Annual Performance Report 2017-18 Contents Welcome from Chair and Chief Officer, Moray Integration Joint Board 3 Introduction 4 Strategic Context 5 Moray Strategic Plan 2016-19 6 National Outcomes 9 People are able to look after and improve their own health and wellbeing and live in good health for longer. 10 People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community. 16 People who use health and social care services have positive experiences of those services, and have their dignity respected. 22 Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services. 24 Health and social care services contribute to reducing health inequalities. 28 People who provide unpaid care are supported to look after their own health and wellbeing, including reducing any negative impact of their caring role on their own health and well-being. 32 People using health and social care services are safe from harm. 34 People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide. 36 Resources are used effectively and efficiently in the provision of health and social care services. 40 Finance Planning and Performance 42 Reporting on the Integrated Care Fund 46 Inspections 46 Localities and working with communities 47 Welcome from Chair and Chief Officer, Moray Integration Joint Board elcome to the Moray Integration Joint Board’s 2nd Annual WPerformance Report. This has been another exciting and challenging year with a huge amount of ongoing effort and activity as we endeavour to make sure we have the right services across Moray helping and supporting people to stay well. We have taken some bold steps in our approach to how we deliver services. We are particularly proud of the housing based models of care developed across a number of different settings working with both with older people and younger adults with specific conditions. We have ensured people can remain independent in their own tenancies with the right care, whilst maintaining the right to privacy and family life. We have had great success in the community based activity programmes we have delivered, working with communities to ensure good social connections and promoting active living. The wide variety of approaches adopted have been well received by communities, the number of people taking part in Shona Morrison activities are testimony to the public interest and engagement with what’s Chair, Moray Integration Joint Board on offer. We have also had our fair share of challenges, recruitment and retention of key personnel and finance resources in particular. However, we have not lost our focus on change and improvement, continuing to reshape our services and always keeping people and families at the centre of what we do. Whilst the challenges will always be there and may often be very difficult, we continue to strive to deliver on our agreed priorities and support our enthusiastic teams and wider support network in making a difference for the people of Moray. We have worked with particular communities around some of their local issues and we thank all of those communities and community councils for working with us to help us better understand what is needed and how we can work better with them. Pam Gowans Chief Officer, Moray Integration Joint Board Annual Performance Report 2017-18 3 Introduction he Public Bodies (Joint Working) T(Scotland) Act 2014 is the legal framework supporting health and social care integration in Scotland and requires that Integration Joint Boards (IJB’s) produce annual performance reports that assess their performance in planning and carrying out their functions. The IJB for this area came into existence on 1 April 2016 and the Moray Integration Joint Board was established. Moray Integration Joint Board (MIJB) has the responsibility for the planning and delivery of the majority of adult health and social care services in Moray. The 2017/18 Report is the second Annual Performance Report of the MIJB and provides an overview of the progress made during the year. In-line with the expectations explicit in the legislation and Scottish Government guidance, the report considers our performance from several different perspectives: • The progress we have made in achieving the nine National Health and Wellbeing Outcomes and the related key priorities of the MIJB; • Making our Strategic Plan a reality; • The views of other people based on service user feedback, carers and external organisations who inspect and regulate our services; • The way in which we have managed our finances and delivered best value 4 Health and Social Care Moray Strategic Context cottish Government’s strategic vision is ‘by 2020 everyone is able to live What do we know about the Slonger healthier lives at home, or in a homely setting’. Moray population in relation to health and wellbeing? The Moray Integration Joint Board (MIJB) was formally established on 1st April 2016. The Moray Integration Joint Board is responsible for prioritisation Historically Moray tends to have a and oversight for delivery of a wide range of Health and Social care services health profile that is better than the based in the community. The integrated delivery of health and care is now Scottish national average. Overall known as Health and Social Care Moray and is made up of the services Moray has: traditionally delivered independently by NHS Grampian and Moray Council. Staff remain employed by these public bodies but are deployed as directed • above average educational by the MIJB. The key aim is to improve quality and efficiency by working attainment at S4 level, smoking together with wider key care partners. The challenge for the MIJB is to rates, fuel poverty transform and modernise services ensuring they are fit for the future and sustainable in the longer term. • average levels of employment, alcohol-related mortality, A key strategic responsibility for the MIJB, like others, is to continue to develop ways of working that shift the balance of care from institutional care • below average income, crime, to care in the community. The legislation has identified specific emergency homelessness, alcohol-related admission pathways to the acute hospital, for Moray this tends to be Dr hospital admissions, Grays, the assumptions are that a proportion of these admissions could be prevented particularly in the case of older people. It is the task of the MIJB • significantly better health to understand the trends, patterns of admission and to identify improvement condition prevalence rates or redesign to ensure we are maximising the opportunities for avoidable than the average across admissions being prevented. It is however acknowledged that this happens Scotland regarding – emergency in the context of many appropriate admissions. It should be noted that in admissions, over 65s multiple the last 10 years Moray has reduced the number of beds in use by circa 20% emergency admissions, against an increase in the over 65yrs population of 10%. This demonstrates new cancer registrations an efficiency and significant shift in the location of care delivery towards and admissions for Chronic community having already taken place to date. Obstructive Airways Disease (COPD), Chronic Heart Disease In addition, the MIJB has responsibility for hosted services of Primary Care (CHD) and asthma. Out of Hours Service (GMED) and Primary Care Contracts (General Medical Services, pharmacy, dentisty and opthimetry), these national contracts are • above average, traffic accident managed on a Grampian wide basis. The hosting IJB is responsible for leading casualties, and potential the strategic planning of these services again to ensure future resilience and geographical challenges to equal sustainability. Hosting arrangements means that one IJB within the Grampian access to services Health Board area hosts the service on behalf of all 3 IJB’s. These services at a local level are important elements of ensuring we can improve on care delivery in the community and maximise the range of skills available across the multi-disciplinary teams 24/7. The Strategic Plan of the MIJB directly responds, in a local context, to the national requirements of the Integration of Health and Social Care set out in the legislation, and the 9 national health and wellbeing outcomes identified. These outcomes are underpinned by performance measures by which the success of the local strategy is measured. The MIJB is a statutory partner of the Moray Community Planning Partnership and a key contributor to the Local Outcomes Improvement Plan (LOIP) that looks to ensure wider partners across the public, third and private sector are working for and with the community to support the people of Moray to thrive in their communities. Annual Performance Report 2017-18 5 Moray Strategic Plan 2016-19 he Strategic Plan 2016-19 Twas approved in April 2016 to allow the MIJB to become fully established was developed by the Strategic Planning and Commissioning Group. This group consisted of stakeholders from across the wider health and social care system, including Our Vision representatives of all sectors and the public to ensure engagement ‘To enable the people of Moray in the preparation, publication and review of the Plan. This process to lead independent healthy supported the development and and fulfilling lives in active and agreement of the strategic priorities in Moray as follows: inclusive communities where everyone is valued, respected and supported to achieve their own goals’ We will achieve our objectives by adopting the principles of: • Working together with all • Supporting people to live partners including patients, independently at home or in unpaid carers, service users a homely setting for as long and their families, promote as possible will always be our choice, independence, quality default position.