Agenda Document Pack - Health and Social Care Integration Joint Board - 18/03/2026
North Lanarkshire Council · 18 March 2026
Back to Health and Social Care Integration Joint Board — 18 March 2026 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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11 March 2026 Members of the Health and Social Care Integration Joint Board Chief Executive’s Office Claire Rae Chief Officer, North Lanarkshire Integration Joint Board Civic Centre, Windmill Street Motherwell ML1 1AB www.hscnl.org.uk Notice is given that a Meeting of the Health and Social Care Integration Joint Board is to be held on MS Teams on Wednesday, 18 March 2026 at 09:30 AM which you are requested to attend. The agenda of business is attached. Claire Rae Chief Officer, North Lanarkshire Integration Joint Board Members : Clerk Name: Clerk Telephone: Clerk Email: A McCrory, C Barclay, B Baudo, B Burgess, P Couser, N Dar, B Moore, S White. Page 1 of 350
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Agenda 1 Welcome and Apologies 2 Declarations of Interest In Terms of the Ethical Standards In Public Life Etc. (Scotland) Act 2000 3 Previous Minute from Integration Joint Board Committee held on 10 December 2025 Submit Minute of Previous Meeting of Integration Joint Board held on 10 December 2025. 7 - 12 4 Previous Minute from Integration Joint Board (Performance, Finance and Audit) held on 22 October 2025 Submit Minute of Previous Meeting of Integration Joint Board (Performance, Finance and Audit) held on 22 October 2025. 13 - 16 5 Membership and Meeting Changes Consider any changes to be made to Board or Committee memberships or amendments to meeting arrangements 6 Rolling Action Log Submit report by the Chair 17 - 22 Standing Items 7 Chief Officer Report March 2026 Submit report by the Chief Officer 23 - 28 Performance and Finance 8 Medium Term Financial Plan 2026-2029 and Long Term Financial Outlook Submit report by the Chief Finance Officer 29 - 52 9 2026-27 Delegated Health and Social Care Budget Submit report by the Chief Finance Officer 53 - 58 10 Reserves Policy Submit report by the Chief Finance Officer 59 - 74 Page 3 of 350
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11 Financial Regulations Submit report by the Chief Finance Officer 75 - 94 12 Population Health Framework & Community Planning -Funding Proposal Submit report by the Chief Officer 95 - 100 Strategic Planning and Development 13 Strategic Commissioning Plan 2026-2029 Submit report by the Chief Officer (Planning, Performance & Quality Assurance) 101 - 108 14 Annual Report to the Chief Social Work Officer 2024-25 Submit report by the Chief Social Work Officer (Children, Families, Justice & Integration) 109 - 182 15 Home Support Submit report by the Chief Officer (Adult Social Work Services) 183 - 202 16 Progress Report on Trauma Informed Practice Submit report by the Chief Officer (Adult Social Work Services) 203 - 218 17 Population Health Framework Action Plan Submit report by Josephine Pravinkumar 219 - 234 Governance and Policy 18 IJB Risk Register Submit report by the Business Support Manager 235 - 254 19 IJB Directions Letters to NLC and NHSL Submit report by the Chief Officer (Planning, Performance & Quality Assurance) 255 - 308 20 Mainstreaming Equalities Report and Equality Outcomes Report Submit report by the Chief Officer (Planning, Performance& Quality Assurance) 309 - 336 21 Integration Joint Boards - Extension of Voting Rights Submit report by the Chief Officer 337 - 346 Page 4 of 350
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22 North Lanarkshire Integration Joint Board Work Plan Submit report by the Business Support Manager 347 - 350 For Noting 23 Risk Consider from the business discussed any new emerging risks to be added to risk register or whether the discussion materially alters the accessed levels of risk/risk tolerance or mitigating controls Page 5 of 350
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Page 1 of 6 ITEM: 3 Integration Joint Board Performance Minutes from the meeting held on Wednesday 10th December 2025, 09.30 – 12.00 via MS Teams PRESENT Voting Members: Cllr Claire Barclay NLC Nominated Councillor Cllr Beth Baudo NLC Nominated Councillor Cllr Bob Burgess NLC Nominated Councillor Cllr Anne McCrory NLC Nominated Councillor Brian Moore (Chair) NHS Lanarkshire Nominated Non-Executive Siobhan White NHS Lanarkshire Nominated Non-Executive Others In Attendance: Andrea Breen Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Alison Gordon Joanne Jenkins Nurse Director NL HSCP / Nurse Representative Peter McCrossan Director for AHPs Catherine McGinty Unison / Staff Side Representative (NHSL) Thomas Moan Senior Manager – Community Solutions VANL Ann Muir Chair of North Lanarkshire Disability Forum Lucy Munro Medical Director for Health & Social Care North Lanarkshire Des Murray Chief Executive - North Lanarkshire Council Claire Rae Chief Officer NL HSCP Nicola Scott Chief Finance Officer Kerry Taylor Business Support Manager Maggs Thomson Head of Health John Watson Employee Representative NLC David Wood Chief Executive Officer with VANL Dawn Wright (Minutes) Management Team Secretary Apologies: John Boyd Audit Scotland Phillip Couser NHS Lanarkshire Nominated Non-Executive Nauman Dar NHS Lanarkshire Nominated Non-Executive Stephen Forrest Performance Manager Diane Fraser Head of Adult Social Care Louise Long Chief Executive Jocelyn Lyall Chief Internal Auditor Clare Louise McDonald Josephine Pravinkumar Director of Public Health and Health Policy Harry Robertson North Lanarkshire Carers Together / Carer Representative Francis Scott Chief Officer (Audit and Risk) Tyra Smyth GP Sub Secretary Item 3 Page 7 of 350
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Page 2 of 6 1. Welcome and Apologies The chair welcomed everyone to the meeting and apologies noted as above. Brian Moore 2. Declaration of Interests No declarations of interest were made. All 3. Minutes IJB (17th September 2025) Minutes approved as an accurate record. Chair noted the new style of minutes is helpful, balanced detail and recommendations. Brian Moore 4. Minutes IJB PFA (21st May 2025) Minutes noted. Brian Moore 5. Membership & Meeting Changes No changes. Brian Moore 6. Matters Arising/ Rolling Action List No issues raised regarding matters arising. All actions either closed or complete. Brian Moore Standing Items 7. Chief Officer Report HIGHLIGHTS Winter planning underway. Admission avoidance, community resilience, discharge facilitation. Additional winter funding confirmed. External care providers engaged. Staff Recognition Awards - two finalists at Scottish Health Awards. Record breastfeeding performance in North Lanarkshire. Transition to sub-national planning models (Scotland East/West) noted. Ambulance delays and hospital flow issues raised by Councillor Claire Barclay and Councillor Bob Burgess. Gold Command established. District nursing and ANP teams deployed to manage waits. Home support resilience discussed. Sickness absence at 13% (above usual 10%). Vaccination uptake concerns - Issues with appointment availability and notifications. ACTIONS – Claire Rae Pick up vaccination service concerns and explore pop-up clinics. Continue monitoring home support staffing and mitigation plans. Claire Rae Page 8 of 350
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Page 3 of 6 8. Chief Finance Officer Report - Medium Term Financial Outlook 2026-2029 HIGHLIGHTS Updated forecast shows £81m budget gap over 3 years. £38m in 2026/27. Savings proposals in progress. Reserves review underway. COSLA settlement changes may affect funding. Outcome expected January. Prescribing cost assumptions remain at 10% increase. Risks around reserve release and savings delivery noted. Concern over use of outdated data for settlement raised. Workforce and prescribing cost volatility discussed. ACTIONS – Nicola Scott Prepare reserve strategy with timelines for review and reallocation. Update Board in March on savings progress and settlement impact. Recommendations i) IJB noted the Medium Term Financial Outlook (MTFO) position for 2026/27 to 2028/29. ii) IJB noted the forecast funding gap over the three-year cycle. iii) IJB recognised the uncertainty in council funding arising from ongoing reviews of Grant Aided Expenditure. iv) IJB recognised this outlook will be subject to ongoing review prior to the Medium Term Financial Plan (MTFP) being presented to the Board for approval in March. v) IJB noted the work underway to identify options for addressing the budget gap. vi) IJB noted the forecast reserves position. Nicola Scott Strategic Planning & Development 9. The Lanarkshire Advocacy Plan HIGHLIGHTS Fourth five-year plan presented. Strong partnership approach. Launch scheduled for February. Focus on accessibility and promotion. Financial framework and referral patterns discussed. ACTION – Morag Dendy Share launch details and ensure visibility on websites. Recommendations i) IJB approved the publication and launch of the 2025-2030 Lanarkshire Advocacy Plan. Morag Dendy 10. CAMHS Recovery & Renewal HIGHLIGHTS Service moved to business-as-usual but challenges remain. Neurodevelopmental pathway, funding instability, psychological therapies waits. Whole-school approach and unscheduled CAMHS highlighted. Partnership working praised. Maggs Thomson Page 9 of 350
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Page 4 of 6 ACTION – Mark Dell Continue comms push on mental health resources and waiting-well support. Recommendations i) IJB noted the contents of report and progress made to date. 11. Paediatric Modernisation HIGHLIGHTS Programme Board established. Workforce stabilisation and care assurance work ongoing. Hospital-at-home model supported by Scottish Government. Focus on family engagement and communication improvements. ACTION – Lucy Munro Report on hospital-at-home pilot and workforce developments. Recommendations i) IJB noted the contents of the report and progress of work achieved to date. ii) IJB noted the scale of challenge to delivery of sustainable transformational change. The success of programme delivery will require clinical modelling and clinician support. This has to be balanced proportionately with safe delivery of care whilst transformational work progresses. iii) IJB noted that elements of this work are impacted by current service level agreements with tertiary partners. This requires sensitive discussion via regional planning process. Maggs Thomson / Lucy Munro / Pauline Izat 12. Care Academy HIGHLIGHTS Five work streams progressing; 1. Recruitment, 2. Young people pathways 3. Adult pathways 4. Funding Procurement 5. Comms. Increase in foundation apprenticeships noted. Challenge remains in tracking recruitment outcomes. ACTION – Morag Dendy Develop delivery framework and metrics for recruitment impact. Recommendations i) IJB endorsed the contents of this report, the progress made and next steps. Morag Dendy 13. Coming Home Report Page 10 of 350
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Page 5 of 6 HIGHLIGHTS Dynamic Support Register: 15 delayed discharges, 3 over 10 years. Challenges: housing, workforce capacity, funding sustainability. £1.1m short-term funding ended May 2025; estimated £5.5m cost for current cases. ACTIONS – Andrea Breen / Claire Rae Embed learning from short-term interventions into workforce development. Explore regional solutions and escalate funding concerns. Recommendations i) IJB noted the current progress to implement the recommendations from the Coming Home Report. Andrea Breen 14. Probable Suicide 2024 Report HIGHLIGHTS Suicide rate in North Lanarkshire above national average. Men disproportionately affected. Campaigns and training ongoing. Engagement with third sector improving. ACTION – Andrea Breen Continue targeted campaigns and monitor training uptake. Recommendations i) IJB noted the contents of this report, including current suicide prevention activity, trends, and progress against national and local strategies. ii) IJB support the continued implementation of Scotland’s Suicide Prevention Strategy 2022–2032 and associated local action plans, ensuring alignment with national priorities. Andrea Breen 15. Drug Related Deaths and Alcohol Specific Deaths 2024 Report HIGHLIGHTS Drug deaths slightly reduced. Alcohol-specific deaths remain high. SIMD 1 & 2 areas most affected. Age group 35–44 highest risk. ACTION – Morag Dendy Maintain focus on targeted interventions and whole-system response. Recommendations i) IJB noted the contents of this report. Morag Dendy 16. ADP Annual Reporting Survey Page 11 of 350
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Page 6 of 6 HIGHLIGHTS Self-assessment submitted. Reflects governance, commissioning, and whole-family approach. ACTION – Morag Dendy Provide richer update report aligned with stakeholder review. Recommendations i) IJB noted the content of the report. ii) IJB noted the content of the Annual Reporting Survey to the Scottish Government that requires approval by the IJB. This was submitted to the Scottish Government via the ADP by June 2025. The survey is designed to collect information on a range of aspects relating to the delivery of the Nation Mission on Drugs, to deliver on the priorities in line with additional investment priority areas; iii) IJB noted the arrangements in place across each priority area; Prevention, Early Intervention and Education Residential Rehab Assertive Outreach and Crisis support Harm reduction – including Naloxone provision Whole Family Approach and Family Inclusive Practice Lived and Living Experience iv) IJB approved the NLADP Annual report acknowledging the appropriate supports and governance arrangements are in place to deliver the National Mission priorities and The Partnership Delivery Framework objectives. Morag Dendy Performance & Finance Governance & Policy 17. IJB Work Plan Development session on finance scheduled for January. Next formal meeting in March. Kerry Taylor For Noting 18. Risk Chair highlighted partnership strengths but noted significant risk around Coming Home agenda and financial sustainability. Date of next IJB meeting: 18 March 2026, 9.30am-12pm, Via MS Teams Page 12 of 350
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Page 1 of 3 ITEM: Integration Joint Board Performance, Finance & Audit Committee Minutes from the meeting held on Wednesday 22nd October 2025, 09.30 – 12.00 via MS Teams PRESENT Voting Members: Cllr Claire Barclay NLC Nominated Councillor Cllr Beth Baudo NLC Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non-Executive Cllr Anne McCrory (Chair) NLC Nominated Councillor Brian Moore (Vice-Chair) NHS Lanarkshire Nominated Non-Executive Siobhan White NHS Lanarkshire Nominated Non-Executive Others In Attendance: Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Joanne Jenkins Nurse Director North HSCP Jocelyn Lyall Chief Internal Auditor Catherine McGinty Unison / Staff Side Representative (NHSL) Thomas Moan Senior Manager – Community Solutions VANL Ann Muir Chair of North Lanarkshire Disability Forum Lucy Munro Medical Director for Health & Social Care North Lanarkshire Claire Rae Chief Office NL HSCP Harry Robertson North Lanarkshire Carers Together / Carer Representative Francis Scott Chief Officer (Audit and Risk) Nicola Scott Chief Finance Officer Kerry Taylor Business Support Manager Maggs Thomson Head of Health North HSCP John Watson Employee Representative NLC Apologies: Cllr Bob Burgess NLC Nominated Councillor Nauman Dar NHS Lanarkshire Nominated Non-Executive Diane Fraser Head of Adult Social Care Alison Gordon Head of Children’s, Families & Justice Services Jacqui Jones Deputy Chief Executive and Director of Human Resources David Wood Chief Executive Officer with VANL Item 4 Page 13 of 350
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Page 2 of 3 1. Welcome and Apologies Cllr Anne McCrory welcomed everyone to the meeting and apologies were notes as above. Chair 2. Declaration of Interests No declarations of interest were made. Board Members 3. Minutes IJB PFA (27th August 2025) The minutes accepted as an accurate record. Chair 4. IJB PFA Rolling Action Log Items 27 to 30 are to be moved to the Governance Tracker. Item 32 (prescribing savings) to be brought to a future meeting. Item 36 Claire Rae to follow up directly with John Watson. Item 37 (use of reserves) scheduled for February IJB PFA meeting. Claire Rae and Kerry Taylor to review conventions on retention of closed actions and report back. Chair 5. Matters Arising No matters arising raised. Chair Performance & Finance 6. Financial Monitoring Report Report covered financial position to 31 August 2025. Projected year-end overspend of £4.226m. Key pressures: care at home, care homes, and healthcare non-pay costs. Request for approval to reinstate £260k organisational development reserve. Concerns raised about slow progress on savings and impact on performance. Discussion on Primary Care Improvement Fund (PCIF) overspend and evaluation. Polypharmacy savings and workforce vacancies discussed in detail. Approval granted to reinstate £260k organisational development reserve. Development session to be held to address savings challenges. Nicola Scott to include unachieved savings in December’s financial outlook. Claire Rae to follow up on workforce data and recruitment challenges. Nicola Scott to provide reserve establishment dates in future reporting. RECOMMENDATIONS i) IJB PFA acknowledge the contents of the report. ii) IJB PFA acknowledge the projected outturn for 2025/26 is an overspend of £4.226m iii) Approve the reinstatement of the £0.260m Organisational Development reserve. Nicola Scott 7. Q1 IJB Performance Report Alcohol Brief Interventions: under-recording identified. Cervical Screening: low uptake in 25–29 age group, data and access issues. Childhood Immunisations: national downward trend, local engagement ongoing. Mental Health: low outpatient consultation rates due to psychiatrist shortages. Speech & Language Therapy (SLT): significant improvement noted. Smoking Cessation: low referral and quit rates. Suggestion for future review. Sickness Absence: improving but still high. Staff wellbeing initiatives underway. Morag Dendy Page 14 of 350
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Page 3 of 3 Include SIMD and health inequalities data in future reports. Explore national initiatives on immunisation uptake. Include digital engagement data in performance reporting. Consider development session on smoking cessation strategy. Update risk registers to reflect polypharmacy and digital health innovations. RECOMMENDATIONS i) IJB PFA noted the contents of the report and the appendix. Governance & Policy 8. Internal Audit Progress Report 2024/25 and 2025/26 Strategy audit in progress; no major issues identified. 2025/26 audits (performance and financial sustainability) scheduled for early completion. Development of IJB internal audit strategy underway. No questions raised from this paper RECOMMENDATIONS i) IJB PFA noted the contents of the report. Jocelyn Lyall 9. Annual Governance Statement Actions - Progress Update Four actions remain outstanding; three are within timescales. No questions raised from this paper RECOMMENDATIONS i) IJB PFA noted the contents of the report. Nicola Scott 10. Risk Report Risks under review, new proposals to be presented in December IJB meeting. Discussion on inclusion of polypharmacy and digital health risks. Concern raised about community alarm systems in rural areas post-landline removal. RECOMMENDATIONS i) IJB PFA noted the contents of the report. Kerry Taylor 11. IJB PFA Work Plan The work plan is a live document. Members invited to suggest additional items. Kerry Taylor For Noting 12. Risk No risks identified beyond those discussed above. Date of Next Meeting: 18th February 2026, 14:00-16:30 Page 15 of 350
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1 ITEM 4 North Lanarkshire Integration Joint Board ROLLING ACTION LOG NO DATE ITEM NO DESCRIPTION ACTION BY ACTION & PROGRESS DUE DATE COMPLETION STATUS 34. 10 December 2025 7 Chief Officer Report C Rae Pick up vaccination service concerns and explore pop-up clinics. In progress 35. 10 December 2025 7 Chief Officer Report C Rae Continue monitoring home support staffing and mitigation plans In progress 36. 10 December 2025 8 Chief Finance Officer Report - Medium Term Financial Outlook 2026-2029 N Scott Prepare reserve strategy with timelines for review and reallocation. 18 March 2026 In progress – on agenda for 18 March 2026 37. 10 December 2025 8 Chief Finance Officer Report - Medium Term Financial Outlook 2026-2029 N Scott Update Board in March on savings progress and settlement impact. 18 March 2026 In progress – on agenda for 18 March 2026 38. 10 December 2025 9 The Lanarkshire Advocacy Plan M Dendy Share launch details and ensure visibility on websites In progress 39. 10 December 2025 10 CAMHS Recovery & Renewal M Dell Continue comms push on mental health resources and waiting-well support In progress 40. 10 December 2025 11 Paediatric Modernisation L Munro Report on hospital-at-home pilot and workforce developments In progress Item 6 Page 17 of 350
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2 41. 10 December 2025 12 Care Academy M Dendy Develop delivery framework and metrics for recruitment impact In progress 42. 10 December 2025 13 Coming Home Report A Breen Embed learning from short-term interventions into workforce development In progress 43. 10 December 2025 13 Coming Home Report A Breen / C Rae Explore regional solutions and escalate funding concerns In progress 44. 10 December 2025 16 ADP Annual Reporting Survey M Dendy Provide update report aligned with stakeholder review In progress Page 18 of 350
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3 CLOSED ACTIONS NO DATE ITEM NO DESCRIPTION ACTION BY ACTION & PROGRESS DUE DATE COMPLETION STATUS 5. 19.06.24 Item 6 Digital System Transformation M Dendy Delegate to the IJB PFA committee -To provide the IJB PFA with additional financial information relating to the programme Report provided to IJB PFA 21st August 2024 Complete 6. 19.06.24 Item 7 Mental Health & Wellbeing Delivery Plan R McGuffie Shared new action plan with the group in Sept/October Action Planned shared and stakeholder sign off currently underway. Complete 28 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Work collaboratively with other IJBs and partners to systematically share learning to identify and develop: - Service redesign focused on early intervention and prevention. - Approaches focused on improving the recruitment and retention of the workforce. “business as usual" item 29 25.09.24 Item 9 Integration Joint Boards Finance C Rae Work collaboratively with other IJBs and partners to understand what data is available and how it can be developed and used to fully “business as usual" item Page 19 of 350
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4 and Performance Report 2024 understand and improve outcomes for those using IJB commissioned services. This should include a consideration of gaps in data. It should also include consideration of measures to understand the impact of preventative approaches. 30. 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Evaluate whether the local commissioning of care and support services, and the contracting of these services, adheres to the ethical commissioning and procurement principles, improving outcomes for people. “business as usual" item 26 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Ensure that their Medium-Term Financial Plans are up to date and reflect all current known and foreseeable costs to reflect short and longer-term financial sustainability challenges. 25.02.25 – Due to be discussed at the next IJB in March 19.03.2025 Discussed on agenda 19.03.25 Complete 31. 25.02.25 Item 6 Q2 Performance Report Improved communication about progress and ensure a shared understanding of what CAMHs services can offer. 21.05.25 - Mark Dell confirmed a communications plan is underway, including a scoping exercise to avoid duplication and engagement with key players. Mark Dell Complete Page 20 of 350
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5 assured the communication would be out soon and would include guidance for elected members. 04.06.2025 – Timeline agreed between MD & CR for end of June 2025. 16.09.2025 - Mark Dell confirmed the strategy circulated to GPs and Health Visitors, followed by wider staff and elected members. A toolkit is going to be provided to support constituent queries. 33. 19.03.20 25 Item 4 Matters Arising Learning Disability Workforce paper to be brought to PF&A Complete 25. Future Meeting C Rae Host a future meeting face to face in Chryston hub 19.03.2025 – March date was cancelled new date to be re-arranged 16.09.2025 - Visit scheduled for 18th September. Complete Chair and Vice- Chair visited Chryston Hub in September 2025 with future invites to SMT walk rounds. 27 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Ensure that the annual budgets and proposed savings are achievable and sustainable. The budget process should involve collaboration and clear conversations with IJB partners, Complete – Moved to Governance Page 21 of 350
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6 workforce, people who use services and other stakeholders around the difficult choices required to achieve financial sustainability. monitoring log for IJB PFA 32. 25.02.25 Item 8 Financial Monitoring Suggestion that Pharmacy Savings Approach could be brought back to IJB to get a restock of where things are and where they are going. 16.09.2025 - Regular update will be included in the work plan. Completed – added to IJB work plan Page 22 of 350
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1 REPORT Item No: 7 SUBJECT: Chief Officer Report TO: Integration Joint Board Lead Officer for Report: Claire Rae, Chief Officer Author(s) of Report Kerry Taylor, Business Support Manager DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Kerry Taylor, Business Support Manager ☒ Reviewed By: ☒ Endorsed By: ☐ Item 7 Page 23 of 350
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2 3. RECOMMENDATIONS 3.1 It is recommended that the IJB Note and comment on the key areas of work and service developments that have been taking place within North Lanarkshire in relation to the work of the Integration Joint Board 4. CHIEF OFFICER REPORT 4.1 Launch of Lanarkshire Advocacy Plan North and South Health and Social Care Partnerships held an event to launch the Lanarkshire Advocacy Plan 2025-2030 on 3 February 2026. The event included presentations from Scottish Independent Advocacy Alliance and people with lived experience. 4.2 Visit from Tom Arthur, Minister for Social Care, Mental Wellbeing and Sport of Scotland Tom Arthur MSP joined University Health & Social Care North Lanarkshire staff at University Hospital Wishaw on 5 February 2026 to meet the Home Assessment Team which supports eligible people discharged from hospital to lead independent lives at home. The team carries out an ongoing assessment of each eligible person’s specific needs in their home with wrap-around support for up to two weeks and often sees them within hours of their discharge from hospital. Mr Arthur said: “I was delighted to meet the Home Assessment team who are making good progress in addressing delayed discharges. It was heartening to hear how they are supporting people in their own homes after they’ve been discharged from hospital and how they play a key role preventing people from hospital admission in the first place. “This is a good example of the work taking place across the country to make sure people can leave hospital as soon as they’re ready to do so.” 4.3 Self Directed Support (SDS) Roadshow In conjunction with Social Work Scotland and SDS Scotland, NLHSCP hosted our first ever SDS roadshow. The roadshow was a platform to recognise and celebrate the collective effort of all our partners who are working together to embed SDS across North Lanarkshire, and the impact of that on people living and working across our communities. Page 24 of 350
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3 The roadshow was held on Wednesday 25th February in Gartlea Community Centre, with approximately 80 people in attendance. This included representation from our leadership team, our workforce, partner agencies, people with lived experience and carers. We plan to build on the momentum and feedback from the day by developing mini roadshow events that will ensure wider engagement and participation across North Lanarkshire. 4.4 Unscheduled Care The most recent validated data, for the month of January 2026 reports North HSCP at 38.0 delays per 100,000 population, which remains below the Scottish average. There has been an increase in AWI’s and CCA’s, with a deep dive being progressed to understand why. 4.5 IJB Voting Rights The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 amends The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014 to make targeted changes to the composition and voting arrangements of Integration Joint Boards. A report with further information will be presented to North Lanarkshire Integration Joint Board under agenda item XX. 4.6 Reduction to Working Week for NHS Employees Staff covered by Agenda for Change (AfC) terms and conditions working week will reduce from 37 to 36 hours for full-time staff and pro-rata for part-time staff from 1 April 2026 without loss of earnings. Full details can be found via NHS Circular PCS(AFC)2025/8, which also contains frequently asked questions: Reduction in the working week for Agenda for Change staff in NHS Scotland. 4.7 Royal College of Nursing (RCN) Scotland Nurse of the Year Awards Two members of North Lanarkshire Health and Social Care Partnership staff were named as finalists in the RCN Scotland Nurse of the Year Awards 2026, recognising outstanding nursing care and support across Scotland. Lynn Melville, Health Care Support Worker, Health Visiting Team, Airdrie Health Centre – Nursing Support Worker of the Year Page 25 of 350
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4 Margaret McLean, Community Staff Nurse, Airdrie Community Health Centre – People’s Choice Award The Nursing Support Worker of the Year category recognises the vital contribution of nursing support workers who are an integral part of the nursing team. It celebrates those who demonstrate outstanding commitment to person- centred care, high-quality practice and a positive impact on the experiences of patients, families and colleagues. The People’s Choice Award is determined through public nomination and recognises nurses and nursing support workers who are valued and appreciated by the people and communities they support, reflecting the difference they make through compassion, professionalism and dedication. 4.8 Whole Population Availability of the Digital Front Door (MyCare) The launch of the Whole Population Availability of the Digital Front Door (MyCare) will go live nationally on 15 April 2026. This provides members of the public to secure access to limited health information (medication, vaccination and allergy info). There is no change local services, operations or clinical responsibilities as part of the national roll out. 4.9 Audit Scotland Report – Delayed Discharges In January 2026, Audit Scotland published its report, Delayed Discharges: a symptom of the challenges facing health and social care which seeks to assess how well the challenge of reducing hospital delayed discharges is being addressed in Scotland. The report identifies the key factors that contribute to people’s discharge from hospital being delayed and analyses the impact of initiatives that have been implemented in an attempt to address them. This report was presented to North Lanarkshire Integration Joint Board Performance Finance and Audit Committee on 18 February 2026 and can be accessed here: NL IJB PFA 18 February 2026 Papers 4.10 Audit Scotland Report - Community Health & Social Care Performance 2025 In January 2026, Audit Scotland published its report Community Health and Social Care: Performance 2025, which provides a detailed assessment of how Page 26 of 350
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5 Integration Authorities (IAs) and Health & Social Care Partnerships are performing across Scotland. The report identifies significant issues with data, demand pressures, and slow progress on long-standing reform goals, making it difficult to fully assess—and improve—system performance. The central message within Audit Scotland’s report Community Health and Social Care: Performance 2025 is that Scotland lacks comprehensive and consistent national performance information regarding health and social care, and particularly around: o Service demand o Workload o Quality of care o Outcomes This report was presented to North Lanarkshire Integration Joint Board Performance Finance and Audit Committee on 18 February 2026 and can be accessed here: NL IJB PFA 18 February 2026 Papers 4.11 The State and Future of Social Work and Social Care Funding in Scotland (Social Work Scotland) On 26th January 2026 Social Work Scotland published its report on The State and Future of Social Work and Social Care Funding in Scotland alongside two complementary research studies: one capturing the lived experience of people who draw on social work and social care support, and another exploring the experiences of social workers operating within the current system. These reports can be accessed here: The State and Future of Social Work and Social Care Funding in Scotland - Social Work Scotland The purpose of the main report and associated research studies is to demonstrate how funding decision, governance arrangements and policy choices shape both the experiences of people who use services and the expectations place on practitioners. By bringing lived experience, workforce realities, and financial analysis, together the paper aims to support informed and constructive discussion on how Scotland can develop a more sustainable, rights-based, and trusted system of care and support. 4.12 The Right to Advocacy - A Review of Advocacy Planning Across Scotland The Mental Welfare Commission has recently published a report reviewing how local authorities and health boards are meeting their legal obligations under the Mental Health (Care and Treatment) (Scotland) Act 2003 and the Mental Health (Scotland) Act 2015. These Acts place a duty on public bodies to ensure the Page 27 of 350
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6 availability of independent advocacy for individuals with mental illness, learning disabilities, dementia, and related conditions. Based on submissions in 2025 from all 31 Health and Social Care Partnership (HSCP) areas, the report highlights the following key findings: o 65% of HSCPs have a strategic advocacy plan in place, while others are currently in the process of developing one; o For children and young people, 97% reported having an Integrated Children’s Services Plan; however, only 23 of these specifically reference advocacy; o Funding levels continue to vary across regions, with 55% of partnerships indicating no change to advocacy budgets over the past two years; o Short-term funding remains a concern, as 51% of the 86 organisations surveyed still receive only one-year funding allocations, presenting ongoing challenges for long-term stability and service planning More information can be found within the newly published Right to Advocacy report 2026.pdf CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact Kerry Taylor kerry.taylor@lanarkshire.scot.nhs.uk Page 28 of 350
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REPORT Item No: 8 SUBJECT: Medium-Term Financial Plan 2026/27 – 2028/29 Incorporating the Long-Term Outlook 2029/30 -2036/37. TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 18 March 2026 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 The report advises the IJB of the medium-term financial forecast position for 2026- 2029 and the long-term financial outlook to 2036. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Acknowledge the statutory duty to set a balanced budget. (2) Acknowledge the cost pressures, income and resulting budget gap detailed in the medium-term financial plan for 2026-2029 as highlighted in section 8 and Appendix 4. (3) Approve the savings programme to meet the 2026/27 budget gap as outlined in Appendix 5. (4) Acknowledge the long-term financial outlook for 2026-2036. 4. VARIATIONS TO DIRECTIONS 5. STATUTORY DUTIES AND DRIVERS FOR MEDIUM-TERM FINANCIAL PLANNING 5.1 The North Lanarkshire Integration Joint Board was established as a corporate body by Scottish Government and became operational in June 2015 with integrated delivery of health and social care services commencing on 1 April 2016. It is a joint venture Yes No N/A Item 8 Page 29 of 350
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between NHS Lanarkshire (NHSL) and North Lanarkshire Council (NLC). The IJB has responsibility for the strategic planning and commissioning of a wide range of services within North Lanarkshire. 5.2 The Public Bodies (Joint Working) (Scotland) Act 2014 requires IJB’s to set a balanced budget as part of their strategic planning. This is essential for delivering integrated functions and budgets under IJB’s control, as outlined in the Act’s statutory guidance. 5.3 The Act mandates that each IJB develop a strategic commissioning plan that includes a budget for integrated functions, ensuring that the budget is balanced and aligned with its strategic goals. 5.4 As part of their 2024/25 Annual Audit Report, Audit Scotland recognised that “In recent years North Lanarkshire IJB has been successful in achieving short term financial balance. However, it still faces significant financial challenges and difficult decisions in ensuring resources are allocated to areas of strategic priority and user demand”. 5.5 Consequently, it was recommended that the IJB continue to develop and refine the arrangements it has in place for securing financial sustainability to include: its medium- and long-term financial plans, incorporating savings plans working effectively in partnership with the local council and the health board on service transformation applying its reserves strategy to effectively manage the use of reserves to supplement savings and efficiencies when required. 5.6 Taken together, these statutory requirements, audit findings, and the ongoing financial pressures facing health and social care services underline the necessity for the IJB to adopt a clear and robust Medium-Term Financial Plan (MTFP) for 2026/27 to 2028/29. Establishing this plan ensures that the IJB can take a proactive, strategic approach to financial sustainability aligning resources with its long-term priorities, supporting effective service transformation with partners, and managing reserves responsibly. 5.7 The MTFP therefore provides the essential framework for securing financial stability while continuing to meet the needs and expectations of the North Lanarkshire population. 6. STRATEGIC COMMISSIONING PLAN 2026 – 2029 6.1 As detailed in section 5, the Public Bodies Act requires each IJB to deliver a strategic commissioning plan (SCP). The current plan was launched in 2023 and covered the period 2023 to 2026. The plan set out how community health, social care and social work functions delegated to the IJB (by NLC and NHSL) will be planned and delivered over the medium term. 6.2 The draft SCP 2026–2029 will be presented to the IJB in March alongside this MTFP. The SCP has been shaped through recent engagement led by the Strategic Planning Group, it establishes a clear shift toward prevention, fairness and community-centred support. The SCP aligns with Scotland’s Population Health Framework and will integrate with forthcoming Local Outcome Improvement Plans. 6.3 Although further consultation is due to take place before final approval is sought in June, the emerging priorities include: 1. Prevention-Focused System 2. Tackling Inequality 3. Places and Communities Page 30 of 350
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4. Enabling Healthy Living 5. Equitable Access to Health & Care 6.4 These priorities are intended to guide investment decisions, resource allocation and transformation activity across the medium term to ensure plans align with the system wide shift toward prevention, equity and community led support. Further details are provided in Appendix 1. 7. FINANCIAL OUTLOOK 7.1 On 26 February the Accounts Commission issued the IJB Finance Bulletin 2024/25 with the key message being: “Despite a real terms increase in funding, Scotland’s Integration Joint Boards (IJBs) are in a critical financial position. With increasing cost pressures and the total level of reserves now lower than the budget gap forecast, IJBs need to take decisive action and make difficult decisions about services.”1 7.2 Audit Scotland recognise that despite a real terms increase in funding between 2023/24 and 2024/25 of 2.3%, the financial position of IJBs has become increasingly concerning. Financial pressures and demands on services continue to grow, outstripping increased funding and savings made, raising concerns around IJBs’ financial sustainability. The Key facts used in the preparation of this bulletin are included at Appendix 2. 7.3 Similarly, the Accounts Commission’s Local Government in Scotland Financial Bulletin 2025/26 (January 2026) warned that Scotland’s councils risk becoming financially unsustainable. Although the Local Government Finance Settlement published in January was widely viewed as better than expected, COSLA and others have stressed that it still falls short of addressing the serious financial pressures facing local authorities. 7.4 NHSL is also experiencing mounting financial challenges across the organisation, with growing demand, rising costs and increasing service pressures impacting its overall financial position. The Board is working intensively to deliver a balanced budget for 2026/27 and has set a 3% recurring savings target across all areas to help safeguard financial sustainability. 7.5 Taken together, these financial pressures across the IJB, the Council and NHSL make it clear that maintaining services in their current form will not be sustainable in the medium term. To continue meeting the needs of North Lanarkshire’s population within the resources available, the Partnership will need to accelerate service redesign, transformation and new models of delivery. This will require continuous prioritisation, redesigning pathways, and shifting capacity to areas of greatest impact, ensuring that limited resources are aligned to outcomes and that services remain safe, effective and financially sustainable. 8. MEDIUM-TERM FINANCIAL PLAN 2026/27 – 2027/28 8.1 The total budget for North Lanarkshire Health and Social Care Partnership (the Partnership) in 2025/26 is £867.391m which is split between: Health Services, Social Care Services, Set Aside budget and South HSCP Hosted Services and as shown in Chart 1. 1 Accounts Commission Integration Joint Bords Financial Bulleting 2024/25. Prepared by Audit Scotland February 2026 Page 31 of 350
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Chart 1 8.2 Taking this approved budget as the baseline, this MTFP updates the projected funding gap for the three-year planning period 2026/27 to 2028/29. 8.3 The financial planning assumptions in Appendix 3 have been updated since the Medium-Term Financial Outlook was presented in December 2025. These assumptions have informed revised envisaged, pessimistic and optimistic scenarios. Based on these assumptions, it is recommended that the IJB adopts the envisaged scenario as the basis for its financial strategy. The scenarios over the three-year planning period are shown in table 1. Table 1 8.4 When compared to the December outlook, the envisaged three-year budget gap has reduced from £80.905m to £67.464m. This reflects adverse movements in Social Care demand and Prescribing costs, offset by improved funding settlements from both partners. The most material change is the increased grant-aided expenditure received by NLC following the updated distribution methodology, resulting in an additional £13.502m being approved for transfer to the Partnership. 8.5 As shown in Table 1 the envisaged forecast budget gap over the three-year planning period is £67.464m with the 2026/27 forecast being £23.923m. The details of this are provided in Appendix 4. 9. SAVINGS PROGRAMME 2026/27 9.1 Work has been ongoing over recent months to develop a savings programme capable of addressing the forecast budget gap for 2026/27 and supporting the ongoing financial sustainability of the Partnership. The updated financial outlook has confirmed the scale of the savings required, necessitating a balanced approach that delivers immediate efficiencies while strengthening the longer-term financial position. Forecast Gap 2026/27 £000 2027/28 £000 2028/29 £000 Total £000 Optimistic £21,160 £18,243 £17,976 £57,380 Envisaged £23,923 £21,721 £21,820 £67,464 Pessimistic £24,825 £23,656 £24,033 £72,514 Page 32 of 350
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9.2 Of the total £23.923m savings requirement, 95% has been identified on a recurring basis, providing a more sustainable position for future years. Non-recurring savings of £1.196m have been identified within Health Services across a range of smaller non-pay budgets. The recurring savings have been grouped into three categories: Medicines, Modernisation and Efficiency, and Transformation, as outlined in Table 2. Table 2 9.3 The recurring savings options have been developed using a risk-based approach, with each proposal assessed against a red–amber–green matrix to consider operational and clinical risk. Only options rated as green or amber are being presented for approval. Each proposal carries associated risks and impacts, which are detailed in Appendix 5, along with proposed mitigations and next steps. The options also set out how they align with the new priorities outlined in the Strategic Commissioning Plan. 9.4 The savings programme is ambitious, and while every effort will be made to deliver the full savings in year one, any in‑year shortfalls will be managed through the prudent use of contingency and risk‑based reserves. 9.5 To oversee delivery of the savings programme, a Savings Board will be established. This group will meet monthly and will be chaired by the Chief Officer, with senior managers reporting on progress, actions taken, and any emerging risks to achieving the targets. Where it becomes evident that a saving will not be delivered, alternative solutions, either recurring or non-recurring, will be identified as appropriate. Progress will be reported to Board members through the quarterly financial monitoring reports presented to the Performance, Finance and Audit Committee. SOCIAL CARE HEALTH TOTAL £m £m £m Total Expenditure 38.714 33.627 72.341 Total Income (26.871) (21.547) (48.418) BUDGET GAP 11.843 12.081 23.923 SAVINGS PROGRAMME Non Recurring Solutions Non-Pay in year underspends - (1.196) (1.196) REVISED BUDGET GAP 11.843 10.884 22.727 Recurring Savings Options Medicines - Prescribing Review - (4.416) (4.416) Modernisation and Efficiency (0.943) (3.545) (4.488) Transformation (10.900) (2.923) (13.823) Total Savings Options (11.843) (10.884) (22.727) BALANCED BUDGET 0.000 0.000 0.000 2026/27 ENVISAGED BUDGET SCENARIO Page 33 of 350
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10. RESERVES STRATEGY 10.1 Adequate reserves are critical to sustaining the IJB’s financial stability and enabling delivery of strategic priorities in the face of future pressures. Holding reserves supports long-term planning and mitigates financial risk, in line with statutory obligations for prudent financial management. 10.2 As highlighted in section 9.4, given service redesign and savings plans require time to implement, contingency and risk-based reserves may be required to manage any short-term funding gaps while these changes are embedded. Using reserves in this way provides a controlled and time-limited mechanism to support delivery of planned savings and maintain financial stability during the transition period. The reserves position as at 31 January, which underpins this approach, is set out in Table 3 and shows forecast useable reserves of £35.655m Table 3 10.3 A separate paper is being presented to the March meeting seeking approval to use £0.667m per year for three years from the usable reserves to support preventative early-years work through the North Lanarkshire Community Planning Partnership. Further detail is set out in the Population Health Framework and Community Planning – Funding Proposal paper. 10.4 Proposals are also being developed to utilise risk and contingency reserves to secure dedicated project management support to accelerate the implementation of the service redesign and transformation required to deliver the approved savings programme. This support will help ensure that changes are implemented effectively, risks are managed, and benefits are realised at pace. Further details and costings will be brought forward for members’ consideration in due course. 10.5 A full review of reserves balances is currently underway to ensure that all earmarked reserves remain aligned to their original purpose, where reserves are no longer required, they will be closed and the balances transferred to risk and contingency reserves. Forecast at 31-Mar-26 £m Ring-Fenced Reserves 14.521 Earmarked Reserves 23.207 37.729 Risk-Based Reserves 21.536 Contingency Reserves 14.119 Useable Reserves 35.655 Total 73.383 SUMMARY Page 34 of 350
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11. LONG TERM FINANCIAL OUTLOOK 11.1 The MTFP assumptions have been extended for a further seven years to provide a Long-Term Financial Outlook (LTFO) through to 2035/36. As shown in Table 4, this analysis identifies cost pressures of £52.393m in 2029/30, reaching £69.026m over the full planning horizon. These projections reflect the scale of the financial challenges that may materialise as demographic trends, demand growth and cost inflation continue to place upward pressure on health and social care services. Table 4 11.2 Both the MTFP and LTFO are underpinned by a range of demand and cost-driven assumptions informed by local and national intelligence. However, forecasting over an extended period remains inherently uncertain, particularly given the potential for policy change, economic volatility and wider system pressures. Despite this uncertainty, it is essential that the IJB adopts a long-term perspective to ensure it can identify emerging risks early and take proactive steps to safeguard financial sustainability. 11.3 On this basis, the IJB must continue to plan for a range of potential outcomes, maintaining sufficient flexibility to respond as risks evolve. Beyond 2025/26, the scale of the projected pressures reinforces the need for ongoing savings, service redesign and transformation. Sustained change in how services are delivered will be critical to ensuring the Partnership can continue to provide modern, sustainable and high-quality services that meet the needs of service users and their families over the longer term. 12. IMPLICATIONS 121 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ Long term Forecast 2026/27 2027/28 2028/29 2029/30 2030/31 2031/32 2032/33 2033/34 2034/35 2035/36 Contractual Pressures 11.959 13.338 14.309 14.946 16.071 17.288 18.605 20.031 21.574 23.247 Pay Pressures 10.806 7.033 7.203 7.376 7.554 7.737 7.924 8.116 8.312 8.514 Social Care Demand 14.557 15.285 16.050 16.691 17.359 18.054 18.776 19.527 20.308 21.120 Purchase of Healthcare 1.478 1.507 1.538 1.582 1.619 1.656 1.694 1.733 1.773 1.813 Health Development Pressures 15.778 6.802 6.802 6.912 7.050 7.191 7.335 7.481 7.631 7.784 Prescribing 8.637 5.628 4.653 4.886 5.130 5.387 5.656 5.939 6.236 6.548 Others 9.127 - - - - - - - - - Total 72.341 49.593 50.555 52.393 54.783 57.312 59.990 62.827 65.834 69.026 Page 35 of 350
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12.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 12.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 12.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated where necessary. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Prescribing Activity and Costs Very High Claire Rae Pharmacy Pressures within Prison Service High Claire Rae Third and Voluntary Sector Low Claire Rae Ineffective Governance Arrangements Low Claire Rae 12.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes The Director of Finance of NHSL and the Chief Officer (Finance) of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings Page 36 of 350
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☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 12.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 13. BACKGROUND PAPERS Medium Term Financial Outlook 2026 - 2029: September Medium Term Financial Outlook 2026 - 2029: December 14. APPENDICES Appendix 1 Strategic Commission Plan 2026-2029 Emerging Priorities Appendix 2 Key Facts - Accounts Commission Integration Joint Boards Financial Bulleting 2024/25 Appendix 3 Assumptions applied in the MTFP Appendix 4 MTFP Envisaged Budget Scenario Appendix 5 Savings Programme Nicola Scott Chief Finance Officer Members seeking further information, please contact Nicola Scott on 07581 007187. Page 37 of 350
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Appendix 1 STRATEGIC COMMISSIONING PLAN 2026 – 2029 EMERGING PRIORITIES 1. Prevention-Focussed System A whole-system transition toward early intervention and proactive support to reduce high demand across acute, primary and social care. This includes expanding anticipatory care, embedding trauma-informed and strengths-based practice, and investing in community-based early-help pathways. 2. Tackling Inequality Targeting resources toward communities most affected by poverty and poor health. Key actions include support for financial inclusion, income maximisation, cost-of-living mitigation, and investment in local initiatives that strengthen fair work, stability and wellbeing. 3. Places and Communities Strengthening community assets and local infrastructure by: investing in community anchor organisations, developing place-based prevention models, enhancing community hubs, and supporting volunteering, community capacity and the Getting It Right For Everyone (GIRFE) approach. 4. Enabling Healthy Living Supporting healthier lives through local programmes focused on healthy weight, physical activity, nutrition and addiction recovery. Mental wellbeing is embedded as a core priority, supported by whole family and whole life course approaches. 5. Equitable Access to Health Care Ensuring fair, accessible and person-centred services by reducing inequalities in access, building flexible and responsive local models of care, and strengthening integration across health, social care and third sector partners. Page 38 of 350
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Appendix 2 KEY FACTS – ACCOUNTS COMMISSION JOINT BOARDS FINANCIAL BULLETIN 2 2 Accounts Commission Integration Joint Bords Financial Bulletin 2024/25. Prepared by Audit Scotland February 2026 Page 39 of 350
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Appendix 3 ASSUMPTIONS APPLIED IN THE MEDIUM-TERM FINANCIAL PLAN Contractual Pressures National Care Home Contract The National Care Home Rate will not be known until Spring. An annual 10% increase has been included. Contract Inflation for Care at Home Provision This represents the increases to the Scottish Living Wage to £1.45. However, the Scottish Government weightings are not yet known therefore an average of the 2025/26 weightings has been applied. Inflation Inflationary pressures are based on the OBR’s Economic and Fiscal Outlook as at November 2025. Pay Pressures Pay Award 2026/27 NHSL agreed at 3.75% fully funded by Scottish Government NLC agreed at 3.5% of which 0.5% funded by Scottish Government. 2027/28 and 2028/29 2% provision for NHSL and 3% for NLC as negotiations have not yet taken place. Demand Pressures Social Care Demand on social care services continues to increase which has been well reported through the 2022 census information. A provision of 5% has been included over the next 3 years. Purchase of Health Care & Development Pressures Service Level Agreements and Resource Transfer Inflation increases applied. Development Pressures National and Regional and Scottish Government Allocations These costs are fully funded developments from the Scottish Government and are based on the allocations released by them. Prescribing Price increase and demand 5% increase has been applied to the forecast costs as at September 2025. A further 5% has been applied to both 2027/28 and 2028/29. Page 40 of 350
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Appendix 4 MEDIUM-TERM FINANCIAL PLAN ENVISAGED BUDGET SCENARIO ENVISAGED BUDGET SCENARIO SOCIAL CARE HEALTH TOTAL SOCIAL CARE HEALTH TOTAL SOCIAL CARE HEALTH TOTAL £m £m £m £m £m £m £m £m £m EXPENDITURE Contractual Pressures 11.532 0.427 11.959 12.941 0.396 13.338 13.905 0.404 14.309 Pay Pressures 3.498 7.308 10.806 2.877 4.157 7.033 2.963 4.240 7.203 Social Care: Demand 14.557 - 14.557 15.285 - 15.285 16.050 - 16.050 Purchase of Healthcare - 1.478 1.478 - 1.507 1.507 - 1.538 1.538 Health: Development Pressures - 15.778 15.778 - 6.802 6.802 - 6.802 6.802 GP Prescribing - 8.637 8.637 - 5.628 5.628 - 4.653 4.653 Others 9.127 - 9.127 - - - - - - TOTAL EXPENDITURE 38.714 33.627 72.341 31.103 18.490 49.593 32.917 17.638 50.555 INCOME Scottish Government Settlements Real Living Wage & FPNC (11.460) - (11.460) (12.104) - (12.104) (12.785) - (12.785) NLC Pass through - Distribution Methodology adjustments (13.502) - (13.502) - - - - - - NLC Pass through - pay award and Children's SLW (0.746) - (0.746) - - - - General Health Allocation - (7.462) (7.462) - (7.612) (7.612) - (7.764) (7.764) SG Allocation - (6.776) (6.776) - (6.776) (6.776) - (6.776) (6.776) SG Allocation - Pay Award AFC - (6.438) (6.438) - - - - - - SG Allocation - Pay Award Other - (0.870) (0.870) - - - - - - - - Charges Uplifts (0.073) - (0.073) (0.077) - (0.077) (0.081) - (0.081) Resource Transfer (1.090) - (1.090) (1.303) - (1.303) (1.330) - (1.330) TOTAL INCOME (26.871) (21.547) (48.418) (13.484) (14.388) (27.872) (14.195) (14.540) (28.735) BUDGET GAP 11.843 12.081 23.923 17.619 4.102 21.721 18.722 3.097 21.820 2028/292026/27 2027/28 Page 41 of 350
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Appendix 5 SAVINGS PROGRAMME TOTAL RECURRING SAVINGS £22.727m No. TITLE LEAD RISK RATING AMOUNT (£M) Medicines £4.416m 1. Medicines – Prescribing Review Medical Director - HSCP Amber Modernisation and Efficiency £4.488m 2 Workforce Review – Health Clinical Services Head of Health Amber £3.056m 3 Workforce Review – Social Care Chief Officer (Adult Social Work Services) Amber £0.300m 4 Non-Pay Budgets Head of Health Amber £0.489m 5 Equipment & Contract Review Chief Officer (Adult Social Work Services) Green £0.643m Transformation £13.823m 6 Individual Budgets Chief Officer (Adult Social Work Services) Amber £3.000m 7 Home First Approach – Review of Independent Care Homes Amber £4.900m 8 Home Support Redesign Amber £3.000m 9 Locality Redesign Head of Health Amber £2.736m 10 Bladder and Bowel Service Review Amber £0.187m Page 42 of 350
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Appendix 5 Prescribing No. 1 Savings Option Prescribing Review Lead Medical Director - HSCP Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☐ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☒ Equitable Access to Healthcare ☐ Option Summary (scope) Continue to maximise cost reductions resulting from savings. This will be done through various workstreams including Polypharmacy Reviews, Scriptswitch, Medicines of Low Clinical Value, Practice Switches, Care Home Team reviews non medicines reviews, special clawback, Renal Switch and any other opportunistic reviews that develop Forecast Savings 2026/27 £4.416m 2025/26 Budget £81.464m Risks & Impact PQES not backfilled for long term absences and secondments, and staff can be redeployed to other workstreams at short notice. This impacts resources to deliver the service and the savings proposed. It also impacts on development and sustainability of workforce/service. Currently diverting pharmacy resource from PQES to co-codamol management to avoid patients going into withdrawal this may impact on the efficiency schemes which have been progressing well Mitigations Ongoing monitoring of PQES workforce issues at the weekly Primary Care Sustainability meeting. Review of S&V progress and any risks at the Medicines S & V meeting that occurs every 6 weeks. Further Consultation / Reporting or Delegation to Officers Ongoing discussions with General Practice and Pharmacy teams re progress and further proposals development Continue to implement nationally driven directives for medicine switches Page 43 of 350
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Appendix 5 Modernisation and Efficiency No. 2 Savings Option Workforce Review – Health Clinical Services Lead Head of Health Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☒ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☐ Equitable Access to Healthcare ☒ Option Summary (scope) Review and redesign infrastructure across Clinical Services to streamline portfolios and reduce posts as they become vacant. Of the £3.056m forecast, £0.590m has already been achieved. Forecast Savings 2026/27 £3.056m 2025/26 Budget £42.177m Risks & Impact Reducing direct delivery staffing levels could impact on ability to meet demand, professional governance and standards Redeployment of staff There is a potential impact on overall performance Reputational risk Mitigations Low risk vacancies currently held to mitigate reduction in staffing Review of skill mix Phased implementation Further Consultation / Reporting or Delegation to Officers Work with NHSL HR services – consideration of redeployment policies Consultation with staff and trade unions Officers to deliver as operational measure following consultation with staff and trade unions Page 44 of 350
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Appendix 5 Modernisation and Efficiency No. 3 Savings Option Workforce Review – Social Care Lead Chief Officer (Adult Social Work Services) Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☒ Tackling Inequality ☐ Place & Communities ☒ Enabling Healthy Living ☐ Equitable Access to Healthcare ☐ Option Summary (scope) Review and redesign infrastructure across Social Care to streamline portfolios and crate more efficient practice to support operations there will be less demand in some areas and opportunity to skill mix. As this develops vacant posts will be reviewed. Forecast Savings 2026/27 £0.300m 2025/26 Budget £6.140m Risks & Impact Reducing staffing levels could impact on ability to meet demand, professional governance and standards Restructuring area wide will reduce the support to locality teams. Mitigations Review of skill mix Phased implementation Further Consultation / Reporting or Delegation to Officers Work with NLC HR services – consideration of redeployment policies Consultation with staff and trade unions Officers to deliver as operational measure following consultation with staff and trade unions Page 45 of 350
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Appendix 5 Modernisation and Efficiency No. 4 Savings Option Health Non-Pay Budgets Lead Head of Health Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☒ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☐ Equitable Access to Healthcare ☐ Option Summary (scope) Removal of non-pay budgets previously used for non-recurring project costs that are no concluded. Forecast Savings 2026/27 £0.489m 2025/26 Budget £3.226m Risks & Impact Reduces flexibility for unforeseen short term expense response support Mitigations Any arising new costs will be risk managed via the aligned leading sector and/or unit Further Consultation / Reporting or Delegation to Officers N/A Page 46 of 350
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Appendix 5 Modernisation and Efficiency No. 5 Savings Option Area Wide Equipment & Contract Review Lead Chief Officer (Adult Social Work Services) Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☒ Tackling Inequality ☐ Place & Communities ☒ Enabling Healthy Living ☐ Equitable Access to Healthcare ☐ Option Summary (scope) Review the infrastructure across area wide social work services by considering; utilising the recurring underspend within the EAS service; utilise saving from recent end to contractual arrangements for community-based day support services and explore commissioning arrangements for Carers and Advocacy contracts within already set exit points. Forecast Savings 2026/27 £0.643m 2026/27 Budget £8.241m Risks & Impact Reducing community-based services will place more pressure on statutory services. Due to contractual requirements the saving from Carers and Advocacy won’t be achieved until 2028/29. Reducing support for Carers and Advocacy will add more pressure to locality teams Reduction in capacity to provide support with equipment could result in people needing a greater level of direct support Challenges with applying the principles of Getting it Right for Everyone and a place-based approach Mitigations Community based day support services have already been given contract end notices. Legal exit points already built into Carers and Advocacy contracts within the 3-year period Recurring underspend on equipment and adaptations Further Consultation / Reporting or Consultation with stakeholders, carers and communities re review/realignment/reduction in capacity of commissioned services Consultation with teams re area wide service review / re-prioritisation/ focus and function Page 47 of 350
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Appendix 5 Transformation No. 6 Savings Option Individual Budgets Lead Chief Officer (Adult Social Work Services) Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☐ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☐ Equitable Access to Healthcare ☒ Option Summary (scope) It is proposed that the work to review Individual Budgets will continue. The work that has been undertaken has demonstrated that by adopting a strengths-based approach and working with families and communities’ people can be supported at home through a broad range of community resources. There will be an emphasis on early intervention and promoting independence for as long as possible utilising resources to compliment individual, paid support. This proposal will Review of Individual Budget Care Packages across Social Care. The saving will be apportioned across each locality. Forecast Savings 2026/27 £3.000m 2025/26 Budget £114.016m Risks & Impact Indicative budgets often come in lower than the final assessed budget Pressure across in-house provision and delays also impacts on individual package costs as independent providers are asked to pick up packages of support without full assessments being completed. This can result in increased cost. Care package costs vary significantly Providers report to struggling financially due to current agreed price points and increased central costs. Reduction to care plans required to meet the savings is 81 packages using an average cost forecast Mitigations Improving first point of contact experience as well as assessment and planning being supported by a Home First approach through an enabling approach will ensure that individuals receive the right support Investment in early intervention and prevention Shifting from traditional service led provision to utilising a wide range of community resources to compliment paid support Full roll out of the Adult Guided Self Assessment (GSA) should mitigate the risk of Indicative budgets often come in lower than the final assessed budget Further Consultation / Reporting or Delegation to Officers Consultation with service users, carers and families Consultation with staff and trade unions Officers to deliver as operational measure following consultations Page 48 of 350
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Appendix 5 Transformation No. 7 Savings Option Home First Approach – Review of Independent Care Homes Lead Chief Officer (Adult Social Work Services) Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☐ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☐ Equitable Access to Healthcare ☒ Option Summary (scope) Fully implement a Home First approach supporting people at home for as long as possible, thus reducing the length of stay per resident. Development of community services to provide a range of support to ensure inclusiveness, reduce isolation as well as being able to access specialist support for those who are frail and/ or living with a long term condition to age well. Forecast Savings 2026/27 £4.900m 2025/26 Budget £48.939m Risks & Impact Costs of care home placements vary and without robust assessments, providers can seek to increase charges to support additional needs identified by them. Care Homes report to struggling financially due to current agreed price points. Reduction to care plans required to meet the savings is approx. 138 care plans using an average cost forecast however this could also be delivered through the reduction in the length of stay. Mitigations Robust assessments will be undertaken to identify care needs prior to admission to avoid additional costs determined by the provider Robust financial assessments will be completed within an agreed period to establish available capital from individuals Reviews will be completed and invoices cease when the placement ends to avoid overpaying and the challenge of recouping costs Solutions should improve outcomes allowing individuals to remain safely in their homes or a homely setting for longer Further Consultation / Reporting or Delegation to Officers Further details on proposal to be presented to Board including details of transformation timeline with project support Consultation with staff, trade unions and independent sector Page 49 of 350
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Appendix 5 Transformation No. 8 Savings Option Home Support Redesign Lead Chief Officer (Adult Social Work Services) Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☐ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☐ Equitable Access to Healthcare ☒ Option Summary (scope) Finalise the Home Support operating model focussing on Home Assessment with a reablement ethos to ensure those requiring ongoing paid support have the right support. In addition, develop and embed work practices that deliver more efficient practices and utilise resource more effectively. This will remove duplication and align staff teams and budgets appropriately. Forecast Savings 2026/27 £3.000m 2025/26 Budget £59.131m Risks & Impact Reducing direct delivery staffing levels could impact on ability to meet demand, professional governance and standards. There may be an impact on flow across the system Mitigations Review underspends on basic pay against overspends on overtime and consider realignment of budgets Maintain a robust review of absence management Consider support for Carers to enable them to continue in their carting role and reduce the need for statutory intervention. Service improvement and developments such as dynamic scheduling tool, assistive technology, proportionate care will reduce duplication Finalise the review on shift patterns Further Consultation / Reporting or Delegation to Officers Work with NLC HR services – consideration of redeployment policies Consultation with staff and trade unions Page 50 of 350
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Appendix 5 Transformation No. 9 Savings Option Locality Redesign Lead Head of Health Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☒ Tackling Inequality ☐ Place & Communities ☒ Enabling Healthy Living ☐ Equitable Access to Healthcare ☒ Option Summary (scope) Transformation and redesign of community-based health services will be progressed through HSCP led change activity, aligned to NHS Lanarkshire system wide improvement priorities. Proposals will be developed through partnership working with South Lanarkshire University Health and Social Care Partnership, with opportunities for cross Lanarkshire alignment and joint working explored where appropriate to support consistency, sustainability and equitable access. As part of this programme, redesign of locality services, including Treatment Rooms, Health Visiting, Community Nursing, Mental Health and Integrated Day Services, will be progressed collaboratively to deliver sustainable, preventative and needs led provision within available resources. Forecast Savings 2026/27 £2.736m 2025/26 Budget £44.910m Risks & Impact Service review and redesign will be considerate of staffing review of skill mix to meet current demands. Current staff alignment has been difficult to maintain across all areas due to recruitment challenges within some care pathways. The impact of review is hopeful that the Partnership ca attract and recruit candidates capable of filling gaps and additionally creating a positive development pipeline for people to pursue professionally registered roles in future. Mitigations Some vacancies current held to mitigate reduction in staffing. These vacancies have been historically difficult to fill from traditional workforce Review of skill mix that ensure continuity and quality assurance of service delivery within localities. Redesign will be considerate of staff attrition norms. Balancing of staff across all localities will be considerate and committed to delivery of same through agreed organisational process. Further Consultation / Reporting or Delegation to Officers This work will be delivered collaboratively with HR, Staff Side and Professional colleagues to ensure appropriate workforce governance and professional assurance are not breached. Transparent communication will be developed to assure ongoing commitment to continuance of service delivery with minimal impact to our valued staff group who deliver these services. The Integrated HSW managers for localities (who manage both budgets) will be mindful of balance between proposed changes in social care and the delicate balance to be struck in timing of redesign implementation across health and social care simultaneously. Page 51 of 350
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Appendix 5 Transformation No. 10 Savings Option Bladder and Bowel Service Review Lead Head of Health Link to Strategic Priority: 2026- 2029 Prevention Focussed System ☐ Tackling Inequality ☐ Place & Communities ☐ Enabling Healthy Living ☒ Equitable Access to Healthcare ☒ Option Summary (scope) Commission a review of the bladder and bowel service. Which will include a review and skill mix of the current staffing model. Also look to move to quarterly delivery of products to care homes as well as a review of products currently supplied to patients across Lanarkshire. Forecast Savings 2026/27 £0.187m 2025/26 Budget £2.550m Risks & Impact SLHSCP may not engage with process Over supply of patients Storage concerns within care home and patient’s homes Impact of increasing product costs Impact More control of product and provision. SL HSCP and NL may require to split costs to deliver savings Mitigations Strengthen partnership working across Lanarkshire between NL and SL HSCP’s Review of skill mix Phased implementation Further Consultation / Reporting or Delegation to Officers Work with NLSL HR services – consideration of redeployment policies Consultation with staff and trade unions Page 52 of 350
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REPORT Item No: 9 SUBJECT: 2026-27 Delegated Health and Social Care Budget TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 18 March 2026 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report describes the financial allocation and budgets made available to the Integration Joint Board (IJB) for 2026/27 by North Lanarkshire Council and NHS Lanarkshire. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Agree to accept the delegated social care budget for 2026/27 in section 8.4 subject to any final adjustments in relation to recurring budget adjustments in March 2026 (2) Agree to accept the delegated health budget for 2026/27 in section 9.4 subject to any final adjustments in relation to recurring budget adjustments in March 2026 and any further funding allocated by the Scottish Government (3) Approve a drawdown of reserves, if required, in order to fund any shortfall in funding for 2026/27. (4) Acknowledge that both NHSL and NLC have passed through full budget uplifts as received from Scottish Government. 4. VARIATIONS TO DIRECTIONS Yes No N/A Item 9 Page 53 of 350
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5. FUNDING FRAMEWORK AND GOVERNANCE RESPONSIBILITIES 5.1 North Lanarkshire IJB operates as an independent legal body and is responsible for the proper management of public resources. This includes ensuring that all activity is carried out in line with recognised public-sector governance standards, with public funds safeguarded, accurately reported, and used in a way that is economic, efficient, and effective. 5.2 The budget provided by the two partner organisations is delegated to the IJB, which in turn uses these resources to commission services delivered by the North Lanarkshire Health and Social Care Partnership. While the Integration Scheme outlines the principles governing how funding is allocated by each partner, the authority to determine how the funding is applied rests with the IJB. 5.3 In accordance with the Integration Scheme, partner bodies are expected to make suitable provision within their own budget-setting processes for pay awards, contractual inflation, demographic pressures, and efficiency requirements. 5.4 The Chief Finance Officer (CFO) of the IJB is required to uphold professional financial standards and comply with the Local Government (Scotland) Act 1973, which includes the statutory obligation to ensure that a balanced budget is set. 6. MEDIUM TERM FINANCIAL CONTEXT 6.1 This report outlines the implications of the Scottish Government’s 2026/27 budget and summarises the IJB’s funding position for the coming financial year. 6.2 Across the medium term, a high degree of uncertainty persists, requiring the Partnership to continue planning for a broad range of financial scenarios. In recent years, the Partnership has adopted a medium-term approach to financial management, progressing transformation and service redesign that has supported the achievement of a balanced budget annually. Ongoing rises in costs and demand, however, continue to create pressures, necessitating continued review, refinement, and alignment of future transformation activity and savings plans. 6.3 Within this context, it is increasingly likely that the Partnership will require to utilise the financial flexibilities available to the IJB, with non-recurring measures expected to support the balancing of the annual revenue position over the medium term. 7. SCOTTISH GOVERNMENT BUDGET 2026/27 7.1 On 13 January 2026, the Scottish Government published its draft Budget for 2026/27, setting out its fiscal priorities for the year ahead. The Budget places a strong emphasis on supporting public services, with £22.5 billion allocated to health and social care, including £17.6 billion for NHS Boards and further investment to expand access to primary and community-based services. This package is presented as part of a wider commitment to strengthen the NHS, improve access to care, and provide stability across the health and social care system. 7.2 Despite this enhanced investment, the Scottish Government acknowledges that Scotland’s public services continue to operate within a highly challenging financial environment. Cost pressures, demographic change, and increasing demand persist across the system, with the Budget signalling the need for continued reform, innovation and efficiency to ensure sustainability in future years. As a result, Integration Authorities and Partnerships will require to retain sufficient flexibility in their financial planning, with a continuing need to manage medium-term uncertainty and prepare for further recurring savings as the fiscal position develops. Page 54 of 350
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8. DELEGATED SOCIAL CARE BUDGET 2026/27 8.1 Similar to 2025/26 and as previously highlighted, demographic, and socio-economic factors continue to drive significant demand and cost pressures for 2026/27 relating to: Funding for pay awards. Cost pressures arising from contractual arrangements. Financial impact of the negotiated application of the increased living wage across the sector. Estimated increases associated with the National Care Home Rate (NCHR) contract. Ongoing pressures on home support service in relation to costs associated with shifting the balance of care, supporting people to live safely at home for as long as possible and facilitating prompt discharge from hospital. Increasing investment in self-directed support packages required to support adults and carers to achieve improved outcomes and live independently. 8.2 Using a range of informed assumptions, the CFO has estimated that the demand and cost growth for social care services in 2026/27 linked to the areas highlighted above, is likely to be in the region of a gross increase of circa £38m, including the increase to the living wage. 8.3 At its meeting on 26 February 2026, North Lanarkshire Council approved a recurring net uplift to the social care budget of £25.708m, incorporating: £11.460m for the Scottish Living Wage of £11.460m £0.249m for the Children’s Social Care Pay Uplift £0.497m for the 2026/27 pay award passed through from Scottish Government £13.502m pass through from the Scottish Government as a result of the changes to the General Revenue Funding (GRF) distribution methodology 8.4 The following table provides a summary of the indicative social care budget 2026/27 from North Lanarkshire Council: Social Care Budget 2026/27 £m Opening Budget 219.931 Uplift Scottish Living Wage 11.460 Children's Social Care Pay Uplift 0.249 2026/27 Pay Award 0.497 GRF Increase 13.502 2026/27 Budget 245.639 8.5 The CFO recommendation to the IJB is, to note and accept the delegated social care budget offer from North Lanarkshire Council for 2026/27 subject to any final adjustments in relation to recurring budget adjustments in March 2026. 9. DELEGATED HEALTH BUDGET 2026/27 9.1 Similar to social care, demographic and socio-economic factors continue to drive significant demand and cost pressures for our delegated health services in 2026/27 including: Pay inflation and the impact of agenda for change. Inflationary cost pressures across service level agreements on non-pay budgets. Prescribing cost, volume, and short supply impact. Page 55 of 350
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9.2 Using a range of informed assumptions, the CFO has estimated that the demand and cost growth for health services (not including Set Aside) in 2026/27 linked to the areas highlighted above, is likely to be in the region of a gross increase of circa £34m. 9.3 The NHSL Board has approved a general allocation of £7.462 as well as a further £14.084m for pay awards and Scottish government development funding giving a total contribution of £21.547m. 9.4 The following table provides a summary of the indicative health budget 2026/27 from NHS Lanarkshire: Health Budget 2026/27 £m Opening Budget 384.141 Set Aside Budget 77.397 General Allocation 7.462 Pay Awards – AFC & Other 7.308 SG Allocations - Developments 6.776 2026/27 Budget 483.084 9.5 The CFO recommendation to the IJB is, to note and accept the delegated health budget offer from NHS Lanarkshire for 2026/27 subject to any final adjustments in relation to recurring budget adjustments in March 2026, and any further funding allocated by Scottish Government during 2026/27. 10. FINANCIAL PLAN 2026/27 10.1 A three-year Medium Term Financial Plan (MTFP) has been developed using the 2025/26 budget as the baseline, incorporating updated financial planning assumptions that are expected to have the most significant impact on the Partnership’s medium-term financial position. A series of risk-based scenarios were assessed, producing envisaged, pessimistic, and optimistic projections, with the envisaged scenario deemed the most appropriate basis for planning. 10.2 Within this medium-term outlook, the Partnership faces an estimated recurring funding pressure of £23.923m in 2026/27. To address this, a range of service redesign and transformation proposals have been brought forward for consideration and approval by the IJB as part of the MTFP. 10.3 A Long Term Financial Outlook (LTFO) has also been developed for the period 2026– 2036, setting out projected cost pressures estimated to range between £52.393m and £69.026m. The LTFO reflects the broader economic environment and adopts a strategic, sustainable approach that is closely aligned to the priorities set out in the Strategic Commissioning Plan. These priorities will continue to inform future budget decisions, ensuring that the delivery of core services is balanced against the resources available. 10.4 The associated financial plans and reserves strategy maintain a focus on long-term financial sustainability, recognising the uncertainty inherent in key planning assumptions and the importance of redirecting resources to support the delivery of strategic priorities. 10.5 The savings programme is ambitious, and while every effort will be made to deliver the full savings in year one, any in‑year shortfalls will be managed through the prudent use of contingency and risk‑based reserves. Using reserves in this way provides a controlled and time-limited mechanism to support delivery of planned savings and maintain financial stability during the transition period. Page 56 of 350
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11. IMPLICATIONS 11.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 11.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 11.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 11.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Prescribing Activity and Costs Very High Claire Rae Pharmacy Pressures within Prison Service High Claire Rae Third and Voluntary Sector Low Claire Rae Ineffective Governance Arrangements Low Claire Rae 11.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Page 57 of 350
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Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes The Director of Finance of NHSL and the Chief Officer (Finance) of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 11.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 12. BACKGROUND PAPERS Medium Term Financial Plan 2026-2029 and Long Term Financial Outlook Nicola Scott Chief Finance Officer Members seeking further information, please contact Nicola on 07581 007187. Page 58 of 350
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REPORT Item No: 10 SUBJECT: Reserves Policy TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 18 March 2026 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report requests that the Reserves Policy for 2026/27 are approved 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Agree to approve the Reserves Policy for the forthcoming financial year, 2026/27. (2) Note only minimal changes have been made to the regulations. 4. VARIATIONS TO DIRECTIONS 5. Review and Amendments 5.1 A review of the Reserves Policy has been completed with no fundamental changes identified. 5.2 The Policy is included at Appendix 1 with the minimal changes highlighted in red font. Yes No N/A Item 10 Page 59 of 350
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6. IMPLICATIONS 6.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 6.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 6.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 6.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Ineffective Governance Arrangements Low Claire Rae 6.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Page 60 of 350
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Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes This report includes all engagement and participation objectives as effective financial governance, including effective use of reserves, ensures the IJB can fulfil its statutory duties. ☒ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 6.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 7. BACKGROUND PAPERS N/A 8. APPENDICES Appendix 1 Reserves Policy Nicola Scott Chief Finance Officer Members seeking further information, please contact Nicola on 07581 007187. Page 61 of 350
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Appendix 1 RESERVES POLICY Author Nicola Scott, Chief Finance Officer Endorsing Body Integrated Joint Board Governance or Assurance Committee Performance, Finance & Audit Committee Approval Date 18 March 2026 Implementation Date 1 April 2026 Version Number 3 Review Date March 2027 Responsible Person Claire Rae, Chief Officer Page 62 of 350
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P a g e 1 CONTENTS 1. INTRODUCTION 2 2. STATUTORY & REGULATORY FRAMEWORK FOR RESERVES 3 3. OPERATION OF IJB RESERVES 4 4. ROLE OF THE IJB CHIEF FINANCIAL OFFICER 7 5. ADEQUACY OF RESERVES 8 6. REPORTING FRAMEWORK 9 7. ACCOUNTING AND DISCLOSURE 10 8. RESERVES PROTOCOL 11 Page 63 of 350
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P a g e 2 1. INTRODUCTION 1.1 As the North Lanarkshire Integration Joint Board (IJB) has the same legal status as a local authority, i.e. a section 106 body under the Local Government (Scotland) Act 1973 Act, and is classified as a local government body for accounts purposes by the Office of National Statistics (ONS), it is able to hold a General Fund and this General Fund will be accounted for in the financial accounts and records of the IJB. Social Care Services. 1.2 To assist local authorities (and similar bodies) in developing a framework for reserves, the Chartered Institute of Public Finance and Accountancy have issued guidance in the form of the Local Authority Accounting Panel (LAAP) Bulletin 99 – Guidance Note on Local Authority Reserves and Balances (July 2014). This guidance outlines the framework for reserves, the purpose of reserves and some key issues to be considered when determining the appropriate level of reserves. 1.3 The purpose of a reserve policy and reserves strategy is to: • outline the legislative and regulatory framework underpinning the creation, use or assessment of the adequacy of reserves • identify the principles to be employed by the IJB in assessing the adequacy of the IJB’s reserves • indicate how frequently the adequacy of the IJB’s balances and reserves will be reviewed • set out arrangements relating to the creation, amendment and use of reserves and balances. Page 64 of 350
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P a g e 3 2. STATUTORY & REGULATORY FRAMEWORK FOR RESERVES 2.1 Local Government bodies, which includes the IJB for these purposes, may only hold reserves for which there is a statutory or regulatory power to do so. In Scotland, the legislative framework includes: Reserve Powers General Fund Local Government Scotland Act 1973 2.2 For each reserve there should be a clear protocol setting out: • the reason / purpose of the reserve • how and when the reserve can be used • procedures for the reserves management and control • the review timescale to ensure continuing relevance and adequacy 2.3 Both usable and unusable reserves should be accounted for in the financial accounts and records of the IJB. • Usable reserves include cash balances that can be utilised by the IJB as part of its financial strategy to ensure effective management of the IJB’s operations. Usable reserves will take the form of a General Fund. • Unusable reserves are kept in order to manage the accounting processes for noncurrent assets, financial instruments and retirement benefits. 2.4 The Local Authority Accounting Code of Practice introduced a number of unusable or technical reserves in line with proper accounting practice associated with capital and retirement benefits such as pensions. 2.5 These unusable or technical reserves are governed by specific accounting treatments and do not form part of the general available usable cash reserves. The IJB is not empowered to hold capital assets or to employ staff therefore unusable or technical reserves will not be required in the short term. 2.6 The reserves protocol to be applied is outlined at section 8 of this policy. In respect of the IJB context, all receipts and payments will be administered through the financial ledgers of the respective partners as appropriate. 2.7 The adequacy and relevance of each fund is reviewed by the Chief Financial Officer at the end of each financial year and through the budget process. All recommendations for movements in balances will be reported to the IJB either through the year-end report or as part of the strategic commissioning plan and budget strategy. Page 65 of 350
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P a g e 4 3. OPERATION OF IJB RESERVES 3.1 In Scotland, under Local Government rules, the IJB cannot have separate reserves within the balance sheet however it can highlight elements of the General Fund balance for specific purposes. IJB Reserves will be held for four specific purposes as follows: • Ring-fenced reserves Section 3.2 • Ear-marked reserves Sections 3.3 • Risk-based reserves Section 3.4 • Contingency reserves Section 3.5 3.2 Ring Fenced Reserves 3.2.1 A ring-fenced reserve will be established when funding has been received for a specific purpose. 3.2.2 If the funding has been received during the year but has not been spent by the year end, the funding may be accounted for by the partner as a pre-payment in line with agreed accounting standards. 3.2.3 If the funding cannot be accounted for as a pre-payment, the IJB will be asked to establish a ring-fenced reserve to ensure the funding received remains available for the specific purpose intended and to minimise the risk that the partner would be asked to repay funding which has not been spent in line with the conditions of receipt of the funding. 3.3 Ear Marked Reserves 3.3.1 An earmarked reserve will be created when the IJB allocates funding to a partner to commission services in line with agreed directions, but the service has not been delivered by a specific time e.g year-end and the Chief Officer has already made a commitment that cannot be accrued because the goods or services have not yet been received. 3.3.2 If the partner has a commitment to spend the funding after the year-end as originally directed by the IJB, the funding may be accounted for by the partner as a pre-payment in line with agreed accounting standards. 3.3.3 If the funding cannot be accounted for as a pre-payment, the IJB will be asked to establish an earmarked reserve to ensure the funding remains available for the original commissioning intention. 3.3.4 The establishment of an earmarked reserve in these circumstances will rely on clarification from the partner that the cost incurred post year-end cannot be accommodated within the core funding allocation from the IJB for the new financial year or there will be necessary service additionality which is required to contribute to the attainment of performance targets and commissioning priorities. 3.3.5 An ear-marked reserve will be established when the IJB has approved a decision to fund a specific cost commitment on a non-recurring basis for a fixed period of time. In Page 66 of 350
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P a g e 5 general, the establishment of an ear-marked reserve in these circumstances will be dependent on: • a transfer from the IJB contingency fund • the receipt of an additional funding contribution from the partner(s) and /or • the revision to a previously issued direction, subject to consultation with the relevant partner, in order to release and redirect funding. 3.3.6 All ear-marked reserves will require to be supported by spending plans provided by the partner and approved by the IJB Chief Financial Officer. 3.3.7 It is recognised that it may be necessary to establish an ear-marked reserve to fund recurring unavoidable costs for a fixed term period to allow sufficient time for savings proposals to be identified, agreed with the partner(s) and implemented or for the partner(s) to confirm the feasibility of making an additional recurring funding contribution to the IJB. 3.4 Risk Based Reserves 3.4.1 A risk-based reserve will be established to provide a contingency to address a specific financial risk. Following consultation with each partner, the IJB Chief Financial Officer will recommend to the IJB the need to establish such a reserve and the amount the reserve should be set at. 3.4.2 The amount of such a reserve will be dependent on the professional judgement of the relevant officers and also the constraints of the overall financial envelope within which both the partners and the IJB are operating. 3.4.3 If it is agreed that the risk-based reserve is not sufficient to fully mitigate the financial implications if the risk materialises, the options to increase the reserve will be set out by the IJB Chief Financial Officer as part of the strategic financial planning process. 3.4.4 If possible, the timing of when the risk-based reserve will be drawn down should be specified. 3.4.5 It may not be possible to specify the timing of when the risk-based reserve will be drawn down, if at all. It is believed however that the financial risk is sufficiently high to warrant the establishment of the specific risk-based reserve. The risk-based reserve will be reviewed at least annually and in line with the risk management approach implemented by the IJB and the partners. 3.5 Contingency Reserves 3.5.1 A contingency reserve will be established by the IJB to cushion the impact of unexpected events or emergencies. The contingency reserve would also provide a working cash balance to help cushion the impact of uneven cash flows. 3.5.2 It is noted that the amount of the contingency reserve will be constrained by the financial envelope available to the IJB from the partners and the commissioning intentions agreed with the partners in the IJB Strategic Plan to meet need. Page 67 of 350
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P a g e 6 3.5.3 The risks associated with a low contingency reserve are partly offset by the process for managing any in-year financial variations as detailed in section 9 of the Integration Scheme and also within the IJB Financial Regulations. This process has been agreed with both partners and includes agreeing a budget recovery plan to address an overspend. 3.5.4 Following consultation with the partner(s) as appropriate, the corrective action set out in the budget recovery plan may include revisions to the original commissioning of services to account for the changed circumstances. The budget recovery plan may also consider the use of any available reserves. 3.5.5 If the budget recovery plan is unsuccessful, the relevant partner has the option to provide additional resources to the IJB on a one-off or recurring basis. These additional resources can be recovered in future years from subsequent underspends in that partner’s contribution if they arise. 3.5.6 The feasible options available for consideration to address an overspend would be the subject of agreement between the IJB and the partner(s) as appropriate. 3.5.7 Although the arrangements set out in section 9 of the Integration Scheme are available to support the partners and the IJB in the event of an overspend, the IJB Chief Financial Officer will review the level of the IJB contingency reserve and assess whether it is sufficient to allow the IJB to manage unforeseen events without placing reliance on further financial support from the partner(s). 3.5.8 In consultation with both partners, this assessment will take into consideration the availability of risk-based reserves, in particular the amount of each risk-based reserve and the likelihood of the risk-based reserve being drawn down. The assessment will also consider the potential for a projected underspend by the year-end which, following consultation with the partner(s) as appropriate, could be retained by the IJB. 3.5.9 In the event that the IJB Chief Financial Officer concludes that the contingency reserve is not sufficient to manage unforeseen events without placing reliance on further financial support from the partner(s) as set out in the Integration Scheme, the options to increase the contingency reserve will be identified. The approach to implementing the preferred option(s) to increase the contingency reserve will be agreed with the partner(s), subject to the approval of the IJB. The plan to increase the contingency reserve will require to be prioritised alongside the immediate demands for services to meet current needs and achieve performance targets. 3.5.10 The options to increase the contingency reserve include the following: • The transfer of a planned underspend • The transfer of an unplanned underspend • The early implementation of agreed savings which could generate a nonrecurring beneficial financial impact • An additional contribution from the partner(s). Page 68 of 350
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P a g e 7 3.5.11 In the event that excessive funds are held as a contingency reserve in excess of the optimum level as advised by the IJB Chief Financial Officer in consultation with the partners, plans to commit the amount of the excess funding will be presented to the IJB for consideration and approval. 3.6 Reserve balances may be established or increased by transfers to reserves approved by the IJB throughout the year. Transfers made by these means will typically be for committed expenditure in future years. Transfers can also be made for uncommitted expenditure through the year-end process and following the approval of the IJB in order to increase the contingency reserve. 3.7 It is the responsibility of the relevant partner to identify and notify the IJB of any unbudgeted surplus that will require to be committed for future years. This will be through a report to the IJB stating the circumstances leading to the unbudgeted surplus, setting out the requirements for the unbudgeted surplus to be made available again in future years in line with the Strategic Plan, providing a timescale for the use of the funds and the consequence of not earmarking the funds. If approved by the IJB, the monies will be committed within the General Fund as part of the year end process. 3.8 If the IJB intended to reject a proposed transfer to reserves, the relevant party may request that they retain the surplus. In this event, an agreement would need to be reached between the IJB and the partner(s). The preferred approach however is for the IJB to retain surpluses in order to continue to maintain transparency and also the effective audit trail in respect of the financial envelope available for commissioning intentions as agreed through the directions. 4. ROLE OF THE IJB CHIEF FINANCIAL OFFICER 4.1 The IJB Chief Financial Officer is responsible for advising on the optimum levels of reserves for the IJB. The IJB, based on this advice, should then approve the appropriate reserve strategy as part of the budget process. Page 69 of 350
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P a g e 8 5. ADEQUACY OF RESERVES 5.1 There is no guidance on the minimum level of reserves that should be held. In determining the reserve levels, the IJB Chief Financial Officer must take account of the strategic, operational and financial risks facing the IJB over the medium term and the IJB’s overall approach to risk management. 5.2 In determining the level of general reserves, the Chief Financial Officer should consider the IJB’s Strategic Plan, the medium term financial outlook and the overall financial environment. Guidance also recommends that the Chief Financial Officer reviews any earmarked reserves as part of the annual budget process and the development of the Strategic Plan. 5.3 The level of earmarked reserves will be established by the IJB as part of the annual budget process. The level of the contingency reserve will be confirmed by the IJB Chief Financial Officer as part of the year-end accounting processes and will take into consideration the financial environment at that time. The value of reserves will be reviewed annually as part of the IJB’s Financial Plan and Strategic Plan. Page 70 of 350
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P a g e 9 6. REPORTING FRAMEWORK 6.1 The IJB Chief Financial Officer has a fiduciary duty to ensure proper stewardship of public funds. 6.2 The level and utilisation of reserves will be formally approved by the IJB based on the advice of the IJB Chief Financial Officer. To enable the IJB to reach a decision, the IJB Chief Financial Officer will clearly state the factors that influenced this advice. As a minimum, the IJB Chief Financial Officer will consider the following: • inflation and interest rates and their impact on future years budgeting • cash flow estimates • potential impact of demand led pressures • insurance or contingency arrangements for major unforeseen risks • future spending reviews • the achievement of the commissioning intention priorities within the financial envelope available, both elements of which are agreed with the partners 6.3 As part of the budget report, the IJB Chief Financial Officer should state: • the current value of the General Fund, the movement proposed during the year • the estimated year-end balance and the extent that balances are being used to fund recurrent expenditure • the adequacy of the General Fund considering the IJB’s Strategic Plan, the medium term financial outlook and the overall financial environment • an assessment of earmarked reserves and advice on appropriate levels and movements during the year and over the medium term • if the reserves held are below the optimum levels as recommended by the IJB Chief Financial Officer, that the IJB should be considering actions to meet the optimum levels through their budget process. Page 71 of 350
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P a g e 10 7. ACCOUNTING AND DISCLOSURE 7.1 Expenditure should not be charged direct to any reserve. Any movement within Revenue Reserves is accounted for as an appropriation and is transparent. Entries within a reserve are specifically restricted to ‘contributions to and from the revenue account’ with expenditure charged to the service revenue account. 7.2 Reserve balances are not a sustainable approach for balancing the IJB budget and should be regarded as one-off funding only. The use of reserve balances will be dependent on the nature of the reserve. 7.3 In respect of reserves committed for use in future years, the Chief Financial Officer will confirm the approval of the IJB to the relevant party through the issue of a written direction, as appropriate. It is ultimately the responsibility of the Chief Financial Officer of the IJB to monitor and reconcile the use of earmarked funds and the earmarked reserve balance. In order to assist, the relevant party must submit as part of their quarterly monitoring an update on use of earmarked reserve balances. 7.4 Uncommitted reserves, which have been established through the accumulation of unbudgeted surpluses, may be used, subject to IJB approval, as a one off funding resource to contribute to the budget in any given year. It will be the responsibility of the relevant party to report to the IJB requesting approval for use of one off resources. The party must present the value required: circumstances surrounding the unexpected expenditure; essential/non essential expenditure; options already explored to fund the expenditure; and consequence of not funding through reserves. If approval is given by the IJB, similar to the use of committed reserves, the Chief Financial Officer will confirm the approval of the IJB to the relevant party through the issue of a written direction, as appropriate Page 72 of 350
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P a g e 11 8. RESERVES PROTOCOL 8.1 General Fund Purpose of the Reserve The General Fund of the IJB will be utilised to hold balances generated within the Income and Expenditure Account. Use of reserve This represents the General Fund of the IJB and is used to manage the financial strategy of the IJB. Any use of General Fund reserves has to be approved by the IJB through the appropriate governance framework. Management and Control Management and control is maintained through the established financial management frameworks and by review through the year end and budget process. 8.2 The IJB will be able to use its power to hold a General Fund so that in some years it may plan for a contribution to build up reserve balances, in other years to break even or to use a contribution from reserves in line with the reserve policy. 8.3 It is important for the long term financial stability of both the IJB and the partners that sufficient usable funds are held in reserve to manage unanticipated pressures from year to year. The General Fund will allow the IJB a degree of flexibility. Given the current economic climate however, the level of reserve must be proportionate and take cognisance of the level of savings required to be delivered within the revenue budget. An optimum level of reserves will require to be built up over time. The process to manage overspends is also set out in section 9 of the Integration Scheme agreed by both partners. 8.4 Ring-fenced, earmarked and risk-based reserves relate to specific funds for specific purposes and will only be used for these purposes, often spanning multiple years. Whilst these reserves are fully committed and therefore not free to use, these too will be regularly monitored. Any change of use, or decisions relating to residual balances will require the approval of the IJB. 8.5 Funding available for specific projects and government priorities will be ring-fenced or earmarked and carried forward into the following financial year(s), either in whole or in part, to allow for spend to be committed and managed in a way which represents best value for the IJB in its achievement of the national outcomes Page 73 of 350
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REPORT Item No: 11 SUBJECT: Financial Regulations TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 18 March 2026 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report requests that the Financial Regulation are approved. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Approve the Financial Regulations for the forthcoming financial year, 2026/27. (2) Note only minimal changes have been made to the regulations. 4. VARIATIONS TO DIRECTIONS 5. Review and Amendments 5.1 A review of the Financial Regulations has been completed, taking account of the Financial Regulations of North Lanarkshire Council and the Standing Financial Instructions of NHS Lanarkshire, with no fundamental changes identified. 5.2 Section 6.11 of the Regulations has been updated to reflect that both a Reserves Strategy and a Reserves Policy are in place and reported to the Performance, Finance and Audit Committee and the IJB respectively. 5.3 The Regulations are included at Appendix 1 with the minimal changes highlighted in red font. Yes No N/A Item 11 Page 75 of 350
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6. IMPLICATIONS 6.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 6.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 6.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 6.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Ineffective Governance Arrangements Low Claire Rae 6.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Page 76 of 350
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Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes This report includes all engagement and participation objectives as effective financial governance through adherence to financial regulations ensures the IJB can fulfil its statutory duties. ☒ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 6.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 7. BACKGROUND PAPERS N/A 8. APPENDICES Appendix 1 Financial Regulations Nicola Scott Chief Finance Officer Members seeking further information, please contact Nicola on 07581 007187. Page 77 of 350
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FINANCIAL REGULATIONS Author Nicola Scott, Chief Finance Officer Endorsing Body Integrated Joint Board Governance or Assurance Committee Performance, Finance & Audit Committee Approval Date 18 March 2026 Implementation Date 1 April 2026 Version Number 3 Review Date March 2027 Responsible Person Claire Rae, Chief Officer Appendix 1 Page 78 of 350
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P a g e 1 CONTENTS 1. INTRODUCTION 2 2. STATUTORY RESPONSIBILITY AND APPLICATION 3 3. RESPONSIBILITIES 4 4. THE STRATEGIC PLAN 6 5. FINANCIAL PLANNING AND BUDGETING 7 6. MANAGING FINANCIAL PERFORMANCE AND FINANCIAL MONITORING 9 7. NOTIONAL SET−ASIDE BUDGET FOR DIRECTED HOSPITAL SERVICES 12 8. HOSTED SERVICES 12 9. ACCOUNTING SYSTEMS AND RECORDS 13 10. CAPITAL 14 11. TAXATION 14 12. HOUSING REVENUE ACCOUNT 15 Page 79 of 350
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P a g e 2 1. INTRODUCTION These Financial Regulations of the North Lanarkshire Joint Integration Board (the Board) apply from 1 April 2026 and set out the arrangements for the proper administration of the financial affairs of the Board. The Public Bodies (Joint Working) (Scotland) Act 2014 received Royal Assent on 1 April 2014. It puts in place the framework for integrating health and social care in Scotland. North Lanarkshire Council (NLC) and NHS Lanarkshire (NHSL) have delegated responsibility to the Board for planning and resourcing service provision for the following adult and older people health and social care services: Social Care Services • Adult Social Care Health Care Services • Locality Services • Addiction Services • Medical and Nursing Directorate • Prescribing • Out of Area Services • Area Wide Services • Family Health Services • Hosted Services o Sexual Health Services o Continence Services o Immunisation Services o Speech and Language Therapy Services o Children and Adolescents Mental Health Services o Children Services o Integrated Equipment and Adaptations Store o Dietetics Services o Podiatry Services o Prisoner Healthcare Services o Blood Borne Viruses Services o Hospital at Home o Mental Health and Learning Disability Services Page 80 of 350
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P a g e 3 2. STATUTORY RESPONSIBILITY AND APPLICATION 2.1 The legislation requires that the Board is subject to the audit and accounts provisions of a body under Section 106 of the Local Government (Scotland) Act 1973 (Section 13). This will require audited annual accounts to be prepared with the reporting requirements specified in the relevant legislation and regulations (Section 12 of the Local Government in Scotland Act 2003 and regulations under section 105 of the Local Government (Scotland) Act 1973). 2.2 The Board is responsible for ensuring that its business is conducted in accordance with the law and appropriate standards and that public money is safeguarded, properly accounted for and used economically, efficiently, effectively, equitably and ethically. The Board's activities are furthermore guided by the Scheme of Delegation which sets out the underlying principles and responsibilities on openness, integrity and accountability. 2.3 In discharging these responsibilities, Board members and senior officers are responsible for implementing effective arrangements for governing the Board's affairs and facilitating the effective exercising of its functions including arrangements for managing risk. 2.4 As a consequence of these responsibilities, the Board must regulate the actions taken on its behalf that carry financial implications to provide assurance of their propriety and consistency. It is furthermore a requirement of these regulations that all financial transactions instructed by the Board are within the legal powers of the Board. These Financial Regulations thus form a key element of the maintenance of a robust, clear and accountable governance framework for the Board. 2.5 The Board has designated the Chief Officer (CO) as having responsibility for the preparation, implementation and reporting of the Board's Strategic Plan and the delivery of all delegated services. 2.6 The Board's Chief Financial Officer (CFO) will be responsible for the administration of the financial affairs of the Board and will support the CO in this respect. 2.7 The financial statements of the Board will be prepared according to the Code of Practice in Local Authority Accounting in the UK. The CFO will be responsible for signing the financial statements. 2.8 Any significant or material breach or non−compliance with these regulations or the associated finance rules, procedures or policies issued under their authority must be reported immediately to the CFO, who may consult others as appropriate to determine the proper action. 2.9 The financial regulations will be reviewed at least annually by the CFO, in consultation with the partners, and presented to the Board for approval if required. Page 81 of 350
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P a g e 4 3. RESPONSIBILITIES 3.1 Chief Officer (CO) 3. 1.1 The Board's Scheme of Delegation sets out the powers delegated to officers pursuant to the Public Bodies (Joint Working) (Scotland) Act 2014 3.1.2 Under the Board's Scheme of Delegation, the CO is responsible for establishing sound arrangements for implementing the Board's strategic direction, ensuring that the planned outcomes of the Strategic Plan are achieved whilst giving due regard to sustainability and equality considerations, continuous improvement and economy, efficiency and effectiveness in the use of resources. 3.1.3 As noted in the Scheme of delegation, the CO has authority over the officers of the Board, not withstanding the legal responsibilities of the Board's CFO. 3.1.4 The Scheme of Delegation will provide for a situation where the CO is unavailable and will detail how urgent decisions are made in his/her absence. 3.2 Chief Finance Officer (CFO) 3.2.1 The Board's CFO has been designated responsible for the administration of the Board's financial affairs. 3.2.2 The CFO is responsible for advising the Board on all financial matters and for monitoring and reporting on the Board's financial performance and position. 3.2.3 This officer will also oversee the development and implementation of appropriate strategies to manage risk, control the delegated resources and comply with governance standards. 3.2.4 With the exception of urgent decisions, which must be taken in accordance with the Board's Scheme of Delegation to Officers, authority to discharge financially−related responsibilities must be delegated formally in writing by the CFO. 3.3 NHS Lanarkshire and North Lanarkshire Council Partners 3.3.1 NHSL and NLC remain fully accountable for the financial performance of their service area against the budget allocated. They may incur revenue expenditure in furtherance of agreed Board policies only to the extent that budgetary provision has been made. 3.3.2 NHSL & NLC will formally report major financial issues to the CO and the CFO, who will instruct appropriate action. Section 5 provides further details. 3.3.3 It will remain the duty of the Council’s Section 95 Officer and the NHS Accountable Officer to monitor and regulate the financial performance of their respective share of the resources available to the Board during each reporting period, throughout the financial year. On a day-to-day basis the financial responsibilities of the NHS Accountable officer are delegated to the Director of Finance. Page 82 of 350
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P a g e 5 3.5 Following the Public Pound 3.5.1 The Board's CFO will establish arrangements to maintain control and clear public accountability over the use of resources identified as in the scope of the Board for use as directed and set out in the Strategic Plan. 3.6 Internal and External Audit 3.6.1 The Board will make appropriate and proportionate arrangements, to review and consider all key matters and outputs relating to internal and external audit provision in line with relevant good governance standards in the public sector. 3.6.2 The Board will arrange for the establishment of adequate and proportionate internal arrangements in line with Public Sector Internal Audit Standards. Detailed arrangements for the production, delivery and reporting on the outcome of Internal Audit Plan shall be submitted to the Board annually for approval 3.6.3 The Board will approve unaudited and audited accounts by the 30 June and 30 September respectively. The Accounts Commission will appoint the external auditors to the Board who will undertake their duties in accordance with relevant auditing standards and the Audit Scotland Code of Audit Practice. All significant External Audit outputs will be reported to the next subsequent meeting of the Board. 3.7 Risk Management 3.7.1 NHSL and NLC are responsible for the delivery of effective implementation of risk management arrangements in relation to their respective service areas and for ensuring its effectiveness and review on an ongoing basis. 3.7.2 The CO is responsible for establishing the Board's risk strategy and profile and ensuring effective risk management arrangements are in place. 3.7.3 There will be regular, bi−annual reporting on risk management to the Board. 3.7.4 The CO will make appropriate provision for insurance according to the risk management strategy. Page 83 of 350
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P a g e 6 4. THE STRATEGIC PLAN 4.1 The Strategic Plan will be underpinned by a financial plan that sets out the expected resource consequences of planned changes in capacity. 4.2 The Board will approve the Strategic Plan after consultation with its stakeholders, in line with the principles and duties set out in the legislation. The resources in the Strategic Plan will comprise: (a) The budget allocation made to the Board by North Lanarkshire Council for delegated adult social care services; (b) The budget allocation made to the Board by the Health Board for delegated healthcare services; and (c) The amount set aside by the Health Board for any delegated services provided in large hospitals for the population of the Board. 4.3 The Strategic Plan will incorporate a medium term financial planning framework (3 years) for the resources within scope of the Strategic Plan as well as a long term financial outlook (10 years). Page 84 of 350
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P a g e 7 5. FINANCIAL PLANNING AND BUDGETING 5.1 The Board will publish an annual budget setting out the total resources included in the Strategic Plan for that year. 5.2 The first year was based on the existing budget contributions from the Health Board and North Lanarkshire Council. 5.3 The resources in the first year of the Board were based on the due diligence carried out during the shadow year. The due diligence process was based on the existing financial plans and actual spend of the Health Board and North Lanarkshire Council including planned savings, and other agreed adjustments, on the performance during the shadow period and on past financial performance in recent years. 5.4 In subsequent years, the CO and the CFO will develop a resource plan and budget for its resources in line with the method set out in the Integration Scheme. 5.5 The legislation requires that in order to determine payments from the Board to the North Lanarkshire Council and the Health Board, a direction will be given. The direction should be in writing and must include information on the integrated functions that are being directed and how they are to be delivered along with the amount of and method of determining the payment to carry out the delegated functions. 5.6 A direction from the Board will take the form of a letter from the CO to the Health Board or North Lanarkshire Council referring to the arrangements for the delivery set out in the Strategic Plan and/or other documentation. Once issued, they can be amended or varied by a subsequent direction. 5.7 Following receipt of a direction, if circumstances change, the Local Authority Section 95 Officer and the Health Board Accountable Officer will consult with the CO and CFO about any required action that has significant financial implications for the Board. Following this consultation and, as appropriate, a request to approve a revised direction will be submitted to the Board for approval. Thereafter, the partner will submit any revised direction to their respective Committees for noting. 5.8 All reports to the Board shall contain a paragraph in respect of the main risks associated with the financial information contained within the report. 5.9 The Board will allocate the resources identified as in scope by the Health Board and North Lanarkshire Council in line with the Strategic Plan as part of the annual budget setting process. 5.10 The annual budget will be built up from a base budget and will consider inflation, demand and other known pressures. This will then be adjusted as appropriate to take account of efficiency saving requirements. 5.11 It is accepted that in year there may be cause for variation in individual budget lines and virements of resources from one heading to another may be required to make best use of the overall resource. In−year virement of budgets after the financial plan has Page 85 of 350
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P a g e 8 been set will require to be specified in the scheme of delegation for each of the partners. Authorisation for in year virements will be required from the Board for any proposed transfer in excess of £0.250m. 5.12 The Chief Officer must discuss any in year virement proposal with the partner holding the funding to determine whether the proposal is sound. This will include determining that the funding is free for virement, that no funding conditions, regulations or tax requirements would be breached by its proposed use and that there are no other unmanageable risks. 5.13 Having determined the proposed virement is feasible the following delegated authorities exist: (i) Where the proposal for virement exceeds £0.250m, the Chief Officer requires the Board approval to proceed. In taking the proposal to the Board any concerns raised by the partner holding the funding, (or in the event of a transfer between partners or a potential impact on the either partner) must be reflected in the virement request to the Board. (ii) For virements below £0.250m between lines within the same partner's budget which have no likely service impact on the other partner, the Chief Officer may proceed providing they have agreement from the relevant accountable officer for that body that the virement is feasible. This would be the Chief Accountable Officer of the Health Board and the Section 95 Officer in the case of North Lanarkshire Council. (iii) It would be for the partners scheme of delegation to determine a proportionate and reasonable mechanism for seeking this agreement for virement under £0.250m. In the event of a difference of opinion between the Chief Officer and the relevant partner's accountable officer as to whether the virement is feasible, the proposed virement should be referred to the Board for a decision. The Board cannot compel the partner to execute a virement that would lead it to be a breach of regulations, funding requirements, its overall budget limits or other duties. In other circumstances the Board may direct the partner to execute the virement but in doing so would also have to agree how the Board would manage the consequences of any residual risk flagged by the partner. (iv) For virements below £0.250m which are likely to have a service impact on the other partner, or which are between partners' budgets the above applies but is widened to take account of both partners' views. (v) If the virement has revenue implications for future years, the virement will firstly be approved by the appropriate partner's Committee and thereafter approved by the Board. Page 86 of 350
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P a g e 9 6. MANAGING FINANCIAL PERFORMANCE AND FINANCIAL MONITORING 6.1 The Health Board and North Lanarkshire Council Directors of Finance and the CFO will establish a process of regular in−year reporting and forecasting to provide the CO with management accounts for both arms of the operational budget and for the Board as a whole. 6.2 The detailed procedures for, and the form of, the financial reporting arrangements for the Board will be determined by the CFO in accordance with the general directions of the Local Authority Section 95 Officer and the Health Board Accountable Officer. 6.3 It will remain the duty of the Local Authority Section 95 Officer and the Health Board Accountable Officer to monitor or regulate the financial performance of their respective share of the resources available to the Board during each reporting period throughout the financial year. Budgetary control information will be provided to the CFO on a 4 weekly / monthly basis. The CFO will have the ultimate responsibility to report the financial performance to the IJB for their scrutiny and review as detailed at section 6.5. 6.4 It will be the responsibility of the Local Authority Section 95 Officer and the Health Board Accountable Officer to comply with the agreed reporting timetable and to make available to the CFO timeously the relevant financial information required for the financial reporting arrangements. This will include such details as may be required for the purpose of reporting to the Integrated Joint Board on the financial planning of revenue expenditure including data on levels of existing services and the development of the strategic commissioning plan and the annual report. 6.5 Quarterly management reports will be prepared and presented to the Board for scrutiny and review. The format and details of the report will be agreed by the Board. The existing budgetary control frameworks adopted by each partner will form the basis of generating the required financial and performance monitoring information. 6.6 Each partner will synchronise the formal budget setting timelines and reporting periods to provide regular information to the CFO. The reporting timetable for information being presented to the Board is detailed in the table below. The reporting timetable reflects the presentation to the Board within 2 months of the period end date: Period Under Review Period End Reports Submitted to the Board by April − June 30 June * 31 August ** July − September 30 September * 30 November ** October − December 31 December * 28 February ** January − March 31 March * 31 May ** * or nearest complete accounting period end. ** or nearest meeting of the Board Page 87 of 350
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P a g e 10 6.7 The CFO will review the financial performance in line with agreed planned outcomes as set out in the Strategic Plan and ensure respective financial plans are updated to support this. 6.8 The Budget for the Board will be set as a balanced budget. 6.9 The Local Authority Section 95 Officer and the Health Board Accountable Officer will not incur, nor will they cause or allow to be incurred, additional expenditure chargeable to the Board which has not been included in the total resources available to the Board without discussion with the CFO. 6.10 Any item of expenditure of an 'emergency' nature will be dealt with by the partner for that service in line with their arrangements for emergency expenditure. 6.11 The Board will approve a Reserve Policy to enable the Board to use its power to hold reserves, this should be reported to the Board annually in March. The Performance, Finance and Audit Committee (PFAC) will approve a Reserves Strategy which will detail the strategic approach to reserves along with a reserves outlook and review. This will be reported to the PFAC annually in February and May. The reserves policy and reserves strategy will detail the level of reserves required and their purpose. 6.12 In order to allow a valid comparison of actual results with the estimated income and expenditure of the service, it shall be the responsibility of the Local Authority Section 95 Officer and the Health Board Accountable Officer to provide such information as may be required for this purpose to the CFO. 6.13 Where it appears that the amount of income received or expenditure made has or may significantly deviate from that included in the total resources included in the Strategic Plan, resulting in a significant change to the Board's overall financial position, or impacting upon the policy of the Board, or revenue implications for future years, it will be the responsibility of the Local Authority Section 95 Officer and the Health Board Accountable Officer to consult with the CFO timeously and identify and advise of solutions to remedy the variance. The responsibility and management of these variances remain with the partner incurring the additional spend. Should an overspend be as a result of action taken by the other partner, then the partners should agree a remedial plan. 6.14 If the Board's CFO is advised that a significant change is likely to the Board's overall financial position, and that the deviation involves a change of policy of the Board, or results in revenue implications for future years, a report will be provided for the Board in good time detailing the financial consequences to enable appropriate action to be taken timeously. 6.15 If an overspend is forecast on either partner's in scope budget, the CO and the Board's CFO will agree a recovery plan with the relevant partner to balance the overspending budget to determine the actions required to be taken to deliver the recovery plan. If the overspend arises from the assumptions in the Board's strategic plan on the impact of service changes that are not realised as anticipated this should be subject to a report Page 88 of 350
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P a g e 11 and corrective action. This corrective action may include a recovery plan which should consider revisions to the commissioning of services and / or financial plans to account for the changed circumstances and the use of any available reserves. 6.16 The CO will determine the actions required to be taken to deliver the recovery plan in conjunction with parties. These actions should be approved by the Board as advised by the CFO. 6.17 In exceptional circumstances, should the North Lanarkshire Council or the Health Board require the Board to identify resources to offset an in−year overspend, they (i.e. the partner) must do this by amending their contributions to the Board. 6.18 Subject to discussion and consultation with the Health Board and North Lanarkshire Council, the Board may increase the payment to the affected body by utilising any balance on the general fund, if available in line with the reserves policy. This may require adjustments to the allocations from the Board to these bodies to reflect the recovery plan agreed. 6.19 If the recovery plan is unsuccessful and there are insufficient general fund reserves to fund a year end overspend, then the overspending partner has the option to: (a) Make additional one−off adjustment to the resources it is making available to the Board, or (b) Provide additional resources to the Board which are then recovered in future years from subsequent underspends in that Partners contribution, (subject to scrutiny of the reasons for the overspend and assurance that there is a plan in place to address this). 6.20 Unplanned underspends effectively represent overfunding by the North Lanarkshire Council or the Health Board with respect to planned outcomes and could be returned to the Local Authority or Health Board in−year through adjustments to their respective contributions to the Board and recurrently through the process for subsequent year adjustments or maintained by the Board to be carried forward through the General Fund Balance. Page 89 of 350
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P a g e 12 7. NOTIONAL SET−ASIDE BUDGET FOR DIRECTED HOSPITAL SERVICES 7.1 In respect of resources for delegated functions that are provided in large hospitals the NHS Lanarkshire Health Board has determined that these resources will be excluded from the aligned budget of the Board and instead retained and set−aside for direction by the Board through the Strategic Plan. These will be termed Set−Aside budgets. 7.2 The method for determining the amount of notional set−aside budgets for NHS Lanarkshire hospital services follows guidance issued by the Integrated Resources Advisory Group (IRAG) and is detailed in section 10.5 of the Integration Scheme. The set−aside budget includes the resources for the in scope hospital services used by the partnership population in the Health Board. 7.3 It is noted that overheads will not be included in directed hospital services. 7.4 Any proposal to transfer resources between the set−aside budget and the directly managed Budget for directed hospital services will require to have been modelled by the Health Board and agreed by the Board. The financial implications must be set out in the Strategic Plan of the Board. It must also be demonstrated by the Health Board that the planned capacity change has actually been delivered. 7.5 This applies to both reductions and increases in hospital capacity. Transfers from the set−aside budget to the directly managed budget will require an increase in the allocation from the Health Board to the Board; conversely, transfers from the directly managed budget to the set-aside budget will require an increase in the allocation from the Board to the Health Board. 7.6 It is not anticipated there would be in-year virements between the Board’s directly managed budget and the notional set-aside budget out with the directions made by the Board pursuant to the Strategic Plan. Should the Board wish to issue new directions in- year, section 6.4 of these Financial Regulations will apply. 8. HOSTED SERVICES 8.1 In line with the Scottish Government’s Integrated Resources Advisory Group Finance Guidance (section 4.3.1.10), it is agreed that the host partnership requires to manage any in-year overspends or underspends within a hosted service. Financial outturns will be reviewed as part of the annual review of all hosted services, bringing potential for budgetary changes for future years. Page 90 of 350
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P a g e 13 9. ACCOUNTING SYSTEMS AND RECORDS 9.1 It is the responsibility of the CFO to determine the appropriate accounting policies for the Board. The Accounting Standards as adapted for the public sector will apply to the Board. The Code of Practice on Local Authority Accounting in the UK will be the applicable guidance for their interpretation. Accounting records are required to be kept in line with Best Practice. 9.2 The Board financial statements will be completed to meet the audit and publication timetable specified in regulations (Local Authority Accounts (Scotland) Regulations 2014). The IRAG guidance states that there should be agreement of in-year transactions and year end balances with North Lanarkshire Council and the Health Board by 30 April. 9.3 The CFO must provide any relevant information required by the Health Board and North Lanarkshire Council to enable their statements to be prepared within the statutory timetable for the preparation and publication of the financial statements. 9.4 Where there is an in−year variance in the Board annual accounts, either an overspend or underspend on service expenditure, the Health Board and the North Lanarkshire Council should agree the creditor/debtor with the Board as part of the year end close down procedures. 9.5 Initially, recording of financial information in respect of the Board will be processed via the local authority ledger. This will be reviewed periodically to ensure this remains an appropriate solution. 9.6 The financial ledger transactions relating the Board will be carried out prior to the end of the financial year with post year−end adjustments for material information only. Year−end balances and transactions will be agreed timeously in order to allow completion of the accounts in line with the required timescales. This date will agreed annually by the Board, the North Lanarkshire Council and the Health Board. Page 91 of 350
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P a g e 14 10. CAPITAL 10.1 In the short term, the Board will not be empowered to own capital assets and the VAT regimes of North Lanarkshire Council, and the Health Board will apply to capital assets used to provide the delegated services. 10.2 Ownership of assets and associated liabilities will remain with each of the partners. 10.3 In preparing the Strategic Plan, the CO will consider all of the resources which are required to deliver the integration outcomes including the relevant non-current assets owned by the Health Board and North Lanarkshire Council. 10.4 The CO of the Board will consult with the North Lanarkshire Council and the Health Board to make best use of existing resources. 10.5 The Board, or partners, should identify the asset requirements to support the Strategic Plan. This will enable the CO to identify capital investment projects or business cases to submit to North Lanarkshire Council and the Health Board for consideration as part of their capital planning processes, recognising that partnership discussion would be required at an early stage if a project was to be jointly funded. 10.6 If a partner proposes capital investment, relative to the Board's activities, a process of consultation with the Board should be undertaken. 10.7 The Board's budget may include payments from the North Lanarkshire Council and Health Board to cover the revenue costs of assets e.g. rents, repairs and maintenance, rates, cleaning, property insurance etc. This should be agreed as part of the budget negotiations. 11. TAXATION 11.1 HMRC have confirmed that the Board is not a taxable person under the VAT Act 1994 as it will not provide services directly. This is on the basis that the Board is not delivering any supplies that fall within the scope of VAT. 11.2 Although the Board will be responsible for producing the Strategic Plan for the delivery of services by North Lanarkshire Council and the Health Board, the Board will not be responsible for the actual delivery of delegated services and as there is no consideration received by the Board for the production of the plan this will not alter the VAT registration position. Page 92 of 350
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P a g e 15 12. HOUSING REVENUE ACCOUNT 12.1 The Board's budget for delegated services includes services that are currently funded by the Housing Revenue Account (HRA). This relates to expenditure on adaptations and also care of gardens. While this budget is to form part of the budget for delegated services, it is part of North Lanarkshire Council's ring-fenced HRA. 12.2 Guidance prepared by the Scottish Government details that the local authority will identify and delegate the budget from the HRA to the Board equal to the amount of money required to pay for council tenants. 12.3 The Guidance clearly states that the HRA ring−fence will continue and that local authorities must ensure that HRA funds are not used for adaptations across other tenures or for different purposes. The checks and safeguards to ensure the integrity of the HRA will be detailed in the Strategic Plan. 12.4 An annual financial statement will be prepared to provide the required level of transparency and accountability. Page 93 of 350
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REPORT Item No: 12 SUBJECT: Population Health Framework and Community Planning – Funding Proposal TO: Integration Joint Board Lead Officer for Report: Claire Rae, Chief Officer Author(s) of Report Claire Rae, Chief Officer DATE: 18 March 2026 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Officer ☒ Reviewed By: HSCP SMT ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Approve the investment of £0.667m per year from reserves for the next three financial years to support preventative work via the Community Planning Partnership. (2) Support partner engagement to secure aligned commitments. (3) Endorse a Short Life Working Group to co‑produce investment options with key partners and community representatives 4. VARIATIONS TO DIRECTIONS 5. POPULATION HEALTH FRAMEWORK 5.1 The Scottish Government and COSLA’s Population Health Framework sets clear expectations for Integrated Joint Boards to strengthen prevention, reduce inequalities and prioritise early years by working closely with Community Planning Partners, aligning resources behind shared priorities and ensuring decisions are informed by robust data. 5.2 For North Lanarkshire, where many communities experience some of Scotland’s highest levels of deprivation, the Framework represents a significant opportunity to direct investment towards prevention and improve long term outcomes. Yes No N/A Item 12 Page 95 of 350
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5.3 For Integrated Joint Boards the framework sets clear expectations for: • Leadership in prevention – IJBs are expected to demonstrate a proactive shift from reactive care to preventative approaches, embedding health equity principles across planning and delivery. • Collaborative working - IJBs should work through Community Planning Partnerships to co-design interventions that address social determinants of health, ensuring alignment with local priorities. • Resource alignment - There is an expectation to allocate both financial and workforce resources to prevention, even within challenging financial contexts, as part of a whole-system approach. • Data-driven decision-making - IJBs are required to use robust evidence and local intelligence to target interventions where they will have the greatest impact, and to contribute to national learning. • Focus on early years and child poverty – IJBs should prioritise actions that reduce inequalities from the earliest stages of life, recognising the long-term benefits for population health and service sustainability. 5.4 The recently published Audit Scotland report NHS in Scotland 2025: Finance and Performance has reinforced that delivery of the Population Health Framework’s ambitions will need leadership and drive across sectors and for partners to take on accountability for improving population health. 6 PROPOSAL FOR LANARKSHIRE 6.1 The Population Health Framework represents a significant opportunity for Lanarkshire. The area experiences some of the highest levels of health inequality in Scotland, with multiple communities ranking among the most deprived according to the Scottish Index of Multiple Deprivation (SIMD). 6.2 Realising the North Lanarkshire IJBs commitment to the Population Health Framework requires: • A sustained shift towards prevention and early intervention. • Collaborative and multi-year investment and resource alignment across partners. • Practical action to address barriers created by budgetary pressures. 6.3 To enable meaningful progress, the IJB are asked to: • Endorse a recommendation to make an initial financial commitment of up to £0.667m per year for three years, through the utilisation of reserves, to support preventative action to improve early years outcomes through the North Lanarkshire Community Planning Partnership. • Support engagement with North Lanarkshire Community Planning Partners to encourage similar commitments, enabling a combined resource to be collectively deployed. 6.4 NHS Lanarkshire’s Board approved an equivalent financial commitment proposed in January 2026, agreeing to provide the same level of funding to both North and South Lanarkshire Health and Social Care Partnerships. This reinforces the NHS Lanarkshire’s shared commitment to strengthening preventative approaches and improving early years outcomes across Lanarkshire. Page 96 of 350
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6.5 North Lanarkshire Council is also considering a parallel financial contribution, aligned to the ambitions set out in The Plan—the Council’s overarching strategy for improving outcomes and strengthening community wellbeing. This approach reflects the Council’s commitment to early intervention, prevention, and long‑term investment in children and families. Together, these commitments strengthen a shared, place‑based focus on improving early years outcomes across North Lanarkshire 6.6 The IJB is asked to endorse the Chief Officer convening a Short Life Working Group (SLWG) to co-produce options for allocating this funding effectively. The Chief Officer will extend invitations to the following key stakeholders to be members/be represented on the SLWG: Voluntary Action North Lanarkshire (representing the Third Sector), the Health and Social Care Forum, the North Lanarkshire Champions Board, and a Community Planning Partnership (CPP) community representative. The Chief Officer will agree the chairing of the SLWG with the Chair and Vice-Chair of the IJB. Co- produced options will be considered by the CPP Leadership Group with reporting across the IJB and CPP. 6.7 By leveraging the Population Health Framework, North Lanarkshire IJB have an opportunity to target resources where they will have the greatest impact and demonstrate leadership in prevention and health equity - helping to influence national policy and secure long-term sustainability. 6.8 This approach will: • Demonstrate the IJBs approach to empowering communities to develop in prevention and health equity in line with Population Health Framework • Enable flexibility to allocate resources where evidence shows greatest impact. 7. CONCLUSIONS 7.1 This proposal enables the IJB to make a tangible and early contribution to delivering the ambitions of the Population Health Framework, with a clear focus on prevention and early‑years outcomes. By committing dedicated resource and working collaboratively through the Community Planning Partnership, the IJB can strengthen its leadership role in reducing inequalities and improving long‑term population health across North Lanarkshire. 8. IMPLICATIONS 8.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Page 97 of 350
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Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 8.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 8.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 8.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner 8.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Page 98 of 350
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Partnership 8.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 9. BACKGROUND PAPERS N/A 10. APPENDICES N/A Claire Rae Chief Officer Members seeking further information, please contact Claire at Claire.rae@lanarkshire.scot.nhs.uk Page 99 of 350
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1 REPORT Item No: 13 SUBJECT: Strategic Commissioning Plan 2026 -2029 TO: Integration Joint Board Lead Officer for Report: Head of Planning, Performance & Quality Assurance Author(s) of Report Senior Manager, Strategy & Performance DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☒ For endorsement ☐ To note ☐ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Senior Manager, Strategy & Performance ☒ Reviewed By: Head of Planning, Performance & Quality Assurance ☒ Endorsed By: ☐ 3. EXECUTIVE SUMMARY 3.1 The current Strategic Commissioning Plan is due to expire in March 2026, and this report sets out the current position in relation to the development of a new plan and its future launch. 4. RECOMMENDATIONS 4.1 It is recommended that the Integration Joint Board: Item 13 Page 101 of 350
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2 i) Approve the draft strategic priorities for the new Strategic Commissioning Plan set out in x.x. ii) Approve arrangements for final consultation 5. VARIATIONS TO DIRECTIONS? 6. BACKGROUND 6.1 The Public Bodies (Joint Working) (Scotland) Act 2014 (the Act) places a duty on Integration Authorities to develop a strategic plan, also known as a strategic commissioning plan, for integrated functions and budgets under their control and the Scottish Government has published guidance to support production of said plans: https://www.gov.scot/publications/strategic-commissioning-plans- guidance/pages/9/. 6.2 The Integration Joint Board approved the Strategic Commissioning Plan 2023- 2026 at its meeting on 22 March 2023, setting out how the Health & Social Care Partnerships plans and delivers services for North Lanarkshire over the medium term and how these arrangements help to contribute towards achieving the national health and wellbeing outcomes. 6.3 Subsequently, a more detailed Programme of Work was approved by the Board at its meeting on 27 September 2023, setting out in more detail the programmes and activities intended to help transform the health and social care system. 6.4 The current Strategic Commissioning Plan and Programme of Work is due to expire in March 2026, and this report sets out the draft strategic priorities for the new plan, alongside next steps to allow final consultation to take place. 7. SUMMARY OF KEY ISSUES 7.1 North Lanarkshire’s draft Strategic Commissioning Plan (SCP) 2026–2029 is being shaped through engagement led by the Strategic Planning Group, and will set a clear direction of travel focused on prevention, fairness and stronger community-centred support. The plan will align with Scotland’s Population Health Framework and will be integrated with forthcoming Local Outcome Improvement Plans. Yes ☐ No ☒ N/A ☐ Page 102 of 350
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3 7.2 Emerging strategic priorities include: 1. Prevention-Focused System A whole-system shift toward early intervention, anticipatory care and proactive support to reduce demand across health and social care. This includes trauma-informed, strengths-based practice and expansion of community early-help pathways. 2. Tackling Inequality Targeted support for communities most affected by poverty and poor health, including income maximisation, financial inclusion, and investment in local community wealth building initiatives. 3. Places and Communities Strengthening local assets through investment in community anchor organisations, place-based prevention models, enhanced community hubs, volunteering, community capacity building and the Getting It Right For Everyone (GIRFE) approach. 4. Enabling Healthy Living Delivering local programmes to support healthy weight, physical activity, nutrition, addiction recovery and mental wellbeing through whole-family and whole-life-course approaches. 5. Equitable Access to Health & Care Improving fairness and accessibility by reducing barriers to services, developing flexible local models of care and deepening integration across health, social care and third-sector partners. 7.3 The timeline for the next steps in the development of the plan are as follows: March 2026: Draft SCP presented to the Integration Joint Board (IJB). Spring 2026: Short period of further engagement on draft priorities. June 2026: - Final SCP presented for approval. - Completion of the review of the current Programme of Work (PoW). - Agreement of a new Programme of Work (PoW) aligned to the SCP. - Confirmation of the IJB’s ongoing monitoring role. - Finalisation of the Joint Strategic Needs Assessment (JSNA). - Alignment of SCP outcomes with new Equality Outcomes. September/October 2026: Launch event for the new Strategic Commisioning Plan and Programme of Work P. 7.4 The final Strategic Commissioning Plan will set a medium-term investment and transformation framework designed to strengthen prevention, reduce inequalities and embed community-led approaches across North Lanarkshire. The June 2026 report will bring together all supporting components – Joint Strategic Needs Assessment (JSNA), and a new Programme of Work —to ensure coherent delivery and oversight. Page 103 of 350
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4 8. IMPLICATIONS 8.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 8.2 ASSOCIATED MEASURE(S) 8.3 FINANCIAL This paper has been reviewed by Finance: 8.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 8.5 ENGAGEMENT & PARTICPATION Yes ☐ No ☐ N/A ☒ Page 104 of 350
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5 Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes ☒ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 8.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: Yes ☐ No ☒ N/A ☐ Page 105 of 350
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6 An EQIA will be included as part of the final approval process for the new Strategic Commissioning Plan. 9. BACKGROUND PAPERS None. 10. APPENDICES HEAD OF PLANNING, PERFORMANCE & QUALITY ASSURANCE Members seeking further information about any aspect of this report, please contact the following; Yes / Date added ☐ No ☒ N/A ☐ Page 106 of 350
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7 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 107 of 350
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1 REPORT Item No: 14 SUBJECT: Annual Report of the Chief Social Work Officer 2024/25 TO: Integration Joint Board Lead Officer for Report: Alison Gordon, Chief Social Work Officer (Education, Families, Justice, & Integrated Practice) Author(s) of Report Alison Gordon, gordonal@northlan.gov.uk Maria Barry, barrym@northlan.gov.uk DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☐ Reviewed By: ☐ Endorsed By: ☒ In accordance with reporting requirements, the Annual Chief Social Work Officer Report has been formally approved by North Lanarkshire Council’s Adult Care and Social Work Committee on 11 November 2025 and by the Education, Children and Families Committee on 18 November 2025. The report was subsequently considered by the North Lanarkshire Partnership Strategic Leadership Board on 6 February 2026. The report is now remitted to the Integration Joint Board for information. Item 14 Page 109 of 350
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2 3. RECOMMENDATIONS 3.1 It is recommended that the Integration Joint Board endorse the contents of this report, the progress made and next steps. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Executive Summary In line with Scottish Government guidance the Chief Social Work Officer (CSWO) is required to provide an annual report. This report provides an overview of social work service delivery in North Lanarkshire for the period April 2024 to March 2025 and covers the following areas: • Governance and accountability arrangements, including partnership working. • Service Quality and Performance, including service developments. • Resources • Workforce • Looking Forward - Future Priorities, Opportunities and Challenges The report, attached as Appendix 1, also reflects social work’s contribution to the Programme of Work underpinning the Plan for North Lanarkshire. 5.2 Background The requirement that each local authority appoint a professionally qualified Chief Social Work Officer is contained in Section 45 of the Local government (Scotland) Act 1994. Statutory Guidance on the role of the Chief Social Work Officer was updated in 2016, to reflect the impact of Health and Social Care integration, extending the responsibilities of the role to provide advice to the Integration Joint Board (IJB). In addition to providing advice both to the Local Authority and IJB in relation to the discharge of statutory social work functions the role continues to carry key responsibilities for professional leadership, values, and standards both for directly provided and commissioned services. Social Work Services in North Lanarkshire continue to play a lead role in supporting and safeguarding our communities. Adult Social Work and Social Care Services are delivered through Health and Social Care North Lanarkshire (HSCNL) whilst Children, Family and Justice Services are delivered through the Council’s Education and Families Service. Yes ☐ No ☐ N/A ☒ Page 110 of 350
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3 The CSWO role requires to be undertaken by one designated individual however delegation of responsibilities is permitted where required by the scale of business. In North Lanarkshire this means that the Chief Officer Adult Social Work Services, routinely exercises delegated responsibilities for decision- making and professional standards within adult services as well as providing support and cover with respect to the wider functions of the CSWO role. The Annual Chief Social Work Report follows a nationally set template and is intended to provide a key overview and support scrutiny of social work service delivery and performance over the period. The Office of the Chief Social Work Advisor (OCSWA) also produces a national report each year which draws on key themes and messages from CSWO reports across Scotland. Due to scope of its coverage, we recognise the report is lengthy and covers some areas on which elected members will have previously received reports. Going forward we will seek to review its presentation both to make it easier to navigate and also to increase the visibility of data and impact information. 5.3 Report Social Work in North Lanarkshire employs just over 3000 staff around 185 of whom are sessional. In collaboration with commissioned services and 3rd Sector partners support is provided to around 30,000 individuals and families at any one time. Social work also makes a key contribution to wider partnership and community activity. As illustrated within the report partnership working is fundamental to social work at every level and a key aspect of the CSWO role involves developing and sustaining partnership working and relationships across a range of organisations and structures. In addition to the specific responsibilities of the CSWO to the Council and HSCNL, the CSWO holds a key leadership role within several local partnership arrangements. The delivery of social work is also supported by the ‘one plan’ ethos of North Lanarkshire and structures which facilitate strong links with other key services such as housing, employability and community learning and development and there are examples throughout this report of how this is helping us improve outcomes for those we support. Income maximisation, tackling poverty and addressing financial wellbeing remain key to social work practice, recognising the link between poverty and the health inequalities which contribute to driving the need for services and in consideration also of the evidence that compulsory interventions are disproportionately experienced by those in poverty within our communities, We are therefore continuing to ensure this focus is embedded in social work practice and that it is embedded within our developing early support services through which we have also been exploring the use of small tailored direct payments to meet specific needs. We are conscious of the particular challenges for specific groups in our community such as carers/parent carers. During the coming year working with our colleagues in education, tackling poverty and Page 111 of 350
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4 commissioned community and voluntary sector services we will have the opportunity through our Fairer Future Partnership to test approaches which will support families of children with additional support needs with a focus on financial wellbeing. Whilst social work services within both education and families and the health and social care services were able to deliver services within overall budgets during this period as reflected in Section 4 of this report, this to some extent masks a range of demand and financial pressures impacting on social work service with vacancies and recruitment challenges in some service areas also a key issue. Section 5 of this report provides further information on how we are managing workforce challenges and also reflects positive progress in some areas such as social worker retention. A range of factors including the legacy impacts of the pandemic, the cost-of- living crisis, new legislative duties, the increased number of people who are impacted by complex needs and frailty and societal factors contributing to new safeguarding needs, have all meant that meeting demand within available resources continues to be challenging. As the report demonstrates however, the service has continued to innovate to ensure not only that statutory duties are delivered to a high standard but to improve outcomes and people’s experience of services. Throughout this period, we have continued to retain a strong balance of care across all care groups, supporting individuals to remain within their homes and communities wherever possible and empowering individuals and families to achieve positive outcomes. In the context reflected above a key focus across all areas of social work continues to be the promotion of trauma-informed, relationship and strength- based practice with a particular focus on preventative approaches and enhancing early support. In adult services system change to support an enabling approach is being rolled with a view to eliminating waits for assessment and to fulfil the commitment of ‘right support, right time’ adopting a ‘Getting it Right for Everyone’ approach. A public health approach within justice is promoting a holistic response to need whilst continuing to manage risk, whilst in children’s social work, work to embed ‘Signs of Safety and Healing’ alongside engagement with ‘empowering clusters’ model and expansion of early family support services are progressing well, with some very tentative indications that this may be impacting positively on volume of referrals. Looking forward the report reflects on the opportunities to continue our whole system approach but is realistic also in setting out the significant challenges facing social work services, in the context of the significant financial challenges impacting on the public sector and communities. Whilst a step back from a maximalist approach to a National Care Service has removed the potential challenge of large-scale structural reorganisation, a number of new areas of legislation in addition to the Care Reform (Scotland) Act will create additional duties on the service and further work is also required to realise locally the aspirations of the Promise. As in other Page 112 of 350
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5 areas of the council significant service transformation, as referenced in the report, has begun and is essential but may be challenged by the very pressures it is setting out to manage, Similarly the establishment of a new National Social work Agency and Partnership will bring a positive focus to the role of social work however arrives with no specific commitments around investment in the profession. Nonetheless this report demonstrates the strong foundation of social work delivery in north Lanarkshire which remains supported by a committed and innovative workforce. 6. CONCLUSIONS 6.1 This report provides an overview of social work activity and performance over a period 2024/25. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) N/A - Annual Report to meet reporting requirement. A range of outcome measures, KPIs and specific service standards are applied across social work services. 7.3 FINANCIAL Page 113 of 350
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6 This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. Where relevant the various risks associated with activity or delivery challenges referenced in the report are include within service risk registers/ 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff Yes ☐ No ☒ N/A ☐ Page 114 of 350
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7 ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership The report provides an overview of activity much of which is underpinned by service user and carer engagement. This has, and will continue, to be reported routinely to IJB and Adult Social Work and Care Committee where this underpins other more specific performance reporting or service development and planning 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS 9. APPENDICES Please include a glossary of terms if not already included. 9.1 Appendix 1 Annual Report of the Chief Social Work Officer 2024/25. Alison Gordon Chief Social Work Officer (Education, Families, Justice, and Integrated Practice) Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☒ Page 115 of 350
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8 CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Alison Gordon GordonAl@northlan.gov.uk Maria Barry BarryM@northlan.gov.uk Page 116 of 350
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9 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 117 of 350
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10 Appendix 1 Chief Social Work Officer Annual Report 2024-2025 Page 118 of 350
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11 .......................................................................................................................................... 10 THE CHIEF SOCIAL WORK OFFICER FUNCTION ........................................................................ 14 ANNUAL REPORT ...................................................................................................................... 14 1. GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS ................................................. 16 1.1 NORTH LANARKSHIRE COUNCIL AND NORTH LANARKSHIRE PARTNERSHIP ................. 16 1.2 HEALTH AND SOCIAL CARE NORTH LANARKSHIRE ......................................................... 18 1.3 SUPPORT, CARE, PRACTICE AND STAFF GOVERNANCE ARRANGEMENTS ....................... 9 1.3.1 SELF ASSESSMENT ................................................................................................... 10 1.4 PUBLIC PROTECTION ARRANGEMENTS ......................................................................... 20 1.5 CARE HOME ASSURANCE……………………………………………………………………….11 1.6 ENGAGEMENT WITH THE PEOPLE WHO USE SUPPORT SERVICES, THE COMMUNITY, AND VOLUNTARY SECTOR .................................................................................................... 20 2. SERVICE DEVELOPMENT, QUALITY AND PERFORMANCE................................................. 14 2.1 PERFORMANCE AND IMPACT MEASUREMENT .............................................................. 14 2.2 SUPPORT TO UNPAID CARERS ........................................................................................ 23 2.3 JUSTICE SOCIAL WORK SERVICES ................................................................................... 24 2.3.1 COMMUNITY PAYBACK ORDER-INCLUDING UNPAID WORK ................................... 16 2.3.2 OTHER ACTIVITY ...................................................................................................... 25 2.3.3 DIVERSION FROM PROSECUTION ........................................................................... 18 2.3.4 OFFENCE FOCUSED WORK ...................................................................................... 18 2.3.5 WOMEN’S COMMUNITY JUSTICE SERVICE (WCJS) AND BAIL SUPERVISION .......... 19 2.3.6 OTHER NEW DEVELOPMENTS ................................................................................. 20 2.3.7 ARREST REFERRAL ................................................................................................... 29 2.4 CHILDREN AND FAMILIES SOCIAL WORK SERVICES ....................................................... 22 2.4.1 THE BALANCE OF CARE ........................................................................................... 30 2.4.2 MOVING ON: SUPPORTING CARE EXPERIENCED YOUNG PEOPLE .......................... 31 2.4.3 A LOVING HOME: ADOPTION, FOSTERING AND KINSHIPCARE .............................. 34 2.4.4 INTENSIVE FAMILY SUPPORT ................................................................................... 29 2.4.5 YOUNG PEOPLE IN CONFLICT WITH THE LAW ........................................................ 39 2.4.6 CHILDREN WITH ADDITIONAL SUPPORT NEEDS (ASN) ........................................... 41 2.5 ADULT SOCIAL WORK SERVICES ..................................................................................... 41 Page 119 of 350
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12 2.6 EARLY AND PREVENTATIVE INTERVENTIONS – RIGHT SUPPORT, RIGHT TIME............... 42 2.6.1 GETTING IT RIGHT FOR EVERYONE (GIRFE)............................................................. 42 2.6.2 MAKING LIFE EASIER (MLE) ..................................................................................... 36 2.6.3 ASSISTIVE TECHNOLOGY TEAM ............................................................................... 36 2.6.4 COMMUNITY ALARMS AND ANALOGUE TO DIGITAL .............................................. 37 2.6.5 EQUIPMENT AND ADAPTATION SERVICE (EAS) ....................................................... 38 2.6.6 SOCIAL WORK TRANSITION TEAM .......................................................................... 39 2.6.7 LOCALITY SUPPORT SERVICES (LSS) ........................................................................ 39 2.6.8 INTEGRATED DAY SERVICES (IDS) FOR OLDER ADULTS: OVERVIEW AND DEVELOPMENT ................................................................................................................. 47 2.6.9 HOME ASSESSMENT TEAM (HAT) ........................................................................... 48 2.6.10 HOME SUPPORT SERVICE – LIVING WELL AT HOME ............................................. 48 2.6.11 TRANSFORMATIONAL SELF-DIRECTED SUPPORT (SDS) AGENDA AND INDIVIDUAL BUDGETS .......................................................................................................................... 49 2.6.12 COMMUNITY LIVING CHANGE FUND/COMING HOME ........................................ 50 2.7 DIGITAL SYSTEMS TRANSFORMATION ........................................................................... 44 3. STATUTORY INTERVENTIONS ............................................................................................ 45 3.1 MENTAL HEALTH OFFICERS SERVICE AND ADULTS WITH INCAPACITY ACT (SCOTLAND) 2000 ..................................................................................................................................... 45 3.2 MENTAL HEALTH (CARE AND TREATMENT) ACT 2003 AND MENTAL HEALTH (SCOTLAND ACT 2015) ............................................................................................................................. 47 3.3 DEVELOPMENT OF MHO SERVICE TO MEET NEEDS ...................................................... 48 3.4 APPROPRIATE ADULT SERVICES ...................................................................................... 49 3.5 PUBLIC PROTECTION ...................................................................................................... 50 3.5.1 ADULT SUPPORT AND PROTECTION INVESTIGATIONS/CASE CONFERENCES AND STATUTORY ORDERS/FUNCTIONS .................................................................................... 50 3.5.2 MAPPA (MULTI AGENCY PUBLIC PROTECTION ARRANGEMENTS) .......................... 52 3.5.3 CHILD PROTECTION INCLUDING CONTEXTUAL SAFEGUARDING ............................ 53 3.5.4 GENDER BASED VIOLENCE ...................................................................................... 56 4. RESOURCES ...................................................................................................................... 57 4.1 FINANCIAL MODELLING FOR SERVICE DELIVERY ....................................................... 59 5. WORKFORCE .................................................................................................................... 59 5.1 WORKFORCE PLANNING ................................................................................................ 59 Page 120 of 350
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13 5.2 SOCIAL WORK RECRUITMENT AND RETENTION ............................................................ 60 5.3 SOCIAL CARE .................................................................................................................. 61 5.4 OTHER RECRUITMENT AND RETENTION CHALLENGES .................................................. 61 5.5 SOCIAL WORK DEGREE PATHWAY .................................................................................. 62 5.6 FOCUS ON HOMECARE .................................................................................................. 63 5.7 NEWLY QUALIFIED SOCIAL WORK PROGRAMME .......................................................... 64 5.8 OTHER KEY TRAINING AND DEVELOPMENT ACTIVITIES ................................................ 64 5.9 TRAUMA INFORMED PRACTICE ..................................................................................... 67 5.10 SUPPORT FOR STAFF WELLBEING ................................................................................ 68 6. LOOKING FORWARD – PRIORITIES FOR 2025-2026 AND BEYOND .................................. 68 Page 121 of 350
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14 ANNUAL REPORT BY CHIEF SOCIAL WORK OFFICER: NORTH LANARKSHIRE 2024- 2025 THE CHIEF SOCIAL WORK OFFICER FUNCTION Every local authority must appoint a professionally qualified Chief Social Work Officer (CSWO) as reflected in Section 46 of the Local Government (Scotland) Act 1994. The CSWO provides professional leadership, accountability, and governance for the delivery of social work and social care services, including commissioned services. The CWSO also provides advice on Social Work service delivery and on related issues to the local authority Chief Executive, Elected Members, and the Integrated Joint Board (IJB) promoting understanding of the range of Social Work and Social Care Services, and the complexities involved in delivering statutory responsibilities which require both consideration of need and the management of risk and liberties. Operationally, the CSWO also has a direct remit for decisions on specific statutory matters including in relation to secure accommodation, adoption and welfare guardianship as illustrated below. The CSWO role within North Lanarkshire is held by the Chief Officer, Children, Families, Justice, and Integrated Services. However, the CSWO is supported by the Chief Officer, Adult Social Work Services who holds delegated responsibilities with respect to adult Social Work and social care, deputises in other areas as required and works alongside the CSWO in relation to the other functions of the role. ANNUAL REPORT In line with Scottish Government guidance, the CSWO is required to provide an annual report. This report provides an overview of Social Work service delivery in North Lanarkshire for the period April 2024 to March 2025 and covers the following areas: • Governance and accountability arrangements, including partnership working and statutory functions. • Service Quality and Performance, including key service improvement activity and challenges impacting service delivery. • Resources • Workforce Issues, including workforce planning, training, and development. • Future Priorities – Social Work landscape and priorities looking forward to 2025/26. Social Work Services continue to play a critical role in supporting communities in North Lanarkshire and in meeting both national and local priorities to improve outcomes, address inequalities and empower those individuals and families who may face exclusion or a range of adversities. Demand challenges driven by a range of societal factors including demographic change and health inequalities continue to impact on Social Work Services alongside financial constraints Page 122 of 350
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15 and new legislative duties reinforcing the need not only to continue to innovate and make improvements in the delivery of statutory functions but to work with partners and those we support to strengthen early support and prevention. This is reflected within the report along with our achievements as staff across the service continue to work with resilience and commitment to support the best possible outcomes for individuals, families, and our community, I would like to record my thanks and pay tribute to all staff involved in the delivery of Social Work services in North Lanarkshire for their work over the past year I would also like to thank all internal and external partners, carers, families and communities who have supported us in our work. Alison Gordon Chief Social Work Officer Page 123 of 350
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16 1. GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS 1.1 NORTH LANARKSHIRE COUNCIL AND NORTH LANARKSHIRE PARTNERSHIP The shared priorities of North Lanarkshire Council (NLC) and partner organisations are set out in The Plan for North Lanarkshire. These continue to have a focus on tackling inequality and poverty and on inclusive and sustainable growth, and development. Social Work has a critical role in supporting key objectives of the Plan in particular in: • Supporting children and young people to achieve their potential • Improving community health and well-being • Supporting and facilitating engagement and participation. A focused and integrated five-year Programme of Work, approved in March 2023, supports the Plan for North Lanarkshire. The Programme of Work has seven priorities for delivery as shown below: Across NLC, all services and partners contribute towards all seven programmes with the social work footprint particularly strong within the Resilient People and Brighter Future programmes. This is reflected by Senior Social Work Manager involvement in the programme boards and the CSWO’s role as SRO for Resilient People, which is focussed on delivering whole family support locally, when families need it, in a way that also addresses the impacts of poverty and reduces inequality. Page 124 of 350
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17 Throughout this report, many strands of work which are positively impacting on these issues are referenced, reflecting that addressing complex problems such as poverty, family breakdown or social isolation require sustained (and sustainable), relationship-based and community-led responses. The programme provides a framework to support a move towards early, preventive or anticipatory support which helps builds trust, strengthens relationships, and promotes resilience. Whilst transformation activity is reported and governed through programme boards, primary oversight of social work activity and performance within NLC continues to be via the council’s committee structure, with children, families and Justice social work reporting to Education, Children and Families Committee and adult social work to the Adult Care and Social Work Committee ( although functions are delegated to the Health and Social Care Partnership/Integrated Joint Board) North Lanarkshire Children’s Services Partnership (CSP) continues to be the structure through which partners provide governance, strategic planning, direction, and delivery of shared priorities for children’s services in North Lanarkshire. The Children’s Service Partnership Board membership includes Elected Members with Voice reflected through links with North Lanarkshire Youth Council and our Children’s Champion’s Board. There are strong links and cross over with other strategic partnerships, such as NL Child Protection Committee and the Tackling Poverty Officer Action Group (TPOAG). The North Lanarkshire Children’s Services Plan is refreshed every three years and supported through annual reporting. This remains also the key strategic vehicle also for the delivery of the Promise in North Lanarkshire. Social Work has a key role in all the CSP priorities as reflected by the CSWO’s role as lead officer for the CSP and chair of the Improving Children’s Services Group which has oversight of the work of associated task groups. The Community Justice Partnership (CJP), also chaired by the CSWO, has responsibility for the multi-agency oversight of Community Justice in North Lanarkshire. The partnership has a strong ethos of collaboration with a wide range of partners including the NL Alcohol and Drug Partnership and employability services. In turn, this supports options such as diversion, throughcare, bail supervision and our local Arrest Referral Pilot initiated in April 2023. Commitment from partners ensures a holistic response to meeting need. The Community Justice Outcome Improvement Plan 2023 to 2028 was informed by engagement including with those with lived experience and by a Strategic Needs Assessment- setting out a framework for our ongoing activity in this area. Both the CSP and CJP report annually to the North Lanarkshire Partnership (NLP) which brings together the major public sector agencies in the area, including Voluntary Action North Lanarkshire (VANL), the local third sector interface. The priorities for delivery across the partnership are set out in The Plan for North Lanarkshire. Nine Community Boards, involving local citizens, continue to support community leadership, involvement, and capacity building, with Local Outcome and Improvement Plans (LOIP) guiding this work. Social Work is fully engaged with these structures with the CSWO continuing to have the role of Community Co-ordinator for one of the local boards whist the Chief Officer Adult Social Work and Senior Managers for Quality Assurance and Strategy & Performance provide links to the UHSCNL and the strategic commissioning activity across all Community Page 125 of 350
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18 Boards. Senior Social Work Managers also participate in area-based teams and the sub- groups which support the delivery of the LOIPs. 1.2 HEALTH AND SOCIAL CARE NORTH LANARKSHIRE UHSCNL’s current Strategic Commissioning Plan 2023-26 sets out key priorities for the three- year period with the aim of ensuring that people are robustly supported to live in their own homes and lead independent lives in their communities. Key priorities include: • Do the right thing first time • Increased focus on prevention, early intervention and tackling inequalities by working with communities and people • Develop and support a workforce for the future • Improve mental health and wellbeing • Support people through a whole family approach Under each priority area, an agreed set of short- and medium-term goals has been developed underpinned by the Programme of Work which sets out in detail the programmes to be progressed. These are updated on an annual basis to ensure response to any new or emerging issues. A mid cycle review was published in December 2024 – further information can be found within the minutes of the IJB meeting held 4th December 2024. The Annual Performance Report for 2024-25 will be published later in the year and twill give further details and achievements of the partnership. 1.3 SUPPORT, CARE, PRACTICE AND STAFF GOVERNANCE ARRANGEMENTS Within adult services the Support Care and Clinical Governance Committee (SCCGC) plays a key role and met eight-weekly over the reporting period. Chairing responsibilities are scheduled to change from the UHSCP Medical Director to the Chief Officer Adult Social Work during 2026. Adult Social Work Governance meetings included a programme of assurance and improvement for Adult Social Work Services. This fed into the SCCGC structure. During 2024-25 a review of the reporting process and format for Social Work Services was undertaken by the professional and operational managers, supported by our Quality Assurance team whose role continues to support all social work care groups. Practitioners and managers are supported with assurance activity including: • A test of change as a precursor to broadening self-evaluation for each of the teams • Engagement with individuals and carers around lived experience • Feedback from staff • Monitoring of regulated services and regulated workforce • Safety • Review of complaints and compliments • 6 monthly reports on learning and development • A review of current policies and procedures is underway • Introduction of a quarterly commissioned services performance report Page 126 of 350
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19 Our In-House Monitoring Framework was previously approved for a test of change. This concluded within the reporting period and, following evaluation, operational roll out will commence in April 25. The range of work undertaken by Quality Assurance is detailed in the QA Annual Report. External scrutiny is primarily undertaken through the Care Inspectorate through regular inspection of regulated services including Care at Home, Support Services, Children’s Houses and Family Placement Services with further detail provided within the Quality Assurance report. Strategic and thematic inspections are also undertaken periodically by the Care Inspectorate, the former with other inspection partners. Over this reporting year a thematic (nationwide) inspection of Children’s Throughcare and Aftercare services was undertaken, with North Lanarkshire one of four areas subject to a ‘deep dive’ – details of the findings of this inspection are included within section 2.4.2 of this report. In addition to the mechanisms referenced above practice and staff governance and development across social work functions continue to be supported by an integrated professional meeting structure (social work leadership, social work solutions and social work workforce planning) which maintain coherence across adult, justice and children and family services. 1.3.1 SELF ASSESSMENT Over the course of the reporting period within Adult Services we developed a self-assessment toolkit, which takes the form of an edited version of the Quality Assurance Framework, as set out in the Healthcare Improvement Scotland’s Quality Management System. This approach allowed us to self-assess our capacity for improvement across a range of themes, with each theme setting out criteria with associated quality indicators. The Framework is not intended a checklist, but a reference guide to support and inform reflection, evaluation and decision making about how best to improve outcomes for people. In March 2025, we engaged a small number of services in piloting this self-assessment approach. Through the completion of this self-assessment, we are able inform discussion on what good care looks like; and identify any actions for learning that supports the importance of Direction, Implementation & Delivery and Results. We recognise that by considering leadership and culture; vision and purpose; and the importance of co-design and relationships, we can shape services to ensure good outcome for people across our communities. The learning from the pilot(s) will inform wider roll out across all Adult Social Work and Social Care services. 1.4 PUBLIC PROTECTION ARRANGEMENTS North Lanarkshire Chief Officer Public Protection Group (NLCOPP), chaired by the Council Chief Executive and supported by the CSWO continues to provide oversight and direction for local multi-agency public protections arrangements updating its terms of reference within this period. The group regularly considers reports and data from the local Child and Adult Protection Committees, pan-Lanarkshire MAPPA Strategic Oversight Group and Violence Against Women and Girls Strategic Partnership and additionally Suicide and Drug Deaths and associated prevention activity. Page 127 of 350
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20 The newly established National Public Protection Leadership Group continues to develop its links with local partnerships and provides a vehicle to address common challenges and improvement areas in particular crosscutting issues, at a local level we continue to address these both at system and practice level, with work continuing on transitional safeguarding and incorporating learning from reviews. With recent guidance broadening the criteria for learning reviews in public protection we are also continuing to explore how these can best be resourced to support improvement. 1.5 CARE HOME ASSURANCE Care Homes continue to benefit from the support offered by the Care Home Liaison Team. The team consists of a range of professionals providing bespoke and specialised advice, guidance and practical assistance specialising in areas such as falls, mental health, infection control, continence, pharmacy, and anticipatory care planning, all of which are conducive to continued wellbeing and improved quality of life for adults and older people living in Care Homes. Focused activity and change projects have reported improved outcomes for people resident within Care Homes within North Lanarkshire. Some of the most significant developments are as follows: • Reduction in falls • Improved continence • Multi-Disciplinary Teams (MDT) facilitate reviews for all new admissions and residents of concern with zero waiting time • RESPECT emergency plan offered to all residents • Call before you convey professional advice line for out of hours advice or input • Increase in Hospital at Home usage • Health colleagues trained as second workers to participate in Adult Support & Protection investigations Following review of the enhanced clinical and care oversight arrangements for care homes reported last year, there has been continued support commissioned through the Care Home Assurance and Support Board and the Care Home Collaborative Group. The Safety Huddle Multi-Disciplinary Forum has continued to build on the good practice embedded during the pandemic. The focus of work has been reviewed and refined to include the RAG ratings for each Care Home within North Lanarkshire. Adult Support and Protection escalations have also been included in discussions. These further enhancements maximise the effectiveness of the arrangements in place enabling intelligence to be shared between agencies to identify and allow support to be provided to care homes at risk. Actions are agreed collaboratively to provide an immediate response to safeguard residents. 1.6 ENGAGEMENT WITH THE PEOPLE WHO USE SUPPORT SERVICES, THE COMMUNITY, AND VOLUNTARY SECTOR Page 128 of 350
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21 Work to increase the capacity to enhance engagement and participation across our communities and amongst supported people and unpaid carers has continued in line with the ambition of the Plan for North Lanarkshire and the UHSCNL Strategic Commissioning Plan. The key ambitions of our continued investment to engage supported people, unpaid carers and communities is to: • Improve communication and increase connections • Increase awareness of what matters to people • Increase capacity for early intervention and prevention During 2024-25 the investment and focus to ensure that the voices of supported people was strengthened and has gathered pace. The partnership of the North Lanarkshire Disability Forum (NLDF), Lanarkshire Links (LL) and Voice of Experience Forum (VoEF), work together to deliver a wide range of recurring and non-recurring actions, events and programmes of work using a wide range of methods to engage with supported people and support active participation. They have a remit that includes to: • Build links, create opportunities, and strengthen the interface with supported people • Develop and support an Engagement & Participation Network (E&PN), bringing together groups and organisations who involve and represent supported people • Administer a Growth Pot Fund to enable engagement and participation activities with an aim to reach out to underrepresented communities During 2024-25 there were two rounds of Growth Pot funding that generated 55 applications and 20 awards totalling just over £80,000. The fund reached minority ethnic groups, rural communities and those who experience disability, mental health issues and addictions, and helped these groups better engage with the UHSCP. In September 2024, the University Health and Social Care Engagement and Participation Strategy was launched alongside the Growth Pot Fund. North Lanarkshire Carers Together are a well-established community-based organisation working on behalf of carers to ensure the voice of carers is raised, amplified, and heard. They reach out to carers, share information, and campaign for identified issues relevant to carers, represent the carers voice in decision making forums. There is a full programme of work with a focus on engagement and participation through a range of approaches and methods. The Strategy for Carers 2024–27 was developed with carers and carer organisations. Supporting this strategy is an annual event - Commitment to Carers - engaging with carers, staff, and relevant partners to acknowledge their commitment, showcase services and supports, share significant achievements and gather views on what is important to them to support future plans in this area. Voluntary Action North Lanarkshire oversees the Community Solutions approach and the Children, Young People and Family Network. This supports a broader reach within communities and opportunities to engage in what matters to people in the localities of North Lanarkshire. Community Solutions enables investment in community led initiatives that build community, family, and individual strengths and resources - with a focus on prevention and Page 129 of 350
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22 early intervention. There is engagement with localities to build community capacity, through anchor organisations and Community Consortia provide leadership and co-ordination of activities. Within Children’s Services the Voice Task Group which supports the work of the partnership has further integrated the voice of young people in planning and decision making, by creating opportunities for dialogue between staff and young people through a bi-ennial Youth Voice Conference and leadership staff attending North Lanarkshire Youth Council meetings. Increasingly children and young people have been actively involved in service design such as aftercare support, funding decisions such as allocation on funds to support the mental health and wellbeing framework and raising awareness of UNCRC through a peer led workshop for children and young people. Parents and carers were involved in the procurement of a whole family support services within the developing community hubs. In Justice Services two development workers with lived experience have continued to support consultation activity with those involved with the service. The digital questionnaire they developed last year has been applied to routinely gather feedback on the experience of supported people as well as ideas for developments and service improvements. This questionnaire is complemented with a mid-point and end point evaluation focused on the experience of engagement with justice services. The commissioning of Care Opinion in Adult Health and Social Care and Mind of my Own in Education and Families ensures there are opportunities online for adults, children, and young people to comment, feedback on their experiences and/ or raise concerns. 2. SERVICE DEVELOPMENT, QUALITY AND PERFORMANCE 2.1 PERFORMANCE AND IMPACT MEASUREMENT In line with the governance arrangements outlined above our formal reporting is presented for a variety of audiences, reflecting the scheme of integration and delegation of services to the North Lanarkshire Integrated Joint Board (IJB) and the governance of services within several partnership arrangements. Indicators are in place for core aspects of service, such as access, operational performance, workforce, quality, and outcomes, ensuring that we both monitor and demonstrate how we have fulfilled statutory responsibilities, met needs and produced positive outcomes for the supported people and that the work represents best value for the Local Authority. Critically, in addition to quantitative data, a variety of methods are used to measure impact, outcomes and how people experience our service as reflected throughout this report. In addition to these internal arrangements, performance and quality is both monitored and regulated by several external bodies. Social Work Services provide validated performance and demographic data to the Scottish Government and the various agencies who support Social Work development in Scotland. This data supports the creation of national indicator sets, such as the Local Government Benchmarking Framework and the Integration Indicators which can then be used to support benchmarking and self-evaluation. The Scottish Social Services Council, and the Care Inspectorate also have an assurance role with respect to registered staff groups and regulated services respectively, the latter through regular inspections whilst the Care Inspectorate also have an oversight and assurance role with Page 130 of 350
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23 respect to case reviews in the areas of public protection and justice services as well as in scrutiny through strategic and thematic inspections in partnership with other inspection bodies. Key performance information covering the range of social work service delivery is set out within this section of the report alongside highlights of continuous improvement and development activity. 2.2 SUPPORT TO UNPAID CARERS Support for unpaid carers continues to be critical to sustaining our families and communities. During 2024, a tender exercise to procure carer support services was undertaken, in line with legislation. The contract value of the tender was £18 million, over a six-year period, demonstrating the financial commitment to supporting carers locally. Five lots were included in the tender, with the successful bidders being: • Lanarkshire Carers: to provide carer support, carer short breaks and to fulfil the devolved responsibility (from NLC) for progressing Adult Carer Support Plans (ACSP's). • North Lanarkshire Carers Together: to provide carer information, advice, engagement, and campaigning. • Alzheimer's Scotland: to provide information and support specific to dementia related care. • Getting Better Together (GBT): to provide support to carers around hospital discharge • Action For Children Young Carers Project: to support young carers and to fulfil the devolved responsibility (from NLC) for progressing Young Carers Statements (YCS) Other organisations, with either a direct, or indirect focus on supporting carers remain important in ensuring that the local carer support landscape benefits from a diversity of provision. Augmenting the wide range of activities undertaken as part of Carers Week in June 2024, the second North Lanarkshire "Commitment to Carers" event took place in May 2024 and marked the launch of the North Lanarkshire Carers Strategy 2024-2027. The strategy was the culmination of engagement and participation activity with carers and sets out how caring related needs can be best met over this period. The innovative Carer Breather approach in North Lanarkshire, administered by NLCT and provided by University Health and Social Care North Lanarkshire to deliver options that give carers, and people being cared for, a break from the caring routine was expanded in early 2025 with 15 organisations successfully bidding for Carer Breather funding, This, alongside the short breaks’ bureau, overseen by Lanarkshire Carers, continues to ensure that a range of carer break options are available to carers locally. Developments in technology, alongside equipment available through Making Life easier (MLE), the Equipment and Adaptation Service and the Community Alarm Service saw an increasing number of people, including carers, being supported through these options, all of which seek to maximise independence and minimise risk. This is a trend which is expected to increase over time, as the benefits of connected, linked in support and the reassurance that assistance and support can be on hand, if needed, become increasingly apparent. Page 131 of 350
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24 Estimates vary but suggest that there may be around 40,000 to 50,000 unpaid carers in North Lanarkshire currently, with around 11,000 of these currently known to services. Demographic information highlights that there is a considerable number of carers aged over 70 locally, so the focus on preventative and anticipatory planning remains as vital as ever. 2.3 JUSTICE SOCIAL WORK SERVICES Justice Social Work Services have seen demand relating to core statutory responsibilities increase as the justice system continues to address the backlog of COVID impacts. Service delivery continues to be shaped by key priorities set out in both our new Community Justice Outcome and Improvement Plan (2023-2028) and the Scottish Government’s Vision for Justice published in February 2022, and its supporting strategy published in June 2022, with an increased focus on areas such as diversion from prosecution and bail supervision. We continue to promote a holistic approach to working with people with convictions, to ensure that in addition to robust risk management, support is offered to address the range of issues, such as health and employment barriers, which can inhibit rehabilitation and inclusion and, in turn, better lives and safer communities. 2.3.1 COMMUNITY PAYBACK ORDER-INCLUDING UNPAID WORK Between 1 April 2024 and 31 March 2025, 898 people were made subject to new Community Payback Orders with a condition of supervision attached. Of those, 551 people were also required to complete unpaid work. The Community Payback Order continues to provide Courts with a credible alternative to Custody, with Justice Services continuing to engage individuals in their communities, utilising a proportionate, trauma informed and rights-based approach, supporting individuals address areas of identified risk, needs and seeking to reduce the likelihood of further involvement in the Justice system. Linked to this, communities within North Lanarkshire have benefited from almost 91,000 hours of unpaid work delivered through the service’s Restorative Justice Team. This year’s figures evidence for the second year running that the operational delivery has returned to levels commensurate with pre-pandemic activity. Demand continues to grow and during the period of this report 139,024 hours were imposed by Courts in relation to Unpaid Work and Other Activity, a further rise of more than 5,000 hours imposed over the previous year. The following paragraphs provide an overview of key unpaid work activities: The woodwork workshop teaches joinery skills which enables bespoke items to be made from reclaimed wood pallets which would otherwise be destined for landfill. Working in partnership with family learning centers, nurseries, schools, and communities has allowed those people engaged in unpaid work to be involved in the construction of outdoor classrooms and play equipment helping to promote outdoor play for children throughout our community. In total, 554 items have been constructed and situated within our communities. The bike recycling workshop refurbished bikes, which have been donated by individuals or have been discarded in local recycling centres. The bikes are repaired to a gold standard and are distributed to local community groups, schools, and individuals, helping to maximise opportunities for better health and well-being and providing greater transportation access. Service users within the workshop also undertake bike repairs for individuals who are unable Page 132 of 350
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25 to afford the cost of this. During this period purchase of a mobile bike recycling trailer has extended the provision of bike maintenance and repair within the local communities. To support this also a further 5 members of staff have obtained Velatech Training in Level 1,2 & 3 bronze, silver and gold. In total, 1,443 hours of unpaid work were completed through this area of activity resulting in 364 bikes being donated to individuals within our community. Our Home Improvement workshop provides opportunities for service users to gain experience in decorating, painting, and plastering, giving service users skills which can help them in the labour market. Once the individual is proficient in these disciplines, they utilise the skills learned on a project within the local community. This provides more experience to enhance employment pathways. Squad placements are focused on activities such as landscaping. In total 2049 hours have been completed within squad placements ranging from one to two-day pieces of work to larger projects with a duration of four to six months. In partnership with local housing colleagues and school staff, the Restorative Justice unpaid work team has also facilitated learning events at our community allotments in Townhead, Clydeside, and Wishaw enabling children and people in the local community to sow seeds and learn about different growing techniques. Participants can be invited back later in the year to experience the harvest taking place and can also take away some of the produce. In total 2876 hours have been completed within our allotments, with the produce being distributed to local sheltered housing complexes, food banks, and the public. 2.3.2 OTHER ACTIVITY The embedding of Scottish Government Covid-19 recovery funding has enabled the continued commissioning of Third Sector colleagues to assist in the delivery of ‘other activity’ programmes including: • The Wise Group provided one to one mentoring support for 50 service users. Between 1 June 2024 and 31 March 2025 each of these service users were allocated a mentor for an average of one month and received approximately 12 hours of support throughout that period. As part of their agreed action plan service users can have access to a small discretionary fund to help with their social inclusion through participation in community activities. Following review, an extension to the mentoring period can be provided if necessary. • Reel Time Music project provides service users with an opportunity to undertake sessions in developing skills in relation to creating and producing music, podcasts, or videos. These groups accommodate eight to ten service users at a time, and their videos, and songs are publicly featured and celebrated. • SACRO provide practical support to service users which is delivered using a mentoring approach. The workers act as role models and assist individuals to build self-esteem and improve motivation. • Ten for Zen provides service users with options to develop mindfulness techniques and to experience the emotional, mental, psychological, and physical health benefits Page 133 of 350
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26 that can be gained from this. Examples of these sessions include changing unhelpful habits, managing stress, anxiety, or addressing a lack of hope or in managing anger. Justice Services also directly provide a range of opportunities for service users to engage in Other Activity. Utilising the e-learning workbook resource pack provides blended digital learning which can be completed in partnership with staff. Individuals also use the resources of The Centre for Clinical Interventions as well as the NHS Mental Health Foundation Trust to undertake work in the following areas: • Anxiety, Self-Care, Social Anxiety, Bereavement, PTSD, Self-harm, Sleeping Problems, Depression and Low Mood, Obsessions/ Compulsions and Panic. • Alcohol and You, Cannabis and You, Cocaine, Gambling, Anger Management and Procrastination. • Goal Setting, Self-Development, Writing applications and Interview techniques. The service provides opportunities for accredited training in First aid at Work Level 5 SCQF; 23 individuals have successfully completed this award. 2.3.3 DIVERSION FROM PROSECUTION In line with the priority of extending the use of diversion from prosecution, eleven awareness raising sessions were delivered to over 70 social work staff across children and families, older and younger adults over this period complementing a 3-year programme of training developed and delivered by NLC Restorative Justice Services to Crown Office and Procurator Fiscal Service and Police Scotland. In 2024-25, 242 Diversion from Prosecution Orders were successfully completed, a 49% increase from the previous year. Following the national Thematic Review of Diversion from Prosecution, aligned to the revised national justice strategy, it is anticipated that more complex cases will be included in the scheme going forward. Preparatory work is underway to ensure local policy and procedures will be in accordance with the revised national guidance once published. 2.3.4 OFFENCE FOCUSED WORK Moving Forward to Change NLC Justice Services have been one of the pilot areas for the new Scottish Government MF2C (Moving Forward to Change) programme which will supersede the MFMC (Moving Forward Making Changes) programme. MF2C is an intensive cognitive behavioural therapy intervention for men over the age of 18 who have committed sexual offences and aims to reduce risk of reoffending and is delivered as part of a Court Order or release License. The new programme has been adapted to incorporate up to date literature and can be delivered within Prison-based establishments as well as the community. The Justice Programme Service has now fully transitioned to the new programme. MF2C has been scaled up during the reporting period and there are now a minimum of two groups being facilitated each week, as well as 2:1 delivery for those with additional needs and risks. The programme has been Page 134 of 350
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27 delivered with relative success in relation to low reoffending rates and Scottish Government are now in the process of fully implementing the new programme across all local authorities. UP2U The UP2U intimate partner violence approach continues to be invested in by Justice Social Work (JSW), with new staff continuing to be trained in this programme and existing staff being given access to refresher training inputs. We are now delivering ‘UP2U – Creating healthy relationships two’ the updated version of the domestic abuse intervention programme to individuals convicted of intimate partner violence and who are subject to a requirement to undertake UP2U. Integral to this intervention is the offer and provision of partner support for those who have been, or are still, victims of intimate partner violence. Our UP2U team has also established partnership arrangements with partner support services such as Aura, Women’s Aid and GBV services and is responsible for representing Justice Social Work as part of the MARAC process reflecting our commitment to preventing domestic homicide and domestic harm. At present the service does not receive funding to support the delivery of the alternative Caledonian Programme however Scottish Government has given an indication of their intention to roll this out to those areas who do not currently receive funding over 2025. Should this progress, it would be our intention to enhance our provision by running both programmes. Prison Based Social Work (PBSW) Increasing accessibility to offence focused interventions is also a priority area in our Prison Based Social Work (PBSW) team, based in HMP Shotts. To assist this, PBSW staff continue to maintain their new streamlined system to ensure all individuals are risk assessed within the first five months of entry into HMP Shotts and ahead of their first Integrated Case Management Meeting (ICM). This has had a positive impact on the Risk Management Teams’ ability to make decisions more timeously on an individual’s progression through the prison estate, leading to better outcomes for people serving prison sentences and their families. 2.3.5 WOMEN’S COMMUNITY JUSTICE SERVICE (WCJS) AND BAIL SUPERVISION The Women’s Community Justice Service (WCJS) was established in 2014 in response to the Commission on Women Offenders. Most service users within the service are subject to Community Payback Orders with requirements of supervision and/or unpaid work however the service also works with women subject to parole board licenses, bail supervision, and alternatives to prosecution. During the reporting period the service has further developed its Bail Supervision offer and now has an established pathway for early identification of these cases in collaboration with the court team so that timeous support can be provided to maximise engagement and supporting the national priority to reduce the number of women who experience custody. Page 135 of 350
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28 We have also strengthened the management of our Women’s unpaid work service during this reporting period by deploying an existing Senior Social Worker to oversee and manage female only unpaid work activities. Most of the women using the WCJS have experienced trauma and supporting them with their emotional and mental health needs remains a key element of interventions to support positive outcomes. Multi-agency partnership working with Children and Families, Shine Women’s Mentoring Service, Domestic Abuse and Addiction Services, is also crucial to support this service user group. A new intervention resource entitled ‘Managing Emotions and Relationships’ enabling staff to utilise Cognitive Behaviour Therapy to facilitate structured conversations that help Women to develop better coping strategies. It is planned to extend delivery from primarily a 1-1 basis to groupwork over the coming year. 2.3.6 OTHER NEW DEVELOPMENTS Voluntary Throughcare Through the local Community Justice Partnership employability subgroup, additional funding was secured to extend the offer of our current voluntary throughcare service beyond HMP Addiewell. As a result, a Justice Support Worker was recruited, and the Bridges and Beyond initiative now offers person-centered outreach support to individuals serving a short-term sentence- in various prisons across central Scotland. The Bridges and Beyond service supported 46 service users in 2024-25. The service aims to remove barriers to employment and resettlement for those serving short term prison sentences. It is crucial in helping to reintegrate individuals into the community and reduce the prison population. During 2024 a new national commissioning exercise for a voluntary throughcare service was initiated through Community Justice Scotland. A focus over the coming year be to consider how this will interface with current local arrangements. Early Release of Prisoners In May 2024, Scottish Government brought forward plans to invoke the emergency release of prisoners under the new Bail and Release from Custody Act (2023). This meant that up to 66 North Lanarkshire residents serving short term prison sentences would be released early, to help address the emergency prison population crisis. A local multi-agency planning group was established in North Lanarkshire and led by Justice Social Work. The group coordinated activity to ensure all individuals had access to services and were supported back into the community safely. This local multi agency group was again mobilised in January 2025, to manage a further tranche of early release activity following The Prisoners (Early Release) (Scotland) Bill coming into Force in February 2025. This new legislation means that individuals serving four years or less will be automatically released when 40% of their sentence has been served in custody. 31 individuals were supported by Justice Social Work and partner agencies as part of this work, with the local authority's public protection frameworks utilised to ensure any presenting risk was managed safely using a partnership approach. Drug and Alcohol Solutions Court Page 136 of 350
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29 In September 2023, NLC Justice Services recruited two Justice Support Workers, funded by the North Lanarkshire Alcohol & Drug Partnership (NLADP), to support the introduction of a Lanarkshire wide Drug & Alcohol Solutions Court. This is a Structured Deferred Sentence initiative based at Hamilton Sherrif Court which adopts a public health approach to working with people aged 21-55 who are impacted by drug and, or alcohol, and who are in conflict with the law. Impact measurement through the use of outcome star data over this period indicates that all service users who have accessed support through the initiative have reported progress across multiple life domains. Of note service user feedback indicates that those individuals who have previously breached more defined orders such as Drug Treatment and Testing Order find the flexibility and assertive outreach dimension to the support as well as the trauma informed approach within court, to be more effective. DTTO Drug Testing and Treatment Orders (DTTO) are a Court sentencing disposal aimed at supporting individuals whose problematic drug use is contributing to their offending behaviour. This is achieved through intensive support, drug testing and monthly appearances in front of the sentencing Sheriff. NL DTTO service was designed, and is delivered, in partnership with North Lanarkshire’s Addictions Recovery Teams. A recent development has included the adoption of an Addiction Worker within the DTTO team, this has enhanced consistency of service delivery. The team continue to benefit from funding from the Alcohol and Drug Partnership, the additional resource enables the staff to deliver assertive outreach to enhance engagement. 2.3.7 ARREST REFERRAL An Arrest Referral test for change has continued in North Lanarkshire’s Police Custody suites. Significantly, support is delivered by people with lived experience of the justice system and offers opportunity for early partnership working with individuals in Police custody with a focus on early intervention, provision of direct and practical support, together with a pathway for referral to appropriate supports. This service was the subject of independent evaluation in 2024-25. Iconic Consultancy completed this evaluation and detailed that the service had received 458 referrals during the evaluated period, 84 % of these in respect of adult males. Findings included evidence that the service was successful in engaging hard to reach individuals and was successfully doing so during a time of personal crises, highlighting positive evidence of the effectiveness of a Public Health approach. The evaluation calculated the average cost for each referral at £262 against projected overall savings to the wider Justice system as a direct result of the service. Given the positive impact of the service to date, funding has been extended for a further 12 months to provide scope for further development and to enable exploration of how the service can be offered sustainably. 2.4 CHILDREN AND FAMILIES SOCIAL WORK SERVICES Page 137 of 350
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30 Children and Families Social Work has continued its focus on creating the conditions and culture that enables practice that is rights-based, trauma informed and built on relationships. To help us achieve this ambition, the service has made good progress in its implementation of Signs of Safety and Healing with all Social Workers, working as lead professionals, trained in the approach. Towards the end of the reporting year, Social Workers began to use the Signs of Safety and Healing approach with families, and the accompanying assessment framework, in all work with children and families in need of care and protection. This was an important step in helping us move away from traditional investigatory approaches to child protection to a way of working which is focused on building safety for children, young people, and families by helping people think their way through the issues they are facing and maximising strengths. Whilst Signs of Safety and Healing is now our core approach to practice, it is complemented by other strengths-based ways of working such as Contextual Safeguarding (for children and young people at risk of harm outside the home) and Safe and Together (for families impacted by domestic abuse) to give Social Workers a strong, coherent and value-driven framework for practice. 2.4.1 THE BALANCE OF CARE During 2024-25, the children and families service received 10,279 referrals (requests for assistance and notifications of concern). While this represents a 20% increase in the rate of referrals pre the COVID-19 pandemic, this level of referral rate is just under the average referral rate of 10,713 over the past 4 years. This level of request for a Social Work Service is due to several factors post Covid, including an increase in children with additional support needs, the impact of poverty, young people at risk of significant harm outside the home and enduring social problems such as domestic abuse. The drop-in referral rate of approximately 700 referrals from 23/24 to 24/25, may be attributable to investment in a range of early help services enabled by a range of temporary funding streams including the Whole Family Wellbeing Fund, Scottish Equity Fund and Community Mental Health and Wellbeing Framework, the latter recently mainstreamed, and if so this is a positive shift. We will however continue to monitor how our investments in preventative family support reduce crises for families and impact on the demand for social work support. Whilst more difficult to measure, it is also notable that there appears to be an increase in complexity of need within families who do require social work intervention. The table below illustrates a snapshot of the balance of care in North Lanarkshire over the past 4 years. The overall balance of care is relatively stable with only a slight increase in our care experienced population over the 5 years. The number of care experienced children receiving care in 2024 was 2% of the child population, which is in line with the national average and slightly less than rate for our family group of local authorities (2.5%). The data show a steady increase in the number of children in kinship care which reflects our commitment for children remaining within their families, supported by approaches such as Family Group Decision Making and by our kinship care team. This increased use of kinship is also reflected in a decrease in the use of foster care as the overall numbers of children supported in family placements have remained relatively stable. Page 138 of 350
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31 Despite the increase in the complexity of children with additional support needs, our integrated approach with education has succeeded in supporting most children in North Lanarkshire with their care and education, avoiding an increase in out-of-authority placement. Of the seven children who experienced secure care at some point over the year, four were placed under the authorization of the Chief Social Work Officer on welfare grounds. As in previous years, this has been due to significant risks including those associated with criminal exploitation (CCE), and it was the second time in secure care for three children who had experienced CCE. Balance of Care Placement Type Number As Of 31 March 2021 Number As Of 31 March 2022 Number As Of 31 March 2023 Number As Of 31 March 2024 Number As Of 31 March 2025 Foster care (NLC) 112 94 89** 91** 85 Foster care (Independent) 61 53 51 57 61 Home Supervision 227 188 205 196 203 Formal Kinship Care 321 307 325 358 365 Informal Kinship Care 170 183 191 180 192 Residential (NLC) 27 27 31 32 30 Residential (Independent) 11 11 9 10 9 Secure* 2 6 7 5 7 Continuing Care 53 73 74 77 73 *The number of young people spending time in secure accommodation during the full year. Note there was an average of 3 NL young people in secure care on any given day during 24/25. This figure includes those remanded or sentenced through court processes. ** adjusted from figures reported in previous CSWO report following data quality review. 2.4.2 MOVING ON: SUPPORTING CARE EXPERIENCED YOUNG PEOPLE Increasing the quality and availability of support for care experienced young people who have left care has been, and continues to be, a focus for improvement. Additional investment from the council and NHSL, and use of the Community Mental Health and Wellbeing Framework monies, has supported us to create an ‘Aftercare Hub’ delivered from our intensive services base which provides holistic social, health, counselling, and housing support from one space. The hub complements support from locality Social Workers to provide additional help to young people over seven days a week where required. The increase in the numbers of young people supported is illustrated in the table below: Care Experienced Young People Experiencing After Care Number As Of 31 March 2022 Number As Of 31 March 2023 Number As Of 31 March 2024 Number As Of 31 March 2025 Page 139 of 350
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32 Number of young people eligible for compulsory aftercare (age 16 and 17) 113 98 59 48 Number of young people in receipt of compulsory aftercare (age 16 and 17) 75 77 42 40 Number of young people eligible for discretionary aftercare (18-25) 197 506 521 531 Number of young people in receipt of discretionary aftercare (18-25) 67 257 252 275 The reduction by more than half in 16- and 17-year-olds leaving care reflects our commitment for young people to remain in care or continuing care until ready to move to independence and it is positive that nearly all 16- and 17-year-olds who do leave care (including care at home with parents) for whatever reason accept the support offered. 63% of young people who left care at the age of 16 or 17 were care experienced at home or in kinship care. In 2024, North Lanarkshire was selected by the Care Inspectorate as one of four partnerships to participate in a focused review of experiences of young people and the quality of the services being provided for them, as part of an overall high level national review of throughcare and after care support. In North Lanarkshire, the Care Inspectorate found: • North Lanarkshire had a clear approach and commitment to supporting and improving the participation of care experienced young people and providing effective opportunities for them to influence service design. • Young people had opportunities to establish supportive, compassionate, and responsive relationships with staff and other key people involved in their support. • Leaders ensured there were mechanisms in place for all services to collaborate effectively to meet the needs of care experienced young people. • Overall, young people said they were receiving the right support at the right time across the pillars of the Care Leavers Covenant. However, some stated they were not receiving support with their mental health, housing, and offending behaviour. • Some young people commented on the difficulties they experienced due to not feeling ready or prepared for moving on, nor in the right place for them once they had moved on. The review also highlighted our integrated approach to health and wellbeing as an area of good practice based on listening to the voices of care experienced young people and involving them in service design to remove barriers for young people to access health services. The approach comprises of Social Work staff, NHSL funded Nurses and the Exchange Counselling staff working collaboratively from the After Care Hub, which we have found is crucial to meet needs and avoid young people being lost or excluded from adult orientated systems. Over 2024, the throughcare and after care nurses worked with 82 young people with a higher number of males than females referred, although this ratio is in line with the local number of males/females who are entitled to aftercare support. The highest number of referrals were for those aged 16-18 years and additionally, those 22–23 years. Below are the reasons stated for young people being Page 140 of 350
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33 referred to this element of our service. Feedback from young people about the service has been very positive, with the service receiving a 4.8 out of 5-star rating. What young people have said about the service: • “There is someone to talk to you.” • “They have helped me a lot I wouldn’t be going to dentist/doctors’ appointments without them they are great and really helpful.” • “I felt listened to and helped by the nurse.” • “I think it’s a great service for young people.” • “It is a lot better than most services I have attended.” The Exchange Counselling Service codesigned and produced with and for care experienced young people increased the number of young people supported from 42 in 2023-24 to 64 young people in 2024-25. 53 young people receiving face-to-face support and 11 alternate methods. The most prevalent reasons for accessing support were Trauma, Bereavement, Anxiety, Family Relationships/ Home issues, and Anger. 81% of young people reported an improved outcome at the conclusion of their intervention, with no requirement for any onward referrals being made to other services. The Aftercare hub is complemented by a bespoke co-designed website, Aftercare Northlan, which went live at the beginning of 24/25. Over the last year there has been over 2100 visits to the site with positive feedback about the content, with the most popular pages visited - Pathway Planning (My Future Planning), Money Matters and Where I Live, a potential reflection of the priority needs of young people. Page 141 of 350
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34 2.4.3 A LOVING HOME: ADOPTION, FOSTERING AND KINSHIPCARE Family Care The Children’s Carers Service provides support to kinship carers, supported carers of young adults, as well as to adopters and foster carers to achieve loving homes for children and young people into adulthood. Despite a reduction of the overall number of in-house foster carers, our use of foster carers from other agencies has remained relatively stable thanks to the commitment and flexibility of our carers supported by our carers team. Our carers have also worked to keep as many brothers and sisters together as possible. Of the 92 children starting a new placement during the year, 61% were living with at least one brother of sister. This represented a slight increase compared to the previous year. The reduction in foster carers is however an area of concern both locally and nationally. Locally from our data we can see that the number of in-house foster carers continued to decrease. Recruitment therefore has continued to be a high priority. While there was a slight reduction in the number of enquiries we received about fostering over the previous year, the proportion of people who progressed to be assessed as foster carers increased as illustrated in the table below. Page 142 of 350
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35 Despite the challenges in recruitment, the number of foster carers is consistent with previous years: As illustrated in the tables above, our adoption data has remained constant since post-Covid. Adoption approvals have also increased, reflecting the continued interest and enquiries on adoption. This means that we can match children in need of adoption to adoptive parents, mostly within North Lanarkshire. We have continued to offer learning and development opportunities to adopters both pre- and post-approval alongside post-adoption support groups and commenced a review of what other supports may be helpful moving forward for adopters, particularly for adopters of teenagers. A short-life working group considered feedback from children, young people, and adopters and will provide the basis for service redesign as part of our wider corporate parenting review. As well as recruitment, retention and support for existing carers has been a priority with access to our training and support programme enhanced to include adopters and kinship carers. Early indications are this has been successful in increasing numbers of participants with positive feedback on the added value to carers understanding of each other's roles and the needs of the children within their care. Initial Enquiries Initial Inverviews Attended Prep Group Progressed to Full Assessment 2021/22 120 63 21 8 2022/23 128 68 28 10 2023/24 131 57 28 9 2024/25 112 48 21 12 0 20 40 60 80 100 120 140 Initial Enquiries and All Outcomes 2021-2025 Approved Assessments Adoption Foster Care 2021/22 14 7 7 2022/23 11 8 3 2023/24 16 10 6 2024/25 17 11 6 0 2 4 6 8 10 12 14 16 18 Approved Assessment by Resource 2024-2025 Page 143 of 350
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36 To support carer wellbeing, sessions in mindfulness and mindful yoga were provided along with a second therapeutic support group for adopters and permanent carers. In response to feedback, we also piloted work with a qualified Social Worker to support carers with an understanding of trauma practice, exploring self-regulation in a space which builds from lived experience. As reflected above many children who live away from home, live in kinship care in North Lanarkshire increasing demand for support from the kinship team. Kinship support groups also took place on a fortnightly basis across North Lanarkshire with individual therapeutic and groupwork sessions also introduced involving mindfulness and trauma informed yoga which were well attended by kinship carers at the children’s carers centre. The number of children formally looked after in kinship care has increased over the past three years and in response, we have recruited additional support workers to help carers manage the complexity and emotional demands of their caring role. This has increased our capacity for practical and emotional support going forward. Our Virtual School has also prioritised support to kinship families including in school holiday periods, this has been well attended and evaluated well. Children’s Houses There continued to be significant pressures on the demand for residential childcare and throughout the year our children’s houses have remained at or slightly over capacity. In large part this has been driven by an increase in young people being at risk of harm out with the family home, in line with UK-wide trends. These risks to young people often compound existing pressures and difficulties facing families meaning our children’s houses have continued to look after young people with a high level of complex needs. To support staff and service development in light of these complexities and the needs of young people in our children’s houses, we have recruited a Senior Social Worker with the specific remit to provide quality assurance and oversight to the children’s houses. This post, subject to review at two years is supporting our self-evaluation work and inspection activities; to develop annual improvements plans and work to strengthen children and young peoples’ voices and individual planning. Unaccompanied Asylum-Seeking Children Within North Lanarkshire we have a well-established multi-disciplinary resettlement team, this comprised of colleagues from Social Work, housing and community learning and development. Social Work staff have specific statutory responsibilities for our unaccompanied children and young people who are deemed as care experienced upon arrival with demand growing over time in line with the increasing number of young people arriving through the mandatory National Transfer Scheme (NTS). As at end March 2025 we were supporting 64 unaccompanied children and young people (UASC) including a small number of ‘spontaneous’ arrivals Following self-evaluation activity, the team have developed links with our local college, New College Lanarkshire to ensure our young people had access to full time further education in Page 144 of 350
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37 our local area, The service also introduced trauma informed yoga and grounding support for access by the children and young people who otherwise find it difficult to participate in mainstream talking therapies due to the language barriers. The team have also developed a partnership with a charity who focus on the benefits of nature and outdoor healing to support with the impacts of trauma. These enhancements in our service were well received and evaluated by the children and young people accessing these and strengthens the offer of support from North Lanarkshire Council that already exists through our social work, housing and Community Learning and Development offer. Whilst tariff funding is received through the Home Office to support associated costs the increasing number of young people supported mean that our previous model of supporting all arrivals through our children’s houses or supported carers is no longer sustainable and we are therefore continuing to develop and review wider accommodation and support models in close liaison with housing colleagues. 2.4.4 INTENSIVE FAMILY SUPPORT Social Work intensive services work alongside locality based Social Workers and support staff to provide additional support to children and young people and their families to prevent accommodation and support maintain family care. This area of our service includes Community Alternatives, working mainly with older children and their families and carers; Families First, working with younger children; Youth Bridges supporting young people in conflict with the law with reintegration from prison/secure care to the community; the Aftercare Hub supporting care experienced young people and care leavers (see 2.4.2 above); and Family Group Decision Making / Lifelong Links supporting individuals and families to strengthen important relationships and their natural support networks. Services operate over seven days, providing intensive (sometimes daily) support on an individual, family and groupwork basis, working with between 450 and 500 individual children at any one time over the year. Between April 2024 and March 2025, the service concluded intervention with 360 children and young people (including those involved with Youth Bridges) with the graph below illustrating the range of issues experienced for these children and their families. Page 145 of 350
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38 (Other – physical and emotional health, housing, life story work, relationships, aftercare) At the conclusion of interventions initial outcomes were assessed as being achieved in full for 66% of children and their families and partially for 15%. In large part, this meant keeping children within the parents or extended family and avoiding the financial and human costs of care out with the family. Further analysis of the 12% of children and families whose outcomes were not considered to have been met is taking place to inform learning and future planning. Our Family Group Decision Making (FGDM) service supports and empowers families build on family assets to sustain family care and has supported 107 families referred during this year. Desired outcomes, identified with families, were to prevent accommodation, support rehabilitation, maximise pre-birth supports, mediate and agree a family contact plan or to mobilise family support. Over the same period 85 families have been supported to agree a plan, concluding through a Family Group Decision Making Meeting or with this being scheduled whilst 22 families have completed a significant piece of work, whereby a plan has been achieved without the requirement for a formal meeting. There were 30 families referred to the service where work did not progress due to a change in the child’s plan, withdrawal of consent or non-engagement. Lifelong Links engaged in new work with 15 young people during April 2024 – March 2025 with an average age of 19 Years. This work is long-term requiring patience and reliability to build a trusting relationship to work with young people in a trauma informed way. All young people who received support have sought an understanding of their care journey having key questions, such as information on their birth family, their experiences, why they became care experienced, or on specific decisions and events in their life, often requiring time to reflect and understand their care journey, in addition to considering who they want to connect or re- connect with and who they want to have as part of their ongoing support network. Of the young people who chase to make connections/reconnect with significant people, 16 young people were supported to make direct contact and 4 made non-direct contact, with Page 146 of 350
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39 plans to sustain contact moving forward. The most connections a young person was supported to make was 13 people and another young person contacted 10 people, with the average being three people. These connections were from a wide range of family members and professionals from their childhood network of support. In September 2024, the FGDM and Lifelong Links Team successfully gained full accreditation from the Family Right Group (FRG), a long-established national organisation with a clear focus on the welfare and family justice, supporting children to live safely and thrive within their family. The Intensive Services Summer Programme targeted 47 families of children under 12 and 30 young people (12-18) where there was a risk of children coming into care recognising the additional pressures of this period for families. The Families First summer activities focused on whole family activities to encourage play and learning as well as building resilience in the children and confidence in the parents. This included Messy play, Tye-Dye Day, Making Music Day, and Canvas painting and finished off with a ‘Grand finale’ fun day and Strathclyde Park. The Families First Newsletter highlights some of the fun had by all involved. 2.4.5 YOUNG PEOPLE IN CONFLICT WITH THE LAW Early and Effective Intervention Over the year 115 young people were referred for Early and Effective Intervention (EEI) which seeks to divert young people who have become involved in offending away from statutory measures through tailored early support. Of these, social work led the planning and support for 49 young people whilst the named person/pupil support staff in school were responsible for the other 65 young people through the planning for children’s wellbeing process within the GIRFEC pathway. To support continuous improvement, we evaluated work with 19 of the young people involved with social work finding that workers felt confident using their relationship with the young person to understand their context and good examples of collaborative working with education and youth work to improve the wellbeing of young people and reducing further conflict with the law. The evaluation also, however, highlighted a need to ensure there is a greater focus on wider needs and that the voice of the young people is clear within the plan for them. In January 2024, we launched the Compass Project to offer a youth work approach to young people referred for EEI using asset-based approaches to empower young people to identify their own needs and strengths. 77 young people have been involved with the Compass Project to date with around 300 group sessions and 130 individual sessions delivered. Ten mainstream secondary schools and the We Aspire Colleges have taken part in EEI/Preventative group work Page 147 of 350
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40 programmes, with 14 young people having the opportunity to take part in two blocks of Fire Skills at Fire Reach with a 95% pass rate for the participants. Youth Bridges Youth Bridges provides intensive, individualised support to young people aged 16-21 who have either been remanded within HMPYOI Polmont or are serving custodial sentences. The focus of this support is the immediate assessment and information sharing for young people upon their arrival to custody, ensuring their wellbeing whilst within custody and supporting in their rehabilitation back to the community, and beyond, aiming to prevent further contact with the adult justice system. Following the implementation of the new Children (Care and Justice) (Scotland) Act 2024, all young people aged 16-17 who are remanded or sentenced to custodial sentences at court are now placed within secure care accommodation. The role of Youth Bridges is therefore developing alongside these legislative changes and assisting in the support of 16-17 years olds placed within secure care accommodation, supporting, where required, subsequent transitions to HMPYOI Polmont. Youth Bridges staff also carry out Diversion from Prosecution assessments and intervention as part of the wider Intensive Services team to help divert young people out of the adult justice system through early intervention. In the period April 2024–March 2025, Youth Bridges staff undertook 23 Diversion from Prosecution assessments of which 19 were completed successfully in diverting the young people involved from the criminal justice system. During the same period, there were 26 young people remanded or sentenced to custody within HMPYOI Polmont who were supported by the Youth Bridges Service. Furthermore, following the changes within the Children (Care and Justice) (Scotland) Act 2024 outlined above, two young people were supported within secure care accommodation following being remanded at court. With this support both young people made a successful transition to the community, including work/training and avoided further conflict with the law. Peer Mentors With CORRA funding, the service established a peer mentoring scheme, following consultation with young people who had been in conflict with the law. The aim of the service was for care experienced peer mentors to work closely with young people and offer flexible support whilst being supported in their roles to work out their own pathways for future careers. This has been a real journey for all the mentors with exceptional emotional and personal growth noted. The peer mentors have co-produced this service, including all processes and how the service is delivered. Initially the peer mentors focussed on providing 1:1 mentoring for young people in conflict with the law, but as time and learning has developed the service is now more geared towards flexible group work in the community and within schools; working closely with young people to develop their confidence as this is what our young people requested when working with the mentors. The peer mentors have also worked with the Compass Project. To support their own development peer mentors have worked closely with CLD colleagues completing a range of SQA accredited courses and First Steps to Youth Work whilst also Page 148 of 350
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41 supported by workers from our After Care Hub in relation to their own specific needs. All the peer mentors now have clear pathway in terms of the next steps for the own career. 2.4.6 CHILDREN WITH ADDITIONAL SUPPORT NEEDS (ASN) Following an increase in demand for ASN related support and rising levels of children in education with additional support needs, mapping work was undertaken both within the children and families service and across the partnership, to scope the landscape of support for families. It was identified that there is a wealth of strategy, support, expertise, and resources in this area, both within Social Work and across all partners; however, the connectivity and integration of support could be improved to take account of need. Mapping identified a need for specific community based, intensive early intervention approaches focusing on ASN, particularly where needs are complex, to complement the support already available. Whole Family Funding has therefore been used to enhance support for children affected by neurodiversity and to provide support to families of children attending ASN schools. An ASN Children with Disabilities Oversight group was established to connect developments in ASN, to take forward a response to gaps identified, to review these regularly and to provide a coordinated and timely response. 2.5 ADULT SOCIAL WORK SERVICES Over the past year within Adult Health & Social Care Services, we have been working on the development of an enabling approach which supports the move from our work on back-to- basics to getting it right for everyone, as we recognise the landscape of health and social care is changing and services, supports and responses need to change to continue to improve the lives of people we support. We have sought to adopt a human learning approach by trying different ways to focus more on people and less on systems and processes, using resources to their best effect to make the most positive impact on peoples’ lives. Through the learning as management strategy (also known as Human Learning System), we have been working with academic and national partners including Healthcare Improvement Scotland and the Centre for Public Impact to make learning and experimentation a key driver in our work. A key element of the learning approach has been the development of a Whole System Enabling Approach strongly embedded within each of the six localities, which supports a place-based model. Overarching this work has been our aim to ensure that when people contact our services the response is quick and effective, with a focus on helping people to help themselves first. Our approach is to work to principles, rather than rules that continue to support people to thrive by providing targeted services that are tailored to reflect their diverse needs. Keeping people central to the decisions that affect them is key and has helped us plan actions that support positive outcomes for those who access our services. Page 149 of 350
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42 Over the coming year we will further develop specific plans and service developments: as this is a whole system approach, we anticipate there will be a lot to focus on and much change across services, supports and responses that are needed to achieve and sustain change. 2.6 EARLY AND PREVENTATIVE INTERVENTIONS – RIGHT SUPPORT, RIGHT TIME 2.6.1 GETTING IT RIGHT FOR EVERYONE (GIRFE) Getting It Right for Everyone is a Scottish Government led, multi-agency approach to Health and Social Care support and services. Building on existing best practice, it is aligned with the Getting It Right for Every Child approach within children’s services. The Getting It Right for Everyone approach was developed in North Lanarkshire and across 8 other Health and Social Care Partnership areas across Scotland following a process of co- design with people who use services, carers, professionals, and those who may use services in future. The co-design process established that many people accessing Health and Social Care were frustrated by: • having to tell their story multiple times • information that is too complex • multiple appointments with different people The Getting It Right for Everyone approach aims to ensure that: • it is easier for people to get the help they need • people are at the centre of decision making • everyone works together to provide consistent support, no matter what kind of help is needed at different times in a person's life Page 150 of 350
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43 Getting It Right for Everyone is focused on providing a more personalised way to access help and support at the time when people need it. It has clear principles in place to guide the Health and Social Care workforce and confirm the service and outcomes people in North Lanarkshire should expect to receive. The Getting It Right for Everyone principles developed for all professionals to use are: • I have the information I need to make decisions about my life, in a way that works for me, and I am supported to understand what options are available to me, and trusted to know what is right for me • the people who support me take the time to listen and understand me as a person and we consider my whole life when making decisions about my life • I know that I can be clear about what matters to me, and I trust that my choices will be respected and understood by the people who support me • if I need to access services or support, I am treated with kindness, dignity, and respect at all times. • the people I am involved with work together with me and each other to share information, in a way that is accessible to me and develop a clear understanding of how to support my wellbeing The Scottish Government have recently made a Getting It Right for Everyone tool kit available online and within North Lanarkshire, the Getting It Right for Everyone Programme Board will ensure that Getting It Right for Everyone is embedded into all work in Health and Social Care. 2.6.2 MAKING LIFE EASIER (MLE) The Making Life Easier and Disability Information Team is a small team with one Resource Worker and two Disability Information Officers providing a comprehensive information, advice, and support service for people with disabilities, their family, friends, and carers. Making Life Easier (MLE), our online resource, offers all North Lanarkshire residents the tools to support people to live active and healthy lives, self-manage their health conditions. MLE also provides pathways to direct supports and services if required. The team have had a successful year, actively promoting Making Life Easier by attending over 70 events, working with our partners and local organisations whilst in 2024-25, 15,396 people in North Lanarkshire used MLE, an 89% increase on the previous year with 490 people completing a self-assessment and a further 170 people completed a LifeCurve™ assessment. Making Life Easier will be refreshed in the coming year in line with the hub operating model and supporting localities with their multi-disciplinary enabling approach. Page 151 of 350
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44 2.6.3 ASSISTIVE TECHNOLOGY TEAM Over the past year, the assistive technology team has firmly embedded itself in every stage of care planning. An ongoing presence in the new enabling approach meetings and the consistent prompts integrated into MOSAIC, our new social work database encourages staff to "think tech first", thus ensuring technology is considered as a means of achieving positive outcomes. Our focus remains on reducing carer stress, empowering individuals, supporting independence, and reducing social isolation. Additionally, we continue to collaborate with other services to help alleviate their increasing pressures and demands. The last year has seen a strong emphasis on integrating assistive technology into the MLE self-assessment platform. Additionally, work is progressing on the "No Need to Fall" project, funded by the Tech for Better Care programme. This initiative, in collaboration with Scotland's Digital Health & Care Innovation Centre and NHS Lanarkshire, aims to develop a technology- enabled approach to relational and proactive falls prevention. A new test of change is currently also in progress for younger adults transitioning from school to post-education placements. This I initiative arose from the realisation that our previous test of change, which focused on Komp, was not likely to benefit this age group. It highlighted the need to implement technology which supports cognitive function that will ensure that individuals of all ages can benefit from the team's input and support. The team are also immensely proud of their recent shortlisting for a Local Government Chronicle award for best medium sized team. Across 2024/2025, 1,364 people were referred to the team. Most of the referrals continued to be for older adults, with 40% of people accessing the service being over 80 years of age and 40% between 61-80. Referrals resulted in 988 assessments of need, informing the allocation of council provided technology, and/or self-purchase items. Page 152 of 350
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45 2.6.4 COMMUNITY ALARMS AND ANALOGUE TO DIGITAL The Community Alarm Service (CAS) supports vulnerable individuals to remain safely in their own homes using discrete and unobtrusive technology and working closely with the Technology Team. The service gives both the person accessing the service, and their family, reassurance that help is always available if required. The service operates 24 hours a day, 365 days a year, and supporting people living within their own homes across North Lanarkshire. Whilst a community alarm most commonly consists of a standard alarm base unit and pendant alarm, dependent upon the person’s level of need, additional devices such as bed or epilepsy sensors, fall detectors and GPS devices can be used to ensure any safety concerns are satisfied. The Community Alarm Service provides a full call monitoring service assessing each contact and to establish what the issue is. Responses can include dispatching a home support worker, contacting family/friends to respond, or contacting emergency services. On average, the response teams attend more than 460 uninjured fall visits each month. This is of significant benefit to the Scottish Ambulance Service and the individual, as it minimises the time someone waits for assistance while easing resource requirements for ambulance staff to attend quickly. The service is currently undergoing a significant transition to a digital model as the UK moves toward digital telecommunication systems. Within the coming months the service will transition from its current Analogue Alarm Receiving Centre to a New Digital Alarm Receiving Centre, in partnership with other councils and organisations across Scotland. The service received positive feedback from its previous inspection and is graded as good and very good across all areas of inspection activity. Activity: As of 31 March 2024, Community Alarm Service supported approximately 7,700 people with 6,150 individuals supported in individual homes and a further 1,550 people in housing with support. The community alarm service also supports around 1,000 pieces of assistive technology equipment, programmed through the alarm receiving centre, with equipment ranging from door contacts to hard-wired smoke detectors for individuals with a cognitive impairment. 118 85 112114 131121 136130 77 117 129 94 0 20 40 60 80 100 120 140 160 Referrals by Month 2024-2025 3% 5% 12% 39% 41% Age Range of Referrals 2024- 2025 0-20 21-40 41-60 61-80 81-100 Page 153 of 350
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46 Response Advisors also provide support to out-of-hours Home Support and takes Social Work emergency service calls from 01.30am. The average call volume each month received within Community Alarm is around 48,000 with around 2,180 of these leading to a visit from a Community Alarm Home Support worker (HSW) for face-to-face support to be provided. The replacement of analogue alarms commenced in January 2023. To date, 6,600 units have been procured, with 3,000 units installed. This rollout is being carried out with the support of staff from the Equipment and Adaptation Service and the Assistive Technology Team, with completion targeted for the end of 2025. Staffing levels within the Community Alarm service have remained unchanged since the service was established and a priority over the next period is to review this in the light of both digital system developments, high call levels and the diversity of needs supported by the service. 2.6.5 EQUIPMENT AND ADAPTATION SERVICE (EAS) The equipment and adaptation service has gone through a transformational change with the implementation of Elms 2, the new online ordering system. There have also been internal process changes to enable and improve the service whilst the quantitative data that the service can now collate allows for more accurate reporting. The service uses a prioritisation framework to enable resources to get to the right people at the right time. This helps with prioritising equipment and adaptations based on the person's functional needs. With these fundamentals in place a wider service redesign is being progressed building on feedback from staff and service users. 2.6.6 SOCIAL WORK TRANSITION TEAM We have seen an incremental increase in the number of school leavers with a range of additional support needs being referred for enhanced Transition planning. As of 31 March 2025, we had 235 summer leavers actively working with the Social Work Transition Team, a 26% increase on last year’s number of 186 school leavers. 2025 School Leavers 18% - Have been assessed as requiring an individual budget and support package 30 % - Require lower level supports from Locality Support Services 52 % - Have been supported throughout transition process and assessed as not requiring ongoing Social Work supports or signposted to universal services There has been a change in complexity of need, resulting in an increase in numbers of young people with life limiting conditions. We have also seen an increase in requests for support with Mental Health. Development Work • As referenced in 2.6.3 above work continues alongside the Assistive Technology team to explore solutions to enhance confidence, independence and potentially eliminate Page 154 of 350
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47 the need for some elements of ongoing support. Tech will be trialled, within young people’s homes and within the college setting. • The team have been liaising with other neighbouring council services to explore provisions for young people with severe and complex physical health needs. Most young people in this cohort benefit from therapies to support mobility and sensory regulation. However, within North Lanarkshire there is an identified gap with families currently travelling to other local authority areas to access Hydrotherapy and Rebound therapy. 2.6.7 LOCALITY SUPPORT SERVICES (LSS) Enabling individuals with additional needs to live the lives they choose—independently, within their own homes and communities—remains a core priority for staff across the six Locality Support Services (LSS) within Health and Social Care North Lanarkshire. These services play a critical role in delivering longer-term reablement and rehabilitation, through consistent and skilled teams ensuring that individuals receive the right support, at the right time, and in the right way. Over time, LSS has evolved a highly effective model for delivering flexible, short- to medium-term support working with individuals in developing key life skills, including community engagement, independent travel, and daily living. While originally established to support people with learning disabilities, LSS now provides support to individuals with a broader range of needs, including sensory impairments, neurodiversity, physical disabilities, and addiction. This often results in a reduced or eliminated need for ongoing social work involvement. In September 2024, management of the LSS transitioned from an area-wide structure to a locality-based model. This shift has enabled localities to deploy resources more responsively in line with local needs. To maintain consistency and coherence in service delivery across North Lanarkshire, area-wide colleagues continue to play a key role in supporting the services. Regular cross-locality meetings are held to oversee the strategic direction, role, and remit of LSS across the partnership. CORE SERVICES: CONTNUING SUPPORT 2.6.8 INTEGRATED DAY SERVICES (IDS) FOR OLDER ADULTS: OVERVIEW AND DEVELOPMENT Integrated Day Services (IDS) for older adults continue to provide essential support for individuals with complex needs, enabling them to live safely in their own homes and often preventing hospital admissions. The service operates across all six localities in North Lanarkshire. During the COVID-19 pandemic, IDS nursing staff were redeployed to older adult community mental health teams in all, but one locality and this model persists. An ongoing service review will address key considerations such as the model of delivery, compliance with safer staffing legislation, transport, and facility requirements with the aim to establish a post-COVID service model that ensures enhanced support for older adults in North Lanarkshire, aligning with the objectives of the Dementia Strategy. Dependency levels and complexity of needs among Page 155 of 350
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48 individuals requiring IDS support have increased. IDS staff remain dedicated to providing comprehensive support, not only to service users but also to unpaid carers. Community outreach through IDS-organized groups also continues in all localities and enjoys strong attendance however transport and community venues can be a constraint. Locality Link Workers are actively collaborating with local partners to address and mitigate these barriers, ensuring accessibility to this alternative, low-level support. These community groups complement the core IDS services, which primarily cater to individuals at more advanced stages of their dementia journey. 2.6.9 HOME ASSESSMENT TEAM (HAT) The Home Assessment Team (HAT) has continued to have a positive impact. Over the last budget year 2024- 2025, HAT received 342 referrals for support, and of these referrals, following a two-week period of assessment, 158 people did not require any further service or support. Discharge planning at both University Hospital Monklands and University Hospital Wishaw has noted an improved picture. This has been supported by the Whole System Change with robust assessments being undertaken at the first point of contact. The aim is to ensure that all assessments are undertaken in people’s own homes, improving outcomes and supporting quicker recovery. More broadly the service remains committed to finalising implementation of the operating model initially approved by IJB in 2018m the Home First approach, which will focus on supporting people through multidisciplinary intervention to be assessed and supported at home, avoiding unnecessary admissions and helping people home from hospital at the earliest opportunity. The Home Support Service will be integral to this approach by facilitating discharges and assessing people at home rather than in hospital. Assessing people in their home environment is more effective in understanding what is needed to help people live within their local communities. Following a period of assessment at home, it may be necessary to provide further support through reablement. The service has been focusing on restoring a fully functioning Reablement Service whilst promoting the use of assistive technology. This will further support the ambition to ensure that people receive support and care which aids recovery and maximises independence in their own homes, thereby reducing the reliance on long term Home Support services and ensure service capacity in the wider service can be focused on those with longer-term needs, The service is also making the changes required to be more responsive and flexible, in line with Self-directed Support, and moving away from time and task to outcome focused service delivery. 2.6.10 HOME SUPPORT SERVICE – LIVING WELL AT HOME Over the last budget year, the service received 3,800 requests for assistance from people not previously known to the service. The number of care hours delivered has risen steadily since the pandemic and remains significantly higher than the hours delivered pre-covid. The service currently supports 2,235 individuals. Page 156 of 350
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49 Data gathered and used to inform planning highlights the significant growth in multi-worker visits whereby 33.5% of all visits require two or more workers to support service users. Despite the increase in the hours provided, the number of service users has fallen in the corresponding period reflecting that those supported present with more complex health and social care needs. As of the end of year there are 1045 Home support workers employed by the service, 977 female and 68 male. 270 of these workers are aged over 60. The service has a rolling recruitment programme to fill vacancies as turnover has been higher due to workers leaving the service through retirals, ill health and other factors. The service continues to work closely with the Care Inspectorate to meet requirements and make improvements which have been identified through the inspection process. Challenges related to staffing have previously impacted on direct delivery and inspection gradings, however, the service is starting to see an improving picture with grades of 3s, 4s, and 5s in all localities. A key aspect of service efficiency and improvement is the implementation of a dynamic scheduling tool to benefit Home Support Workers in the community and for those who schedule and plan work. It is an essential development to aid back-office staff in scheduling support and to adapt quickly to changing needs efficiently and effectively. There is a detailed roll out plan for the implementation of the new system which commenced with the Bellshill Home Support Team in March 2025. It is anticipated that the system will be operational across all teams by August 2025. To ensure efficiencies are realised, frontline worker shift patterns have also been reviewed as worker availability does not always match demand for service delivery. 2.6.11 TRANSFORMATIONAL SELF-DIRECTED SUPPORT (SDS) AGENDA AND INDIVIDUAL BUDGETS The Self-Directed Support (SDS) Transformation Agenda in North Lanarkshire aims to support and empower people living in North Lanarkshire to lead full and meaningful lives by achieving outcomes, whilst being connected to the people and things that are important to them. As we progress on this agenda, we continue to involve a diverse range of leaders and stakeholders from across our whole system, partner agencies, and third sector organisations in the development of an SDS implementation plan. Over the past 12 months, we have commenced a self-evaluation in relation to the national SDS Framework of standards to consider how well we are implementing this and what the impact of this is on people. We will continue to engage with people with lived and living experience, their carers and those around them, to understand in more detail the impact we have on people's lives and to inform both an improvement plan and our implementation plan. In line with the implementation of Getting it Right for Everyone and our new information management system, a new Guided Self-Assessment (GSA) was developed - to reflect unmet need and risk, using a whole system and strength-based approach, ensuring a fair and equitable resource allocation. This is a key feature of enhanced local autonomy and accountability and ensuring that decisions are made closest to people. The vision is that one Guided Self-Assessment for adults will align with the principles of one assessment and one review. Page 157 of 350
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50 We have also worked in partnership with ILF Scotland following the re-opening of the fund in April 2024. Through this collaboration and proactive work across locality teams, we have enabled 113 people living in North Lanarkshire to access additional funding which will contribute towards achieving their identified outcomes. Our engagement and approach to using this funding for people living across our communities has been lauded by the ILF. Activity: In 2024/2025 we supported 2,971 people with an individual budget, delivered across the four options as shown with a financial resource of £106.7M. This includes NHSL contributions of £2.2 million and ILF contributions of £4.1 million. The breakdown across the four options is set out below: • Option 1 – Direct payment – 395 • Option 2 – Budget managed by support provider – 2,371. • Option 3 – Budget managed by local authority - 185. • Option 4 – Budget managed by a mixture of first three options – 20. The focus for the year ahead is to complete the self-evaluation and develop our implementation plan. 2.6.12 COMMUNITY LIVING CHANGE FUND/COMING HOME The Coming Home team, established in 2023 and funded through the Scottish Government’s Community Change Fund, has been central to identifying and supporting individuals who have experienced prolonged and unnecessary hospital stays or out-of-area placements. In partnership with NHS Lanarkshire and advocacy colleagues, the team has successfully implemented Health and Social Care North Lanarkshire’s Dynamic Support Register (DSR), in line with national policy direction. Although the Community Change Fund concluded in March 2025, the work continues through the Multidisciplinary Complex Care Review Group and the Coming Home Implementation Group. These structures remain focused on reducing the need for individuals to leave North Lanarkshire for care or treatment. The Area-Wide Adult Team continues to collaborate closely with allocated social workers for all individuals recorded on the DSR, with a particular focus on those categorised as Red or Amber. Progress is actively monitored through bi-weekly prompts, ensuring timely updates and accurate case recording. In parallel, work is progressing to identify bespoke housing solutions for individuals with complex needs. Strengthened collaboration with housing colleagues supports the early identification of specialist housing requirements, enabling these to be incorporated into local planning and development frameworks. Provider engagement also remains a strategic priority to ensure the availability of appropriate and sustainable care options. A key element of the programme is the prevention of hospital admissions through early identification of individuals at risk of support breakdown. Work is underway to develop a more detailed understanding of this at-risk population, with the aim of ensuring individuals remain safe, well-supported, and able to live within their communities. To strengthen oversight and resource alignment, plans are in place to extend the remit of financial governance meetings to include DSR monitoring. Page 158 of 350
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51 With the conclusion of the Change Fund and no further funding anticipated, the focus has now shifted to embedding and sustaining this work within existing structures and resources. The overarching objective remains to deliver on the core ambitions of the Coming Home agenda, ensuring that individuals with complex needs are supported to live in the right place, with the right support, at the right time. 2.7 DIGITAL SYSTEMS TRANSFORMATION During 2024-25, there has been significant progress and investment in digital solutions to support the management of social work and social care services. In addition to developments in Assistive Technology and those linked to the Community Alarm Service reference above these have included: Mosaic Case Management System As part of the North Lanarkshire Council’s Digital NL programme of work and Digital and IT Strategy 2019-24, the council carried out a cloud readiness assessment to determine which line of business system would be suitable for transitioning to a range of cloud-based solutions. This reinforced existing service concerns around the functionality of our SWIS case management system and led to a tender for a new system. Mosaic, the new Social Care Case management system, will be used across all social work services and the tackling poverty team presenting significant opportunities to improve worker access to relevant information, provide a single source for data on the people we support, improve data analytics and reporting to inform service improvement, and better opportunities for data sharing across the partnership. Reflecting the scale of work required to safely and effectively support this transition the development and implementation of Mosaic is supported by a project team, which has led the design and configuration of the systems throughout 2025- 25. Work has progressed with teams from across all care groups and the wider system to configure the system to reflect our streamlined processes and workflows. Training for staff commenced in early 2025, with a range of online and in-person training available to staff and tailored to their roles. Focus throughout 2024-25 has been on preparing for the go live of the new system and assessing and testing the system and staff’s readiness for a significant change in working practice. At the time of writing, we are on track for our new system to go live in the early part of 2025-26 (June 2025). Dynamic Scheduling System for Care at Home Services (CM 2000) As reflected above, the Home Support Service is currently engaged in a service redesign exercise and within the context of the wider redesign activity, has procured a digital solution to ensure staff capacity is optimally utilised supporting the provision of over 6,000 visits per day by the approximately 750 home support workers on shift daily and importantly also supporting improvement in continuity of service and the matching of the right staff with the right skills to people at the right time, essential to the provision of quality care and services. ELMS 2 – Equipment Management System (Integrated Equipment & Adaptation Service) Page 159 of 350
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52 The Integrated Equipment & Adaptation Service has for many years used a software platform which is no longer supported. During 2024-25, a newly procured software solution, ELMS 2, has been implemented to better support service requirements including: • Direct ordering and tracking of orders technology providing delivery routes and times • Linking directly to the stock control process • Use on handheld devices reducing the reliance on printed paperwork and providing real-time delivery information to the prescribers and route management • Improved monitoring of equipment due for review and maintenance • Direct access to equipment catalogues stock levels and service users equipment history ELMS 2 also offers interoperability and integration with Mosaic Implementing these systems presents not just a shift from legacy systems, some of which are end of life, but also a cultural shift in using digital platforms which allow the service to function differently. The ability to access and generate accurate and real time information to support practitioners, the ability for supported people to access their own data and the enhanced data quality and integration offered by these products will continue to support the service across a range of settings. 3. STATUTORY INTERVENTIONS 3.1 MENTAL HEALTH OFFICERS SERVICE AND ADULTS WITH INCAPACITY ACT (SCOTLAND) 2000 The Mental Health Officer (MHO) Service continued to experience significant demand in relation to interventions under the Adults with Incapacity (Scotland) Act 2000 (AWI) across the year. Whilst there appeared to have been a drop in Local Authority applications – likely owing to orders previously being sought as part of Large-Scale Investigation related activity - there was an increase in the number of new requests being made from ‘Private’ Solicitors which placed pressure on the service. The reasons for this increase are unclear, although demographics of an ageing population are likely to be one contributing factor. Figure 1 – Details number of Guardianship Orders & Intervention orders across the 6 Locality areas of North Lanarkshire. 32 57 37 26 29 42 133 114 218 101 81 136 5 6 3 4 11 7 0 50 100 150 200 250 Airdrie Coatbridge Cumbernauld Bellshill Motherwell Wishaw AWI Orders by Locality 2024-25 L.A. Guardianship Private Guardianship Intervention Orders Page 160 of 350
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53 Figure 1 above illustrates the spread of orders under AWI across the 6 Localities. There has been a very modest reduction in the total number of active Guardianship Orders – both ‘Local Authority’ and ‘private’ orders - in place for individuals’ resident in North Lanarkshire, falling very slightly from 1,008 to 1,006. Of the 1,006 current orders, 783 (77.8%) are ‘private’ orders and 223 (22.2%) are ‘Local Authority’ orders where the CSWO is the appointed Guardian. Figure 2 – Outlines the number of new and renewed orders in 2024-25 by Locality. The total number of new and renewed Guardianship Orders granted in 2023-24 was 340 and in 2024-25, this total was 382 a 10% increase on the previous year. Figure 3 below shows the increase in new AWI requests from 2021-22 to 2024-25. This is a 195.6% increase over the past 4 years. Figure 3 – Compares new AWI requests made over a 4-year period. 39 24 30 83 25 44 12 11 15 21 12 24 6 5 8 3 8 7 0 10 20 30 40 50 60 70 80 90 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw New Orders by Locality 2024-25 Private Local Auth. Intervention Order 135 223 362 399 2021-22 2022-23 2023-24 2024-25 New AWI requests 2021-22 to 2024-25 Page 161 of 350
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54 The statistics are indicative of a general upward trend in AWI requests. This trend is also reflected in Scotland-wide statistics where in 2014-15 there were 9,333 Guardianship Orders and by 2023-24 a total of 19,078 – a 104.4% increase nationally (Mental Welfare Commission, 2024). This increased demand in relation to Adults with Incapacity (Scotland) Act 2000 will inevitably cause further pressures on an already strained MHO resource. These pressures leave the MHO service in a position where AWI applications which are deemed as less urgent being required to await MHO allocation for periods significantly longer than the statutory timeframe of 21 days, within which, following request from a ‘private’ Solicitor, the Local Authority has a legal duty to provide a MHO report creating a level of organisational vulnerability and concern from families despite a proactive approach to management of this pressure. In cases where powers under AWI are required to facilitate discharge from hospital, Sessional MHOs are generally allocated prior to a formal request being received in order that preliminary MHO work can be undertaken. This is in accordance with recommendations made by the Scottish Government in its ‘Authority to Discharge’ report in 2021. 3.2 MENTAL HEALTH (CARE AND TREATMENT) ACT 2003 AND MENTAL HEALTH (SCOTLAND ACT 2015) The past year has seen an increasing number of civil detentions under the Mental Health (Care and Treatment) (Scotland) Act 2003 within North Lanarkshire. Whilst there has been a 28.6% decrease in the use of Emergency Detention Certificates (EDC) with MHO consent over the past year there has been a 72.3% increase in the use of EDC without MHO consent. The latter is a concerning trend which both NHS Lanarkshire and the Mental Welfare Commission are monitoring. Notably there has been significant increase of 34% in the number of Short-Term Detention Certificates (STDC) and, in turn, a 26.3% increase in Compulsory Treatment Orders (CTOs) over the same period. The past year has also seen a further 10% increase in ‘forensic’ requests for MHO input although the total number of Compulsion Orders (CO) and Compulsion Order with Restriction Orders (CORO) requiring MHO allocation has seen no change. Overall is apparent that there has been significant increase in demand placed upon the MHO Service in relation to measures under the Mental Health (Care & Treatment) (Scotland) Act 2003 and the Criminal Procedure (Scotland)(Act) 1995. Compulsory measures used under Mental Health (Care & Treatment) (Scotland) Act 2003 and Criminal Procedure (Scotland) Act 1995. Total Emergency Detention consents [203] 145 28.6% decrease Total Emergency Detentions where no consent was sought [47] 81 72.3% increase Consent refused by MHO – Emergency Detentions [0] 0 No change Total Short Term Detentions consents [258] 346 34.0% increase Consent refused by MHO – Short Term Detentions [6] 6 No change Total Compulsory Treatment Orders [186] 235 26.3% increase Total Forensic Report requests [30] 33 10% increase Page 162 of 350
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55 Total Forensic orders supervised (CORO/CO) * [29] 29 No change 2023-24 data highlighted in red. *Compulsion Order with Restriction Order/Compulsion Order 3.3 DEVELOPMENT OF MHO SERVICE TO MEET NEEDS During Summer 2023, an agreement was reached to move back toward a ‘Locality Model’ structure within the MHO Service aligned to the 6 Social Work Localities. Strategy Meetings have been held on a 6-weekly basis over the past 12 months to support the transition. Feedback has been largely positive, particularly in terms of re-establishing and strengthening links with Social Work and Community Mental Health Teams already operating within Localities. Since 2023, North Lanarkshire Council has enrolled 5 Social Workers to the Postgraduate Certificate in Social Work for Mental Health as external recruitment of MHO’s remains a challenge due to national shortages of qualified MHOs. The MHO Service is supported by x 6 Sessional MHO’s, whose work primarily consists of cases where intervention(s) under Adults with Incapacity (Scotland) Act 2000 is required to enable lawful discharge from hospital to nursing home placements. This has had a positive impact on reducing delays in discharging patients from hospital, although other aspects of the legal process out with the control of the MHO service does remain a barrier to further progress in this area. NLC has played an active part in consultation processes relating to this area of practice with notable consultations to proposals for overhauling incapacity law in Scotland; responses in terms of the use of and review of AWI; use of community-based measures under Mental Health (Care & Treatment) (Scotland) Act 2003 and policy developments by Social Security Scotland. 3.4 APPROPRIATE ADULT SERVICES Within the reporting period, there were 64 referrals for the Appropriate Adult service, demonstrating a decrease of 16.8% (-13 referrals). There has been an identified trend of decreasing referral numbers both nationally and locally; noting an approximate decline of 50% in referral numbers since 2015 (see chart below). Concern that this may not reflect true need remains on the National Agenda, within Scottish Appropriate Adult Network (SAAN), and is being actively discussed at the Appropriate Adult National Oversight Group. Within North Lanarkshire, this has been discussed with Police Scotland, who have recirculated AA guidance within the Lanarkshire Division. At national level, the Appropriate Adult Guidance for Local Authorities is being reviewed by COSLA, and any update will be shared in due course. Page 163 of 350
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56 Within North Lanarkshire Council, there are 39 employees who are trained Appropriate Adults (AA). 14 of the 39 undertake the AA role within Social Work Emergency Services (SWES) and 26 undertake their role as AA as part of the in-hours duty rota. Refresher training is available for AAs to attend every 6 months with uptake monitored. Discussions are taking place with SWES in relation to all SWES staff being trained to meet the demand of the Out of Hours AA service. 3.5 PUBLIC PROTECTION 3.5.1 ADULT SUPPORT AND PROTECTION INVESTIGATIONS/CASE CONFERENCES AND STATUTORY ORDERS/FUNCTIONS For the reporting period there were a total of 2916 ASP referrals to North Lanarkshire Social Work services. This represents a 12% decrease in referrals in comparison to 2023/24 (3, 314). For 2024-25, the primary source of ASP referrals was colleagues from NHSL (including the Scottish Ambulance Service, with a total of 772 referrals). This marks a shift from the previous five years, where care homes were the main referrers. Due to collaborative efforts with care homes and key stakeholders to both address risks and ensure appropriateness and 118 140 99 108 92 71 69 77 64 2016/17 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 2023/24 2024/25 Annual AA Requests – North Lanarkshire NLC 4790 4600 3987 3474 2807 2865 2393 2334 2199 2488 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 2023/24 Annual AA Requests - Scotland SAAN Page 164 of 350
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57 consistency in referral practice, referrals from this sector have steadily decreased, to 644 for the period, a 42% drop from the 1,124 referrals in 2023/24. In addition, there have been smaller declines in referral numbers from other public sector partners: - compared to 23/24; internal Social Work referrals dropped 11% (from 400 to 356). Police Scotland referrals dropped 2% (from 410 to 403) and Scottish Fire and Rescue referrals fell 2% (from 116 to 114). Whilst Police ASP referrals have slightly decreased, Police ‘Adult Concern reports’ remain stable at a high level with a total of 4,294 Police ‘Adult Concern’ Reports received during the period, an increase of 14 on last year. Taken together the number of ASP referrals and Police Adult Concern reports reflect the significant activity undertaken to keep adults in our communities safe. Physical harm remains the most common harm type referral with 1,137 referrals received, an absolute and proportionate decrease compared with last year (1,594 referrals) which can be linked to the decrease in referrals from the care home sector, where a number of referrals from care homes related to witnesses/unwitnessed falls. Practitioners within the care home sector have recognised that not every fall should result in an ASP referral, with good practice evident in some care homes supported by robust recording and defensible decision making. Cases featuring self-neglect can be some of the most difficult and complex for practitioners to manage as they often span ethical, legal, and practical considerations. For the period, there were 335 ASP referrals relating to self-neglect, an 8% increase in comparison to the previous year. Supporting good practice in these circumstances is a priority and a new self-neglect and hoarding toolkit has been made available for practitioners working with this harm type, there remains a specific focus on defensible decision making and professional curiosity in this area. ASP Inquiry with investigatory activity April 2025 marks one year since NLC’s revised ASP Policy and Procedures were implemented. It was anticipated that inquiries involving investigatory activities would increase, 400 116 410 646 1123 3314 356 114 403 772 644 2916 0 500 1000 1500 2000 2500 3000 3500 Social Work Fire and Rescue Police Scotland NHS/L Care Homes Total ASP referrals ASP referral source 2023-24 2024-25 Page 165 of 350
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58 as the revised guidelines clarified the use of investigatory functions under the Act. Data indicates that this increase has indeed occurred. There were total of 872 inquiries with investigatory activity in the reporting period reflecting that 30% of all referrals moved to inquiry with investigatory activity. This is a significant and appropriate increase compared to last year when 15% (490) of referrals were recorded as having progressed to investigatory activity. This sits above the previous average conversion rate in Scotland from referral to inquiry with investigatory activity of 18%, however this is anticipated to increase when the Scottish Government publish its annual report for this period. ASP Case Conferences A total of 82 initial case conferences and 94 review case conference are recorded for the period an increase on the 77 initial case conferences and 88 review case conferences the previous year. Whilst this is considered positive, the overall conversion rate from investigatory activity to case conference has dropped compared to last year from 14% to 9% in part due to the sharp increase in the number of investigatory activities taking place. Ongoing monitoring and audit activity will ensure appropriate decision-making underpins changes in this rate. Statutory Order issues in 2024-25 Type of Protection Orders Number of Protection Orders Granted Assessment Order 0 Removal Order 0 Temporary Banning Order 0 Banning Order 0 Temporary Banning Order with Power of Arrest 4 Banning Order with Powers of Arrest 2 Total 6 The use of protection orders fell by one compared to last year (seven to six). It is recognised that where “adults at risk” are subject to protection planning measures, and a range of actions have been implemented to mitigate risk of harm, this can reduce the requirement for an ASP Protection Order. 3.5.2 MAPPA (MULTI-AGENCY PUBLIC PROTECTION ARRANGEMENTS) Justice Social Work continues to work within MAPPA arrangements to promote community safety and engage with people convicted of sexual offences and those considered to present a risk of serious harm, to maximise public protection, whilst maintaining a proportionate and individualised approach to risk and need. The number of individuals managed under MAPPA has continued to grow, in part, due to the rise in online offences contributing to increased demand pressures. Moving forward, demand will further increase through the inclusion of Terrorist Offenders within the MAPPA process. Page 166 of 350
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59 Preparatory work continues in this area to ensure that North Lanarkshire is well placed to manage relevant individuals effectively and safely. The increase in the number of individuals managed under the MAPPA process with no corresponding increase in resources continues to put pressure on the service. This is a situation which shows no signs of diminishing in the coming years. This reporting year has witnessed an 8.5% increase in MAPPA activity from the previous year. Overall, the number of individuals managed under MAPPA has grown significantly since arrangements were established 18 years ago. MAPPA arrangements interface often with other public protection processes including child and adult protection, and with adult Social Work more broadly, due to the increasing number of individuals managed through MAPPA who have care needs relating to frailty or disability. MAPPA awareness sessions for wider staff groups are therefore held regularly. More specific details of MAPPA related activity are published annually within the Lanarkshire MAPPA report. available on the council website. North Lanarkshire Justice Service continues to contribute to national discussion and preparation for the introduction of MAPPS an updated information sharing platform with key partners including Police Scotland. 3.5.3 CHILD PROTECTION INCLUDING CONTEXTUAL SAFEGUARDING A substantial increase in the number of notifications of child protection concerns was seen coming out of the COVID pandemic, but this number reduced by 16% over 24/25. While it is too early to draw firm conclusions, we think this reflects our additional investments in whole family support and strengthened integrated working across the partnership. Year Number of Referrals by Child Child Protection Assessments (Investigations) Percentage Of Referrals Proceeding to Assessment Number of Assessments That Proceeded to Child Protection Planning Meeting Number Of Registrations from Child Protection Planning Meeting 2024- 25 1960 674 34% 201 153 2023- 24 2326 768 33% 254 179 2022- 23 1895 775 41% 264 198 2021- 22 1714 754 44% 229 177 2020- 21 1482 831 56% 261 199 Work has continued across the partnership to improve our GIRFEC planning to ensure that children’s needs were addressed collectively and ensure children were not unnecessarily referred into a child protection process. We also note that child poverty rates increased over Page 167 of 350
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60 this period and while this does not cause child protection concerns, it is, as the Promise sets out, a critical factor in increasing stress for families. Neglect (as shown below) continues to be the concern type most frequently recorded at child protection planning meetings Income maximisation and other tackling poverty measures remain critical to our work with families more broadly and all families whose children’s names are on the child protection register are supported to engage with our financial inclusion team where this is appropriate. In my previous report, we highlighted the need to improve consistency in the quality of reports and plans for children and young people at risk of harm along with the quality of engagement with some families. To this end, we have now trained all social workers as lead professionals in the Signs of Safety Healing model as referenced in 2.4 above. In recognition that protecting children is a partnership responsibility, partners from health, education and other services have also been trained. This is strengthening relationship-based practice in both child protection and our broader work with families. Contextual Safeguarding Over the past year we continued to work to tackle ongoing concerns regarding the exploitation of young people into criminal activity, most notably, over this period, involving the theft of high value alcohol to order. Addressing this issue has required coordinated activity across local authority boundaries as well as within the partnership as young people were being pulled towards Glasgow and particularly the city centre. Data from Glasgow indicated that between May 25 and Feb 25, 19% of the young people accused of crime in the city centre were from North Lanarkshire. Of the 21 young people discussed at our multi-agency Young Person’s Safeguarding Panel over this period, 17 were identified as the victims of criminal exploitation leading to young people coming into frequent conflict with the law (charges of theft and altercations with retailers) with the risk of subsequent measures such as exclusion orders and curfews further criminalising young people, as they struggle to comply with these. Within social work various strategies have been used to support the young people including group work, outreach to the city centre, joint work with other authorities, police and youth work Page 168 of 350
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61 colleagues and diversionary activity from intensive services, residential staff and social workers, including activities/time outside the area. Within the past year, three young people have had time in secure care linked to the risks around CCE. The case study below illustrates this work. Bairns Hoose The Bairns Hoose model promotes a child-centred, trauma-informed and multi-agency approach that supports children recover from abuse with roll out across Scotland a commitment made within the national programme for government. Whilst not a pathfinder area our pan-Lanarkshire partnership was awarded a Development Fund budget of £102,640.00 from Scottish Government to support planning and the development of a business case for a Lanarkshire Bairns Hoose. The model aims to • Minimise re-traumatisation of children • Improve access to specialised support services • Enhance the effectiveness of our justice system for young people • Foster faster recovery and healing for affected children and families and is designed with children's needs at the forefront by engaging with children, young people and their families who have experienced the child protection system. One of the core elements of this model, a trauma informed joint investigative interview model has operated successfully in Lanarkshire for the past five years. A Steering Group supported by a commissioned consultancy has over this period undertaken extensive planning and consultation work which will now underpin decisions on next steps to take forward the wider model in Lanarkshire. Page 169 of 350
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62 3.5.4 GENDER BASED VIOLENCE The strategic vehicle for work to tackle gender-based violence in North Lanarkshire is through the local VAWG (Violence Against Women and Girls Structures) with social work staff playing a key role in both preventative and safeguarding activity including delivery of the UP2U programme referenced in section 2.3.4 above. MARAC (Multi-Agency Risk Assessment Conferencing) Pan-Lanarkshire MARAC arrangements are a key mechanism to facilitate a joint approach from partners where incidents of domestic violence suggest a high future risk of harm and are now supported through a formal joint funding arrangement in place with Women’s Aid South Lanarkshire and East Renfrewshire to support the management and co-ordination of MARAC in the area. The MARAC annual report 2024/ 2025 highlighted: • 77 MARAC locality meetings took place in the year. • 500 referrals were received for North Lanarkshire • 87% of all referrals received were allocated to a MARAC meeting. • 26% were repeat referrals. • 98% of victims discussed were female. There was a reduction of 113 referrals being received for MARAC in 2024/5 to 2023/4. This is considered likely to be due to Police Scotland Q Division bringing in a quality assurance process to ensure that appropriate referrals were progressed to MARAC. Safe and Together Safe and Together is an approach to working with families where domestic abuse is a concern. It aims to overcome the gender bias in parenting by holding to account the parent perpetrating domestic abuse (usually fathers) to the same high parenting standards as the parent being abused (usually mothers). Over the summer of 2024, the Improvement Service supported North Lanarkshire Safe and Together Steering Group to evaluate the impact of the roll-out of Safe and Together so far, with a particular focus on generating learning around what has supported practitioners to put the training into practice, what the challenges are and the impact that the Safe and Together is having for families experiencing domestic abuse who are coming into contact with social work and other services across North Lanarkshire. The findings of the report have been drawn from nine 1:1 interviews with Safe and Together trained Social Workers and one Children’s Reporter, two multi-agency focus groups and a small case file audit. The Improvement Service found there was clear and consistent evidence of increased understanding of and recognition of the impact of domestic abuse, and examples of domestic abuse informed practice by individual social workers and other practitioners. Key findings included: • Practitioners expressed feeling more confident engaging with parents who perpetrate domestic abuse, recognising their patterns of behaviour and the links to child wellbeing, the survivors’ safety and wellbeing and framing this as a parenting choice. Page 170 of 350
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63 • Practitioners also shared examples of increased positive engagement as a result of using the Safe and Together model in their work with families experiencing domestic abuse, and emphasised the strengths of the model in developing relationships of trust with survivors as well as supporting survivors to understand the full impact of perpetrators’ patterns of abuse on their lives and the lives of their children. • Practitioners also expressed that the commitment to the roll-out of Safe and Together across North Lanarkshire is supporting them to challenge practice not aligned with domestic-abuse informed systems, services, and workforce. • The support from the Safe and Together Co-Ordinator was highlighted as key to embedding the training into their practice, and practitioners consistently noted the need for ongoing training and practice support to sustain and embed change. Funding, through the national Equally Safe fund has been made available to support on-going implementation of Safe and Together across North Lanarkshire until March 2026 with the position beyond this subject to wider national review. 4. RESOURCES To support Social Work service delivery, North Lanarkshire Council had a gross expenditure budget of approximately £327m in the 2024-25 budget year (£310m Financial Year 2023/24). More specifically, this budget comprised Adult Social Care (c. £272m) and Children & Families and Justice (c. £55m) respectively. Children, Families & Justice - Gross Expenditure Budget 2024-25 - £55.19m All Support Functions (£5.27m) CHILDREN AND FAMILIES (£31.54m) JUSTICE SERVICES (£9.34m) Children & Families A&P (£9.04m) Page 171 of 350
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64 In total, Social Work activity during the 2024-25 budget year was delivered within the overall budget resource allocations and resulted in an underspend position. Within Adult Social Care, the underspend position was predominantly the result of the non- recurring underspend relating to pension costs (reduced contribution rate to the Strathclyde Pension Fund), coupled with underspends due to vacancies. This underspend position was offset by overspends contained within the service including overtime within employee costs, transport costs, and Payments to Other Bodies. The overspend within 'Payments to Other Bodies' was related to cost pressures within the care-at-home sector as well as independent care home providers. The overall underspend across Children & Families and Justice consisted of an underspend within employee costs because of the non-recurring reduced pension rates (as above) as well as establishment of vacancies across various service delivery functions. In addition, following the receipt of an additional £1.162m Scottish Government funding in relation to the Scottish Recommended Allowance (SRA) in the 2024-25 budget year, an underspend within Family Placements (Payments to Other Bodies) occurred, which reflected the level of demand compared to overall resources currently available. Proposals are however being developed for further investment in this area to support address challenges in respect of carer support and foster care recruitment and retention as outlined in 2.4.3 above. 4.1 FINANCIAL MODELLING FOR SERVICE DELIVERY Adult Social Care - Gross Expenditure Budget 2024/25 - £272.233m Support Functions (£19.588m) Self Directed Support (£107.431m) Mental Health & Adult Protection (£1.654m) Carers Support (£3.011m) Access Social Work (£1.108m) IEAS (£6.397m) Home Support (including Com Alarms) (£58.198m) Care Homes (£47.093m) Registered Social Landlords (£0.779m) Assistive Technology (£1.523m) Page 172 of 350
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65 Financial planning and monitoring continue to be key responsibilities for the Management Team. The Council’s Financial Strategy includes Service input into four key processes as follows: • Preparation of detailed single year budget • In–year budget monitoring and projections • Preparation of rolling three-year budgets • Preparation of a Medium-Term Financial Plan Alongside these processes, the Council’s Finance Team works closely with the IJB Chief Finance Officer to prepare a medium-term financial plan for the Health and Social Care Partnership. In terms of financial modelling, the Management Team increasingly takes a whole systems approach in delivering new and more efficient operating models which often requires joint working with other Council Services and key external partners. With respect to Children’s Services, the Council and local partnership is continuing to work with the national Promise Team on ‘Human and Economic Cost Modelling.’ This work is intended to support longer term change both nationally and locally, by identifying how resources are currently spent and what system changes are required to move the balance of spend toward early intervention and family support, in line with the aspirations of the Christie Report. ‘Investing in Prevention’ is a key strand of the Resilient People programme of work and a key focus within both adult and children’s services as a vehicle for cost avoidance as well as improving outcomes in the face of wider budget pressures, new legislative duties and growing demand. To this end as demonstrated throughout this report social work services are working creatively across service boundaries and in partnership with the community and voluntary sector. The reliance on multiple short-term, often ring-fenced funding streams to support innovation continues however to challenge capacity for more fundamental and sustainable change despite emerging evidence of positive impacts in areas such as family support. 5. WORKFORCE Workforce planning within Social Work is overseen by the Social Work Workforce Planning Group, which both informs and is informed by the Council’s corporate ‘Workforce for the Future Strategy’ and the wider UHSCPNL workplan. 5.1 WORKFORCE PLANNING Considering continued public sector savings requirements and unrelenting demands on local authorities and HSCPs, workforce planning has a crucial part to play to ensure current and future service demands are met. These pressures, coupled with recruitment challenges in areas such as the Home Care sector, can clearly also have an impact on current staff, enhancing the importance of staff welfare. Positively, both the council and HSCP have committed to the implementation of a Trauma Informed Workforce, and we maintain a strong range of HR policies and other supports which continue to support staff to work flexibly whilst recognising that despite digital developments effective social work and relationship-based practice continues to require significant levels of face-to-face contact reflected Page 173 of 350
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66 in limited percentage of fully hybrid roles within the service. 5.2 SOCIAL WORK RECRUITMENT AND RETENTION Enhanced whole career support and development, allied to the wider ambitions of Workforce for the Future and the Scottish Government ambition to create a strategic framework from qualification though to enhanced practice, remains at the forefront of NLC’s commitment to Social Workers. Our Social Work Trainee Scheme has supported both enhanced career pathways for NLC employees and internal social work recruitment planning. Eight employees joined the current scheme with four graduating and moving into social work posts this year and others scheduled to complete within the next two years. Work is also ongoing with HR and Training & Organisational Development to develop the Social Work Graduate Apprenticeship Scheme, which is likely to go live in September. In addition to internal pathways, we continue to recruit externally with a reduction in vacancies and turnover likely to be linked to the re-evaluation of social worker and first line manager post two years ago leading to more competitive salaries and recruitment although a balance of experience levels in some teams remains a challenge, with the need identified also for more focussed support for first line managers. Work is ongoing with Training and Organisational Development (TOD) colleagues to address this. Immediate access to our Senior Practitioner scheme for eligible Social Workers is an option if the criteria, as set out in the scheme, are met. Our Senior Practitioner Scheme has also recently been reviewed. Updated guidance and a review of the process has ensured that the requirements of the scheme are clearer for Social Workers and Community Occupational Therapists, and that the additional responsibilities carried out by Senior Practitioners also meet service needs. With over 60 practitioners holding the status, the scheme facilitates further support for Social Work services whilst rewarding practitioners, for their experience and effort, with an enhanced salary. Challenges around temporary cover requirements remain with temporary vacancies not automatically filled due to the financial implications and often difficult to recruit to, impacting the team’s capacity. For this reason, temporary vacancies are being closely monitored in terms of numbers and locations with a number of longer-term cover requirements advertised recently with some success. Where specialist experience has been deemed essential, for example, in Social Work Emergency Services (out-of-hour service), the hospitals and the Home Assessment Team (HAT), role-specific Social Worker and Senior Social Worker adverts have been used. This approach has continued to produce positive results. One area that has remained a challenge is appointment to our Community Mental Health Teams. Qualified Mental Health Officer vacancies in the past year have impacted service provision across localities. Continuous advertising has now resulted in appointments, but the challenge of supporting new appointees and retaining staff continues. We continue to be committed to promoting the MHO programme to existing Social Workers within the service. Work is also ongoing to prepare interested Social Workers for future courses. Two funded MHO Traineeship Scheme places are currently within the structure, with a recent review agreeing to an increase to this number in future years. Our Practice Assessor continues to Page 174 of 350
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67 work with MHO students and those who express an interest in attending the postgraduate course, supporting the development of Social Workers in Community Mental Health Teams across the localities. As reflected in section 3.3 above six sessional MHOs also provide support for the service. 5.3 SOCIAL CARE As was the case last year, a significant focus remains on the recruitment of Home Support Workers and other social care roles. Continuous recruitment to the post of Home Support Worker has been ongoing for several months with new Home Support Workers now onboarding, however high numbers of leavers continue to impact on the staffing overall. The Home Support Service review continues to review current and project future service demands, with employee age and skill profiles being considered when future staffing considerations are being made. 5.4 OTHER RECRUITMENT AND RETENTION CHALLENGES A review and redesign of Social Work business support and administration has taken place over this period with a view to modernising roles and responsibilities and is anticipated to conclude in summer 2025. The aim is not only to update the structure and roles in line with current business needs but to improve career pathways for staff and address retention challenges in an area which remains critical to the effective delivery of social work services. Challenges remain also within our Locality Support Services, as turnover can be high across the mix of grades supporting direct delivery, which makes it difficult to maintain stable staffing levels across the six localities. Overall, the service has benefited from the support provided by the Summer Placement Programme and the opportunities that have arisen for students following placements. Following an initial intake of 18 summer placements in 2023, and building on the success of that, across the reporting period 52 summer placements were taken up across the service. For summer 2025 planning is at an advanced stage for further expansion of the scheme, to 64 placements. This programme offers paid work to NLC pupils for seven weeks of the school summer holidays within Social Work services in roles such as Home Support Worker, Locality Support Worker and in various roles within the Integrated Equipment and Adaptation Store promoting also interest in the field of social work and social care amongst school leavers and subsequent interest in both sessional and substantive opportunities, a key priority in the light of both recruitment challenges and the age profile of our workforce. 5.5 SOCIAL WORK DEGREE PATHWAY Since the disbanding of Learning Network West, we have been working hard to establish and create new partnerships with Universities and Further Education providers across Central Scotland. These partnerships will also enable students to have access to more sustainable and achievable placement opportunities within their own locale. Page 175 of 350
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68 These links have further enabled us to also address some of the concerns raised post-covid regarding the learning and realistic expectations of students with respect to roles within Social Work. The Practice Learning Team has been invited to universities to present input and learning events for students to enhance their knowledge and understanding and our links support them in preparing students for placement by fully aligning their learning needs resulting in a more meaningful placement for both them and the Council. We have developed our links with South Lanarkshire Council and are working on the implementation of a local placement pathway agreement allowing students to gain two statutory placements during their studies with us. It is anticipated this will better prepare them for their supported year as a Newly Qualified Social Worker (NQSW), making them more confident and competent in their role. Since August 2024 we have hosted 51 external students on placement from four different universities We continue to operate a student hub based within Motherwell Social Work Locality offices with our students and trainee social workers working together as a team under the supervision of a Senior Practice Learning Officer. Work is sourced and allocated from across all Social Work Service in NLC. Graduate Apprenticeships Route and Internal Pathway Developments As referenced above we are currently a working with Scottish Government, Skills Development Scotland, UWS Paisley campus, the Open University, SASW and with two Local Authorities - Fife and Edinburgh, to develop a Graduate Apprenticeship (GA) in Social Work with the proposal for the GA programme currently with SSSC for approval. If successful, we predict this pathway to commence in late 2025. In preparation of this we are currently developing a process that will enable internal staff already on the Social Work pathway to apply and envisage supporting six GA placements in the first year, with a rolling programme every year thereafter. In addition to our trainee posts we are also supporting 38 members of staff with individual learning plans; all of whom are undertaking Open University modules and working towards a degree in Social Work. Twelve from this pathway have progressed as far as independently possible without the agreement of sponsorship from the service, therefore we are looking at ways to further progress this route. WORKFORCE DEVELOPMENT 5.6 FOCUS ON HOMECARE SSSC – registration process We have engaged with SSSC to enable a smoother process for Home Support Workers who have a qualification to achieve their registration. The Talent and Organisation Development (TOD) team have been collaborating with the Scottish Social Services Council (SSSC) to ensure staff are well-informed about their responsibilities regarding registration. Care Management 2000 (CM2000), our new scheduling system is critical to significantly enhancing efficiency for both our employees and service users. In September 2024, priority Page 176 of 350
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69 was given to the roll out of training to Home Support Workers introducing them to CM Mobile, the new app that they will be using to access their schedules. By December 2024 sessions 1,129 workers had been fully trained, and as of April 2025 we have now delivered training to 1,264 members of staff in total. Moving and Positioning Training In partnership with a range of stakeholders, we have conducted a robust review of the Service's "moving and positioning" training requirements. As a result, we have updated and enhanced our training offerings to better align with the needs of the Service. We have also been engaged in discussions regarding the rebranding and renaming of the current "Moving and Positioning" training programme to align with North Lanarkshire Council's commitment to person-centred language and Trauma-Informed Practice. As part of this update, we have replaced the previous course title with ‘Supporting Individuals with Moving and Positioning.’ This training is also important for our staff in other settings including Integrated Day and Locality Support Services. In addition to the broader role of our care academy two significant projects have also supported the development of the homecare workforce over the past year: Upskilling for Home Care Workers In line with the qualification agenda, we continue to utilise the monies available from the UK Prosperity Fund to develop a training pathway for our Home Support staff. Our partnership with New College Lanarkshire has enabled us to procure access to ongoing spaces for the programme over the next year with another 60 workers currently undertaking qualification from our Aug 2024, Nov 2024, and March 2025 cohorts. The success of this programme has also allowed us the opportunity to extend this relationship with New College Lanarkshire with us recognising the ongoing staffing difficulties within the service and the level of new recruits requiring access to qualifications within a shorter timescale. Home Care Support Officers We are continuing to identify opportunities to support this group of staff to access suitable qualifications and opportunities for future employment pathways. However, this work will now be aligned with the redesign of the home support service. 5.7 NEWLY QUALIFIED SOCIAL WORK PROGRAMME The practice learning team has inherited additional duties and pressures following the decision from SSSC not to extend the funding for Newly Qualified Social Worker (NQSW) supported year programmes. In response to this we have now linked each of our three full-time Practice Educators with two Locality teams to ensure that we can support all six localities and the current 65 NQSW across the services. The Practice Learning team facilitate Early Professional Development sessions monthly as well as individual and group learning sessions. The team also supports all Senior Social Workers and managers who currently have a NQSW in their team. Page 177 of 350
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70 Expectations of the NQSW in terms of demonstrating achievement of multiple learning requirements required for registration have created a level of anxiety amongst this cohort of our workforce and challenge for line managers. In response to this, the practice learning team are working in collaboration with the Clyde Valley consortium to develop a more streamlined NQSW pathway by developing a workbook that will be easier to navigate to support NQSW and managers when gathering evidence and validating work, whilst ensuring that we are working and following the same principles. 5.8 OTHER KEY TRAINING AND DEVELOPMENT ACTIVITIES Development of a Social Work learning dashboard on Learn NL December 2024 saw the launch of our newly designed and developed Social Work Learning dashboard which was a key driver in enabling staff across the service to have easy access to training and development opportunities, also providing a space to share and promote resources that are specific and relevant to services. To date, the feedback and response has shown that staff are now more able to navigate and find training in relation to their service and role and also becoming more active in relation to self-booking and securing training dates and attendance at both online and face-to-face opportunities. The dashboard also allows managers to readily monitor the uptake of training. Training Needs Analysis As part of the development of the Learn NL Social Work dashboard, substantial training needs analysis has been completed across all Social Work and Social Care services. The findings from these TNAs have been used to identify and prioritise learning and development opportunities over the coming year. Below are examples both of core training delivery and the development of training offers to address specific service needs, developments and improvement priorities: Provision of Getting it Right in Child Protection training We continue to work alongside our colleagues on the Child Protection Committee to offer a range of multi-agency training opportunities across the partnership. These are made up of in- person training, online training sessions as well as e-Learning modules. Since April 2024, we have delivered a range of learning including: Core five-day training Getting it Right in Child Protection, Introduction to Contextual Safeguarding, CEOP Child Exploitation and Online Protection Training, Presenting Your Evidence Training as well as inputs on Child Criminal Exploitation and Parental Substance Misuse. We have also seen a steady increase in the use of Learn NL for eLearning modules and learning materials including on: Child Protection Awareness, Contextual Safeguarding, Child Sexual Exploitation, Understanding Child Neglect, Equal Protection, Age of Criminal Responsibility and Assessment and Planning for Children and Young People Safe & Together We have been supporting the commissioning of specialist eLearning modules and materials from the Safe and Together Institute. We are now working alongside our Digital Lead colleagues and legal advisers to ensure copyright, compliance and programme integrity issues Page 178 of 350
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71 are addressed so that we can bring these materials to North Lanarkshire; as potentially the first local authority in the UK to gain access to these materials. United Nations Convention on the Rights of the Child (UNCRC) We are also working together on the United Nations Convention on the Rights of the Child (UNCRC) training framework, looking at ways to implement this aligning with the standards and identifying any gaps or areas for improvement that need to be addressed. Adult Support and Protection Training We continue to work alongside our colleagues from the Adult Protection Committee and Senior Officers within Adult Health and Social Care to refresh and align our Adult Support Level 1 training, offered to all Home Support Workers and admin staff, to that offered through multi agency settings Assessment, Planning and Recording Practice training Working alongside our colleagues in Senior Social Work Management, we have developed a new, refreshed and rebranding of the above training to ‘Getting it right for everyone: Person centred; outcome focused training’ which is aligned to the current focus on our Back 2 Basics agenda, enabling hubs and strengths-based approaches. This training has been delivered to all Senior Social Workers, and work is ongoing to cascade this across the Social Work workforce. There will be an emphasis on this training being delivered to our colleagues in Adults Health and Social Care in the first instance with this then being adapted to also include colleagues in Children & Families and Justice. Sensory Impairment Awareness Training We continue to work with our Rehabilitation and Mobility Officers who deliver Sensory Impairment Training throughout the year extending access to third sector colleagues and refreshing content including working with our colleagues from Corporate Communications and the Civic Centre Ancillary staff to develop interactive video and accompanying resources. Subject Access Request Social work leads have worked with TOD and Legal Information Governance and Standards services to support staff to develop a more tailored offer for social work staff with respect to Subject Access Requests (SARs). Incorporating learning from our work on historical abuse a key focus has been not only to ensure compliance with statutory responsibilities but to ensure requests are managed in a way which is trauma- informed and sensitive to individual needs. We have delivered two sessions so far which were well received, having achieved an attendance of 238. Unpaid Work Learning Clusters In partnership with Community Justice Scotland, South Lanarkshire and Glasgow City Council, the Restorative Justice team has developed Unpaid Work Learning Clusters. This specific learning relates to the unique role of an Unpaid Work Supervisor and is aimed at improving the knowledge, understanding, skills, and values of paraprofessionals working within unpaid Page 179 of 350
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72 work teams. Nine ‘taster modules’ in various aspects of Social Work theory and practice that are highly relevant to the role, particularly to Placement Managers and Supervisors, were delivered. Restorative Justice hosted 10 events from May 2024 until November 2024 involving local authorities from across the West of Scotland. Social Work Induction Working alongside our Colleagues across Social Work Services and Quality Assurance; work is ongoing in the development of a digital Social Work Induction which will be available for all members of Social Work Staff and a useful resource for service information. It is also envisaged that work will continue in this area to further develop in-house induction to complement the suite of opportunities and information being made available as well as the National Induction Framework being made available through SSSC Practice learning pathway for link workers We currently have a practice learning pathway for Social Workers with two years post qualifying experience and interested in becoming link workers. At present we have 140 Link Workers, and 22 Practice Educators based in service throughout NLC. We also have a number of Link Workers applying to undertake the Practice Development Award in Learning, which will start later this year use partnership links to access four places on the Glasgow City Council PDA in Practice Learning (PDAPL) route and two places at Napier University starting January 2026. Over the coming year, the TOD team exploring the potential to bring this qualification in-house through our Assessment Centre. Policies and Procedures Resource We are working alongside our colleagues in Quality Assurance and our HR Transformations Team via short-life working group to look at updating and improving access to all resources relating to live Social Work policies and procedures. This follows on from a growing number of requests from staff asking to access such information and being unsure if the information is still relevant and up to date Continued provision of qualifications through the Assessment Centre The Assessment Centre continues to support SVQ and PDA qualifications required to meet registration, role, and CPD requirements. This is achieved through both in-house assessment and access to SVQs through external providers. Provision of post-graduate qualifications The team also continues to provide access to Post Graduate Certificate opportunities through the Learning and Development budget. The numbers undertaking some forms of qualification are detailed below: • Postgraduate in Child Welfare and Protection – three • Postgraduate in Adult Support and Protection – one • Postgraduate in Dementia Studies – one • Postgraduate in Contemporary Drug & Alcohol Studies – one • Mental Health Officer - two • Postgraduate Certificate in Leadership Pathways – one Page 180 of 350
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73 5.9 TRAUMA INFORMED PRACTICE The development of the council’s Trauma Plan is led within social work supported by a multi- service Steering Group. Since the introduction of the Trauma Informed Practice eLearning modules on Learn NL in March 2024 over 5,000 staff have accessed these. Supporting information and videos are also available relating to specific service areas including Justice Services, Dementia Care and Learning Disabilities whilst a successful Train the Trainer event also identified 11 in-house facilitators who can support the roll out of Transforming Connections, our skilled level of the face-to-face training programme. Critically we are working to ensure trauma-informed practice is embedded across our training and learning offers. 5.10 SUPPORT FOR STAFF WELLBEING Staff Health and Wellbeing (HWB) is a key element of our approach to workforce, recognising alongside wider needs the particular factors which can cause pressure within social work and social care settings. During this time, a dedicated staff HWB worker has supported the activity across locality teams. Elements of the work undertaken include leadership wellbeing workshops, the continued role out of the ‘Stay Conversation’ project, delivery of bespoke wellbeing sessions for individual teams and the development of wider initiatives which include a peer support network in conjunction with voluntary sector partners. In addition, there has been work undertaken to identify leadership focused wellbeing approaches across teams that promote good practice including embedding HWB in staff supervision and CPD. 6. LOOKING FORWARD – PRIORITIES FOR 2025-2026 AND BEYOND A number of national and local priorities reflected in this report will carry forward into the next year and beyond as underpinning many of these priorities remains the need for longer term system change which cannot be taken forward in single year. Critical amongst these are the drive to shift our focus to prevention and the whole system work required to address the poverty and health inequalities which impact significantly on the demand for social work services and critically on the outcomes and life chances of those we support. In these areas North Lanarkshire’s Programme of Work alongside that of the HSCP will continue to provide a framework for the social work contribution. We are pleased also to have the opportunity to undertake new work with SHERU (Scottish Health Equity Research Unit) and as part of our new Fairer Futures Partnership (FFP) to drive progress in this area whilst also continuing our work with Promise Scotland. Continuing to embed and promote trauma-informed, relational, strengths based practice and enabling approaches is also fundamental to transforming our services Across Adult Health & Social Care Services, we will align the work developed through our pathfinder as we progress from our Back-to-Basics approach to Getting it Right for Everyone to ensure that meaningful outcomes are realised, with people accessing the right support at the right time, whilst also minimising pressure on services. Whilst in Children’s Services we will continue to progress our Signs of Safety and Healing and Contextual Safeguarding approaches. We will also progress our multi-agency review of family support alongside a stocktake of progress as we move beyond the half-way point of the national Promise transformation programme. Page 181 of 350
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74 The further strengthening of integrated working both within social work and across partner services and agencies will also remain critical in areas such as transitional safeguarding, child criminal exploitation and in supporting the growing cohort of children and young people with additional support needs, the focus to for our FFP work. Work around the strategic intent set out in the North Lanarkshire Carers Strategy 2024 -2027 will continue, with a specific focus around parent carers, an area identified where further engagement would be beneficial. 2024 saw the formal adoption, within Scotland, of the United Nations Convention on the Rights of the Child (UNCRC). Alongside this, a Child Friendly Complaints Handling Procedure was introduced by the Scottish Public Services Ombudsman (SPSO). As we progress into 2025, we will seek to continue to implement learning from complaints to improve practice. A range of additional legislation will also place new duties and demands on social work as these are rolled out including the Children (Care and Justice Act) 2024, Care Reform (Scotland) Act 2025, Prison (Early Rease) (Scotland) Act 2025 and the Children (Care, Care Experience and Service Planning) (Scotland) Bill which is progressing through the parliamentary process. Despite the relatively healthy outturn position reported in Section 4 of this report there remain substantial financial pressures across the sector as demand for services outweighs capacity as well as a range of workforce challenges outlined above, within a context where the service’s core social worker staffing per head of population is lower than the national average and the lowest in our family group. The establishment of the New National Social Work Agency and National Social Work Partnership should support progress with respect to core areas in scope including social work education and learning, workforce planning and leadership and governance of the profession, building also on the findings of the recent national thematic review of social work governance. Capacity to invest to resource improvement in these areas however remains uncertain. In this context local partnership working to drive and support change and gain best value from our joint resource will remain key, as will building on our learning on how we can best support and develop our staff. Alongside this the embedding of new digital systems should support both greater efficiency as well as improved data on which to plan although there is need also for active consideration of the potential opportunities (and limitations) of AI applications to support staff in areas such as recording and analysis As we move forward to take on some of these challenges and opportunities this report demonstrates that we have a solid base of good practice on which to build. Page 182 of 350
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1 Item No: 15 SUBJECT: HOME SUPPORT TO: INTEGRATION JOINT BOARD Lead Officer for Report: Diane Fraser, Head of Adult Social Work Author(s) of Report Margaret Flavell DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By M Flavell: ☒ Reviewed By: D Fraser ☒ Endorsed By: ☐ Item 15 Page 183 of 350
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2 3. RECOMMENDATIONS It is recommended that the Integrated Joint Board acknowledge the progress on the redesign and performance within the service. The digital transformation that has taken place over the preceding twelve months and request your continued support as we continue our transition throughout 2026. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES The Health and Social Care Partnership remain committed to providing services at the right time and place, leveraging a personalised, choice driven model that enhances wellbeing and independence. The operating model we aspire to is structured around five core pillars: Integrated Discharge to Assess; Same Day Response and Reablement; Specialist and Intensive Support; Living Well at Home; and Quality Assurance. The model is aligned to prevention, proportionality, and independence, ensuring people are supported at home wherever safe and appropriate. Demographic projections indicate a growth of over 70% in the 75+ population over the next two decades, with increased prevalence of multi-morbidity and frailty. 20% of North Lanarkshire data zones are within the 20% most deprived areas in Scotland. Over the last reporting cycle, implementation has progressed from design and testing activity, planning and preparation, change management support, into increased operational activity across localities via a phased approach. This has included service redesign activity to support assessment at home, digital implementation across Home Support and continued quality improvement activity aligned to the wider Getting it Right for Everyone programme. Robust assessment within a person’s home environment, supported by direct intervention where necessary enables evidence-based decision making about long term need. Home Support Workers contribute to independence through practical support and rehabilitation activity, working closer with wider multi-disciplinary teams (including Yes ☐ No ☒ N/A ☐ Page 184 of 350
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3 allied health professionals and social work staff) as well as the person and their families. This ensures resources are targeted to those with the greatest level of need. North Lanarkshire continues to support a strong balance of care, sustained through investment in community provision and a long-standing commitment to Self-Directed Support. The model supports more people to be assessed at home and, where appropriate, to receive time limited reablement and rehabilitation before longer term care arrangements are considered. This is essential due to demographic change and sustained financial pressure. The case for change continues to be reinforced by population ageing, increasing prevalence of long-term conditions, and growing reliance on informal/unpaid care. The Home Support delivery model aligns to the Health and Social Care Partnership (HSCP) operating model and the principles of Getting it Right for Everyone. As part of this, the service continues to develop values-based practice that promotes enabling, prevention, and a Home First ethos. This report provides an update on progress made since the last report cycle and into 2026 across four key themes: 1. Embedding an enabling approach, 2. Workforce realignment to strengthen Home First and ongoing paid support delivery 3. Implementing and embedding of dynamic scheduling and digital reporting capability. 4. Transition from analogue-to-digital for community alarms while sustaining quality and continuity. Embedding an Enabling Approach The enabling approach has now been adopted across all localities which promotes: Do no harm Home First Empower People Focus on prevention Whole system approach No waits The approach has now been implemented across all localities, informed by early learning from locality test-of-change activity in Wishaw. This has supported improvements in pathway clarity, user experience, and multidisciplinary confidence in applying enabling practice. Page 185 of 350
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4 Taking a whole system approach, Getting it Right for Everyone: Person Centred, Outcome Focused, Assessment & Planning Training is now being delivered to all practitioners across social work services who support people through assessment. This programme of training continues to be developed and will be rolled out across the whole system to ensure integrated approaches continue to be embedded. The training will form part of the mandatory training programme for all social work service practitioners including Home Support Service Delivery Managers, Senior Home Support Managers, and Team Leaders. Again, this training delivery is phased and will become more integrated across the partnership. In addition, the Interim Change Management Team, supporting the implementation of the first stage of the functional split within Home Support, are developing key training for Team Leaders, Schedulers and Home Support Workers. This encompasses further promotion of the Enabling Approach, refreshing reablement and rehabilitation approaches, embedding outcome focused practice with people providing direct support, care planning, and multidisciplinary working. The service continues to reinforce that longer-term support should not routinely be determined within acute settings except in exceptional circumstances. Processes have been developed with NHSL colleagues to support this principle including the Target Operating Model and One For Lanarkshire, both of which focus on Home First for assessment. As part of the Home First approach, assessment-at-home pathways remain a key enabler. The service is continuing to see the impact of Home Assessment and reinforces why the Home First approach is essential. The proportion of HAT completions with no further service required following intervention has increased, demonstrating why early assessment at home is essential, this is demonstrating positive outcomes for service users who are being supported to regain their independence at home. Page 186 of 350
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5 Reviewing the age profile for HAT service users indicates a positive response to Home Assessment and the importance of assessment at home. Hospital Flow: 7% 9% 12% 10% 9% 8% 7% 21% 18% 15% 21% 18% 21% 16% 39% 43% 44% 41% 44% 37% 46% 31% 28% 28% 27% 27% 32% 30% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2024/25 Q1 2024/25 Q2 2024/25 Q3 2024/25 Q4 2025/26 Q1 2025/26 Q2 2025/26 Q3 HAT Age Distribution by Quarter Referred 18-49 50-64 65-74 75-84 85+ Page 187 of 350
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6 Current delay data is impacted by an increase of patients who have been assessed as lacking capacity. In addition, there are increased delays because of housing issues. Both areas are being explored in relation to supporting discharges to appropriate settings in a timely manner. Planned Date of Discharge (PDD) setting remains a challenge and is one of the areas to be reviewed alongside the use of the Target Operating Model (TOM) and the One For Lanarkshire request for assistance. As the focus towards Home First continues to be driven, demand to provide direct support as part of the Home Assessment ethos has increased, however the capacity of resource within HAT has not. In addition, there have been challenges to maximising Home Assessment for people due to vacancies and absences. As part of the Winter Scheme for 2025/2026, an initiative to extend Home Assessment in partnership with Independent Providers has commenced. The initiative seeks to support up to 90 people to return home from hospital for assessment which supports rehabilitation and helps them to regain confidence and skills following a period in hospital. The Extended Home Assessment Pathway is minimising delays in discharge and the impacts for people on their health and wellbeing associated with protracted hospital stay. 11 weeks into the 6-month scheme, fifty-five people have been supported to return home. Reablement Activity Reablement activity has been a key cornerstone of Home Support since 2011, however is currently transitioning into Assessment and Planning which will have a clear Home Assessment approach and focus within the “Home First” arena. This will positively impact capacity to support home assessment. Page 188 of 350
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7 The proportion of new or increased Home Support packages that go through a Reablement process has increased over time. However, the proportion of those completing Reablement with no, or a reduced Home Support service at the end of Reablement has decreased. As has been outlined earlier within the report, North Lanarkshire has an ageing population with some of the highest levels of deprivation across Scotland, the 2022 census reports demographic changes in those who identify as having a long-term health condition has grown by 30.6% (+43,943). Coordination continues to be supported by locality-based decision making and strengthened by emerging real-time operational visibility from digital scheduling tools. However, the Performance Report highlights that standardised reporting is being rebuilt following the introduction of Mosaic and other system changes, which has created short-term disruption in routine metric reporting while reports are validated. A continued focus through 2026 is placed on strengthening evening and out-of-hours resilience, responding to historic gaps and supporting a balanced system response to both planned and unplanned care. Living Well at Home continues as a locality-based service enabling integrated responses aligned to communities, supported by clearer description of purpose, eligibility focus, and complexity-based prioritisation. The aim of Living Well at Home is to promote independent living, choice and control, social inclusion, and wellbeing, through personalised support to meet identified outcomes. The primary focus remains on supporting adults with significant complexity of need (physical and/or social complexity, including public protection considerations), determined through assessment and multi-disciplinary decision making. Page 189 of 350
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8 Workforce North Lanarkshire in line with other local authorities are experiencing challenges in relation to recruitment of Home Support Workers, this is a national issue across all 32 local authority areas. The SSSC outline the current challenges facing all local authorities. data.sssc.uk.com In addition to recruitment challenges North Lanarkshire has an ageing workforce population as outlined below. Page 190 of 350
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9 The workforce continues to be central to implementation. Engagement activity has supported the transition to new ways of working, with emphasis on improving quality for people supported while strengthening workforce experience and sustainability. Operational alignment of frontline and supervisory roles has progressed to support the assessment and planning model and Living Well at Home service delivery, supporting seamless pathways and clearer role function. To complete full operational embedding, key management alignment continues as a focus, ensuring accountability and consistency across both Assessment and Planning and Living Well at Home. Workforce and HR processes continue to support this transition. Recruitment and retention remain priorities in the context of an ageing workforce and turnover pressures. Ongoing actions include values-based recruitment approaches and creating clearer development routes and career pathways within redesigned delivery structures. The service has strengthened recruitment approaches and broadened entry routes into social care, supporting improved conversion of applicants while building future capacity. Participation in youth and employability programmes continues alongside progression pathways, including modern apprenticeships and sessional roles, where available. Training and development remains a core enabler of implementation, ensuring staff are competent and confident in delivering enabling practice and working effectively with allied health professionals and multidisciplinary colleagues. Dynamic Scheduling System The roll out of the Access CM scheduling tool is now fully complete across the Home Support Service. Implementation began with the Bellshill Home Support Team which went live on 24 March 2025 and concluded with the Home Assessment Team on 3 November 2025. This marks a significant milestone in modernising our scheduling processes across the service. Home Support Team Back Office Go Live Date Full Go Live Date Bellshill 17/03/2025 24/03/2025 Wishaw 26/05/2025 02/06/2025 Motherwell 23/06/2025 30/06/2025 Airdrie 14/07/2025 21/07/2025 Coatbridge 11/08/2025 18/08/2025 Cumbernauld 15/09/2025 22/09/2025 Home Assessment Team 27/10/2025 03/11/2025 Page 191 of 350
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10 All staff both office based and frontline demonstrated exceptional engagement and commitment throughout the transition. Their willingness to learn, adapt and embed new ways of working has been critical to success of the rollout. It must be noted that during this time the service has also implemented additional new systems such as Mosaic and the council’s new telephony system. Training delivery across the service to support the roll out has been extremely positive. A training refresh is currently being reviewed to strengthen understanding and consistency. As well as staff attending formal training sessions (figures detailed below), onsite support and remote guidance was also provided throughout the roll out. System use across the service means for Home Support Workers across all localities including the Home Assessment Team, are using CM Mobile to access their work schedule and service user information and receive real-time updates to visits. Office based staff are using CallConfirmLive!( CCL) to schedule care and support and record key information relating to service users and staff to support the delivery of person-centred care. The Client Portal provides service users and family members with direct access to key information at any time including the name of allocated worker/s and scheduled visit times. The service continues to promote the Client Portal to increase engagement as this is the only method for service users and families to access real-time care information, other than contacting the service directly by telephone. The introduction of the portal has delivered efficiencies by reducing postage and printing costs for previously associated with authorisation letters which were outdated as soon as they were issued due to necessary changes in care delivery. The Care Inspectorate recently raised questions regarding alternative methods without digital technology during an unannounced inspection of the Cumbernauld Home Support Service. It is worth nothing that other providers and local authorities do not offer alternative options, with some not having a client portal at all. Page 192 of 350
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11 A Lessons Learned workshop was held on 29 January 2026 bringing together key stakeholders to review achievements to date, areas requiring improvement and future development opportunities. The workshop allowed staff to reflect what was working well and provided the opportunity to highlight some challenges in the use of the new tool such as: Travel-&me accuracy and limita&ons in scheduling flexibility. CM mobile synchronisation issues. Optimisation configuration within MaxCare. Interim payroll processes that remain time-consuming and reliant on manual checks. Dependencies on other systems (iTrent, mySWIS, Mosaic and CMBI) which can affect workflow. A need for improved functionality including bulk assignments and enhanced continuity options for dynamic scheduling. As work continues to work alongside Access CM to address challenges to resolve system limitations and progress optimisation solutions, phase 2 has been agreed and will focus on additional training and support for teams experiencing staff changes, and refining processes to align with the Assessment and Planning / Living Well at Home Service functional split. The next phase will also develop system integrations particularly around payroll, Mosaic and enhancing the reporting tools available. Development work will include new functionality for staff by introducing messaging, electronic forms, and mileage processes within the system. These enhancements aim to streamline workflows and reduce duplication. The completion of the scheduling tool rollout represents a major transformation in the way scheduling and care information is managed across the Home Support Service. While challenges remain, strong staff engagement, ongoing training, and the planned Phase 2 improvements and developments will continue to enhance the effectiveness of the system and support high quality, person-centred care. Improving Quality There continues to be a positive improvement in performance across all locality teams supported by ongoing work to address requirements and areas for improvement. This activity remains essential in restoring the historically high grades previously achieved during unannounced Care Inspectorate inspections. Action plans remain in place to support Registered Managers to drive service improvements, ensure high quality care delivery, and maintain a focus on strengths, requirements, areas for improvement and overall service development in preparation for future inspection activity. Page 193 of 350
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12 Wishaw was the first service to be inspected in 2026. The team successfully met two outstanding areas for improvement, with no new requirements or areas for improvement identified. The service also improved on their existing grades, including grade 5 – Very Good, which reflect the team’s sustained efforts and commitment to continuous improvement. An unannounced inspection then took place within the Motherwell Home Support Team also in January 2026. The team provided evidence to fully meet two requirements. Of the 11 areas for improvement, 4 areas were met in recognition of the progress made. Four of the remaining areas have now been incorporated into a new area for improvement under key question 1. Grades remained at 3 – Adequate across all key questions The team progress work on one new Requirement and 2 areas for improvement. An inspection was carried out in Cumbernauld Home Support Team in February 2026. The service met 1 requirement and 5 areas for improvement. Quality grades have been awarded for 4 – Good across key areas with no requirements or areas for improvement. (inspection report currently being finalised). With the exception of the Bellshill Home Support Service – who currently have no requirements or areas identified for improvement – all remaining teams continue to work toward meeting outstanding requirements and/or improvement actions ahead of deadlines; Airdrie 0 Requirements 9 Areas for Improvement Coatbridge 2 Requirements 5 Areas for Improvement Community Alarm Service 0 Requirements 1 Area for Improvement In addition, all four services are actively preparing for inspection supported by their improvement plans and ongoing managerial oversight. Statutory work required to meet legislative requirements in relation to reviews and personal support plans remains a significant challenge for all teams. Page 194 of 350
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13 Community Alarm Service The community alarm service has undergone significant change over the last twelve months with a continued focus on the analogue to digital transformation of the community alarm service. A comprehensive data cleansing programme resulted in all current service user records being validated, ensuring improved contact accuracy, responder reliability, and governance assurance. The new Digital Alarm Receiving Centre (ARC) went live on the 23rd of February 2026 with Sky Response/ Chubb supporting this milestone. Community alarm service users has remained static with very little year on year fluctuations as outlined in the table below: The service has been installing the Digital Alarms throughout the last 18 months and the service commenced tracking progress from April 2025 where the service had installed around 3000 new alarms. You can see the progress over the last 10 months. The service aims to have all community alarm service users transitioned to the new digital alarm by the end of 2026. Crucially service users who have not transitioned yet to the new digital alarm will still be supported as work is ongoing with telephony providers via a Service Level Agreement which identifies service users whose telephone line is due to be digitised which then allows the service to install a new digital alarm to ensure no loss of service. 6,180 6,213 6,214 6,218 6,229 6,318 6,306 6,295 6,248 6,219 6,203 6,149 6,286 1,580 1,572 1,552 1,550 1,555 1,552 1,553 1,542 1,535 1,409 1,366 1,367 1,360 - 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Service User Details No of dispersed No of Housing Page 195 of 350
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14 The community alarm service receives on average 35,000 service activations per month as outlined below, this is where a service user has come through the alarm receiving centre seeking advice, support, or reassurance. Following a service user activating the alarm most of those calls are for reassurance, however, please see the breakdown below that outlines the reason for a responder to visit a service users’ home is for personal care and falls activations . 3,000 3,374 3,543 3,783 3,899 4,494 4,564 4,587 4,626 4,817 - 1,000 2,000 3,000 4,000 5,000 6,000 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Total no of digital alarms installed 34,107 29,081 34,411 34,400 34,475 31,458 33,362 35,917 36,710 36,482 35,145 34,294 35,072 - 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 Jan-25 Mar-25 May-25 Jul-25 Sep-25 Nov-25 Jan-26 Total Activations Page 196 of 350
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15 The community alarm service has made significant progress since the last reporting cycle and will soon be awarded gold status for its digital transformation. 6. CONCLUSIONS This report provides a significant update in relation to the progress made in relation to embedding the enabling approach across all locality teams. There is a demonstrable increase of individuals being supported via Home Assessment and Reablement. Continued focus required to address workforce ageing profile and mitigations being undertaken to attract the workforce of the future. Dynamic Scheduling has now been fully implemented with phase one now complete; work is ongoing to roll out the next phase of the system; this will ensure refined processes are implemented to take account of Assessment and Planning and Living Well at Home. The service is moving forward with increased Care Inspectorate grades following inspection, however through 2026 services will be registered under Assessment and Planning and Living Well at Home. The Community Alarm Service has reached key milestones on relation to its progression from Analogue to digital transformation. 1,466 1,315 1,478 1,293 1,328 1,265 1,303 1,331 1,150 1,237 1,285 1,248 1,360 484 420 516 429 462 445 425 429 415 423 426 486 446 13 14 9 20 16 8 8 5 16 7 4 11 5 181 118 116 192 178 202 193 187 176 215 178 219 232 - 500 1,000 1,500 2,000 2,500 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Callouts HSW Attended - Personal Care HSW Attended - Fall HSW Attended - Power Failure HSW Attended - No Response Page 197 of 350
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16 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) Improved wellbeing of supported peoples’ outcomes. Service Quality Improvements - Inspection ratings increased across all localities. Technological Integration of the Access CM dynamic scheduling system. The technological integration of the digital ARC within the Community Alarms Service. Improved discharge response from Lanarkshire and Glasgow Hospitals. Workforce Stability and Engagement. Ensure a sustainable financial model. 7.3 FINANCIAL This paper has been reviewed by Finance: Yes ☐ No ☒ N/A ☐ Page 198 of 350
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17 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Medium Diane Fraser 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☒ Provide stakeholders with information on how to get involved Regular newsletters issued, outlining milestones and achievements. ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs A variety of engagement methods are being undertaken across localities to ensure participation is available for all. ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Service user questionnaire are regularly issued with follow up actions and responses communicated out to all service users. ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership Participation events have been held across a number of localities with further engagements planned. Page 199 of 350
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18 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS 9. APPENDICES Please include a glossary of terms if not already included. Diane Fraser, Head of Adult Social Work CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following. Margaret Flavell, Senior Manager, Adult Social Work Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☒ Page 200 of 350
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19 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 201 of 350
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1 REPORT Item No: 16 SUBJECT: Progress Report on Trauma Informed Practice TO: Integrated Joint Board Lead Officer for Report: Diane Fraser, Head of Adult Social Work Author(s) of Report Margaret Flavell, Senior Manager Adult Social Work DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: M Flavell ☒ Reviewed By: D. Fraser ☒ Endorsed By: ☐ 3. RECOMMENDATIONS It is recommended that the Integrated Joint Board acknowledge the progress made in the implementation of Trauma Informed Practice across the Health and Social Care Partnership. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES Yes ☐ No ☒ N/A ☐ Item 16 Page 203 of 350
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2 5.1 The evidence of the profound and lasting effects of adversity and trauma within childhood and adulthood continue to emerge. Consequently, the importance of embedding a trauma informed culture across the service sectors and local communities in Scotland is essential. (Appendix A). 5.2 The ‘Transforming Psychological Trauma: A Knowledge and Skills Framework for the Scottish Workforce’ (NES, 2017) along with the ‘Scottish Psychological Trauma Training Plan’ (NES, 2019) specify four practice levels: trauma informed, trauma skilled, trauma enhanced and trauma specialist (Appendix B). The levels are determined by role and function, with the aspiration that all workers within health and social care services are trauma informed. 5.3 Trauma informed practice is the ability of practitioners and organisations to recognise trauma and to adjust how we respond in a way that supports recovery and resilience. It is rooted in 5 key principles: Choice, Collaboration, Trust, Safety and Empowerment. 5.4 The ambition to embed trauma informed and trauma responsive practice across workforces and services in Scotland is supported by the National Trauma Transformation Programme (formerly the National Trauma Training Programme), funded by the Scottish Government and delivered in partnership with COSLA, NES, the Improvement Service and the Resilience Learning Partnership. 5.6 The National Trauma Transformation Programme (NTTP) provides a range of learning resources, guidance and frameworks to support practitioners and organisations. The ‘Roadmap for Creating Trauma-Informed and Responsive Change’ (NTTP, 2023) replaces the previous ‘Trauma Informed Practice Toolkit’ (NTTP, 2021) and has been designed to help services and organisations identify and reflect on progress, strengths and opportunities for embedding a trauma-informed and responsive approach across policy and practice. 5.7 The Roadmap identifies the following key drivers required to embed trauma informed practice within an organisation: - Organisational culture - Leadership - Staff wellbeing - Feedback loops - Sharing of Power with those with lived experience - Staff knowledge, confidence, skills and capacity - Policies and Processes - Budget - Service design and delivery Page 204 of 350
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3 5.8 In 2023, the Integrated Joint Board endorsed proposals to support, promote and embed trauma informed practice across the Health and Social Care Partnership, including committing to the Leadership Pledge of Support. In 2026, over 70 organisations have now signed the Leadership Pledge. This report will provide an update on the progress achieved to date, using the key drivers from the Roadmap as a framework. Policies and Processes 5.9 The Health and Social Care Partnership (the Partnership) has demonstrated its sustained commitment to embedding trauma informed practice across strategic planning, policies and operational processes1. It is evident that the principles of trauma informed practice are woven through each of the fundamental areas of work across the partnership. 5.10 The Partnership has integrated these into actions evidenced through its work on a whole-systems approach; improving mental health and wellbeing; workforce development and wellbeing; prevention and early intervention; tackling inequalities and applying a trauma-informed lens to service redesign. Leadership and Culture 5.11 The leadership has demonstrated a clear commitment to trauma-informed practice through visible and proactive discussions on key priorities, including enhanced community engagement, delivery of person-centred care in alignment with Getting it Right for Everyone (GIRFE) principles and the promotion of staff wellbeing alongside training opportunities. 5.12 The National Trauma Transformation Programme highlights ways in which leadership and organisational culture can be trauma informed, including increasing awareness of language used, feedback loops, a clear vision and providing the workforce with opportunities to attend training and receive robust support and supervision/ 1:1. Reflective Supervision guidance was updated to ensure attention given to engage the workforce in meaningful discussion in a trauma informed way. 5.13 A recent focus on the importance of language has been facilitated at strategic and organisational management levels (e.g. Strategic Planning Group 26th November 2025; Adult Social Work Governance Meeting). The discussions undertaken to date have highlighted the need for a consistent and shared understanding of language. Following this, a glossary was created and 1 Examples include: The Strategic Commissioning Plan 2023-2026, The Plan for North Lanarkshire-Programme of Work 2023-2028, North Lanarkshire Children’s Service Plan 2023–2026, Engagement and Participation Strategy 2024-2027, Violence Against Women Strategy and Action Plan 2022- 2025, Review of Equality Strategy, Review of Lanarkshire Mental Health & Wellbeing Strategy, Adult Support and Protection Procedures 2024 Page 205 of 350
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4 circulated, evidencing feedback loops in a system striving to embed trauma- informed practice at its core. 5.14 A current example of the commitment from leadership to promote and ensure the workforce has the necessary skills, confidence and understanding is the recent development of mandatory Getting it Right for Everyone, Assessment and Planning training with a focus on early intervention, assessment and ensuring the right supports are provided at the right time in the right place. This is currently being delivered to Social Work staff with plans for delivery in a more integrated approach including Health colleagues later this year. 5.15 The North Lanarkshire Trauma Steering Group continues to support the coordination and development of the trauma implementation plan. The Steering Group membership has evolved over the last 12-18 months to optimise inclusion, a wider partnership approach and to facilitate a streamlined approach to workstreams. The Trauma Steering Group meet every 8 weeks and in September 2025, identified key actions and priorities for the future, which will be collated into service action plans. Workforce knowledge and skills 5.16 There is an established commitment across the Partnership to ensure that all staff have the confidence, knowledge and skills to recognise and respond to people affected by trauma. The progress below notes continued workforce engagement with trauma training, a trauma informed approach underpinning all training programmes and evidence provided by frontline teams of trauma informed practice being embedded in daily operations. 5.17 The trauma training programme implemented is aligned with the national framework – Level 1 (informed), Level 2 (skilled) and Level 3 (enhanced). 5.18 At Level 1 (informed), all staff have access to an online module (LearnNL for Council staff and Turas for Health staff). As of 12th February 2026, 2271, NLC workers have completed the module on LearnNL. Although the data from the equivalent module on Turas has not been available for this report, the information from NHS teams has confirmed similarly high volume of engagement at Level 1 (informed). The intention is to collate this training data in future reports. There are services within the Partnership, such as the Addiction Recovery Teams, that have additional workforce development plans in trauma informed practice to support the implementation of the MAT standards 6 and 10 (aligned to trauma informed and reflective practice). In addition, there have been awareness raising sessions delivered to Elected Members and the Scottish Trauma Informed Leaders Training (STILT) has been provided to over 100 managers across the Partnership. Page 206 of 350
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5 5.19 At Level 2 (skilled) the training is separated into 4 modules. The first provides an overview of trauma and its impact. The other modules are divided into a focus on children and young people, mental health and the use of substances as a coping mechanism. The data for each is shown on the table below: Trauma Training Number completed within AHSCP Level 1 (Informed) 2271 Level 2 (Skilled): Per module Module 1 193 Module 2 56 Module 3 42 Module 4 35 5.20 At Level 3 (enhanced), the Safety and Stabilisation Training has been delivered to those who are explicitly supporting people affected by trauma. There is also a shared Level 3 online resource available to Health and Social Work staff. 5.21 In addition to this specific training, there is clear evidence that all training delivered across the Partnership is underpinned by the principles of trauma- informed practice. This includes sessions for Social Work students, within the induction programmes for all new Partnership staff, and core training on Dementia, Adult Support and Protection and Assessment and Planning. Another recent example is the ‘bite-size’ sessions delivered by the Adult Protection Committee on ‘Executive Function and Ability to Protect’ and ‘Adult Support and Protection and Mental Health’ that clearly highlight and address the complexity of trauma and how trauma informed practice is pertinent to support and protect adults at risk. 5.22 To sustain workforce confidence in trauma informed practice, it is recognised that it must be embedded in everyday activities. Evidence of this is visible across Partnership teams through its inclusion in assessments, case recordings (particularly in relation to Adult Support and Protection), team meetings, development days and peer support sessions. The Partnership Organisation Development lead has worked across localities with staff on health and wellbeing, psychological safety and on practice and culture at Strategic Commissioning Planning roadshows and events and Getting it Right for Everyone events. The feedback gathered from teams has also evidenced their use of other resources, particularly the National Trauma Transformation Programme and NHS Education (NES) websites. 5.23 There has been a request for further input on trauma informed practice from some teams within the Partnership and this will be progressed by the Trauma Steering Group. 5.24 The Trauma Steering Group has identified a key action in strengthening the workforce knowledge and skills to undertake a review of recruitment processes using a trauma lens. Page 207 of 350
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6 Workforce wellbeing 5.25 A key aspect of a trauma informed organisation is ensuring the workforce feels valued and supported. The Partnership remains committed to staff wellbeing, recognising the effects of secondary (vicarious) trauma, compassion fatigue and the emotional demands that staff can face when working with people affected by trauma. 5.26 Regular and meaningful reflective supervision/1:1 with staff is widely recognised by all teams across the Partnership as integral in cultivating a psychologically safe working environment that fosters resilience across the workforce. Positive examples provided by teams identify this approach in action, where wellbeing is a standing agenda item on supervisions and enables a relationship-based focus with opportunity for reflection rather than an exclusive emphasis on operational tasks. It has also been reported that this can vary across the Partnership with key influencing factors of service demands, competing priorities, reduced staffing and specific to individual managers’ approach. It is recognised that there could be benefit in a renewed focus on this for managers, and consideration of this will be progressed by the Trauma Steering Group. 5.27 There is a confidence reported by teams across the Partnership, particularly by managers, of the knowledge of available resources for supporting and promoting staff wellbeing. Positive feedback was also noted by those who had utilised these supports, often signposted by their managers or colleagues. 5.28 It is notable that team meetings and peer-led sessions are held in high regard as a source of emotional support by several teams across the Partnership. Furthermore, examples were provided by some teams of additional activities that increased staff wellbeing. These included regular wellbeing sessions, taking short breaks during the day for an activity and themed seasonal activities. 5.29 A clear, defined role and expectations around tasks was identified as instilling value for staff, with a reflection on how changes within the wider system can destabilise this. A protected lunch break and having a manager who is mindful of working outside core hours were also highlighted as positive. 5.30 The importance of having briefing and de-briefing opportunities when staff are working closely with those affected by trauma was identified by several teams across the Partnership where this is woven into usual practice. There were also examples provided of when additional support and bespoke sessions were arranged as a response to particularly challenging or distressing circumstances. Positively, these often involved a joint approach involving colleagues across different disciplines and in some cases, utilised support from NHSL Psychological Services. While acknowledging the good examples of trauma informed practice, more in-depth training on secondary (vicarious) trauma may be beneficial as many teams commented on the increase of Page 208 of 350
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7 complex, often trauma related work and its effects, which is echoed within the national data. 5.31 Within Child Protection and Adult Protection, trauma informed principles are explicitly embedded within the procedures, guidance and training and there is an awareness of the effect this work can have on staff wellbeing. Furthermore, the approach adopted for Learning Reviews by the Child Protection and Adult Protection Committees has focused on psychological safety and trauma with the changes introduced including available psychological support (provided by NHSL Psychological Services), ensuring discussions are held face to face and employs a systems approach to promote organisational learning. Service delivery and design 5.32 A person’s experience of a service should be trauma informed from their first contact and throughout any intervention. Key aspects of this are: supports offered that are relationship based and avoid people having to repeat their story; minimising barriers to accessing support and a trauma lens applied to the physical environments where service delivery occurs. 5.33 The evolution of how services are delivered and implemented through the enabling approach and underpinned by the Getting it Right for Everyone principles, aims to ensure people receive the right support at the right time, with a focus on early intervention and relationship-based practice. 5.34 Since 2024, all localities have had a weekly multi-agency meeting to discuss requests for assistance, share information and expertise. Following a successful pilot in one locality in October 2025, these meetings are now held daily in every locality. These shared-responsibility forums optimise local knowledge to respond quickly to requests for assistance, with outputs including signposting, agreement for assessment or service provision. This model supports efficient, person-centred integrated working with trauma-informed principles at its core. 5.35 Key benefits include: - Identification of the most appropriate worker / team - ‘the sticky person/team’ approach to lead assessment or intervention, reducing duplication and building on existing information. - Provide a way for teams to share information, expertise and offer advice. - Near-immediate responses, minimising anxiety for those awaiting the outcome. - Increased efficiency with achievable meetings (10-30 minutes on average) and swift solutions. - Increase in job satisfaction with quick responses from decision-makers, shared expertise across the Partnership and improved outcomes for the people they work with. The plan for an evaluation framework around this innovative way of working is developing, with above noted benefits for the service, workforce and those who require support. The work provides further evidence of trauma informed practice in action. Page 209 of 350
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8 5.36 There has also been positive progress made in terms of commissioned supports. Last year, there were 3 tenders (Adult Advocacy, Support for unpaid Carers, and Peer Support, Mental Health) developed in line with trauma informed principles, with trauma informed awareness raising sessions provided to these organisations. There are plans being developed for trauma informed awareness raising sessions for other commissioned services. 5.37 There is ongoing work to ensure community, public spaces and service delivery areas are trauma informed across the Partnership. This is supported by the development and implementation of the Trauma Informed Design Toolkit (NLC, 2025), walkthroughs from managers and consultation with the local community and those with lived experience. A recent example of this is the development of the Coatbridge Community Hub at Buchanan Street. 5.38 The Trauma Steering Group has recently completed an audit of locality Social Work buildings where a trauma-lens was applied, and this is being considered across Health buildings. The data gathered demonstrated an inconsistency in service delivery areas being trauma informed across the localities, particularly in reference to colour schemes (e.g. supporting people with dementia), furniture and leaflets or information boards not aligning to trauma principles. The Steering Group plans to fully analyse the data, undertake audits of other buildings and encourage walkthroughs with a trauma lens to inform the final recommendations. Collaborative / lived experience 5.39 The Partnership remains committed to ensuring the voice of those with lived experience of trauma is integral and continues to work with representative organisations across the community through engagement and participation events, everyday service delivery and in developing specific workstreams. 5.40 Following the launch of the Engagement and Participation Strategy in September 2024, a Participation Day was held in September 2025. This brought together supported people, carers, community representatives, community organisations, North Lanarkshire residents and Partnership staff to highlight the importance of involvement and raise the profile of organisations, activities and good practice. The collated views and analysis from the ‘What matters to you?’ initiative were presented at this day, and at the Strategic Planning Group in November 2025, with considerations to how these can influence the Strategic Commissioning Plan and the review of the Locality Outcome Improvement Plans. It was welcomed that the key messages correspond positively with the work being undertaken across the Partnership. 5.41 The work undertaken as part of the improvements in trauma informed service design has included consultations and walkthroughs with people with lived experience of trauma. As noted above, this work is ongoing with an integral aspect of increased involvement with people who use services. Page 210 of 350
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9 5.42 In everyday practice, teams within the Partnership have reported positively on improvements in collaborative trauma informed working. These have included increased awareness of power imbalances, the use of language both verbally and in recording practices and the importance of choice - for example on location, timing and format of meetings. The consideration of advocacy services has also been noted as positive. Feedback loops 5.43 Feedback loops with the workforce, partner agencies and those who use services promotes areas of good practice, provides ongoing evaluation and identify areas for improvement. 5.44 There is evidence of established formal feedback loops within the Partnership in annual reports, quarterly performance frameworks, iMatter reports and staff roadshows. Evaluations and surveys undertaken for specific workstreams and training continue to be utilised as improvement tools. 5.45 As noted in the previous section, there have been notable positive examples of increased engagement and participation by the Partnership with those with lived experience, with the explicit aim of influencing the way services are delivered. 5.46 Within the Partnership, there is evidence of feedback forums for staff inclusive of team meetings, supervisions/1:1 and teams having their own MS Teams channel. Additionally, some teams noted that they will arrange bespoke sessions to hear feedback when required, with recent examples provided following the implementation of the enabling approach and progression to daily meetings. It has been noted as positive that many of the forums with frontline staff have been jointly facilitated by the local managers in Health and Social Work. Another example provided by the Social Work teams was following the introduction in June 2025 of the new information recording system (Mosaic) which led to several bespoke feedback and learning sessions being held. 5.47 Within service provision spaces, there is evidence of active encouragement of staff views and feedback is encouraged using Care Opinion. The use of Care Opinion could be promoted more widely, particularly by Social Work teams. A process has also now been implemented which reviews complaints, providing feedback to the locality Social Work management teams to support continuous improvement. 5.48 As noted within the ‘National Learning Report 2025: Embedding trauma- informed and responsive organisations, systems and workforces’ (NTTP, 2025) the absence of an agreed evaluation tool or framework to measure trauma informed practice is a shared challenge nationally. The Trauma Steering Group has recommended that further work may be beneficial to review staff surveys Page 211 of 350
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10 and exit interviews, and in consultation with experts by experience, to consider the development of an evaluation framework. 5.49 It is also recommended that the use of tools within the ‘Roadmap’ such as the self-assessment checklist and trauma-lens walkthrough are utilised more widely to further enhance the feedback frameworks. 6. CONCLUSIONS 6.1 The report demonstrates the positive progress made in embedding trauma informed practice across the Partnership, using the key drivers identified in the Roadmap. 6.2 The Trauma Steering Group continues to have a key role to ensure trauma informed practice is embedded across the Partnership, with identified key future actions and a commitment to fully represent the work across all services within the Partnership. 6.3 A more coordinated Partnership approach will be developed to inform a HSCP action plan. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐ 7.2 ASSOCIATED MEASURE(S) Page 212 of 350
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11 7.3 FINANCIAL This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes Steering Group ☒ Provide stakeholders with information on how to get involved Regular National information distribution ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs Roadshows, walkarounds, SCP planning events, Getting it Right for Everyone events, Enabling Hubs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery As outline above ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings Embedded in core practice ☐ Develop participation guidelines to ensure a common understanding and set of Yes ☐ No ☒ N/A ☐ Page 213 of 350
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12 expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership Developing in LPGs and Community Boards 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS Transforming Psychological Trauma: A Knowledge and Skills Framework for the Scottish Workforce (NES, 2017) Scottish Psychological Trauma Training Plan (NES, 2019) (Both available on: www.traumatransformation.scot/knowledge-skills/) A Roadmap for Creating Trauma-Informed and Responsive Change: Guidance for Organisations, Systems and Workforces in Scotland (Available on: www.traumatransformation.scot/implementation/ ) Useful resources, including on trauma informed practice across different service areas, policy documents, trauma lens and walkthrough tools: (Available on: www.traumatransformation.scot/implementation/tools-and-resources/ ) Guidance for Child Protection Committees Undertaking Learning Reviews (Scottish Government, 2021) Guidance for Adult Protection Committees Undertaking Learning Reviews (Scottish Government, 2022) Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☐ Page 214 of 350
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13 Trauma Design Toolkit: Embedding trauma design principles across the built environments (NLC, 2025) 9. APPENDICES Appendix A: Trauma informed system Appendix B: Trauma Training Plan CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Margaret Flavell, Senior Manager Adult Social Work Page 215 of 350
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14 Appendix A: Trauma-Informed System Page 216 of 350
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15 Appendix B: Trauma Training Plan Page 217 of 350
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1 REPORT Item No: 17 SUBJECT: Population Health Framework Action Plan TO: Integration Joint Board (IJB) Lead Officer for Report: Professor S. Josephine Pravinkumar, Director of Public Health and Health Policy Author(s) of Report Professor S. Josephine Pravinkumar, Director of Public Health and Health Policy Dr Nick Riches, Acting Consultant in Public Health DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been to the North Lanarkshire’s Strategic Leadership Borad (SLB) and NHS Lanarkshire Board. Prepared By: ☐ Reviewed By: ☐ Endorsed By: ☒ Item 17 Page 219 of 350
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2 3. EXECUTIVE SUMMARY The report provides an update on the implementation of the Population Health Framework (PHF) and outlines the proposed approach of aligning NHSL and Community Planning Partnership activities for implementing the PHF. Primary responsibility for many PHF actions sits outwith NHS Lanarkshire and HSCP structures, or requires coordinated whole-system leadership. The NHS Lanarkshire PHF Action Plan is therefore intended to inform and connect with the planned joint Community Planning Partnership PHF collaborative. This pan-Lanarkshire, whole-system forum will support shared leadership, coordination and appraisal of system-wide approaches to delivering the PHF across Lanarkshire. With the clear intention to improve life expectancy and reduce health inequalities through a prevention-focused, whole-system approach across Lanarkshire. 4. RECOMMENDATIONS The IJB is asked to approve the following recommendations:. 4.1 Note the strategic intent, scope and structure of the NHSL Population Health Framework Action Plan. 4.2 Endorse the establishment of a Joint CPP–PHF Collaborative. 4.3 Support ongoing alignment of NHS and CPPs’ prevention activities with national PHF drivers. 4.4 Acknowledge that a more detailed plan, including refined actions and an agreed monitoring approach will be brought to NHSL and CPP Boards meetings. 5. VARIATIONS TO DIRECTIONS This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required Yes ☐ No ☐ N/A ☒ Page 220 of 350
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3 6. BACKGROUND Scotland’s Population Health Framework (2025–2035)1 sets a clear national direction to improve life expectancy and reduce health inequalities through a prevention- focused, whole-system approach. It recognises that improvements in health outcomes require coordinated effort across public services, communities, the third sector and national policy, sustained over time. A Population Health Framework (PHF) Action Plan is being developed to align existing activity, clarify accountability, and strengthen governance across NHS and HSCP structures. Much of the work contributing to the PHF is already underway across NHS Lanarkshire, HSCPs and the wider system involving community planning partners, but is dispersed across multiple strategies. The Action Plan will consolidate this into a single, coherent assurance and planning framework overseen by the Population Health Committee for actions pertaining to NHS Lanarkshire and by the CPPs for joint actions. Early discussions have commenced on potential actions and metrics to support future monitoring of progress against the PHF, with an overview of this work provided in the appendices. The report on the CPP Joint Event Report was taken to the SLB on 9th December 2025. This paper is a further update to the implementation of PHF. The paper is a proposed approach aligning NHSL and CPP activities for implementing the PHF. The PHF identifies five interconnected drivers of health and wellbeing: i. A prevention-focused system; ii. Social and economic factors; iii. Places and communities; iv. Enabling healthy living; v. Equitable health and care. Appendix 1 lists the 30 key actions which sit underneath these five drivers; and also the two “super-priorities” which the PHF recommends are particularly prioritised during the initial PHF implementation period; namely: Embedding prevention in our systems and Enabling healthy weight. 1 Scottish Government and COSLA (2025). Scotland’s Population Health Framework 2025–2035. Edinburgh: Scottish Government. Available at: https://www.gov.scot/publications/scotlands-population-health- framework/ (accessed 8 January 2026). Page 221 of 350
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4 While many of the wider determinants of health sit beyond the direct control of the NHS, Health Boards and HSCPs have a critical leadership and delivery role across all areas of the PHF; including in relation to prevention, early intervention, and ensuring equitable access to health and care services. Within Lanarkshire, many services already directly contribute to PHF actions; for example, through maternity and early years pathways, screening and immunisation, health protection, health improvement, anticipatory care and inequalities-focused service design. However, this contribution is currently described across multiple strategies and plans, making it difficult to present a coherent account of NHS Lanarkshire’s collective role in supporting population health outcomes. The NHS Lanarkshire PHF Action Plan is therefore intended to sit beneath the national framework, translating its drivers into a clear statement of what NHS Lanarkshire and HSCPs are accountable for, how this aligns with existing plans (including Marmot work in South Lanarkshire), and how progress will be governed through the Population Health Committee. Development to date has been led by Public Health, drawing on existing NHS and HSCP strategies, national policy and available intelligence. Engagement with wider NHS departments and HSCP colleagues is at an early stage, and detailed actions, ownership and metrics will be developed as the plan matures. Primary responsibility for many Population Health Framework actions sits outwith NHS Lanarkshire and HSCP structures, or requires coordinated whole-system leadership. The NHS Lanarkshire PHF Action Plan is therefore intended to inform and connect with the planned joint Community Planning Partnership PHF collaborative. This pan- Lanarkshire, whole-system forum will support shared leadership, coordination and appraisal of system-wide approaches to delivering the PHF across Lanarkshire. 7. SUMMARY OF KEY ISSUES Cross-cutting themes from the Joint CPP event included: Whole-system leadership and governance; Long-term, multi-year investment; Shared data and intelligence; Workforce culture and capacity; Community empowerment; Equity and proportionate universalism. Page 222 of 350
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5 The following were identified as immediate system priorities: 1. Leadership: Maintain visible commitment to prevention at CPP and Board meetings. 2. Governance: Establish the Joint CPP–Population Health Framework Collaborative in alignment with existing governance structures. 3. Strategic Alignment: Map all existing prevention and inequality programmes (PHF, Marmot, Anchor, Child Poverty, LOIPs). 4. Measurement: Develop shared system-level dashboards tracking prevention and inequality indicators 5. Workforce: Embed prevention and inequality objectives within all partner training and performance frameworks. 6. Community Engagement: Implement neighbourhood prevention forums and invest in community capacity. 7. Communication: Develop a joint prevention narrative and communication plan to sustain engagement and visibility. These actions will enable Lanarkshire’s CPPs and NHS partners to operationalise the PHF and strengthen shared accountability for health and wellbeing outcomes. PHF Action Plan Structure a. The PHF Action Plan will interpret national PHF drivers into local areas of NHS and HSCP accountability. Example action tables are included in Appendix 2 to demonstrate how each driver will be operationalised. b. Metrics will be selected for each PHF action, drawing on existing IPQR measures and developing new indicators where necessary. The metrics will align with national outputs and have quantitative and qualitative metrics and include process measures as well. c. We propose presenting a sub-section of metrics at Population Health Committee (PHC) meetings as an overview; continuing this for the period of the PHF, to monitor trends over time. Detailed scrutiny would continue through existing topic-specific reports to the Committee, or to other relevant governance routes, where fuller analysis and assurance are required. Given the breadth of the Framework’s 30 headline actions, this approach is intended to balance comprehensive coverage with a manageable and focused reporting model. d. The PHF Action Plan will include clear and proportionate accountability within NHS Lanarkshire’s statutory remit. Areas of activity that sit within HSCP or Integration Joint Board accountability (e.g. Health Improvement functions) are Page 223 of 350
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6 included to support alignment of activities, rather than to imply agreement or delegated responsibility at this stage. 8. CONCLUSIONS The NHS Lanarkshire Population Health Framework Action Plan sets out a clear and proportionate approach to aligning national PHF priorities with local accountability, governance and delivery. It consolidates existing activity across NHS Lanarkshire, HSCPs and Community Planning Partnerships, while recognising the need for whole-system leadership to improve population health and reduce inequalities. Ongoing engagement with CPPs and Integration Joint Boards will support further refinement of actions, ownership and metrics, ensuring the Action Plan develops into a robust framework for prevention-focused, system-wide improvement. 9. IMPLICATIONS Quality / Patient Care Assessment No immediate implications. Long term gains in improving population health outcomes anticipated through a stronger focus on prevention, early intervention, and addressing wider determinants of health. Employee Implications There are no immediate employee implications associated with this report. Financial Implications The PHF emphasises an action around investing in preventative approaches and it is vital that a shift to investment in prevention focus activities remain a priority to ensure positive outcomes. Climate Change, Sustainability and Environmental Implications There are no implications for climate change, sustainability or the environment in terms of the information contained within this report. Integrated Impact Assessment and Consultation Requirements There are no Equality Impact Assessment or consultation arrangement implications associated with this report. 9.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ Page 224 of 350
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7 People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 9.2 ASSOCIATED MEASURE(S) N/A 9.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 9.4 RISK ASSESSMENT/RISK MANAGEMENT Sustaining leadership and cross-sector momentum amid financial pressures and workforce constraints. Fragmented data and governance arrangements that limit shared accountability and measurement. Short-term funding cycles undermining innovation, continuity and workforce stability. Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Page 225 of 350
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8 Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes No N/A EQIA added to website: Yes No N/A Page 226 of 350
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9 10. BACKGROUND PAPERS Population Health Framework Scotland's Population Health Framework - gov.scot 11. APPENDICES Appendix 1: List of Population Health Framework Actions Appendix 2: Example Action Plan CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Name: Professor S. Josephine Pravinkumar Organisation: NHS Lanarkshire Email: Josephine.Pravinkumar@lanarkshire.scot.nhs.uk Page 227 of 350
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10 Appendix 1 List of Population Health Framework actions Driver Actions Super-priority (2025- 27) SP1. Embedding prevention in our systems SP2. Improving healthy weight 1. Prevention Focused System PFS1. Preventative investment PFS2. Accountability PFS3. Health in all policies PFS4. Community planning PFS5. Collaboration for Health Equity in Scotland PFS6. Digital population health PFS7. Research and innovation PFS8. Evaluation and learning 2. Social and Economic Factors SEF1. Early years and child development SEF2. Education SEF3. Economic activity SEF4. Income maximisation SEF5. Community wealth building 3. Places and Communities PAC1. Community and voluntary sector PAC2. Social prescribing PAC3. Planning PAC4. Housing PAC5. Climate change and nature 4. Enabling Healthy Living EHL1. Food environment and nutrition EHL2. Physical activity EHL3. Tobacco free generation EHL4. Drugs and alcohol EHL5. Preconception and pregnancy EHL6. Healthy digital use EHL7. Gambling harm 5. Equitable Health and Care EHC1. Healthcare inequalities EHC2. Vaccination and immunisation EHC3. Screening EHC4. Health protection EHC5. Sexual health and blood borne virus Page 228 of 350
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11 Appendix 2 Examples of NHSL PHF Action Plan tables The following examples demonstrate how NHS Lanarkshire intends to operationalise its contribution to each driver through a local action plan overseen by the Population Health Committee. One action table is presented for each driver; the final NHSL PHF action plan will contain action tables for all 32 actions and super-priorities listed in Appendix 1. These examples are illustrative only and do not represent finalised delivery or reporting commitments. DRIVER 1: PREVENTION-FOCUSED SYSTEM PFS2: Improve whole system accountability for primary prevention Scope of NHS/HSCP accountability NHS Lanarkshire and HSCPs are accountable for how prevention and inequalities are embedded within their own governance, planning and prioritisation processes. This includes ensuring that prevention is explicitly considered within NHS Board, IJB and HSCP decision-making, while recognising that wider system accountability extends beyond the NHS. Current activity Board-level oversight of some preventative activities, health inequalities, screening, immunisation and early-years outcomes through NHS Lanarkshire Population Health Committee. Integrated prevention governance within HSCP Strategic Commissioning Plans, Directions and Locality Planning. Statutory cross-sector reporting on prevention, poverty, early years and inequalities through Children’s Services Plans and Child Poverty Action Reports. Data-led assessment / review on prevention and inequalities through PHIL and Marmot Data Group locality dashboards. Clinical governance oversight of prevention through routine reporting on screening, immunisation and early diagnosis. Chief Executive Performance Reviews: quarterly HSCP indicators for breastfeeding, tobacco quits, cervical screening, alcohol brief interventions. Exemplar actions (under consideration) Strengthen the visibility of primary prevention within NHS and HSCP planning and reporting cycles Ensure population health and inequalities intelligence is routinely used to inform strategic decisions Align NHS and HSCP prevention reporting to support oversight through the Population Health Committee Key stakeholders NHS Lanarkshire Board and Executive Team Integration Joint Boards & HSCP Senior Management Teams Directorate of Public Health Metrics For discussion – e.g. Tracking progress of Action Plan by Board and CPPs Page 229 of 350
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12 DRIVER 2: SOCIAL AND ECONOMIC FACTORS SEF1: Early years and child development Scope of NHS / HSCP accountability NHS Lanarkshire and HSCPs are accountable for delivery of universal and targeted early years health pathways, including child health surveillance and follow-up support. While action on some wider determinants of child development sit beyond the NHS, early identification and appropriate response are core responsibilities. Current activity Children’s Services Planning alignment across NHS, HSCPs, education, social care and third sector on early-years outcomes. Universal child health surveillance and developmental review through health visiting. Targeted early-years support for vulnerable families facing adversity, including Health Visitor referral pathways to tackling poverty services. Early learning and childcare partnership input to developmental monitoring, intervention and support Parenting and early-relationship provision supporting social, emotional and language development. Exemplar actions (under consideration) Ensure early identification and timely follow-up and referral for children with identified developmental concerns Intensified early intervention and support in high-need areas Strengthen alignment of health visiting and HSCP family support pathways Key stakeholders Health Visiting Services Family Nurse Partnership NHSL Specialist Children’s Services Unit HSCP Children and Families Services Children’s Services Planning Partnerships (North and South) Directorate of Public Health and Health Improvement service Metrics 27-30 month child health review, % children with a concern Stillbirth Rate Breastfeeding Initiation Drop-Off in breastfeeding by 6-8 week review Page 230 of 350
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13 DRIVER 3: PLACES AND COMMUNITIES PAC2: Social prescribing Scope of NHS / HSCP accountability NHS Lanarkshire and HSCPs are accountable for implementing social prescribing and community link approaches within local services; for ensuring equitable access through primary care and HSCP pathways; and for supporting Community Link Workers and wider delivery partners in the community and voluntary sector. Current activity Established social prescribing Community Link Worker networks across HSCPs, primary care and third-sector partners. Community infrastructure for referral, including Community Solutions, Locality Anchors, leisure, green-health and third-sector provision. Integration of link workers within primary care and mental health pathways. Digital community directories and referral tools supporting social prescribing. Place-based outreach and link worker activity focused on high- inequality communities. Distress brief interventions to support people experiencing emotional distress below the threshold for referral to secondary mental health services. Exemplar actions (under consideration) Support delivery of social prescribing through primary care and HSCP-commissioned services Strengthen links between NHS services, HSCPs and community organisations Use locality intelligence to improve reach in communities with greatest need Digital solutions for social prescribing referrals. Key stakeholders Primary Care HSCP Locality Teams and Health Improvement Community and Voluntary Sector Directorate of Public Health Metrics General Practice - community link workers report on referral rate per 1000 population, by locality. General Practice - Community Link worker referrals reporting isolation as reason for referral. Page 231 of 350
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14 DRIVER 4: ENABLING HEALTHY LIVING EHL2: Physical activity Scope of NHS / HSCP accountability NHS Lanarkshire and HSCPs are accountable for supporting physical activity through healthcare pathways, anticipatory care and community-based services, rather than for wider environmental or legislative action. Current activity Active travel and transport partnership working across councils, NHS Lanarkshire, HSCPs and Sustrans. Green health and outdoor activity promotion through the Lanarkshire Green Health Partnership. Leisure and HSCP collaboration on targeted physical activity programmes to aid prevention and support prehabilitation/rehabilitation programmes Physical activity promotion within schools and early-years settings. Workplace physical activity and wellbeing initiatives within NHS Lanarkshire. Exemplar actions (under consideration) Further embed physical activity advice and referral within NHS and HSCP services. Increase capacity for local physical activity provision to enable strengthened links with healthcare pathways. Target support towards populations experiencing the poorest health outcomes. Key stakeholders Primary and Community Care HSCP Commissioning Teams Leisure and Physical Activity Partners Public Health Metrics Summary activity levels (options: very low activity, low activity, some activity, meets recommendations) Whether meets MVPA (moderate to vigorous physical activity) and muscle strength recommendations (options: meets neither, meets MVPA recommendations only, meets muscle strength recommendations only, meets both) Active travel - mode of travel to work Page 232 of 350
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15 DRIVER 5: EQUITABLE HEALTH AND CARE EHC2: Vaccination and immunisation Scope of NHS / HSCP accountability NHS Lanarkshire has direct accountability for delivery of vaccination programmes, with HSCPs supporting access, engagement and equity through local services and partnerships. Current activity Transition towards a single lifespan vaccination service with strengthened governance and clinical assurance. Inequalities-focused vaccination improvement activity targeting low-uptake communities. Operational planning and delivery of seasonal vaccination programmes across multiple settings. Primary care, school-age and early-years vaccination delivery through coordinated local pathways. Data-driven monitoring, quality assurance and governance of vaccination programmes. Exemplar actions (under consideration) Deliver vaccination programmes in line with national standards Use local data to identify and address inequalities in uptake, including for care experienced children and young people. Implement targeted approaches for underserved populations. Work with Education Departments to strengthen education around vaccination in schools. Key stakeholders Vaccination and Immunisation Services HSCPs Primary Care Directorate of Public Health Metrics Vaccination uptake rate for various programmes by locality, SIMD and specific groups Page 233 of 350
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16 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 234 of 350
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1 REPORT Item No: 18 SUBJECT: IJB Risk Register TO: North Lanarkshire Integration Joint Board Lead Officer for Report: Claire Rae, Chief Officer Author(s) of Report Kerry Taylor, Business Support Manager DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☒ For Endorsement: ☐ To Note: ☐ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Kerry Taylor, Business Support Manager ☒ Reviewed By: Claire Rae, Chief Officer ☒ Endorsed By: ☐ Item 18 Page 235 of 350
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2 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) considers the risks identified, the control measures in place, and the risk actions in progress to mitigate their impact; (2) makes recommendations it thinks appropriate to the Chief Officer in relation to those risks, controls and actions (3) approve the proposed new risk register for North Lanarkshire Integration Joint Board 5. VARIATIONS TO DIRECTIONS? This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required 6. BACKGROUND From a good practice and sound governance perspective, all public bodies are required to identify and take account of the impact of any potential risks in delivering their business. A risk overview and the IJB risks were discussed at an IJB members development session in September 2025. A range of proposed risks were discussed, including financial, governance, performance and workforce risks. PROPOSED NORTH LANARKSHIRE IJB RISKS Work has been carried out to complete a review of all IJB risks noted on the register. A decision was made by the HSCP SMT to close all risks and create a new risk register detailing the current risks relating to the North IJB. In total, there are nine proposed new IJB risks. Risks scoring between 16-25 are considered Very High, with two proposed risks within this category: NLIJB-R02: Financial Sustainability - Medium Term – Risk Score 20 NLIJB-R03: Financial Sustainability - Long Term – Risk Score 16 Yes ☐ No ☐ N/A ☒ Page 236 of 350
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3 Risks scoring between 10-15 are considered High, with three proposed risks within this category: NLIJB-R01: Financial Sustainability - Short Term – Risk Score 12 NLIJB-R06: Governance Failure – Risk Score 12 NLIJB-R09: Delayed Discharge – Risk Score 12 Risks scoring between 5-9 are considered Medium, with three proposed risks within this category: NLIJB-R04: Performance Delivery – Risk Score 8 NLIJB-R05: Inadequate Performance Management – Risk Score 6 NLIJB-R07: Failure to Meet Legislative Requirements – Risk Score 7 NLIJB-R08: Workforce Availability and Capacity – Risk Score 9 NEXT STEPS Members of North Lanarkshire Integration Joint Board are invited to discuss the proposed risks, and if deemed appropriate to approve the new risk register. It is proposed that the IJB Risks will be presented to the Performance Finance and Audit Committee on a quarterly basis. Work is ongoing to develop a new risk management strategy in partnership with NHS Lanarkshire and North Lanarkshire Council which will be presented to a future meeting of the IJB. 9.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 9.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner New IJB Risk Register Proposed Choose an item. Page 237 of 350
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4 10. BACKGROUND PAPERS 11. APPENDICES Appendix 1 – IJB Risk Dashboard (March) Appendix 2 – Risk Scoring Matrix CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Kerry Taylor kerry.taylor@lanarkshire.scot.nhs.uk Page 238 of 350
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5 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction Page 239 of 350
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6 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 240 of 350
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Executive Summary • New risk register being presented to NL IJB on 18 March 2026 for approval • Previous IJB risk register has been reviewed by SMT with proposals for all previous risks to be closed • Work is ongoing in partnership with NHSL and NLC to develop new Risk Management Strategy North Lanarkshire IJB Risks Dashboard – March 2026 Risk Register Number of Risks North Lanarkshire Integration Joint Board 9 Risk Movement Since Last Report No Change Increase Decrease Closed De-escalated New Escalated - - - - - 9 - NL IJB Risk Heat Map 0 1 2 3 4 5 6 Within Optimal Zone Within Tolerable Zone Out with Tolerable Zone IJB Risks IJB Risk Appetite 0 111 2 21 4 5 Risk Register Overview Number of Risks Very High (16-25) 2 High (10-15) 3 Medium (5-9) 4 Low (1-4) 0 1 Page 241 of 350
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Risk Ref Risk Date Opened Optimal Zone Tolerable Zone Current Risk Score Risk Owner Accountable Officer NLIJB- R01 Financial Sustainability – Short Term 18 March 2026 1-4 5-9 12 Chief Finance Officer Chief Officer NLIJB- R02 Financial Sustainability – Medium Term 18 March 2026 5-9 10-15 20 Chief Finance Officer Chief Officer NLIJB- R03 Financial Sustainability – Long Term 18 March 2026 5-9 10-15 16 Chief Finance Officer Chief Officer NLIJB- R04 Performance Delivery 18 March 2026 1-4 5-9 8 Head of Planning, Performance and Quality Assurance Chief Officer NLIJB- R05 Inadequate Performance Management 18 March 2026 1-4 5-9 6 Head of Planning, Performance and Quality Assurance Chief Officer NLIJB- R06 Governance Failure 18 March 2026 1-4 5-9 12 Chief Finance Officer Chief Officer NLIJB- R07 Failure to Meet Legislative Requirements 18 March 2026 1-4 5-9 6 Head of Health / Head of Adult Social Work / Nursing Director Chief Officer NLIJB- R08 Workforce Availability and Capacity 18 March 2026 1-4 5-9 9 Head of Health / Head of Adult Social Work / Nursing Director Chief Officer NLIJB- R09 Delayed Discharge 18 March 2026 1-4 5-9 12 Head of Health / Head of Adult Social Work Chief Officer North Lanarkshire IJB Risks Overview – March 2026 Page 242 of 350
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NLIJB-R01: Financial Sustainability - Short Term Risk Description Risk Owner Accountable Officer The Public Bodies (Joint Working) (Scotland) Act 2014 requires IJB’s to set a balanced budget as part of their strategic planning. This is essential for delivering integrated functions and budgets under IJB’s control, as outlined in the Act’s statutory guidance. There is a risk of North Lanarkshire Integration Joint Board not achieving a balanced budget within the current year as approved by the IJB annually in March. Chief Finance Officer Chief Officer Current Controls • Chief Finance Officer (S95 officer) • Due diligence by S95 officer on budget contributions from partner bodies each year as part of annual budget process • Financial position monitored on ongoing basis by SMT, IJB Performance, Finance and Audit Committee and full IJB, underpinned by a strong system of internal financial control and governance • Financial position reported to NHSL Board and NLC Adult Care & Social Work Committee quarterly • Monthly savings Board being introduced in 2026 to monitor progress against annual savings targets • Financial Regulations in place • NL Integration Scheme – agreed financial and budgetary responsibilities including for overspends against delegated IJB functions • Ongoing monitoring of in year budget and key risk areas regularly reported to the Board • Reserves strategy & policy in place Actions • Agree 2026/2027 budget and Medium-Term Financial Plan on 18 March 2026 • Continue to report financial position via SMT, IJB Performance, Finance and Audit Committee and full IJB • Continue monthly meetings between Partner finance teams and budget managers to ensure variances are reported timeously Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Three financial risks proposed to replace previous risks of IJB.01/21, IJB.04/21 and IJB.05/21 This will link to the financial risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 No 12 Page 243 of 350
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NLIJB-R02: Financial Sustainability - Medium Term Risk Description Risk Owner Accountable Officer The Public Bodies (Joint Working) (Scotland) Act 2014 requires IJB’s to set a balanced budget as part of their strategic planning. This is essential for delivering integrated functions and budgets under IJB’s control, as outlined in the Act’s statutory guidance. There is a risk of North Lanarkshire Integration Joint Board failing meet this statutory duty by not delivering financial balance over the medium three year financial planning cycle due to income levels not keeping pace with increasing demand and costs pressures. Chief Finance Officer Chief Officer Current Controls • Chief Finance Officer (S95 officer) • Due diligence by S95 officer on budget contributions from partner bodies each year as part of annual budget process • Medium Term Financial Outlook prepared and reported to IJB and Partners annually in September and December • Medium term financial plan prepared annually as part of the annual budget setting process and approved by IJB each March • Financial position monitored on ongoing basis by SMT, IJB Performance, Finance and Audit Committee and full IJB, underpinned by a strong system of internal financial control and governance • Monthly savings Board being introduced in 2026 to monitor progress against annual savings targets • Financial Regulations in place • NL Integration Scheme – agreed financial and budgetary responsibilities including for overspends against delegated IJB functions • Reserves strategy and policy in place Actions • Agree 2026/2027 budget and Medium-Term Financial Plan on 18 March 2026 • Continue to report financial position via SMT, IJB Performance, Finance and Audit Committee and full IJB • Savings proposals to be presented to IJB members early to allow full consideration before the budget is set in March • Regular review of reserves to maximise funds that can be held in contingency to meet budget gaps Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Three financial risks proposed to replace previous risks of IJB.01/21, IJB.04/21 and IJB.05/21 This will link to the financial risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 5-9 No Risk Appetite: Tolerable Zone 10-15 No 20 Page 244 of 350
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NLIJB-R03: Financial Sustainability - Long Term Risk Description Risk Owner Accountable Officer Forecasting over an extended period remains inherently uncertain, particularly given the potential for policy change, economic volatility and wider system pressures. Despite this uncertainty, it is essential that the IJB adopts a long-term perspective to ensure it can identify emerging risks early and take proactive steps to safeguard financial sustainability. There is a risk of North Lanarkshire Integration Joint Board not forecasting the long-term factors appropriately resulting in being unable to achieve a balanced budget over the 10-year forecasting timeline. Chief Finance Officer Chief Officer Current Controls • Chief Finance Officer (S95 officer) • Due diligence by S95 officer on budget contributions from partner bodies each year as part of annual budget process • Long term financial outlook is presented alongside the Medium term financial plan annually • Financial position monitored on ongoing basis by SMT, IJB Performance, Finance and Audit Committee and full IJB, underpinned by a strong system of internal financial control and governance. • Financial Regulations in place • NL Integration Scheme – agreed financial and budgetary responsibilities including for overspends against delegated IJB functions • Key risk areas regularly reported to the Board • Reserves strategy and policy in place Actions • Continue to report financial position via SMT, IJB Performance, Finance and Audit Committee and full IJB • Savings proposals to be presented to IJB members early to allow full consideration before the budget is set in March • Regular review of reserves to maximise funds that can be held in contingency to meet budget gaps • Long Term Financial Forecast to be presented to IJB in March each year along with the Medum Term Financial Plan • Assumptions are updated annually using census date, OBR forecasts and demand forecasts from Partners Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Three financial risks proposed to replace previous risks of IJB.01/21, IJB.04/21 and IJB.05/21 This will link to the financial risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 5-9 No Risk Appetite: Tolerable Zone 10-15 No 16 Page 245 of 350
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NLIJB-R04: Performance Delivery Risk Description Risk Owner Accountable Officer There is a risk of deterioration in performance delivery of the priorities and outcomes of the Strategic Commissioning Plan due to required expenditure reduction, workforce supply challenges and service demands resulting in North Lanarkshire Integration Joint Board not meeting its statutory duty. Head of Planning, Performance and Quality Assurance Chief Officer Current Controls • Quarterly Performance reviews • Benchmarking against national comparators • Medium term and long-term financial forecasting in place • Service redesign and innovation to progress implementation of the Strategic Commissioning Plan • Regular reporting to IJB Performance, Finance and Audit Committee Actions • Draft Strategic Commissioning Plan for 2026-2029 to be presented to IJB in March 2026 • Final SCP to be presented in June 2026 Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Two performance risks proposed to replace previous risks of IJB.19/23 and IJB.11/21 This will link to the performance risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 Yes 8 Page 246 of 350
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NLIJB-R05: Inadequate Performance Management Risk Description Risk Owner Accountable Officer There is a risk that achieve key objectives will not be achieved due to processes for the review and scrutiny of health and council performance either not being in place or are ineffective, resulting in less than robust scrutiny arrangements, and failure to identify, challenge, or rectify poor performance. Head of Planning, Performance and Quality Assurance Chief Officer Current Controls • Regular reporting to IJB Performance, Finance and Audit Committee • Agreed outcomes / performance measures • Robust performance management within NLC / NHSL • Regular monitoring by IJB and SMT • Annual performance report Actions • Draft Strategic Commissioning Plan for 2026-2029 to be presented to IJB in March 2026 • Final SCP to be presented in June 2026 Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Two performance risks proposed to replace previous risks of IJB.19/23 and IJB.11/21 This will link to the performance risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 Yes 6 Page 247 of 350
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NLIJB-R06: Governance Failure Risk Description Risk Owner Accountable Officer There is a risk that less than robust scrutiny arrangements and appropriate internal processes and procedures are either not in place or are ineffective, leading to a lack of leadership, accountability or scrutiny, resulting in a failure to meet key objectives, financial overspends or reputational damage. Chief Finance Officer Chief Officer Current Controls • Chief Officer • Chief Finance Officer (S95 officer) • Standing Orders • Financial Regulations • Code of Conduct • Local Code of Corporate Governance, Annual Governance Statement and Governance Issues Log • Performance, Finance and Audit Committee • Internal auditor, annual audit plan and internal audit annual report • IJB Development sessions Actions • Appoint Standards Officer • New Risk Management Strategy in progress • Review of IJB constitutional documents • Timetable of future development sessions / training for IJB members • New induction pack for IJB members Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Governance risk proposed to replace previous risks of IJB.10/21 Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 No 12 Page 248 of 350
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NLIJB-R07: Failure to Meet Legislative Requirements Risk Description Risk Owner Accountable Officer There is a risk that the IJB has limited ability to commission services efficiently due to financial and workforce instability alongside demand pressures sufficiently resulting in failure to meet legislative requirements (including safe staffing). Head of Health / Head of Adult Social Work / Nursing Director Chief Officer Current Controls • Financial and performance monitoring reports to the IJB and IJB PFA • Further information to be added Actions • Ongoing collaborative working with partners to deliver requirements under Health & Care Staffing Act, and escalation of arising Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 Yes 6 Page 249 of 350
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NLIJB-R08: Workforce Availability and Capacity Risk Description Risk Owner Accountable Officer There is a risk that full implementation of workforce plans can not be achieved due to financial and demand pressures which could lead to longer term workforce difficulties, shortages in some skill sets, negatively impacting on service delivery and the IJB’s ability to deliver the strategic plan. Head of Health / Head of Adult Social Work / Nursing Director Chief Officer Current Controls • Lanarkshire Health and Social Care Workforce Plan 2025 – 2028 in progress • NLC Workforce Plan • Service transformation, including redesign/review of services • Regular workforce monitoring • Partnership working between NHSL and NLC HR Services with workforce reports presented to the HSCP SMT Actions • Ongoing collaborative working with partners to deliver requirements under Health & Care Staffing Act, and escalation of arising Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. Risk proposed to replace previous risks of IJB.20/23 Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 Yes 9 Page 250 of 350
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NLIJB-R09: Delayed Discharge Risk Description Risk Owner Accountable Officer There is a risk that patients are not being discharged in a timely manner resulting in suboptimal patient flow, impacting on poor patient and staff experience and poorer outcomes of care. Head of Health / Head of Adult Social Work Chief Officer Current Controls • Daily enabling hubs • Senior decision makers within team to oversee • Daily reporting of delays • Home Assessment Model • Home Care Redesign • Escalation process in place • weekly scrutiny meeting with HSCP senior managers present • Weekly oversight meetings with whole system representation • Agreed Target Operating Model implementation • Close working with Acute Colleagues • Criteria to Reside Audits • Daily Dynamic Scheduling tool implemented within home care Actions • Deep Dive into current performance inclusive of daily meetings with Senior staff • Home care redesign roll out/completion Risk Update March 2026 – New risk proposed to be included within new IJB Risk Register. This will link to the DD risk on the level 2 risk register for the HSCP (NHSL) Is current assessment within Risk Appetite? Risk Appetite: Optimal Zone 1-4 No Risk Appetite: Tolerable Zone 5-9 No 12 Page 251 of 350
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Risk Matrix (Standard 5 x 5 Model) 1 Page 252 of 350
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Risk Scoring Matrix – Likelihood 2 Page 253 of 350
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Risk Scoring Matrix – Impact 3 Page 254 of 350
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1 REPORT Item No: 19 SUBJECT: IJB Directions Letters to NLC and NHSL TO: Integration Joint Board Lead Officer for Report: Claire Rae Chief Officer Author(s) of Report Maria Barry on behalf of Morag Dendy Chief Officer/Head of Planning, Performance & Quality Assurance DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☒ For endorsement ☐ To note ☐ 1.2 This report seeks the approval of the IJB in regard to the issue of the directions to each partner for 2026/2027 in line with the Strategic Commissioning Plan and the IJB Financial Plan. 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☐ Item 19 Page 255 of 350
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2 2.1 This paper has been prepared by the Senior Manager, Quality Assurance on behalf of the Chief Officer/Head of Planning, Performance and Quality Assurance and has been reviewed by the Chief Officer and Chief Financial Officer. 3. RECOMMENDATIONS 3.1 The IJB is asked to agree the following recommendations: 3.1.1 Approve the issue of the directions to North Lanarkshire Council for the financial year 2026/2027 attached at Appendix 1 3.1.2 Approve the issue of the directions to Lanarkshire NHS Health Board for the financial year 2026/2027 attached at Appendix 2 4. VARIATIONS TO DIRECTIONS? 4.1 The directions to each partner for 2026/2027 are detailed within Appendix 1 and 2 of this report. 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 In accordance with the requirements set out in the Public Bodies (Joint Working) (Scotland) Act 2014, the North Lanarkshire Integration Joint Board is required to issue a direction to Lanarkshire NHS Health Board and North Lanarkshire Council in respect of the delivery of integrated functions and how resources are to be allocated for the resultant services. 6. CONCLUSIONS 6.1 The letters of direction are attached at Appendix 1 and Appendix 2 and, following the approval of the IJB, will be issued to North Lanarkshire Council and Lanarkshire Health Board by 31 March 2026. 6.2 The focus for the year ahead will be on implementation of the programme of work of the IJB’s Strategic Commissioning Plan 2026-29. 6.3 The financial resources available are detailed in Annex 4 of each direction. The budget for 2026/27 is indicative at this stage. Recurring budget allocations have been agreed by the Director of Finance of NHS Lanarkshire and the Chief Officer (Finance & Technology) for North Lanarkshire Council in respect of the preparation of the IJB Financial Plan 2026/2027. 6.4 As part of the detailed budget setting process, it may be necessary for the IJB Chief Financial Officer to vary the 2026/27 allocations to reflect the detailed Yes ☒ No ☐ N/A ☐ Page 256 of 350
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3 budget setting process undertaken by each partner. Any such accounting adjustment to assist with budget monitoring arrangements will be undertaken in consultation with the Director of Finance of NHSL and the Chief Officer (Finance & Technology) for the Chief Officer (Finance & Technology) for North Lanarkshire Council. 6.5 Additional funding received in-year by the NLC and NHSL partners, which is ring fenced for areas covered by the IJB will be delegated to the partner responsible for service delivery. These in-year allocations will be agreed with each partner as appropriate. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) 7.2.1 A comprehensive performance framework is established across the health and social care partnership to monitor progress in respect of the achievement of agreed outcomes. 7.3 FINANCIAL This paper has been reviewed by Finance: Page 257 of 350
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4 7.3.1 Budget monitoring reports will be submitted to the Performance, Finance and Audit Committee and the IJB in accordance with the Financial Regulations. 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner IJB Financial Risk High Chief Finance Officer 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff Yes ☒ No ☐ N/A ☐ Page 258 of 350
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5 ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS None 9. APPENDICES Appendix 1- Letter of Direction to North Lanarkshire Council Appendix 2 - Letter of Direction to NHS Lanarkshire. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following: Claire Rae Claire.Rae@lanarkshire.scot.nhs.uk Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒ Page 259 of 350
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6 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 260 of 350
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7 Appendix 1 Councillor Jim Logue Leader of North Lanarkshire Council 31 March 2026 Dear Councillor Logue As part of the requirements set out in the Public Bodies (Joint Working) (Scotland) Act 2014, the North Lanarkshire Integration Joint Board (IJB) is required to continue to direct North Lanarkshire Council to carry out the integrated functions delegated to the IJB and to confirm the resources to be allocated for the resultant services in the forthcoming year. The direction from the IJB for the financial year 2026/2027 is therefore set out in Annexes 1, 2 and 3. North Lanarkshire Council is directed to continue to carry out the delegated functions and deliver services in a way which complies with and achieves the following: (a) The Integration Delivery Principles (b) The Integration Scheme (c) The Strategic Commissioning Plan 2026 - 2029 (d) The National Health and Wellbeing Outcomes (e) All Legal and Regulatory requirements This direction will remain in force until it is varied, revoked or superseded by a later direction in respect of the same function. A summary of our commissioning intentions is outlined in our Strategic Commissioning Plan at Annex 2. North Lanarkshire’s draft Strategic Commissioning Plan (SCP) 2026–2029 is being shaped through engagement led by the Strategic Planning Group and will set a clear direction of travel focused on prevention, fairness and stronger community centred support. The plan will align with Scotland’s Population Health Framework and will be integrated with forthcoming Local Outcome Improvement Plans The budget allocation for the delegated functions is outlined in Annex 4 and reflects the financial planning principles agreed at the IJB on 18 March 2026. The detailed budget setting process for the financial year 2026/2027 is being finalised. Once this work has been completed, the IJB will issue a further direction confirming the final budget. This should be concluded by no later than 30 June 2025. The IJB financial strategy must ensure sustainability for the current and future years whilst recognising the significant challenges for both partners currently. Efficient, effective and affordable services fit for the future will need to be developed as part of Page 261 of 350
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8 the integration and transformational change activities. The IJB Medium to Long Term Financial Plan provides context in respect of the ongoing financial challenges for both partners and to support future shared priorities. The Integration Scheme was revised and approved on the 19 March 2025 covering the period 2025-2028. The directions correspond to the revised responsibilities delegated to the IJB which exclude Children and Family Services and Justice Services. The final Strategic Commissioning Plan will set a medium-term investment and transformation framework designed to strengthen prevention, reduce inequalities and embed community led approaches across North Lanarkshire. The June 2026 report will bring together all supporting components – Joint Strategic Needs Assessment (JSNA), and a new Programme of Work —to ensure coherent delivery and oversight. On behalf of the officers across the partnership, I would like to thank North Lanarkshire Council for the continued support during this period of significant change. We will continue to ensure that Elected Members, officials and stakeholders are fully involved over the forthcoming year in the implementation of our commissioning intentions to improve the health and wellbeing outcomes for the people of North Lanarkshire. Yours sincerely Claire Rae Chief Officer North Lanarkshire Integration Joint Board Cc. Brian Moore, Chair, North Lanarkshire Integration Joint Board; Katharina Kasper, Chair, Lanarkshire Health Board; Des Murray, Chief Executive, North Lanarkshire Council; Louise Long, Chief Executive, Lanarkshire Health Board. Page 262 of 350
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9 DIRECTIONS UNDER SECTION 26 OF THE PUBLIC BODIES (JOINT WORKING) (SCOTLAND) ACT 2014 TO: NORTH LANARKSHIRE COUNCIL 31 March 2026 1. The North Lanarkshire Integration Joint Board is required to give Direction to North Lanarkshire Council on the carrying out of the functions delegated to it through the North Lanarkshire Integration Scheme as approved by the Scottish Ministers effective from 1 April 2026. 2. The North Lanarkshire Integration Joint Board is required to set out in writing how these functions are to be carried out and detail the financial resources that are available for carrying out the functions that are subject to these directions, including the allocated budget and how that budget is to be used. 3. North Lanarkshire Council must comply with the directions that are issued by the North Lanarkshire Integration Joint Board in respect of integrated functions. 4. Pursuant to the powers under Section 26 of the 2014 Act, the North Lanarkshire Integration Joint Board directs North Lanarkshire Council: a. that these directions relate to the functions and resultant services as set out in Annex 1; b. to carry out all integrated functions in line with the North Lanarkshire Integration Joint Board strategic plan and programme of work as set out in Annex 2; c. that the carrying out of all functions will be delegated to North Lanarkshire Council on the express understanding that North Lanarkshire Council will delegate those functions to Officers of the Council in accordance with the scheme of delegations set out in Annex 3 of this direction; d. that resources will be allocated to services as set out in Annex 4. 5. These directions shall remain in force until such time as the North Lanarkshire Integration Joint Board considers it appropriate to amend, revoke or supersede them. Signed on behalf of the North Lanarkshire Integration Joint Board Claire Rae Chief Officer North Lanarkshire Integration Joint Board Date: 31 March 2026 Page 263 of 350
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10 1 Section 26(1); Public Bodies (Joint Working) (Scotland) Act 2014. 2 Section 27(5)(b); Public Bodies (Joint Working) (Scotland) Act 2014. 3 Section 27(1)(a), (b) & (c); Public Bodies (Joint Working) (Scotland) Act 2014. 4 Section 27(4); Public Bodies (Joint Working) (Scotland) Act 2014. Page 264 of 350
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11 FUNCTIONS AND SERVICES ANNEX 1 Functions delegated by the Local Authority to the Integration Joint Board Set out below is the list of functions that will be delegated by North Lanarkshire Council to the Integration Joint Board. Column A Enactment conferring function Column B Limitation National Assistance Act 1948 Section 48 (Duty of councils to provide temporary protection for property of persons admitted to hospitals etc.) Section 45 (Recovery in cases of misrepresentation or non-disclosure.).) The Disabled Persons (Employment) Act 1958 Section 3 (Provision of sheltered employment by local authorities) The Social Work (Scotland) Act 1968 Section 1 (Local authorities for the administration of the Act.) So far as it is exercisable in relation to another integration function. Section 4 (Provisions relating to performance of functions by local authorities.) Section 5 (Powers of Secretary of State.) So far as it is exercisable in relation to another integration function. Section 8 (Research.) So far as it is exercisable in relation to another integration function. Section 10 (Financial and other assistance to voluntary organisations etc. for social work.) So far as it is exercisable in relation to another integration function. Section 12 (General social welfare services of local authorities.) Except in so far as it is exercisable in relation to the provision of housing support services. Column A Enactment conferring function Column B Limitation Section 12A (Duty of local authorities to assess needs.) Page 265 of 350
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12 So far as it is exercisable in relation to another integration function. Section 12AZA (Assessments under section 12A - assistance) So far as it is exercisable in relation to another integration function. Section 12AA (Assessment of ability to provide care.) Section 12AB (Duty of local authority to provide information to carer.) Section 13 (Power of local authorities to assist persons in need in disposal of produce of their work.) Section 13ZA (Provision of services to incapable adults.) So far as it is exercisable in relation to another integration function. Section 13A (Residential accommodation with nursing.) Section 13B (Provision of care or aftercare.) Section 14 (Home help and laundry facilities.) Section 27 (Supervision and care of persons put on probation or released from prisons etc.) Section 27ZA (Advice, guidance and assistance to persons arrested or on whom sentence deferred.) Section 28 (Burial or cremation of the dead.) So far as it is exercisable in relation to persons cared for or assisted under another integration function. Section 29 (Power of local authority to defray expenses of parent, etc., visiting persons or attending funerals.) Section 59 (Provision of residential and other establishments by local authorities and maximum period for repayment of sums borrowed for such provision.) Section 78A (Recovery of contributions) So far as it is exercisable in relation to another integration function. Column A Enactment conferring function Column B Limitation Section 80 (Enforcement of duty to make contributions.) Section 81 (Provisions as to decrees for ailment.) Section 83 (Variation of trusts.) Section 86 (Adjustment between authority providing accommodation etc., and authority of area of residence.) Page 266 of 350
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13 The Local Government and Planning (Scotland) Act 1982 Section 24(1) (The provision of gardening assistance for the disabled and the elderly.) Health and Social Services and Social Security Adjudications Act 1983 Section 21 (recovery of sums due to local authority where persons in residential accommodation have disposed of assets.) Section 22 (Arrears of contributions charged on interest in land in England and Wales) Section 23 (Arrears of contributions secured over interest in land in Scotland) Disabled Persons (Services, Consultation and Representation) Act 1986 Section 2 (Rights of authorised representatives of disabled persons.) Section 3 (Assessment by local authorities of needs of disabled persons.) Section 7 (Persons discharged from hospital.) In respect of the assessment of need for any services provided under functions contained in welfare enactments within the meaning of section 16 and which have been delegated. Section 8 (Duty of local authority to take into account abilities of carer.) In respect of the assessment of need for any services provided under functions contained in welfare enactments (within the meaning set out in section 16 of that Act) which are integration functions. Column A Enactment conferring function Column B Limitation The Adults with Incapacity (Scotland) Act 2000 Section 10 (Functions of local authorities.) Section 12 (Investigations.) Section 37 (Residents whose affairs may be managed.) Only in relation to residents of establishments which are managed under integration functions. Section 39 (Matters which may be managed.) Only in relation to residents of establishments which are managed under integration functions. Section 40 (Supervisory bodies.) Section 41 (Duties and functions of managers of authorised establishment.) Page 267 of 350
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14 Only in relation to residents of establishments which are managed under integration functions Section 42 (Authorisation of named manager to withdraw from resident’s account.) Only in relation to residents of establishments which are managed under integration functions Section 43 (Statement of resident’s affairs.) Only in relation to residents of establishments which are managed under integration functions Section 44 (Resident ceasing to be resident of authorised establishment.) Only in relation to residents of establishments which are managed under integration functions Section 45 (Appeal, revocation etc.) Only in relation to residents of establishments which are managed under integration functions The Housing (Scotland) Act 2001 Section 92 (Assistance to a registered for housing purposes.) Only in so far as it relates to an aid or adaptation. The Community Care and Health (Scotland) Act 2002 Column A Enactment conferring function Column B Limitation Section 4 (The functions conferred by Regulation 2 of the Community Care (Additional Payments) (Scotland) Regulations 2002) Section 5 (Local authority arrangements for of residential accommodation outwit Scotland.) Section 6 (Deferred payment of accommodation costs.) Section 14 (Payments by local authorities towards expenditure by NHS bodies on prescribed functions.) The Mental Health (Care and Treatment) (Scotland) Act 2003 Section 17 (Duties of Scottish Ministers, local authorities and others as respects Commission.) Section 25 (Care and support services etc.) Except in so far as it is exercisable in relation to the provision of housing support services. Section 26 (Services designed to promote well-being and social development.) Page 268 of 350
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15 Except in so far as it is exercisable in relation to the provision of housing support services. Section 27 (Assistance with travel.) Except in so far as it is exercisable in relation to the provision of housing support services. Section 33 (Duty to inquire.) Section 34 (Inquiries under section 33: Co-operation.) Section 228 (Request for assessment of needs: duty on local authorities and Health Boards.) Section 259 (Advocacy.) The Housing (Scotland) Act 2006 Section 71(1)(b) (Assistance for housing purposes.) Only in so far as it relates to an aid or adaptation. The Adult Support and Protection (Scotland) Act 2007 Column A Enactment conferring function Column B Limitation Section 4 (Council’s duty to make inquiries.) Section 5 (Co-operation.) Section 6 (Duty to consider importance of providing advocacy and other.) Section 7 (Visits) Section 8 (Interviews) Section 9 (Medical examinations) Section 10 (Examination of records etc.) Section 11 (Assessment Orders.) Section 14 (Removal orders.) Section 16 (Right to remove adult at risk) Section 18 (Protection of moved person’s property.) Section 22 (Right to apply for a banning order.) Section 40 (Urgent cases.) Section 42 (Adult Protection Committees.) Page 269 of 350
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16 Section 43 (Membership.) Social Care (Self-directed Support) (Scotland) Act 2013 Section 3 (Support for adult carers.) Only in relation to assessments carried out under integration functions. Section 5 (Choice of options: adults.) Column A Enactment conferring function Column B Limitation Section 6 (Choice of options under section 5: assistances.) Section 7 (Choice of options: adult carers.) Section 9 (Provision of information about self-directed support.) Section 11 (Local authority functions.) Section 12 (Eligibility for direct payment: review.) Section 13 (Further choice of options on material change of circumstances.) Only in relation to a choice under section 5 or 7 of the Social Care (Self-directed Support) (Scotland) Act 2013. Section 16 (Misuse of direct payment: recovery.) Section 19 (Promotion of options for self-directed support.) Carers (Scotland) Act 2016 (b) Section 6 (Duty to provide adult carer support plan) Section 21 (Duty to set local eligibility criteria) Section 24 (duty to provide support) Section 25 (provision of support to carers: break from caring) Section 31 (duty to prepare local carer strategy) Section 34 (information and advice service for carers) Column A Enactment conferring function Column B Limitation Section 35 (short breaks services statements) Page 270 of 350
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17 Part 2 Services currently provided by the Local Authority which are to be integrated The services that pertain to the functions in Part 1 and will be delegated are set out below. Social work services for adults and older people The functions in relation to social work services for adults and older people noted below will be delegated. a) Services and support for all adults with disabilities and long term conditions; b) Mental health services; c) Addiction services; d) Adult protection; e) Carers’ services; f) Community care assessment and planning services; g) Support services provided by contracted services; h) Care home services; i) Intermediate Care Services; j) Health and wellbeing improvement services; k) Aspects of housing support, including provision of equipment and adaptations to people’s homes; l) Day opportunities and day services; m) Homecare Services; n) Supported Living Services; o) Respite Support; p) Occupational therapy services; q) Re-ablement services’ r) Smart technology, equipment and telecare Page 271 of 350
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18 NORTH LANARKSHIRE IJB STRATEGIC COMMISSIONING PLAN AND PROGRAMME OF WORK ANNEX 2 North Lanarkshire’s draft Strategic Commissioning Plan (SCP) 2026–2029 is being shaped through engagement led by the Strategic Planning Group and will set a clear direction of travel focused on prevention, fairness and stronger community centred support. Emerging strategic priorities include: 1. Prevention-Focused System A whole system shift toward early intervention, anticipatory care and proactive support to reduce demand across health and social care. This includes trauma informed, strengths-based practice and expansion of community early help pathways. 2. Tackling Inequality Targeted support for communities most affected by poverty and poor health, including income maximisation, financial inclusion, and investment in local community wealth building initiatives. 3. Places and Communities Strengthening local assets through investment in community anchor organisations, place-based prevention models, enhanced community hubs, volunteering, community capacity building and the Getting It Right For Everyone (GIRFE) approach. 4. Enabling Healthy Living Delivering local programmes to support healthy weight, physical activity, nutrition, addiction recovery and mental wellbeing through whole family and whole life course approaches. 5. Equitable Access to Health & Care Improving fairness and accessibility by reducing barriers to services, developing flexible local models of care and deepening integration across health, social care and third sector partners. The final Strategic Commissioning Plan will set a medium-term investment and transformation framework designed to strengthen prevention, reduce inequalities and embed community led approaches across North Lanarkshire. Once finalised, information on North Lanarkshire IJB Strategic Commissioning Plan 2026 – 2029 and the Programme of Work will be updated on the following website: https://hscnl.org.uk/about-us/ Page 272 of 350
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19 The current Strategic Commissioning Plan and Programme of Work is due to expire in March 2026. A report submitted to IJB sets out the draft strategic priorities for the new plan, alongside next steps to allow final consultation to take place. Information on North Lanarkshire Health and Social Care Partnership is available on the following website: https://hscnl.org.uk/about-us/ Page 273 of 350
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20 SCHEME OF DELEGATION TO OFFICERS OF NORTH LANARKSHIRE COUNCIL ANNEX 3 This is the Appendix 1 referred to in the foregoing Authorisation of the Chief Officer to Officers of North Lanarkshire Council Column A Enactment conferring function Column B Limitation Column C National Assistance Act 1948 Section 48 (Duty of Councils to provide temporary protection for property of persons admitted to hospitals etc.). Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Disabled Persons (Employment) Act 1958 Section 3 (Provision of sheltered employment by local authorities) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Social Work (Scotland) Act 1968 Section 1 (Local authorities for the administration of the Act.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 4 (Provisions relating to performance of functions by local authorities.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 8 (Research.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 10 (Financial and other assistance to voluntary organisations etc. for social work.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12 (General social welfare services of local authorities.) Page 274 of 350
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21 Except in so far as it is exercisable in relation to the provision of housing support services. Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Section 12A (Duty of local authorities to assess needs.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12AZA (Assessments under Section 12A – assistance) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12AA (Assessment of ability to provide care.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12AB (Duty of local authority to provide information to carer.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 13 (Power of local authorities to assist persons in need in disposal of produce of their work.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 13ZA (Provision of services to incapable adults.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 13A (Residential accommodation with nursing.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 13B (Provision of care or aftercare.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 275 of 350
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22 Section 14 (Home help and laundry facilities.) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 28 (Burial or cremation of the dead.) So far as it is exercisable in relation to persons cared for or assisted under another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 29 (Power of local authority to defray expenses of parent, etc., visiting persons or attending funerals.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 59 (Provision of residential and other establishments by local authorities and maximum period for repayment of sums borrowed for such provision.) So far as it is exercisable in relation to another integration function. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Local Government and Planning (Scotland) Act 1982 Section 24(1) (The provision of gardening assistance for the disabled and the elderly.) Chief Social Work Officer Chief Accountable Officer Head of Housing Property Disabled Persons (Services, Consultation and Representation) Act 1986 Section 2 (Rights of authorised representatives of disabled persons.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 3 (Assessment by local authorities of needs of disabled persons.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 7 (Persons discharged from hospital.) In respect of the assessment of need for any services provided under functions contained in welfare enactments within the meaning of Section 16 and which have been delegated. Column A Enactment conferring function Page 276 of 350
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23 Column B Limitation Column C Chief Social Work Officer Head of Adult Social Work Services Chief Accountable Officer Head of Children Families and Justice Social Work Services Section 8 (Duty of local authority to take into account abilities of carer.) In respect of the assessment of need for any services provided under functions contained in welfare enactments (within the meaning set out in Section 16 of that Act) which are integration functions. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Adults with Incapacity (Scotland) Act 2000 Section 10 (Functions of local authorities.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12 (Investigations.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 37 (Residents whose affairs may be managed.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 39 (Matters which may be managed.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 41 (Duties and functions of managers of authorised establishment.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 42 (Authorisation of named manager to withdraw from resident’s account) Only in relation to residents of establishments which are managed under integration functions. Column A Enactment conferring function Column B Limitation Page 277 of 350
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24 Column C Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 43 (Statement of resident’s affairs.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 44 (Resident ceasing to be resident of authorised establishment.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 45 (Appeal, revocation etc.) Only in relation to residents of establishments which are managed under integration functions. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Housing (Scotland) Act 2001 Section 92 (Assistance to a registered social landlord for housing purposes.) Only in so far as it relates to an aid or adaptation. Head of Housing Services Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Community Care and Health (Scotland) Act 2002 Section 5 (Local authority arrangements for of residential accommodation outwit Scotland.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 14 (Payments by local authorities towards expenditure by NHS bodies on prescribed functions.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Mental Health (Care and Treatment) (Scotland) Act 2003 Section 17 (Duties of Scottish Ministers, local authorities and others as respects Commission.) Page 278 of 350
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25 Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 25 (Care and support services etc.) Except in so far as it is exercisable in relation to the provision of housing support services. Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 26 (Services designed to promote well-being and social development.) Except in so far as it is exercisable in relation to the provision of housing support services. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 27 (Assistance with travel) Except in so far as it is exercisable in relation to the provision of housing support services. Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 33 (Duty to inquire.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 34 (Inquiries under Section 33: Co-operation.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 228 (Request for assessment of needs: duty on local authorities and Health Boards) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 259 (Advocacy.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Housing (Scotland) Act 2006 Section 71(1)(b) (Assistance for housing purposes.) Only in so far as it relates to an aid or adaptation. Page 279 of 350
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26 Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Head of Housing Services The Adult Support and Protection (Scotland) Act 2007 Section 4 (Council’s duty to make inquiries.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 5 (Co-operation.) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 6 (Duty to consider importance of providing advocacy and other.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 11 (Assessment Orders.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 14 (Removal Orders.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 18 (Protection of moved person’s property.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 22 (Right to apply for a Banning Order.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 40 (Urgent cases.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 42 (Adult Protection Committees.) Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 43 (Membership.) Page 280 of 350
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27 Chief Social Work Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Social Care (Self-directed Support) (Scotland) Act 2013 Section 3 (Support for adult carers.) Only in relation to assessments carried out under integration functions. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 5 (Choice of options: Adults.) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 6 (Choice of options under Section 5: assistances.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 7 (Choice of options: Adult Carers.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 9 (Provision of information about self-directed support.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 11 (Local authority functions.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12 (Eligibility for direct payment: review.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 13 (Further choice of options on material change of circumstances.) Only in relation to a choice under Section 5 or 7 of the Social Care (Self-directed Support) (Scotland) Act 2013. Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 16 (Misuse of direct payment: recovery.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 281 of 350
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28 Section 19 (Promotion of options for self- directed support.) Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services, Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services The Community Care and Health (Scotland) Act 2002 Section 4 The functions conferred by Regulation 2 of the Community Care (Additional Payments) (Scotland) Regulations 2002 Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services National Assistance Act 1948 Section 45 (Recovery in cases of misrepresentation or non- disclosure) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Matrimonial Proceedings (Children) Act 1958 Section 11 (Reports as to arrangements for future care and upbringing of children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Social Work (Scotland) Act 1968 Section 5 (Powers of Secretary of State) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 6B (Local authority inquiries into matters affecting children). Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 27 (Supervision and care of persons put on probation or released from prisons etc.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 27ZA (Advice, guidance and assistance to persons arrested or on whom sentence deferred) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 78A (Recovery of contributions) Page 282 of 350
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29 Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 80 (Enforcement of duty to make contributions) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 81 (Provisions as to decrees for ailment) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 83 (Variation of trusts) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 86 (Adjustment between authority providing accommodation etc. and authority of area of residence) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Children Act 1975 Section 34 (Access and maintenance) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 39 (Reports by local authorities and probation officers) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 40 (Notice of application to be given to local authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 50 (Payments towards maintenance of children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Health and Social Services and Social Security Adjudications Act 1983 Page 283 of 350
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30 Section 21 (Recovery of sums due to local authority where persons in residential accommodation have disposed of assets) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 22 (Arrears of contributions charged on interest in land in England and Wales) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 23 (Arrears of contributions secured over interest in land in Scotland) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Foster Children (Scotland) Act 1984 Section 3 (Local authorities to ensure wellbeing of and to visit foster children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 5 (Notification by persons maintaining or proposing to maintain foster children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 6 (Notification by persons ceasing to maintain foster children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 8 (Power to inspect premises) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 9 (Power to impose requirements as to the keeping of foster children) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 10 (Power to prohibit the keeping of foster children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Children (Scotland) Act 1995 Page 284 of 350
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31 Section 17 (Duty of local authority to child looked after by them) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 19 (Local authority plans for services for children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 20 (Publication of information about services for children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 21 (Co-operation between authorities) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 22 (Promotion of welfare of children in need) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 23 (Children affected by disability) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 24 (Assessment of ability of carers to provide care for disabled children) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer Chief Accountable Officer, Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 24A (Duty of local authority to provide information to carer of disabled child) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 25 (Provision of accommodation for children etc.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 26 (Manner of provision of accommodation to child looked after by local authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 26A (Provision of continuing care: looked after children) Page 285 of 350
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32 Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 27 (Day-care for pre-school and other children) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 29 (Aftercare) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 30 (Financial assistance towards expenses of education or training and removal of power to guarantee indentures etc.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 31 (Review of case of child looked after by local authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Section 32 (Removal of child from residential establishment) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 36 (Welfare of certain children in hospitals and nursing homes etc.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 38 (Short term refuges for children at risk of harm) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 76 (Exclusion orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Criminal Procedure (Scotland) Act 1995 Section 51 (Remand and committal of children and young persons) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 286 of 350
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33 Section 203 (Reports) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 234B (Drug treatment and testing order) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 245A (Restriction of liberty orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Column A Enactment conferring function Column B Limitation Column C The Adults with Incapacity (Scotland) Act 2000 Section 40 (Supervisory bodies) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services The Community Care and Health (Scotland) Act 2002 Section 4 (Accommodation more expensive than usually provided) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 6 (Deferred payment of accommodation costs) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Management of Offenders etc. (Scotland) Act 2005 Sections 10 (Arrangements for assessing and managing risks posed by certain offenders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 11 (Review of arrangements) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Adoption and Children (Scotland) Act 2007 Section 1 (Duty of local authority to provide adoption service) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 287 of 350
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34 Section 4 (Local authority plan) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 5 (Guidance) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Section 6 (Assistance in carrying out functions under sections 1 and 4) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 9 (Assessment of needs for adoption support services) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 10 (Provision of services) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 11 (Urgent provision) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 12 (Power to provide payment to person entitled to adoption support service) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 19 (Notice under Section 18 local authority’s duties) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 26 (Looked after children - adoption is not proceeding) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 45 (Adoption support plans) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 47 (Family member’s right to require review of plan) Page 288 of 350
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35 Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 48 (Other cases where authority under duty to review plan) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 49 (Re-assessment of needs for adoption support services) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 51 (Guidance) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 71 (Adoption allowance schemes) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 80 (Permanence Orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 90 (Precedence of certain other orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 99 (Duty of local authority to apply for variation or revocation) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 101 (Local authority to give notice of certain matters) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Section 105 (Notification of proposed application for order) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 289 of 350
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36 The Adult Support and Protection (Scotland) Act 2007 Section 7 (Visits) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 8 (Interviews) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 9 (Medical examination) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 10 (Examination of records etc.) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 16 (Right to remove adult at risk) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Children’s Hearings (Scotland) Act 2011 Section 35 (Child assessment orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 37 (Child protection orders) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 42 (Parental responsibilities and rights directions) Column A Enactment conferring function Column B Limitation Column C Chief Social Work Officer, Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 44 (Obligations of local authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 48 (Application for variation or termination) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 290 of 350
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37 Section 49 (Notice of an application for variation or termination) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 60 (Local authority’s duty to provide information to Principal Reporter) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 131 (Duty of implementation authority to require review) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 144 (Implementation of a compulsory supervision order: general duties of implementation authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 145 (Duty where order requires child to reside in a certain place) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 153 (Secure accommodation regulations) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Column A Enactment conferring function Column B Limitation Column C Head of Adult Social Work Services Section 166 (Review of requirement imposed on local authority) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 167 (Appeal to Sheriff Principal: section 166) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 180 (Sharing of information: panel members) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 183 (Mutual Assistance) Page 291 of 350
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38 Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 184 (Enforcement of obligations of health board under section 183) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Social Care (Self-directed Support) (Scotland) Act 2013 Section 8 (Choice of options: children and family members) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 10 (Provision of information: children under 16) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Section 4 (The functions conferred by Regulation 2 of the Community Care (Additional Payments) (Scotland) Regulations 2002) Chief Social Work Officer Chief Accountable Officer Head of Children Families and Justice Social Work Services Head of Adult Social Work Services Page 292 of 350
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39 BUDGET ALLOCATION FOR THE DELEGATED FUNCTIONS ANNEX 4 The financial resources which will be delegated by the IJB to North Lanarkshire Council (NLC) for the financial year 2026/27 are as follows: 1. The NLC recurring budget allocations for in-scope social care services and housing services. For 2026/27, the total allocation is £219.931 based on the net budget as at January 2026. This budget will be uplifted as appropriate to reflect the 2026/27 additional funding of £25.708m, subject to confirmation of the financial planning assumptions. The final budgets, including agreed budget realignments, will be confirmed following the detailed budget setting process for 2026/27. 2. The additional funding highlighted at paragraph 1 allocated to NLC in 2026/27 is to support the strategic commissioning intentions and contribute to the agreed Scottish Government priorities which include the uplift of the free personal care rate and the contribution to the payment of the Scottish Living Wage. 3. NLC will implement as appropriate any agreed efficiency savings plans, budget realignments and management actions for 2026/27 as detailed in the IJB Financial Plan 2026/27. 4. Additional funding received in-year by the NLC and NHSL partners which is ring fenced for areas covered by the IJB will be delegated to the partner responsible for service delivery. These in-year allocations will be agreed with each partner as appropriate. 5. Notwithstanding the above allocations, the IJB is asked to note that it may be necessary for the IJB Chief Financial Officer to vary the 2026/27 allocations to reflect the detailed budget setting process undertaken by each partner. Any such accounting adjustment to assist with budget monitoring arrangements will be undertaken in consultation with the Director of Finance of NHSL and NLC’s Chief Officer (Finance). Page 293 of 350
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40 Appendix 2 Ms Katharina Kasper Chair of NHS Lanarkshire Health Board 31 March 2026 Dear Ms Kasper As part of the requirements set out in the Public Bodies (Joint Working) (Scotland) Act 2014, the North Lanarkshire Integration Joint Board (IJB) is required to continue to direct NHS Lanarkshire to carry out the integrated functions delegated to the IJB and to confirm the resources to be allocated for the resultant services in the forthcoming year. The direction from the IJB for the financial year 2026/27 is therefore set out in Annexes 1, 2 and 3. NHS Lanarkshire is directed to continue to carry out the delegated functions and deliver services in a way which complies with and achieves the following: (f) The Integration Delivery Principles (g) The Integration Scheme (h) The Strategic Commissioning Plan 2026 - 2029 and Programme of Work (I) The National Health and Wellbeing Outcomes (j) All legal and regulatory requirements This direction will remain in force until it is varied, revoked or superseded by a later direction in respect of the same function. A summary of our commissioning intentions is outlined in our Strategic Commissioning Plan and Programme of Work at Annex 2. North Lanarkshire’s draft Strategic Commissioning Plan (SCP) 2026–2029 is being shaped through engagement led by the Strategic Planning Group and will set a clear direction of travel focused on prevention, fairness and stronger community centred support. The budget allocation for the delegated functions is outlined in Annex 4 and reflects the financial planning principles agreed at the IJB on 18 March 2026. The detailed budget setting process for the financial year 2026/2027 is being finalised. Once this work has been completed, the IJB will issue a further direction confirming the final budget. This should be concluded by no later than 30 June 2025. The IJB financial strategy must ensure sustainability for the current and future years whilst recognising the significant challenges for both partners currently. Efficient, effective and affordable services fit for the future will need to be developed as part of the integration and transformational change activities. The IJB Medium to Long Page 294 of 350
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41 Term Financial Plan provides context in respect of the ongoing financial challenges for both partners and to support future shared priorities. The Integration Scheme was revised and approved on the 19 March 2025 covering the period 2025-2028. For completeness, the Health Board are advised that the directions to North Lanarkshire Council continue to correspond to the revised responsibilities delegated to the IJB by North Lanarkshire Council. The final Strategic Commissioning Plan will set a medium-term investment and transformation framework designed to strengthen prevention, reduce inequalities and embed community led approaches across North Lanarkshire. The June 2026 report will bring together all supporting components – Joint Strategic Needs Assessment (JSNA), and a new Programme of Work —to ensure coherent delivery and oversight. On behalf of the officers across the partnership, I would like to thank NHS Lanarkshire for the continued support during this period of significant change. We will continue to ensure that Health Board Members, officials and stakeholders are fully involved over the forthcoming year in the implementation of our commissioning intentions to improve the health and wellbeing outcomes for the people of North Lanarkshire. Yours sincerely Claire Rae Chief Officer North Lanarkshire Integration Joint Board Cc. Brian Moore, Chair, North Lanarkshire Integration Joint Board; Louise Long, Chief Executive, Lanarkshire Health Board. Des Murray, Chief Executive, North Lanarkshire Council; Page 295 of 350
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42 DIRECTIONS UNDER SECTION 26 OF THE PUBLIC BODIES (JOINT WORKING) (SCOTLAND) ACT 2014 TO: LANARKSHIRE HEALTH BOARD 31 MARCH 2026 1. The North Lanarkshire Integration Joint Board is required to give directions to Lanarkshire Health Board on the carrying out of the functions delegated to it through the North Lanarkshire Integration Scheme as approved by the Scottish Ministers effective from 1st April 2025. 2. The North Lanarkshire Integration Joint Board is required to set out in writing how these functions are to be carried out and detail the financial resources that are available for carrying out the functions that are subject to these directions, including the allocated budget and how that budget is to be used. 3. Lanarkshire Health Board must comply with the directions that are issued by the North Lanarkshire Integration Joint Board in respect of integrated functions. 4. Pursuant to the powers under Section 26 of the 2014 Act, the North Lanarkshire Integration Joint Board directs Lanarkshire Health Board: a. that these directions relate to the functions and resultant services as set out in Annex 1; b. to carry out all integrated functions in line with the North Lanarkshire Integration Joint Board strategic plan and commissioning summary as set out in Annex 2; c. that the carrying out of all functions will be delegated to Lanarkshire Health Board on the express understanding that Lanarkshire Health Board will delegate those functions to Officers of the Health Board in accordance with the scheme of delegations set out in Annex 3 of this direction; d. that resources will be allocated to services as set out in Annex 4. 5. These directions shall remain in force until such time as the North Lanarkshire Integration Joint Board considers it appropriate to amend, revoke or supersede them. Signed on behalf of the North Lanarkshire Integration Joint Board Claire Rae Chief Officer North Lanarkshire Integration Joint Board Date: 31 March 2026 Page 296 of 350
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43 5 Section 26(1); Public Bodies (Joint Working) (Scotland) Act 2014. 6 Section 27(5)(b); Public Bodies (Joint Working) (Scotland) Act 2014. 7 Section 27(1)(a), (b) & (c); Public Bodies (Joint Working) (Scotland) Act 2014. 8 Section 27(4); Public Bodies (Joint Working) (Scotland) Act 2014. Page 297 of 350
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44 FUNCTIONS AND SERVICES ANNEX 1 Functions delegated by the Health Board to The Integration Joint Board Set out below is the list of functions that will be delegated by NHS Lanarkshire to the Integration Joint Board Functions prescribed for the purposes of section 1(8) of the Act Column A Enactment conferring function Column B Limitation The National Health Service (Scotland) Act 1978 All functions of Health Boards conferred by, or by virtue of, the National Health Service (Scotland) Act 1978 Except functions conferred by or by virtue of— section 2(7) (Health Boards); section 2CB ((Functions of Health Boards outside Scotland); section 9 (local consultative committees); section 17A (NHS Contracts); section 17C (personal medical or dental services); section 17I (use of accommodation); section 17J (Health Boards’ power to enter into general medical services contracts); section 28A (remuneration for Part II services); section 38 (care of mothers and young children); section 38A (breastfeeding); section 39 (medical and dental inspection, supervision and treatment of pupils and young persons); section 48 (provision of residential and practice accommodation); section 55 (hospital accommodation on part payment); section 57 (accommodation and services for private patients); section 64 (permission for use of facilities in private practice); section 75A (remission and repayment of charges and payment of travelling expenses); section 75B (reimbursement of the cost of services provided in another EEA state); section 75BA (reimbursement of the cost of services provided in another EEA state where expenditure is incurred on or after 25 October 2013); Page 298 of 350
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45 section 79 (purchase of land and moveable property); section 82 use and administration of certain endowments and other property held by Health Boards); section 83 (power of Health Boards and local health councils to hold property on trust); section 84A (power to raise money, etc., by appeals, collections etc.); section 86 (accounts of Health Boards and the Agency); section 88 (payment of allowances and remuneration to members of certain bodies connected with the health services); section 98 (charges in respect of non- residents); and paragraphs 4, 5, 11A and 13 of Schedule 1 to the Act (Health Boards); and functions conferred by— The National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989; The Health Boards (Membership and Procedure) (Scotland) Regulations 2001/302; The National Health Service (Clinical Negligence and Other Risks Indemnity Scheme) (Scotland) Regulations 2000/54; The National Health Services (Primary Medical Services Performers Lists) (Scotland) Regulations 2004/114; The National Health Service (Primary Medical Services Section 17C Agreements) (Scotland) Regulations 2004; The National Health Service (Discipline Committees) Regulations 2006/330; The National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006/135; The National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009/183; The National Health Service (General Dental Services) (Scotland) Regulations 2010/205; and The National Health Service (Free Prescription and Charges for Drugs and Appliances) (Scotland) Regulations 2011/55. Disabled Persons (Services, Consultation and Representation) Act 1986 Section 7 (Persons discharged from hospital) Community Care and Health (Scotland) Act 2002 All functions of Health Boards conferred by, or by virtue of, the Community Care and Health (Scotland) Act 2002. Page 299 of 350
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46 Mental Health (Care and Treatment) (Scotland) Act 2003 All functions of Health Boards conferred by, or by virtue of, the Mental Health (Care and Treatment) (Scotland) Act 2003. Except functions conferred by— section 22 (Approved medical practitioners); section 34 (Inquiries under section 33: co-operation); section 38 (Duties on hospital managers: examination notification etc.); section 46 (Hospital managers’ duties: notification); section 124 (Transfer to other hospital); section 228 (Request for assessment of needs: duty on local authorities and Health Boards); section 230 (Appointment of a patient’s responsible medical officer); section 260 (Provision of information to patients); section 264 (Detention in conditions of excessive security: state hospitals); section 267 (Orders under sections 264 to 266: recall); section 281 (Correspondence of certain persons detained in hospital); and functions conferred by— The Mental Health (Safety and Security) (Scotland) Regulations 2005; The Mental Health (Cross Border transfer: patients subject to detention requirement or otherwise in hospital) (Scotland) Regulations 2005; The Mental Health (Use of Telephones) (Scotland) Regulations 2005; and The Mental Health (England and Wales Cross border transfer: patients subject to detention requirement or otherwise in hospital) (Scotland) Regulations 2008. Education (Additional Support for Learning) (Scotland) Act 2004 Section 23 (other agencies etc. to help in exercise of functions under this Act) Public Services Reform (Scotland) Act 2010 All functions of Health Boards conferred by, or by virtue of, the Public Services Reform (Scotland) Act 2010 Patient Rights (Scotland) Act 2011 All functions of Health Boards conferred by, or by virtue of, the Patient Rights (Scotland) Act 2011 Except functions conferred by— Page 300 of 350
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47 section 31(Public functions: duties to provide information on certain expenditure etc.); and section 32 (Public functions: duty to provide information on exercise of functions). Except functions conferred by The Patient Rights (Complaints Procedure and Consequential Provisions) (Scotland) Regulations 2012/36. Part 2 Services currently provided by the Health Board which are to be integrated The functions that are set out in Part 1 are delegated in relation to the services as set out below and relate to both adults and children. Interpretation 1. In this part— “Allied Health Professional” means a person registered as an allied health professional with the Health Professions Council; “general medical practitioner” means a medical practitioner whose name is included in the General Practitioner Register kept by the General Medical Council; “general medical services contract” means a contract under section 17J of the National Health Service (Scotland) Act 1978; “hospital” has the meaning given by section 108(1) of the National Health Service (Scotland) Act 1978; “inpatient hospital services” means any health care service provided to a patient who has been admitted to a hospital and is required to remain in that hospital overnight, but does not include any secure forensic mental health services; “out of hours’ period” has the same meaning as in regulation 2 of the National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004; and “the public dental service” means services provided by dentists and dental staff employed by a health board under the public dental service contract. Services 2. Accident and Emergency services provided in a hospital. 3. Inpatient hospital services relating to the following branches of medicine— (a) general medicine; (b) geriatric medicine; (c) rehabilitation medicine; (d) respiratory medicine; and Page 301 of 350
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48 (e) psychiatry of learning disability. 4. Palliative care services provided in a hospital. 5. Inpatient hospital services provided by General Medical Practitioners. 6. Services provided in a hospital in relation to an addiction or dependence on any substance. 7. Mental health services provided in a hospital except regionally or nationally organised forensic mental health services 8. District nursing services. 9. Services provided out with a hospital in relation to an addiction or dependence on any substance. 10. Services provided by allied health professionals in an outpatient department, clinic, or out with a hospital. 11. The public dental service. 12. Primary medical services provided under a general medical services contract, and arrangements for the provision of services made under section 17C of the National Health Service (Scotland) Act 1978, or an arrangement made in pursuance of section 2C (2) of the National Health Service (Scotland) Act 1978. 13. General dental services provided under arrangements made in pursuance of section 25 of the National Health (Scotland) Act 1978. 14. Ophthalmic services provided under arrangements made in pursuance of section 17AA or section 26 of the National Health Service (Scotland) Act 1978. 15. Pharmaceutical services and additional pharmaceutical services provided under arrangements made in pursuance of sections 27 and 27A of the National Health Service (Scotland) Act 1978. 16. Services providing primary medical services to patients during the out-of- hours period. 17. Services provided out with a hospital in relation to geriatric medicine. 18. Palliative care services provided out with a hospital. 19. Community learning disability services. 20. Mental health services provided out with a hospital. 21. Continence services provided out with a hospital. 22. Kidney dialysis services provided out with a hospital. 23. Services provided by health professionals that aim to promote public health. Page 302 of 350
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49 NORTH LANARKSHIRE IJB STRATEGIC COMMISSIONING PLAN AND PROGRAMME OF WORK ANNEX 2 North Lanarkshire’s draft Strategic Commissioning Plan (SCP) 2026–2029 is being shaped through engagement led by the Strategic Planning Group and will set a clear direction of travel focused on prevention, fairness and stronger community centred support. Emerging strategic priorities include: 1. Prevention-Focused System A whole system shift toward early intervention, anticipatory care and proactive support to reduce demand across health and social care. This includes trauma informed, strengths-based practice and expansion of community early help pathways. 2. Tackling Inequality Targeted support for communities most affected by poverty and poor health, including income maximisation, financial inclusion, and investment in local community wealth building initiatives. 3. Places and Communities Strengthening local assets through investment in community anchor organisations, place-based prevention models, enhanced community hubs, volunteering, community capacity building and the Getting It Right for Everyone approach. 4. Enabling Healthy Living Delivering local programmes to support healthy weight, physical activity, nutrition, addiction recovery and mental wellbeing through whole family and whole life course approaches. 5. Equitable Access to Health & Care Improving fairness and accessibility by reducing barriers to services, developing flexible local models of care and deepening integration across health, social care and third sector partners. The final Strategic Commissioning Plan will set a medium-term investment and transformation framework designed to strengthen prevention, reduce inequalities and embed community led approaches across North Lanarkshire. Once finalised, information on North Lanarkshire IJB Strategic Commissioning Plan 2026 – 2029 and the Programme of Work will be updated on the following website: https://hscnl.org.uk/about-us/ Page 303 of 350
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50 The current Strategic Commissioning Plan and Programme of Work is due to expire in March 2026. A report submitted to IJB sets out the draft strategic priorities for the new plan, alongside next steps to allow final consultation to take place. Information on North Lanarkshire Health and Social Care Partnership is available on the following website: https://hscnl.org.uk/about-us/ SCHEME OF DELEGATIONS ANNEX 3 That the carrying out of integrated functions that relate to the services set out in 1 and 2 below will be delegated to Officers of Lanarkshire Health Board by the Chief Executive of Lanarkshire Health Board at his discretion, in accordance with all applicable legal requirements; 1. Accident and emergency services provided in a hospital; 2. Inpatient hospital services relating to the following branches of medicine: • General medicine; • Geriatric medicine; • Rehabilitation medicine; • Respiratory medicine; • Palliative care services provided in a hospital; That the carrying out of integrated functions that relate to the services set out in 3 to 29 below will be delegated to Officers of Lanarkshire Health Board by the Chief Accountable Officer for the Integration Joint Board at her discretion, in accordance with all applicable legal requirements; 3. Inpatient hospital services relating to the following branches of medicine: • Paediatrics; • Psychiatry of learning disability; • Inpatient hospital services provided by general medical practitioners; • Services provided in a hospital in relation to an addiction or dependence on any substance; Page 304 of 350
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51 • Mental health services provided in a hospital except regionally or nationally organised forensic mental health services. 4. District nursing services; 5. Health Visiting; 6. Allied health professionals in an outpatient department, clinic, or out with a hospital; 7. Public dental services; 8. Primary medical services; 9. General dental services; 10. Ophthalmic services; 11. Pharmaceutical services; 12. Primary care out-of-hours; 13. Geriatric medicine; 14. Palliative care; 15. Community learning disability services; 16. Kidney dialysis services provided out with a hospital; 17. Services provided by health professionals that aim to promote public health; 18. Care Home Liaison; 19. Community Children’s Services; 20. Dietetics; 21. Psychology; 22. Sexual and Reproductive health and Blood Borne Viruses; 23. Speech and Language Therapy; 24. Prisoner Health Care; 25. Podiatry; 26. Mental Health and Learning Disability services; 27. Community Paediatrics; 28. Continence Services; 29. Addiction Services. That the carrying out of integrated functions that relate to the services set out in 30 to 38 below will be delegated to Officers of Lanarkshire Health Board by the Chief Page 305 of 350
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52 Accountable Officer for the South Lanarkshire Integration Joint Board at her discretion, in accordance with all applicable legal requirements; 30. Community Dental Services; 31. Diabetes Services; 32. Health & Homelessness; 33. Primary Care Administration; 34. Palliative Care; 35. Physiotherapy; 36. GP Out of Hours; 37. Traumatic Brain injury; 38. Occupational Therapy. Page 306 of 350
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53 BUDGET ALLOCATION FOR THE DELEGATED FUNCTIONS ANNEX 4 The financial resources which will be delegated by the IJB to NHS Lanarkshire (NHSL) for the financial year 2026/27 are as follows: 1. The NHSL recurring budget allocations for in-scope health care services including hosted services. For 2025/26, based on the budget as at January 2026, the total allocation for directly managed services, including hosted services, and the set aside budget of £77.397m is £654.839m. It includes non- recurring funding as at January 2025. This budget will be uplifted as appropriate to reflect the 2026/27 additional funding of £21.546m, subject to confirmation of the financial planning assumptions. The final budgets will be confirmed following the detailed budget setting process for 2026/27. Non- recurring budgets will be adjusted as appropriate as part of this exercise. 2. NHSL will implement as appropriate agreed efficiency savings plans in 2026/27. 3. Additional non-recurring funding received in-year from NHSL which is ring fenced for areas covered by the IJB will be delegated to the partner responsible for service delivery. These in-year allocations will be agreed with each partner as appropriate. 4. Notwithstanding the above allocations, the IJB is asked to note that it may be necessary for the IJB Chief Financial Officer to vary the 2026/27 allocations to reflect the detailed budget setting process undertaken by each partner. Any such accounting adjustment to assist with budget monitoring arrangements will be undertaken in consultation with the Director of Finance of NHSL and the Chief Officer (Finance & Technology) for NLC. Page 307 of 350
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1 REPORT Item No: 20 SUBJECT: Mainstreaming Equalities Report and Equality Outcomes Report TO: Integration Joint Board Lead Officer for Report: Head of Planning, Performance & Quality Assurance Author(s) of Report Senior Manager, Strategy & Performance DATE: 18 March 2026 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☒ For endorsement ☐ To note ☐ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Senior Manager, Strategy & Performance ☒ Reviewed By: Head of Planning, Performance & Quality Assurance ☒ Endorsed By: ☐ 3. RECOMMENDATIONS It is recommended that the Integration Joint Board: Item 20 Page 309 of 350
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2 (1) Approve the Mainstreaming Equality and Equality Outcome Progress Reports prior to publication on the Health and Social Care North Lanarkshire website. (2) Approve the draft Equality Outcomes to enable further consultation to take place. 4. VARIATIONS TO DIRECTIONS? 5. SUMMARY 5.1 This report presents University Health and Social Care North Lanarkshire’s Equality Mainstreaming Report and Equality Outcomes Progress Report for the period 2023-2025 for consideration and approval, prior to being published on the University Health and Social Care North Lanarkshire website. 5.2 A new set of draft Equality Outcomes for 2026–2030, are also presented for consideration and approval. 5.3 The Equality Mainstreaming Report describes how equality, diversity and inclusion are embedded within the Partnership’s governance, planning, commissioning and service delivery arrangements. The Equality Outcomes Progress Report outlines progress made in delivering the Equality Outcomes 2022-2026, demonstrating how the Partnership has met its statutory duties under the Public Sector Equality Duty (PSED). 5.4 The report concludes with a new set of draft Equality Outcomes for the period 2026–2030, informed by evidence, monitoring data and initial engagement activity, to guide future equality-related work. 5.5 Collectively, these reports provide evidence of how the Partnership is meeting Its statutory equality obligations and contributing to the reduction of inequalities in health and social care access, experience and outcomes. 6 BACKGROUND 6.1 The PSED, set out in the Equality Act 2010, requires the IJB, as a listed authority in Scotland, to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations between people who share protected characteristics and those who do not. In addition, the IJB is subject to the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012, which require public authorities to publish Equality Yes ☐ No ☒ N/A ☐ Page 310 of 350
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3 Outcomes and Equality Mainstreaming Reports, assess and review the equality impact of policies and practices, report on progress in delivering Equality Outcomes, consider equality in public procurement, and ensure equality information is published in an accessible manner. 6.2 University Health and Social Care North Lanarkshire meets the duties of the PSED by embedding equality, diversity and inclusion across its governance, planning and service delivery. The Equality Mainstreaming Report and Equality Outcome Progress Reports are produced on a biannual basis to demonstrate compliance and assess progress. Future equality related activity is informed through the development of Equality Outcomes, which are set on a four yearly cycle. 8. REPORT Mainstreaming Equality Report 8.1 The Mainstreaming Report sets out the legislative context for the work of the IJB under the PSED, including the Equality Act 2010 (Specific Duties) (Scotland) Regulations. The report demonstrates how the Health and Social Care Partnership is systematically integrating the PSED into its day-to-day functions. This includes policy development, service delivery, workforce development, and decision-making, with examples provided to evidence practice and impact. 8.2 The report highlights progress made in strengthening governance arrangements, improving the availability and use of equality monitoring data, and increasing awareness and understanding of equality and human rights across the workforce. By publishing this Mainstreaming Report, the IJB demonstrates transparency in its approach to meeting its equality duties and provides assurance of leadership accountability. Equality Outcomes Progress Report 8.3 The Equality Outcomes Progress Report also outlines the legislative context for the work of the IJB under the PSED, including the Scotland Specific duties. The report provides assurance on how the IJB is meeting its duties under the PSED by evidencing progress against the Equality Outcomes 2022–2026. 8.5 The Equality Outcomes 2022–2026 were developed in response to the Covid19 pandemic and aligned with the Strategic Commissioning Plan 2020–2023. They focus on reducing inequality, improving accessibility and independence, strengthening engagement with seldom heard groups, supporting a sustainable independent sector, and expanding technology enabled care. The report highlights the progress made through targeted action to improve access, reduce barriers, and respond to local needs. Page 311 of 350
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4 8.6 Key developments include enhanced preventative and community-based support, strengthened first response and assessment arrangements, improved engagement and participation, and sustained partnership working with the independent sector. The continued expansion of digital and technology-enabled care has increased choice, connectivity, and inclusion, and continues to inform service redesign, commissioning, and future planning. Draft Equality Outcomes 2026-2030 8.7 A new draft set of Equality Outcomes for 2026–2030 has been developed following analysis of a range of evidence sources. These include population needs and inequality data for North Lanarkshire, national and local research and policy priorities, and evidence of inequality across communities. This has included consideration of key areas such as suicide prevention and mental health, carers’ rights and recognition, domestic abuse and male violence against women and girls, and the needs of Black and ethnic minority communities. The development of the outcomes has also been informed by relevant external frameworks and recommendations, including the Equality and Human Rights Commission’s A Fairer Scotland report and the Council of Europe’s Group of Experts on Action against Violence against Women and Domestic Violence (GREVIO) findings. An Equality Impact Assessment (EqIA) is being progressed to support the development of the proposed outcomes, across all Protected Characteristics under the Equality Act 2010, ensuring they contribute to advancing equality and reducing inequalities in health and social care. 8.8 The new draft outcomes are; Outcome 1 – Choice and Control in Social Care People across North Lanarkshire perceive that they have choice and control in how their social care is arranged, particularly older people and disabled people. Outcome 2 – Suicide Prevention Suicide rates across North Lanarkshire are reduced, particularly for boys and men Outcome 3 – Culturally Sensitive Services The delivery of Health and Social Care services, including personal care and mental health services, is culturally sensitive and recognises the needs of North Lanarkshire’s Black and ethnic minority and faith based communities. Outcome 4 – Gender Sensitive approach to Domestic Abuse Mental Health and Addiction Services recognise the need for a gender sensitive approach to domestic abuse, ensuring services appropriately Page 312 of 350
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5 support women in North Lanarkshire and contribute to improved safety and recovery. Outcome 5 – Equitable Support for Carers Carers across North Lanarkshire experience equitable access to health and social care support, are recognised as equal partners in care, and do not face disadvantage or discrimination because of their caring role. This includes: Adult carers Young carers and parent carers Lesbian, Gay and Bisexual carers Carers with the protected characteristic of Gender Reassignment 8.9 The table below demonstrates continuity of our approach and shows how learning from the previous Equality Outcomes has shaped and strengthened the Equality Outcomes for 2026–2030. Previous Equality Outcome (2022– 2026) Key Themes / Learning Linked Equality Outcome 2026– 2030 How the New Outcome Builds on Progress People will be supported to maintain their health and wellbeing through the pandemic. • Disproportionate mental health impacts • Importance of early intervention and prevention • Gendered and age-specific risk factors Suicide rates across North Lanarkshire are reduced, particularly for boys and men. Moves from generic pandemic wellbeing support to a targeted, evidence-based approach addressing groups with the highest inequality and risk, particularly men. Services will be more accessible to maximise independence and connectedness. • Need for flexible models of care • Barriers experienced by older and disabled people • Importance of choice and control People perceive that they have choice and control in how their social care is arranged, particularly older and disabled people. Shifts from access during crisis to long-term empowerment, embedding choice, control and independence as core principles of service delivery. Active engagement of seldom-heard groups in the delivery and design of services. • Inequalities in access and experience • Under-representation of BME and marginalised communities • Importance of Health and Social Care services are culturally sensitive and recognise the needs of North Lanarkshire’s Moves from engagement activity to service design and delivery, ensuring cultural and gendered needs are recognised and embedded. Page 313 of 350
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6 culturally competent practice BME communities. Mental Health and Addiction Services recognise the need for a sex based approach to domestic abuse, ensuring services appropriately support women abused by men and contribute to improved safety and recovery. Support the independent and third sector to flourish to ensure people have greater choice and control. • Value of community-based and third sector provision • Importance of partnership working • Impact on carers and service users Carers experience equitable access to support, are recognised as equal partners in care, and do not face disadvantage or discrimination. Builds on sector collaboration to ensure carers’ rights, recognition and equity, including groups who experience compounded disadvantage. Development of technology-enabled care. • Digital inclusion and exclusion • Need for accessible, person-centred technology use • Hybrid models of support Choice and control in social care and equitable access for carers (cross-cutting) Technology-enabled care is now embedded as an enabler across outcomes, supporting independence, access and connectedness rather than existing as a standalone objective. 8.10 Following IJB consideration and approval, further consultation on the draft Outcomes will be undertaken. The final Equality Outcomes will then be brought back to the IJB for approval, alongside an evidence framework, prior to publication. 9. IMPLICATIONS 9.1 NATIONAL OUTCOMES Page 314 of 350
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7 Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ 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 ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 9.2 ASSOCIATED MEASURE(S) 9.3 FINANCIAL This paper has been reviewed by Finance: 9.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 9.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details Yes ☐ No ☐ N/A ☒ Page 315 of 350
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8 ☒ Involve stakeholders in the development work aimed at achieving the national outcomes Consultation on the draft equality outcomes commenced with involvement of the Strategic Planning Group. The approval of the draft outcomes will allow further engagement to take place with key stakeholders. ☒ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☒ N/A ☐ Page 316 of 350
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9 An EQIA will be included as part of the final approval process for the new Equality Outcomes. 10. BACKGROUND PAPERS None. 11. APPENDICES Appendix 1 - Equality Outcomes Progress Report 2023 – 2025 Appendix 2 - Equality Mainstreaming Report 2023 - 2025 HEAD OF PLANNING, PERFORMANCE & QUALITY ASSURANCE Members seeking further information about any aspect of this report, please contact the following; Page 317 of 350
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10 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 318 of 350
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The Public Sector Equality Duty Integration Joint Board Equality Outcomes Progress Report 2023 - 2025 Page 319 of 350
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1 Introduction 1.1 This progress report sets out the Integration Joint Board’s (IJB) progress in delivering its Equality Outcomes 2022-2026 and highlights key actions taken to embed equality, diversity and inclusion within service planning, commissioning and delivery. It demonstrates how equality considerations continue to inform decision-making and service improvement, with a focus on reducing inequalities in access, experience and outcomes across North Lanarkshire. 2 Legislative context 2.1 The Public Sector Equality Duty (PSED) was established by section 149 of the Equality Act 2010. As a listed authority in Scotland, the IJB is required to comply with the three general needs or the ‘General Duty’ of the PSED; 1. To eliminate unlawful discrimination, harassment and victimisation, 2. To advance equality of opportunity between people who share a protected characteristic and those who do not and 3. To foster good relations between those who share a protected characteristic and those who do not. 2.2 IJBs were added to Part 3 of Schedule 19 of the Equality Act 2010 by the Equality Act 2010 (Specification of Public Authorities) (Scotland) Order 2015. This amendment came into force on 1 April 2015, at which point the IJB became a listed public authorities subject to the general equality duty under section 149 of the Equality Act 2010. 2.3 The IJB is also subject to the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 which are designed to help public authorities demonstrate how they are meeting the General Duty. These specific duties include Publishing Equality Outcomes Publishing Mainstreaming Equality Reports Assessing and reviewing the equality impact of policies and practices Reporting progress on delivering Equality Outcomes Considering equality in public procurement Publishing equality information in an accessible manner 2.4 Under the Scotland Specific Duties of the PSED, the IJB has a duty to set and publish Equality Outcomes at least every 4 years and to report on progress every 2 years. These outcomes translate the general duty into clear, evidence-based priorities and actions, enabling the IJB to demonstrate impact against the three needs in a transparent and measurable way as a key mechanism through which to demonstrate how the PSED is met. 3 Equality Outcomes 3.1 An Equality Outcome is a long-term outcome which sets out the results the IJB seeks to achieve in order to further one or more of the three needs of the Public Sector Equality Duty: to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. By focusing on outcomes rather than activities or outputs, meaningful and practical improvements Page 320 of 350
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are enabled in the lives of people and communities who experience discrimination, inequality or disadvantage. 3.2 Outcomes represent change that occurs as a result of action taken. Defining Equality Outcomes therefore provides a clear framework for measuring progress and understanding the impact of work undertaken to reduce inequality and improve experiences and outcomes. 3 Progress on Equality Outcomes 2022-2026 4.1 The Health and Social Care Partnership’s Equality Outcomes 2022-2026 were informed by the challenges presented by the COVID-19 pandemic and aligned to the 2020–23 Strategic Commissioning Plan. The outcomes focused on: Supporting people to maintain their health and wellbeing through the pandemic Making services more accessible to maximise independence and connectedness Promoting the active engagement of seldom-heard groups in the design and delivery of services Supporting the independent and third sector to flourish, ensuring greater choice and control for individuals Progressing the development of technology-enabled care 4.2 North Lanarkshire Health and Social Care Partnership has made significant progress towards achieving these outcomes over the past 4 years. Key actions and developments have helped improve access to services, reduce barriers and ensure that we respond more effectively to the needs of people and communities across North Lanarkshire. 4.2 Equality Outcome 1 - Mitigating the impact of Covid-19 on people with protected characteristics Health and Social Care North Lanarkshire took targeted action to address the disproportionate impact of the Covid-19 pandemic on people with protected characteristics and those experiencing socio-economic disadvantage. This included improving access to treatment, preventative support and vaccination, alongside outreach and engagement activity to reduce barriers to services and support health and wellbeing during pandemic recovery. The vaccination programme was delivered using an inclusive, targeted approach, supported by practical preventative health measures and strengthened engagement with seldom-heard groups to improve access to services. 4.3 Equality Outcome 2 - Improving accessibility and independence through first responses Significant progress has been made in improving access to timely and appropriate services, supporting people with protected characteristics to remain as independent as possible. Home Assessment Teams have been developed in each locality, providing rapid assessment and intervention in people’s own homes. This has supported earlier hospital discharge and prevented unnecessary admissions, particularly benefiting older people and those with complex needs. Access to mental health and wellbeing services has been improved through the implementation of the Choice and Partnership Approach (CAPA) for children and young people and the Page 321 of 350
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development of Mental Health in Primary Care teams for adults. These models provide faster access to the right level of support, reducing waiting times and improving outcomes. The creation of Community Connector roles within the third sector has strengthened preventative, community-based support. Community Connectors provide proactive assistance to individuals of all ages to access local services, social supports and mental health and wellbeing resources. 4.4 Equality Outcome 3 - Strengthening engagement and participation Health and Social Care North Lanarkshire has a firm commitment to ensuring ongoing meaningful involvement with the communities it serves. North Lanarkshire Council’s Engagement and Participation Strategy 2024-2027 sets out how we will achieve this and has strengthened our ability to engage meaningfully with a wider range of individuals, including those from seldom-heard and under-represented groups. Locality Profiles have been developed to build a detailed understanding of local populations, needs and inequalities. These profiles inform service planning and support targeted responses. A broader range of engagement methods has also been introduced, ensuring participation opportunities are accessible to people with different needs and preferences. Practical support has been provided to enable people with lived experience, carers and communities to participate meaningfully in engagement activity. Locality Planning Group structures have been developed to strengthen engagement at a local level, while the Strategic Planning Group has been expanded to increase representation from patients, service users and carers. 4.5 Equality Outcome 4 - Supporting a sustainable and inclusive independent sector Health and Social Care North Lanarkshire has taken a proactive approach to engagement and market facilitation to support a diverse, sustainable and person-centred independent sector. The partnership’s Market Facilitation Plan has been developed and refreshed to support sustainability. There is regular and ongoing dialogue, shared learning and collaborative working with provider organisations. Progress has also continued in the development of Self-Directed Support, enabling people – including those with disabilities, long-term conditions, mental health problems or frailty – to exercise choice and control over their care while supporting local employment opportunities. 4.6 Equality Outcome 5 - Expanding Technology Enabled Care to support independence and inclusion The continued development of Technology Enabled Care (TEC) has improved access to services and supported people to live independently and remain connected within their communities. The sustained rollout of Near Me has provided alternative ways for people to engage with health and social care services, particularly benefiting those with mobility issues, caring responsibilities or anxiety. The development of the ‘TEC Flat’ has enabled staff, service users and carers to explore practical technology solutions that support independent living. The further development of the Assistive Technology team has focused on the promotion of technology to enhance the lives of North Lanarkshire's most vulnerable residents. The team continues to strengthen connections and collaborative working across the partnership, reducing Page 322 of 350
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pressures on other services through the use of technology and encouraging a "tech first" mindset when assessing need and planning supports. The Making Life Easier website has continued to expand, improving access to information, self-management tools and simple equipment. A wide range of online mental health resources has also been rolled out, increasing access to support and reducing barriers to help. 5 Progress summary 5.1 Collectively, the actions described above demonstrate University Health and Social Care North Lanarkshire’s ongoing commitment to advancing equality, reducing barriers to access and addressing inequalities. Progress against these Equality Outcomes has demonstrated that, while the pandemic context in which they were set has changed, the themes underpinning the outcomes remain relevant. Key areas of progress include Increased use of digital, community-based and technology-enabled approaches to support independence and connectivity Strengthened partnership working with the independent and third sector, supporting service flexibility, resilience and choice Expanded engagement activity with seldom-heard and marginalised communities, helping to inform service redesign and commissioning Improved awareness of accessibility barriers and the ongoing need to address digital exclusion and inequality of access to services 6 Conclusion 6.1 The IJB’s Equality Outcomes 2022–2026 have provided strong and effective drivers for advancing and evidencing equality and improving access to health and social care services. Progress made during the reporting period demonstrates how equality considerations have been increasingly embedded into service planning, commissioning and delivery, supporting more inclusive and person-centred approaches. 6.2 Key principles established through these outcomes, including a focus on accessibility, meaningful engagement, digital inclusion and partnership working with provider organisations, continue to shape current practice and inform future work. This provides a solid foundation on which to build, supporting the IJB’s ongoing commitment to reducing inequalities and meeting the Public Sector Equality Duty. 6.3 Progress continues to be embedded within service planning, commissioning and delivery, ensuring that services respond effectively to the diverse needs of North Lanarkshire’s communities. Page 323 of 350
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The Public Sector Equality Duty Integration Joint Board Equality Mainstreaming Report 2023 - 2025 Page 324 of 350
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Contents Foreword 1. Introduction to Mainstreaming Report 2. Legislative Context 3. Operational Context 4. Mainstreaming Equality 5. Governance, Commissioning, and Performance Oversight 6. Driving forward our Equality Ambitions 7. Conclusion Page 325 of 350
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Foreword This Equality Mainstreaming report for sets out how University Health and Social Care North Lanarkshire is integrating the Public Sector Equality Duty (PSED) into its everyday functions, demonstrating how equality is built into normal decision-making, services, policies and employment practices. This report details our work from our previous mainstreaming report in 2023 to the end of 2025, reaffirming our ongoing commitment to meeting the duties of the Equality Act 2010 and to embedding equality, inclusion and human rights across all aspects of our governance, planning and service delivery. The population of North Lanarkshire has long experienced significant and persistent inequalities across many areas of life, including health, income, employment, education and life chances. These inequalities are deeply rooted and continue to influence how people access services, experience care and support and achieve outcomes across the health and social care system. While recent years have brought additional social and economic pressures, including those related to the Covid 19 pandemic, the challenges faced by many of our communities reflect long-standing structural disadvantage rather than experience of short-term detriments. Evidence continues to show that particular groups are more likely to experience poorer outcomes and barriers to access, including disabled people and those experiencing long term health conditions, older people, women, carers, people from Black and Minority Ethnic communities and those affected by socio-economic deprivation. Issues such as social isolation, digital exclusion, domestic abuse and poor mental health also remain significant and ongoing concerns. Poverty and continued cost of living pressures present further challenges for individuals, families and communities, as well as for the wide range of organisations delivering health and social care services. As with other forms of inequality, these pressures are not experienced equally and risk widening existing gaps if not addressed through targeted and inclusive approaches. We recognise that it is essential that service planning, commissioning and delivery remain focused on those most at risk of inequality, and that improvement and transformation activity is designed to actively reduce disadvantage. Learning from previous Equality Outcomes has also strengthened our focus on accessibility, cultural competence, meaningful participation, choice and control, and effective partnership working. Our vision remains to place individuals, families and communities at the centre of service planning and delivery, enabling locality-based, person-centred approaches that promote independence and wellbeing and foster dignity. University Health and Social Care North Lanarkshire is committed to ensuring that people receive fair, consistent and non-discriminatory services, regardless of protected characteristics, background or circumstances. Page 326 of 350
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1. Introduction 1.1 The North Lanarkshire Integration Joint Board (IJB) continues to demonstrate a strong and sustained commitment to the values and principles of the Equality Act 2010. Equality is actively mainstreamed within the IJB’s governance, strategic planning and commissioning responsibilities, supporting the delivery of fair, inclusive and person-centred health and social care services. 1.2 The IJB recognises the importance of ensuring that people across North Lanarkshire have equal opportunities and are treated with dignity and respect, regardless of age, disability, sex, sexual orientation, gender reassignment, race, religion or belief, pregnancy and maternity and marriage or civil partnership status. In addition, the IJB acknowledges that wider social, economic and structural factors can also create barriers to accessing services and achieving good outcomes. This includes, but is not limited to, people experiencing poverty, insecure housing or employment, digital exclusion, social isolation, poor mental health, or other forms of exclusion. These factors are intersectional and cumulative. 1.3 The Integration Joint Board recognises that many individuals, groups and communities across North Lanarkshire continue to experience systemic inequality in how they access and experience health and social care services. These inequalities are shaped by a complex interplay of social, economic, environmental and structural factors, and can result in multiple forms of inequality and poorer outcomes. 1.4 The IJB is committed to making a real and lasting contribution to creating a fairer North Lanarkshire by reducing inequalities in health, access and opportunity for the whole population. This commitment is reflected in our Equality Outcomes, which focus on addressing known areas of inequality, strengthening participation and engagement, and embedding equality considerations consistently within service planning, commissioning and delivery. 2. Legislative Context 2.1 The Public Sector Equality Duty (PSED) was established by section 149 of the Equality Act 2010. As a listed authority in Scotland, the IJB is required to comply with the three general needs or ‘General Duty’ of the PSED; 1. To eliminate unlawful discrimination, harassment and victimisation, 2. To advance equality of opportunity between people who share a protected characteristic and those who do not and 3. To foster good relations between those who share a protected characteristic and those who do not. 1.2 The IJB is also subject to the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 which are designed to help public authorities demonstrate how they are meeting the General Duty. These specific duties include Publishing Equality Outcomes Publishing Mainstreaming Equality Reports Assessing and reviewing the equality impact of policies and practices Page 327 of 350
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Reporting progress on delivering Equality Outcomes Considering equality in public procurement Publishing equality information in an accessible manner 2.3 The Equality Act 2010 also defines nine Protected Characteristics; specific personal characteristics for which individuals are legally protected from unlawful discrimination, harassment and victimisation when accessing services, employment, education and public functions. These are 1. Age 2. Disability 3. Gender reassignment 4. Marriage and civil partnership 5. Pregnancy and maternity 6. Race 7. Religion and belief 8. Sex 9. Sexual orientation 2.4 As a listed authority, the IJB is also subject to the Fairer Scotland Duty. This duty requires the IJB, when making strategic decisions, to actively consider how its decisions can reduce inequalities of outcome caused by socio-economic disadvantage. 2.5 In addition, the IJB’s new draft Equality Outcomes also support delivery of our statutory duties under the Carers (Scotland) Act 2016, the Public Bodies (Joint Working) (Scotland) Act 2014 and the Domestic Abuse (Scotland) Act 2018, ensuring equality considerations are embedded within strategic planning, commissioning and service delivery. 3. Operational Context 3.1 Since 2016, the IJB has been responsible for planning, commissioning and overseeing the delivery of integrated health and social care services across North Lanarkshire, including adult and child community health services, unplanned hospital care and adult social work and social care services. 3.2 IJBs must contribute to the delivery of nine national health and wellbeing outcomes for integration under the Public Bodies (Joint Working) (Scotland) Act 2014. These are; 1. People are able to look after and improve their own health and wellbeing and live in good health for longer. 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community. 3. People who use health and social care services have positive experiences of those services, and have their dignity respected. Page 328 of 350
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4. Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services. 5. Health and social care services contribute to reducing health inequalities. 6. 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 well-being. 7. People using health and social care services are safe from harm. 8. 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. 9. Resources are used effectively and efficiently in the provision of health and social care services. 3.3 The IJB also publishes a detailed Annual Performance Report on progress to achieve each Outcome, as well as on twenty-three pre-determined National Performance Indicators set by the Scottish Government. In addition, locally derived performance indicators have also been developed to ensure information is tailored to North Lanarkshire’s circumstances. 4. Mainstreaming Equality Benefits 4.1 The IJB recognises mainstreaming equality as a means of embedding equality, diversity and inclusion into the day-to-day work of the Health and Social Care Partnership. This requires equality considerations to be an integral part of planning, commissioning, decision-making and the delivery of health and social care services for the people of North Lanarkshire, rather than an additional or separate activity. 4.2 The IJB is committed to meaningful and ongoing engagement with stakeholders, including people with lived experience, carers, communities, partner organisations and the third and independent sectors. This collaborative approach is central to effective equality mainstreaming, supporting inclusive service design, improving service quality and delivering shared integration aims and improved outcomes. Our Approach Leadership and Corporate Commitment 4.1 The IJB is committed to mainstreaming equality as a shared organisational responsibility. Equality considerations are embedded within the IJB’s leadership, governance and strategic decision-making arrangements, ensuring compliance with statutory duties and supporting improved outcomes for people and communities across North Lanarkshire. The IJB has agreed arrangements for regular reporting and oversight of equality activity through its established governance structures, including performance and audit reporting mechanisms. 4.2 The IJB will continue to ensure that clear, consistent and visible leadership messages are communicated to senior officers across partner organisations, emphasising the importance of: Recognising and responding to the diverse equality needs of service users, carers and communities Page 329 of 350
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Promoting inclusive and equitable approaches to service planning, commissioning and delivery Supporting an inclusive working environment for employees across health and social care services This approach supports a culture where equality is not viewed as an isolated requirement, but as a fundamental element of good governance and quality service delivery. 4.3 IJB Board Members are committed to ongoing development and learning to strengthen their understanding of equality legislation and its practical application within integrated governance. This includes participation in equality-focused development activity to ensure Members are: Clear about their roles and responsibilities in relation to compliance with the Equality Act 2010 Able to identify and support priority equality actions to be progressed by senior officers Confident in the use and interpretation of Equality Impact Assessments (EqIAs) to inform, scrutinise and support effective decision-making This commitment supports informed challenge, effective governance and continuous improvement in how equality is mainstreamed across the Partnership. Workforce and Workforce Development 4.4 While staff delivering Health and Social Care services in North Lanarkshire continue to be employed by NHS Lanarkshire and North Lanarkshire Council, rather than directly by the IJB, the Partnership recognises the central role of its workforce in delivering equitable, high-quality and person-centred services. Valuing staff, promoting inclusion and supporting ongoing workforce development remain key priorities for Health and Social Care North Lanarkshire. 4.5 Through strategic planning and service improvement activity, significant engagement with staff has taken place to support the development of shared values for those working across health and social care in North Lanarkshire. This work has contributed to a positive organisational culture in which staff are respected, supported and encouraged to contribute to decision-making that affects service delivery and the experience of people who use services. 4.6 Equality, diversity and inclusion training is actively promoted and supported by both employing organisations - NHS Lanarkshire and North Lanarkshire Council. Health and Social Care North Lanarkshire continues to encourage staff participation in relevant learning and development activity. This includes training that supports: Increased equality awareness and inclusive practice Improved understanding of diverse needs and lived experience Positive workplace behaviours and respectful professional relationships In addition, wider learning opportunities that promote work-life balance, staff wellbeing and mental health are encouraged, supporting staff in both NHS Lanarkshire and North Lanarkshire Council to apply inclusive and compassionate approaches in both personal and professional interactions. Page 330 of 350
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4.7 The publication of Equal Pay and Gender Pay information remains the responsibility of NHS Lanarkshire and North Lanarkshire Council as the employing bodies. Health and Social Care North Lanarkshire will continue to support transparency and awareness of this information and will consider its implications for workforce planning, equality and fair employment practices within the integrated context. Impact Assessments 4.8 University Health and Social Care North Lanarkshire is committed to carrying out Equality Impact Assessments (EqIAs) on its strategies, policies, practices and services to ensure that they are designed, developed and delivered in a way that avoids unlawful discrimination, advances equality of opportunity and fosters good relations. EqIAs are a key tool for identifying potential impacts on people who share protected characteristics and for informing decisions that promote fair, inclusive and proportionate outcomes. In meeting this commitment, the Partnership ensures that: EqIAs are undertaken on all relevant strategies, policies and services in line with statutory requirements and local governance arrangements EqIAs are carried out on proposals for budget savings, with specific consideration of intersectional and cumulative impacts and mitigations to reduce potential inequality To support consistent and effective use of EqIAs, training and bespoke EqIA learning sessions are now in place for staff involved in policy development, service redesign and decision-making. This programme is designed to: Strengthen understanding of equality legislation and duties Improve the quality and robustness of impact assessments Support practical application of EqIAs in real service and commissioning contexts This approach supports a culture where equality considerations are embedded early in the decision making process rather than applied retrospectively. Completed Equality Impact Assessments are published in line with transparency and accessibility requirements and available through the IJB website, supporting openness and accountability in governance and decision-making. All Committee and Board paper templates now include a specific section on EqIAs, ensuring that equality considerations are explicitly addressed and visible within reports presented to Members. This strengthens assurance that equality impacts are routinely considered and informs effective scrutiny and challenge. Participation and Engagement 4.9 The Integration Joint Board (IJB) recognises effective participation and engagement as essential to advancing equality and reducing inequalities with meaningful engagement, including with people who share protected characteristics and those experiencing socio-economic disadvantage, as critical to understanding lived experience and improving service design and delivery. Page 331 of 350
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The Health and Social Care Partnership’s Engagement and Participation Strategy 2024- 2027 sets out how communities, people with lived experience, carers and partners are meaningfully involved in shaping services and decisions. The Strategy supports inclusive, accessible and proportionate engagement, recognising both geographical communities and communities of interest. Equality considerations are embedded across engagement activity to support the delivery of high-quality, person-centred, safe and effective services. This is underpinned by agreed engagement principles, including fairness, accessibility, shared responsibility across the workforce, and a commitment to learning and continuous improvement. Engagement and participation activity also supports delivery of the National Health and Wellbeing Outcomes and informs planning, commissioning and service improvement at both partnership and locality levels. A range of existing forums, networks and stakeholder groups are utilised, alongside more flexible and targeted approaches—such as thematic or time-limited engagement—to ensure wider inclusion and reduce reliance on traditional structures alone. In line with the Community Planning Partnership approach, a review of the Local Outcome Improvement Plans (LOIPs) will take place in 2026. Health and Social Care North Lanarkshire will play an active role in this process, ensuring engagement and participation activity reflects lived experience, supports identification of priorities and contributes to reducing inequality at partnership and locality levels. 5 Governance, Commissioning, and Performance Oversight 5.1 In accordance with the Public Bodies (Joint Working) (Scotland) Act 2014, the IJB is responsible for the development of Strategic Commissioning Plans. Strategic commissioning encompasses the full range of activities required to understand population need and inequality, forecast future demand, link resources to outcomes, explore service delivery options, and plan the nature and range of health and social care services. Strategic commissioning is a central mechanism through which the IJB seeks to improve outcomes, reduce inequalities and ensure that services are effective, sustainable and person-centred. 5.2 The IJB is currently undertaking work to develop a new Strategic Commissioning Plan, building on learning from the previous planning period and informed by local strategic needs analysis. The Plan will ultimately reflect local priorities, population needs and partnership ambitions. Equality considerations are embedded throughout this process, supported by engagement activity, needs assessment, evidence of inequality and an EqIA. 5.3 The new draft Equality Outcomes 2026-2030 have also been informed by emerging Strategic Commissioning Plan priorities, and contribute to the commissioning process, ensuring that the Plan ultimately explicitly addresses known inequalities and the needs of people sharing Protected Characteristics across North Lanarkshire. 5.4 The development of the new Strategic Commissioning Plan has provided a key opportunity to further mainstream equality by Strengthening the focus on prevention, early intervention and reducing inequality Page 332 of 350
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Embedding lived experience and engagement with seldom-heard groups in commissioning decisions Ensuring inclusive, accessible and culturally competent service models Aligning commissioning priorities with the Council’s Equality Strategy 2025–2029 and the National Health and Wellbeing Outcomes 5.5 The procurement of health and social care services will continue to be undertaken by NHS Lanarkshire and North Lanarkshire Council as the employing and contracting bodies. Relevant staff involved in commissioning and procurement processes are required to comply with Equality and Diversity legislation, ensuring equality considerations are integrated into service specifications, procurement processes and contract management. Monitoring, Reporting and Publishing 5.6 Effective equality monitoring and reporting are supported by the Strategic Needs Analysis, which brings together data on population trends, service use and outcomes. This approach enables the IJB to identify trends, unmet need and barriers affecting people with protected characteristics and those experiencing socio-economic disadvantage, and to use this evidence to inform the Strategic Commissioning Plan and support targeted action to reduce inequalities. 5.7 A combination of national and local data sources are used to support robust analysis and reporting. National datasets provide consistency and comparability, while local service-level data offers insight into the characteristics, access patterns and experiences of people using health and social care services in North Lanarkshire. Together, these sources support a comprehensive understanding of equality impacts and outcomes. 5.8 Monitoring progress against the Equality Outcomes is a formal responsibility of the Performance, Finance and Audit Sub-Committee, providing assurance to the IJB on delivery, impact and compliance. Progress updates are provided through established reporting arrangements and inform continuous improvement activity. 5.9 Progress against Equality Outcomes and mainstreaming activity will be included within the IJB’s Annual Report, meeting statutory reporting requirements and supporting transparency and public accountability. Equality information and reports are published in an accessible format, in line with legislative requirements, to enable stakeholders, partners and communities to review and understand progress. 6 Driving Forward Our Equality Ambitions 6.1 Our work in mainstreaming equalities continues to be supported by NHS Lanarkshire’s strategic aims, as previously outlined in the NHSNL Equality Strategy 2017–2021, and the recent introduction of North Lanarkshire Council’s Equality Strategy 2025–2029 provides a renewed strategic framework for advancing equality across services. University Health and Social Care North Lanarkshire’s service-level action planning will be aligned with the priorities set out in the Strategy. 6.2 North Lanarkshire Council is continuing to strengthen its approach to EqIAs. A revised EqIA process, supported by refreshed training and clearer oversight arrangements, will help ensure Page 333 of 350
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equality considerations are consistently embedded across all key decisions. An Equalities Lead (Senior Manager, Strategy and Performance) leads this work. 6.3 NHS Lanarkshire continues to embed equality across the organisation through enhanced use of EqIAs. The EqIA tool incorporates socio-economic impacts, in line with the Fairer Scotland Duty, and gives consideration to the United Nations Convention on the Rights of the Child (UNCRC). The NHS Lanarkshire Equality and Diversity Steering Group will continue to provide bi-annual progress reports on delivery of Equality Strategy actions. 6.4 NHS Lanarkshire have published Equality Outcomes for the period 2025-2029 focusing on eliminating sexual harassment across all NHS Lanarkshire and HSCP workplaces, reinforcing its Anti-Racism Plan to eradicate racism in both service delivery and employment practices, and reducing inequalities in health by increasing awareness and uptake of key national screening programmes; Breast, Bowel, and Cervical. Together, these outcomes highlight a commitment to tackling discrimination, improving staff wellbeing, and ensuring equitable access to essential healthcare services. 6.5 The IJB has developed a draft set of Equality Outcomes for the period 2026-2030. These outcomes aim to ensure that people, including older adults and disabled people, feel genuine choice and control over how their social care is arranged. They reflect our commitment to a reduction in suicide rates, with particular focus on boys and men and our aim of ensuring that Health and social care services are culturally sensitive and responsive to the needs of Black, ethnic minority, and faith-based communities. The outcomes also focus on ensuring a gender-sensitive approach to domestic abuse is embedded within mental health and addiction services, ensuring women abused by men receive appropriate, safe, and recovery-focused support. Additionally, the outcomes focus on carers, across a range of Protected Characteristics; that they experience fair and equal access to support, are recognised as equal partners in care, and are protected from discrimination related to their caring role. 6.6 NHS Lanarkshire continues to mainstream equality within day-to-day operations. The NHS Lanarkshire Equality Action Plan sets out a range of actions to embed equality within service planning, workforce policies and organisational decision-making. Oversight of delivery is provided through the NHS Lanarkshire Equality and Diversity Steering Group, which reports progress to: NHS Lanarkshire Board Corporate Management Team Staff Governance Committee Population Health, Primary and Community Services Governance Committee 6.7 North Lanarkshire Council’s Equalities Board, with representation from all Council services, including Adult Health and Social Care, provides strategic leadership and oversight of equality and inclusion and will play a key role in supporting Health and Social Care North Lanarkshire’s role in the delivery of the Council’s new Equality Strategy 2025–2029. Page 334 of 350
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6.8 The role of the North Lanarkshire Council Equality Board includes: Enabling collective ownership of the delivery of the Council’s Equality Strategy and associated outcomes Ensuring effective implementation of the Equalities Delivery Framework Promoting a consistent, cross-service approach to advancing equality in line with the Plan for North Lanarkshire Advising on compliance with General and Specific Equality Duties and implications for policy and service delivery Supporting the development and monitoring of Service Equality Action Plans Strengthening equality performance monitoring and reporting Championing engagement activity, equality campaigns and key equality-related events 7 Conclusion 7.1 This 2025 Equality Mainstreaming Report reaffirms the Integration Joint Boards’ commitment to embedding fairness, dignity, and human rights at the centre of health and social care delivery across North Lanarkshire. By advancing clear equality outcomes, strengthening culturally competent and gender-sensitive practice, and prioritising the voices and needs of marginalised groups, the IJB continues to build services that are responsive, inclusive, and accountable. 7.2 This report demonstrates meaningful progress to date while recognising that sustained improvement relies on ongoing collaboration with communities, partners, and staff. The IJB remains dedicated to reducing inequalities, supporting wellbeing, and ensuring that everyone in North Lanarkshire can access high-quality, person-centred care that enables them to live healthier, safer, and more empowered lives. Page 335 of 350
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1 REPORT Item No: 21 SUBJECT: Integration Joint Boards – Extension of Voting Rights TO: North Lanarkshire Integration Joint Board Lead Officer for Report: Claire Rae, Chief Officer Author(s) of Report Claire Rae, Chief Officer DATE: 18 March 2026 1. PURPOSE OF REPORT The purpose of the report is to provide members with an update on the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 (SSI 2025/405), which has been made by the Scottish Ministers, laid before the Scottish Parliament under the negative procedure, and is scheduled to come into force on 1 September 2026 This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐ Item 21 Page 337 of 350
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2 Claire Rae, Chief Officer 3. EXECUTIVE SUMMARY 4. RECOMMENDATIONS 4.1 It is recommended that the IJB: (1) note the update provided on the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 (SSI 2025/405); and (2) note that officers will provide further engagement and reporting to the Integration Joint Board (IJB) as appropriate to support implementation 5. VARIATIONS TO DIRECTIONS? This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required 6. BACKGROUND The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 (SSI 2025/405, the 2025 Order) was made by the Scottish Ministers on 17 December 2025 under powers contained in sections 12(1) and 69(1) of the Public Bodies (Joint Working) (Scotland) Act 2014, and was laid before the Scottish Parliament on 19 December 2025 under the negative procedure. The purpose of the 2025 Order is to extend voting rights on IJBs to include members appointed to represent the third sector, service users and unpaid carers (referred to in accompanying documentation as “lived experience” representatives). The instrument also makes related amendments concerning the resignation of members and proxy arrangements. 6.1 Update The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 amends The Public Bodies (Joint Working) Yes ☐ No ☐ N/A ☒ Page 338 of 350
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3 (Integration Joint Boards) (Scotland) Order 2014 to make targeted changes to the composition and voting arrangements of Integration Joint Boards. In summary, the instrument:- Extends voting rights on IJBs to include members appointed to represent the third sector, service users and unpaid carers, in addition to existing voting members appointed by the NHS Board and the local authority. Provides for proxy arrangements for all voting and non-voting members, setting out who may act as a proxy and confirming that proxies attending under the relevant provisions for voting members may also vote. Clarifies requirements in relation to the resignation of members, ensuring consistency with the revised voting and membership arrangements. The instrument is procedural in nature, focusing on governance and decision‑making arrangements within IJBs. It does not alter the statutory accountability of the NHS Board or the local authority, nor the overall integration framework established under the Public Bodies (Joint Working) (Scotland) Act 2014. . The statutory instrument was accompanied by a Policy Note, which was published at the point the instrument was laid before the Scottish Parliament on 19 December 2025. Policy Notes are published alongside Scottish Statutory Instruments to provide a non‑binding explanation of the purpose of the instrument, the policy objectives being pursued, the consultation and engagement undertaken, and any anticipated impacts, in order to assist parliamentary scrutiny and wider understanding. The instrument has completed the parliamentary process applicable to negative instruments. In line with parliamentary procedure, the instrument was subject to scrutiny by the Delegated Powers and Law Reform Committee on technical grounds and by the Health, Social Care and Sport Committee, as the lead committee, on policy grounds during the 40‑day period following laying. The instrument will take effect from 1 September 2026. The Policy Note states that, to support implementation, the Scottish Government intends to review and update the statutory guidance Integration Joint Board: roles, responsibilities and membership to reflect the change to voting membership. Officers will continue to monitor national developments and provide further engagement or reporting to the IJB as appropriate to support effective implementation and support for local members. In particular, it might be the case that the Integration Scheme and the IJB’s Standing Orders will both need updated to reflect the changes resulting from the 2025 Order. In respect of the Integration Scheme there are national discussions underway, and officers will update further on this once the position is clearer, noting that the 2025 Order takes effect in September 2026. 6.2 Employment Implications Page 339 of 350
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4 The Standards Commission for Scotland’s Advice Note for Members of Health and Social Care Integration Joint Boards describes the role of the Standards Officer as ensuring that appropriate training is provided to IJB members on the ethical standards framework, the IJB’s Code of Conduct and associated guidance. The Advice Note also highlights the importance of supporting members to understand and manage conflicts of interest and to understand differing organisational cultures across councils and NHS boards. Any additional training or induction requirements arising from the changes to IJB voting membership will be considered in line with updated national guidance and existing local governance arrangements. 6.3 Financial Implications The Policy Note states that no Business and Regulatory Impact Assessment has been prepared, on the basis that the instrument has no financial effects on the Scottish Government, local government or on business. The Policy Note further states that the extension of voting rights does not change the statutory accountability of the local authority or health board, nor change existing financial effects associated with the operation of IJBs. 6.4 Climate Change, Sustainability and Environmental Implications There are no implications for climate change, sustainability or the environment in terms of the information contained in this report. 6.5 Other Implications The Policy Note states that, to support implementation, the Scottish Government intends to review and update the statutory guidance on IJB: roles, responsibilities and membership to reflect the change to voting membership. The Policy Note accompanying the instrument records that issues raised during engagement included:- appointment and recruitment processes training, development and ongoing support requirements accessibility and practical support arrangements potential conflicts of interest the resource implications associated with supporting those members who will have voting rights when they did not previously Page 340 of 350
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5 The Scottish Government have convened a working group to consider implementation and the statutory guidance on IJB Roles, Responsibilities and Membership. 6.6 Integrated Impact Assessment and Consultation Requirements The statutory instrument was accompanied by Equality Impact Assessment and Children’s Rights and Wellbeing Impact Assessment documentation at national level. The Policy Note accompanying the instrument records the consultation process undertaken by the Scottish Government in preparation of the instrument. This consultation took place between 24 November and 5 December 2025, building on exploration of the issue of voting rights over the previous 4 years, as detailed in the Policy Note. 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL Page 341 of 350
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6 This paper has been reviewed by Finance: Yes No N/A 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner N/A Choose an item. 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of Page 342 of 350
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7 other engagement activity and local plans across the Community Planning Partnership 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes No N/A EQIA added to website: Yes No N/A 10. BACKGROUND PAPERS Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 (SSI 2025/405) https://www.legislation.gov.uk/ssi/2025/405/made Policy Note: The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Amendment Order 2025 (SSI 2025/405) https://www.legislation.gov.uk/ssi/2025/405/pdfs/ssipn_20250405_en_001.pdf Integration Joint Board: Roles, Responsibilities and Membership: Statutory Guidance https://www.gov.scot/publications/roles-responsibilities-membership- integration-joint-board/pages/0/ Standards Commission for Scotland’s Advice Note for members of Health and Social Care Integration Joint Boards https://www.standardscommissionscotland.org.uk/uploads/files/17431763352 50328AdviceNoteforMembersofHealthandSocialCareIntegrationJointBoards2 025v2.pdf 11. APPENDICES Page 343 of 350
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8 Please include a glossary of terms if not already included. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Kerry Taylor kerry.taylor@lanarkshire.scot.nhs.uk Page 344 of 350
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9 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction Page 345 of 350
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10 10 Performance Management / Governance arrangements 11 Date direction will be reviewed Page 346 of 350
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Wednesday 18 March 2026 Chief Oicer Report Chief Oicer 18 March 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 18 March 2026 Standing Item IJB Budget – Medium Term Financial Plan Chief Finance Oicer 18 March 2026 Annual Strategic Commissioning Plan 2026 Head of Planning, Performance & Quality Assurance 18 March 2026 Chief Social Work Oicer Report Chief Social Work Oicer 21 January 2026 Annual Home Support Head of Adult Social Work 18 March 2026 Biannual As approved in the Programme of Work at IJB in Sept 23 IJB Risk Register Business Support Manager 18 March 2026 Trauma Informed Practice Head of Planning, Performance & Quality Assurance 18 March 2026 Annual Moved from December 2025 As approved in the Programme of Work at IJB in Sept 23 Wednesday 17 June 2026 Chief Oicer Report Chief Oicer 17 June 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 17 June 2026 Standing Item Unaudited Annual Accounts Report Chief Finance Oicer 17 June 2026 Annual IJB Annual Performance Report Head of Planning, Performance & Quality Assurance 17 June 2026 Annual APR must be published online by 31 July each year Item 22 Page 347 of 350
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Primary Care Improvement Plan (PCIP) Update Chief Oicer / Medical Director 17 June 2026 Annual Public Health Annual Report Director of Public Health 17 June 2026 Annual IJB Self-Assessment Questionnaire (Issue) Business Support Manager 17 June 2026 Annual IJB SAQ approved at IJB in June 2025 to be issued annually Coming Home Report – Dynamic Support Register Head of Adult Social Work 17 June 2026 Biannual Freedom of Information Requests Business Support Manager 17 June 2026 Quarterly To be included in the Chief Oicer Report. Quarterly reporting submitted to Scottish Information Commissioner. Wednesday 16 September 2026 Chief Oicer Report Chief Oicer 16 September 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 16 September 2026 Standing Item Audited Annual Report & Financial Statement 2024/25 Chief Finance Oicer 16 September 2026 Annual Audited Annual Accounts must be presented to Board and published online by 30 September each year Audit Scotland - Final Audit Report 2025/26 Chief Finance Oicer 16 September 2026 Annual IJB Self-Assessment Questionnaire (Results) Business Support Manager 16 September 2026 Annual IJB SAQ approved at IJB in June 2025 to be issued annually Page 348 of 350
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Probable Suicide 2024 Report TBC 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS) Alcohol Specific Deaths 2024 Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS) Drug Related Deaths 2024 Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS) Supporting Resilience Head of Planning, Performance & Quality Assurance 26 September 2026 Annual Quality Assurance Annual Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual Wednesday 16 December 2026 Chief Oicer Report Chief Oicer 16 December 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 16 December 2026 Standing Item 16 December 2026 Coming Home Report – Dynamic Support Register Head of Adult Social Work 16 December 2026 Biannual Page 349 of 350
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Freedom of Information Requests Business Support Manager 16 December 2026 Quarterly To be included in the Chief Oicer Report. Quarterly reporting submitted to Scottish Information Commissioner. Future Reports Pharmacy Savings Approach Pharmacy Lead TBC As requested at Board meeting – incorporated to work plan Review of IJB Performance, Finance and Audit Committee Business Support Manager TBC Page 350 of 350