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Paper 21

Ayrshire and Arran NHS Board

Monday 27 May 2019

East Ayrshire Integration Joint Board Annual Review of Strategic Plan, Workforce Plan and Property and Assets Management Strategy 2018-21

Author: Erik Sutherland, Planning and Performance Manager, EAHSCP

Sponsoring Director: Eddie Fraser, Chief Officer, EAIJB

Date: 30 April 2019

Recommendation

The NHS Board is asked to:

(i) Receive the report;(ii) Note that the three complementary plans were presented to the IJB at its meeting of

26 March 2019;(iii) Note the findings of the Annual Review of the Strategic Plan 2018-21, specifically

that there is no requirement for a replacement plan;(iv) Note the changing policy environment in relation to increasing the progress and

pace of integration;(v) Note that the IJB approved the Annual Review of the Workforce Development and

Support Plan;(vi) Note that the IJB endorsed the development of a toolkit to support the development

of workforce plans across service areas, and;(vii) Note that the IJB approved the Annual Review of the Property and Asset

Management Plan;(viii) Endorse the Annual Review of the Strategic Plan, Workforce Development and

Support Plan, and Property and Asset Management Plan (at Appendices i-iii);(ix) Note that the report will be presented to East Ayrshire Council at its meeting of 9

May 2019 in line with the initial agreement;(x) Note that the IJB agreed Directions in respect of commissioning services from East

Ayrshire Counci l and NHS Ayrshire & Arran in line with the Strategic Plan, asrefreshed by the Annual Review, and within the allocated budget for 2019/20, and;

(xi) Note that the Chief Officer is instructed to produce detailed Directions to Parties tothe Integration Scheme following the meeting of the IJB on 8 May 2019.

Summary

The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty on the IIJB to develop a Strategic Plan for the integrated functions and budgets under its control. The Strategic Plan is the document setting out the arrangements for carrying out the integration functions and how these are intended to contribute to the achievement of the

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relevant national health and wellbeing outcomes for the HSCP. Due to the expanded scope of the delegated functions to East Ayrshire IJB, relevant outcomes in relation to Children and Young People and Justice are also included. The Workforce Plan and Property and Asset Management Strategy complement and support the Strategic Plan.

Key Messages:

• The Annual Review shows no need for a replacement Strategic Plan;• Considerable progress has been made in delivering the Workforce Development

and Support Plan;• The Annual Review of the Property and Asset Management Plan shows progress

and plans for localities, and;• The report is presented to parties to the Integration Scheme in line with the initial

integration agreement.

Glossary of Terms

NHS A&A FACE GPwER HSCP IJB MDT

NHS Ayrshire & Arran Flexible, Approachable, Caring and Empowered General Practitioners with Enhanced Roles Health & Social Care Partnership Integration Joint Board Multi-Disciplinary Team

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1. Situation

Report presents to the NHS Board for endorsement the Annual Reviews for 2018-19 of the Integration Joint Board Strategic Plan, Workforce Plan and Property and Asset Management Strategy for the period 2018-21. To present plans for these key strategies for 2019-20. To present the indicative partnership budget to deliver on these commitments. These reports were presented to IJB on 26 March 2019.

2. Background

The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty on the IJB to develop a Strategic Plan for the integrated functions and budgets under its control.

The Strategic Plan is the document setting out the arrangements for carrying out the integration functions and how these are intended to contribute to the achievement of the relevant national health and wellbeing outcomes for the HSCP. Due to the expanded scope of the delegated functions to East Ayrshire IJB, relevant outcomes in relation to Children and Young People and Justice are also included. The Workforce Plan and Property and Asset Management Strategy complement and support the Strategic Plan.

The remainder of this report presents an Annual Review of the three year plans for 2018-19 and future actions for 2019-20.

3. Annual Review of Strategic Plan

Since establishment of the East Ayrshire Health and Social Care Partnership a process of Annual Review of the Strategic Plan has been in place through the Strategic Planning Group.

The Annual Review process has facilitated the presentation of key priorities for delivery alongside the delegated budget made available from parties to the Integration Scheme available to achieve this to the IJB.

In reviewing activity on an annual basis partners must have due regard to the integration delivery principles and to the national health and wellbeing outcomes together with national outcomes for chi ldren, young people and justice.

The integration delivery principles and the relevant national outcomes are set out in the tables below:

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Integration Delivery Principles

(i)

(ii)

(iii)

(iv)

(v)

(vi)

(vii)

(viii)

(ix)

(x)

(xi) (xii)

(xiii)

(xiv)

that the main purpose of services which are provided in pursuance of integration functions is to improve the wellbeing of service-users;

that, in so far as consistent with the main purpose, those services should be provided in a way which, so far as possible;

is integrated from the point of view of service-users;

takes account of the particular needs of different service-users;

takes account of the particular needs of service-users in different parts of the area in which the service is being provided; takes account of the particular characteristics and circumstances of different service-users;

respects the rights of service-users;

takes account of the dignity of service-users;

takes account of the participation by service-users in the community in which service-users live;

protects and improves the safety of service-users;

improves the quality of the service; is planned and led locally in a way which is engaged with the community (including in particular service-users, those who look after service-users and those who are involved in the provision of health or social care);

best anticipates needs and prevents them arising; and

makes the best use of the available facilities, people and other resources.

National Outcomes for Children

Outcome 1 Our children have the best start in life. Outcome 2 Our young people are successful learners, confident individuals,

effective contributors and responsible citizens. Outcome 3 We have improved the life chances for children, young people and

families at risk. Health and Wellbeing Outcomes

Outcome 4 People are able to look after and improve their own health and wellbeing and live in good health for longer.

Outcome 5 People, including those with disabilities, 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.

Outcome 6 People who use health and social care services have positive experiences of those services, and have their dignity respected.

Outcome 7 Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services.

Outcome 8 Health and social care services contribute to reducing health inequalities.

Outcome 9 People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and wellbeing.

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Outcome 10 People who use health and social care services are safe from harm. Outcome 11 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.

Outcome 12 Resources are used effectively and efficiently in the provision of health and social care services.

National Outcomes Justice

Outcome 13 Community safety and public protection. Outcome 14 The reduction of reoffending. Outcome 15 Social inclusion to support desistance from offending.

The Strategic Plan 2018-21 centres on the ‘triple aim’ of better care, better health and better value. As such it refocuses activity on a smaller number of core themes. These are:

• Scaling up work on prevention and early intervention across all ages;• Supporting New Models of Care;• Building Capacity in Primary and Community Care, and;• Transformation and Sustainability.

The Strategic Planning Group formed under Section 32 of the Public Bodies (Scotland) Act 2014 and the Wellbeing Delivery Group established to lead the implementation of the Wellbeing theme of the Community Plan 2015-30 were brought together during 2018.

At the Strategic Planning and Wellbeing Delivery Group Workshop on 19th February 2019, the Annual Review of the Strategic Plan was undertaken (Appendix i).

Partners considered key questions in relation to: the appropriateness and relevance of the vision, values, priorities, enablers, together with any newly identified challenges. The Annual Review Workshop assessed whether a ‘replacement plan’ was required.

The vision and values were reaffirmed with the recognition that the workforce contract with the public developed by East Ayrshire Council needs to be reflected – Flexible, Approachable, Caring and Empowered (FACE). Partners also noted the need to promote the narrative around ‘stay connected’ and tackling social isolation.

The four Strategic Commissioning Intentions were seen to be appropriate and should remain stable. There are a range of ‘must do’ themes arising from local and national policy which fit with the Strategic Commissioning Intentions. Specifically these are:

• demand management;• delivering core priorities of Programme for Government;• waiting times improvement;• mental health including children and young people;• shift balance of spend to mental health and primary, community and social care;• living wage, extending free personal care, the Carers Act;• efficiencies from reducing variation in unscheduled care and ‘set aside’, and;• local cost pressures, pay settlement, National Care Home Contract.

A key strategic priority for the IJB over 2019/20 is to increase the progress and pace in integration in line with the Audit Scotland ‘Health and Social Care Integration – Update on

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Progress’ and Ministerial Strategic Group ‘Review of Progress with Integration of Health and Social Care’ findings. This requires focus on:

• collaborative leadership;• integrated finances and financial planning;• effective strategic planning for improvement;• collective understanding of governance and accountability;• information sharing in relation to frameworks and good practice, and;• meaningful engagement of communities, supported people and carers.

The financial challenges have been highlighted in successive Annual Reviews and in the modelling around the Medium Term Financial Plan. For 2019/20 the indicative financial gap between demand and cost pressures and the delegated budget from parties to the Integration Scheme is estimated to be in the region of £5m with further cash-releasing efficiencies of 1.5 per cent.

The Strategic Planning and Wellbeing Delivery Group noted a risk to the core theme of scaling-up prevention and early intervention from resourcing constraints and a need to mitigate this risk to support ongoing demand management.

Supporting plans in relation to the Workforce Development Plan and the Property and Asset Management Strategy were seen as critical enablers in directing activity in ensuring the right people, right skills, right place, right time and making the best use of the premises that we occupy to deliver care and support effectively and efficiently. Key areas for focus over 2019/20 are in relation to the third and independent sector workforce and in implementing smarter working.

In undertaking the Annual Review, partners noted a need to strengthen communication and engagement with the whole workforce, partners and local communities in 2019/20. Engagement with partners includes the wider future vision for housing and infrastructure such as transport. The focus should be on empowerment and building confidence in the workforce to ‘do the right thing’.

The Strategic Plan 2018-21 was assessed as fit for purpose, effective, taking into account the changing policy environment, and that no replacement plan is required.

Further engagement with national improvement support will be progressed during 2019/20 including iHub support.

4. Annual Review of Workforce Plan

The Workforce Development and Support Plan (Appendix ii) has as its ambition ensuring that we have the right people with the right skills in the right place at the right time.

The Plan recognises the demographic and financial challenges that face health and social care and identifies a need for transformation, new ways of working where prevention and enablement are at the forefront of our work across all partners.

The Plan is guided by the ‘six step’ methodology:

• defining the plan;• mapping the service change;• defining the required workforce;

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• understanding workforce availability; • planning to deliver the required workforce, and; • implement, monitoring and refresh.

Progress over 2018/19 relates to:

• investment in supporting the workforce – palliative care training for the care at

home workforce, continuing to strengthen links with Further Education, recruitment of newly graduated nurses to our two-year development programme;

• multi-disciplinary team working – primary care MDTs, realising new opportunities such as Pharmacy First and Eyecare Ayrshire;

• improved access to support – through the community ‘front door’ service, seven day working in the Intermediate Care Team, and integrating school nursing, looked after nursing and staff nursing;

• recruitment – learning from the campaign to recruit to the Intermediate Care Team and GPs using social media and other innovative methods;

• skills mix – positively redesigning roles to meet service objectives, such as the pharmacotherapy service;

• general Practitioners with Enhanced Roles (GPwER) – attracting GP trainees and making roles more attractive, and;

• youth employability – the range of initiatives to support school leavers into positive destination and opportunities to attract a younger workforce to health and social care and the positive recruitment policy with access to entry level posts for looked after and accommodated children meeting essential criteria.

Plans for 2019/20 are included in the Annual Review and cover:

• proactive recruitment methods; • exploring ski lls mix; • making role more attractive; • integrated team focus; • opportunities to attract a younger workforce, and; • utilising new technology to support the workforce.

5. Annual Review of Property and Assets Strategy The Annual Review of the Property and Asset Management Plan complements the Strategic Plan and the Workforce Plan and aims to support these through making best use of the estate that health and social care services use, to enhance provision of health and social care in local communities and to rationalise the estate for reinvestment in frontline services (Appendix iii).

The review incorporates revised governance structures for the delivery of capital programme in both East Ayrshire Health and Social Care Partnership and NHS Ayrshire & Arran.

In East Ayrshire Health and Social Care Partnership a Property and Asset Management Board has been established to oversee the PAMS and feed into both NHS and Council Structures. The report also highlights progress during the year. This includes:

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• Kirklandside Estate;• Bentinck Centre;• Primary Care, and;• HMP Kilmarnock.

Finally the report looks forward to the remainder of the strategy period with a focus on both accommodation, but also digital services and modules of agile working.

6. Recommendation

The NHS Board is asked to:

(i) Receive the report;(ii) Note that the three complementary plans were presented to the IJB at its

meeting of 26 March 2019;(iii) Note the findings of the Annual Review of the Strategic Plan 2018-21,

specifically that there is no requirement for a replacement plan;(iv) Note the changing policy environment in relation to increasing the progress

and pace of integration;(v) Note that the IJB approved the Annual Review of the Workforce Development

and Support Plan;(vi) Note that the IJB endorsed the development of a toolkit to support the

development of workforce plans across service areas, and;(vii) Note that the IJB approved the Annual Review of the Property and Asset

Management Plan;(viii) Endorse the Annual Review of the Strategic Plan, Workforce Development

and Support Plan, and Property and Asset Management Plan (at Appendicesi-iii);

(ix) Note that the report will be presented to East Ayrshire Council at its meeting of9 May 2019 in line with the initial agreement;

(x) Note that the IJB agreed Directions in respect of commissioning services fromEast Ayrshire Council and NHS Ayrshire & Arran in line with the StrategicPlan, as refreshed by the Annual Review, and within the allocated budget for2019/20, and;

(xi) Note that the Chief Officer is instructed to produce detailed Directions toParties to the Integration Scheme following the meeting of the IJB on 8 May2019.

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Monitoring Form

Policy/Strategy Implications The Report is presented in accordance with the legal requirements of the Public Bodies (Joint Working) (Scotland) Act 2014.

Workforce Implications Human resource implications are considered through appropriate governance arrangements detailed in the Workforce Plan and Property and Asset Management Strategy.

Financial Implications The report has implications for finance in relation to the need for the IJB to be assured that the indicative partnership budget is sufficient to deliver the outcomes and priorities set out in the Strategic Plan. Under Scottish Government guidance, developed by the Integrated Resource Advisory Group (IRAG), the Strategic Plan should incorporate a medium term financial plan for the resources within its scope. An indicative integrated budget for delivering the Strategic Plan 2018-21 accompanies this report, subject to finalisation and detai led service level allocation. The IJB sets direction and commissions the resultant integrated services from the NHS Board and Council through the HSCP.

Consultation (including Professional Committees)

Consultation has taken place through the Strategic Planning and Wellbeing Delivery Group.

Risk Assessment There are no risk implications arising directly from the report.

Best Value

- Vision and leadership- Effective partnerships- Governance and

accountability- Use of resources- Performance management

The Annual Reviews of the Strategic Plan, Workforce Plan and Property and Asset Management Strategy have implications for supported people and carers in relation to the integrated delivery principles, national outcomes, ensuring that we have the right people with the right skills in the right place at the right time and that we make the best use of the premises that we occupy to deliver care and support effectively and efficiently.

Compliance with Corporate Objectives

The report aligns with the Transformation Strategies of the parties to the Integration Scheme in terms of its contribution to the imperative for change in health and social care and recommendations for putting this into effect through engagement with stakeholders, strategic planning, governance and leadership. The report fits with the delivery of positive outcomes for people and ‘a fairer, kinder, connected East Ayrshire’.

Impact Assessment The Report refers to the principles of the Public Bodies etc. Act which require Integration Authorities to take account of the particular needs of different service users and take account of particular characteristics and circumstances of individuals in keeping with the equality ambitions of the Community Plan.

EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP

INTEGRATION JOINT BOARD: 26th MARCH 2019

ANNUAL REVIEW OF STRATEGIC PLAN 2018-21

Report by Director of Health and Social Care

Direction Required toCouncil, Health Boardor Both

Direction to:1. No Direction Required2. East Ayrshire Council √

3. NHS Ayrshire & Arran √

PURPOSE1. To present to Integration Joint Board (IJB) for approval the Annual Review for 2018-19 of

the Strategic Plan 2018-21. To set out the indicative partnership budget to deliver on thecommitments contained within that Plan.

BACKGROUND2. The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty (Sections 29-39) on

the IJB to develop a Strategic Plan for the integrated functions and budgets under itscontrol.

3. The Strategic Plan is the document setting out the arrangements for carrying out theintegration functions and how these are intended to contribute to the achievement of therelevant national health and wellbeing outcomes for the HSCP. Due to the scope of thedelegated functions to East Ayrshire IJB, relevant outcomes in relation to Children andYoung People and Justice are also included.

STRATEGIC PLAN 2018-214. The Strategic Plan 2018-21 centres on the ‘triple aim’ of better care, better health and

better value. The Plan focuses activity on a small number of core themes. These are:

Scaling up work on prevention and early intervention across all ages; Supporting New Models of Care; Building Capacity in Primary and Community Care, and; Transformation and Sustainability.

5. The four core themes are further described in the Plan, with a greater level of detailprovided on Lead Partnership arrangements.

6. The financial framework incorporated into the Plan highlights the challenge facing publicbodies and the implications of this for the IJB. This has been further detailed in theMedium Term Financial Plan which projects a £38M demand and cost-pressure gap in thelifetime of the Plan.

7. Strategic Commissioning Intentions are detailed in the Plan for the core themes.

Appendix i

8. The Strategic Commissioning Intentions related to Prevention and Early Intervention isfocused on scaling up action on the main wellbeing challenges of alcohol, tobacco andobesity across all ages. The population and resource impact of this are quantified.

9. New Models of Care Strategic Commissioning Intentions sets out plans for moreintegrated, multi-disciplinary working in localities for older people and people with complexneeds and long-term conditions.

10. The impact of this and trajectories submitted to the Ministerial Strategy Group on‘Measuring Performance Under Integration’ is quantified in the Plan.

11. The local impact of the national commitment to see investment in Primary and CommunityCare rising to more than half of frontline spending is described in the StrategicCommissioning Intention – Building Capacity in Primary and Community Care. Thisrelates to the 2018 General Medical Services Contract, the new role for GPs as ‘expertmedical generalists’ and the extended multi-disciplinary teams in Primary and CommunityCare linked to the Primary Care Improvement Plan.

12. Transformation and Sustainability is the fourth of the Strategic Commissioning Intentions inthe Plan. This section highlights the projected financial gap set out in the Medium TermFinancial Plan, links this to feedback from the engagement programme on making bestuse of relationships and resources, and to the transformational programmes of partners inEast Ayrshire Council and NHS Ayrshire and Arran.

13. The Transformation and Sustainability section of the Plan summarises the potential impactof the Commissioning Intentions in ‘closing the gap’ with appropriate agreement onmechanisms for resource release, invest to save programmes, and joint planning inrelation to the ‘set aside’ budget.

14. Key enablers to the delivery of the Strategic Plan 2018-21 are set out in the final sectionsof the Plan covering:

workforce planning; information communication technology; property and assets management; ‘thinking differently’;

housing contribution, and; leadership and improvement.

15. In reviewing activity on an annual basis partners must have due regard to the integrationdelivery principles (Section 31) and to the national health and wellbeing outcomes (asprescribed under Section 5) together with national outcomes for children, young peopleand justice.

16. The integration delivery principles and the relevant national outcomes are set out in thetables below:

INTEGRATION PRINCIPLES AND WELLBEING OUTCOMES

Integration Delivery Principles

i

ii

iiiivv

vi

viiviiiix

xxixii

xiiixiv

that the main purpose of services which are provided in pursuance ofintegration functions is to improve the wellbeing of service-users,that, in so far as consistent with the main purpose, those services shouldbe provided in a way which, so far as possible;is integrated from the point of view of service-users,takes account of the particular needs of different service-users,takes account of the particular needs of service-users in different partsof the area in which the service is being provided,takes account of the particular characteristics and circumstances ofdifferent service-users,respects the rights of service-users,takes account of the dignity of service-users,takes account of the participation by service-users in the community inwhich service-users live,protects and improves the safety of service-users,improves the quality of the service,is planned and led locally in a way which is engaged with the community(including in particular service-users, those who look after service-usersand those who are involved in the provision of health or social care),best anticipates needs and prevents them arising, andmakes the best use of the available facilities, people and otherresources.

National Outcomes for ChildrenOutcome1

Our children have the best start in life.

Outcome2

Our young people are successful learners, confident individuals,effective contributors and responsible citizens.

Outcome3

We have improved the life chances for children, young people andfamilies at risk.

Health and Wellbeing OutcomesOutcome4

People are able to look after and improve their own health and wellbeingand live in good health for longer.

Outcome5

People, including those with disabilities, long term conditions, or who arefrail, are able to live, as far as reasonably practicable, independently andat home or in a homely setting in their community.

Outcome6

People who use health and social care services have positiveexperiences of those services, and have their dignity respected.

Outcome7

Health and social care services are centred on helping to maintain orimprove the quality of life of people who use those services.

Outcome8

Health and social care services contribute to reducing healthinequalities.

Outcome9

People who provide unpaid care are supported to look after their ownhealth and wellbeing, including to reduce any negative impact of theircaring role on their own health and wellbeing.

Outcome10

People who use health and social care services are safe from harm.

Outcome11

People who work in health and social care services feel engaged withthe work they do and are supported to continuously improve the

information, support, care and treatment they provide. Outcome 12

Resources are used effectively and efficiently in the provision of health and social care services.

National Outcomes Justice Outcome 13

Community safety and public protection.

Outcome 14

The reduction of reoffending.

Outcome 15

Social inclusion to support desistance from offending.

2018-19 ANNUAL REVIEW OF STRATEGIC PLAN

17. The Strategic Planning Group formed under Section 32 of the Public Bodies (Scotland) Act 2014 and the Wellbeing Delivery Group established to lead the implementation of the Wellbeing theme of the Community Plan 2015-30 were brought together during 2018.

18. At the Strategic Planning and Wellbeing Delivery Group Workshop on 19th February 2019, the Annual Review of the Strategic Plan was undertaken. Partners considered key questions in relation to: the appropriateness and relevance of the vision, values, priorities, enablers, together with any newly identified challenges. The Annual Review Workshop assessed whether a ‘replacement plan’ was required.

19. The vision and values were reaffirmed with the recognition that the workforce contract

with the public developed by East Ayrshire Council needs to be reflected – Flexible, Approachable, Caring and Empowered (FACE). Partners also noted the need to promote the narrative around ‘stay connected’ and tackling social isolation.

20. The four Strategic Commissioning Intentions were seen to be appropriate and should

remain stable. There are a range of ‘must do’ themes arising from local and national policy which fit with the Strategic Commissioning Intentions. Specifically these are:

Demand management; Delivering core priorities of Programme for Government; Waiting times improvement; Mental health including children and young people; Shift balance of spend to mental health and primary, community and social care; Living wage, extending free personal care, the Carers Act; Efficiencies from reducing variation in unscheduled care and ‘set aside’, and; Local cost pressures, pay settlement, National Care Home Contract.

21. A key strategic priority for the IJB over 2019/20 is to increase the progress and pace in

integration in line with the Audit Scotland ‘Health and Social Care Integration – Update on Progress’ and Ministerial Strategic Group ‘Review of Progress with Integration of Health and Social Care’ findings. This requires focus on:

collaborative leadership; integrated finances and financial planning; effective strategic planning for improvement; collective understanding of governance and accountability; information sharing in relation to frameworks and good practice, and; meaningful engagement of communities, supported people and carers.

22. The financial challenges have been highlighted in successive Annual Reviews and in the modelling around the Medium Term Financial Plan. For 2019/20 the indicative financial gap between demand and cost pressures and the delegated budget from parties to the Integration Scheme is estimated to be in the region of £5M with further cash-releasing efficiencies of 1.5 per cent.

23. The Strategic Planning and Wellbeing Delivery Group noted a risk to the core theme of scaling-up prevention and early intervention from resourcing constraints and a need to mitigate this risk to support ongoing demand management.

24. Supporting plans in relation to the Workforce Development Plan and the Premises and

Assets Management Strategy were seen as critical enablers in directing activity in ensuring the right people, right skills, right place, right time and making the best use of the premises that we occupy to deliver care and support effectively and efficiently. Key areas for focus over 2019/20 are in relation to the third and independent sector workforce and in implementing smarter working.

25. In undertaking the Annual Review, partners noted a need to strengthen communication

and engagement with the whole workforce, partners and local communities in 2019/20. Engagement with partners includes the wider future vision for housing and infrastructure such as transport. The focus should be on empowerment and building confidence in the workforce to ‘do the right thing’.

26. The Strategic Plan 2018-21 was assessed as fit for purpose, effective, taking into account

the changing policy environment at Para. 19 above, and that no replacement plan is required.

27. Further engagement with national improvement support will be progressed during 2019/20

including iHub support. CARER/ PEOPLE WHO USE SERVICE IMPLICATIONS

28. The Annual Review of the Strategic Plan 2018-21 report has implications for supported people and carers in relation to the integration delivery principles and the wellbeing outcomes for adults, children and young people, and justice. This implies aiming for the best start in life, inclusion, having a life alongside caring and integrated rights-based support where required. FINANCIAL IMPLICATIONS

29. Under Scottish Government guidance, developed by the Integrated Resource Advisory Group (IRAG), the Strategic Plan should incorporate a medium term financial plan for the resources within its scope. The IJB in leading on the preparation of the Strategic Plan should set out the total resources included in each year of the plan in order to ensure that there is appropriate resourcing and devolution of responsibility to deliver in line with the outcomes and priorities set out in the plan.

30. According to statutory guidance, the relevant resources are:

The payment made to the Integration Joint Board by the Local Authority for delegated services;

The payment made to the Integration Joint Board by the Health Board for delegated healthcare services, and;

The amount set aside by the Health Board for any delegated services provided in large hospitals for the population of the Integration Joint Board.

31. In keeping with the guidance cited above, parties to the Integration Scheme are expected

to provide indicative three year allocations to the IJB in line with the Strategic Plan.

32. This rolling indicative allocation is subject to annual approval through the budget setting processes. The Annual Review of the Strategic Plan aligns these processes.

33. An indicative integrated budget for delivering the Strategic Plan 2018-21, as updated

by the Annual Review, is provided at Appendix 1. Detailed budgetary information is presented in the Approved Budget Position Report at Agenda Item 6.

34. The IJB must be assured that the resources available are, within the strategic context of

the NHS Ayrshire & Arran and East Ayrshire Council, consistent with the delivery of the Strategic Plan 2018-21, taking into account the changing policy environment as presented in this report.

HUMAN RESOURCE IMPLICATIONS

35. There are no Human Resource implications arising directly from this report.

LEGAL IMPLICATIONS 36. The Annual Review of the Strategic Plan report is presented in accordance with legal

requirement on the IJB to review the Strategic Plan on a periodic and regular basis, to involve the Strategic Planning Group in this review and to decide whether a replacement plan is required.

COMMUNITY PLANNING

37. The Annual Review of the Strategic Plan 2018-21 contributes directly to the Wellbeing theme of the Community Plan 2015-30 and was undertaken by the Strategic Planning and Wellbeing Delivery Group.

EQUALITY IMPLICATIONS

38. None arising from the Annual Review of the Strategic Plan 2018-21 report. RISK IMPLICATIONS

39. Risk implications are identified and managed through strategic and operational Risk Registers. The Annual Review process noted a risk to the prevention and early intervention priority of the Strategic Plan. The Partnership Risk Register includes reference to “insufficient resources available to commission services that not only meet immediate demand but also facilitate preventative activity that supports population wide health improvement and addresses inequalities”.

40. IJB risk appetite and prioritisation should continue to be reviewed in relation to the Strategic Plan.

RECOMMENDATIONS 41. It is recommended that Members:

(i) Receive the report on the Annual Review of the Strategic Plan 2018-21; (ii) Approve the findings of the Annual Review of the Strategic Plan 2018-21,

specifically that there is no requirement for a replacement plan; (iii) Note and comment on the changing policy environment in relation to increasing

the progress and pace of integration; (iv) Direct the Chief Officer to commission services from East Ayrshire Council and

NHS Ayrshire & Arran in line with the Strategic Plan, as refreshed by the Annual Review, and within the allocated budget for 2019/20;

(v) Otherwise comment on the Annual Review of the Strategic Plan 2018-21.

Erik Sutherland Senior Manager Planning and Performance 7th March 2019

Implementation Officer: Erik Sutherland, Senior Manager Planning and Performance,

erik.sutherland@east-ayrshire.gov.uk

Background Papers Strategic Plan 2018-21 (Summary)

https://www.east-ayrshire.gov.uk/Resources/PDF/E/EAHSCP-Strategic-Plan-Summary.pdf Strategic Plan 2018-21

https://www.east-ayrshire.gov.uk/Resources/PDF/E/EAHSCP-Strategic-Plan-2018-21.pdf Workforce Development and Support Plan 2018-21

https://www.east-ayrshire.gov.uk/Resources/PDF/H/HSCP-Workforce-Development-and-Support-Plan.pdf

Property and Assets Management Strategy 2018-21 https://www.east-ayrshire.gov.uk/Resources/PDF/P/Property-Asset-Management-Strategy.pdf

Medium Term Financial Plan http://docs.east-ayrshire.gov.uk/r/?f=http://docs.east-

ayrshire.gov.uk/CRPADMMIN/2012%20AGENDAS/TRANSITION%20INTEGRATION%20BOARD/30%20NOVEMBER%202017/medium%20term%20financial%20plan.pdf

APPENDIX I – INDICATIVE INTEGRATED BUDGET

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EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP

INTEGRATION JOINT BOARD: 26 MARCH 2019

WORKFORCE PLANNING ANNUAL REVIEW 2018/19

Report by Workforce Planning Lead

Getting the right people with the right skills in the right place at the right time, to deliver sustainable and high quality health and social care services for the

people of East Ayrshire

Our Workforce Delivering Our Future

OUR AMBITIONS

1. A year since we developed our Workforce Development and Support Plan to recogniseour workforce as our most valuable asset, our ‘right people with the right skills in theright place at the right time’ ambition is still very much at the heart of the plan. Thekey themes focus on:

Engaging with people who use our services in the design and delivery of careand support

Transforming how we deliver services in light of our local population needs,workforce availability and financial constraints

Recognising we do not deliver services in isolation and the contribution ofpartners from all sectors is essential to ensuring we have a workforce fit for thefuture which is integrated and puts people at the heart of all we do.

Having a workforce which is flexible, innovative and empowered to thinkcreatively

Attracting and retaining employees across all ages and experience Retaining the skills and experience of our current workforce Providing training and development for our workforce to ensure they are

appropriately skilled Working in partnership on outcomes for individuals rather than how we provide

or deliver services

2. Our ambition and themes remain relevant as we move into the second year of the planwhere we will continue to progress and build on the significant achievements alreadymade.

WHAT IS WORKFORCE PLANNING AND WHY IS IT IMPORTANT

3. Workforce can be understood in different contexts - it could be organising next month’srota or redesigning an entire service but ultimately it is about making sure we have theright people in the right place with the right skills at the right time.

Appendix ii

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.

4. It is good practice to workforce plan to ensure that we have the resource, or are able to access or develop this, to deliver our strategic aims within a financial envelope. This includes new ways of working, considering job roles, skills mix, re-training, recruitment, re-provision and possible exit strategies.

5. There are various good methodologies to support workforce planning. The Six Steps process adopted by the NHS gives a clear example of what should be considered.

6. The key is to define the plan from the outset and be clear about what the ambition is e.g. what our services will look like. By defining this we can identify the future workforce, consider the workforce available and plan how we will bridge any gaps to enable us to provide a sustainable workforce to deliver the new service or way of working. OUR PROGRESS OVER 2018/19

7. Some of the many achievements across the partnership are highlighted below which are the result of our workforce’s ability to see things differently, be prepared to do things differently and get the right people around the table to find a solution, regardless which department, service or organisation they are from:

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Investment to Support our Workforce Our training programme is continually reviewed to ensure we are offering what we need at a general and professional level. Our palliative care training for all Care at Home staff has been piloted and ready to be rolled out across the service. Our links with further education providers continue to strengthen, with our first cohort of H&SC SVQ 2 student placements in our Care at Home team, developing our future workforce as well as our current workforce by supporting them to be mentors. We have successfully recruited our first tranche of 9 newly graduated nurses who will participate in a new 2 year development programme, AGRAND, within our GP practices in the community.

Smarter Working We are rolling out smarter working across the partnership and

exploring where we can maximise peoples time and skills with the use of technology, integrating systems and piloting new ones such as the care at home scheduling system. We need to work smarter and provide robust technology to allow our workforce to be agile and flexible. Less time on the road means more time serving our communities. This is happening not only with those roles you’d expect like managers but also within our clinical teams such as our Allied Health Professionals within our Intermediate Care Team.

Multi-disciplinary Team Working The creation of multi-disciplinary team (MDT)

working in primary care means teams of professionals such as Mental Health specialists, Allied Health Professionals, Pharmacists and Community Link workers, support general practices ensuring patients see the right person at the right time, reducing waiting times and delays in treatment. Our next steps will ensure these additional resources are integrated with the wider health and care system in our new models of care. We continue to provide training and explore new opportunities where we can enhance our redirection provision with our primary care partners, including Pharmacy First and Eyecare Ayrshire.

Challenging Traditional Barriers Exploring innovative ways to overcome traditional barriers and provide joined up services in the community with our partners, Dalmellington successfully piloted a palliative care service involving GP Practice, community nursing, hospice, palliative care nurse and local care home working in partnership to facilitate support in the community and prevent unnecessary hospital admission creating a positive outcome for people and their families.

Improved Access to Services Our Front Door Services has been implemented where professionals come together to review those accessing our services and ensure their pathway is the most appropriate. Our Integrated Care Team service has moved to 7 day working to provide a flexible service to help support those ready to be discharged from hospital, preventing unnecessary delays by transferring care to the community.

Succession Planning We are currently exploring areas where recruitment and/or retention is particularly challenging and developing ways to ensure sustainability such as ‘grow our own’ workforce by providing opportunities to train for qualifications such as ANP Academy and the graduate nurses in primary care already mentioned, which also supports the development of career paths.

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Workforce Reports A suite of workforce reports have been prepared for

services giving a baseline which highlights the current structure of their workforce and any areas of concern/consideration which will help inform their workforce plans.

LEARNING

8. Cognisance must be given in sharing good practice that what works in one area, will not always work in another and it is important to appreciate unintended consequences can arise even with the best planning. Not every change leads to improvement and we are learning from all change, not just that which leads to positive outcomes. It is good practice to consider where positive change could be shared within other areas, some examples include: Recruitment

9. Having successfully utilised social media and redesigned our recruitment campaigns and processed for ICT and GPs, we now need to enhance this with a focus in areas where we struggle to recruit by using proactive, innovative recruitment methods to maximise applications. Skills Mix

10. We are innovative in how we provide services such as clinical pharmacy services in practices, by exploring skills mix to fit with the service rather than fitting service around traditional roles. We will look to embed this across our redesign and sustainability work. General Practitioner Enhanced Roles GPwER (GPs with Enhance Roles)

11. This initiative has been pivotal in attracting GP trainees back to A&A by making roles more attractive, in this case providing an opportunity to pursue other areas of interest alongside the GP journey and supported by MDTs. Integrating Teams

12. By integrating the School Nursing, LAAC Nurse and Staff Nurses in to one group we improved outcomes for children and young people. With additional support and training for various workforce this enabled an integrated team to focus on a collaborative approach to meet the outcomes of services.

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Youth Employability

13. In our efforts to maximise opportunities to attract a younger workforce in our recent Joint Inspection for Services of Children and Young People (March 2018) the Care Inspectorate commended our range of initiatives to support school leavers into positive destinations and our approaches to reducing youth unemployment in East Ayrshire. Some examples include our positive recruitment policy which ensures looked after and accommodated children have access to entry level posts prior to advertising, guaranteed interview if they meet the essential criteria and a targeted approach, through Project Search, to secure employment for young people with learning disabilities or autism. Technology

14. We are at the early stages of the District Nursing workforce accessing and utilising the Emis Web system to improve allocation of workload and productivity. This is an example of where it is not a replacement for the workforce but where using technology complements and enhances the workforce, releasing time to care. NATIONAL LINKS

15. Whilst we progress workforce planning locally, nationally workforce planning is becoming a priority and legislation and policy is being developed to support effective workforce planning. We take every opportunity to help influence and learn from national work such as attending Scottish Government to discuss the Safe Staffing legislation, inputting to the National Health and Social Care Workforce Plan consultation and membership of the National Workforce Planning Group sub group looking at guidance. We are now participating in New Roles for Integration and Implications of National and Local Labour Markets working groups and Audit Scotland have engaged us in an audit of primary care workforce planning. We will continue to participate in and influence national direction where we can. WHAT NEXT FOR 2019/20?

16. We need to enhance and apply good practice from all we have learned over the past year to other areas of the service where appropriate:

using proactive, innovative recruitment methods to maximise applications exploring skills mix to fit with the service making roles more attractive integrated team to focus on a collaborative approach to meet the outcomes

of services maximise opportunities to attract a younger workforce using technology to complement and enhance the workforce

17. We need to continue to advance the change programmes already in progress and

identified to begin this year (Appendix A).

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18. We need to continue to deliver our workforce action plan (Appendix B) to achieve our ambition of ‘right people with the right skills in the right place at the right time’ and our associated themes.

19. Both of these will support development of robust workforce plans for each

department/service.

20. Continue our engagement with national workforce initiatives and implement locally as appropriate.

21. Ensure all our workforce initiatives support delivery of our Strategic Plan and can be

delivered within the parameters of our Financial Plan and Property & Assets Plan. Danielle McManus Workforce Planning Lead 15th March 2019

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Workforce Planning 2018/19 Progress & Planning Appendix A Aim Purpose Action Taken 2018/19 2019/20 Primary Care and Out of Hours Services Developing a Community Care and Treatment Service

To support Advance Nurse Practitioners (ANP) and Practice Nurses to maximise potential and provide a robust community nursing structure

Workload scoping exercise of General Practice Nurses (GPN) done and analysed. GPN workforce data captured to ascertain resources within community. District Nursing team completed workload tool.

All information/data to be considered as a whole when designing the service and resources required to deliver.

Development of Multi-Disciplinary Teams.

To have a team of professionals as a first point of contact and reduce waiting times to access services ‘right person, right time’ and help facilitate the Expert Medical Generalist role

New roles within community which would not traditionally be associated with the primary care setting e.g. physiotherapists, mental health nurses, community link workers and pharmacists. Progressed recruitment more flexibly and used social media to maximise. Additional recruitment so far: Advanced Practice Physio (Band 8a),Physios (Band 7), MH Workers (Band 6)

Expand MDT’s across all GP Clusters, matched to needs of the community. Consider smart recruitment/training/ development to minimise impact on local Acute and Independent Providers.

Create Phlebotomy Service

To realise resource within General Practice and streamline process.

Test sites for Renal and Urology have been established and tested and are currently being evaluated.

Evaluation will inform next areas to be included and workforce requirements to resource service.

Investment in future workforce

To provide opportunities for new and existing workforce to develop and ensure sustainability

Year 2 of the ANP academy has 10 students. Recruitment of 9 graduate nurses to undertake a 2 year graduate nursing development program, AGRAND, within a Primary Care setting, 3 in each HSCP.

Consider where future candidates will come from for ANP academy. Explore the use of the ANP academy for ANP roles outwith General Practice. Review of how this model can be extended to include other professional roles such pharmacotherapy. Continue to develop Primary Care Nursing program with NES.

Support and Development for

Support skills availability in community to help patients to be seen

Pharmacy First - Provision of training and support to enable pharmacists to treat more minor ailments. Educate community/practice workforce to maximise re-direction opportunities to opticians and dentists etc.

Continue to develop the workforce to enhance skills to provide profession specific care.

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independent partners

quicker by appropriate specialist

Develop a Pharmacotherapy service

To deliver the conditions of the GMS contract and provide enhanced service within the community

Extensive recruitment and leadership structure established by recruiting: Pharmacotherapy Lead (Band 8b), Pharmacist (Band 8a), Pharmacists (Band 7), Pharmacy Technicians (Band 5).

Ongoing recruitment for Project Support Asst (Band 5), Pharmacists (Band 6), GP Clinical Pharmacist (Band 7) and Pharmacy Technicians (Band 5)

Transform Dental Services

Review both Public and General Dental services to meet population needs.

Recruitment of 2 Specialist Dental Officers to transform and upskill the dental team

-

Provide comprehensive Ayrshire Urgent Care Service

Ensure the appropriate clinicians/professionals work together to provide a robust service

- Review roles, responsibilities, technology and workforce requirements to deliver the needs of the service

Community Health and Care Services Ensure a robust and sustainable Personal Carer (PC) workforce

Ensure our PC workforce is registered, qualified and sustainable for the future

Support PC to attain SSSC registration and SVQ2 within timescales. 2 PC recruitment days held - the full process from application to interview was completed on the day and over 50 candidates were successful. Our first student placements in the Care at Home team in conjunction with Ayrshire College.

Ongoing review, recruitment and future placements.

Caring for Ayrshire - Unscheduled Care

Redesigning services by increasing community based care/preventative care

Current submission in progress to support Cardiology redesign and Pulmonary Rehabilitation with increased workforce requirements

-

Review provision of Intermediate Care & Rehabilitation Team

Develop service to be more user focussed and deliver services when needed.

Workforce engagement to move to a 7 day working week to support enhanced provision of service completed.

Workforce plan to meet the needs of the service including ANPs, use of TEC Development work to support integration of teams

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Develop Front Door Service

Provide a one point of contact for users and streamline their pathway within the community

Development of multi-disciplinary team hubs to discuss care and treatment of users to ensure most appropriate support is provided promoting self-management and enablement. Identified demand and recruited to support.

Incorporate Addiction services

Implement Electronic Scheduling System

To maximise Care at Home provision

Pilot currently underway in Care at Home Evaluate and review pilot to inform wider implementation. Review workforce requirements.

Implement OD Plan

Engage with the workforce

Engagement programme complete and attitude survey results available. Teams managing outcomes through team meetings.

-

New Supported Accommodation in Hurlford

Maximising Independence

- Assess workforce requirements to ensure project is successfully resourced.

Review Community Hospital – EACH workforce

Consider existing pathways and new models of care

- Develop workforce plan to support new models of care but also to include robust succession planning

A sustainable DN service

Consider resource needed to establish a robust DN service

- Interlinked to the outcomes from Primary Care Community Care and Treatment Service.

Children’s Health Care and Justice Services Review Mental Health Officer role

Maintain a sustainable MHO workforce

Following development of a workforce planning paper, commitment has been secured to support a rolling programme of supporting 3 candidates to undertake the MH award on an annual basis to support sustainability of the MHO service

-

Improvements in Prison Healthcare

Equity of access/service in Prison healthcare provision.

Training needs for nurses being identified to improve AHP service input

To improve MH provisions recruiting for Clinical Psychologist, Occupational Therapist and Speech & Language roles.

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Developing the Workforce

Improve quality of practice recording across services to aide improved decision making

Eleven 1 day development sessions held and attended by 59 delegates. Current delivery of development sessions on the subject of information analysis.

-

Ensure equity of service in Prison services

Address limited access to some resources.

- Consider counselling service for victims of sexual abuse

Health Visiting Sustainability

Ensure there is enough HV to provide services across Ayrshire

- Workforce paper to support sustainability to be developed considering pan-Ayrshire approach to recruitment and ‘grow your own’.

Support Services Smarter Working

To reduce un-utilised space within buildings and co-locate HSCP workforce where possible.

Scoping exercise to determine workforce levels e.g. fixed, flexible, agile and potential buildings for HSCP workforce.

Planned move of each service to allocated premises with necessary technology to support smarter working.

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Workforce Action Plan 2018-2021 Appendix B Aim Priority What will we do How will we do it Achievements 2018/19

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Be an employer of choice

Promote East Ayrshire Health and Social Care Partnership as a career choice

Promote East Ayrshire as an attractive place to work and live

Robust recruitment advertising campaigns to attract especially for difficult to recruit posts

Design career opportunities for those who wish to progress within the HSCP

Provide smarter working opportunities to attract a wide range of candidates

Engage champions/role models to share their experiences

Innovative and successful recruitment campaigns for Intermediate Care Team and General Practitioners

General Practitioners with enhanced role posts created

Introduction of smarter working across services

Engage a younger workforce

Create opportunities for young people to join the Partnership through learning contracts

Attract school/college/university leavers

Promote the Partnership as a career choice

Improve accessibility of modern apprenticeships, work experience and foundation apprenticeship opportunities

Collaborate with Ayrshire College to develop relevant qualifications and learning opportunities

Visit schools and colleges to promote the opportunities in the partnership and explain choices which best fit

Two Graduate Interns employed to Partnership and plans for a third underway

First cohort of Health & Social Care students in place within the Care at Home team

Attract returners to the Partnership

Provide opportunities for career changers to come to the Partnership

Offer flexible learning opportunities to re-train

Offer flexible working patterns to support training and work/life balance

OD Business Partners proactively support OD and L&D in line with strategic direction

Trainee Pharmacy Technicians and Care at Home employees supported to obtain qualifications whilst working

Be inclusive and diverse employers

Ensure recruitment opportunities are accessible to all groups

Provide appropriate training and awareness raising of different equality areas

Refer to the Share Equality Outcomes 2017-2021 document and ensure actions are undertaken within Equality Outcome 4.

Equality & Diversity covered in corporate induction and mandatory training

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Ensure workforce is fit for purpose, sustainable & affordable

Ensure workforce planning is embedded into Service Improvement Plans for each area of the Partnership

Conduct workforce review for each service Support managers to integrate workforce

planning into everyday responsibilities

Workforce position statements provided for each area to inform local workforce planning.

Review panels in place to review vacancy approval and encourage alternative thinking.

Work with our partners to support appropriate staffing to deliver and sustain services

Liaise with our third and independent partners to share expertise

Encourage our partners to plan forward to ensure appropriate skills and resources are accessible

Work together to promote recruitment of professional roles e.g. nurses

Support our partners to produce workforce plans

Share training and development opportunities

Working together to ensure every resident in East Ayrshire care homes have an Anticipatory Care Plan

Collaborative delivery of the Care About Physical Activity improvement programme supporting care home residents

Third Sector Providers Forum

Value our Volunteers

Attract, recruit, train and support our volunteers

Continue to recognise importance and contribution of our volunteers

Publicise benefits and necessity of volunteers.

Provide training opportunities and support networks

Link with and promote opportunities through Volunteer Centre East Ayrshire, EA Volunteer Framework and other volunteering routes.

EAC’s volunteers framework providing supportive environment for volunteering

Partnership working with Vibrant Communities to encourage and support volunteer recruitment, training and support of volunteers in play, sport, health, youth work, adult literacies, active schools and befriending.

The role of the Third Sector, the Volunteer Centre specifically, in recruiting and supporting volunteering across a range of areas promoting wellbeing, e.g., befriending, intergenerational work, ConnectCall, community hubs and foodbanks

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Develop a workforce aligned to the values and behaviours of the Partnership

Promote values and behaviours of the Partnership at all opportunities

Incorporate FACE workforce commitment – Flexible, Approachable, Caring, Empowered

Incorporate values and behaviours into recruitment and selection process

Provide robust induction programme for all new starts

Integrate into day to day service delivery e.g. team meetings

Lead by example and adopt values and behaviours

Employees adopting new qualities and behaviours of FACE. Now embedded in recruitment and in EAGER processes. Full launch of FACE planned and FACE to be embedded in all future development activity

All new employees attend corporate induction

Ensure workforce is fully equipped to fulfil their role

Ensure appropriate process is in place to identify workforce needs

Support training and development requirements

Encourage and support the workforce to work at the top of their competency level

Undertake ongoing training needs analysis Promote learning and development

opportunities for employees Ensure personal development discussions

e.g. EAGER/TURAS are implemented and monitored

Training needs analysis forms part of development activity to align suitable support and development. Proactive in CH&CS. Feedback required from CHC&JS and PC & OOH

Regular EAGER/TURAS/Mandatory Training reports provided to management team.

Ensure workforce is focussed on prevention and early intervention

Ensure workforce are confident and competent to seek and utilise opportunities to improve health and reduce inequalities

develop a programme of capacity building in line with the public health skills and knowledge framework

The new Front Door Service is a dedicated multi-disciplinary team of professionals including partner agencies who aim to promote early intervention, enablement and link individuals to appropriate support.

Encourage and provide opportunities to develop skills

Ensure opportunities are available to help people retrain or attain new qualifications to support Partnership growth

Utilise flexible working policies Support access to learning and

development opportunities internally and externally

Explore retraining opportunities in redeployment situations

The EAC process, EAGER, numbers are reported on regularly and are positive.

The NHS process has been updated with a simpler process called TURAS to support employees and managers.

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Promote and deliver truly integrated working

Develop a more efficient and effective workforce

Ensure workforce is appropriately qualified and has the flexibility to move across the partnership

Review existing roles to determine where roles can be more generic/flexible

Engage with education providers to review courses being delivered

Develop management teams who champion integrated working

First Cohort of SVQ student placements in our Care at Home service in conjunction with Ayrshire College

9 graduate nurses taking part in AGRAND, Graduate Nurse Development programme in collaboration with our general practices and community nursing.

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Continue to support the shift of balance of care to the community and locality working

Ensure skilled and sustainable workforce in community where it is needed

Consider benefits of teams working close together

Enhance multi-disciplinary teams within primary care setting

Ongoing recruitment of Personal Carer workforce

Ensure workforce available to support services delivering alternative options - ‘know where to go’

Explore co-location opportunities

Our Intermediate Care Team moved to 7 day working to support effective discharge from hospital.

Ongoing development of MDT in primary care to ensure patient sees the right person first time

Continuous development and expansion of redirection programme e.g. Pharmacy First & Eyecare Ayrshire

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Have a skilled workforce at the right time

Plan ahead to ensure a resource is available to deliver service needs at the right time

Workforce plans within Service Improvement plans need to consider lead times for training and development

Consider recruitment timescales Succession planning and workforce

planning embedded into management objectives

Aligned to financial availability

Workforce position statements prepared for all areas to support workforce plan development

Inputting to development of national policy, planning and guidance

Involved in various national workforce planning groups e.g. reviewing roles which are difficult to recruit

Support people to be at work

Ensure maximise all opportunities for attendance by supporting the workforce in line with policies and procedures

Improve workforce attendance e.g. sickness absence

Provide resilience training to ensure the workforce are prepared to deal with change

Provide 4 weekly management information

HR Support in meetings and for managers

Training on policies and procedure Refresh Tool Box Talks delivered

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Ensure workforce is familiar with policies and procedures and responsibilities

Ensure managers are trained in implementing policies and procedures

Plan for ageing workforce

Consider the challenges and potential solutions to address an ageing workforce

Consider alternatives to retirement e.g. new roles, mentorship roles

Utilise work/life balance policies to support continued employment

Age profiling across the services to understand impact and support planning.

Looking at those due to retire in key roles and explore what opportunities we could provide to retain their skills and knowledge in a different capacity considering flexible working.

All of the above actions should be progressed in conjunction with both partner organisations where possible to ensure an integrated approach. At all times cognisance must be given to the policies and procedures in place within each partner organisation. Where it is possible, any developments from either EAC, NHSAA or the Partnership should be approached collaboratively to ensure the total workforce benefits and to support the integration process.

EAST AYRSHIRE HEALTH & SOCIAL CARE PARTNERSHIP

INTEGRATION JOINT BOARD: 26 MARCH 2019

PROPERTY & ASSET MANAGEMENT STRATEGY 2018 - 2012ANNUAL REVIEW 2018/19

Report by Senior Manager Business Support

INTRODUCTION

1. In April 2018 the IJB endorsed our first Property and Asset Management Strategy (PAMS)2018/21. The PAMS covers the full scope of the functions of East Ayrshire Health andSocial Care Partnership and was acknowledged at that time as a baseline report uponwhich we will build in conjunction with partners particularly East Ayrshire Council and NHSAyrshire & Arran.

2. This report is the first annual review of the PAMS. It seeks to consider, progress during18/19, changes that have emerged throughout the period and priorities for the remainderof the Strategy.

OBJECTIVES

3. The key objectives of the Property & Asset Management Strategy are:-

To support the Strategic aims of the Integration Joint Board and the CommunityPlanning Partnership.

To gain best value from our use of property; To ensure that health and social care services are provided in and from fit- for-

purpose, modern buildings; To enhance provision of health and social care services in local communities; To rationalise our estate in order to reinvest savings into frontline services;

4. A number of principles were also adopted in the implementation of the 2018/21 Propertyand Asset Management Strategy and these are:-

Designing and delivering services to meet the needs of individuals, carers andcommunities;

Being transparent and demonstrate fairness when allocating resources; Delivering services to people in their local communities; Making best use of the assets available to us;

GOVERNANCE STRUCTURE

5. In April 2018 the initial PAMS set out the governance arrangements within which the HSCPoperates. During 2018/19 there has been development of Strategic Planning of the Healthand Care Infrastructure and this has resulted in the subsequent development ofGovernance Arrangements as outlined below.

Appendix iii

6. NHS Ayrshire & Arran are seeking to develop a Health estate over the next 10 years that

meets the needs of the population. This aligns Primary / Community services, District General Acute Services, and Regional Services. East Ayrshire Council have a substantial Capital Programme that seeks to support both Social Care and the Wellbeing theme of the Community Plan, through investment in Strategic Housing Investment Programme, the Schools Estate, Leisure Services and Office Accommodation.

7. A strategic priority of both East Ayrshire Council and NHS Ayrshire & Arran is to take full

advantage of opportunities Digital bring both in service delivery and agile working. The IJB through our PAMS will seek to be aligned and at the forefront of our ambitions.

8. To support this a new “Whole System Estate and Digital Services Planning Board” has

been established in NHS Ayrshire & Arran and this will seek to align the Pan Ayrshire Service Plan (including the priorities of the 3 IJB Strategic Plans) with the 10 year plan to develop the NHS Estate. This will also be integrated with current Strategic Planning and Operational Group (SPOG) arrangements, through which a wider alignment with wellbeing priorities of IJB and Community Planning Partnership is intended.

9. To take forward the objectives in Paragraph 3 above a new HSCP Property and Asset

Management (PAMS) Board Chaired by the Chief Officer has been established that links with new and existing arrangements, within both NHS Ayrshire & Arran’s Whole System Estate Plan Programme Board and East Ayrshire Council’s General Services 10 Year Capital Investment Programme.

10. Whilst strategic planning of our Property and Assets is essential to deliver future

developments and sustainability of services, equally important is ensuring the current premises and accommodation within which we operate, is conducive to the effective delivery of service and the health, safety and wellbeing of our employees.

11. The Partnership’s existing Premises and Accommodation Group will continue with a direct

link to the newly formed PAMS Board. This new Governance Structure is attached at Appendix 1.

12. The monitoring and scrutiny of the PAMS continues to fall within the Governance of the

IJB Audit and Performance Committee with reference to the IJB where appropriate.

PROGRESS MADE DURING 2018/2019

13. The 2018/21 PAMS set out the property utilised by the HSCP in respect of Northern Locality; South Locality; Kilmarnock Locality and East Ayrshire Wide issues. The report also set out key strategic issues and emerging themes in each area. Progress with each and emerging themes is outlined at Appendix 2.

14. In addition to the overall progress reported in Appendix 2 there have been a number of

significant developments of the PAMS during 2018/19 and these are outlined below.

KIRKLANDSIDE ESTATE

15. Inpatient activity in Kirklandside Hospital ended in August 2016. The wider Estate however continued to provide accommodation for Intermediate Care; Physiotherapy and OT Community Rehabilitation; Community Alarms; Health Promotion; Dietetics and Business Support Services. The accommodation was not fit for purpose and in NHS Ayrshire & Arran Capital Programme there was an ambition to move off the Kirklandside site during 2018.

16. As part of the service re-design, a Service Base was required to be identified for the 6

services, incorporating 88 employees, located at the Kirklandside Hospital Site and this resulted all employees being relocated to alternative sites in East Ayrshire in November 2018. The feedback received from employees is that these alternative locations have improved communication between services and further enhanced integrated working.

17. Another part of the service re-design was the Models of Care Programme and work has

been undertaken during 2018/19 to develop and design a bespoke housing model which will provide an opportunity to replace the 10 in-patients beds that EAHSCP commission at Woodland View, Irvine.

18. A test of change is currently underway (October 2018 – March 2019) to deliver a

community based service to replace the model previously delivered at the Community Rehabilitation Service, Kirklandside. Integral to this community model is working in partnership with our Third Sector colleagues to offer rehabilitation classes in a community setting. Currently working with Alzheimer’s Scotland the rehabilitation class is delivered in a modern town centre (Kilmarnock) facility every Friday afternoon.

19. Working with East Ayrshire Council Housing colleagues, Springfield Housing and Hanover

Trust, the business case for this model (re-provision of the commissioned beds) will be finalised and this will include the design and development costs. This project forms part of the Strategic Housing Investment Plan and the anticipated site start date is 2019/20.

BENTINCK CENTRE

20. The Bentinck Centre provides treatment services in East Ayrshire to clients/patients with drug and alcohol dependencies, including a needle exchange service. The Centre also has a harm reduction service that includes advice, blood and urine sampling, and wound care.

21. The Bentinck Centre is situated in a residential area within the community, providing easy

and discreet access to service users. It has been leased by NHS Ayrshire & Arran from East Ayrshire Council on a long term basis and the terms of the lease stipulate that the responsibility for maintenance and upkeep lies with NHS Ayrshire & Arran.

22. The accommodation no longer meets the requirements of the Service and alternative

options for Bentinck Centre and provision of East Ayrshire Addiction Services are being investigated and a number of alternative venues have been identified to enable essential clinical service delivery to continue within the Kilmarnock area. The accommodation challenges of the Bentinck Centre present a significant service risk and will require addressed early in 2019/20.

HMP KILMARNOCK

23. Her Majesty’s Inspectorate of Prisons (HMIP) inspected HMP Kilmarnock in November 2016 and the Healthcare Improvement Plan included property issues and the progress against these actions, during 2018/19, are included in Appendix 2.

24. There is further work required to make the Healthcare Department within HMP Kilmarnock

fit for purpose, however this comes at an estimated cost of £500K. The Scottish Government Health and Justice Collaboration Improvement Board asked Prisons across the estate to identify any healthcare infrastructure needs in order that they could consider making improvements to the healthcare environments in prisons.

25. There has been £1,000,000 identified for 19/20 to spend on prison healthcare

infrastructure. As yet the criteria for how this will be allocated is not clear. Our requirements have been submitted to the Board for consideration and a further meeting with Serco and SPS has been arranged to prioritise the work that has been put forward.

PAN AYRSHIRE PRIMARY CARE SERVICES

26. Ambitious for Ayrshire set out a clear direction for primary care within communities across Ayrshire recognising Primary Care is the front door and the first point of contact for communities when they access health and social care services. The pressures on primary health and social care include increasing demand for services combined with challenges relating to public sector funding and workforce recruitment and retention.

27. A key element of the Whole Systems Estate and Digital Services Planning Board, outlined

in Paragraph 8, is to plan 10 years forward setting out a framework of what the Health and Social Care / Wellbeing operating model will be and subsequent property and asset implications for Acute, Primary and Community Services.

28. The Primary Care Premises Group oversees the strategic direction of travel for Primary

Care Premises within Ayrshire and Arran. The Group has representation from each of the H&SCPs who also feed into the Partnership Premises Group. The new GMS Contract seeks to reduce the risk relating to premises for general practice with a view to offer loans to practices and support for lease arrangements. Details of this national support are emerging.

29. Between November 2016–January 2017 a Review of Primary Care Premises, IT

infrastructure and Digital Technology in NHS Ayrshire & Arran was completed with the findings included in NHS Ayrshire and Arran Property and Asset Management Strategy (PAMS). In addition, each H&SCP has reviewed their premises, risks and future plans for developments to contribute to PAMS and the Health Board’s estate masterplan.

30. Premises will feature as a focussed piece of work within the PCIP to encompass the risk

to GP Practices as well as to progress the space requirements for the additional MDT consultations.

DIGITAL STRATEGY

31. East Ayrshire Health & Social Care Partnership is committed to providing continued service improvement for its customers and the provision of integrated digital health and social care records will facilitate continued improvement in customer service to the people of East Ayrshire, enabling further focus on the whole person, enhancing efficiency and providing value for money.

32. Social Work Paper Case Files were replaced by Electronic Case Records during 2018.

Funding of £185,601 was approved by the Council’s Transformation Board for the procurement of the Northgate Information @ Work Document Management System, integration with SWIFT and back scanning all current case files.

33. Feedback from employees has been very positive following the introduction of the

electronic case record, with the following benefits being highlighted:-

a. Workers found it easier to view the case file, especially for teams who work across the authority;

b. Time is being saved for Managers when transferring and closing cases; c. Time is being saved when finding relevant documentation; d. The back scanned file saves time when searching for specific pieces of

information; e. Files are being updated timeously and are therefore more accurate and up-to-

date; f. Smarter working has resulted in a reduction in requirement of storage facilities; g. Reduction in the need for printing numerous copies for different purposes; h. Reduction in the duplication of filing multiple copies of paperwork across

services for example case record and finance records.

34. NHS Ayrshire & Arran’s New Digital Strategy aims to connect citizens, health and social care through digital information, tools and services to help achieve the healthiest life possible for everyone in Ayrshire and Arran.

35. The strategy includes objectives specifically to address current issues within communities

in Health and Social Care, including:-

a. Creation of an integrated health and social care Electronic Patient Record, which will be accessible across organisational boundaries and in different care settings. Community-based Services, Mental health and Child Health.

b. Whilst EMIS Web already provides the clinical record for many community-based Services, including AHPs and Integrated Care Teams, implementation for District Nursing and other AHP services is now underway.

c. Additional functionality will also be introduced, including support for care planning and data capture for national reporting. The community clinical record will also be accessible through the Clinical Portal.

d. Care Partner provides the electronic care record for several Services, including Mental Health, Child Health and Learning Disabilities. Further enhancements are planned, including integration with other systems.

e. Support will be provided to expand the use of mobile-working for community- based services.

36. With regards to GP Systems, the new GP contract came into being in April 2018 it is intended the current GP system will be replaced within the first 2 years of the new strategy. This will provide an opportunity for even greater integration with the Electronic Care Record, subject to appropriate information governance arrangements being agreed. More seamless care, where records can be shared between the Primary Care systems and EMIS Web and between Practices and the Community teams, will also be possible. There will also be an opportunity for Primary Care to access the Clinical Portal.

37. There is a significant opportunity to support Primary Care to adopt a clustered model of

working, where resources can be shared more effectively across the wider teams. The adoption of digital services will underpin this shift and deliver efficiencies within the service through sharing critical and scarce clinical resources.

38. Work is currently underway to improve network connectivity for General Practices including

the implementation of a Community of Interest Network (CoIN) which is in effect a private Wide Area Network.

39. Support has been given to practices through a national digital fund including providing dual

screens for more efficient working and remote access to allow GPs to complete documentation management at home.

40. Telehealth has been rolled out across some GP practices. There are currently forty-eight

GP practices using, or trained to use, telehealth protocols for hypertension, Chronic Obstructive Pulmonary Disease (COPD) or Beating the Blues, computerised Cognitive Behavioural Therapy (cCBT). Across the H&SCPs, this equates to nineteen in South, thirteen in East and sixteen in North. With regards to breakdown per protocol, 45 are using, or trained, for hypertension and 43 for cCBT. The COPD protocol is currently suspended. Not all practices currently trained to use telehealth are currently making referrals, as there is ongoing capacity issues within the TEC Hub.

41. The Attend Anywhere video consulting platform is currently in the development phase, with

system tests ongoing. There currently no practices using Attend Anywhere for consultations.

PRIORITIES FOR 2019/2020

SMARTER WORKING

42. It is recognised that we don’t make effective use of the skills and expertise of our employees. Time in travel, and unnecessary processes detract from the core priorities. To maximise the use of both staff and premises we have initiated a programme of “Smarter Working” aligned to the development of the Digital Infrastructure.

43. The Premises and Accommodation Group received a report in relation to the requirement

to maximise capacity and encourage further integrated working in Council premises within Kilmarnock Town Centre. This report also supported East Ayrshire Council’s smarter working approach as part of the Transformation agenda and is being implemented across all Council premises.

44. The HSCP’s Partnership Management Team approved the report’s proposals for the

majority of HSCP employees to be based in The Johnnie Walker Bond and the North West Kilmarnock Area Centre and for Managers and their respective teams to commence relocating to these locations from May 2019 onwards.

45. This will be a significant opportunity to take forward the key objectives of the PAMS

2018/21. It is recognised that this will be a challenging period of change for all employees and will be managed through the key principles outlined in Paragraph 4 and existing employee relations framework.

CUMNOCK

46. EAHSCP has been reviewing the Health and Social Care needs of the Cumnock Locality and this includes community hospital provision. Key focus include improving rehabilitation, palliative care and end of life care. This investment of time is important as we want the local people to receive the very best local care but also to achieve their desired outcomes.

47. Over the course of the next 18 months to 2 years, the HSCP will be carrying out locality

engagement sessions with the public and stakeholders to look at health needs within the area. This is to help plan the future of the hospital in the context of wider health and social care. We need to do this within this timeframe as we need to make a decision on the future of EACH with local people. As the PFI contract comes to an end in 2025, we need to make a decision on the contract before this. STEWARTON

48. The Local Development Plan has seen significant increase in population in Stewarton and Northern Locality and this is intended to continue in forthcoming years with the provision for further housing building. Health and Social Care Services are already severely stretched in this area to meet demand. This risk this poses to effective delivery of Primary and Community Health and Care Services is resulting in considerations of objections from NHS Ayrshire & Arran in relation to future planning applications to meet the ambition of the Local Development Plan.

49. As part of the PAMS Board, a Business Case is required to be developed in Partnership

with NHS Ayrshire & Arran and East Ayrshire Council to improve Health and Social Care Services in the Stewarton Community and this will be taken forward in 2019/2020.

Amanda McInnes Senior Manager Business Support 11th March 2019

Appendix 1

Partnership Management

Team

IJB

East Property & Asset

Management Board (PAMS)

NHS A&A CMT

EAC EMT

East Premises and

Accommodation Group

NHS A&A Whole Estate Plan

Programme Board

East Ayrshire Council

General Services 10 Year Capital Investment Plan

EAC Smarter Working Project

Building User Groups

Appendix 2

NORTHERN LOCALITY AREA ACTION TAKEN IN 2018/19 2019/20

Galston There are currently District Nurses, Health Visitors and Podiatrists located in Galston Town Centre within Galston Clinic and we are working with Council Corporate Services to look at the possibility of having a Wellbeing Centre within the new build in Cross Street in Galston or the use of the Library Building close to Galston Clinic.

Liaison with Galston Programme Board.

The Galston Programme Board are scheduled to complete this project in 2019/20 which may present an opportunity for the development of a HSCP Wellbeing Centre.

Stewarton The Local Development Plan has seen significant increase in population in Stewarton and Northern Locality and this is intended to continue in forthcoming years with the provision for further housing building.

Local conversations have taken place in relation to the Community Lead Action Plan. The Whole Systems Estate and Digital Services Planning Board was established.

As part of the PAMS Board, a Business Case is required to be developed in Partnership with NHS Ayrshire & Arran and East Ayrshire Council to improve Health and Social Care Services in the Stewarton Community.

SOUTHERN LOCALITY AREA

ACTION TAKEN IN 2018/19 2019/20

Co-location of NHS Mental Health Teams The relocations of teams from Netherthird Clinic to Rothesay House and Lister Street to the NWKAC will take place in 2019/20 and will endorse the principles of Smarter Working as set out in East Ayrshire Council’s Transformation Strategy which will result in different working practices for all Partnership employees based in Council buildings.

Cumnock / East Ayrshire Community Hospital (EACH) EAHSCP has been reviewing the Health and Social Care needs of the Cumnock Locality and this includes community hospital provision. Key focus include improving rehabilitation, palliative care and end of life care. This investment of time is important as we want the local people to receive the very best local care but also to achieve their desired outcomes.

Locality Meetings have been established.

Over the course of the next 18 months to 2 years, the HSCP will be carrying out locality engagement sessions with the public and stakeholders to look at health needs within the area. This is to help plan the future of the hospital in the context of wider health and social care. We need to do this within this timeframe as we need to make a decision on the future of EACH with local people. As the PFI contract comes to an end in 2025, we need to make a decision on the contract before this.

Lease of Offices within Bield Sheltered Housing Complex, Cumnock Community Health & Care Services have leased the offices in the Bield Sheltered Housing Complex in Menzies Court in Cumnock for approximately 20 years and the use of this building reduced following the opening of Rothesay House in 2015.

Due to restructuring the number of employees based in this complex has continued to reduce and it was agreed that these employees could be relocated to Rothesay House and enable this lease to be terminated resulting in a saving of £15,000 per annum.

KILMARNOCK LOCALITY AREA

ACTION TAKEN IN 2018/19 2019/20

Relocation of Employees based at Kirklandside Inpatient activity in Kirklandside Hospital ended in August 2016. The wider Estate however continued to provide accommodation for Intermediate Care; Physiotherapy and OT Community Rehabilitation; Community Alarms; Health Promotion; Dietetics and Business Support Services. The accommodation was not fit for purpose and in NHS Ayrshire & Arran Capital Programme there was an ambition to move off the Kirklandside site during 2018

As part of the service re-design, a Service Base was required to be identified for the 6 services, incorporating 88 employees, located at the Kirklandside Hospital Site and this resulted all employees being relocated to alternative sites in East Ayrshire in November 2018. The feedback received from employees is that these alternative locations have improved communication between services and further enhanced integrated working.

Kirklandside: NHS Based Complex Care Provision The Rowallan Ward was the final inpatient

provision at Kirklandside Hospital and was closed in 2016 due environment challenges that impinged on patient care. A Stakeholder Reference Group was convened to oversee and agree a public engagement plan in respect of future service provision.

After carefully considering stakeholder feedback

on how best to re-provision this service, the group overwhelmingly agreed a new ‘blended’ housing model of care which will make services available closer to people’s own homes and communities. It will

Work has been undertaken during 2018/19 to develop and design a bespoke housing model which will provide an opportunity to replace the 10 in-patients beds that EAHSCP commission at Woodland View, Irvine.

Working with East Ayrshire Council Housing colleagues, Springfield Housing and Hanover Trust, the business case for this model (re-provision of the commissioned beds) will be finalised and this will include the design and development costs. This project forms part of the Strategic Housing Investment Plan and the anticipated site start date is 2019/20.

include clustering of a supported housing and hospital at home approach, with peripatetic multi-disciplinary teams providing care when needed.

Kirklandside: Rehabilitation – The

Kirklandside site also accommodated the Community Rehabilitation Centre. This was a consultant led multi-disciplinary rehabilitation for people over 65 with complex care needs.

A review of the service was undertaken and after

carefully considering stakeholder feedback on how best to deliver rehabilitation services in the 21st century, the group overwhelmingly agreed on a mobile community model where the service can be delivered in a community rather than a hospital setting.

A test of change is currently underway (October 2018 – March 2019) to deliver a community based service to replace the model previously delivered at the Community Rehabilitation Service, Kirklandside. Integral to this community model is working in partnership with our Third Sector colleagues to offer rehabilitation classes in a community setting. Currently working with Alzheimer’s Scotland the rehabilitation class is delivered in a modern town centre (Kilmarnock) facility every Friday afternoon.

The test of change will be evaluated and the final model of service provision agreed.

Co-location of NHS Mental Health Teams

The relocations of teams from Netherthird Clinic to Rothesay House and Lister Street to the NWKAC will take place in 2019/20 and will endorse the principles of Smarter Working as set out in East Ayrshire Council’s Transformation Strategy which will result in different working practices for all Partnership employees based in Council buildings.

Future Delivery of Services from the Bentinck Centre The accommodation no longer meets the requirements of the Service and alternative options for Bentinck Centre and provision of East Ayrshire Addiction Services are being investigated and a number of alternative venues have been identified to enable essential clinical

A proposal to address the functionality and risks associated with the Bentinck Centre was submitted to CPMG in early 2018 for funding. The group advised that the level of investment required did not fully address the clinical risks or the safety

The accommodation challenges of the Bentinck Centre present a significant service risk and will require addressed early in 2019/20.

service delivery to continue within the Kilmarnock area.

of the staff and requested Capital Planning undertake a full feasibility study to determine the most practical and cost effective solution Based on the information provided in the feasibility study a further report was presented to CPMG in August highlighting 3 possible options; do the minimum required at a cost of £255,550; do a full refurbishment at a cost of £1.08M; do a New Build at a cost of £1.3M. None of these options were considered appropriate by the group. Alternative options for Bentinck Centre and provision of East Ayrshire Addiction Services are being investigated and a number of alternative venues have been identified to enable essential clinical service delivery to continue within the Kilmarnock area

PAN AYRSHIRE AREA

ACTION TAKEN IN 2018/19 2019/20

Crosshouse Campus Crosshouse Campus The co-location of Out of Hours Service and Mental Health services was completed as part of the development of the new Urgent Care Hub with East Ayrshire leading the pan Ayrshire implementation as part of the national pilot programme.

The EAHSCP Employees currently based in the Lister Street complex will relocate to The Johnnie Walker Bond and the North West Kilmarnock Area Centre in 2019/20.

The Strategic Housing Investment Plan (SHIP)

The Support Accommodation Project in Cessnock Road, Hurlford has commenced.

This project is scheduled to be completed in 2019/20.

HMP KILMARNOCK Healthcare physical infrastructure is hindering the ability to deliver core and specialist clinics

Due to the current lack of appropriate rooms progression of MH group work has been restricted

Triage room not fit-for- purpose

Due to the current lack of appropriate rooms progression of Addiction group work has been restricted

Agreement has been made between all parties to convert 2 single cells into interview rooms which will increase the capacity for mental health and addictions services. Office space for staff (nursing and healthcare administrator staff) is also being relocated to give appropriate space and light.

There is accommodation now identified for carrying out mental health group work Triage rooms are only used to administer medications. Addiction group work now takes place weekly.

This work will be completed April 2019.

EMERGING THEMES

AREA

ACTION TAKEN IN 2018/19 2019/20

Agile / Mobile Working / Digital Services

Social Work Paper Case Files were replaced by Electronic Case Records during 2018. Funding of £185,601 was approved by the Council’s Transformation Board for the procurement of the Northgate Information @ Work Document Management System, integration with SWIFT and back scanning all current case files With regards to GP Systems, the new GP contract came into being in April 2018 it is intended the current GP system will be replaced within the first 2 years of the new strategy. This will provide an opportunity for even greater integration with the Electronic Care Record, subject to appropriate information governance arrangements being agreed. More seamless care, where records can be shared between the Primary Care systems and EMIS Web and between Practices and the Community teams, will also be possible. There will also be an opportunity for Primary Care to access the Clinical Portal.

The Premises and Accommodation Group have had contributions in relation to the requirement to maximise capacity and encourage further integrated working for the Partnership and in particular in Council premises within Kilmarnock Town Centre. Proposals considered supporting East Ayrshire Council’s smarter working approach as part of the Transformation agenda and is being implemented across all Council premises. The HSCP’s Partnership Management Team approved the proposals for the majority of HSCP employees to be based in The Johnnie Walker Bond and the North West Kilmarnock Area Centre and for Managers and their respective teams to commence relocating to these locations from May 2019 onwards.