ITEM 13 Annual Performance Report 2023 2024
North Lanarkshire Council · 25 September 2024
Back to Health and Social Care Integration Joint Board — 25 September 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
1 REPORT Item No: 13 SUBJECT: Annual Performance Report 2023/24 – University Health & Social Care North Lanarkshire TO: Integration Joint Board Committee Lead Officer for Report: Morag Dendy, Chief Officer Planning, Performance and Quality Assurance Author(s) of Report Stephen Forrest – Performance Manager, Graeme Cowan – Senior Manager, Strategy & Performance Contact details for Author(s) of Report Stephen Forrest – Performance Manager Stephen.Forrest@lanarkshire.scot.nhs.uk Graeme Cowan – Senior Manager, Strategy & Performance cowang@northlan.gov.uk DATE: 25th September 2024 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: ☐ Prepared by: Performance Manager Reviewed by: Senior Manager, Strategy & Performance
Page 2
2 3. EXECUTIVE SUMMARY Per the legislative requirements, North Lanarkshire IJB has published a draft Annual Performance Report, presenting the performance in relation the National Integration Indicators and other performance and inspection information. The draft report is submitted to the IJB for approval. 4. RECOMMENDATIONS It is recommended that the IJB Committee: (1) Review the content of the draft Annual Performance Report 2023/24 - University Health & Social Care North Lanarkshire, which is appended to this report. (2) Approve for publication the content of the draft Annual Performance Report 2023/24 - University Health & Social Care North Lanarkshire. 5. VARIATIONS TO DIRECTIONS? 6. BACKGROUND/SUMMARY OF KEY ISSUES North Lanarkshire IJB is required by the Public Bodies (Joint Working) Regulations 2014 to publish an Annual Performance Report by July 31st each year. The content of the Annual Performance Report is focused on the National Integration Indicators (the Core Suite and Ministerial Steering Group indicators). The purpose of standardising Annual Performance Reports for Integration Authorities in this way is to support Integration Authorities in improving the consistency of reporting for these indicator sets. 7. SUMMARY OF KEY ISSUES The Annual Performance Report 2023/24 - University Health & Social Care North Lanarkshire presents the performance in relation to these metrics, alongside performance information relating to inspections carried out by the Care Inspectorate and additional local performance information in the form of the Chief Executive’s scorecard. Progress against the National Health & Wellbeing Outcomes is also described in the report. A section has been dedicated to presenting and describing financial performance for 2023/24. Yes ☐ No ☐ N/A ☒
Page 3
3 In order to comply with the requirements to publish the APR by 31st July 2024, a draft version has been available on the IJB website since that date, pending approval by the IJB. This was required due to the timescales imposed on the partnership to produce and publish an Annual Performance Report by 31st July using Public Health Scotland data that is not published on their website until 04th July 2024, as previous publications of the data set are provided to the Integration Authorities for management use only. The document appended is a draft, with a desktop published version being produced by colleagues in North Lanarkshire Council Graphic Design. Some sample pages of the desktop published version are also appended for the Board’s information. Members should note the most up-to-date available has been used in the report, however for many indicators this relates to previous years; for indicators NI12 – NI16, the performance for calendar year 2023 is presented per the instructions of Public Health Scotland as the 2023/24 data for these indicators has not been validated for publication. 8. CONCLUSIONS The Annual Performance Report 2023/24 - University Health & Social Care North Lanarkshire describes progress made in pursuit of the National Health & Wellbeing Outcomes. This progress has been made against a challenging position for Health and Social Care nationally, which is reflected in the performance in some of the metrics presented in the report. Performance in North Lanarkshire is broadly comparable with similar authorities and the Scottish average in many areas and in those areas where performance improvements are required, this is managed through the performance framework in place within the Health and Social Care Partnership. 9. IMPLICATIONS 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 ☒ 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 ☒
Page 4
4 Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 9.2 ASSOCIATED MEASURE(S) The content of the Annual Performance Report is focused on the National Integration Indicators (the Core Suite and Ministerial Steering Group indicators). A framework is in place within the North HSCP to ensure the continual monitoring of performance data and information, and any improvement actions associated with the performance monitoring. 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 Level 2 Risk Register NL H&SCP - Meeting performance targets High Ross McGuffie 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 ☐ 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 The APR provides information on community stakeholders and how they are involved in our services. Yes ☒ No ☐ N/A ☒
Page 5
5 ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery The APR provides information on engagement with community stakeholders. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings The APR provides performance information that will enable stakeholder representatives to participate in wider discussion about performance. ☐ 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 The performance information included in the APR supports locality planning. 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 10. BACKGROUND PAPERS The results of the Health and Care Experience Survey are available in full, with results for each General Practice, General Practice Cluster, Health and Social Care Partnership and NHS Board, as well as time series trends where applicable, via an online dashboard hosted by Public Health Scotland. Health and Care Experience Survey 2023/24: National Results Health and Care Experience Survey 2023/24 Technical Report Health and Care Experience Survey 2023 to 2024: Results by geography Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
Page 6
6 Public Health Scotland provide detailed reporting on the annual rates for the Core Suite of Integration Indicators for each Integration Authority area and Scotland Annual information used to review progress towards achieving each of the national health and wellbeing outcomes. This is available at the following website: https://publichealthscotland.scot/publications/core-suite-of-integration- indicators/core-suite-of-integration-indicators-4-july-2023/ 11. APPENDICES Appendix One Annual Performance Report 2023/24 - Health & Social Care North Lanarkshire Appendix Two – Sample desktop published pages Appendix Three – PowerPoint presentation CHIEF ACCOUNTABLE OFFICER (or Depute) Chief Officer Planning, Performance and Quality Assurance Members seeking further information about any aspect of this report, please contact the following; Stephen Forrest – Performance Manager Stephen.Forrest@lanarkshire.scot.nhs.uk Graeme Cowan – Senior Manager, Strategy & Performance cowang@northlan.gov.uk
Page 7
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 8
8 Appendix 1 Annual Performance Report 2023/24 University Health & Social Care North Lanarkshire
Page 9
9 1. Foreword As Chief Officer of the North Lanarkshire Health and Social Care Partnership, it gives me great pleasure to present the Annual Performance Report for the financial year 2023/24. This report encapsulates our collective efforts and achievements in delivering high-quality health and social care services to the residents of North Lanarkshire. Over the past year, our partnership has continued to make significant strides in enhancing the well-being and quality of life for individuals across our community. Through the collaborative efforts of the North Lanarkshire Integrated Joint Board, NHS Lanarkshire, North Lanarkshire Council, and the North Lanarkshire Health and Social Care Partnership, we have witnessed several commendable accomplishments that highlight our commitment to excellence in care delivery. One of the key successes of the past year has been our unwavering dedication to person- centred care. By placing individuals at the heart of everything we do, we have been able to tailor our services to meet their unique needs and preferences, fostering a culture of empowerment and dignity. Whether it's supporting older adults to live independently, providing essential care and support to individuals with disabilities, or offering mental health services that promote recovery and resilience, our approach has always been rooted in compassion and respect. Furthermore, our focus on innovation and service improvement has led to the implementation of several initiatives aimed at enhancing the efficiency and effectiveness of our delivery model. From the adoption of digital technologies to streamline processes and improve access to care, to the development of integrated care pathways that facilitate seamless transitions between services, we have continually sought out innovative solutions to meet the evolving needs of our population. I am also delighted to highlight the collaborative partnerships forged with community organisations, voluntary groups, and other stakeholders, which have played a vital role in extending the reach of our services and promoting holistic health and well-being. By working together, we have been able to leverage the strengths and resources of our collective network to deliver impactful outcomes and drive positive change in our communities. As we reflect on the achievements of the past year, it is essential to acknowledge the dedication and hard work of our staff, volunteers, and partners who have contributed tirelessly to the success of our endeavours. Their unwavering commitment to excellence and their passion for making a difference have been instrumental in shaping the positive outcomes we celebrate today.
Page 10
10 Looking ahead, we remain steadfast in our commitment to building on our successes and addressing the challenges that lie ahead. By continuing to foster collaboration, innovation, and a relentless focus on improving outcomes for those we serve, I am confident that we will continue to make meaningful progress towards our shared vision of a healthier, more inclusive North Lanarkshire. In closing, I extend my sincere gratitude to all who have contributed to the achievements documented in this report. Your dedication, creativity, and tireless efforts are truly inspiring. Ross McGuffie - Chief Officer, University Health & Social Care North Lanarkshire
Page 11
11 2. Contents Contents 1. Foreword ....................................................................................................... 9 2. Contents ...................................................................................................... 11 3. National Health and Wellbeing Outcomes ................................................... 13 4. Introduction ................................................................................................. 13 5. National Health and Wellbeing Outcomes Framework ................................ 15 6. Measuring Performance Under Integration (MPUI) ..................................... 22 7. Managing Performance Under Integration .................................................. 28 HSCP University status ........................................................................................ 28 CAMHS Udston development and service recovery ............................................. 29 New Chryston Health Centre ................................................................................ 31 Breastfeeding ....................................................................................................... 32 Family support workers ......................................................................................... 32 Cancer Support .................................................................................................... 33 New winter health hub to help direct patients to most appropriate care ................ 34 Spring Health Hub Launch .................................................................................... 35 Healthy Schools .................................................................................................... 36 Reablement, Rehabilitation and Home Assessment Teams ................................. 37 Coming Home Summary ...................................................................................... 37 HMP Shotts improvements ................................................................................... 39 MAT standards progress ...................................................................................... 40 Launch of North Lanarkshire Alcohol & Drug Partnership website ....................... 40 Children and Young People Mental Health Directory of Services and Resources launched ............................................................................................................... 41 New team members devoted to supporting North Lanarkshire’s District Nurse and Mental Health teams ............................................................................................. 42 Carer Engagement, Involvement and Participation .............................................. 43 Carer Support Network ......................................................................................... 43 LENS Workshops - Turning Ideas into Action Programme ................................... 43 Community Solutions ............................................................................................ 44 Support in the Right Direction ............................................................................... 45 Improving Lives Initiative ...................................................................................... 45
Page 12
12 Community Connectors ........................................................................................ 46 Crisis Care – Distress Brief Intervention (DBI) ...................................................... 46 Engagement & Participation North Lanarkshire .................................................... 47 Engagement and Participation Strategy 2024-2027 ............................................. 48 Strategic Engagement and Participation Working Group ...................................... 48 Embedding Participation ....................................................................................... 49 Care Opinion ........................................................................................................ 49 Podiatry case study .............................................................................................. 50 Summary of Financial Performance ...................................................................... 50 8. Care Inspectorate Grades 2023/24 ............................................................. 53 NLC Care Homes .............................................................................................. 53 Other services ................................................................................................... 54 9. Strategic Planning ....................................................................................... 55 Strategic Commissioning Launch 2023 - 2026 Event ........................................ 55 10. Looking Forward – Our Next Steps ............................................................. 57 11. Appendices ................................................................................................. 58
Page 13
13 3. National Health and Wellbeing Outcomes National Health and Wellbeing Outcome 1 People are able to look after their own health and wellbeing and live in good health for longer National Health and Wellbeing Outcome 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 National Health and Wellbeing Outcome 3 People use health and social care services have positive experiences of those services and have their dignity respected National Health and Wellbeing Outcome 4 Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services National Health and Wellbeing Outcome 5 Health and Social Care Services contribute to reducing health inequalities National Health and Wellbeing Outcome 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 wellbeing National Health and Wellbeing Outcome 7 People using health and social care services are safe from harm National Health and Wellbeing Outcome 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 National Health and Wellbeing Outcome 9 Resources are used effectively and efficiently in the provision of health and social care services 4. Introduction Welcome to the Annual Performance Report of the North Lanarkshire Health and Care Partnership (HSCP) for the period from April 2023 to March 2024. This report presents a range of both qualitative and quantitative information, demonstrating our performance in relation to the National Health & Wellbeing Outcomes, National Core Integration Indicators, Ministerial Strategic Group indicators, and local performance measures. The Integration Joint Board receives regular progress reports on performance,
Page 14
14 and you can find these reports, along with our previous Annual Performance Reports on our website: https://www.hscnorthlan.scot/ . The Annual Performance Report provides an opportunity to reflect on the past year and celebrate the accomplishments of North Lanarkshire Health and Social Care services, employees, and partners. It acknowledges the ongoing collaborative work undertaken with service users, carers, families, and communities to improve on performance. Moreover, it recognises and acknowledges the existing and future challenges that the partnership faces, many of which are influenced by the long-lasting effects of the COVID-19 pandemic. The report presents data and information on performance and describes significant developments in 2023/24. The initial section of the report focuses on statutory reporting of performance information showing a comparison with the Scottish position and a trend analysis is provided to understand the local context for these performance indicators. Regrettably, due to circumstances beyond the partnership's control, we are unable to present a complete picture for some of the indicators and where this is the case, the reasons for this limitation are explained within the corresponding section of the report. The remaining part of the report provides more information for each of the National Outcomes, highlighting the various advancements and achievements throughout the year 2023/24
Page 15
15 5. National Health and Wellbeing Outcomes Framework Since 2016/17, Integration Authorities have been required by legislation to report on the Core Suite of Integration Indicators within their Annual Performance Reports. These indicators were developed to help Integration Authorities review their progress towards achieving each of the National Health and Wellbeing Outcomes, which focus on improving how services are provided and the difference that integrated health and social care services should make for people. The indicators were developed in consultation with a wide range of stakeholders and are intended for consideration within the wider context of health and social care. They help us, as a partnership, identify areas for improvement and assist us with planning for the future. Indicator values are derived from national data sources for each of the 23 indicators to enable comparability between local areas and with Scotland. There are 23 indicators in total, comprising nine indicators based on the Health and Care Experience Survey and ten other measures mainly using health activity, community and deaths information. The remaining four indicators cannot be reported on as national data is not available or there is not yet a nationally agreed definition. The nine indicators based on the Health and Care Experience Survey, which has been run every two years since 2009 detail people's experiences of accessing and using various services. The Health and Care Experience Survey (successor to the GP and Local NHS Services Patient Experience Survey) asks about people’s experiences of accessing and using their GP practice and Out of Hours services, aspects of care and support provided by local authorities and other organisations and caring responsibilities and related support: https://www.gov.scot/publications/national-health-wellbeing-outcomes-framework Scottish Health and Care Experience Survey Scottish Health and Care Experience Survey Indicator Title NL 2015/16 NL 2017/18 NL 2019/20 NL 2021/22 NL 2023/24 Scotland 2023/24 HSCNL Trend from Previous Survey Scotland Trend from Previous Survey NI -1 Percentage of adults able to look after their health very well or quite well 91.70% 90.30% 90.50% 87.50% 87.41% 90.66%
Page 16
16 NI - 2 Percentage of adults supported at home who agreed that they are supported to live as independently as possible 77.60% 79.80% 67.74% 72.39% NI - 3 Percentage of adults supported at home who agreed that they had a say in how their help, care, or support was provided 71.20% 67.10% 57.11% 59.62% NI - 4 Percentage of adults supported at home who agreed that their health and social care services seemed to be well co- ordinated 70.20% 66.60% 56.04% 61.36% NI - 5 Percentage of adults receiving any care or support who rate it as excellent or good 77.80% 74.00% 65.76% 70.02% NI - 6 Percentage of people with positive experience of care at their GP practice 79.30% 75.50% 68.30% 51.80% 52.80% 68.52% NI - 7 Percentage of adults supported at home who agree that their services and support had an impact on improving or maintaining their quality of life 75.70% 77.00% 67.70% 69.75% NI - 8 Percentage of carers who feel supported to continue in their caring role 41.20% 33.20% 32.60% 25.10% 28.46% 31.19% NI - 9 Percentage of adults supported at home who agreed they felt safe 80.00% 79.80% 68.44% 72.67% N.B. Results for indicators 2, 3, 4, 5, 7 and 9 from 2019/20 on are not directly comparable to results in previous years due to changes in survey wording and methodology. Performance is better than previous reporting period Performance is worse than previous reporting period
Page 17
17 National Outcome Indicators – Benchmarking – 2023/24 Scotland North Lanarkshire East Ayrshire Eilean Siar Dundee City North Ayrshire Inverclyde West Dunbartonshire Glasgow City Percentage of adults able to look after their health very well or quite well 90.66% 87.41% 89.06% 91.70% 88.27% 89.09% 88.94% 88.44% 87.60% Percentage of adults supported at home who agree that they are supported to live as independently as possible 72.39% 67.74% 81.17% 78.86% 77.05% 67.46% 75.90% 62.67% 72.28% Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided 59.62% 57.11% 69.51% 68.99% 65.13% 50.64% 67.78% 59.11% 61.46% Percentage of adults supported at home who agree that their health and social care services seemed to be well co-ordinated 61.36% 56.04% 70.42% 63.16% 63.87% 55.47% 68.65% 54.33% 65.18% Percentage of adults receiving any care or support who rate it as excellent or good 70.02% 65.76% 78.59% 76.08% 68.01% 68.39% 70.72% 66.87% 71.24% Percentage of people with positive experience of care at their GP practice 68.52% 52.80% 55.72% 85.51% 71.19% 60.03% 64.97% 63.83% 73.74% Percentage of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life 69.75% 67.70% 74.02% 67.00% 71.25% 67.62% 73.64% 63.97% 69.73%
Page 18
18 Percentage of carers who feel supported to continue in their caring role 31.19% 28.46% 36.02% 32.57% 34.34% 31.57% 31.88% 26.67% 34.48% Percentage of adults supported at home who agree they felt safe 72.67% 68.44% 75.77% 75.76% 76.52% 67.48% 72.67% 66.67% 72.61% The table above provides a comparison for 2023/24 with North Lanarkshire’s ‘Family Group’ of Integration Authorities for those National Outcome Indicators that are sourced from the Health and Care Experience Survey. The results highlight some areas where improvement might be made, including supporting people to live as independently as possible, health and social care services being well co-ordinated, improving or maintaining quality of life, people having a positive experience of care at their GP practice and carers feeling supported to continue in their caring role. Use of 2023 calendar year data instead of 2023/24 financial year data for indicators 12, 13, 14, 15 and 16 The primary source of data for these indicators are Scottish Morbidity Records (SMRs) which are nationally collected discharge-based hospital records. Following recommendations made by Public Health Scotland (PHS) and communicated to all Health and Social Care Partnerships, the most recent reporting period available is calendar year 2023; this ensures that these indicators are based on the most complete and robust data currently available. Indicator 20 The data for Indicator NI – 20, Percentage of health and care resource spent on hospital stays where the patient was admitted in an emergency is no longer available from Public Health Scotland and has been excluded from this report. Core Suite of Integration Indicators Indicator Title NL 2017 NL 2018 NL 2019 NL 2020 NL 2021 NL 2022 Scotland 2022 HSCNL Trend Scotland Trend NI -11 Premature mortality rate per 100,000 persons 482 517 515 581 580 510 442 Indicator Title NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023 Scotland 2023 HSCNL Trend Scotland Trend
Page 19
19 NI -12 Emergency admission rate (per 100,000 population) 15829 16280 13829 15122 15111 15396 11707 NI – 13 Emergency bed day rate (per 100,000 population) 120784 122569 107300 121842 126261 122120 112883 NI – 14 Emergency readmissions to hospital within 28 days of discharge (rate per 1,000 discharges) 101 106 123 115 117 116 104 NI - 15 Proportion of last 6 months of life spent at home or in a community setting 89% 89% 90% 90% 89% 89% 89% NI – 16 Falls rate per 1,000 population aged 65+ 23 21 19 21 20 21 23 NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023/24 Scotland 2023/24 HSCNL Trend Scotland Trend NI -17 Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections 76% 83% 80% 78% 77% 76% 77% NL 2018 NL 2019 NL 2020 NL 2021 NL 2022 NL 2023 Scotland 2023 HSCNL Trend Scotland Trend NI – 18 Percentage of adults with intensive care needs receiving care at home 75% 74% 75% 75% 71% 70% 65% NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023/24 Scotland 2023/24 HSCNL Trend Scotland Trend NI – 19 Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) 996 1109 781 821 970 973 902 Performance is better than previous reporting period Performance is worse than previous reporting period
Page 20
20 National Integration Indicators – Benchmarking – 2023 Scotland North Lanarkshire East Ayrshire Western Isles Dundee City North Ayrshire Inverclyde West Dunbartonshire Glasgow City Latest data Premature mortality rate per 100,000 442 510 515 473 546 527 542 551 615 2022 Emergency admission rate per 100,000 11707 15396 14294 13464 14335 14009 12689 13642 11513 2023 Emergency bed day rate for adults per 100,000 112883 122120 125700 125928 110615 142222 148350 141660 127396 2023 Emergency readmission to hospital within 28 days of discharge (per 1,000 discharges) 104 116 107 97 147 101 79 84 96 2023 Proportion of last 6 months of life spent at home or in the community 89.1% 89.1% 89.5% 90.8% 90.7% 88.2% 87.7% 88.2% 88.0% 2023 Falls rate per population aged 65+ 23 21 19 21 35 22 26 24 27 2023 Proportion of care services graded ‘Good’ (4) / better in Care Inspectorate Inspections 77.0% 75.8% 78.0% 89.8% 77.5% 82.9% 80.6% 81.4% 82.7% 2023/24
Page 21
21 Percentage of adults with intensive care needs receiving care at home 64.8% 69.9% 71.6% 60.2% 61.8% 77.7% 67.4% 70.2% 59.3% 2023 Number of days people aged 75+ spend in hospital when ready to be discharged, per 1,000 population 902 973 700 1478 428 1087 554 1327 962 2023/24 The table above provides a comparison across the National Integration Indicators, within North Lanarkshire’s ‘Family Group’ of comparators. Our comparative position is fairly positive on areas such as emergency bed day rate (reflecting the lower average length of stay in hospital), falls rate, and the proportion of people with intensive needs supported at home. However, the figures also highlight areas that we can improve on across a range of areas.
Page 22
22 6. Measuring Performance Under Integration (MPUI) Emergency Admissions - Based on agreed trajectories, our objective for 2023/24 was to achieve a 5% reduction in emergency admissions by March 2024. Performance throughout the year was generally positive; either in line with, or positive when compared with the trajectory set. 2,000 2,500 3,000 3,500 4,000 4,500 Emergency Admissions April 2019 - March 2024 Performance Trajectory
Page 23
23 Unscheduled Bed Days - Based on agreed trajectories, our objective for 2023/24 was to achieve a reduction in the number of unscheduled bed days. The trajectory for the reduction in bed days was based on the ongoing reducing length of stay improvement work and the embedding of the Flow Foundations Bundle across all acute and community wards, to improve efficiency and effectiveness across the whole system. 0 5,000 10,000 15,000 20,000 25,000 30,000 Apr-19 Jun-19 Aug-19 Oct-19 Dec-19 Feb-20 Apr-20 Jun-20 Aug-20 Oct-20 Dec-20 Feb-21 Apr21 Jun21 Aug21 Oct21 Dec21 Feb22 Apr-22 Jun-22 Aug-22 Oct-22 Dec-22 Feb-23 Apr-23 Jun-23 Aug-23 Oct-23 Dec-23 Feb-24 Unscheduled Care Bed Days Acute Specialties April 2019 - March 2024 Performance Trajectory
Page 24
24 A&E Attendances - Based on agreed trajectories, our objective for 2023/24 was to achieve a 10% reduction in A&E attendances. Performance throughout the year was generally positive when compared with the trajectory set. 4,000 5,000 6,000 7,000 8,000 9,000 10,000 11,000 12,000 Apr-19 Jun-19 Aug-19 Oct-19 Dec-19 Feb-20 Apr-20 Jun-20 Aug-20 Oct-20 Dec-20 Feb-21 Apr21 Jun21 Aug21 Oct21 Dec21 Feb22 Apr-22 Jun-22 Aug-22 Oct-22 Dec-22 Feb-23 Apr-23 Jun-23 Aug-23 Oct-23 Dec-23 Feb-24 A&E Attendances April 2019 - March 2024 Performance Trajectory
Page 25
25 Delayed Discharge - Based on agreed trajectories, our objective for 2023/24 was to reduce the number of occupied bed days due to standard delays. 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Delayed Discharge Bed Days Standard Delays April 2019 - March 2024 Standard Bed Days Target
Page 26
26 End of Life Care - The percentage of the last six months of life spent at home or in community settings has gradually increased since 2015/16. 82.0% 83.0% 84.0% 85.0% 86.0% 87.0% 88.0% 89.0% 90.0% 91.0% % spent at home or in community setting (6 months) Community Community Target
Page 27
27 Balance of Care - The percentage of people aged 75+ who live at home in North Lanarkshire remains high; this compares well with the Scottish average and other similar Health & Social Care Partnerships. N.B Full financial year figures are not available at time of publication Performance Dashboard The Health & Social Care Partnership also has in place a corporate performance dashboard which is monitored and reported on a quarterly basis and is attached as Appendix 2. This comprises a range of performance metrics and Key Performance Indicators that are used to give the Strategic Leadership Team and Integration Joint Board an assurance of progress against key performance targets. 80.0% 81.0% 82.0% 83.0% 84.0% 85.0% 86.0% 87.0% Balance of Care - Home (unsupported) - 75+ Home (unsupported) Home (unsupport) Target
Page 28
28 7. Managing Performance Under Integration National Health and Wellbeing Outcome 1 People are able to look after their own health and wellbeing and live in good health for longer National Health and Wellbeing Outcome 4 Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services National Health and Wellbeing Outcome 5 Health and Social Care Services contribute to reducing health inequalities HSCP University status Glasgow Caledonian University (GCU) has granted university status to North Lanarkshire Health and Social Care Partnership (HSCP). The granting of this status highlights the contribution of Lanarkshire Health and Social Care Partnership as an organisation that offers significant opportunity for education, training, research and innovation. The organisations share common values and a commitment to the common good, with the aim to transform lives across North Lanarkshire, exemplified through the academic partnership of University Health and Social Care North Lanarkshire.
Page 29
29 Through enhanced and extended partnership working, there is an aim to develop sustainable, innovative and practical solutions to health and social care challenges, directly benefiting and transforming lives North Lanarkshire communities and leading innovation in health and care for the benefit of the whole of Scotland. As part of the agreement, GCU renewed its strategic partnership with NHS Lanarkshire and signed a Memorandum of Understanding with North Lanarkshire Council, consolidating the formal, multi-agency collaboration. CAMHS Udston development and service recovery A new £1.5 million specialist centre transforming the way children and young people in Lanarkshire receive mental health care was officially opened in 2023/24. Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport, opened the new Child and Adolescent Mental Health Service (CAMHS) outpatient facility at Udston Hospital.
Page 30
30 The state-of-the-art facility, hosted by Health & Social Care North Lanarkshire, assesses and treats young people aged 18 years old and younger who have emotional, behavioural or mental health difficulties. The bespoke designed centre provides specialist services including: CAMHS assessment Neurodevelopmental treatments Talking treatments Psychiatry Medication It is a completely new facility specifically for young people, developed with input from young people and their families, ensuring that it is tailored to meet their needs and this new specialist centre is an important part of the new, modern mental health service for Lanarkshire’s young people. We know that mental health issues can have a significant impact on children and young people and that it is crucial that they receive the support they need as quickly as possible. In addition to the new state-of-the-art facility, the service has introduced a new way of working which allow patients to pick their appointment dates and times. The Child and Adolescent Mental Health Service is now using the innovative CAPA (The Choice and Partnership Approach) model. Developed by CAMHS consultant psychiatrists, this model involves working closely with children and young people to offer a ‘choice’ appointment, allowing them to choose the time and date of their appointment, making it more convenient and accessible for them, helping to ensure children and young people receive the support they need, when they need it. cutting waiting times for an initial assessment The new facility ensures that we see young people in an environment that puts them at ease and is designed specifically for, and by them, which provides the best possible environment to make a positive impact on peoples’ lives and by offering more timely and effective
Page 31
31 treatment, in the best possible environment, we are helping young people to get back on track and achieve their potential. New Chryston Health Centre In December 2023, the new state-of-the-art community health clinic was opened in Chryston, representing a £3.65 million investment in the community that will benefit patients for many years to come. The new larger community health clinic, which is part of the Chryston Community Hub, features 17 clinical rooms over 682 square metres of space, providing a variety of community services ranging from midwifery and Health visitors to breastfeeding support and treatment rooms. Serving more than 27,000 local people, the new clinic replaces Muirhead Clinic which provided a limited number of community health services due to its size and lack of dedicated car parking. The development of a modern health clinic that delivers key services in the heart of their community is a fundamental positive change, providing an opportunity to further tackle health inequalities by improving the delivery of services; shaping them around the needs of patients. It is a significant part of our commitment to provide all community services in people’s local areas through integrated health and social care teams. The facility was purpose built with engagement from the local community who worked with us to design and deliver it so that it meets their needs, building stronger co-operation between patients, their carers and families, staff and all partner agencies. Following similar successful joint projects with North Lanarkshire Council, the new facility is part of a wider development including the new Chryston Primary School. This approach reflects a wider vision to create town and community hubs for everyone. The hub in Chryston is the first of its kind and will offer significant benefits to the wider community for local groups and organisations to use.
Page 32
32 Breastfeeding Hundreds of new babies across North Lanarkshire are now being given the best possible start in life every year thanks to a range of breastfeeding initiatives. The number of babies breastfed in their first days in North Lanarkshire’s most deprived areas has increased by more than 12% in the last five years. North Lanarkshire Council also became Scotland’s first local authority to achieve gold status in the Breastfeeding Friendly Scotland Local Authority Award. As part of its commitment to supporting breastfeeding in the workplace and wider community, the council has implemented a number of initiatives over the last three years with 30.4% of babies now being breastfed by their 6 - 8-week review. North Lanarkshire has worked collaboratively with the Scottish Government to develop the new evidence-based accreditation process aimed specifically at local authorities in Scotland. This has led to a wide range of North Lanarkshire Council’s services incorporating breastfeeding into their delivery in order to positively impact on culture and practice to promote long-term progress in breastfeeding. Family support workers North Lanarkshire now has eight new family support workers dedicated to providing an extra layer of support and advice to mums with a new baby. Working as part of Health Visiting Teams, family support workers engage with new parents and provide guidance to support infant feeding and care of their baby. They work to Baby Friendly Standards with the aim of
Page 33
33 building and strengthening the confidence of new parents getting to know and bond with their baby. Cancer Support A new service ensuring that cancer patients are offered emotional, practical and financial support was officially launched in Lanarkshire during March 2024, as part of a successful model being adopted around Scotland to deliver services that will make a positive impact for people who have been newly diagnosed with cancer. North Lanarkshire are working with a range of partners across Lanarkshire, including Macmillan Cancer Support, VANL, South Lanarkshire University Health & Social Care Partnership and VASLAN to make sure local people affected by cancer can access the help they need – via just one call or email. Anyone affected by cancer, including family members and carers, can access the new Lanarkshire Macmillan Improving the Cancer Journey Service at any stage from diagnosis to beyond treatment. The service is part of Lanarkshire’s cancer pathway, offering all people newly diagnosed with cancer a meeting with a dedicated one-to-one support worker/specialist. They will then help the person access a wide range of non-clinical supports, from benefits advice and emotional support to help at home or with other practical needs, with the partner agencies working together to provide a seamless, accessible and personal support for people affected by cancer.
Page 34
34 New winter health hub to help direct patients to most appropriate care A new Winter Health Hub was launched in 2023/24, designed to help Lanarkshire residents access a wide range of healthcare services during the winter period. The online hub provides a centralised portal, outlining the healthcare options available to help people to seek the right care in the right place. The website gives a guide to the healthcare support available throughout winter as well as details of pharmacy and GP opening times over the festive period. It also directs to support available for mental health, the cost of living and weather and travel advice.
Page 35
35 Spring Health Hub Launch A new online Spring Health Hub was launched in 2023/24, designed to help Lanarkshire residents to navigate the wealth of healthcare options available and empower them in seeking the right care at the right place, offering a wealth of information on all available healthcare services, tailored specifically to the spring season. The Hub covers a variety of areas to assist with health and wellbeing, such as information on seasonal allergies, information and advice for those in need of mental health support, or seeking guidance on maintaining your wellbeing; the hub serves as a centralised web resource and a go-to destination for essential healthcare information.
Page 36
36 Healthy Schools To give the future generation of Lanarkshire the healthiest start possible, NHS Lanarkshire has partnered with education services in North and South Lanarkshire Councils to equip schools with an updated health and wellbeing resource for all pupils; Healthy Schools. The covid-19 pandemic disrupted the life of every child and had consequences for their wellbeing, further highlighting the importance of Healthy Schools which supports children and young people from nursery throughout Primary and Secondary school with their health and wellbeing. This interactive website is used by teaching staff to empower children and young people to make positive choices, and it’s available to be accessed by all members of the public, meaning parents and carers can use it too. Created in 2014 with input from children and young people, it provides a safe space for pupils to learn about various topics that can support them as they grow such as nutrition, mental and physical health, substance misuse, planning for change and more. It has now been re-launched in 2023/24 with a new look and design, updated materials for all levels and now has new resources specifically aimed at S5 and S6 pupils. To mark this, NHS Lanarkshire held an event in September 2024 to showcase it to various stakeholders within Lanarkshire. The website can be visited at www.healthyschools.scot. National Health and Wellbeing Outcome 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
Page 37
37 in a homely setting in their community Reablement, Rehabilitation and Home Assessment Teams The aim of Rehabilitation and Reablement services in North Lanarkshire is to ensure that our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities, including preventative approaches, self- management and choice over supports and services. The way we deliver services is changing and there is an overall shift in the balance of care toward delivering services by Self-directed Support, allowing people to have greater choice and control in their own lives. The development of the North Lanarkshire Reablement service is interdependent with our work to develop Home Assessment Teams and the development of Locality Enabling Approach within North Lanarkshire. We know that our work in this area contributes to an increase in wider Health and Social Care system capacity and an improvement in patient flow by reducing the occupied bed days caused by any Delayed Discharge from NHS facilities. The work started during 2023/24 will continue to develop a cohesive and integrated approach to Reablement and Rehabilitation practice across Home Assessment Teams, Home Support and Integrated Rehabilitation Teams. The work to expand this approach to services that support admission prevention and avoidance will be developed in the next year. The Home Assessment Team take a multi-disciplinary approach to person centred care and work to the principle of “Home First”, enabling people to be discharged from NHS care, supported to return home for a period of assessment where their rehabilitation and care needs can be assessed and understood in their own home environment. Throughout 2023/24, HAT received an increasingly greater volume of referrals and through raising awareness and understanding of the practice of assessment at home and the overall “Home First” approach, this is now embedded in everyday practice in North Lanarkshire. During 2023/24, the service discharged it’s 2000th patient, with an according number of referrals received. This represents an enormous achievement for a service developed in challenging circumstances post-pandemic. Coming Home Summary The Coming Home Report was published in November 2018, detailing the issues experienced by authorities managing Out of Area Placements and delayed discharge arrangements for people with Learning Disabilities and Complex Needs. This report had been produced in response to issues raised by the Mental Welfare Commission in their earlier report “No Through Road”. The Coming Home Report identified that some people with learning disabilities and complex needs were living far from home or in NHS hospitals and that there was an urgent need to address this issue. The report was the first time that an overview report was available for Scotland on the characteristics and circumstances of people with complex needs who are placed into care settings, those that are distant from their families and communities, or those who unfortunately remain in hospital settings beyond the clinical need for them to be there.
Page 38
38 In February 2021, the Scottish Government through their Community Living Change Fund allocated £20 million to Integration Authorities across Scotland. The allocation was designed to bring home people with complex needs and those with enduring mental health problems that are placed outside Scotland, and also to support the discharge of those that have endured long stays in hospital settings. A review would also be conducted of current arrangements and how community-based solutions could be designed that would negate or limit future long term hospital use and out of country placements, and the inappropriate use of institutional care settings including private and local authority for people with complex needs. North Lanarkshire’s allocation of funding is £1,298.332 to support this work until March 2025. A multidisciplinary team was recruited to carry out the initial work, consisting of a social worker (SW), a social work mental health officer (MHO) and a resource worker (RW). The team planned to recruit a registered nurse, however were unsuccessful in recruiting to that post. The work of the team has included the establishment of the Dynamic Support Register (DSR), with an overview of an initial assessment of each person on the register. To produce this has required collaborative work with the person, their families, a funded coming home advocacy service and an allocated social worker to produce an assessment of each person’s situation and to establish a forward plan for them. A RAG rating is used to understand the cases and at the end of 2023/24, we had 31 people on the DSR, 17 of whom were identified as red. A comprehensive review of the work in 2023/24 was carried out and identified the need for development of approaches for such complex cases to prevent and expedite delayed discharge and redesign the way services are provided to prevent hospital admission. A number of themes emerged from the review, which will form the basis of development and improvement work in the next year, including: Training and development to support a suitably skilled and experienced workforce. Increased collaborative and coordinated multidisciplinary approaches to support people to live in their own home. Research and analysis of the long-term demand and the resource required to meet that demand and the needs of those with the most complex needs within North Lanarkshire. National Health and Wellbeing Outcome 3 People use health and social care services have positive experiences of those services and have their dignity respected
Page 39
39 HMP Shotts improvements Following an inspection by Healthcare Improvement Scotland (HIS), an improvement plan was put in place to implement the 22 initial recommendations made in the inspection report. At the close of 2023/24, of the 22 initial recommendations made, 20 have been fully completed and closed, with the 2 outstanding recommendations only remaining open due to their dependence on a wider Pharmacy review. In addition to the HIS inspection and improvement plan, a comprehensive service review of Prisoner Healthcare was Commissioned in January 2022 and all 31 actions originating from that review are now closed. The significant service changes and improvements made in the Prison Health Centre at HMP Shotts resulted in HIS commending the efforts made to address the recruitment, retention, and overall staffing issue in the prison. The service held open days, undertook focussed work to address staff culture and psychological safety. In addition, improvements were made in how staff meetings were prioritised and managed, questionnaires were issued to gain feedback on the work carried out and sessions held to engage and communicate with the staff affected by the changes. The work has impacted positively on recruitment and retention and a careers event showcasing the unique job opportunities for registered nurses and final year nursing students at Shotts prison took place in February 2024. This event gave the nurses the chance to visit the health centre at HMP Shotts and learn about multi- disciplinary teams working in prison healthcare.
Page 40
40 The workforce position at HMP Shotts improved greatly during 2023/24 and in addition to the commendation from HIS, feedback from colleagues is that the work has been transformative in the working environment at HMP Shotts. MAT standards progress Significant progress has been made during 2023/24 in implementing the Medication Assisted Treatment (MAT) Standards, which has seen transformation in practice and how those standards are embedded within service delivery. The service has made significant improvements with regard to the collection and use of both experiential and process data. Better data allows for reflective practice and a continual process of review and evaluation of the evidence in relation to the MAT standards, ensuring continued positive progress. The national benchmarking report released this year shows significant improvements and progress for North Lanarkshire in our implementation of the standards. The majority of standards are embedded in everyday practice with only two of the ten remaining to be met fully, with plans in place and progressing to achieve those two standards. North Lanarkshire have been approached by the national MIST Team (MAT Implementation Support Team) to participate in a video communication to be shared with other areas celebrating the positive progress made with implementation in North Lanarkshire, presenting our work as an example of best practice. Launch of North Lanarkshire Alcohol & Drug Partnership website
Page 41
41 North Lanarkshire Alcohol & Drug Partnership (ADP) was established in 2019 as a strategic, multi-agency partnership made up of key agencies and stakeholders including local services, people with lived and living experience of substance use and family members, all working together to tackle alcohol and drug related harms and improve the health and wellbeing of our communities, families and individuals affected by alcohol or drugs. The work of the ADP is centred around improving quality, offering choice and creating more connections to keep people safe, well and thriving. To assist people accessing support and services, and to make information and advice around alcohol and drugs more accessible, a new website was launched during 2023/24. For more information visit the North Lanarkshire ADP website www.northlanadp.org Children and Young People Mental Health Directory of Services and Resources launched A new directory dedicated to mental health services and resources developed specially for and with children and young people across Lanarkshire was launched in 2023/24. Developed by University Health & Social Care North Lanarkshire, the directory is a result of extensive engagement with children, young people and a range of stakeholders. It has been created to help young people and their families access mental health services and supports they feel suit them and their circumstances best. Hosted on the NHS Lanarkshire website, the directory is divided into North and South Lanarkshire resources with some services being available across both areas. Information available includes: Ways to help and improve wellbeing Varying levels of support Websites and helplines Online workshops
Page 42
42 New team members devoted to supporting North Lanarkshire’s District Nurse and Mental Health teams During 2023/24, North Lanarkshire welcomed 17 new assistant practitioners dedicated to providing a further layer of support for multi-disciplinary teams working in the community. To support rising demands for community services, the new roles have been developed to bridge the gap between healthcare support workers and registered nurses. NHS Lanarkshire is the first health board in Scotland to put in place a pathway for assistant practitioners to go through a Higher National Diploma course and move directly into the third year of nurse training. National Health and Wellbeing Outcome 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 wellbeing
Page 43
43 Carer Engagement, Involvement and Participation In alignment with the principles of Equal Partners in Care (EPIC) and Getting It Right for Everyone (GIRFE), our local approaches have been informed through engagement and participation opportunities, Carer Strategy planning, Community Solutions approaches and our ongoing commitment to genuine partnership working and co-produced / jointly agreed approaches to supporting unpaid carers. Carer Support Network We have a strong and well-established Carer Support Network (CSN), bringing together a wide range of Community and Voluntary Sector organisations involved in supporting carers, to minimise the risk of people “slipping through the support net.” This network involves a diverse range of age-related, or condition specific organisations, as well as a much wider range of community organisations with a direct, or indirect role around supporting carers. As examples, a range of diverse organisations such as Getting Better Together, Watch Us Grow, Bazooka Arts, The Haven and PAMIS, amongst others, are all part of the CSN. LENS Workshops - Turning Ideas into Action Programme The LENs ‘Turning Ideas into Action’ programme has been co-designed to enhance and develop a range of interventions and ideas within the Community Solutions Programme in North Lanarkshire. It aligns with the aims of North Lanarkshire’s University Health and Social Care Partnership and is designed to support its objectives and mission. The Programme will be available to a range of partners within Community Solutions, with priority given to third sector partners. The Programme inspires, empowers, provides a framework for enabling leadership and gives permission for people to take action. The Programme planning and delivery began in March 2024, with a co-production workshop with key stakeholders and follow-up discussions with partners, to identify the following six ideas: Community Connector Pathway Development
Page 44
44 The future of the Hospital Discharge Programme The future of the Carer Breather and Carer Sitter Services The expansion of the volunteer driver scheme Proactive Engagement with People in the Community Development of a Locality Community Weight Management Service Model The Programme involves an intensive series of six workshops to be delivered in financial year 2024/25, culminating in the identified ideas being presented to an Investment Panel comprising senior Decision Makers from the Health & Social Care Partnership and its statutory partners. Each idea will be sponsored and supported by a representative of the statutory partners and a representative from the Community and Voluntary Sector (CVS). Community Solutions Community Solutions, established in 2012, is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire. Community Solutions is improving people’s health, wellbeing, quality of life and equality by investing in community-led initiatives which build community, family and individual strengths and resources, with a focus on prevention and early intervention. Community Solutions ensures a co-ordinated approach throughout North Lanarkshire, promoting local opportunities and solutions for and with people, avoiding the need for more formal services for longer periods of time. Community Solutions is an effective and active example of co-production: a true partnership between people, communities and services. The range of achievements via the Community Solutions Programme Approach include significant development through local anchor organisations; Support in the Right Direction, Community Connectors and Improving Cancer Journeys. Community Solutions builds capacity in the wider Health and Social Care System by facilitating the allocation of funding to enable Community and Voluntary sector organisations to deliver support to priority groups, providing information and guidance on key issues such as governance, planning, training, accreditation, finance and evaluation. The Community Solutions model has been used in Children’s Services to test out new models of support to address distress and promote positive mental health. A significant portion of new Scottish Government funding targeted at early intervention and community support through the Children and Young People’s Mental Health and Wellbeing Framework is allocated to organisations though VANL to develop new supports in partnership with school clusters, children, young people and their families. Future investment will be used to continue the community capacity building work already well embedded in the Community Solutions Programme through Voluntary Action North Lanarkshire. The new Improving Lives work stream will see development across a number of key priorities for the Partnership in line with the aims of the Strategic Commissioning Plan and will ensure there is sufficient capacity within the community and voluntary sector to respond to demand.
Page 45
45 Support in the Right Direction The Scottish Government funded a national ‘Support in the Right Direction’ (SiRD) programme from 2019-2024. The programme aimed to empower people and carers who are receiving social care support and services to be equal partners in their care, giving them real choice and control over their lives, including: Decisions about where they live and the services they receive Participation in fulfilling activities and their community Employment, if appropriate The national SIRD Fund is managed by Inspiring Scotland on behalf of the Scottish Government. 30 organisations across the 32 local authority areas in Scotland are funded to deliver SIRD projects. Voluntary Action North Lanarkshire (VANL) managed the SiRD fund for North Lanarkshire, and distributed this funding through the Community Solutions Programme to two Community and Voluntary Sector (CVS) organisations: Equals Advocacy North Lanarkshire Disability Forum (NLDF) NLDF have hosted two Community Connectors since 2019, who were responsible for: Raising awareness of SDS throughout North Lanarkshire Supporting those who are not yet eligible for an individual social care budget by linking them to key supports At the end of 2023/24, £463,800 of SiRD funding over the five-year period has supported 2,576 individuals providing 820 people with general independent support, 392 people with case work, and 442 individuals with focused support. Improving Lives Initiative As the SiRD funding came to an end in 2024, NLDF have secured a further £808.9k funding over two years through the Community Solutions Improving Lives Initiative (ILI).
Page 46
46 The proposal for ILI was developed collaboratively with: the Community Solutions Governance Group University Health and Social Care North Lanarkshire (UHSCNL) Core Management team NHS Lanarkshire Health Improvement senior staff Macmillan Cancer Support The ILI aims to help improve people’s physical, mental, and social wellbeing through a locally co-ordinated approach to providing community-based support for vulnerable and equality groups, as set out in the Community Solutions Strategy and Investment Plan 2022- 25. Community Connectors ILI/ICJ funding has enabled NLDF to continue to fund Community Connectors and employ a further eight, making a team of 10 Community Connectors to support people who are living with a long-term condition/disability and those affected by cancer, including their carers, with accessing non-clinical support. The Community Connectors are responsible for: Signposting people to community supports provided by CVS organisations and where appropriate, linking to statutory services such as the Home Assessment and Integrated Rehabilitation Teams. Practical support, such as form filling Linking into community groups, or activities Providing information on benefits/funds/initiatives Emotional support In 2023/24, 696 people with long-term conditions were referred to NLDF for support through the ILI service. 406 of these referrals were carried over from the SiRD programme. A total of 1,016 referrals were received in North Lanarkshire during 2023-24 from both the ILI and ICJ services. National Health and Wellbeing Outcome 7 People using health and social care services are safe from harm Crisis Care – Distress Brief Intervention (DBI) The need to improve the response to people presenting in distress has been strongly advocated by people who have experience of distress and by front line service providers,
Page 47
47 resulting in the launch of the Scottish Government Distress Brief Intervention (DBI) Programme. DBI is a non-clinical intervention, consisting of two interrelated parts: - For adults (those over 16), Level 1 sees trained front-line staff such as health, police, ambulance and primary care staff help ease the person’s distress, provide a compassionate response and where appropriate, involves an offer of a seamless referral, with confidence and clarity to a DBI Level 2 service. For the children and young people (CYP), i.e. those aged 14 and above, in four North Lanarkshire schools currently involved in a pilot (until 2026), the Level 1 service will be provided through the Pupil Support team within the school. Level 1 staff within these organisations are trained to provide a compassionate response to individuals experiencing distress and offer them the opportunity to be referred to a brief (around 14 days), compassionate, community-based problem-solving intervention (DBI Level 2). Level 2 is provided by commissioned and trained third sector staff who contact the person within 24-hours of referral and provide community-based problem solving support, wellness and distress management planning, supported connections and signposting. The Scottish Government’s “Protecting Scotland, Renewing Scotland, the Governments Programme for Scotland, 2020-21, published Sep 2020, set out that it expected local health boards and H&SC Partnerships to have DBI embedded locally by 2024. Following a pilot, Lifelink have been commissioned to deliver a pan-Lanarkshire Distress Brief Intervention service, with funding agreed for a 3-year period and North Lanarkshire Council acting as the lead authority in a tri-partite agreement. Trained and dedicated staff from Lifelink will contact people within 24-hours of referral and provide community-based problem solving support, wellness and distress management planning, supported connections and signposting for all people referred to the DBI service. National Health and Wellbeing Outcome 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 Engagement & Participation North Lanarkshire During 2023/24, there has been continued focus on further developing our approach engagement and participation that ensures the voices of supported people; carers and our communities are strengthened. The refreshed Engagement and Participation Strategy 2024- 27 is the result of co-production with our local communities. Several stakeholder events were held to help shape the refreshed content and ensure that the National Standards for Community Engagement, promoted by Scottish Community Development Centre, have been applied throughout.
Page 48
48 The Strategic Engagement and Participation Working Group (SEPWG) have identified three main areas of investment that support Engagement and Participation across our communities (Community, Carers and Supported People). Our ambition is to ensure strong voices to: • Improve communication and increase connections. • Increase awareness of what matters. • Increase capacity for early intervention and prevention. Following on from the successful procurement exercise resulting in a contract award to North Lanarkshire Disability Forum (NLDF) as the lead partner, alongside Lanarkshire Links and Voice of Experience Forum, work has begun again on the recommendations from an independent review of our engagement and participation structures that concluded in June 2022. There is a long history of engagement and participation in North Lanarkshire and the strength of connection across our network continues to promote involvement and representation. There have been some key achievements over the past year as set out below. Engagement and Participation Strategy 2024-2027 In the second half of 2023/24, a focused effort was directed towards refreshing the Engagement & Participation Strategy to serve as the foundation across all areas of our work. In the development of the Strategy, we have actively engaged with stakeholders; representatives of community-based organisations, supported people, carers and staff teams. The learning from these sessions has highlighted what is considered good engagement and participation, and provided confirmation that the refreshed strategy should: • Be short and user friendly. • Be an overarching strategy that can guide communication and action planning across all areas of services and supports. • Build from the current strategy, including what we have learned and what people have told us. It is anticipated that the Strategy will support all stakeholders across our networks and it is purposefully written with accessibility in mind to assist people who do not work in the sector but have an interest in Health and Social Care, and/or are receiving services and supports. Strategic Engagement and Participation Working Group The primary function of the Strategic Participation and Engagement Working Group (SEPWG) is to lead and progress the development of the refreshed Strategy 2024-27. The group brings together representation from across the partnership and includes people who have a specific role to support and develop engagement and participation. The primary objective is to coordinate, streamline and synchronise the various activities and initiatives across North Lanarkshire that are aimed at fostering robust and effective engagement and
Page 49
49 participation, prioritise community involvement and also to ensure that the voices, needs, and perspectives of people in North Lanarkshire are not just heard but actively integrated into the design and delivery of our services. Embedding Participation There has been good progress in 2023/24, with an increase in the resource and capacity across community-based organisations to strengthen the voice of supported people, particularly those who tend to be harder to reach, e.g. BAME, LGBTQI+ and those who live in more rural communities. We recognise the importance of ensuring that engagement and participation is meaningful and not tokenistic, and to support this, the principles of engagement and participation are now included in the Staff Induction programme, both as written information and as a direct input to programme for new social work and social care practitioners. A wide range of stakeholders have been actively engaged in the development of the Strategy, whether through consultation or direct involvement. Promoting and implementing the Strategy is a shared responsibility to support: • An evidence base on how people experience our services and how their experience shapes and improves future development of services and supports. • The voice of supported people in our communities • Increased capacity for early intervention and prevention. • Two-way communication and a strengthened feedback loop back to decision makers. • Increased use of feedback and the role of lived experience in the improvement of services and supports. • Increased connections with supported people and communities that are harder to engage with. • Increased awareness of what is important to supported people and their communities. Care Opinion We recognise the importance of feedback and actively promote the use of Care Opinion, which is an independent, non-profit, web-based feedback platform where people submit stories to share their experiences of health and social care services. These can be both
Page 50
50 positive and negative. They are moderated and quickly forwarded to the relevant area of service who can respond directly to the story. Since 2020: • 310 stories have been submitted through Care Opinion by people of North Lanarkshire. • 239 of these stories have been shared during 2023/24. The majority of stories received a response from the service within 24 hours. Podiatry case study The Podiatry service has completed a successful recovery, with significant re-design being embedded in practice during 2023/24. Following a change management process, the hub single point of access model, alongside Active Clinical Referral Triage (ACRT) has been embedded in Podiatry practice, resulting in waiting times being maintained within the 12- week target, whilst offering a “rapid access” of 48 hours (2 working days) for people with urgent presentations of new wounds. Building on this success, the focus for the next 2-3 years is on developing a “grass-roots” clinically led Research strategy and a culture of Quality Improvement, Evidence and Research based practice. This work will be facilitated by our strategic academic partners at Glasgow Caledonian University, who have been working with clinical podiatry staff and the musculoskeletal Consultant Podiatrist to develop a departmental research strategy. The aim is to encourage and facilitate colleagues at all levels to lead on service evaluation, quality improvement projects and traditional research. Two examples of this work in action are: Nail Surgery service evaluation - The Clinical Lead for Nail surgery is working alongside the NHS Lanarkshire Research and Development department, the service development lead and a specialist Podiatrist who is a current PhD Fellow to carry out a service evaluation. NHS Lanarkshire Podiatry are the only service in Scotland that are carrying out a robust evaluation on TCA. As such, the department has been asked to share the learning and the outcomes with other health boards. Comparison of digital self-directed advice verses clinician-led self-care to support musculoskeletal health - The total service demand for Musculoskeletal (MSK) complaints is 28% and of this, 11% are directed to non-clinician supported self-care via the NHS Lanarkshire Podiatry website. Current data suggests that after an average of 161 days, 80% of patients directed to self-care did not re-engage with the service. Following a further average of 698 days, 72% of patients did not re-engage with the service. National Health and Wellbeing Outcome 9 Resources are used effectively and efficiently in the provision of health and social care services Summary of Financial Performance The financial year 2023/24 presented fresh challenges for the Health and Social Care Partnership, including a continued recovery from the pandemic, the cost of living crisis, a changing demographic profile, pressures attributable to hospital discharges, staffing shortages, rising costs and increased demand for services.
Page 51
51 Through regular updates to the board from the Chief Finance Officer (CFO) and by ensuring decisions made throughout 2023/24 were taken to support financial sustainability, the North Lanarkshire IJB has successfully managed to deliver year-on-year financial balance. This has been achieved through: • flexible use of recurring and non-recurring funding; • creation and use of reserves for specific commitments; • delivery of approved savings through efficiency measures and redesign; • a focus on workforce planning and the Strategic Commissioning Plan Programme of Work; • effective governance and audit controls. North Lanarkshire IJB delivers and commissions a range of health and social care services to our local population. This is funded through budgets delegated from both North Lanarkshire Council and NHS Lanarkshire. The level of funding available to the IJB is therefore heavily influenced by the grant settlement that the organisations receive from the Scottish Government. The combined recurring and non-recurring budgets available to the IJB during 2023/24 to progress the intended commissioning in line with the Strategic Commissioning Plan, was circa £821m. Included within this funding is a ‘Large Hospital Service’ (Set Aside) budget totalling £74.575m. This budget is set in respect of the functions delegated by the Health Board that are carried out in a hospital setting. The Set Aside budget is determined by apportioning the hospital expenditure to individual patient episodes, separating out episodes for services delegated to the IJB from those that are not, and then assigning these to the relevant IJB based by postcode. Also included is £40.641m for several delegated services where South Lanarkshire IJB acts as the lead host on behalf of North Lanarkshire IJB. The value consumed by North Lanarkshire equates to 52% of the South Lanarkshire IJB hosted budget.
Page 52
52 Throughout 2023/24, the CFO financial monitoring reports to the IJB projected an underspend; this was prior to the transfer of year-end balances to general and earmarked reserves at the financial year end. This included the transfer of specific ring-fenced monies (including Scottish Government funding for Mental Health Services, Alcohol & Drug Services, Hospital at Home, and other Nursing) in line with Scottish Government guidance. Note: The figures differ to financial reporting elsewhere, such as the Comprehensive Income and Expenditure Statement (CIES) due to differences in the presentation of in year adjustments between the partners. The year-end underspend totalled £18.710m. Drawdown of reserves in 2023/24 totalled £41.132m, leaving a deficit on the provision of services of £22.422m. The following provides a high-level summary of the key pressures and the main reasons why the IJB’s final outturn resulted in an underspend against its budget in 2023/24: The net underspend of £7.800m for Locality and Other Services relates to the ongoing challenge of recruitment and retention of staff across all mainstream service areas. This underspend also includes Scottish Government funding of £4.277m, allocated to help address the current staffing pressures. This funding will be carried forward into 2024/25 within specific ring-fenced reserves to be used in 2024/25. North Lanarkshire Hosted Services have a combined net underspend totalling £5.063m. This is due to additional funding received from Scottish Government (£4.457m), which will be carried forward into 2024/25 and allocated against approved spending plans within Mental Health. The remaining underspend is in relation to vacant posts across the service. Addiction Services have a net underspend of £3.597m. The total underspend relates to Scottish Government ring-fenced funding, which will be carried forward for use in 2025/26. Social Care Services have a net underspend of £3.331m and this relates to the ongoing challenge of recruitment and retention of staff across all service areas. The Prescribing net overspend of £1.781m is attributable to the continued increase in costs associated with the number of medicines being prescribed. Medical/Nursing Directorate and Area Wide Services have a combined net underspend totalling £0.967m that is due to additional Scottish Government funding (£1.034m), which will be carried forward into 2024/25 and allocated against approved spending plans within Pharmacy, Frailty and District Nursing.
Page 53
53 As demand continues to rise, the costs of providing health and social care services across Lanarkshire have also been increasing year on year. This table shows the cost of our services incurred over the last three years, as presented in the Comprehensive Income and Expenditure Statement. 8. Care Inspectorate Grades 2023/24 The Care Inspectorate provide an overall evaluation for each of the key questions that they inspect using a six-point scale from unsatisfactory (1), to excellent (6). This will be taken from the specific quality indicators that they inspect within a “key question”, which will inform an overall evaluation (using the same scale) for that particular key question that the quality indicators sit under. NLC Care Homes As of 31st March 2024, there were 27 care homes within North Lanarkshire. All 27 of the care homes had been assessed by the Care Inspectorate against their key question of, ‘How well do we support people’s wellbeing?’. None of the care homes assessed achieved the highest grade of ‘Excellent’, however 11.1% of care homes achieved ‘Very Good’. The majority of care homes were assessed as ‘Good’ or better against this question, totalling 66.7%. The care homes who were assessed as ‘Very Good’ were Blair House, Kirknowe, and Summerlee. Of the 27 care homes, 13 were assessed under the key question ‘How well is care and support planned?’. Of the 13 that had been assessed, 69.2% received a grade of ‘Good’ or better. During the reporting period Centenary House continued to be subject to a Large Scale Investigation Notification, in place till 11th October 2023. An improvement notice was also served by the Care Inspectorate to Centenary House on 12th July 2023. This was removed in December 2023 following significant improvements having been made. During the reporting period, six care homes were closed to admissions due to them agreeing to a voluntary moratorium. One care home had an enforced moratorium placed upon them. The reasons for the application of moratoriums were due to concerns around the quality of
Page 54
54 care being provided and also to allow care home providers the opportunity to make the necessary improvements. Other services There are 50 commissioned services that have been inspected by the Care Inspectorate under their new methodology framework. Forty-nine commissioned services were inspected against the key question ‘How well do we support people’s wellbeing?’. One service received a grade of ‘Excellent’ for this key question; this was Support for Ordinary Living (SOL). A grade of ‘Very Good’ was received by 55.1% of services and 87.8% of services inspected received grades of ‘Good’ or above. For the key question ‘How well do we support people’s wellbeing?’, 4% of services received grades of ‘Weak’. The two services were Cera Care and Care 1 Professional’ both of these services continue subject to moratorium at the end of this reporting period. The reasons for the moratorium were due to the quality of care assessed by the Care Inspectorate. Application of the moratorium is to support the provider to make the necessary improvements required. Of the 50 commissioned services, 21 were inspected by the Care Inspectorate against the key question ‘How well is care and support planned?’. Of these, 33.3% received grades of ‘Very Good’ and 76.2% received grades of ‘Good’, or above.
Page 55
55 9. Strategic Planning The overarching strategic vision and objectives of the IJB are detailed in the IJB Strategic Commissioning Plan 2023/20261 which sets out the key outcomes the IJB is committed to delivering with its partners. Strategic Commissioning Launch 2023 - 2026 Event Health & Social Care North Lanarkshire launched its Strategic Commissioning Plan 2023- 2026 on Thursday, 05th October 2023, hosted by the staff and pupils at Coltness High School. The opportunity to hold the launch at the school is in line with our ambition to engage with people at a local level and the event was attended by service users, health and social care professionals, voluntary sector partners, and stakeholders. In addition, Higher Modern Studies students from the school were able to join delegates for the session presented by the keynote speaker, Sir Harry Burns, professor of practice and special adviser at the University of Strathclyde. Guests were treated to a musical performance by three of the school’s singers, Isla McGowan, Freya McIntyre and Millie Costello, accompanied by fellow pupil Kurtis Fang on the piano, which was a fantastic way to end the day and a reminder of the talent and potential we have in North Lanarkshire. The feedback from the launch event was extremely positive, with many delegates providing feedback on how inspired they were by the event, the quality of both the speakers and their presentations and that it had provided a clear understanding of Health & Social Care North Lanarkshire’s goals for the next three years, with a clear message that people are central to everything that we do. The feedback clearly shows the strong foundations that are already in place and our commitment to working with service users, patients, carers, families, communities and partner organisations to improve the health and wellbeing of North Lanarkshire residents. 1 IJB Strategic Commissioning Plan 2023/2026
Page 56
56 The Strategic Commissioning Plan 2023-2026 for North Lanarkshire sets out ambitious key local priorities for health and social care services over the next three years to ensure people are robustly supported to live in their own homes and lead independent lives in their communities. It was developed through a collaborative process with people who use health and social care services, partners, the public and partnership staff. Key priorities include: Improving access to services Reducing health inequalities Delivering high-quality, person-centred care Promoting early intervention and prevention Empowering individuals and communities Fostering partnership working Contributing towards national health and wellbeing outcomes The chief executives of North Lanarkshire Council and NHS Lanarkshire set out in detail how their respective organisational plans align, complement and support the Strategic Commissioning Plan. Presentations were also delivered at the launch event on people-led system transformation and human learning systems, which are approaches the partnership are employing in bold and innovative new ways of delivering health and social care services across North Lanarkshire. The plan reflects the feedback and input from people across North Lanarkshire to develop a shared vision for local health and social care. It focuses on promoting early intervention, empowering communities and fostering partnerships to ensure that our services meet the needs of the population. The plan outlines our commitment to developing and delivering services that provide support to individuals, families, and our wider communities to improve their health, wellbeing, and overall quality of life. High quality community health and social care services play a crucial role in supporting people to maintain a better level of health. This is achieved through prevention, support and treatment to help people to live a better life at home for as long as possible. The plan will be implemented over the next three years, with ongoing monitoring to ensure that services continue to meet the needs and goals of local people. The Strategic Planning Group sets out the IJB’s approach to engage with stakeholders. Consultation on the future vision and activities of the IJB is undertaken with its Health Services and Local Authority partners with a Programme of Work setting out in detail the commitments that will be progressed over the next three years.
Page 57
57 The Medium-Term Financial Plan 2023/2026 outlines the financial challenges and opportunities the HSCP faces over the next three years and provides a framework which will support the HSCP to remain financially sustainable. It complements the IJB Strategic Commissioning Plan, highlighting how the financial plan will support the delivery of the IJB’s strategic objectives and priorities. Our joint focus with all our partners and stakeholders, will be to ensure that all resources in scope are maximised to their full potential and health and social care services are efficient, effective and sustainable for the future. 10. Looking Forward – Our Next Steps The North Lanarkshire HSCP Strategic Commissioning Plan 2023 – 2026 Programme of work sets out in detail the key work Programmes that will be undertaken over the three-year period to meet the key priorities within the Strategic Commissioning Plan. The Programme of Work is aligned to the transformational change priorities for the partnership, reflects the requirement to manage the interconnections and dependencies in a complex system, as well as give clarity and structure to wider partners and stakeholders. The Plan sets out revised ambitions for the HSCP, which were agreed following consultation with the public and other stakeholders: 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
Page 58
58 11. Appendices Appendix 1 – Summary of Performance against Core Suite of Integration Indicators Indicator Title NL 2015/16 NL 2017/18 NL 2019/20 NL 2021/22 NL 2023/24 NI -1 Percentage of adults able to look after their health very well or quite well 91.70% 90.30% 90.50% 87.50% 87.41% NI - 2 Percentage of adults supported at home who agreed that they are supported to live as independently as possible 77.60% 79.80% 67.74% NI - 3 Percentage of adults supported at home who agreed that they had a say in how their help, care, or support was provided 71.20% 67.10% 57.11% NI - 4 Percentage of adults supported at home who agreed that their health and social care services seemed to be well co-ordinated 70.20% 66.60% 56.04% NI - 5 Percentage of adults receiving any care or support who rate it as excellent or good 77.80% 74.00% 65.76% NI - 6 Percentage of people with positive experience of care at their GP practice 79.30% 75.50% 68.30% 51.80% 52.80% NI - 7 Percentage of adults supported at home who agree that their services and support had an impact on improving or maintaining their quality of life 75.70% 77.00% 67.70% NI - 8 Percentage of carers who feel supported to continue in their caring role 41.20% 33.20% 32.60% 25.10% 28.46% NI - 9 Percentage of adults supported at home who agreed they felt safe 80.00% 79.80% 68.44%
Page 59
59 Indicator Title NL 2017 NL 2018 NL 2019 NL 2020 NL 2021 NL 2022 NI -11 Premature mortality rate per 100,000 persons 482 517 515 581 580 510 Indicator Title NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023 NI -12 Emergency admission rate (per 100,000 population) 15829 16280 13829 15122 15111 15396 NI – 13 Emergency bed day rate (per 100,000 population) 120784 122569 107300 121842 126261 122120 NI – 14 Emergency readmissions to hospital within 28 days of discharge (rate per 1,000 discharges) 101 106 123 115 117 116 NI - 15 Proportion of last 6 months of life spent at home or in a community setting 89% 89% 90% 90% 89% 89% NI – 16 Falls rate per 1,000 population aged 65+ 23 21 19 21 20 21 NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023/24 NI -17 Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections 76% 83% 80% 78% 77% 76% NL 2018 NL 2019 NL 2020 NL 2021 NL 2022 NL 2023 NI – 18 Percentage of adults with intensive care needs receiving care at home 75% 74% 75% 75% 71% 70% NL 2018/19 NL 2019/20 NL 2020/21 NL 2021/22 NL 2022/23 NL 2023/24 NI – 19 Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) 996 1109 781 821 970 973
Page 60
60 Appendix 2 – HSCP Performance Dashboard Outcome (National Health & Wellbeing) Ref . KPI Target 2023- 24 2023/24 Q1 2023/24 Q2 2023/24 Q3 2023/24 Q4 Current Performan ce 1. People are able to look after and improve their own health and wellbeing and live in good health longer 1.1 Alcohol Brief Interventions North 2883 718 790 772 598 1.2 Alcohol Brief Interventions (all settings) NHSL 7381 1978 2040 1949 1806 1.5 Cervical Screening 80% 72.3% 72.3% 71.8% 71.2% 1.6 Immunisations – %s of 2 year olds 95% 94.8% 95.0% 95.1% 95.4% 1.7 Immunisations – %s of 5 year olds 95% 91.4% 89.9% 90.6% 90.1% 1.8 Addictions – Completed Waits 90% 90.1% 84.2% 87.8% 89.8% 1.9 Addictions – Ongoing Waits 90% 86.6% 98.5% 91.8% 95.9% 1.1 0 Addictions – Ongoing Waits NHSL 90% 86.1% 83.1% 82.3% 95.9% 1.1 2 Percentage of people who have completed 6-8 week review 90% 79.9% 81.3% Data not available Quarterly/ 1 quarter behind ... 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, 2.4 Delayed discharge bed days - standard delays 31,796 8,438 16,110 24,098 31,405 2.5 A&E Attendances - NL Residents 116,45 6 30,637 30,044 29,292 Quarterly/ 1 quarter behind 2.6 Emergency Admissions - NL Residents 44,001 10,834 11,055 9,401 Quarterly/ 1 quarter behind 2.7 Unscheduled Bed Days - all specialties, NL residents 294,99 9 66,941 77,508 67,694 Quarterly/ 1 quarter behind 2.1 1 Inpatient Activity – Readmissions 7 days 8 5.75 5.90 5.65 5.67
Page 61
61 independent ly and at home or in a homely setting in their community. 2.1 3 Percentage of patients waiting less than 12 months to begin PDS (waiting less than 12 months/total number waiting) 70% 90.6% 86.2% 88.3% 83.9% 2.1 4 Mental Health - bed occupancy rate … 86.4% 87.5% 86.3% 86.2% ... 2.1 5 Assistive Technology - Number Of People With Technology (0-17 yrs) 1,452 28 28 31 31 2.1 6 Assistive Technology - Number Of People With Technology (18-64yrs) 632 631 618 624 2.1 7 Assistive Technology - Number Of People With Technology (65+) 818 825 856 858 2.1 8 Reablement - Number Of People Completing Reablement Process 2000 (500 per quarte r) 376 816 1355 2011 2.1 9 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 64.0% 70.3% 70.0% 60.8% 2.2 Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 45.8% 48.0% 58.8% 58.5% 2.2 1 Balance Of Care - % Of People (Age 65+) 45% 40.2% 36.7% 34.0% 36.4% 2.2 2 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 47.5% 49.9% 53.5% 63.4% 3. People who use health and social care services have 3.1 18 Week RTT Performance – CAMHS NHSL (NORTH HOSTED) 90% 28.1% 47.1% 72.6% 58.7% 3.4 18 Week RTT Performance – Psychology (NHSL) (NORTH HOSTED) 90% 81.7% 79.1% 82.5% 78.1% 3.5 Consultant Outpatient WT - Adult Mental Health - 12wks (NHSL) (NORTH HOSTED) 90%* 57.4% 48.9% 40.4% 37.7%
Page 62
62 positive experiences of those services, and have their dignity respected 3.6 Consultant Outpatient WT - Older Adult Psychiatry - 12wks (NHSL) (NORTH HOSTED) 90%* 81.9% 79.9% 77.8% 74.7% 3.7 Consultant Outpatient WT - Learning Disability - 12wks (NHSL) (NORTH HOSTED) 90%* 100% 100% 100% 100% 3.8 Medical Paediatrics WT - 12 wks (NHSL) (NORTH HOSTED) 90%* 49.5% 56.1% 88.8% 88.2% 3.9 Admission to MH Wards: Proportion NHSL Patients >=95% 97.7% 98.5% 97.8% 98.8% 3.1 1 MSK Podiatry - 12wks (NORTH HOSTED) 90%* 100% 100% 100% 100% 3.1 2 Podiatry - 12wks (NORTH HOSTED) 90%* 96.6% 94.5% 99.0% 100% 3.1 3 Podiatry - domiciliary visits - 12wks (NORTH HOSTED) 90%* 100% 100% 100% 100% 3.1 4 SLT - Paediatrics - 12wks (NORTH HOSTED) 90%* 25.1% 18.3% 23.2% 21.2% 3.1 5 SLT - Adult - 12wks (NORTH HOSTED) 90%* 81.4% 96.0% 90.0% 91.5% 3.1 8 Dietetics - 12wks (NORTH HOSTED) 90%* 75.4% 69.1% 74.8% 74.1% 4. Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.7 22.0 21.9 22.0 4.4 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 44.9 45.8 45.6 45.9 4.5 Care Home - Average Length of Stay 865 832 891 835 834 4.6 Number Of People With Self Directed Support 1,000 2070 2093 2092 2089 4.7 Number Of People With A Direct Payment 240 329 342 357 379
Page 63
63 5. Health and social care services contribute to reducing health inequalities 5.1 Sustain and embed successful smoking quits, at 12 weeks post quit, in 40% of SIMD areas. (AOP) (NORTH HOSTED) 902 53 110 Quarterly/ 2 quarters behind Quarterly/ 2 quarters behind 6. People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact on their caring role on their own health and wellbeing 6.1 Community Alarm Service Users 75 Years And Over Per 1000 Population ... 191.8 193.9 196.5 195.8 … 7. People who use health and social care services are 7.6 Manual Handling Awareness 90% 94.9% 95.6% 94.8% 97.7% 7.7 PAMOVA Training 90% 94.1% 96.5% 93.5% 98.1% 7.8 Adult Basic Life Support 90% 84.3% 92.6% 90.3% 89.6% Paediatric Basic Life Support 90% 91.3% 92.9% 91.2% 86.7% 7.9 Fire Safety Training 90% 94.6% 95.4% 95.2% 94.4% 7.1 Hand Hygiene Training 90% 89.5% 94.1% 92.3% 95.1%
Page 64
64 safe from harm 7.1 1 Safe information Handling Training 90% 92.3% 96.5% 95.2% 97.6% 7.1 2 Child Protection Awareness Training 90% 95.6% 97.7% 97.0% 98.5% 7.1 4 Health and Safety Awareness Training 90% 94.2% 95.9% 95.9% 99.2% 7.1 5 Occupational Health Service Awareness Training 90% 94.1% 95.9% 96.2% 99.6% 7.1 6 Adult Support and Protection Awareness Training 90% 95.5% 92.6% 96.8% 99.3% 7.2 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 12.4% 14.8% 12.7% 20.1% 7.2 1 % Of Adult Protection Investigations Going To Initial Case Conference 20% 20.3% 10.4% 19.2% 11.9% 7.2 2 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 76.6% 77.8% 76.3% 81.7% 7.2 3 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 76.6% 74.2% 75.9% 71.5% 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, 8.1 TURAS compliance (NHSL, North) >80% 68% 69% 65% 78%
Page 65
65 care and treatment they provide 9. Resources are used effectively and efficiently in the provision of health and social care services 9.1 Breakeven Position - YTD Variance Including Prescribing (NHSL) >=0 0.042m Underspen d 0.006m Underspen d 2.013m Underspen d £15.379m underspen d ... 9.2 Breakeven Position - YTD Variance Excluding Prescribing (NHSL) >=0 1.392m Underspen d 2.346m Underspen d 2.631m Underspen d £17.160m underspen d ... 9.5 Sickness Absence (NHSL, North) 4% 7.41% 6.88% 6.46% 6.88% 9.6 Sickness Absence (NLC) - days lost per person 9.22 3.34 6.93 10.29 13.74
Page 66
66 Appendix 3 – Inspection Findings 2022/23 Further information on 2023/24 inspection activity can be found in the HSCP Quality Assurance Annual Report, or more detailed information is available at the Care Inspectorate website: Publications & Statistics (careinspectorate.com). Service Resource Name Service Group Date Last Inspected How well do we support people's wellbeing? How well is care and support planned? How good is our setting? How good is our staff team? How good is our leadership? Cumbernauld Locality Support Service 25/09/2023 Very Good Excellent Very Good Very Good Very Good Coatbridge Locality Support Service 26/05/2023 Very Good Very Good Very Good Very Good Very Good Wishaw Locality Support Service 12/06/2023 Very Good Very Good Good Very Good Very Good Airdrie Locality Support Service 16/05/2023 Very Good Excellent Very Good Very Good Very Good The New Harry Walker Integrated Day Services Support Service 27/07/2023 Very Good Very Good Very Good Very Good Adequate Bellshill Locality Support Service 23/06/2023 Very Good Very Good Very Good Very Good Very Good Phew Care Home Service 29/02/2024 Good Good Good Good Adequate Avondale Nursing Home Care Home Service 13/07/2023 Good Good Good Good Good Craig En Goyne Care Home Service 21/04/2023 Good Good Very Good Good Good Darroch Nursing Home Care Home Service 09/11/2023 Good Good Good Very Good Adequate Rawyards House Care Home Care Home Service 06/11/2023 Good Adequate Good Adequate Good Sir John Mann Integrated Day Service Support Service 12/01/2024 Very Good Good Good Very Good Very Good Sinclair Integrated Day Service Support Service 14/04/2023 Very Good Good Very Good Very Good Good Capability Scotland - North Lanarkshire Services Support Service 17/04/2023 Very Good Good Good Very Good North Lanarkshire Supported Living Service Housing Support Service 07/09/2023 Very Good Very Good Very Good Good East Dunbartonshire Phase 1 Housing Support Service 01/06/2023 Very Good Very Good Good Good
Page 67
67 Service Resource Name Service Group Date Last Inspected How well do we support people's wellbeing? How well is care and support planned? How good is our setting? How good is our staff team? How good is our leadership? East Dunbartonshire Phase 2 Housing Support Service 01/06/2023 Very Good Good Good Good East Dunbartonshire Phase 3 Housing Support Service 06/06/2023 Good Good Good Good Enable Scotland (Leading the Way) - Lanarkshire Services Housing Support Service 11/03/2024 Weak Weak Weak Weak Tenancy Support Service Cumbernauld Housing Support Service 03/10/2023 Very Good Very Good Very Good Very Good Potential Living Housing Support Service 17/04/2023 Very Good Excellent Very Good Very Good Potential Living Support Service 17/04/2023 Very Good Excellent Very Good Very Good Coatbridge Home Support Service Housing Support Service 24/05/2023 Weak Weak Adequate Weak Coatbridge Home Support Service Support Service 24/05/2023 Weak Weak Adequate Weak Cumbernauld Home Support Service Housing Support Service 17/08/2023 Weak Weak Weak Weak Cumbernauld Home Support Service Support Service 17/08/2023 Weak Weak Weak Weak Wishaw and Shotts Home Support Service Support Service 21/02/2024 Adequate Adequate Adequate Adequate Airdrie Home Support Service Housing Support Service 28/09/2023 Weak Weak Good Adequate Airdrie Home Support Service Support Service 28/09/2023 Weak Weak Good Adequate Community Alarm Service Housing Support Service 26/04/2023 Very Good Adequate Very Good Good Community Alarm Service Support Service 26/04/2023 Very Good Adequate Very Good Good Motherwell Home Support Service Support Service 11/10/2023 Good Adequate Adequate Good
Page 68
68 Service Resource Name Service Group Date Last Inspected How well do we support people's wellbeing? How well is care and support planned? How good is our setting? How good is our staff team? How good is our leadership? Motherwell Home Support Service Housing Support Service 11/10/2023 Good Adequate Adequate Good Wishaw and Shotts Home Support Service Housing Support Service 21/02/2024 Weak Weak Weak Weak Sciensus Pharma Services Limited Nurse Agency 17/07/2023 Very Good Very Good Very Good Adequate Blair House Care Home Care Home Service 28/03/2024 Very Good Good Good Good Very Good Key Community Supports - North Lanarkshire Housing Support Service 12/06/2023 Very Good Very Good Good Very Good East Dunbartonshire Phase 2 Support Service 01/06/2023 Good Good Good Good East Dunbartonshire Phase 1 Support Service 01/06/2023 Very Good Very Good Good Good East Dunbartonshire Phase 3 Support Service 06/06/2023 Good Good Good Good North Lanarkshire Supported Living Service Support Service 07/09/2023 Very Good Very Good Very Good Good The View Park Project Housing Support Service 30/06/2023 Very Good Very Good Good Very Good Enable Scotland (Leading the Way) - Lanarkshire Services Support Service 11/03/2024 Very Good Very Good Very Good Very Good Key Community Supports - North Lanarkshire Support Service 12/06/2023 Very Good Good Very Good Good Elaina Nursing Home Care Home Service 21/02/2024 Good Good Good Adequate Adequate Rosehall Manor Care Home Service 13/12/2023 Good Good Very Good Good Good Morningside Care Home Care Home Service 18/01/2024 Adequate Adequate Adequate Adequate Adequate Motherwell Locality Support Service (Disability) Support Service 07/07/2023 Very Good Very Good Very Good Very Good Very Good
Page 69
69 Service Resource Name Service Group Date Last Inspected How well do we support people's wellbeing? How well is care and support planned? How good is our setting? How good is our staff team? How good is our leadership? GMD Community Services Housing Support Service 31/07/2023 Very Good Very Good Very Good Good Rosepark Care Home Care Home Service 22/12/2023 Good Good Good Good Good Summerlee House Ltd. Care Home Service 07/03/2024 Very Good Good Good Good Very Good GMD Community Services Support Service 31/07/2023 Very Good Very Good Very Good Good Lanarkshire Care Partners Housing Support Service 14/07/2023 Good Good Good Very Good Partners in Play - Community Support Support Service 10/10/2023 Very Good Good Very Good Good Very Good Carnbroe Care Centre Care Home Service 26/06/2023 Good Good Good Good Good The Village Nursing Home Care Home Service 12/12/2023 Good Adequate Adequate Adequate Adequate Lanarkshire Care Partners Support Service 14/07/2023 Good Good Good Very Good Wheatley Care Personalised and Self Directed Support Services (North Lanarkshire) Support Service 19/02/2024 Good Adequate Good Good Wheatley Care Personalised and Self Directed Support Services (North Lanarkshire) Housing Support Service 19/02/2024 Good Adequate Good Good Rannoch Lodge Care Home Care Home Service 17/08/2023 Good Good Good Good Good Deanston House Nursing Home Care Home Service 04/12/2023 Good Good Very Good Good Good Kirknowe Nursing Home Care Home Service 29/08/2023 Very Good Good Good Good Very Good Local Lanarkshire Care Housing Support Service 21/07/2023 Very Good Very Good Very Good Very Good Local Lanarkshire Care Support Service 21/07/2023 Very Good Very Good Very Good Very Good Lochside Manor Care Home Service 21/08/2023 Good Good Good Good Good Tezlom Nurse Agency 27/04/2023 Very Good Very Good
Page 70
70 Service Resource Name Service Group Date Last Inspected How well do we support people's wellbeing? How well is care and support planned? How good is our setting? How good is our staff team? How good is our leadership? SAMH North Lanarkshire Support Service Support Service 13/10/2023 Very Good Very Good Very Good Very Good SAMH North Lanarkshire Support Service Housing Support Service 13/10/2023 Very Good Very Good Very Good Very Good ION Care and Support Services (Care at Home)(Lanarkshire) Support Service 07/04/2023 Very Good Good Good Good ION Care and Support Services (Housing Support) (Lanarkshire) Housing Support Service 07/04/2023 Very Good Good Good Good Constance Care North Lanarkshire and East Renfrewshire Housing Support Service 21/09/2023 Good Good Very Good Very Good Constance Care North Lanarkshire and East Renfrewshire Support Service 21/09/2023 Good Good Very Good Very Good Beechwood Care Home Care Home Service 12/07/2023 Good Good Good Good Good Bespoke Care Services Ltd Support Service 18/10/2023 Good Good Good Good Cornerstone Borders CS Housing Support Service 14/02/2024 Good Adequate Good Good Murdostoun Neurological Care Centre Care Home Service 22/09/2023 Adequate Adequate Adequate Good Adequate Flexible Healthcare One Solutions Ltd Nurse Agency 17/05/2023 Good Good Centenary House Care Home Service 14/12/2023 Adequate Adequate Adequate Adequate Adequate
Page 71
71 Glossary of Terms A&E Attendance An A&E attendance is when a patient attends an Accident & Emergency department. ADP The Alcohol and Drug Partnership (ADP) is responsible for commissioning and developing local strategies for tackling problem alcohol and drug use and promoting recovery based on an assessment of local needs. Adult Protection Committee The Adult Protection Committee is a multi- agency committee which monitors and reviews what is happening locally to safeguard adults. It is made up of senior staff from many of the agencies involved in protecting adults who may be at risk. Adult Support & Protection (ASP) Adult Support and Protection relates to the protection of adults at risk of harm and the measures and duties within the Adult Support and Protection (Scotland) Act 2007. CAMHS The NHS Lanarkshire Child & Adolescent Mental Health Service (CAMHS) is a specialist service for infants, children and young people. Delayed Discharge A delayed discharge occurs when a patient is ready to leave a hospital or similar care provider but is still occupying a bed. Emergency Admission An emergency admission is one where a patient is admitted to hospital urgently and unexpectedly (i.e. the admission is unplanned). Health & Care Experience Survey The Health and Care Experience Survey is a national survey which asks about people’s experiences of accessing and using their GP practice and Out of Hours services aspects of care and support provided by local authorities and other organisations
Page 72
72 caring responsibilities and related support Integration Authority Integration Authorities are responsible for planning, designing and commissioning health and social care services in an integrated way from a single budget in order to take a joined up approach, more easily shifting resources to best meet need. Integration Joint Board (IJB) Health Boards and Local Authorities delegate a significant number of functions and resource to the Integration Joint Board, which is responsible for the planning of integrated arrangements and onward service delivery. Measuring Performance Under Integration (MPUI) A small set of indicators was developed as a way of measuring performance of Health & Social Care Partnerships. Ministerial Strategic Group for Health and Community Care (MSG) A key strategic decision taking group in relation to transformational change in health and community care in Scotland. The group is chaired by the Cabinet Secretary for Health and Sport and the COSLA Spokesperson for Health and Social Care. National Core Integration Indicators A core suite of indicators that Integration Authorities use to measure progress towards the National Health and Wellbeing Outcomes. National Health & Wellbeing Outcomes There are nine national health and wellbeing outcomes which apply to integrated health and social care. Health Boards, Local Authorities and Integration Authorities work together to ensure that these outcomes are meaningful to people in their area. Social Work Scotland (SWS) Social Work Scotland is the professional body for social work and social care leaders.
Page 73
73 Unscheduled Bed Day A bed-day is a day during which a person stays overnight in a hospital. An unscheduled bed day is where the patient’s admission was unplanned. VANL Voluntary Action North Lanarkshire is a charitable organisation which provides support to community and voluntary organisations across the whole of North Lanarkshire.
Page 74
74 Appendix Three – Sample desktop published pages
Page 75
75