTISM ARE ABLE TO PARTICIPATE IN ALL ASPECTS OF 4 COMMUNITY AND SOCIETY BY SUCCESSFULLY TRANSITIONING FROM SCHOOL INTO MEANINGFUL EDUCATIONAL OR EMPLOYMENT OPPORTUNITIES.

WHAT WE WILL DO

Improve access to appropriate transition planning across the lifespan WHY WE NEED TO DO THIS?

People with autism can experience barriers to participation in aspects of community life including education, employment opportunities and social activities. A good transition plan from school will enable young people with autism to plan their future participation in and contribution to their community.

WHAT WE HAVE ACHIEVED

It was recognised that children with additional support needs, particularly those with Autistic Spectrum Condition have difficulty with changes and transitions in their lives. Perth and Kinross created the Transitions in the Community project in 2012, including three areas; Building Family Support (including Woodlea and Child Health team), Transitions Team and Enhanced Educational Provision who deliver a number of different services, interventions and activities.

To keep children and adults in their own homes wherever possible. Children, young people and adults are ‘included’ and benefit from a personalised approach to meeting need in line with ‘Getting it Right for Every Child’ and the personalisation agenda. Services are more sustainable and cost effective. A range of learning, achievement and employment opportunities is made available and accessible to children and adult service users; Parental confidence is increased.

The Building Family Support service area incorporates a number of diverse services, many of which have been achieved through a reorganisation of services based at or delivered through Woodlea Cottage. This includes residential short breaks (respite care), various forms of family support, outreach work, and support for the acquisition of independent living skills.

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The Transitions Team has been established to support young people and their families to be active participants in changes in their lives; this includes transitions into adulthood. The Transitions Team is managed through Housing and Community Care and includes workers from a 44 range of different backgrounds. The aim of the team is to allow young people to experience smooth transitions and to provide them with support to achieve their ambitions and enjoy success. For some, this may eventually include training, further education, employment and independent living. Team members consider that to achieve these aims it is necessary to ensure that major shifts take place in service and community cultures. As well as mainstream local services and activities, the Transitions Team help to link families into initiatives which support the transitions process in practical ways:

The Independent Living Skills Programme has been developed in partnership with Woodlea Cottage and the Transitions Team. Eight students attend Woodlea Cottage at weekends to develop a range of skills such as cooking, shopping, planning meals etc. This service provides an example of Child Care and Adult Care services working together

The Child Health Team and the Woodlea Outreach Team worked together to develop child-centred programmes of individually tailored support for children and young people with complex needs and their families. By pooling resources and expertise, and working differently, they were able to develop programmes that did not create dependencies on the service, but altered expectations and ambitions, and developed children and family’s confidence, skills and abilities to manage the challenges of daily life. The staff works in partnership with parents within the family home to address issues such as sleep, routine and eating which were often challenging in the home environment. The staff brought their skills and experience and intimate knowledge of the child and worked alongside parents to develop consistent approaches at home, school and respite. The number of children and young people receiving a service has been expanded and referrals from other agencies have increased. The team has shared the good practice of Intensive Family Support with delegations from other local authorities, head teacher groups, and external organisations.

The Independent Travel Trainer is part of the Transitions Team and works with primary and secondary schools to ensure that children and young people can learn and develop skills such as the use of public transport which will help promote independence. Apart from the confidence and self-esteem which this gives young people and their families, travelling independently also reduces the cost to the Council in respect of taxi fares and similar transport fees.

Day Opportunities : Over time, Perth and Kinross Council has tended to move away from centres for adults with learning disabilities. There are, however, three Day Opportunity Programmes within the area and a ‘Joining-In Group’ has been developed which provides a resource for some people who previously attended Day Opportunities but who no longer need such a service. At present, the Joining-In Group is supported by two staff from a Day Opportunity programme but it is hoped that this model can gradually be rolled out to other areas and become less reliant on the input of professionals.

Further Education : Two local colleges (Dundee and Perth College (University of the Highlands and Islands)) provide relevant courses and support for young people and work closely with the Transitions Team to identify opportunities and facilitate successful transitions.

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AUTISM DEVELOPMENT FUND

Perth & Kinross council recently secured funding from the Scottish Government Autism Development Fund to develop two projects the first of 4 which is our ASC Work Experience Coordinator post which has been created to improve access to appropriate transition from senior school age to adult life, by providing work experience opportunities for those with an ASC in 4/5th year of all ten secondary school within Perth & Kinross. We provide work experience placements throughout the school year within Perth & Kinross council and these placements are supported by Perth Autism Support. This project is jointly run by Perth & Kinross, Education and Children’s Services, Housing and Community Care and Perth Autism Support. We have existing strong links and will further build on this relationship, thus enhancing the opportunities available to young people with an ASC through Perth & Kinross. Perth Autism Support has evidenced clearly their capacity to support those on the autism spectrum and have existing relationships with the young people we will be engaging.

This project aims to:

Improve transition from school and into employment for those with an ASC. Provide people with an ASC an employment opportunity allowing them to use their skills and to make a valuable contribution in the workplace. Allow those with an ASC to be an active and valued part of society affording significant psychological and social benefits. Have a positive impact on the lives of people who have little or no experience in the workplace and to help them achieve their highest potential, as they interact with colleagues and grow to become more confident and competent in their abilities. Acquire extended work experience, employment opportunities via the associated modern apprentice programme or by moving on to secure full-time jobs elsewhere. PAS : - will tailor the support needed for each individual, ranging from one to one high intensity support to, independent travelling to, training and assisting PKC employees in understanding autism and how to get the most out of each student on placement. We will ensure we job match specifically to the skillset of these individuals. We will ensure our HR team are autism confident by providing bespoke training designed by Perth Autism Support and our Autism coordinator.

“In creating sources of pride and a meaningful life, one of the biggest challenges will be to create job opportunities for autistic people. I am convinced that every autistic person can contribute to society and that this feeling of contributing is one of the main sources of wellbeing ”. Peter Vermeulan (2016).

Ease the Move Project: Perth and Kinross Housing and Community Care staff are working jointly with Perth Autism Support to deliver this highly specialised and focussed provision , we receive additional support from the local school specialist provision, where many of these individuals would have been educated and supported in the secondary school years.

Ease the Move is based in an existing small day service in Blairgowrie; we were keen to target this area as our statistics currently indicate a larger proportion of young people with autism living in the North locality. Ease the Move has funding for two to three years and is aimed at young adults 16-25 in line with the Principles of Good Transition guidance, 10 places, with two reserved places for those who are currently inappropriately placed or out of area.

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We provide a tailored day service which is completely autism specific in nature, highly structured and person centred, our service will examine closely the impact of Autism Spectrum Condition’s (ASC’s) upon the individual and devise strategies with them and their families that address 4 issues they may have with for example emotional regulation, sensory issues, low self-esteem, depression, anxiety or distressed behaviour. Individuals will benefit from a completely person centred approach, people can spend time in the centre if need be but also make use of local community activities and projects. Access to the service is through a management referral team who will be made up of education, social care and third sector staff (with an autism understanding/knowledge base) who will decide the suitability of each individual being referred. This ensures the needs of those already in the service is taken into account and that we do not disrupt or damage any of the existing good work already in place, but also to ensure the staff skill in place is sufficient to meet an individual’s needs. We acknowledge that transition is a process that evolves over several years and therefore this project is looking at spending 1 – 2 years with individuals easing the move between children’s and adult services. We aim to enable these individuals to go on to further education, independent living or supported employment opportunities, other more mainstream services or simply to lead happier more fulfilled lives.

Interventions that help to build resilience, or address mental health symptoms are also potentially very important. In addition, of course, changing the mind-set of employers could make a huge difference to the chances of autistic people getting and keeping meaningful employment. Housing and Community Care have created a bespoke ASC Modern Apprentice scheme , where young people with an ASC can access Modern Apprentice placements within PKC, but with support from our local third sector autism organisations Perth Autism Support and Autism Initiatives or our Autism Coordinator. They can have their hours adjusted to suit their needs, teams working with the young person will receive training and support and if a young person isn’t quite ready for work we have linked in with a company called IDTC, who are funded by Skills Development Scotland and provide work readiness skills.

AUTISM INITIATIVES : - works in partnership with secondary schools, Perth Autism Support and Youth Services to ensure young people receive the correct support at time of transition from school. The service works with Higher Education facilities, mainly Perth and Dundee Colleges and supports individuals to access funding and financial support via the Student Awards Agency for Scotland and to access educational support the college’s student support services and Disabled Students Allowance. Number 3 works closely with Job Centre Plus, other local employment support providers (Check In/Giraffe, the Shaw Trust, Capability Scotland, Barnardo’s) and with PKC Modern Apprenticeship scheme. For those who require additional support when they reach adulthood, Number 3 supports individuals to contact PKC’s Community Care Access Team. Ensure individuals and families have a full understanding of SDS. Liaise with service providers. Provide a support & advocacy role at meetings then provide ongoing support to individuals, family and service provider once support package is arranged.

WHAT WE WILL DO NEXT

Over the course of our lives, each of us will make many transitions, some of which go smoothly and some of which do not. They could include starting school for the first time or moving between schools, starting and leaving university, beginning our first job, losing a job unexpectedly, moving house, becoming a parent, coping with the death of someone close to us, or suddenly discovering that we have a serious illness.

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“Transitions of this kind can be stressful for anyone, but particularly so for an autistic person who seeks sameness, this may not be recognised by others or responded to adequately. Recognition and response may be even less likely if the professionals seen by an autistic person in the 4 health, social care, education or housing sectors are themselves changing all the time”. (National Autism Project 2017) Some transitions in life are predictable and we should be able to plan effectively for these, apply autism thinking to the situation, be flexible in our approach, and be cognisant of the stress that any such transitions can cause autistic people, parents and other carers.

We aim to get better at providing the information required to help families prepare, fundamental to anyone with autism is how their transition from education to adult services is handled; the risks associated with an inadequate transition are high. The risks vary dependent on where on the spectrum the young person sits but if they are seen as having a high functioning condition, their needs are often not recognised and support is insufficient, leading to mental health issues, unemployment and dependence on their families. Those seen as having a more complex condition are often placed in services that are unable to cope with this complexity and therefore suffer situations that cause great stress and worsen their Autism often ending up in secure environments which are not designed to meet the needs of those with ASC.

Within Perth & Kinross we have paid a substantial amount of attention to these issues and invested in this area of provision, we will continue to do so in the coming years, we believe that a combination of early intervention a good quality transition will radically alter the experience many with autism experience, and as a consequence reduce the strain and stress felt by families.

HOW DO WE MEASURE SUCCESS

Assessing success should take into account the perspectives of different stakeholders, seeking to achieve whatever is considered to be the right balance between the competing interests and commitments of autistic people, family members and other carers, public sector commissioners and wider society. We have acknowledged that there is a need to move beyond ‘simply’ improving what might be considered ‘clinical’ outcomes, such as social interaction, communication skills and behaviours, these are important for many autistic people but don’t necessarily equate to happier lives.

We are aiming to improve outcomes for autistic individuals and the families/carers, not by making them less autistic but by understanding the unique presentation of their condition and what adaptations we can make to improve that individuals ability to be part of the community workplace and education system

“Not less autistic, but autistically happy” Autisme Centraal

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CONSULTATION FEEDBACK IN RESPONSE TO OUTCOME 4: 4 “I think that a lot of people with autism are missed and are not diagnosed properly and find these transitions harder than others”. “Greater opportunities for young people to undertake extended work experience placements whilst at school that extend beyond leaving school to support transition”..

“Recognising that people with Autism are capable of much more meaningful and range of employment with support”.

“We have had no support with transition so far and don't know how to access help”.

“I am researching what PAS in my local area can provide for my son now he has become a teenager as now he has moved into secondary I need to think about a career for him and how he can be supported in that. Again I would prefer to have the opportunity to have that information offered to me at the right time”.

“Important that employers offer equal opportunities for everyone”.

“Education and more awareness to as many people as possible. Understanding how to help and make them to feel included even though it can be extremely hard to interact and bring them out of their shells”.

“Helped my son understand life from a different perspective, supported him with leaving school and into work, support to get PIP payments and free bus pass, entertainment/leisure, somewhere to go for advice...the list goes on”

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