Transformation Plan Progress Update
North Ayrshire Council · 19 September 2024
Back to Integration Joint Board — 19 September 2024 and its agenda
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Integration Joint Board 19th September, 2024 Subject : Transformation Plan Progress Update Purpose : This update is for awareness and to assure IJB of progress. Recommendation : The IJB should note the progress to date. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required x 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership IJB Integration Joint Board PID Project Initiation Document 1. EXECUTIVE SUMMARY 1.1 The North Ayrshire HSCP Transformation Plan 2024-27 is an ambitious programme of change consisting of a range of improvement and reform projects across all service areas, each aiming to improve the quality of our services and contribute to the long- term sustainability of health and care in North Ayrshire. 1.2 This report highlights key activity and general updates on progress made in the six months since approval. 2. BACKGROUND 2.1 The Plan was approved by IJB in March 2024. Since that time the financial outlook has deteriorated, and the need for transformation and the redesign of services has become more urgent and more important to the long-term sustainability of the functions for which we are responsible. 2.2 Since approval in March the Transformation Board has updated their Terms of Reference and approach, and many new projects have been initiated across every area of the partnership.
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Key Activity 2.3 In April the Transformation Board agreed governance and approach, including Terms of Reference, format of meetings, and project management methodology (including template documents). It was agreed that each meeting would have a ‘Focus On’ a specific area of the Transformation Plan, but with space on the agenda for raising Risks, Issues, Requests, or Successes from any area of the plan, particularly where a time-critical decision is required. 2.4 May had a ‘Focus On Transformation’ and the board was updated on Workforce Planning, and agreed to the development of a HSCP Digital and Data Plan. Also in May, two members of the transformation team were successful in achieving a fully funded place on Cohort 23 of NES' Digital Health and Care Leadership Programme (DLP). This programme supports Scotland's Digital Health and Care Strategy and Delivery Plan and aims to: maximise the potential of digital solutions to benefit people; and, to support participants to develop the strategic leadership skills required to influence the use of digital solutions in health and social care delivery. 2.5 June ‘Focus on Adult Health and Community Care’ had seven new projects being initiated in that area, and an additional project request approved. June also saw the first Ayrshire-wide Innovation Network Event with over 80 attendees and presenters from across Scotland sharing examples of innovation to support transformation of health and social care services across Ayrshire. 2.6 August ‘Focus on Mental Health and Learning Disabilities’ had eight new projects initiated. 2.7 The second Ayrshire-wide Innovation Event took place on 10th September and had a range of examples of innovation and transformation, including an overview of a new companion robotic device from the National Robotarium, as part of an early intervention and prevention model of care. Later in September the Transformation Board will have a ‘Focus on’ Children, Families and Justice. 2.8 Coming up: October is a ‘Focus on Transformation’ again, including the Workforce Plan 2 Year Report, and the new Digital and Data Plan. November will ‘Focus on Partnership-wide Projects’.
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Service Updates 2.9 Adult Health and Community Care • The Anam Cara refurbishment project, completed and Anam Cara re-opened on 18 March 2024. • The Alarm Receiving Centre project concluded, with a new supplier appointed and contract commencing on 1 May 2024. • The Care at Home Review concluded in June 2024 with the successful transfer for SDS Option 3 supports to inhouse Service Delivery. • The packages of Care Project has concluded the initial analysis and review stage. This will now move to an options appraisal with a draft report setting these out, and detailing service risks and challenges. • The Analogue to Digital project continues with 85% of digital alarms installed across North Ayrshire. National timescales associated with the Analogue to Digital transition have now been extended with the phase out of analogue lines not expected to complete until 2026/27. The project has a final stage for completion and this is expected to conclude mid-2025. The project has secured additional funding to offset inflationary rises and costs of digital technology. • The Blue Badge Scheme Review is on track, with refreshed processes leading to significant streamlining. • The Community Rehab Project has started, with a draft PID and initial workshop completed, and the PID is expected to be approved and endorsed by the end of October 2024. A Community Rehab Programme Board has been established and will oversee the progress of the project and associated workstreams. • The Enhanced Intermediate Care Team review is advancing with four subgroups established to consider specific service areas, and the work of this will also link into the community rehab project. • The Palliative and End of Life Care Group has established and a project PID due to be submitted for endorsement. The group will take forward agreed Caring for Ayrshire outputs. • The Technology First Project has held its initial meeting and a staff questionnaire has been issued to help focus the scope of works. Ongoing scoping continues and a technology hub is being explored.
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• The Day Service Review has identified £100,000 in savings for the current financial year and is now focusing on securing £200,000 per annum budget savings from year two onwards. The Review work is ongoing and will ensure engagement with key stakeholders as part of the process. • The Delayed Discharge and Winter Preparedness Project continues, with a recent workshop to review and refresh the action plan. The group will agree a plan for winter 2024/25 and implement an oversight group to monitor the progress of this. • The Arran Single Point of Contact project is delayed due to pending IT infrastructure upgrades at Arran War Memorial Hospital. However, the initial setup for Netcall is being reviewed prior to sign off. A testing and training period will follow before a 'go live' date is agreed. • Home First Strategy has experienced delays due to capacity issues within the staffing resource. The strategy is now unlikely to meet its November 2024 deadline, and a report will be submitted to the Transformation Board outlining the issues and identifying mitigation actions. 2.10 Children, Families and Justice • Brighter Pathways Board set up and meeting regularly. Terms of Reference and PID are agreed. All workstreams have commenced except for Children’s Houses- Model of Care (Scheduled for 18th September). Crisis Support & Early Intervention Service mapping has taken place with a view of identifying any gaps in service provision, with the view of developing solutions (where possible). New UASC Policy has been developed. New Supported Carer Policy agreed. An update will be provided to Transformation Board in September. • Neuro Developmental Supports (this is a lifespan focus not just Children’s) is progressing well: workstreams have commenced and a new strategic group launched (chaired by Caroline Cameron). This has oversight of a Neurodevelopment implementation group for both Children and Adults building on the work of the two extreme teams. A business case is being developed with a full options appraisal for a preferred solution for a diagnostic service and the investment required. This will include options for a preferred model, workforce and digital solutions. • The work to review the North Ayrshire Justice Court team is underway and we’re currently collating data from the Service to assist with developing an Options Appraisal Paper. • The Transport Provision PID is in development, will be taken to Transformation Board in September.
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2.11 Mental Health and Learning Disabilities • MAT Standards have continued to be rolled out and North Ayrshire received green and provisional green (where evidence did not reach 12 months of data) from the MAT Implementation Support Team (MIST) in their benchmarking report. • Adult Community Mental Health Nursing team has begun to use TrakCare for all appointments again which allows for more visibility of service user appointments across the system and better data collection. • Scottish Government has awarded North Ayrshire HSCP funding for 2024/25 to start an Early Intervention in Psychosis service. • The Intensive Support Service for Learning Disabilities has launched with Nursing, Occupational Therapy and a Nurse Support Worker. While there have been challenges with recruiting, the service has been supporting individuals experiencing delayed discharge within Ward 7A, and those living in the community but at risk of placement breakdown. Along with supporting individuals with interventions, linkage to their community, and connection with third sector partners such as TACT and Neighbourhood Networks, the team has also been supporting carers and staff teams. It has seen a variety of positive outcomes, including successful engagement with individuals who did not previously engage with services. • A review of the Adult Community Mental Health Service is underway. Data and research is being gathered to inform the project group of the current state and best practices from around the world. Staff engagement is due to start Monday, 9 September with Service User engagement scheduled to begin shortly thereafter. The project is on track to deliver recommendations by early 2025. • The Community Wellbeing services are being looked at through a cross-functional project bringing together Mental Health & Learning Disabilities and Health and Community Care. This project will take a particular look at the commissioned service provision across the partnership, come up with recommendations for savings of £100,000 and look at how best to structure Wellbeing services for an efficient, integrated and inclusive approach. The PID for this project is scheduled to go to the Transformation Board Meeting on Monday, 9 September. • Work continues for the Digital Programme with more Mental Health Services making a coordinated transition onto TrakCare patient management system. Concurrently, a review of the entire digital landscape for Mental Health services across Ayrshire and Arran is underway with a report of work required to achieve the aims of the national strategy is expected to be complete by October 2024.
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• A draft PID has been developed for the Implementation of the National Specification of the Care and Treatment of Eating Disorders which is expected to deliver improvements to the Community Eating Disorders service. • As part of the Extreme Team implementation plan to improve support for people with disabilities throughout their life course, two engagement sessions have taken place with relevant teams with a further two sessions planned in the coming months. A dedicated Service Manager post has been recruited with the appointee due to begin on 28 October with two Senior Practitioner posts expected to follow thereafter. This will build stability within the teams and support any changes to practice that may be necessary. • Review of Out of Area placements has been ongoing via the Learning Disability Social Work team. • As part of the models of care work at Woodland View, a Project Initiation Document has been drafted with a view to developing a business case for an Alcohol Related Brain Damage service. This is following a prolonged pilot process to gather demand data. A workshop has also taken place with a number of relevant stakeholders to help with the business planning process. • An initial scoping and information gathering meeting has taken place to address overspends in Woodland View, a PID is being developed to outline how best to go about this project. • Recruitment and retention of staff in Ward 7A (assessment and treatment ward for clients with Learning Disabilities) has been increasingly difficult. We are currently looking at contingencies to mitigate the immediate circumstances and work will progress in the near future to further explore the best model of care for the needs of the client group. • While the MAT Standards Implementation is predominantly complete, the implementation of MAT Standard 7 involving the right to receive this service in Primary Care settings does not currently have recurring funding. By the end of 2025/26 financial year the funding allocated to getting this service started will run out and no permanent funding stream has currently been identified. 2.12 Partnership Wide • The Carers Gateway North Ayrshire Service is now embedded with full recruitment and outreach model operating across all localities and school clusters offering support on carers doorsteps and in community spaces. Development of carer information and self-help continues on the Carers Gateway website and with Bridgit – online digital resource. Short breaks fund has opened with 53 applications in the month of July. Engagement with carers on Arran has been a great success as was the inaugural Carers Conference in June where 120 carers
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and professionals came together. Locality roadshows are set for Arran, Kilwinning and Garnock Valley. The Gateway are soon to recruit a Carer Support Role (Health) covering community hospital and primary care settings to support carers at the point of hospital discharge and will begin Carers Champions Board training and preparation in October to replace the longstanding HSCP Carers Advisory Group. NAHSCP Carers Team will also be submitting a proposal to Council to commit to the Young Carers Covenant to continue to support change and equal futures for young carers. • The implementation of the agreed recommendations from the SDS learning review are ongoing in partnership with Horizons Research. We are currently drafting the ethics of care framework, have produced a draft Public Value Proposition and accompanying set of ‘Anchors’ to guide staff. The front face of an SDS website is being designed and populated, NAHSCP SDS Policy being drafted and change stories being gathered to tell the story of SDS in a different or more relatable way. Three SDS sessions have been offered to HSCP Team Management staff to consider what change, control and flexibility looks in their service with the final session scheduled for 27th September. • The Front Door Review has been underway since January 2024 and is making good progress, with consideration now being given to key design features of any alternative model of provision. The review is on track with recommendations due in December. • The development of the Digital & Data Plan is also well underway with a staff survey of current digital experience, and a Landscape Review both now complete. The Plan is due to go to Transformation Board in October. • The 2 year report for the current workforce plan 2022-2025 is being developed and will be published later this year. This will report the progress of delivering the workforce plan and identify any actions that may need to carry over into the next plan. The Workforce Plan for 2025-2028 will begin with the evaluation of the current plan, and incorporate information from the census and labour market forecasting data to identify the future health and care needs of North Ayrshire. Work to develop the new strategy will begin early next year. • The implementation of our new information recording system for social care, Eclipse, is progressing. The development of all service defined recording processes is almost complete and the focus of works is now transitioning to the preparation of essential statutory, strategic, and management reporting in advance of launch. A ‘go live’ date is to be agreed very soon and that will provide a renewed focus for the staffing group using the new system in support of the training to be delivered.
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3. PROPOSALS 3.1 It is proposed that IJB note the progress to date. 3.2 Anticipated Outcomes Informing IJB and the people of North Ayrshire on the progress of the Transformation Plan, and also providing assurance of the governance arrangements and that the Transformation Board has appropriate oversight. 3.3 Measuring Impact Stakeholders are assured of progress. 4. IMPLICATIONS 4.1 Financial A number of the transformation projects will deliver financial savings once they are fully operational; financial targets are being finalised as part of the budget development for 2025/26 and will be reflected in the Medium-Term Financial Outlook. 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk None. 4.6 Community Wealth Building None. 4.7 Key Priorities None.
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5. CONSULTATION Consultation has taken place with Planning Managers in the Transformation Team, and with the Transformation Board. Lee Ballantyne, Senior Manager (Strategic Planning and Transformation), LeeBallantyne@north-ayrshire.gov.uk Appendices • Transformation Plan • Transformation Board Terms of Reference
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Children, Families and Justice Services √ √ Develop Throughcare and Aftercare Policy with Housing providers Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ Grow and nurture and increase Foster placements and supported carers - recruitment, policy and support Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ Develop pathway to Residential School Placements with Education Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ √ Reconfigure Model of Care in Children's Houses Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ √ Early intervention and crisis/intensive support pathways Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ √ Strategic Needs Assessment/Data/Workforce Plan, Initiate, Monitor Monitor, Close by Mar 26 x √ √ √ Best Practice Models and research Plan, Initiate, Monitor Monitor, Close by Mar 26 x Transport provision √ √ Transfer children's transport provision to the HSCP and reconfigure how service is provided moving away from single journey taxi provision Plan, Initiate, Monitor, Close by end 24 x x CF&J SMT North Ayrshire Justice court team √ Carry out a review of the current delivery model at Kilmarnock Sheriff Court. Plan, Initiate, Monitor, Close by end 24 x x CF&J SMT Family Support - Early Intervention and Crisis Approaches √ √ √ √ In line with Whole Family Wellbeing Funding and investment in Early Intervention Teams review approach to crisis response (eg Rosemount and Whole Family Wellbeing Service) Plan, Initiate, Monitor Monitor, Close by Mar 26 x CF&J SMT Neurodevelopmental Supports - Children √ √ √ √ √ Implement the Neuro Specification for Children and Young People Plan, Initiate, Monitor Monitor Monitor, Close North Ayrshire Lifespan Neurodevelopment strategy group Re-modelling Children's Care Options Strategic Priorities Brighter Pathways Programme Board Project Profiling Primary Project Governance Route
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route Mental Health and Learning Disabilities √ √ √ √ Continued programme of review of inpatient models of care with a focus on promotion and expansion of community rehabilation models of care for mental health, building on learning from Warrix Avenue.This will include development of business cases for ARBD (Alcohol Related Brain Damage), CAMHS tier 4, forensic provision, community based forensic rehabilitation, EMH phase 3 ACH site (Caring for Ayrshire) Monitor, Close x x Income generation for national highly specailist service gap in forensic services to other boards - Low secure & forensic rehabilitation Plan Monitor, Close x Income generation for national specialist inpatient services gap (IPCU) bed to other Boards Plan Monitor, Close x Review and extend programme of inpatient income generation SLA's including AMH services to other boards. Plan, Initiate, Monitor Monitor, Close x √ √ √ Workforce redesign in alignment with new models of carel Plan, Initiate, Monitor, Close x x √ Review high cost placements including UNPACS Plan TBC (based on Plan) TBC (based on Plan) MAT Standards √ √ √ √ √ Set up the systems required to report on Medical Assisted Treatment standards for Addictions and roll out the 10 standards across NA. The programme will be run on a pan ayrshire basis led by NA. Includes dual diagnosis pathway development. Monitor, Close x x North Ayrhsire MAT implementation group & Pan Ayrshire MAT oversight group √ √ √ √ √ Building on the business case development for MH Primary Care and investment in SW and MHO capacity in Mental Health Community Services undertake a review of CMHT/Primary Care MH service configuration, access criteria, pathways and capacity. Ties in with meeting Adult Secondary Mental Health Services Quality Standards Plan, Initiate, Monitor, Close x x √ √ √ √ √ Launch a pilot Early intervention in first episode psychosis service - revisit business case, bid for national funding Initiate, Monitor, Close (if funded) x x √ √ √ √ √ Review community recovery and rehab service provision across 3rd sector, Recovery College, Acorn, mental health in primary care and community link workers. Plan, Initiate, Monitor, Close x x √ √ √ √ √ Launch the LD Intensive Support Team and monitor progress of assessments of out of area placements. A dynamic register should be developed and maintained which will feed into national data. Monitor Monitor, Close x √ √ √ √ √ Review provision Acute Assessment model (Ward 7A) based at Woodland View alongside community models and in alignment with IST service Plan, Initiate Monitor, Close x √ √ √ √ √ Implement recommendations from Extreme Team - Supporting People with Learning Disabilities through the whole life course Monitor Monitor Monitor, Close Community Mental Health Services and Primary Care Mental Health services Extended Pan Ayrshire SMT/SMT, MH governance group and Pan Ayrshire Strategy Leadership group North Ayrshire Mental health & wellbeing group (to be established), Core standards group & Pan Ayrshire Leadership strategy group North Ayrshire complex care group, LD Transformation board & Pan Ayrshire leadership strategy group Woodland View - Models of Care Complex Care/ Coming Home
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route √ √ √ √ √ Review the service delivery and workforce model for Trindlemoss complex care service Plan, Initiate, Monitor, Close x x √ √ Review service delivery model at Trindlemoss Supported Accommodation Plan, Initiate, Monitor, Close x x √ √ √ √ √ Implement TEC/Responder Service, piloting at Trindlemoss base Plan, Initiate, Monitor, Close x x √ √ √ √ √ Complex Care Accommodation Requirements: Research and recommend options for effectively meeting the housing needs of complex care users in North Ayrshire. (added 19/6/24) Plan, Initiate, Monitor, Close x x √ √ √ √ Engage in and influence West of Scotland CAMHS pathways and service developments Plan, Initiate, Monitor Monitor Monitor √ √ √ √ Reconfigure West Road as the Ayrshire and Arran CAMHS/CEDS Centre for specialist assessments Monitor and Close by Sep 24 x x √ √ √ √ √ Implement National Eating Disorders strategy and delivery plan Plan, Initiate Monitor Monitor, Close Digital Transformation √ √ √ √ √ Delivery of a programme of Digital Transformation including development of a business case for wider MH services in alignment with national strategy, Implementation of Trakcare Patient Management System in Community Services and pilot phase 1 of Strata health SPOC, triage and decision making approcahes. Monitor, Close x x Pan-Ayrshire MH Digital Transformation Group MH Unscheduled Care √ √ √ √ Open and monitor impact of Adult Mental Health Assessment Hub (Ward 7B) in Woodland View Monitor Monitor, Close x ESMT/SMT MH governance & Pan Ayrshire Leadership strategy group Neurodevelopmental Supports - Adults √ √ √ √ √ Through the Extreme Team implement pathways of support for Adults seeking neurodevelopment service support and diagnosis Plan, Initiate, Monitor Monitor Monitor, Close North Ayrshire Lifespan Neurodevelopment strategy group reporting to CSSP and Pan Ayrshire Leadership strategy group Psychiatry Review √ √ Review of service workforce model and leadership structures Plan, Initiate, Monitor, Close x x MH Governance, Professional leadership group, ESMT/SMT & Pan Ayrshire ;leadership strategy group LD/MH social supports √ √ √ √ Review low level social support provided to LD/MH service users in alignment with the wellbeing model review to reduce variance and implement an equitable approach Plan SMT & LD transformation board CAMHS North Ayrshire complex care group, LD Transformation board & Pan Ayrshire leadership strategy group CAMHS Governance group, MH governance & Pan Ayrshire Strategy leadership group Complex Care/ Coming Home
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route √ √ √ √ √ Suicide Prevention - "Creating Hope Together" Monitor Monitor Monitor √ √ √ √ √ Dementia Strategy - "Everyone's Story" Plan, Initiate, Monitor Monitor Monitor √ √ √ √ √ Mental Health and Wellbeing Strategy Plan, Initiate Monitor Monitor √ √ √ √ √ Self-harm Strategy Plan, Initiate Monitor Monitor √ √ √ √ √ Psychological Therapies specification & standards Plan, Initiate Monitor Monitor √ √ √ √ √ Adult Secondary Mental Health Services Quality Standards Monitor Monitor Monitor √ √ √ √ √ Barron Review - Forensic Mental Health Services Monitor Monitor Monitor ESMT/SMT, MH governance, North Ayrshire MH & Wellbeing strategy group & Pan Ayrshire leadership strategy group Scottish Government Strategy - Local Implementation
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route Health and Community Care Systems & Technology √ Explore and identify all available technology options and implement systems to identify and enhance the use of technology as first point of provision for accessing formal supports. x Plan, Initiate, Monitor, Close Evaluate H&CC SMT √ √ Analogue to Digital: Phased project to manage access to Community Alarm and Telecare services during the analogue to digital telephony transition. Monitor and Close by March 25 x x Analogue to Digital Project Board √ √ Review and streamline processes within the Blue Badge team. Monitor and Close by March 25 x x Transformation Board √ √ Review provision of Community Alarm and Telecare call monitoring service. CLOSED (SUCCESSFUL) Close by June 24 x x Analogue to Digital Project Board √ √ CM2000: Review workforce scheduling and monitoring of service delivery system. (MOVED TO PW) Close by June 24 x x Transformation Board √ √ √ Care packages: Programme of waiting list and existing community package reviews - targeting lower packages of care to consider alternatives, reablement approaches and need in line with eligibility criteria for support. Monitor and Close by March 25 x x H&CC SMT √ √ Implement the reconfiguration of Care at Home service delivery from June 2024, as agreed by IJB in March 2023. Review required to minimise additional costs when transferring service. Monitor, Close by July 24 x x CaH Steering / Oversight Group √ √ Take forward Pan Ayrshire programme of work following the Palliative/EOL Business Case, agreed PID in June 2023 and National Strategy due later in 2024. Reframing and reconfiguring existing service provision, including hospice care, within existing resources. Plan, Initiate, Monitor Monitor, Close x P/EOL Group √ √ Review and improve the Dementia Support and Respite models of care. (to follow Day Services Review below) Plan, Initiate, Monitor Monitor, Close x H&CC SMT TBC √ √ Evaluate recent Day Services Review and current Day Services models both on the mainland and the islands of Cumbrae and Arran. This should incorporate learning from recent pilots with focus on blended approach inlcuding outreach opportunities. Plan, Initiate, Monitor Monitor, Close x H&CC SMT TBC √ Explore current packages of care model and consider future sustainable delivery. [CLOSED WITH NO RECOMMENDATIONS] Plan, Initiate, Monitor, Close by end of 24 x x H&CC SMT √ √ Home first Strategy Plan, Initiate, Monitor, Close by March 25 x x H&CC SMT √ √ Delayed Discharge and Winter Preparedness Improvement Plan with a focus on Care at Home Capacity, Adults with Incapacity and Discharge to Assess. Monitor and Close by March 25 x x H&CC SMT Arran Integrated Services model √ √ √ Continue to work towards an Integrated Hub on Arran building on the frailty work and developing a single point of contact for all health and social care services. Initial Agreement has been redrafted. Close (or change) x x n/a Unscheduled Care Improvement Programme Models of Care
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route Primary Care MDTs - GP Premises √ √ √ Implement HSCP MDTs across each of the localities to support GP practices and HSCP service coordinate care for those with the most complex needs. Address premises capacity issues initially in Frew Terrace, Oxenward and Beith. Monitor Monitor, Close by end of 25 x H&CC SMT √ √ Review of the Enhanced Intermediate Care Service Plan, Initiate, Monitor Monitor, Close x Community Rehab PB √ √ Review of community rehab provision incorporating the range of community rehab services and how these better link together. Plan, Initate, Monitor, Close by end Mar 25 x x Community Rehab PB √ √ Community wards: Review current inpatient ward functions and rehab models. Plan, Initiate, Monitor, Close by end of 24 x x Community Rehab PB √ √ Policy review for access to and criteria for Aids and Adaptations, linking with Housing Review. Plan, Initate, Monitor, Close by end Mar 25 x x Community Rehab PB √ √ Review of podiatry service provision with a specific focus on reducing waiting lists including eligibility criteria. Plan, Initiate, Monitor Monitor, Close x TBC √ √ Review of OT service provision with a specific focus on reducing waiting lists including eligibility criteria. Plan, Initiate, Monitor Monitor, Close x TBC √ √ Review of speech and language therapy service provision with a specific focus on reducing waiting lists including eligibility criteria. Monitor, Close x x TBC √ √ Moving and Handling: Building on investment in Castleview training centre for social care staff - improve quality of risk assessment process, support to frontline staff, support with moving and handling aids and consider provision to wider services (including providers and Carers) Plan, Initiate, Monitor Monitor, Close by end of 25 x Community Rehab PB Community AHP Provision Community Rehab Models
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Service Area Project Description/Workstream Enable Communities Develop and support workforce Early and Effective Support Mental and Physical Health and Wellbeing Tackle Inequalities 2024/25 2025/26 2026/27 Strategic Priorities Project Profiling Primary Project Governance Route Partnership Wide Self Directed Support (SDS) Review √ √ √ Engage with all stakeholders to look at how we encourage a more innovative and person centred approach to SDS. Implement the next phase of work from the Learning Review. Initiate, Monitor Close April 25 x SWGB/PSMT Carers Strategy and Service √ √ √ √ Implement the Carers Strategy agreed at IJB in August 2023 together with new enhanced model of support from Unity. Plan TBC, based on plan TBC Direct to IJB Implementation of Eclipse information system √ Implementation of new information recording system for social care to replace Care First. This will include development of new protocols and transfer of data from current system to the new one. Monitor, Close Evaluation x Eclipse Project Board Front Door Review √ √ √ √ Commence a review of the HSCP front door first point of contact across services including duty systems. Scope to include first point of public contact, to maximise capacity and mitigate current risk. 12 month review 6 month to implement recommendation s x Accessing Health and Social Care Services Learning Review Board √ Update and further develop workforce plans to ensure the partnership has the right skills, roles, and number of people, now and in the future, including developing learning pathways, upskilling and reskilling opprtunities, and other strategies to improve recruitment and retention. Workforce Plan 2 year update by Oct 24 New workforce plan Oct 2025 x F&T SMT √ Develop approaches and explore options to provide alternative supports to workforce to address and support a reduction in staff absence levels, for example additional Occupational Health capacity or support. Workforce Plan 2 year update by Oct 24 New workforce plan Oct 2025 x F&T SMT Digital & Data Plan: Phase 1 √ √ √ √ √ Develop and implement a NAHSCP Digital & Data Plan, aligned to national digital and data strategies. - fully articulating the digital & data requirements of a cohesively integrated value-based health and social care service - generating a baseline of digital capability / maturity - identifying barriers and opportunities for improvement - embedding digital & data across all teams and functions - creating a data-driven culture that supports innovation Initial Plan developed with recommended next steps TBC TBC F&T SMT Leadership structures √ Review leadership structures across the Partnership Plan, Initiate, Monitor,Close x x PSMT CM2000 √ √ Review workforce scheduling and monitoring of service delivery system (currently CM2000 - contract ends Mar 25 ) Plan, Initiate, Monitor,Close by Dec 24 x x PSMT Eligibility Criteria √ √ √ √ Consider whole-scale review of service eligibility criteria including policy and procedure used within services to ensure - resources are targeted to those most in need and an equitable approach to providing support and managing waits. Plan TBC TBC PSMT Workforce Planning
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NORTH AYRSHIRE Health and Social Care Partnership Transformation Board Terms of Reference 2024-2027 1 Introduction 1.1 Transformation is defined as making best use of available resources to transform products and services to achieve better outcomes and experiences. It is a deliberate planned process that sets out to achieve our high aspirations of health equity, improved social circumstances, and long-term sustainability for the people of North Ayrshire. It delivers measurable improvement by fundamentally changing how care is delivered, what staff do (changing both the types of roles, and the capabilities, required in the future), as well as the role of communities and individuals. 1.2 Our high aspirations are set out in our Strategic Plan where we have defined five strategic priorities to enable us to achieve our vision for people of North Ayrshire to have a safe, healthy, and active life: • enabling communities • developing and supporting our workforce • providing early and effective support • improving mental and physical health and wellbeing • tackle inequalities The measurable improvement and fundamental change required to achieve our high aspirations will be underpinned by: • a deliberate and planned process – Transformation Plan • understanding the types of roles, and the capabilities, required in the future – Workforce Plan • better use of digital, and specifically data, to inform decision-making and measure impact – Digital & Data Plan 1.3 The Transformation Plan is an ambitious programme of change consisting of a range of improvement projects each aiming to advance value-based and data-driven products and services, to contribute to the long-term sustainability of health and care in North Ayrshire. 1.4 The Transformation Plan will be overseen by a programme board who will oversee the development and implementation of the plan and provide assurance to the Integrated Joint Board (IJB). 1.5 The programme board will be known as the Transformation Board.
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2 Purpose & Remit 2.1 The purpose and remit of the Transformation Board is to: • ensure the Transformation Plan is aligned to our strategic priorities and aims to deliver measurable improvement. • oversee the delivery of the Transformation Plan through effective programme monitoring. • provide whole system oversight, and to monitor associated risks and benefits, to ensure health equity, improved social circumstances, and long-term sustainability, are prioritised. • support system wide change management where required. • ensure any proposed change is safe, and is compliant with current legislation and/or relevant policy directive (e.g. Equality Impact Assessments) 3 Membership 3.1 The Transformation Board shall comprise the following core members: • Director (Chair) • Chief Finance and Transformation Officer • Heads of Service • Chief Social Work Officer • Senior Manager (Strategic Planning and Transformation) • Principal Manager (Business Support) • Principal Manager (Finance) And the following optional members: • Planning Managers • Team Manager (Information Systems and Performance) • Associate Nurse Director • Senior Manager (Allied Health Professionals) • Director of Psychological Services • Senior Manager (Contracts and Commissioning) 4 Attendance 4.1 Members are permitted (and encouraged) to nominate a deputy to attend meetings in their absence. 4.2 Additional members may be co-opted as required. 5 Quorum 5.1 The meeting shall be quorate when the Chair, or nominated deputy, is present together with 50% of the representatives of the membership.
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6 Meetings 6.1 The Board will meet monthly and will be chaired by the NAHSCP Director. 6.2 The Chair may at any time convene additional meetings of the Transformation Board 7 Duties 7.1 The Transformation Board will work within existing governance structures to: • provide assurance to IJB on effectiveness of the Transformation Board and progress of the Transformation Plan. • both inform, and be informed, by the Strategic Planning Group. • contribute to the development and implementation of an appropriate Digital & Data Plan to ensure transformation is value-based, data-driven, and has measurable impact. • ensure appropriate alignment with Workforce Planning. • ensure effective communication across the Health and Social Care Partnership to champion transformation, and support system wide change where required. 7.2 Members are responsible for assuring the development of robust project plans, aligned to the strategic priorities, with measurable outcomes, clear actions, milestones, timescales, roles and responsibilities, and a defined approach for managing risks and benefits. (Monitoring of individual projects is by Service SMT or dedicated/nominated Project Board, reporting back to the Transformation Board only by exception.) 7.2 Members may be required to lead areas of work in support of the transformation programme and will be responsible for ensuring that allocated areas of work are progressed. 7.3 Members are responsible for ensuring that they accurately reflect the views of the those they represent, and to provide regular updates on the progress of the Transformation Plan to relevant stakeholders. 8 Administration of Meetings 8.1 Appropriate administrative support for the Transformation Board will be arranged by the HSCP Finance & Transformation Team. 8.2 Action notes will be circulated in draft form to members and considered at the subsequent meeting for agreement. This information will be shared at each IJB via the Directors report. 8.3 The agenda and supporting papers will be sent to members at least five working days before the date of the meeting. 9 Authority 9.1 The service representatives and members of the Transformation Board have authority in line with that delegated to them in the scheme of delegation, however the Transformation Board does not have decision making authority and will therefore make recommendations to IJB or PSMT for decisions.
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10. Reporting 10.1 The Transformation Board will provide regular reports to the Integrated Joint Board to ensure effective governance arrangements. The Senior Manager (Strategic Planning and Transformation) will draft reports on behalf of the Transformation Board. 10.2 The Senior Manager (Strategic Planning and Transformation), responsible for the day-to- day management of the programme, will ensure the Transformation Board is kept appropriately informed and has the information required to oversee the delivery of the Transformation Plan. Once robust project plans are in place updates are by exception. 10.3 The Planning Managers, and/or Service Leads, responsible for the day-to-day management of individual projects, will ensure the Senior Manager (Strategic Planning and Transformation) and Service SMT (and/or Project Board) is kept appropriately informed and has the information required to oversee the delivery of the projects. 10.4 The Board will be supported by a robust and consistent HSCP approach to project and programme management, supported by Planning Managers.