MIDLOTHIAN LOCALITIES

APPENDIX 4 | Tom Welsh Localities Midloth ian’s Approach The Christie Commission on the Future of Public The Government’s Localities Guidance Services concluded that reforms must empower acknowledges that the size of localities will vary, individuals and communities receiving public but will need to feel ‘right’ to people living and services by involving them in the design and working in the area: large enough to offer delivery of the services they use. In relation to sufficient scope for service improvement, but health and social care services the All Hands on small enough to feel local and ‘real’. Deck Report argued that localities were the is small geographically and in population terms “engine room” of integration. and due to the practicalities and implications of commissioning on small scales, the impact of a The Public Bodies (Joint Working) () Act localities based approach was discussed with 2014 requires Health and Social Care Scottish Government. Partnerships to identify at least two localities and to include representatives from these While the requirement for at least two localities localities in the Strategic Planning Group. A was upheld it was recognised that Midlothian’s locality is defined in the Act as a smaller area size is smaller than some localities in other within the borders of an Integration Authority. Partnership areas. The emphasis therefore is on developing a stronger ethos of working with Their purpose is to provide an organisational natural communities while also developing mechanism for local leadership of service formal plans for two localities in Midlothian planning, to be fed upwards into the Integration based up on a pragmatic East/West split (figure Authority’s strategic commissioning plan – 3.1a). localities must have real influence on how resources are spent in their area.

Locality Neighbourhood Area Population % Over 75s West Penicuik & District 13,948 7.2% Howgate 854 Roslin / Bilston 3,185 8.5% Damhead 624 6.6% Loanhead & District 5,508 8.5% / 11,538 7.3% Poltonhall & District 6,046 Rosewell & District 1,500 5% Total Population 43,167 7.40% East & District 8,800 7.7% Eskbank / Newbattle 5,634 Danderhall & District 3,636 Mayfield / Easthouses 7,577 Newtongrange 4,931 Gorebridge & District 6,197 7% Moorfoot 596 Tynewater 1,924 8.4% Total Population 39,295 7.18%

Mayfield and Woodburn. In total there are 8 Background data zones in most deprived 20%areas in Comprised of smaller Neighbourhood Areas, Scotland. In these areas the life expectancy each locality has a different health and social can be significantly (up to 12 years) less than care profile and distinctive characteristics. A for people residing in more affluent areas of significant difference is East Midlothian is the Midlothian. presence of three areas of multiple The population is getting healthier as deprivation (parts of Gorebridge, Mayfield indicated by a steady decline in all cause and, Woodburn [Dalkeith & District]); in total mortality in East Midlothian between 2006/8 there are 8 data zones in most deprived 20% and 2011/13. However deaths under the age areas in Scotland. In these areas the life of 75 years, which are described as ‘early’ and expectancy can be significantly (up to 12 analysed separately, While West Midlothian years) less than for people residing in more has shown a downward trend in East affluent areas of Midlothian. Though ‘All Midlothian the picture is a more variable one. Cause Mortality rates’ for the population of Midlothian as a whole demonstrates a East Midlothian has higher mortality levels consistent downward trend, this hides from all causes of cancer than West variation in disease specific mortality in East Midlothian locality. However, there has been and West localities. a convincing downward trend in deaths from cancer in East Midlothian over the period of In seeking to develop services responsive to analysis. Deaths from lung cancer in East the needs of particular communities and Midlothian remain above the Scottish adopting a co-productive approach we will average. take steps to strengthen links to Community Councils and Neighbourhood Planning Groups However, as is the case across Midlothian: as well as working with the newly reformed Public Partnership Forum now addressing  There is an increasing trend of people social care issues as well as health matters. being admitted to hospital because of We will also continue to work closely with falling The will be addressed through the groups who have a specific area of interest development of a Midlothian Falls e.g. Learning Disability rather than a Strategy including through the application geographical focus referred to as communities of telehealthcare of interest.  There has been a gradual increase in the number of unplanned admissions from East Midlothian East Midlothian over recent years. The The Area increased numbers of people admitted to hospital as an emergency will in part be East Midlothian is the area to the east of the addressed by enhancing the MERRIT A7 Carlisle to trunk road. It consists (rapid response) service and through an of eight Community Council areas and the in-depth review being undertaken in main settlements are listed in Figure 3.1a collaboration with Scottish Government above as part of the plan to save 200,000 hospital bed days across Scotland. Joint Needs Assessment  There has been an apparent increase in the East Midlothian includes three areas of standardised mortality rates from suicide in multiple deprivation-parts of Gorebridge, East Midlothian in recent years. However it is likely that changes in coding of possibility of providing extra care housing deaths will have contributed at least in part to through these properties will be considered. this rise. Mental Health Planned Service Developments Outreach day services will be developed in Mayfield and Gorebridge building on the Addressing Health Inequalities approach adopted in Dalkeith during 2014.We The Community Planning Partnership, in will also develop Gateways to Recovery - collaboration with Scottish Government, has initially in the 3 areas of deprivation made a funding bid to the European Union to undertake focussed work in three areas of Long Term Conditions deprivation. Health and Social Care services The Health and Wellbeing (House of Care) will be an active participant with the objective service will be piloted, initially in Newbattle of all public bodies, voluntary organisations Health Centre. We will also extend the Local and the local communities seeking to reduce Area Coordination and Neighbourhood Links inequality including health inequalities. The services to younger people with long term resource allocation to health and care is conditions in the area. dependent on the outcome of the bid. List of Services in Midlothian MHS has funded the Third Sector to To complete employ a Community Empowerment Development Worker to work in these three Planned Expenditure by Service areas as part of the local Joint Health Heading Improvement Strategy To complete Strengthening Primary Care West Midlothian Improvements are planned to Newbyres The Area: Health Centre 2016-17.Proposed improvements in capacity will be considered West Midlothian is the area to the west of the for funding by NHS Lothian for both A7 Carlisle to Edinburgh trunk road. It consists Danderhall and Newbattle of eight Community Council areas and the main settlements are listed in Figure 3.1a Services for Older People above

Local Area Coordination services will be Joint Needs Assessment funded through the Integrated Care Fund as will the continued enhancement of day The population is getting healthier as services in both St Davids and Woodburn. indicated by trends such as:

Extra Care Housing Building on the success of  There has been a steady decline in all cause mortality in West Midlothian Cowan Court in Penicuik work will be between 2006/8 and 2011/13 undertaken to redesign sheltered housing services to provide more integrated care and  Deaths under the age of 75 years are support in Dalkeith and Mayfield. The described as ‘early’ and analysed specialist housing provision in Gore Avenue separately, (in 2006/8 there were 865 (12 properties) will be rebuilt and the deaths in Midlothian, in 2011/13 there were 924. West Midlothian has Learning Disability consistently had lower death rates than New build accommodation for 12 people with the rest of Lothian or indeed Scotland complex care needs will be completed in However, as is the case across Midlothian: 2016-17 although this will serve the whole of the Midlothian population rather than the  There is an increasing trend of people West Locality only. being admitted to hospital because of falling The will be addressed through the Mental Health development of a Midlothian Falls Strategy including through the application We will develop Gateways to Mental Health of telehealthcare Services in Penicuik and Bonnyrigg

 There has been a gradual increase in the Long Term Conditions number of unplanned admissions from The Health and Wellbeing (House of Care) West Midlothian over recent years. The approach will be piloted initially in Penicuik increased numbers of people admitted to Health Centre and potentially in Roslin. The hospital as an emergency will in part be Local Area Coordination and Neighbourhood addressed by enhancing the MERRIT Links services will be extended to younger (rapid response) service and through an people with disabilities. in-depth review being undertaken in collaboration with Scottish Government Health Inequalities as part of the plan to save 200,000 A new Homelessness Unit will be opened hospital bed days across Scotland during 2015 in Penicuik . Through joint working between the Homelessness Staff, the There has been an apparent increase in the standardised mortality rates from suicide in local Primary care Teams and the new Health West Midlothian in recent years. However it is and Wellbeing Service (House of Care) it is likely that changes in coding of deaths will planned to take a proactive approach to have contributed at least in part to this rise addressing the health and care needs of the residents. While West Midlothian does not have concentrated areas of deprivation as is the List of Services in Midlothian case in East Midlothian there are pockets of To complete deprivation throughout the locality and it will be important that action taken in relation to Planned Expenditure by Service health inequalities is appropriately targeted. Heading Planned Service Developments To complete

Primary Care Improvements are planned to Penicuik Health Centre 2016-17 while new premises planned for Loanhead Health Centre 2017-18

Older People Local Area Coordination services will be funded through the Integrated Care Fund.

Figure 3.1a: Midlothian Districts