000 - 2025-12-10 IJB Agenda and Papers Combined PDF
North Lanarkshire Council · 10 December 2025
Back to Health and Social Care Integration Joint Board — 10 December 2025 and its agenda
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1 A meeting of the IJB will be held on Wednesday 10 December 2025 at 9.30am – 12.00pm via MS Meetings If anyone would like to join this meeting, please contact the governance team at NLHSCPGovernance@lanarkshire.scot.nhs.uk for the relevant information. Chair: Brian Moore AGENDA No. Item Action Attachment Reporting 1. Welcome & Apologies Chair 2. Declaration of Interests Members are invited to declare any interest in relation to agenda items Board Members 3. Minutes IJB (17 September 2025) For Approval Attachment Chair 4. Minutes IJB PFA (21 May 2025) For Noting Attachment Chair 5. Membership & Meeting Changes Consider any changes to be made to Board or Committee membership or amendments to meeting arrangements 6. Matters Arising/ Rolling Action Log For Noting Attachment Chair Standing Items 7. Chief Officer Report For Noting Attachment Claire Rae 8. Chief Finance Officer Report - Medium Term Financial Outlook 2026-2029 For Noting Attachment Nicola Scott Strategic Planning & Development 9. The Lanarkshire Advocacy Plan For Approval Attachment x2 Morag Dendy 10. CAMHS Recovery & Renewal For Noting Attachment Maggs Thomson 11. Paediatric Modernisation For Noting Attachment Maggs Thomson 12. Care Academy For Noting Attachment Morag Dendy
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2 13. Coming Home Report For Noting Attachment Diane Fraser 14. Probable Suicide 2024 Report For Noting Attachment Diane Fraser 15. Drug Related Deaths and Alcohol Specific Deaths 2024 Report For Noting Attachment Morag Dendy 16. ADP Annual Reporting Survey For Approval Attachment x2 Morag Dendy Performance & Finance Governance & Policy 17. IJB Work Plan For Noting Attachment Kerry Taylor For Noting 18. Risk Consider from the business discussed any new emerging risks to be added to risk register or whether the discussion materially alters the accessed levels of risk/risk tolerance or mitigating controls Date of Next Meeting 18 March 2026 9.30am-12pm
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Page 1 of 6 ITEM: 3 Integration Joint Board Performance Minutes from the meeting held on Wednesday 17th September 2025, 09.30 – 12.00 via MS Teams PRESENT Voting Members: Cllr Claire Barclay NLC Nominated Councillor Cllr Beth Baudo NLC Nominated Councillor Cllr Bob Burgess NLC Nominated Councillor Cllr Anne McCrory NLC Nominated Councillor Brian Moore (Chair) NHS Lanarkshire Nominated Non-Executive Siobhan White NHS Lanarkshire Nominated Non-Executive Others In Attendance: John Boyd Audit Scotland Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Stephen Forrest Performance Manager Diane Fraser Head of Adult Social Care Joanne Jenkins Nurse Director NL HSCP / Nurse Representative Jocelyn Lyall Chief Internal Auditor Clare Louise McDonald Catherine McGinty Unison / Staff Side Representative (NHSL) Thomas Moan Senior Manager – Community Solutions VANL Ann Muir Chair of North Lanarkshire Disability Forum Lucy Munro Medical Director for Health & Social Care North Lanarkshire Des Murray Chief Executive - North Lanarkshire Council Josephine Pravinkumar Director of Public Health and Health Policy Claire Rae Chief Officer NL HSCP Harry Robertson North Lanarkshire Carers Together / Carer Representative Nicola Scott Chief Finance Officer Francis Scott Chief Officer (Audit and Risk) Tyra Smyth *Left 09.59 GP Sub Secretary Kerry Taylor Business Support Manager Maggs Thomson Head of Health David Wood Chief Executive Officer with VANL Dawn Wright (Minutes) Management Team Secretary Apologies: Nauman Dar NHS Lanarkshire Nominated Non-Executive Phillip Couser NHS Lanarkshire Nominated Non-Executive Louise Long Chief Executive John Watson Employee Representative NLC Peter McCrossan Director for AHPs
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Page 2 of 6 1. Welcome and Apologies The chair welcomed everyone to the meeting and apologies noted as above. Brian Moore 2. Declaration of Interests No declarations of interest were made. All 3. Minutes IJB (16th June 2025) Minutes approved as an accurate record. Brian Moore 4. Minutes IJB PFA (21st May 2025) Minutes noted. August IJB PFA minutes will be presented at the next IJB meeting. Brian Moore 5. Membership & Meeting Changes Two formal membership changes noted; Councillor Beth Baudo replaced Councillor Paul Kelly as NLC Nominated Councillor (July 2025). Dr Martin Downey replaced Dr Kenneth Dagg as NHS Lanarkshire professional advisor (March 2025). Kerry Taylor 6. Matters Arising/ Rolling Action List No issues raised regarding matters arising. Rolling Action 25 Chryston Hub Visit scheduled for 18 September. Wider IJB member invitations to follow. 27 Ongoing, may not need to be noted on the action log. 31 CAMHS Communication Strategy - Mark Dell confirmed the strategy will be circulated to GPs and Health Visitors, followed by wider staff and elected members. A toolkit will be provided to support constituent queries. 32 Pharmacy Savings - Regular updates will be included in the work plan and will come to the IJB PFA meetings. Claire Rae noted the need for due dates and clearer timelines, to pick up with Brian Moore offline. Brian Moore / Claire Rae Standing Items 7. Chief Officer Report Care Reform Act The Scottish Government approved the Care Reform (Scotland) Bill on 10 June 2025 and received Royal Assent on 22 July 2025. Standards Commission for Scotland After consultation, the Commission revised its Advice Note for IJB members, clarifying their responsibilities under ethical standards and aiding in conflict of interest management to ensure strong governance. Delayed Discharges North Lanarkshire HSCP has met the national target and is lower than the Claire Rae
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Page 3 of 6 Scottish average. July/August saw increases due to acute referrals, especially from Monklands. Freedom of Information (FOI) Requests During quarter 1 of 2025/2026, there were 3 information requests received and responded to within statutory deadlines. National Records Scotland Data As the publication dates are scheduled for September of this year, the reports will be submitted to the Integration Joint Board in December 2025. Drug-Related Deaths In 2025, Scotland recorded 1,017 drug misuse deaths—down 155 (13%) from 2023 and the lowest since 2017. Despite this decline, rates remain high compared to 1996. In North Lanarkshire, deaths dropped from 103 in 2024 to 85. Jane Davies Award 2025 Motherwell District Nursing Team were awarded runners up for Person Centred Care. Vaccination Service Review A review of Vaccination Service Delivery within Lanarkshire is underway. Updates will be provided to the Integration Joint Board at future meetings. Recruitment Two NHS Lanarkshire Director positions have recently been advertised for recruitment as two members of staff move to other NHS Boards. Arwell Williams has been appointed as Acute Services Director. An update will be provided once the position of the Executive Director of Finance have been appointed. Meeting, Event and Media Updates The Chief Officer Group met with the Minister for Social Care and Mental Wellbeing on July 25 to discuss the IJBs’ financial challenges and rising demand. NHS Lanarkshire’s Health Improvement Team in Wishaw held a family fun day, ‘Tea in the Garden,’ at University Hospital Wishaw in July 2025 to promote local community services. In August 2025, South and North Lanarkshire HSCPs and NHS Lanarkshire held a Winter Planning Event to review past winter learnings and identify follow-up actions. A joint Community Planning Partnership event on Population Health Framework is scheduled for October 2025, involving NHS Lanarkshire, South Lanarkshire Council, and North Lanarkshire Council. A July 2025 media article focused on Dementia services highlighted NHS Lanarkshire for recent changes in Hospital Based Complex Clinical Care. Frailty Assessment Unit Expansion from 12 to 25 beds approved for December launch.
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Page 4 of 6 8. Chief Finance Officer Report - Medium Term Financial Outlook 2026-2029 Projected budget gap: £63 million over three years. In-year gap for 2026–27, £24.8 million. Development sessions planned for October, November, and January. Pay award assumptions discussed, no immediate cash flow impact. Savings proposals to be developed and discussed at upcoming sessions. Updated financial outlook to be presented at the IJB in December. Recommendations i) IJB acknowledged Medium Term Financial Outlook (MTFO) position for 2026/27 to 2027/29. ii) IJB acknowledged the forecast funding gap over the 3-year cycle. iii) IJB recognise this outlook will be subject to ongoing review with an update reported in December before the Medium Term Financial Plan (MTFP) is presented to the Board for approval in March. iv) IJB acknowledge the forecast reserves position. Nicola Scott Strategic Planning & Development 9. IJB Annual Performance Report Reflects positive outcomes and alignment with IJB priorities. Published in draught form on 31 July, now approved for final publication. Suggestions made to create a condensed version for public engagement. Recommendations i) IJB reviewed the content of the draft Annual Performance Report 2024/25 – University Health & Social Care North Lanarkshire. ii) IJB approved for publication the content of the draft Annual Performance Report 2024/25 – University Health & Social Care North Lanarkshire. Morag Dendy 10. Strategic Commissioning Overview Plan Update Work underway for next plan (post-March 2026). Alignment with Local Outcome Improvement Plans (2027) and Health & Care Renewal Framework. Emphasis on joined-up public engagement and strategic needs assessment. Recommendations i) IJB approved the arrangements set out in the report for the development of a new Strategic Commissioning Plan. Morag Dendy 11. Supporting Resilience Focus on community resilience, unpaid carers, and early intervention. Community wealth building and digital inclusion highlighted. Discussion on aligning with population health framework and tackling inequalities. Recommendations i) IJB endorsed the ongoing work to support resilient communities. Morag Dendy
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Page 5 of 6 12. Quality Assurance Annual Report Comprehensive report covering complaints, care opinion, and inspection activity. Increase in complaints noted, variation by locality. Care Opinion underused in social care, promotion encouraged. Suggestion to improve joint reporting with NHS complaints. Recommendations i) IJB noted and endorse the contents of the report. Morag Dendy 13. Hospital @ Home Expansion to Clydesdale and CamGlen underway. Funding remains non-recurring and conditional on bed base targets. Paediatric model development funded and progressing. Risks include workforce recruitment and unpaid carer support. Members praised the service and noted national recognition. Recommendations i) IJB noted that in line with the Board’s Unscheduled Care strategy, that work is underway within the H@H service with the aim to expand the virtual bed capacity and equity of services with the roll out of provision to Cambuslang/Rutherglen locality. Maggs Thomson 14. Home Support Functional management split introduced to improve service delivery. Dynamic scheduling tool implemented, portal allows families to view schedules. Recruitment and retention challenges addressed via Care Academy and sessional roles. Absence management linked to ageing workforce and capability terminations. Recommendations i) IJB acknowledged the developments within Home Support Service and the progress being made to implement the approved operating model. Diane Fraser 15. Learning Disabilities Unit Nursing Workforce Recruitment of nurses and healthcare support workers underway. Earn-as-you-learn initiative launched. LD Health Checks programme initiated, population identification ongoing. Risk of non-compliance with national policy reduced due to permanent staffing. Further report on “Coming Home” to follow. Recommendations i) The IJB noted the contents of this report. Joanne Jenkins Performance & Finance 16. Internal Audit Annual Report 2025/25 Reasonable assurance provided on governance, risk management, and internal control. Strategic Commissioning Plan audit nearing completion. Jocelyn Lyall
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Page 6 of 6 Recommendations i) IJB endorse the opinion of the Chief Internal Auditors that Reasonable Assurance can be placed upon the adequacy and effectiveness of the IJB’s framework of governance, risk management and internal control for the year ended 31 March 2025. 17. Audit Scotland – Final Audit Report 2024/25 • Unmodified opinion issued. • Financial sustainability highlighted as key risk. Recommendations i) IJB acknowledged Audit Scotland AAR in advance of the approval of the IJB Annual Accounts 2024/25. ii) IJB approve the management response to the action points which is highlighted at pages 19 to 21 of the annual audit report, attached at appendix 2. John Boyd 18. Audited Annual Accounts & Financial Statement 2024/2025 • Approved with no material changes. • Healthy reserve position noted. Recommendations i) IJB acknowledge the External Auditor’s opinion. ii) IJB approve the North Lanarkshire IJB Annual Accounts 2024/25 for signature. iii) IJB acknowledge that the signed audited IJB Accounts will be available to view electronically on the HSCP website. Nicola Scott Governance & Policy 19. Self-Assessment Questionnaire Results 8 responses received, out of 19. Key themes noted were training, induction, work plan consistency and public engagement. Future development session suggested. Recommendations i) IJB noted the results of the self-assessment survey; and ii) IJB to discuss if any actions should arise from the results Kerry Taylor 20. IJB Work Plan A live work plan document has been introduced for both IJB and IJB PFA meetings. This will be updated regularly and used for forward planning. Kerry Taylor For Noting 21. Risk LD Health Checks and Hospital @ Home funding identified as key risks. Revised risk register to be presented at next PF&A. Date of next IJB meeting: 10th December 2025, 9.30am –12pm, Via MS Teams
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Page 1 of 12 ITEM: 4 Integration Joint Board Performance, Finance & Audit Committee Minutes from the meeting held on Wednesday 21st May 2025, 14.00 – 16.30 via MS Teams PRESENT Voting Members: Cllr Claire Barclay NLC Nominated Councillor Cllr Bob Burgess NLC Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non-Executive Cllr Paul Kelly NLC Nominated Councillor Cllr Anne McCrory NLC Nominated Councillor Brian Moore (Chair) NHS Lanarkshire Nominated Non-Executive Siobhan White NHS Lanarkshire Nominated Non-Executive Others In Attendance: Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Margaret Flavell Senior Manager Adult Social Work Diane Fraser Head of Adult Social Care Jocelyn Lyall Chief Internal Auditor Ann Muir Chair of North Lanarkshire Disability Forum Lucy Munro Medical Director for Health & Social Care North Lanarkshire Claire Rae Chief Office NL HSCP Harry Robertson North Lanarkshire Carers Together / Carer Representative Marie Rooney Associate Nurse Director – Mental Health Fiona Sanderson Lead Pharmacist - Primary Care Nicola Scott Chief Finance Officer Francis Scott Chief Officer (Audit and Risk) Kerry Taylor Business Support Manager John Watson Employee Representative NLC David Wood Chief Executive Officer with VANL Dawn Wright (Minutes) Management Team Secretary Apologies: Nauman Dar NHS Lanarkshire Nominated Non-Executive Alison Gordon Head of Children’s, Families & Justice Services Joanne Jenkins Nurse Director NL HSCP / Nurse Representative Catherine McGinty Unison / Staff Side Representative (NHSL) Thomas Moan Senior Manager – Community Solutions VANL Maggs Thomson Head of Health North HSCP Rose Walker Governance Support Manager
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Page 2 of 12 1. Welcome and Apologies The chair welcomed everyone to the meeting and apologies were noted as above. The committee was advised that the "Tackling Poverty Team Report" and the "Lanarkshire Winter Plan Report" were deferred to a future IJB meeting. Brian Moore 2. Declaration of Interests No conflicts of interest were declared. All 3. Minutes IJB PFA (25th February) Councillor Claire Barclay requested a minor amendment to the previous minutes (25.02.25) to specify her full name, replacing "Councillor Claire" with "Councillor Claire Barclay" in order to clearly differentiate her from Claire Rae. The minutes, with above noted minor changes, were approved. Brian Moore 4. Matters Arising/ Rolling Action List John Watson raised concerns regarding the withdrawal of the Tackling Poverty Paper and the temporary contracts of Unison members in that team. Concerns were voiced about the sustainability of funding, given the team's success in securing significant funds. Claire Rae clarified that the paper was pulled to explore a more sustainable approach to tackling poverty, not due to funding issues, and reassured that trade unions would be involved. Brian Moore added that discussions have previously emphasised the need for an exit strategy and the requirement for sustainable funding, also noting the involvement of other funding partners. Claire Rae confirmed that the annual safe staffing report, required by Scottish Government under new legislation, is underway across Health and Social Care and will be brought back to a future IJB meeting. Brian Moore inquired about a previous query from John regarding the resourcing or training for age assessments in the context of the asylum seeking report. Claire Rae confirmed no response had been provided yet and this issue will be followed up. An update was requested on communications surrounding the CAMHS service, with Mark Dell confirming a communications plan is underway, including a scoping exercise to avoid duplication and engagement with key players. Councillor Claire Barclay requested a timeline for the communication rollout, highlighting that while improvements have been made, councillors still receive inquiries. Mark Dell assured the committee that the communication would be out soon and would include guidance for elected members. Claire Rae agreed to add a timeline to the action log. Philip Couser questioned the inclusion of general "business as usual" items (28, 29, and 30) on the action log, as they lacked specific outputs or dates. He also suggested a review of the long list of closed actions, some dating back to 2018, proposing a retention policy, e.g., two years. It was agreed that the action log be revised to remove "business as usual" items (28, 29, 30) and old completed actions to be deleted. Brian Moore
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Page 3 of 12 Strategic Planning & Development 5. Lanarkshire Winter Plan Debrief Deferred to future IJB meeting Performance & Finance 6. Chryston Hub Update Claire Rae provided an update on the Chryston Community Health Clinic, noting that all physical health services have been repatriated from NHS Greater Glasgow and Clyde (GGC), including Community Diabetic Service, Dietetics, Physiotherapy, and Sexual Health. Mental health and substance misuse services were not repatriated due to clinical safety concerns as the SLA did not include medical staffing and concerns about fragmentation of the Community Mental Health Team and Substance Misuse Team. Discussions are ongoing with GGC about using the clinic as a satellite clinic, with a visit scheduled for tomorrow. There are no associated cost implications of the transfer of services at this stage. Claire Rae proposed holding a future IJB meeting at the Chryston Community Hub during the school holidays to utilize the larger area and allow members to see the facility. Siobhan White inquired about the need for further public consultation since the original plan included mental health services, which are now excluded. Claire Rae clarified that consultation would not be required due to clinical safety decisions, but communications will be issued to the population explaining the changes and reasons. Philip Couser inquired about feedback from service users regarding the impact of the changes. Claire Rae stated that specific feedback hasn't been sought yet but will be in the future, as well as general feedback on the community hub model. Councillor Anne McCrory asked about the timeline for instigating satellite clinics if GGC decides to proceed. Lucy Munro, explained it would depend on the discipline, with some potentially happening more quickly than others due to existing clinic schedules. Recommendations: 1. The IJB PFA Committee noted the progress and current position of the repatriation of the clinical services from NHS Greater Glasgow & Clyde (NHSGG&C) 2. The IJB PFA Committee noted the change in provision for Mental Health and Substance Misuse Services. 3. The IJB PFA Committee noted the change in the financial position and work to date to progress towards final conclusion. Claire Rae
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Page 4 of 12 7. Prescribing: Sustainability and Value Programme Progress Update The report provided benchmarking information regarding the number of prescriptions per head of population by Board. Information on the cost and volume of prescriptions in North Lanarkshire was also provided. The report also set out the financial pressures and savings proposals within Lanarkshire at present. Despite pressures, Lanarkshire achieved its highest savings in 2025, with 80-90% of primary care prescribing deemed appropriate but within safe margins. The report set out the objectives of the Sustainability and Value Programme and the planned actions with an emphasis on the importance of changing prescribing culture. Active efforts are underway to reduce Medicines of Low Therapeutic Value and tackle polypharmacy in older, multi-morbid patients through pharmacist-led reviews and locality- specific plans. Practices are also addressing unique prescribing patterns and working with acute partners to limit costly catheter use. The Prescribing Change Scheme is under consideration to incentivise safe and effective prescribing adjustments, amid concerns about potential negative incentives. The overall program projects £8 million savings for the year and is currently on track. Councillor Claire Barclay inquired about any backlash from doctor's surgeries or patients. Lucy Munro noted that, although there is some dissatisfaction and concern expressed by GPs and pharmacists, these reactions are minimal and are not hindering the progress of the programme. Representatives from the GP sub and LMC on the Partnerships Medicines Management Board are largely positive about the need for the programme, and Fiona's team strives to make the process as easy as possible. Fiona Sanderson added that patient feedback from polypharmacy reviews will be collected automatically, building on a pilot of 50 patients which showed overwhelmingly positive responses from patients who appreciated the opportunity to review and adjust their medications. Siobhan White asked for clarification on where polypharmacy reviews are conducted (hospitals, practices, or both) and whether "Pharmacy First" prescriptions fall outside the control of the programme. Lucy Munro explained that polypharmacy reviews are practice-based and are linking with fieldwork and district nurses to identify patients, particularly those who have been at the front door of care but turned around in terms of frailty. Fiona Sanderson clarified that while some reviews start in the hospital, better outcomes are often achieved in primary care, with referrals made to primary care teams. Regarding Pharmacy First, the program monitors for unintended consequences where stopping one medication might lead to another being prescribed. New reports will analyse prescribing within "Pharmacy First" and "Pharmacy First Plus" (where community pharmacists are independent prescribers) to track changes across systems. She emphasised that Pharmacy First always involves a consultation with patients. Brian Moore noted the significant difference in value between "medicines of low therapeutic value" (£2 million) and "non-medicines" (£22 million). He questioned the alternatives for sourcing or funding non-medicines if they are not prescribed in the future. Lucy Munro
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Page 5 of 12 He also noted the potential saving of £1 million if switch to generic Sitagliptin. He welcomed the development of dashboards for better data reliance and which will provide evidence of the polypharmacy work's benefits. Lucy Munro stated that nicotine patches constitute the largest portion of low-value medicines, and savings from this are part of a wider strategy to improve chronic pain management. The £22 million non-medicine savings target is based on disparities, such as two suitable catheters costing £2.20 and £22, with hospitals often receiving free, more expensive options from pharmaceutical companies, influencing continued prescription. Fiona Sanderson stated a "non-medicines effective prescribing" subgroup collaborates with nurses and pharmacy to improve efficiency and quality. She highlighted that switching the DPP4 class drug Sitagliptin to a generic—already done elsewhere—could save £1.4 million without affecting safety, with the pharmacy team overseeing the process and patient follow-up. Recommendations: 1. The IJB PFA Committee noted the savings for the financial year 24/25 2. The IJB PFA Committee noted the project workstream activities planned for 25/26 8. Supporting Unpaid Carers & North Lanarkshire Carers Strategy Update Morag Dendy spoke to the submitted report. The report focused on the North Lanarkshire Carers Strategy, emphasising the importance of identifying unpaid carers early, providing timely support, and aligning with national policy drivers. The implementation of the Carers (Scotland) Act 2016 and the challenges in identifying and supporting hidden carers were discussed. The role of various partners, including the North Lanarkshire Carers Together Steering Group and the Carers Network, was highlighted. The importance of data collection to measure the impact of interventions for carers was emphasised. Concerns were raised about the decreasing number of carers assessments and the need to understand the reasons behind this trend. The committee requested information on supports available for carers during periods of crisis. Discussions included the difficulties in reaching "hidden carers" and the reliance on general practitioners for identification, with a need for broader outreach. The need for a robust communication strategy to identify and support carers was highlighted. Recommendations: 1. IJB PFA Committee endorse the approach to supporting Carers in North Lanarkshire. 2. IJB PFA Committee noted the range of supports to unpaid carers available locally. Morag Dendy
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Page 6 of 12 9. Financial Monitoring Nicola Scott presented the 2024-2025 financial report, showing a £10.716 million underspend, which became £10.1 million after accounting for ring-fenced funds of £614,000. Part of this underspend was due to reserve drawdowns that were later replenished. Employee costs had a £19 million underspend, mainly from a £6 million non-recurring saving on the Strathclyde pension fund, offset by a prescribing overspend. Closing reserves were reported at £64 million after drawdowns, before this year underspend allocation. The reserves report addresses prior IJB and PFA comments on long-held reserves. The savings strategy aimed for £29 million over two years, with £15.4 million achieved before the plan was reviewed rolling unachieved savings into the 2025-2026 Medium Term Financial Plan. The report also covered vacancies and digital projects. Councillor Bob Burgess inquired about Scottish Government allocations for diabetes technology and mental health funding. Lucy Munro explained diabetes technology relates to transformative closed-loop systems for type one diabetics, funded partly by the Scottish Government. Claire Rae added that mental health allocations are tied to Scottish Government service targets, with demand rising significantly. Siobhan White asked about 2025-2026 allocations and the lack of an inflationary rise in the 2024-2025 prescribing budget. Claire Rae confirmed ongoing allocations and mentioned that the Chief Officer Group raises concerns over the prescribing budget with policymakers. Nicola noted that the 2025-2026 Medium Term Financial Plan includes an inflationary increase for prescribing and outlined recurring costs for digital alarms that need future budget considerations. Brian Moore highlighted Appendix 6 on the savings program, calling for a development session to address a £20 million deficit. He queried the planned use of unscheduled care and CAMHS reserves. Nicola Scott clarified that the £14.7 million savings gap is not new unmet need but carries previous savings targets into the new plan, with reserves being ring-fenced funds meant for specific purposes. Claire Rae added that work on using the neurodevelopment service reserve will be proposed at the next IJB meeting, emphasizing that future discussions will focus on savings and risks related to social care budgets. Brian Moore briefly inquired about a £1.5 million allocation for mental health services, to which Nicola responded that it aims to support anticipated funding reductions from the Scottish Government using some of the underspend. Recommendations: 1. IJB PFA Committee acknowledged the year-end financial position of a £10.716m underspend. 2. IJB PFA Committee referred to the IJB Reserves Strategy report to approve the allocation of this underspend. Nicola Scott
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Page 7 of 12 10. IJB Reserves Strategy Nicola Scott presented the 2025-2026 reserves strategy, seeking approval for realignments in Appendix 1 and a contingency reserve percentage change. She corrected report date errors: Table 1 should start with 2024, Table 3 with 2025. Reserves began at £75.524m, now £64.8m after drawdowns, with a full review by Council and NHS finance teams. Proposed realignments: • Remove £2.2m surplus reserves • Allocate £128k to summer placements from social care demand risk • Increase risk and contingency reserves by £10.8m • Establish five new reserves totalling £2.183m Post-approval, opening reserves would be £75.553m, a minimal £30k net change indicating reserves are actively used but continue to grow. She also proposed reducing the contingency reserve target from 5% to 4% due to current financial constraints and ongoing reviews. Brian Moore queried Mental Health Officer funding; Diane Fraser explained it is Scottish Government support for training, with some underspends held in anticipation of future requests. Regarding summer placements, Nicola Scott detailed an annual program for S4–S6 students, with increased demand in social care. Morag Dendy highlighted the program’s success, offering paid placements that enhance young people's skills and employment prospects, with some choosing to stay in paid roles. The program now includes apprenticeships, with positive feedback from participants and staff. Councillor Anne McCrory asked about participation numbers, retention, and full-time stays; Morag Dendy confirmed some students have opted to stay employed rather than return to school, and interest continues to grow. She emphasised that placements develop practical skills and employability through community and virtual experiences, with partnerships across sectors supporting expanded opportunities. Councillor Claire Barclay inquired about Care Academy retention and understanding; Morag Dendy explained the program’s four work streams focusing on recruitment, pathways for youth and adults, and broader employment initiatives, aiming for more ambitious targets. Recommendations: 1. IJB PFA Committee acknowledged the contents of the report. 2. IJB PFA Committee approved the proposed realignments & new reserves detailed in Appendix 1. 3. IJB PFA Committee approved the change to the percentage of risk based & contingency reserves to be held as detailed in section 8. Nicola Scott
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Page 8 of 12 11. Q3 Performance Report Morag Dendy presented the Q3 Performance Report, noting monitoring of key areas within the health and social care partnership. Scrutiny panels support underperforming services. Highlights: Alcohol Brief Interventions: Underreporting persists due to technical issues; a future report will cover the North Lanarkshire alcohol summit. Cervical Screening: Targeted outreach aims to boost participation. Immunisations & 6-8 Week Reviews: Supported by a working group, with ongoing monitoring. Rehab/Re-ablement: Emphasis on early assessments and revised targets; progress made despite unmet goals. Discharge Performance: 50-60 delayed discharges remain, showing improvement. Mental Health: Recruitment challenges affect performance; innovative management approaches are being applied. SLT & Dietetics: Learning from CAMHS to improve waiting list management. Complaints: Staff capacity issues impact response times; 69% positive feedback. Care Home Length of Stay: New models and initiatives are expected to gradually influence figures and costs. Smoking Cessation: Increasing social media engagement for referrals. Sickness Absence: Continues to be a key focus for the partnership. Siobhan White raised a procedural point about ensuring actions and recommendations from other committees (like population health, e.g., childhood immunisations, cervical screening) are captured in the same place as the Q3 report, to avoid governance overlap. Morag Dendy confirmed that they do join up information from different forums and scrutiny panels. Councillor Bob Burgess requested figures on long-term sickness within the system for the next meeting. Claire Rae agreed to break down absence figures in a deeper dive. Brian Moore noted that home assessment teams dropped considerably in January and the readmission rate remained at 14%, with work underway to understand this better. Paediatric SLT (Speech and Language Therapy) was highlighted as a continuing main concern due to poor performance. Claire Rae mentioned Forth Valley's integrated approach with education as a learning opportunity, and they are looking to implement similar strategies. Brian Moore suggested that given significant reserves, investment in this service might be considered, as there is no sense of progress and reputational issues remain a high concern. Claire Rae agreed to bring back proposals if reserves are to be used for this. A deeper dive into this area was also suggested. Recommendations: 1. IJB PFA Committee noted the contents of the report and the appendix. Morag Dendy
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Page 9 of 12 12. Cat 1 Responders Update Margaret Flavell provided an update, highlighting its duties, responsibilities, and readiness under the Civil Contingencies Act 2021. The business continuity plan was reviewed late last year and will be reviewed again mid- year, with plans for a desktop scenario. The report aims to offer reassurance regarding their ability to put an appropriate response in place, with a focus on caring for people and ensuring a "people first" approach. Phillip Couser asked about the challenges of maintaining or sustaining capability in this area, referring to Section 7.18 of the report. Margaret Flavell responded that challenges were identified during a review of the business continuity plan and across health and social care localities, where there was a general understanding but a need to break it down into detailed responses. They are gathering information and looking at training support, noting a loss of involved people due to changes and departures. The main challenge is the lack of readily available information and knowledge. Brian Moore questioned the confidence in business continuity plans for commissioned services like care homes. Margaret Flavell confirmed strong links with commissioned services and providers, ensuring immediate contact if their business continuity plans are required. They work across the partnership to support them and will ensure these links are updated when their own business continuity plan is updated. Brian Moore inquired about the reflection of integrated arrangements within the report, specifically how the HSCP's is referenced in the North Lanarkshire Council Corporate Resilience Plan but no explicit link to the Health Board equivalent, Margaret Flavell acknowledged that it probably reads that way and committed to refreshing it with Kerry to ensure a full "whole system approach" across the partnership. Recommendations: 1. IJB PFA Committee noted the contents of the report 2. IJB PFA Committee understood the duties of a Category 1 responder 3. IJB PFA Committee are aware of the roles and responsibilities of a Category 1 responder 4. IJB PFA Committee have a knowledge of activities undertaken 5. IJB PFA Committee acknowledge the challenges and supports actions to address Margaret Flavell
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Page 10 of 12 13. Internal audit 2025/26 work plan Jocelyn Lyall presented the draft internal audit plan for 2025/2026, which aims to assess the adequacy and effectiveness of the IJB’S framework of Governance, risk management, and control for the year. The plan will be jointly delivered by North Lanarkshire Council and NHSL internal audit teams. The plan is designed to support the achievement of objectives and target priority issues, informed by a review of the risk register and consultation with the Chief Officer and Chief Finance Officer to ensure maximum value from audit assignments. Regular meetings are held every four to five weeks to discuss planning and progress. Jocelyn Lyall noted that Section 6 of the cover paper provides background on the planning process and sets out the requirements of the new global internal audit standards in relation to planning, which will be discussed further at the next agenda item. The proposed plan for 2025/2026 was set in Appendix 1. A total of 60 days are available for the audit, and the IJB will also benefit from assurances provided through partner organisation audits, which will be reported in each progress report. Of the 60 days, 27 are allocated to standard deliverables, including planning, audit management, general governance advice, production of the annual internal audit report, and the audit follow-up system. This leaves time for two full audits, which are proposed to be on financial sustainability and performance, and committee effectiveness. No questions were raised from the IJB PFA board members. Recommendations: 1. IJB PFA Committee approved the proposed Internal Audit Plan for 25/26 (Appendix 1) 2. IJB PFA Committee approved the recommendation by the Chief Financial Officer that the joint working arrangements between the North Lanarkshire Council (NLC) and NHS Lanarkshire (NHSL) Internal Audit teams continue in order to deliver the IJB Internal Audit Service. 3. IJB PFA Committee approved the delegation of authority to the Chief Finance Officer to agree with the Chief Officer (Audit and Risk) (NLC) and the Chief Internal Auditor (NHSL) the scope of the audit assignments in the Internal Audit Plan for 25/26 including the allocation of responsibilities for completion of assignments. Jocelyn Lyall
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Page 11 of 12 13.1 Internal audit progress report 2024/25 Jocelyn Lyall summarised the January 2024 global internal audit standards, effective from April 2024 in the public sector. Supplemented by UK-specific notes from CIPFA and the Scottish Government, these standards replace previous internal audit rules. They comprise 15 principles across five domains, with standards detailing requirements, implementation, and conformance evidence. While current practices largely align, departments will formalize evidence of compliance in 2025/26. Key changes include a mandated internal audit Charter, aligned audit strategy, enhanced ethics emphasising professional scepticism, and clarify roles for management and audit committees—who are also expected to champion the internal audit function. The 160-page document guides compliance, with revised policies forthcoming. Brian Moore welcomed the new standards, highlighting their role in clarifying the Audit and Risk Committee's purpose. He emphasised using the upcoming mandate to reaffirm this purpose. He supported the August audits and noted progress on completed Health Board audits. Additionally, he mentioned a minor issue from a recent NHSL ICE report regarding an outdated Integration Scheme on the HSCP website, which has now been resolved. Siobhan White inquired if the new mandate aligns with the Audit Committee's terms of reference. Jocelyn Lyall clarified that while terms of reference remain necessary, the mandate specifies legal authority per legislation, codes of practice, and the Scottish Public Finance Manual, and will complement internal arrangements. Siobhan White asked if Jocelyn would assist the committee in meeting new standards, including promoting internal audit. Jocelyn confirmed she would, emphasizing the relevance of the terms of reference and work plan, including private meetings. Jocelyn also announced a gap analysis-based improvement plan, to be reported to the NHS Lanarkshire Audit and Risk Committee, with updates provided at each meeting to ensure compliance. Francis Scott noted they are conducting a gap analysis. Full compliance is not required April 1st, but work is ongoing to embed the new standards. The new standards are more demanding and require greater demonstration. Originally designed by the IIA for private firms, they have been adapted for the public sector with extra documentation, necessitating time to adjust. Siobhan White requested that the internal audit plan include last audit dates to illustrate the audit history. Recommendations: 1. IJB PFA Committee reviewed the Progress Report and the summary of relevant partner reports. 2. IJB PFA Committee considered the changes arising from the new Global Internal Audit Standards (GIAS) and the implications for the Internal Audit Service and the Performance, Finance and Audit Committee. Jocelyn Lyall
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Page 12 of 12 Governance & Policy 14. Risk Report Morag Dendy presented the Risk Report, noting that there were no significant changes since the last review. The primary change highlighted was the National Care Service risk, which has been reduced, reflecting its recording within each organization. Morag also mentioned that the strategic leadership team is exploring the approach to risk within NLC and NHSL. This will be further explored and refreshed during IJB development sessions likely in September, aiming to ensure the risk approach aligns with expectations. Phillip Couser questioned the medium risk rating for workforce, citing recruitment challenges and budget impact. He proposed separating immediate financial issues from longer-term risks in the register, akin to NHS Lanarkshire, to prevent persistent "red" ratings. He also emphasised defining risk appetite and establishing clear actions and timelines. Claire Rae concurred, noting she and Nicola Scott were reviewing risk articulation. She questioned the current risk level, considering turnover, and stressed the importance of understanding tolerable risk by September. She agreed the risk report needs restructuring for better clarity, discussion, and actionable insights. Recommendations: 1. IJB PFA Committee noted the contents of the presentation which includes a review of the highest rated risks within the IJB risk register and a note of those operational risks highlighted by the Heath & Social Care North Lanarkshire partnership that impact upon delivery of IJB business. 2. IJB PFA Committee noted that an IJB Liaison session will be focused on risk to take account of and strengthen the consideration of risk through the IJB taking account of the revised approaches to risk within NHS Lanarkshire and NLC; and the refreshed governance arrangements within the UHSCP. Morag Dendy For Noting 15. Risk Brian Moore noted the paediatric SLT risk and advised that it is important that the board review this in detail and consider including it in the risk register for further monitoring. 16. Date of next meeting: 27th August 2025, 14:00-16:30, Via MS Teams Claire Rae noted that Kerry Taylor is working on refining the agenda for future IJB PFA meetings to focus more on PFA, with the possibility of moving some reports to the main IJB meeting.
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1 ITEM 4 North Lanarkshire Integration Joint Board ROLLING ACTION LOG NO DATE ITEM NO DESCRIPTION ACTION BY ACTION & PROGRESS DUE DATE COMPLETION STATUS 34. 35. 36. 37. 38. 39. 40.
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2 CLOSED ACTIONS NO DATE ITEM NO DESCRIPTION ACTION BY ACTION & PROGRESS DUE DATE COMPLETION STATUS 5. 19.06.24 Item 6 Digital System Transformation M Dendy Delegate to the IJB PFA committee -To provide the IJB PFA with additional financial information relating to the programme Report provided to IJB PFA 21st August 2024 Complete 6. 19.06.24 Item 7 Mental Health & Wellbeing Delivery Plan R McGuffie Shared new action plan with the group in Sept/October Action Planned shared and stakeholder sign off currently underway. Complete 28 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Work collaboratively with other IJBs and partners to systematically share learning to identify and develop: - Service redesign focused on early intervention and prevention. - Approaches focused on improving the recruitment and retention of the workforce. “business as usual" item 29 25.09.24 Item 9 Integration Joint Boards Finance C Rae Work collaboratively with other IJBs and partners to understand what data is available and how it can be developed and used to fully “business as usual" item
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3 and Performance Report 2024 understand and improve outcomes for those using IJB commissioned services. This should include a consideration of gaps in data. It should also include consideration of measures to understand the impact of preventative approaches. 30. 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Evaluate whether the local commissioning of care and support services, and the contracting of these services, adheres to the ethical commissioning and procurement principles, improving outcomes for people. “business as usual" item 26 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Ensure that their Medium-Term Financial Plans are up to date and reflect all current known and foreseeable costs to reflect short and longer-term financial sustainability challenges. 25.02.25 – Due to be discussed at the next IJB in March 19.03.2025 Discussed on agenda 19.03.25 Complete 31. 25.02.25 Item 6 Q2 Performance Report Improved communication about progress and ensure a shared understanding of what CAMHs services can offer. 21.05.25 - Mark Dell confirmed a communications plan is underway, including a scoping exercise to avoid duplication and engagement with key players. Mark Dell Complete
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4 assured the communication would be out soon and would include guidance for elected members. 04.06.2025 – Timeline agreed between MD & CR for end of June 2025. 16.09.2025 - Mark Dell confirmed the strategy circulated to GPs and Health Visitors, followed by wider staff and elected members. A toolkit is going to be provided to support constituent queries. 33. 19.03.20 25 Item 4 Matters Arising Learning Disability Workforce paper to be brought to PF&A Complete 25. Future Meeting C Rae Host a future meeting face to face in Chryston hub 19.03.2025 – March date was cancelled new date to be re-arranged 16.09.2025 - Visit scheduled for 18th September. Complete Chair and Vice- Chair visited Chryston Hub in September 2025 with future invites to SMT walk rounds. 27 25.09.24 Item 9 Integration Joint Boards Finance and Performance Report 2024 C Rae Ensure that the annual budgets and proposed savings are achievable and sustainable. The budget process should involve collaboration and clear conversations with IJB partners, Complete – Moved to Governance
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5 workforce, people who use services and other stakeholders around the difficult choices required to achieve financial sustainability. monitoring log for IJB PFA 32. 25.02.25 Item 8 Financial Monitoring Suggestion that Pharmacy Savings Approach could be brought back to IJB to get a restock of where things are and where they are going. 16.09.2025 - Regular update will be included in the work plan. Completed – added to IJB work plan
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1 REPORT Item No: 7 SUBJECT: Chief Officer Report TO: Integration Joint Board Lead Officer for Report: Claire Rae, Chief Officer Author(s) of Report Kerry Taylor, Business Support Manager DATE: 10 December 2025 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Kerry Taylor, Business Support Manager ☒ Reviewed By: HSCP SMT 24 November 2025 ☒ Endorsed By: ☐
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2 3. RECOMMENDATIONS 3.1 It is recommended that the IJB Note and comment on the key areas of work and service developments that have been taking place within North Lanarkshire in relation to the work of the Integration Joint Board 4. CHIEF OFFICER REPORT 4.1 Winter Planning Update Plans continue to advance for Winter planning, supported by additional funding secured from the Scottish Government. Our key priorities include: Maintaining patient flow across Acute sites by ensuring sufficient capacity over a 7-day period Supporting individuals to remain at home wherever possible and, where admission is necessary, facilitating timely discharge Strengthening community capacity, with a particular focus on our Home Assessment Teams to enable rapid response and continuity of care 4.2 Delayed Discharge Since July, we have observed an increase in delayed discharges across both Lanarkshire and Greater Glasgow & Clyde (GGC). In response, targeted improvement actions have been implemented in collaboration with operational teams to address performance challenges. The most recent validated data, for the week commencing 10 November, reports North HSCP at 35.5 delays per 100,000 population. This remains below the Scottish average and is consistent with the performance target set by the First Minister of 36.4 per 100,000 population. 4.3 Staff Recognition Awards We are proud to acknowledge the outstanding contributions of our staff who have been shortlisted for national awards: Lauren Kerr, Community Mental Health Charge Nurse for Older Adults, has been recognised for her exceptional outreach work at local foodbanks, which has contributed to a 15% reduction in mental health referrals. Lauren has also championed early intervention initiatives
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3 within schools and CAMHS, demonstrating leadership and innovation in community mental health care The CAMHS Pharmacy Team has been shortlisted as finalists for the Mental Health Leadership Award at the upcoming Scottish Healthcare Awards. This recognition reflects their pivotal role in implementing pharmacy services within CAMHS and the Neurodevelopmental Service (NDS), enhancing medication management and improving patient outcomes These achievements highlight the dedication and innovation of our teams in delivering high-quality, person-centred care across Lanarkshire. 4.4 Freedom of Information Requests The Board is required to submit quarterly statistics on requests for information to the Office of the Scottish Information Commissioner (OSIC). Freedom of Information (Scotland) Act 2002 is an Act of the Scottish Parliament which gives everyone the right to ask for any information held by a Scottish public authority. During quarter 2 of 2025/2026, there was 1 information requests received. 4.5 Breastfeeding Improvement Performance North Lanarkshire has exceeded its breastfeeding improvement targets for 2024/25, achieving an initiation rate of 53.3%, representing an increase of 2.6 percentage points from last year and 9.6 points since 2016/17. This progress reflects the effectiveness of our whole-systems approach, incorporating UNICEF Baby Friendly Standards and Breastfeeding Friendly Scotland initiatives. Notably, attrition rates have halved since 2016/17, and local data indicates sustained improvement into 2025/26. These achievements, delivered despite complex social determinants, demonstrate the commitment and collaborative effort of staff and partners across North Lanarkshire. 4.6 NHS Scotland – National Planning NHS Scotland has announced a transition to a sub-national planning model, introducing two regional structures—Scotland East and Scotland West. This shift moves from organisation-level planning to a population-based approach, designed to strengthen service sustainability, workforce planning, and consistency of care.
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4 The regional model aims to foster greater collaboration across Health Boards and aligns with the Health and Social Care Service Renewal Framework and the Population Health Framework. This approach is expected to support more integrated planning, reduce duplication, and enhance resilience across the system. 4.7 Voting Rights The Scottish Government has launched a consultation on voting rights within Integration Joint Boards (IJBs) to address concerns about the limited influence of non-voting members, such as unpaid carers, third sector representatives, and individuals with lived experience. 4.8 Winter Planning Correspondence The Scottish Government’s latest winter planning correspondence “Surge and Winter Preparedness: National Planning Priorities and Principles” was issued on 13 November 2025 emphasising a year-round approach to surge preparedness across health and social care. Key priorities include protecting those most at risk, strengthening urgent and unscheduled care pathways, maximizing system capacity to reduce delays, and supporting workforce wellbeing. The correspondence highlights integrated, place-based planning, enhanced vaccination and prevention measures, and the use of real-time data to improve patient flow. These principles aim to ensure safe, timely and person- centred care throughout the winter period while maintaining resilience in planned services. 4.9 Strategic Planning Group A meeting of the Strategic Planning Group was held on the 26 November in Forgewood Community Centre in Motherwell, attended by over 60 key stakeholders. The discussion focused on the development of the Strategic Commissioning Plan 2026 and beyond. There was time to reflect on current strengths, priority areas and feedback from “what matters to you” engagement, aligning to the refresh of the Locality Outcome Improvement Plans. The write up of group discussions will be reflected in the drafting of the Strategic Commissioning Plan. 4.10 Public Sector Climate Change Report The Climate Change (Duties of Public Bodies: Reporting Requirements) (Scotland) Order 2015, came into force in November 2015, requiring all public bodies classed as ‘major players’ to submit a climate change report to the
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5 Scottish Government using a standardised template by 30 November each year. A report was submitted to Sustainable Scotland Network (SSN) on behalf of North Lanarkshire Integration Joint Board by the required deadline. 4.11 North Lanarkshire Health and Social Care Partnership Staff Roadshow On Wednesday 5 November 2025, North Lanarkshire Health and Social Care Partnership hosted a Staff Roadshow with the focus of staff health and wellbeing and staff belonging. The roadshow was attended by a range of staff throughout the partnership who heard presentations from Su Ross, Consultant Clinical Psychologist who spoke about what helps promote and what can rupture team belonging, introducing some models around the window of tolerance, the drama triangle and radical candour. Massimo Tarsia, Rebecca Dalgetty and Amy McGregor from the Bellshill Psychological Therapies Team then presented their approach to wellbeing and belonging within their team. The next staff roadshow is planned for May 2026. 4.12 Meeting, Event and Media Updates Chief Executive Visit planned for Speech and Language Therapy on 21/11. Visit on 19/11 with Acute and South Lanarkshire HSCP colleagues to Edinburgh Royal Infirmary to hear about their USC improvements Joint Community Planning Partnership Event took place in October with SLC/NLC/NHSL/PHS/North HSCP/South HSCP to launch the Population Health Framework – discussions ongoing on the commitment CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact Kerry Taylor kerry.taylor@lanarkshire.scot.nhs.uk
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REPORT Item No: 8 SUBJECT: Medium Term Financial Outlook 2026-2029 TO: Integration Joint Board Lead Officer for Report: Chief Officer Author(s) of Report Chief Finance Officer DATE: 10 December 2025 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) For approval For endorsement For noting 1.2 This report advises the IJB of the medium term financial forecast position for 2026- 2029. 2. ROUTE TO THE INTEGRATION JOINT BOARD 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Note the Medium Term Financial Outlook (MTFO) position for 2026/27 to 2028/29. (2) Note the forecast funding gap over the three-year cycle. (3) Recognise the uncertainty in council funding arising from ongoing reviews of Grant Aided Expenditure. (4) Recognise this outlook will be subject to ongoing review prior to the Medium Term Financial Plan (MTFP) being presented to the Board for approval in March. (5) Note the work underway to identify options for addressing the budget gap. (6) Note the forecast reserves position. 4. VARIATIONS TO DIRECTIONS Yes No N/A
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5. BACKGROUND 5.1 In September, the IJB received a report presenting the initial iteration of the MTFO for 2026/27 to 2028/29. The report highlighted the financial challenges facing the University Health & Social Care Partnership (the Partnership) over the next three years. 5.2 That outlook indicated an envisaged 3 year budget gap of £63.388m (2026/27 £26.241m, 2027/28 £17.727m and 2028/29 £19.420m). Taking that position as the new baseline, this paper provides an updated outlook, reflecting a refresh of the underlying assumptions and incorporating the latest intelligence on cost pressures, funding projections, and service demand. The purpose of this update is to ensure that the Board has a clear and current understanding of the financial outlook, enabling informed decision-making and strategic planning in the context of ongoing fiscal constraints. 6. FINANCIAL CONTEXT 6.1 Health and Social Care Partnerships operate within a highly complex and dynamic environment, where national policy decisions and systemic pressures directly influence service delivery models and the financial resources available to sustain them. 6.2 Analysis of recent census data and sector-wide trends confirms that demand for health and social care services continues to exceed the funding allocated. This imbalance creates significant operational and financial risk for the Partnership, compounded by the increasing difficulty of implementing service redesign options that do not adversely impact service users. Despite these challenges, it remains imperative that the Partnership maintains a service model that is both effective and financially sustainable over the long term. 6.3 The Partnership’s financial planning framework is subject to ongoing review and refinement through a scenario-based approach. This methodology reflects the considerable uncertainty surrounding future cost trajectories and the variability of potential funding settlements, ensuring that strategic decisions are informed by robust risk assessment and contingency planning. 7. FORECAST ASSUMPTIONS 7.1 This MTFO focuses on the likely cost pressures that the Partnership can reasonably expect over the next three years. These assumptions have been informed by the local and national context within which the Partnership operates, Appendix 1 sets out the assumptions underpinning the financial outlook presented to members in September. This section highlights the key pressures that have evolved since that time. Contractual Pressures 7.1.1 The National Care Home Rate will not be known until Spring 2026. An annual 10% increase was included in the September outlook and there is currently no evidence to suggest that this should be reduced therefore the pressure remains at £4.893m. 7.1.2 Contract inflation for Care at Home services reflects increases in the Scottish Living Wage, which has recently been set at £13.45. However, the actual cost to the Partnership will also depend on Scottish Government weightings that are not yet confirmed. As a result, the financial forecast assumes an average of the anticipated weighted increase for 2025/26. This results in a provision of £7.014m which is £0.417m higher than the September outlook.
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7.1.3 A provision of £2.545m has been included in the 2026/27 outlook for inflationary pressures across the Partnership. This is based on the OBR’s Economic and Fiscal Outlook as at March 2025 (the most recent available forecast). Demand Pressures – Social Care 7.1.4 Demand on social care services continues to increase which has been well reported through the 2022 census information. A provision of £34.821m has been included over the next 3 years which is based on an average 5% increase. The projected value for 2026/27 is £12.825m, representing an increase of £11.633m compared to the September outlook. This substantial change is primarily due to limited progress on the £10.686m savings target, with only £1.168m achieved to date. For forecasting purposes, the outlook assumes no further savings will be delivered in this area. Pay Pressures 7.1.5 Employee costs represent 34% of the IJB net budgets therefore any increase in pay awards have a material impact on the forecast plan. 2026/27 Pay Award The pay award for NHS staff has been agreed at 3.75% however 0.75% of this will be funded by Scottish Government therefore the cost is £3.109m. Council staff have agreed a pay award of 3.5% which will be fully absorbed by the Partnership at a cost of £3.420m. Pay Award – future years Negotiations have yet to take place for 2027/28 and 2028/29 therefore 3% has been assumed reflecting the Public Sector Pay agenda at a cost of £12.339m. Prescribing 7.1.6 The MTFP included a 10% increase for 2026/27 and 2027/28; based on current projections this remains unchanged for this financial outlook. The provision for 2026/27 is £8.534m with the total 3 year provision being £28.249m Reinstatement of Non Recurring Solutions 7.17 The September outlook highlighted that several non-recurring measures were used to address budget gaps in 2024/25 and 2025/26. As no recurring solutions have yet been identified to replace these, a cost pressure of £16.547m has been included to reinstate these budgets Funding 7.1.8 Funding contributions from both Partners are significantly influenced by the Scottish Government Finance Settlement which will remain unknown until January. The MTFP currently includes a 3% increase on Health Services and 5.6% for Council Services. These forecasts would generate recurring income of £20.640m in 2026/27 and £64.482m over the 3 years. 8. GRANT AIDED EXPENDITURE 8.1 Grant Aided Expenditure (GAE) is part of the General Revenue Funding (GRF) that local authorities receive annually from the Scottish Government. It is a needs-based methodology used to allocate total revenue funding equitably among local authorities based on relative need.
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8.2 The three main GAE lines in relation to social care for the elderly are: Residential Care for the Elderly, Services for Home-based Elderly, and Personal and Nursing Care for the Elderly Historically, social care for older people in Scotland was means-tested, in 2002, the policy changed to provide free personal and nursing care to all elderly individuals, regardless of income. 8.3 The distribution methodology for these budget lines includes indicators calculated based on data collected through the census. The COSLA Settlement and Distribution Group (SDG) periodically review existing distributions to ensure they remain fit for purpose and have identified that the current distribution methods rely on out-of-date data (including some from 2001). SDG have found that many are either incorrect or not using needs-based indicators therefore are not reflecting the expected number of clients in each authority. Therefore, SDG have since agreed that these GAE lines need to be updated to best reflect the latest client numbers. In addition, the modelling of the client numbers, the variable weightings, and the quality of the weightings also need to be updated to ensure that sufficient weight is given to the correct older-age client numbers that drive the most need. 8.4 There is currently no indication as to which authorities are likely to be positively or negatively affected and there is also no indication of the amounts. To manage the financial impact of these changes, the SCDG recommends using the “Floor” mechanism to ensure the impact is smoothed. The Floor is designed to reduce the immediate financial impact of funding distribution changes on individual councils and ensures no council receives less than a set minimum change compared to the national average. The mechanism is self-funding with Councils above the Floor contributing proportionally to those below it. The SDG however have recently advised that prior to application of the floor, the combined impact of all changes gave a largest percentage increase of 22% and a largest percentage decrease of 20%, with these reducing to a 2.6% increase and 0.75% decrease following application of the floor (assuming no other changes within the settlement). 8.5 If agreed, these changes will take place from 2026/27 onwards and importantly would not have any retrospective impact. Council Leaders have included a specific recommendation that the Local Government Settlement cannot require any specific amount relating to past years funding be passed to IJBs. As members know, recent Council practice has been to pass on all changes in Adult Social Care funding lines to the IJB. Given the potential for significant changes, when the settlement figures are released in January, an assessment will be made by the Council on whether it would be appropriate to calculate the impact on their Floor contribution with the view to including this within the overall adjustment passed to the IJB. 8.6 Members should therefore note that this financial outlook does not include any forecast adjustments in relation the settlement methodology changes, further updates will be provided in the coming months 9. MEDIUM TERM FINANCIAL OUTLOOK SUMMARY 9.1 Using the financial planning assumptions detailed in section 7, a range of risk-based scenarios have been considered, resulting in optimistic, envisaged and pessimistic positions. 9.2 Table 1 provides a summary of these scenarios over the forthcoming 3 years.
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Table 1 9.3 It is recommended that the IJB progresses with a financial strategy based on the envisaged scenario. This scenario projects an estimated budget gap of £80.905m over the 3-year planning period 2026/27 to 2028/29 of which £38.177m relates to 2026/27. 9.4 It is a statutory requirement for the IJB to set a balanced budget. Board Members will meet in March 2026 to agree the Medium-Term Financial Plan to fulfil this obligation. To achieve this, a range of options will need to be considered: 9.4.1 Savings Proposals The Senior Management Team are currently working with budget managers across the Partnership to develop savings proposals equivalent to 10% and 20% of existing budgets as part of the strategy to address the projected budget gap. Each proposal will include a comprehensive assessment of associated risks, operational impacts, and implications for workforce planning. They will undergo a risk assessment using a traffic light system and will be presented to Board Members for discussion during a development session scheduled for December. Further refinement will take place during a subsequent development session in January to ensure alignment with organisational priorities and risk appetite. Final recommendations will be submitted to the Board for approval in March, supporting a balanced and sustainable financial position. 9.4.2 Non-Recurring Underspends In 2025/26, the Partnership is forecasting £6m in underspends which are being used to offset overspends and unmet savings targets. An assessment will be undertaken to determine the quantum of these underspends which may continue into 2026/27. Once established, this value of underspend could be assumed on a non-recurring basis to help reduce the 2026/27 budget gap as a temporary measure, allowing more time to implement recurring savings. However, this is not a permanent solution for the three- year budget gap. 9.4.3 Utilisation Reserves The latest reserves forecast indicates a year-end balance of £71.965m. However, a projected overspend of £3.504m will be funded from reserves, reducing the forecast to £68.461m. Of this, £31.901m represents risk-based and contingency reserves classified as usable, as detailed in Table 2. Forecast Gap 2026/27 £000 2027/28 £000 2028/29 £000 Total £000 Optimistic £32,498 £18,289 £19,318 £70,104 Envisaged £38,177 £20,587 £22,140 £80,905 Pessimistic £39,306 £23,233 £25,392 £87,931
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Table 2 A review is currently being conducted with all budget managers to confirm whether previously earmarked reserves are still intended for their original purpose. If they are no longer required for that purpose, these reserves will be closed and reclassified as risk-based reserves to help address the budget gap. 10. Budget Timetable 10.1 The Medium Term Financial Plan for 2026/27 to 2028/29 as well as the Long Term Financial Outlook to 2036/37 will be presented at the Board meeting in March 2026. The timeline leading up to the meeting is detailed in Table 3. Table 3: Budget Setting Timeline Date Meeting Purpose 3rd December 2025 IJB Development Day Discussion on savings proposals 10th December 2025 Integrated Joint Board Medium Term Financial Outlook Update 2026/27 – 2028/29. TBC - January IJB Development Day Discussion on savings proposals 18th March 2026 Integrated Joint Board Approval of Medium Term Financial Plan 2026/27 – 2028/29 and Long Term Financial Outlook to 2036. 11. IMPLICATIONS 11.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ Reserves £000 Ring Fenced 14.118 Earmarked 22.442 Sub Total 36.560 Risk Based 17.782 Contingency 14.119 Sub Total 31.901 Total 68.461
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People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care, and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 11.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 11.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 11.4 RISK ASSESSMENT/RISK MANAGEMENT The strategic financial risks detailed in the IJB Risk Register have also been updated where necessary. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges Very High Nicola Scott Prevention and Detection of Fraud, Bribery and/or Corruption Low Claire Rae National Set-Aside Budget High Claire Rae Hosted Services Medium Claire Rae Prescribing Activity and Costs Very High Claire Rae Pharmacy Pressures within Prison Service High Claire Rae Third and Voluntary Sector Low Claire Rae Ineffective Governance Arrangements Low Claire Rae 11.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes The Director of Finance of NHSL and the Chief Officer (Finance) of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services
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☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 11.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 12. BACKGROUND PAPERS Medium Term Financial Outlook 2026/27 - 2028/29 : September Board 13. APPENDIX Appendix 1 Assumptions applied in the September MTFO Nicola Scott Chief Finance Officer Members seeking further information, please contact Nicola Scott on 07581 007187.
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Appendix 1 ASSUMPTIONS APPLIED IN THE SEPTEMBER MEDIUM TERM FINANCIAL OUTLOOK Contractual Pressures National Care Home Contract The National Care Home Rate will not be known until Spring 2026. An annual 10% increase was included in the MTFP approved in March with the actual increase being 6.8%. For the financial outlook it is prudent to keep the envisaged increase at 10%. Contract Inflation for Care at Home Provision This represents the increases to the Scottish Living Wage which is unknown at this stage, therefore the financial outlook includes an average of the weighted 2025/26 increase. Inflation Inflationary pressures are based on the OBR’s Economic and Fiscal Outlook as at March 2025. Demand Pressures Social Care Demand on social care services continues to increase which has been well reported through the 2022 census information. A provision of 5% has been included over the next 3 years. Pay Pressures 2025/26 Pay Award A pay offer has been agreed for NHS Agenda for Change staff at 4.25% in 2025/26 which is higher than the 3% included in the MTFP presented to the Board in March. The budgeted increase was based on the Scottish Government’ Public Sector Pay Policy of a 9% increase over 3 years. The expectation is that Scottish Government will provide the necessary funding to meet the 1.25% increased offer. The 2025/26 MTFP also includes a 3% increase for council services pay award, however an offer of 4% has been agreed. It is also anticipated that Scottish Government will fund the differential for Council staff therefore there is no change in relation to these cost projections. Pay Award Future Years For future years the projected pay awards have been budgeted at 3% again reflecting the Public Sector Pay agenda. Prescribing Price increase and demand The price of drugs is set nationally and influenced by factors such as supply and demand, currency movements and patents. Activity is a clinical decision, and demand is ever changing despite positive work being undertaken to reduce the number of drugs prescribed. The MTFO includes a 10% increase.
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Appendix 1 Reinstatement of Non-Recurring Solutions Non-Recurring Solutions In 2024/25 and 2025/26 a number of non-recurring solutions were used to support the budget gaps and as yet recurring solutions have not been identified to replace these budgets. Scottish Government Settlement Funding Funding contributions from both Partners are significantly influenced by the Scottish Government Finance Settlement which will remain unknown until December. The MTFP currently includes a 3% increase on Health Services and 5.23% for Council Services.
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1 REPORT Item No: 9 SUBJECT: Lanarkshire Advocacy Plan TO: IJB Lead Officer for Report: Morag Dendy – Chief Officer, Performance, Planning & Quality Assurance Maria Barry – Senior Manager, Quality Assurance Author(s) of Report Patricia Kearns – Senior Officer, Quality Assurance DATE: 10 December 2025 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: ☐ Patrica Kearns Maria Barry Morag Dendy & Claire Rae Senior Officer Senior Manager Head of Service/ Chief Officer
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2 3. RECOMMENDATIONS The Integrated Joint Board are asked to approve the publication and launch of the 2025-2030 Lanarkshire Advocacy Plan. 4. VARIATIONS TO DIRECTIONS? Adult Care and Social Work Committee South Lanarkshire Integrated Joint Board South Lanarkshire Social Work Resources Committee 5. BACKGROUND/SUMMARY OF KEY ISSUES The Lanarkshire Advocacy Plan 2025-2030 is a collaborative partnership between North and South Lanarkshire Council, North and South University Health and Social Care Partnership, NHS Lanarkshire, and local advocacy organisations. As host for mental health, learning disability and prisoner healthcare services, University Health & Social Care North Lanarkshire take the lead on producing a joint Advocacy Plan. The Scottish Government’s expectation, as set out in “Independent Advocacy: Guide for Commissioners”, published in December 2013, is that local strategic advocacy plans should be developed on a five yearly cycle. The Plan ensures that advocacy is focused, strategic and adaptive whilst ensuing resources are used effectively. Several pieces of legislation mention or confer the right to independent advocacy. The Mental Health (Care and Treatment) (Scotland) Act 2003, the primary legislation, imposed a duty on local authorities and health boards to collaborate to ensure the availability of independent advocacy services in their area. The Act gave everyone with mental illness, learning disability, dementia and related conditions the right to access independent advocacy support. The Mental Health (Scotland) Act 2015 builds on the right in the 2003 Act to independent advocacy support, by requiring health boards and local authorities to tell the Mental Welfare Commission how they have ensured access to services up to now, and how they plan to do so in the future Independent advocacy is the practice of providing support and representation to citizens who may need assistance to ensure that their voices are heard, and their rights upheld without any conflict of interest. Advocates act solely in the interest of the Yes ☒ No ☐ N/A ☐
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3 person that they are supporting, helping them to make informed decisions, express their wishes, and navigate complex systems that are often inherent within large organisations such as health and social care. Following approval of the plan, the intention is to host a formal launch date on 3rd February 2026. Letter re Mental Health Related Advocacy Provision in Scotland In late September 2025, IJB Chief Officers received a letter from Stephen Gallagher, Director of Mental Health, Health & Social Care Directorates expressing concerns regarding the potential reduction of independent advocacy provision across Scotland. The letter stated section 259 of the Mental Health (Care and Treatment) (Scotland) Act 2003 (“the 2003 Act”) provides individuals with a mental illness, learning disability, dementia and related conditions a legal right of access to independent advocacy. Through the principles outlined in our Engagement and Participation Strategy, we adopt a proactive approach to ensure people have their voices heard and can actively participate in decisions about their care and support. We recognise the right of access to independent advocacy is an essential component of person-centred and rights- based care and we have commissioned advocacy support arrangements in place. Investment in Advocacy Support across North Lanarkshire has increased over the period. In 2025 investment was £968,694 per annum, an increase from £737,131 in 2020. A breakdown of the allocation is noted in the table below: 6. CONCLUSIONS The publication of the Lanarkshire Advocacy Plan strengthens: Clarity of Purpose Co-ordination and Alignment Collaboration and Partnerships Accountability and Transparency Resource Planning The Plan ensures that all stakeholders are working towards the same agreed objectives. Furthermore, it demonstrates that advocacy provision is strategic, evidence-based, result-orientated and has impact. Local advocacy services are commissioned, managed and administered by North Lanarkshire Council. 7. IMPLICATIONS The Advocacy Breakdown for North Lanarkshire is as follows: Project Service North Lanarkshire Who Cares Scotland C&F £241,000.00 Equal Say Adults [Adults, Carers, Addictions, Older Adults] £701,481.00 Shelter Adults [and families if required] £25,000 Advocacy Network £1,213.00 Total North Lanarkshire Wide Investment £968,694.00
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4 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL This paper has been reviewed by Finance: There is no budget implications related to this paper. All currently commissioned advocacy provision has already been approved by finance. Investment in Advocacy Support in 2025 is £968,694 per annum, an increase from £737,131 in 2020. 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner n/a 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details Yes ☐ No ☐ N/A ☒
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5 ☒ Involve stakeholders in the development work aimed at achieving the national outcomes Early drafts of the Lanarkshire Advocacy Plan 2025-2030 were shared with a range of stakeholders for comment, amendment and to identify gaps within the plan. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: EQIA in place for North Lanarkshire Council. Review underway re whether this needs to incorporate NHSL and SLC, or each organisation has their own. Once clarified, appropriate version will be published. Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☐
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6 8. BACKGROUND PAPERS none 9. APPENDICES Please include a glossary of terms if not already included. Lanarkshire Advocacy Plan 2025-2030 CHIEF ACCOUNTABLE OFFICER (or Depute) Morag Dendy, Chief Officer (Performance, Planning & Quality Assurance) Members seeking further information about any aspect of this report, please contact the following; Maria Barry, Senior Manager (Quality Assurance) barrym@northlan.gov.uk 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:
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7 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
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1 REPORT Item No: 10 SUBJECT: CAMHS and NDS Recovery and Renewal Programme Board TO: Integrated Joint Board Lead Officer for Report: Maggs Thomson, Head of Health, NLHSCP Author(s) of Report Pauline Izat, General Manager, Specialist Children’s Health Services Unit, NLHSCP DATE: 10 December 2025 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: Pauline Izat ☒ Reviewed By: ☐ Endorsed By: ☒ 3. EXECUTIVE SUMMARY The report will give detail of scope and scale of modernisation that has been delivered by the CAMHS and NDS Recovery and Renewal Programme Board to facilitate delivery of a CAMHS and an NDS model aligned to the individual national specifications.
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2 4. RECOMMENDATIONS 4.1 It is recommended that the IJB PFA note contents of report and progress made to date. (1) Robust reporting is now available as an electronic patient management system with aligned electronic patient record is now in place. Performance is monitored and managed within the unit and formally reported via IQPR (2) All work streams have completed work initially advised with exception of capital planning. However, this work is in progress and can be managed locally with support from planning colleagues. Additionally, the information available to us, due to improvements in robustness of data capture is capable of informing redesign in a way that was not possible in first phase of capital investment. (3) The CAMHS and NDS Recovery and Renewal Programme Board has been stood down and programme of work is being taken forward operationally through a business as usual approach. The governance of approach is assured via monthly CAMHS Operational and Professional Group, CAMHS and NDS Quality Governance Group that meets monthly and a CAMHS, 8 weekly NDS Quality Governance Group and NDS Management Team Meeting. Assurance is provided via Partnership Governance structures North, Operational and Professional and North SCCG and MH QGG. (4) Continued review of performance is monitored via unit Performance Meeting and reported monthly via Integrated Quality Performance Report. 5. VARIATIONS TO DIRECTIONS? 6. BACKGROUND 6.1 In 2021, the Scottish Government Children and Young Peoples Mental Health and Wellbeing Taskforce published national specifications for Child and Adolescent Mental Health Services and Neurodevelopmental Services. Both specifications aim to ensure that children and families receive the supports and access to services that meet their needs at the earliest opportunity, based on the GIRFEC approach. For many children and young people, such support is likely to be community based, and should be quickly and easily accessible. These services are required to be available for all children and young people who are aged 0- up to 18th birthday. Yes Health Board ☒ No ☐ N/A ☐
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3 6.2 The Lanarkshire CAMHS and NDS Programme Board had been in place since 2021. The Programme Plan articulated how the National CAMHS Service Specification – as well as associated Scottish Government directives – will be locally implemented. The purpose of this programme was to assess, evaluate and where appropriate redesign Child & Adolescent Mental Health services ensuring a whole systems approach based on children and young people’s rights and relationships. 6.3 The board remains committed to delivery of safe, effective and child centred mental health care for children and young people across Lanarkshire who require support and intervention to manage their complex mental health challenge. 6.4 The strategic commissioning of CAMHS and NDS for the NHS Lanarkshire area is hosted by the North Lanarkshire IJB and managed by the North Lanarkshire Health and Social Care Partnership (HSCP). There was a change in SG funding commitment in third quarter of 2024. This reduced stability of budget. Funding deficit was strengthened by NHS Lanarkshire support. The current funding balance within Recovery and Renewal monies is £7,749,189. 6.5 A significant change to the CAMHS model was required to meet the national service specification. Plans were submitted to the Scottish Government outlining how it would be implemented. This specification focusses CAMHS on the needs of children and families affected by complex mental health problems, moving early intervention support to the Schools Counselling Model, School Nursing and the Community Wellbeing Framework. It also separated the request for assistance pathway for children and young people who primarily required assessment and diagnosis of neurodevelopmental disorders including Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Intellectual Disability (ID), Foetal Alcohol Spectrum Disorder (FASD), Developmental Coordination Disorder (DCD) and Tourette’s and tic disorders. 6.6 In order to co-ordinate and monitor the delivery of the programme plan, North Lanarkshire HSCP established the CAMHS & NDS Recovery and Renewal Programme Board, chaired by the North Lanarkshire HSCP Medical Director and had support from a Professional Adviser from the Scottish Government. 6.7 There were 6 work streams within the Programme. These have all either been fully completed or are well progressed to a business as usual model of operational delivery: - Neurodevelopmental Service – all work completed. All neurodevelopmental requests for assistance are now channelled via established Neurodevelopmental Service. This combined 3 previous waiting lists (CAMHS, NDS and Paediatrics) and provided transparency of referral pathway, consistency of response and quality assurance of assessment. This is a highly
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4 skilled workforce and maximum efficiencies within resource are assured. Time limited commission of an external provider has provided additional capacity that facilitated assessments of young people before they graduated to adult service referral routes. Demand for assessment continues to exceed capacity. This has been highlighted nationally and is common across all health board areas. It is advised that national work will influence next steps with neurodevelopmental services. Choices & Partnership Approach (CAPA) Implementation within CAMHS- all work completed. This new model of patient management has been operational since May, 2023. It can now provide robust data capable of assuring planning of service capacity and informing trajectories over a longer time period. HR & Workforce – all work completed. A full review of workforce in line with CAMHS and NDS specifications was undertaken and professional and support staff gaps addressed. Communication and Engagement- all work completed. An Engagement Officer role has established a process that facilitates consultation with children, young people and their families. This provides assurance that the child’s voice is represented in our strategic planning and individual care planning. A website has been established and design of CAMHS and NDS logos were undertaken in partnership with New College Lanarkshire and decided by public vote. EHealth- all work completed. Trakcare build completed to facilitate delivery of CAPA Model. Electronic case record now in place across whole service. Capital/Strategic Planning- ongoing. Large scale refurbishment delivered in South Lanarkshire. Work ongoing across 3 sites in North Lanarkshire to deliver same. The main objectives of the Programme were: - Review CAMHS referral and assessment pathways with a view to implementing the Choices and Partnership Approach (CAPA) model. Full implementation of the Child and Adolescent Mental Health Service (CAMHS) Specification – Community CAMHS. Clearance of any backlogs on waiting lists for CAMHS. Clearance of any backlogs on waiting lists for Psychological Therapies. Agree a workforce model to utilise the funding provided by the Mental Health Recovery Fund to enable the effective implementation of CAPA Engage all key stakeholders to achieve consensus and clarity and enhance communication of new ways of working across all CAMHS teams and Neurodevelopmental Pathway. 6.8 The IJB should be assured that the objectives initially set by Programme Board have been realised and have now progressed to a stage of sustainability of performance and quality assurance that is aligned with national specification. 6.9 The performance trajectory is positive. A Referral to Treatment Target (RTT) of 90% was delivered for the first time in September of 2024. This has been consistently maintained since then with exception of October 2024(89.34%) and December (86.84%).
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5 6.10 There is a difference in recording of performance within CAMHS and LD CAMHS. LD CAMHS is managed within MH Directorate and they measure RTT to delivery of Psychological Therapeutic Interventions (PTT). The variance in this approach has become increasingly evident as universal CAMHS performance has improved. This is being reviewed locally. Currently CAMHS have no children or young people waiting beyond 18 weeks to be seen. We have sought Scottish Government assurance that they remain happy for reporting of RTT to continue to date of first appointment. This has been provided. 6.11 Additionally, we continue to work with West of Scotland colleagues to deliver a standard of care provision capable of managing care locally and consistently to facilitate equity with other health board areas. This has included expansion of our unscheduled CAMHS (UCAMHS) model. It has combined the expertise of CAMHS Duty Team, Intensive Treatment Team and Nurse Team. Hours of service delivery were extended in October 2024. The service is available Monday to Friday between 8am and 8pm. The Intensive Treatment Team is available during hours of 9-5 over weekend. This additional capacity and expertise has supported admission avoidance, care planning, safe hospital discharge and management of risk appropriate to environment. The UCAMHS response model is available to all children and young people on both CAMHS and NDS lists who experience deterioration in mental health whilst waiting to be seen or awaiting specific treatment. This service is also open, by referral, to any child or young person previously unknown who has presented with an acute deterioration in mental health with aligned escalation of risk. 6.12 CAMHS will continue to work towards delivery of a Psychological Therapeutic Therapy target of 90% that will bring RTT and PTT performance into closer alignment. This will be of benefit to the overall experience of the child and their family and/or carers. Work to date has included a review of all waits within CAMHS. Amongst the longest waits we have identified a cohort of YP who historically would have been accepted within CAMHS but would now be diverted to the NDS for assessment. Additionally, there is a group of YP who require a neurodevelopmental assessment but require additional therapeutic interventions. In response:- A waiting list cleanse and validation has been undertaken Specialist PRL appointments have been allocated as partnership appointments within CAPA model of appointment allocation. A Group has been established to address specific waits for anxiety support. The group(s) will provide evidenced based group psychological therapeutic intervention that support reported anxiety challenges experienced by a significant number of YP who remain amongst our longest waits beyond their initial assessment. Progress will be monitored via unit Performance Management Meeting and reported via Integrated Quality Performance Board.
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6 Identification of underspend monies secondary to vacancies that have supported additional capacity provision ( overtime and additional hours). PHS colleagues will continue to support with modelling of trajectory. 6.13 Our Neurodevelopmental Service continues to face challenges of long waits. The waits in Lanarkshire are transparent as they have all been collated on 1 waiting list since October of 2022. This is not true of all other Health Board areas. Positively, we are starting to see evidence that the referral rate to the service has slowed since 2022. Our Neurodevelopmental Service Lead is a key member of a national task force focussed on sharing of learning and good practice. The service has established a Whole School Approach model that has been based on a previous Tests of Change. This approach was able to evidence assessment capacity efficiencies without any reduction to assurance of assessment quality. It has been collaboratively developed with education colleagues and will commence in January 2026 with a plan to double the capacity of team by commencement of new school year in August 2026. 6.14 The Neurodevelopmental Service has a waiting list of 10,122 children and young people. Demand consistently outstrips capacity by approximately 40%. Additional capacity has been implemented by paid overtime. A proposal is in progress to support anticipated further capacity challenge due to number of upcoming maternity leaves. This would reduce capacity by a further 27%. 6.15 The demand for dietetic input support via NDS has grown a waiting list of 529 patients. 7. SUMMARY OF KEY ISSUES 7.1 Financial instability continues to challenge workforce stability. Much of funding being used to deliver scale of change needed was provided via Recovery and Renewal funding route and has required NHS Lanarkshire support throughout this financial year due to a centralised reduction from SG. 7.2 The Neuro Developmental service works independently of CAMHS. Demand continues to significantly out strip capacity of service. The trajectory will continue to widen if resource not made available to address directly. Referrals and demand are in line with other HB areas. Support within school is based on assessment of need not diagnosis. 7.3 Increasing complexity is both anecdotally and formally reported. Care assurance work is being undertaken in response to learning from significant adverse events. This includes assurance of consistent process in relation to mental health assessment; risk assessment; care planning and risk management. Training was undertaken across all staff groups to support
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7 implementation of this consistent process. Care assurance reporting framework planning is in process and is reported via CAMHS and NDS Quality Governance Group and onwards for assurance via HSCP Support Care and Clinical Governance meeting and via MHLD and Addictions for information. 7.4 Continuance of trajectory and ongoing performance is reported via CAMHS Performance Meeting and reported via the Specialist Children’s Unit Management meeting. 8. CONCLUSIONS 8.1 The initial aims of CAMHS and NDS Recovery and Renewal Programme Board have been delivered. It is acknowledged that performance against target remains fragile due to instability of finance. However, there is now clear evidence available that can assure efficiency of service delivery aligned with monies available. 8.2 The second phase of improvement work is underway to align the RTT and PTT Performance targets to a closer position. 8.2 Assurance of performance and quality of service delivery have become embedded within reporting structures aligned to operational and clinical governance structures. 8.3 Financial stability will be a focus of ongoing work within CAMHS and NDS Programme Board to ensure models that have been built remain sustainable within current funding envelope. 8.4 The IJB should note that the formal Programme of Works Steering Group has now been stood down. The operational, financial, clinical and performance governance is being managed from a business as usual position and reported via established governance structures. 9. IMPLICATIONS The implications of additional work stream will be minimal as initial objectives have been delivered. Planning will be required to ensure changes made are sustainable despite financial pressures. 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 ☐
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8 People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 9.2 ASSOCIATED MEASURE(S) 9.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A x 9.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Level 3 High Pauline Izat 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes Wide range of professional stakeholders attend Programme Board meeting. ☐ Provide stakeholders with information on how to get involved This is provided to CYP and families via our engagement officer and encouragement to use Care Opinion
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9 ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs Our Engagement Officer has provided a range of opportunities for CYP and their families to provide feedback on service delivery and service planning. This can take form of focus groups or 1:1 ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services A CYP questionnaire that rates service delivery is undertaken annually ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Our Engagement Officer provides update to our CYP and families of what changes have been made due to their input. ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership Contribute to wider organisational stakeholder engagement processes (UNCRC etc.) 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes No N/A Requires review and update to reflect UNCRC EQIA added to website: Yes No N/A
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10 10. BACKGROUND PAPERS 11. APPENDICES Please include a glossary of terms if not already included. CHIEF ACCOUNTABLE OFFICER (or Depute) Claire Rae, Chief Officer. Members seeking further information about any aspect of this report, please contact the following; pauline.izat@lanarkshire.scot.nhs.uk Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB
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11 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
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1 REPORT Item No: 11 SUBJECT: Paediatric Modernisation Board TO: Integration Joint Board Lead Officer for Report: Maggs Thomson, Head of Health, NLHSCP Author(s) of Report Pauline Izat, General Manager, Specialist Children’s Health Services Unit DATE: 10 December 2025 1. PURPOSE OF REPORT This paper is coming to the IJB PFA for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Pauline Izat ☒ Reviewed By: Maggs Thomson ☒ Endorsed By: ☐ 3. EXECUTIVE SUMMARY The report will provide detail of the Paediatric Modernisation Board Structure, objectives and progress of work to date.
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2 4. RECOMMENDATIONS 4.1 It is recommended that the IJB note the contents of the report and progress of work achieved to date. 4.2 It is recommended that the IJB note the scale of challenge to delivery of sustainable transformational change. The success of programme delivery will require clinical modelling and clinician support. This has to be balanced proportionately with safe delivery of care whilst transformational work progresses. 4.3 It is recommended that the IJB note that elements of this work are impacted by current service level agreements with tertiary partners. This requires sensitive discussion via regional planning process. 5. VARIATIONS TO DIRECTIONS? This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required 6. BACKGROUND 6.1 The Paediatric Modernisation Board was established in current form, formally, in February 2023. The Board is Chaired by Dr Adam, Daly, Associate Medical Director for the Health and Social Care Partnership in North Lanarkshire. Membership is inclusive of professional leadership, operational management colleague and corporate support colleagues (Communication, Digital and HR Teams). Each member was made clear of expectation of their representation and role in delivering this programme of work. 6.2 The Paediatric Board is focussed on modernisation of service delivery and clinical activity generated via acute hospital and aligned community based paediatric services. The delivery of the services within scope of board, inclusive of in-patient care are the responsibility of the Specialist Children’s Health Services Unit, and hosted on behalf of NHS Lanarkshire within North Lanarkshire Health and Social Care Partnership. The Board forms part of NLHSCP Strategic Commissioning Plan and reports to North Lanarkshire CORE, North Lanarkshire Integration Joint Board, South Lanarkshire Integration Joint Board and NHS Lanarkshire. 6.3 The agreed remit of Board is: - Ensure a collaborative, inclusive approach to the design and delivery of a programme of work to implement the Paediatrics Modernisation Programme Plan Yes Health Board ☒ No ☐ N/A ☐
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3 Monitoring the financial position across the Programme, including the use of Scottish Government funding for specific areas of work; Encourage and strengthen links between the Programme, North and South Lanarkshire Paediatrics Services Plans and other relevant strategies of all key partners; Approve Programme documents and deliverables; Monitor the progress of Programme and delivery plans; Approve significant changes to the Programme scope, objectives, deliverables, funding and timescales; Provide assurance that outputs are operationally fit for purpose and implemented satisfactorily; Identify and manage risks and issues ensuring mitigating actions Agree and track benefits realisation and achievement of outcomes Approve Programme closure following implementation and ensure that any end project reports, issues, lessons learned and risks are documented and passed on to the appropriate body. 5 working groups were initially planned and established to progress this work. Not all groups have been fully implemented due to pace of progress. Comms and Engagement – has been interwoven and is responsive to the service improvement work that is being undertaken. Accommodation – accommodation challenges have been limited and been able to be managed operationally to this point. Transition and Interfaces – continues to develop through corporate work being undertaken elsewhere. EHealth (now Digital) – Trakcare activity is now being appropriately logged across acute and community. HR and Workforce – Medical Rota has stabilised. Consultant workforce has remained stable and being positively recruited to. Nursing has required a skill mix and capacity review in response to increasing supplementary staffing challenge. Additional capacity has been supported by partnership due to evidence provided. Regional and National Links – this has been focussed in particular on our surgical pathways. A 3 Horizon approach was taken to prioritisation and phasing of work to be planned and delivered: - 6.4 Horizon 1- covers current issues that require quick response. Nursing Care Assurance Review of Continence Services The Paediatric Modernisation Board are happy to advise that Horizon 1 work is progressing well. The nursing care assurance work has been led by the Associate Director of Nursing and been supported by NHS Lanarkshire Quality Improvement Team. The standards agreed have been inclusive of contributions
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4 made by nurse colleagues who work within paediatric in patient environment and of community based nurses who support specialist care for children within a clinic, their home and/or school environment(s). The Review of Continence Service has been led by Clinical Lead for Community Paediatrics. This has been more challenging to progress due to clinical demands on colleagues involved, changes within continence aligned workforce and assurance work identified that required address prior to full commencement of work. Despite these challenges, a literature review and a review of current service model has been undertaken. Progress and development of an agreed tiered pathway of support has been slower than initially anticipated. This has been due in part to clinical capacity and in part due to negotiation required to assure capacity for early interventions to be firstly offered within universally offered services- Health Visiting. This piece of work aims to conclude by June 2026 We expect further projects to be undertaken subject to availability of clinical staff. Further examples of work already undertaken or in in progress, but not specifically noted in Programme of Works include:- Development and delivery of Hospital at Home Pathways for Constipation, IV Therapy, Neuro Respiratory and Diabetes – various stages of clinical governance approval and will be established by April 2026 FNC support of incoming calls to the Paediatric Unit –commenced week beginning 01/12/2025. Palliative Care pathway – in collaboration with ICCN and CHAS. A nurse led discharge process for Bronchiolitis – Test of Change position 6.5 Horizon 2 -covers emerging issues that are likely to be faced in the next one to three years. Sustainability of medical rota This Horizon 2 focus of work emerged quickly as a clinical risk due to unsustainability of Tier 1 and 2 medical rotas that require to be in place to ensure safe function of in-patient care. Tier 1 is junior trainee doctors who provide the foundation of medical intervention within ward. Tier 2 trainees are higher trainee doctors who are working towards becoming a consultant within paediatrics. This is an important trainee rota to fill as it provides a pathway for interested trainees to return in the future as consultants. If numbers are not coming through and/or they do not have a good trainee experience whilst with us, it will have a negative impact on long term recruitment of these specialist colleagues to Lanarkshire. Tier 3 is our consultant level rota. All rotas are inextricably linked and cannot be separated without negative impact on wider system, and at times on individuals. This fragility of rota is due to a culmination of factors which included less availability of trainees being provided by deanery and increasing numbers of
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5 trainees who want to work less than full time. This has resulted at times, in increased pressures resulting in use of locums and of requests generated to consultants to act down into senior trainee roles. This negatively impacts on planned community care assessment and review and places an additional burden of stress on an already tired workforce. Due to level of risk identified, additional support was approved by Core management team. Additionally, our Medical Director continues to have dialogue with deanery to assure that we are receiving an equitable offer of trainees. This has been successful and as a result we have been offered a further 2 colleagues in 2026.This will ease pressures on rota and improve opportunities for training and development. This will enhance our reputation as a future employer. This piece of work has now concluded and a stable position achieved that will continue to be kept under review. 6.6 Horizon 3 - covers issues that might come into play in the future. New clinical model Key members of the paediatric Modernisation Board have taken time away from the main meeting to consider what next steps should be in advancing our aspiration of a paediatric service that fits current need and will be sustainable in the future. We recognised that main focus until now has been delivery of a stabilised workforce and care assurance position. This approach has been facilitated by Organisational and Development colleague. Going forward, the board leadership team have recognised the need for aspirational goal setting that uses the learning themes from our last 2 years of activity. They include:- Staff Awareness and Understanding of need for change and the activity around it. Importance and awareness of governance infrastructure. Collaborative working and a commitment to move away from siloed care approaches. Importance of staff development and proactive promotion of a positive workplace culture. 6.7 The Paediatric Modernisation Board planned activity has to be considerate of clinical demand challenge that is faced in winter months. The Modernisation Board will complete:- Getting it Right Approach fully completed within ICCN workforce by December 2026 Delivery of a Hospital at Home Service by June 2026 Delivery of a robust complex continence pathway June 2026 Increase medical training opportunities by August 2026
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6 7. SUMMARY OF KEY ISSUES 7. 1 The pace of transformational change has been slowed by limited capacity of clinicians to commit time to service improvement work. This is due to clinical demand, which can be variable throughout seasons of year. 7.2 The lack of a Project Team to support the delivery of this piece of work has slowed progress and delivery of outcomes. This will require to be considered in year going forward. 8. CONCLUSIONS 8.1 The IJB should note the progress of work to date. 8.2 The IJB should note that timescale of progress is balanced with clinical demand and activity and is affected by a seasonal element of intensity due to clinician availability. 8.3 The IJB should note that discussions in regard to service level agreement with regional partners will be supported by NHS Lanarkshire Planning colleagues. 9. IMPLICATIONS There is potential that there will be a shift in balance of care away from acute hospital to community care based sites and/or homes. This has potential further challenge demand for space within local health centres. 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 ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐
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7 9.2 ASSOCIATED MEASURE(S) 9.3 FINANCIAL There are no specific financial implications of work to date. Programme of works is considerate of current financial environment. This paper has been reviewed by Finance: Yes No N/A x 9.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes Scoping event with stakeholders took place in February 2023. This was supported by NL HSCP Project Management colleagues. This event prioritised approach and informed Horizon model. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery This is provided via staff meetings
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8 ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings Representation within Programme Boards of community and acute colleagues who interface with acute and community paediatric care. ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA is in progress and will be considerate and informed by UNCRC legislation. Yes No N/A In progress EQIA added to website: Yes No N/A 10. BACKGROUND PAPERS 11. APPENDICES Please include a glossary of terms if not already included. CHIEF ACCOUNTABLE OFFICER (or Depute)
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9 Maggs Thomson- maggs.thomson@lanarkshire.scot.nhs.uk Members seeking further information about any aspect of this report, please contact the following; Pauline Izat - pauline.izat@lanarkshire.scot.nhs.uk IJB Report Checklist Please note reports that are not completed as per the IJB Reporting Guidance Document or contain mistakes will not be submitted to the IJB and will be returned to the author for amendment. Late reports will only be accepted in exceptional circumstances as approved by Chief Officer / IJB Chair. The correct IJB Template has been used You have consulted the IJB Report Guidance Document Report is written in Ariel 12, Single Spacing Paragraphs are numbered e.g. 1.2, 1.3, 1.4 Spelling and Grammar has been checked Limited use of Appendences Appendences have been added/included in the report after the Chief Officer signature , not as an attachment Report does not include any embedded papers All aspects of the template have been completed including Risk and Finance Section The report has been agreed by the appropriate Chief Officer/ Director/ Head of Health. Report has been shared/ signed off via the appropriate governance structure (Route to Board)
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10 Information details of author is included for members to contact for further information EQIA has been attached to the report – if EQIA has not been completed please state why. 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
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11 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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1 REPORT Item No: 12 SUBJECT: Care Academy Update TO: Integration Joint Board Lead Officer for Report: Morag Dendy, Chief Officer Planning, Performance and Quality Assurance Author(s) of Report Lynsey Smith, Brighter Futures Manager DATE: 10 December 2025 1. PURPOSE OF REPORT This report sets out the considerable progress that has been made across the Care Academy workstreams over the past 12 months ensuring a reach across a wide range of groups within North Lanarkshire. Some key next steps exist within the workstreams which have been described throughout the 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: ☒ This report has been reviewed by the Senior Management Team and was presented to North Lanarkshire Council’s Adult Care and Social Work Committee on 11 November 2025 for endorsement and approval.
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2 3. RECOMMENDATIONS It is recommended that the IJB endorse the contents of this report, the progress made and next steps. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 The Care Academy is a collaborative initiative between NHS Lanarkshire, North Lanarkshire Council, South Lanarkshire Council, University Health and Social Care Partnership North Lanarkshire and University Health and Social Care Partnership South Lanarkshire. Its vision is to build a vibrant, sustainable workforce for health and social care across Lanarkshire. This report outlines progress and next steps across five strategic workstreams for 2025/26. 5.2 The pan-Lanarkshire Care Academy is in place to respond to opportunities arising from workforce challenges and future demand which exist within the Health and Social Care sector across Lanarkshire. The partnership formalises working relationships between the councils, NHS Lanarkshire and partners such that there is a process in place for identifying, defining, and progressing potential opportunities for engagement and collaboration. 5.3 In an employment context, in 2024, Human Health and Social Work was the largest employing industry in Lanarkshire, accounting for 48,100 people. This industry is forecast to remain in the top employing sectors in the Lanarkshire between 2026 and 2033. Future job openings are expected to be concentrated in a small number of industries. Within the period 2024 – 2027, figure 1 highlights the forecast total requirement by industry. As is clear, Human Health and Social Work has a requirement of 5,200 people (1,000 based on predicted expansion demand and 4200 based on replacement demand). Yes ☐ No ☒ N/A ☐
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3 Figure 1 – forecast total requirement by industry Source: Skills Development Scotland Regional Skills Assessment, October 2024 5.4 Employment growth in this sector is driven by Scotland’s ageing population along with the aim to protect the provision of frontline services. It is therefore crucial that the attractiveness and retention of jobs within this sector remains a key focus for the Care Academy activity. Vision, aims and objectives 5.5 The overall vision for the Care Academy is to: Develop a robust, sustained, vibrant Care Academy attracting and developing a diverse workforce for health and care services in Lanarkshire and promoting the sector as a rewarding choice for careers. Increasing awareness and engagement about the Care Academy across all partners and organisations to support people from our communities working in our communities. 5.6 The Care Academy aims to: Create the health and social care workforce for the future that best services the needs of people living in Lanarkshire. Contribute to addressing deprivation and inequalities across Lanarkshire to help people live their lives to the fullest.
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4 Provide pathways to fair work, meaningful employment, and progression across the breadth of health and social care. Build a strong talent pipeline to meet future demand and reduce skills shortages within the health and social care sector across Lanarkshire. 5.7 The overarching primary objective of the Care Academy is in building and maintaining capacity in the workforce, aligning activity within and across organisations and filling workforce demand to enhance capacity and future proof the workforce within this sector. Remit 5.8 The Care Academy focuses upon a number of key areas - providing strategic direction of all activity within the remit of the Care Academy Steering Group, oversight of and alignment of funding, resource and collaboration to increase and maximise effectiveness, risk management, maintaining oversight of and mapping outcomes. It has 5 dedicated workstreams to take this work forward to ensure that all activity aligns to the vision, aims and objectives of the academy. Report 5.9 Activity and next steps across the 5 dedicated workstreams exist to progress towards the aims of the Care Academy and respond to opportunities arising from workforce challenges (and future demand) which exist within the Health and Social Care Partnerships across Lanarkshire. Figure 2 highlights the link between the Care Academy aims, the supporting workstreams and their purpose. Figure 2 – Care Academy aims and workstreams
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5 5.10 The range of programmes and activity within each of the workstreams is highlighted in figure 3: Figure 3 – Care Academy activity for workstreams 1,2 and 3
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6 5.11 Workstreams are convened by Leads for their subject matter and members include representatives of each of the collaborating partners and key stakeholders, including North and South Lanarkshire Councils, NHS Lanarkshire, Higher and Further Education, Skills Development Scotland and Developing the Young Workforce (DYW). The below provides an update on the current progress and activities under each workstream. Workstream 1 - Attraction, recruitment, retention and wellbeing 5.12 In line with national priorities to grow and sustain the health and social care workforce, NLC, NHS Lanarkshire and SLC have implemented a range of initiatives to promote careers in the sector across Lanarkshire. These initiatives aim to attract individuals from all backgrounds, including those furthest from the labour market, into meaningful and sustainable employment in health and social care. 5.13 Areas of focus: Review and assessment of gaps in skills and progression within the care sector and development of pathways within the sector. Review and assessment of hard to recruit posts. Retention of current workforce. Continue to support current and future best practice in relation to recruitment and retention. Practical examples of activity 5.14 All three organisations operate targeted recruitment campaigns to widen access and promote inclusive employment. NHS Lanarkshire’s recruitment website highlights current vacancies and outlines structured career pathways, aligned with NHS Scotland’s national values-based recruitment approach. SLC and NLC advertises opportunities via the MyJobScotland portal, complemented by bespoke campaigns for priority roles such as home carers and support workers. 5.15 There is active engagement with schools, colleges, and community partners through employability services. These services provide tailored support to job seekers, including those with disabilities or other barriers to employment, and are aligned with the Scottish Government’s No One Left Behind and Young Person’s Guarantee policies. Apprenticeships form a key component of the workforce development pipeline, offering structured, work-based learning opportunities that align with both local and national workforce planning priorities Next Steps 5.16 Now activity has been formally consolidated, the group will focus on identifying areas of joint activity and shared practice. Revised recruitment material will be promoted through the Care Academy website and use of common branding to promote career opportunities and pathways into social care.
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7 Workstream 2 – Pathways to care for young people 5.17 Areas of focus: Expand and increase school-based pathways and programmes that lead to employment/careers in health and social care at all levels. Raise awareness of the wide-ranging opportunities that exist within the health and social care sector including allied health professions and the progression opportunities available to all. Expand and develop the partnership between NHS Lanarkshire’s Next Gen Team and Lanarkshire Schools to widen reach and to include health and social care, third and independent sectors. Practical examples of activity 5.18 South Lanarkshire College and New College Lanarkshire are now represented on Workstream 2 to continue to build upon the existing relationship with both education institutions. 5.19 ‘The Bungalow’ (former janitor’s house on Our Lady’s High School Motherwell Campus) has been repurposed to a skills for learning, life and workspace with one room set up specifically for health and social care activities and learning experiences and in the same theme, a classroom at Braidhurst High School has also been repurposed as a rehearsal space for clinical and a wide range of health and social care activities. 5.20 Health and Social Care awards and qualifications are offered at SCQF levels 5-7 across all schools in the senior phase of learning. In the academic session 2024/25, 14 young people completed a Higher National Certificate in Health and Social Care in S6 at High School. This leads to progression to year 2 of a Higher National Diploma with New College Lanarkshire and then to year 3 of a Degree with University of West of Scotland. In this same year, 79 young people completed a Foundation Apprenticeship in Social Care. In session 2025/26, 151 young people opted to embark on these subjects in the senior phase of learning. 5.21 Health and Social Care activity and learning experiences with care experienced young people included work placements and a wide range of activities raising awareness of and providing opportunities and experiences in this important employment sector. 5.22 Alongside this, activity also took place across in the following areas: • Audit of Health and Social Care subjects and opportunities offered in secondary schools. • Health and Social Care - Immersive and digital classroom experiences • NextGen events. • Monklands Replacement Project summer schools x3. • Health and Social Care Foundation Apprenticeships and links with NHS. • Future Fridays Health and Social Care related activity.
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8 • Health and Social Care in primary schools in partnership with New College Lanarkshire. • Summer placements across NLC and NHS Lanarkshire provided work experience within the sector to attract a future workforce. Workstream 3 – Adult pathways to care 5.23 Areas of focus: • Practical additional activity targeted at adult employability participants. • A greater emphasis on Health and social care roles alongside the wider occupational areas / job roles in the NHS supported by some current programmes. • Providing additional value to current activity through increased use of NHS and council work placements and innovative recruitment practice to move participants into employment. Practical examples of activity 5.24 Project Search The programme supports young people 16-24 with learning disabilities to take part in a programme of work placements, employability support and training delivered at NHS Lanarkshire hospitals in partnership between the Councils, NHS and New College Lanarkshire (NCL) and ISS facilities management. Placements are in predominantly in non-clinical roles including portering, catering and stores. Within North Lanarkshire, 16 young people are currently on the project at University Hospital Monklands and Wishaw and within South Lanarkshire, 8 participants are on project at University Hospital Hairmyres. 5.26 Demonstrator Paid 6-monthly work placements within a range of NHS Lanarkshire workplaces leading to progression to employment. Funded by NLC and SLC No One Left Behind parental employment programmes. Placements are in a blend of clinical and non-clinical roles. Participants to date are noted below: NLC – 20 parents SLC – 14 parents confirmed) NHS – 10 confirmed, 9 spaces still to fill (recruitment in process) ISS (Hairmyres) – 2 The State Hospital – 2 SLC Social Work – 2 5.27 Through programmes with their respective ALEOS both local authorities also contribute the following: 5.27.1 Routes to Work South (RTWS) RTWS deliver keywork support to adults with barriers to employment through the Gateway to Employment and Making it Work Programmes. as part of the support available RTWS can deliver ‘sector routeways’ in response to employer / participant needs. This includes social care – programmes are designed to equip the participants with the knowledge and skills to secure employment
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9 within the specified industry sectors through a combination of certificated and non-certificated elements together with employability skills and tailored employability wrap around support and job brokerage to progress participants to employment within the sectors 5.27.2 Routes to Work (RtW) Ltd (North Lanarkshire) RtW deliver keyworker support to all age employability clients and to low- income parents via the Working for Families project in North Lanarkshire. Many will go into jobs in Health and Social Care including roles such as carers, support workers, admin, catering, porters, pharmacy assistant and activities co- ordinators. To support their progression into these opportunities they provide vocational training focused on the health and social care sector prior to presenting clients to employers in the public and private sectors. These include qualifications such as REHIS Food & Health/ First Aid/ Safe Manual Handling/ Health & Safety in the Workplace/ Food Hygiene /Cleaning and Disinfection. 5.28 Care Routeways are also provided which includes personal development elements such as Positive Mental Attitude, SQA Mental and Wellbeing, Confidence Building and ‘a day in the life of’ and work with external training providers to deliver vocational training appropriate to the sector. 5.29 Clinical Support Worker Programme Led by New College Lanarkshire, the programme offers a comprehensive support programme to 80 participants in total annually (over 4 intakes) that delivers accredited training, work experience and a guaranteed positive outcome for those who pass the course. The delivery of the programme is split over 6 weeks and over the first 2 weeks the college delivers: IOSH Working Safely (Industry qualification) Values and Principles in Care (SQA unit qualification) Confidence Building Personal Resilience Team Building/Collaborative Skills Organisational and Problem-Solving Skills 5.30 The next 2 weeks NHS delivers: Moving and Handling Techniques Infection Control Tissue Viability Basic Life Support Hygiene Practice Clinical Practice and Induction Standards 5.31 The last 2 weeks is the period beneficiaries are based in the wards of NHS Lanarkshire, where they demonstrate their Hygiene and Clinical Practice skills. 5.32 Employment Application
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10 Towards the end of the 4-week training process, before the beneficiaries’ progress to their work experience in the wards, they complete the NHS application process, and the feedback from the wards, course tutors and mentors will be considered along with their application. 5.33 Job Entry The job is within the NHS Nurse Bank, where the partnership creates a gateway and widening access role into developing along a career pathway to becoming a registered healthcare practitioner should the individual seek to develop this. Once on the Nurse Bank, the beneficiary will get the opportunity to apply for a substantive post within NHS Lanarkshire or remain on the Bank. Being on the Nurse Bank, gives the beneficiary the flexibility to work shifts that suit their work life balance, without being curtailed to a substantive post with shift patterns. 5.34 South Lanarkshire Works – Keyworker programmes The council’s employability team supports key priority groups including young people aged 16-19, people with additional support needs and parents. Participants can take part in work placements as part of their individual action plans and will receive a training allowance (subject to Better Off calculations) in agreed blocks of 6 weeks. Work placements are sourced to meet participants needs and can be across the public, private and third sectors. Those participating to employment can access sector specific training of up to £2000. 5.35 Parents in low wage / low paid employment can be supported to increase their earnings through the Aim to Achieve programme which can include the provision of training where the employer has agreed to increase wages / hours. 5.37 Employment Clearly workstream 3 demonstrates tangible routes to employment within the care sector for those unemployed and economically inactive residents receiving support from both local authorities’ employability programmes and in partnership with NHS Lanarkshire and local care providers. This is increasing employment within the sector and bringing in people who, without the Care Academy model, would not be employed into secure, sustainable employment. 5.38 There is an ongoing commitment from the delivery partners to increase co- ordination and integration of these programmes in future years and use them to drive up employment levels in both areas.” Workstream 4 – Funding and procurement 5.39 The Funding and procurement workstream has more recently been developed following feedback from the Care Academy Steering Group who identified a need to continually review and assess current and upcoming funding streams and identify potential gaps and opportunities. The group also identified a need to consider the potential of community benefits opportunities to support the work of the Care Academy workstreams. 5.40 Areas of focus: • Assess community benefits within current contract arrangements
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11 • Direct, where possible, community benefits into Care Academy activity • Community wealth building and entrepreneurship • Market facilitation • Identification of funding opportunities and “scoping out” potential programmes that match these • Sharing funding opportunities / pilot programmes etc with other workstreams to deliver / ensure mainstream funding where possible. Practical examples of activity: 5.41 Funding has been secured via UK Shared Prosperity Fund (UKSPF) from NL Academies allocation to develop and deliver a pilot Care Focused Employability Programme. This will be delivered in North Lanarkshire by partner providers within the care sector, providing training in all aspects of the care environment, work-based experience in care settings and either employment or guaranteed interviews for a cohort of 20 people. Routes to Work and DWP will support in identification of potential candidates. The programme is targeted at economically inactive individuals who are resident in North Lanarkshire and will address barriers to employment by being flexible in delivery (including short or part time hours if required). Workstream 5 – Communications and Marketing 5.43 It was identified by the Care Academy Steering Group that a specific Communications and Marketing workstream was required to focus upon all aspects of this activity in relation to the Care Academy. The focus includes the promotion of activity under a single Care Academy “brand”, developing and updating the website to ensure it is accurate and reflects all partner activity, and consideration of further using social media channels and ensure a consistent Care Academy presence in all forms of communications and marketing. This workstream is also responsible for identifying suitable awards programmes and progressing entries on behalf of the Academy and developing promotional events. Given the cross-cutting nature of this workstream, the below areas of focus link directly with the activity across all other Care Academy activity. 5.44 Areas of focus: Identifying hard to recruit roles and hard to reach demographic groups across our bases and outline career progression opportunities. We're rebranding the Care Academy website to reflect a pan-Lanarkshire identity and enhance its functionality as a central digital hub, by reviewing and updating content, and integrating accessible tools and resources for users exploring careers in care. We're working to identify and promote awareness of the spectrum of roles available, and ensuing career paths, and career progression opportunities across health and social care sector. Other areas of development 5.45 A Delivery Framework for the Care Academy is being developed to ensure alignment and interconnection across the five workstreams. This will provide
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12 focused actions as it will set out the deliverables and projects/activities being undertaken by each workstream to achieve the aims and objectives of the Care Academy. To measure value and outputs, performance measures are also being developed and aligned to deliverables. 6. CONCLUSIONS 6.1 Considerable progress has been made across the Care Academy workstreams. Various projects have been developed and implemented over the past 12 months ensuring a reach across a wide range of groups within North Lanarkshire. Some key next steps exist within the workstreams which have been described throughout the report. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐ 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL
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13 This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff Yes ☐ No ☐ N/A ☐
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14 ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS 9. APPENDICES Please include a glossary of terms if not already included. N/A Morag Dendy Chief Officer, Planning, Performance and Quality Assurance CHIEF ACCOUNTABLE OFFICER (or Depute) Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☒
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15 Members seeking further information about any aspect of this report, please contact the following;
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16 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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17
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1 REPORT Item No: 13 SUBJECT: Coming Home Implementation TO: Integration Joint Board Lead Officer for Report: Diane Fraser, Chief Officer Adult Social Work Services Author(s) of Report Andrea Breen, Senior Social Work Manager, Adult Social Work Claire Leslie, Service Manager, Adult Social Work DATE: 10 December 2025 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: ☐
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2 3. RECOMMENDATIONS The Integration Joint Board to note the following 1. To note the current progress to implement the recommendations from the Coming Home Report 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES Introduction This report provides an update to the Integration Joint Board (IJB) on the requirements of the Coming Home programme and North Lanarkshire’s progress. The work is aligned with the Scottish Government’s Coming Home Implementation Report (2022), which set out a national ambition to reduce delayed discharges and inappropriate out- of-area placements for adults with learning disabilities and complex care needs. The report emphasised the importance of visibility, accountability, and rights-based approaches, and introduced mechanisms such as the Dynamic Support Register, National Support Panel, and Peer Support Network to drive improvement across Health and Social Care Partnerships. This report focuses specifically on individuals identified as high risk through the Dynamic Support Register (DSR). And outlines key developments and emerging challenges in improving outcomes for people with complex and neurodivergent needs. The purpose of this report is to: Update the IJB on current DSR data, including the increase in individuals rated RED due to hospitalisation or risk of support breakdown. Highlight systemic barriers and emerging risk factors impacting service delivery and outcomes. Ensure alignment with national policy and the Coming Home vision of enabling individuals to live in their own homes, with care tailored to their unique needs. The Dynamic Support Register (DSR) is a tool introduced as part of the Scottish Government’s Coming Home Implementation Report (2022) to help Health and Social Care Partnerships Yes ☐ No ☐ N/A ☒
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3 identify and monitor individuals with learning disabilities and complex needs who are at risk of poor outcomes due to inappropriate placements, delayed discharges, or support breakdowns. This work is governed by Health Important Scotland and collated and shared Nationally. NSC Partnerships submit the Dynamic Support Register quarterly to inform the National Picture. There are currently 15 people in hospital on the local Dynamic Support Register, there are 2 people who are at risk of breakdown, and 4 people with enhanced monitoring. There is no one inappropriately placed out of area whilst 14 people are appropriately placed out of area and 16 people have been removed from the register. North Lanarkshire Health and Social Care Partnership (NLHSCP) has made notable progress in tackling delayed discharges and reassessing out-of-area placements through the Coming Home Implementation Plan. Supported by £1.1 million from the Community Living Change Fund, a temporary specialist team was established to work in close collaboration with allocated social workers. This initiative enhanced coordinated care management and prioritised discharge planning for individuals whose circumstances had previously stalled. Background In 2018, the Scottish Government initiated a national focus on reducing inappropriate out-of- area placements and delayed hospital discharges for people with learning disabilities and complex care needs. This report concluded that all adults with learning disabilities, including those with complex needs, should experience meaningful and fulfilled lives closer to home and this was to be achieved by 2024. It led to the Coming Home Implementation Report (2022), which set out a joint ambition with COSLA to ensure that individuals are supported to live in their own communities, with care tailored to their needs and rights respected. A key milestone was set for March 2024, by which time significant reductions in out-of-area placements and hospital delays were expected. To support this ambition, the report introduced three core mechanisms: Dynamic Support Registers (DSRs) to improve visibility and local case management A National Support Panel to provide oversight and challenge A Peer Support Network to share best practice across partnerships North Lanarkshire HSCP Position and Progress North Lanarkshire has actively engaged with the Coming Home agenda and established a local DSR to monitor individuals at risk. This was to improve the monitoring of those at risk of hospital admission or living in inappropriate placements. Since the establishment of the dynamic risk register an oversight group has been established to monitor the position in North Lanarkshire. The dynamic support register reviews and monitors those people who are delayed in hospital, out of area placements and those at risk of their placements breaking down. As a consequence of the dynamic support register our
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4 local information highlights that the age group at risk is 17-18 year old. In addition, 3 of the 31 individuals on the dynamic risk register have been delayed in hospital for over 10 years. Current and future demand The strategic group have worked closely together to analyse the information and consider the current and future demands. An increasing number of young adults in North Lanarkshire, particularly those with autism, are presenting with significant behavioural dysregulation. This dysregulation is not associated with a recognised physical or mental health diagnosis, which creates barriers to accessing appropriate support through conventional service pathways. Families frequently report feeling overwhelmed and unsupported, struggling to manage behaviours at home. These challenges often escalate into crisis situations, resulting in hospital admissions or placements in residential schools. Such placements are often unsuitable and misaligned with the principles of the Coming Home agenda. This trend highlights a gap in current service provision for neurodivergent individuals whose needs fall outside conventional diagnostic categories. It highlights the need for, flexible, rights- based support models tailored to neurodivergent profile, enhanced early intervention and crisis prevention strategies as well as workforce development to build capacity in supporting complex behavioural needs. The Coming Home Implementation Plan emphasises supporting individuals to live in their own homes with care that reflects their unique needs. Addressing the evolving needs of neuro divergent younger adults is essential to achieving this vision and reducing reliance on institutional or out-of-area placements. Several individuals in North Lanarkshire remain in hospital settings despite being clinically ready for discharge, often due to complex needs, limited provider availability, or unresolved professional disagreements. While the Coming Home Implementation Plan and Community Living Change Fund have supported progress, systemic barriers persist. The graph below shows the estimated cost for individuals currently in hospital Community Living Change Fund £100,000 £1,000,000 £500,000 £250,000 £190,000 £370,000 £500,000 £400,000 £500,000 £1,000,000 £400,000 £200,000 £30,000 £50,000 £50,000 £0 £200,000 £400,000 £600,000 £800,000 £1,000,000 £1,200,000 A B C D E F G H I J K L M N O Individuals on the Dynamic Support Register Total Estimated Cost - £5,540,000
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5 The Scottish Government provided a non-recurring Community Living Change Fund £1.1m to support delivery of local implementation with North Lanarkshire. This was non-recurring funding to support the implementation of Coming Home recommendations in local areas. The primary aim of the Community Living Change Fund was to support local implementation of the Scottish Government’s Coming Home recommendations. Specifically, to reduce delayed discharges for adults with learning disabilities and complex care needs, reduce out of area placements to ensure people can remain closer to home, build on provider flexibility and workforce skills to offer the right support for complex care at home, enable right based care models and develop suitable housing solutions. In North Lanarkshire, the fund (approximately £1.1 million) was used to create a temporary specialist team and enhance two independent providers within the commissioning framework. These interventions improved discharge planning, reduced hospital readmissions, and demonstrated more flexible, skilled approaches to care. However, the funding was non- recurring, so while short-term improvements were achieved, sustainability remains a challenge without ongoing investment. Insights from these interventions must now be embedded into ongoing practice to ensure sustainability. The Partnership continues to collaborate with local housing colleagues and framework providers to develop long-term housing solutions, including purpose-built accommodation offering independent tenancies and personalised care. Despite progress, challenges remain—particularly in securing appropriate housing, addressing workforce capacity, and managing risks of support breakdown. Increasing demands on clinical services and financial pressures further impact the delivery of person- centred care. North Lanarkshire Council faces significant operational and strategic implications as a result of the current DSR profile. The number of individuals delayed in hospital reflects both systemic pressures and gaps in community-based support. This not only impacts individual wellbeing and rights but also places strain on acute services and local budgets. Supporting people closer to home remains a core priority. However, achieving this requires targeted investment, improved provider matching, and enhanced workforce capability. The current challenges highlight the need for a coordinated response that strengthens local capacity, embeds preventative practice, and ensures timely transitions from hospital to appropriate community settings. Through the focused work undertaken it has been possible to gather information on emerging themes and risks which are outlined below. Emerging Themes and Risk Factors 1. Support Breakdown Without Clinical Diagnosis A growing number of younger adults with autism are experiencing dysregulation not linked to a defined physical or mental health condition. Families report exhaustion, lack of meaningful support, and an inability to manage behaviours at home, leading to crisis situations and, in some cases, hospital or residential school admissions. 2.Developing a enabling approach which is person centred, and outcome focused.
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6 Focusing on assessment which promotes an enabling approach that supports early intervention when someone is discharged or at risk of admission. Discharge planning from the point of admission is necessary which is underpinned by strong multidisciplinary working is essential. People in North Lanarkshire have access to a range of community, health and social care supports. The commissioning framework is unique and does provide a range of flexibility. At present their framework has expanded to approximately 84 providers, offering support across the full spectrum of social work needs. While this expansion has increased choice, it is recognised that not all providers have the skilled workforce or infrastructure to support those individuals with complex care needs. It is essential that individuals and their families are engaged in identifying their support and suitability is prioritised over availability. This ensures that right care is provided to individuals who require a more tailored and nuanced approach—where provider expertise, flexibility, and a deep understanding of neurodivergent and complex needs is necessary. Alongside this, we have identified a pressing need for development to reduce the risk of support breakdown. Individuals with complex needs—particularly those whose dysregulation is not linked to a diagnosed physical or mental health condition—require providers who can deliver consistent, responsive, and relationship-based support. This is necessary to prevent carer breakdown. Addressing this gap is essential to achieving the core vision of the Health and Social Care Partnership: that everyone should be supported to live in their own home, with care tailored to their unique needs and built around natural supports. Realising this vision will require recurrent training and reflective practice for staff involved in assessment and care management, ensuring decisions are informed by a deeper understanding of complexity and neurodivergence. 3. Housing Appropriate housing is key to successful planning. While housing mechanisms are generally effective, individuals with complex needs require intensive coordination. Close working with NLC Housing Service colleagues, Enterprise and Communities, Registered Social Landlords is required to source housing. There is ongoing collaboration to identify appropriate housing provision including new build. 4. Children and Families: Early Indicators of Systemic Risk The rise in children and young people entering residential schools due to breakdowns in community support is concerning. Many young people present with complex needs linked to autism or neurodivergence, often without a formal diagnosis. These cases correlate with family strain and caregiving challenges. Early education settings, health visitors, and GPs are critical touchpoints for identifying emerging needs. Equipping these professionals with tools, training, and escalation pathways is essential to enable preventative intervention and continuity planning.
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7 There is a clear need for earlier, proactive intervention—at or before diagnosis—through universal services. Supporting caregivers with education, emotional support, and practical strategies can strengthen family resilience, improve outcomes, and reduce crisis-driven transitions. This aligns with a rights-based, whole-family model of care, offering the best opportunity for children and adults to thrive within their communities. Financial Planning Implications: Rising numbers on the DSR and persistent hospital delays signal growing demand for complex care services. Sustained investment is needed to expand local capacity, strengthen provider capability, and develop scalable, community-based support models. 15 individuals who are in hospital will require varying levels of support. The anticipated financial implications is estimated to cost approximately £5.5 million. Workforce The wider health and social work/ care workforce across the system including those supporting the Coming Home agenda is working to capacity supporting people with a range of clinical and social care needs. Staffing levels are beginning to stabilise following a prolonged period of instability, the teams require support to manage the complexity of this work. To support complex discharges there is a requirement for an appropriately skilled and resilient workforce that will strengthen service delivery but also reduce the risk of placement breakdowns and improve outcomes for individuals and families. Conclusion North Lanarkshire has made notable strides under the Coming Home agenda, especially in reducing inappropriate placements and delayed discharges. The DSR has improved visibility and accountability, enabling targeted interventions and supports collaborative working. To meet national ambitions, continued investment, strengthened partnerships, and integration of learning into long-term practice are essential. 7. IMPLICATIONS: NATIONAL OUTCOMES This work contributes directly to several National Health and Wellbeing Outcomes, particularly those focused on enabling individuals to live independently in their communities, improving the quality of life for people who use services, and ensuring that care is person-centred and rights based. The Coming Home agenda supports a shift away from institutional settings toward sustainable, community-based models of care.
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8 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐ 7.2 ASSOCIATED MEASURE(S) Progress will continue to be monitored through the DSR, with regular updates provided to the IJB. Key indicators include reductions in delayed discharges, improved transitions from hospital to home, and increased stability in community placements. 7.3 FINANCIAL The implementation of the Coming Home agenda has been supported by the Community Living Change Fund, with £1.1 million allocated to North Lanarkshire HSCP. While this has enabled short-term improvements, ongoing financial pressures and increasing demand for complex care services present sustainability challenges Anticipated future demand for complex care services driven by rising numbers on the DSR and increasing hospital delays will require sustained financial investment to expand local capacity, enhance provider capability, and ensure long-term viability of community-based support models. This paper has been reviewed by Finance:
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9 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership ENGAGEMENT & PARTICIPATION Yes ☐ No ☐ N/A ☐
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10 Ongoing engagement with individuals, families, advocacy services, and provider organisations is central to the Coming Home approach. Participation mechanisms are being strengthened to ensure that service users have a meaningful voice in planning and decision-making. The Coming Home agenda is underpinned by a commitment to reducing inequalities and promoting rights-based care. EQIA and Fairer Scotland assessments will be completed to ensure that strategic decisions reflect the needs of all individuals, particularly those with complex and neurodivergent profiles. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: The Coming Home agenda is underpinned by a commitment to reducing inequalities and promoting rights-based care. EQIA and Fairer Scotland assessments will be completed as we progress with this agenda, to ensure that strategic decisions reflect the needs of all individuals, particularly those with complex and neurodivergent profiles 8. BACKGROUND PAPERS 9. APPENDICES Please include a glossary of terms if not already included. Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☒ N/A ☐
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11 Diane Fraser CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following;Andrea Breen, Senior Manager BreenA@northlan.gov.uk
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12 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
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1 REPORT Item No: 14 SUBJECT: Suicide Prevention update TO: Integration Joint Board Lead Officer for Report: Diane Fraser Author(s) of Report Andrea Breen Anne Marie Darcey DATE: 10 December 2025 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: ☐ 3. RECOMMENDATIONS It is recommended that the Integration Joint Board: 1. Note the contents of this report, including current suicide prevention activity, trends, and progress against national and local strategies.
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2 2. Support continued implementation of Scotland’s Suicide Prevention Strategy 2022–2032 and associated local action plans, ensuring alignment with national priorities. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES Introduction This report provides the Integration Joint Board with an update on suicide prevention activities across North Lanarkshire. It reflects Scotland’s Suicide Prevention Strategy 2022–2032: Creating Hope Together and its associated action plans, which promote a whole-system approach to prevention. The report aims to inform members of current trends, progress against national and local strategies, and highlight collaborative efforts to reduce suicide rates. This update is presented for noting, ensuring the Board remains aware of key developments, emerging data, and ongoing initiatives that support the delivery of Scotland’s Suicide Prevention Strategy and local action plans. Background Suicide remains a significant public health challenge in Scotland, with complex social, economic, and health determinants influencing risk. The five-year average suicide rate (2020-2024) in North Lanarkshire stands at 16.5 per 100,000 population, which is higher than the national average of 14.Detailed data published in September 2025 by the National Records of Scotland shows that in 2024, there were 704 probable suicide deaths across Scotland, a reduction of 86 deaths, or 11%, compared to 2023. In North Lanarkshire, the number of probable suicides also declined, from 61 in 2023 to 57 in 2024, a decrease of 6.5%. Scotland’s Suicide Prevention Strategy 2022 -2032: Creating Hope Together was launched, alongside the National Action Plan The Scottish Government and Convention of Scottish Local Authorities (COSLA) have introduced a strategy to lower suicide deaths in Scotland over a 10-year plan. Yes ☐ No ☐ N/A ☒
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3 Both documents are based on what people said was needed to lower the numbers of suicides. The Strategy sets out long term plans whilst the Action Plan sets out what will happen to help lower the number of suicides in the shorter term. It is recognised Nationally that Suicide is complicated. The Plan looks at what can be done by the Government and others to help lower suicides. Government, businesses, services, health, housing, education, the voluntary sector, and charities must work in collaboration. Suicide is a growing public health crisis. https://www.gov.scot/publications/creating-hope-together-scotlands-suicide- prevention-action-plan-2022-2025/ https://www.gov.scot/publications/creating-hope-together-scotlands-suicide- prevention-strategy-2022-2032 Suicide Prevention continues to remain a priority for Lanarkshire. It is central to Lanarkshire’s Mental Health Strategy and continues to be embedded across work streams to ensure we maximise opportunities for collaborative working. Early in 2025, Lanarkshire Suicide Prevention Reference Steering Group was created for those working across Lanarkshire in suicide prevention roles. The group meets quarterly to share information and offer training and learning opportunities. By increasing awareness and understanding of suicide, we can direct people their friends and families to the appropriate support at the right time. North Lanarkshire Council Suicide Prevention Partnership Board meet every 8 weeks and continue to review the North Lanarkshire Action Plan on a regular basis. With the recent appointment of a dedicated Suicide Prevention Officer Lead in South Lanarkshire Council, there is an opportunity to consider a Pan-Lanarkshire action plan and coordinated approach to suicide prevention work. Men continue to be disproportionately affected by suicide. In 2024, male deaths in Scotland fell by 12% to 518, while female deaths decreased by 7% to 186. In North Lanarkshire, 39 men and 18 women died by suicide, down slightly from 42 and 19 in 2023. Nationally, the male suicide rate was nearly three times higher than the female rate; locally, it was approximately twice as high. The suicide mortality rate in Scotland’s most deprived areas was two and a-half times higher than in the least deprived areas. Although SIMD-specific data is not available at the local authority level, locally held, though unverified, data suggests that over half of suicide deaths in North Lanarkshire were completed by people living in the most deprived communities. Local data also indicates that the age groups most affected by suicide in North Lanarkshire are individuals aged 30–44 and 45–59.
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4 Locally held data for 2024 for the information on age groups. 2024 Female Male Total Female Male 16-29 2 4 6 33% 67% 30-44 9 12 21 43% 57% 45-59 4 13 17 24% 76% Over 60 3 6 9 33% 67% Total 18 35 53 34% 66% The data for 2025 (to date) is shown in the table below which suggests the same age groups are most affected by suicide: The data below is “live time” data which is provided to NLC, suicide prevention Lead, by Police Scotland. It should be noted that 5 year running average data is used to provide a more accurate picture of trends rather than year on year. 2025 Female Male Total Female Male 16-29 2 3 5 40% 60% 30-44 3 4 7 43% 57% 45-59 1 5 6 17% 83% Over 60 1 1 2 50% 50% Total 7 13 20 35% 65% In North Lanarkshire we continue to be focused on groups most at risk of suicide and those hardest to reach, we use a suicide-safer community approach that aims to build communities that talk openly and freely about suicide, promoting wellness and mental health and supporting those bereaved by suicide. We have promoted several campaigns alongside partners and stakeholders to raise awareness about suicide prevention. Over the past three years, North Lanarkshire Council has delivered two targeted suicide prevention campaigns in response to local intelligence. One campaign focused on individuals aged 35 and over, using YouTube and Facebook, while the other targeted the 16–25 age group via Snapchat and YouTube. These digital campaigns have achieved significant reach, generating nearly 3 million impressions and over 26,000 click-throughs to the Council’s suicide prevention webpage from platforms including Google, Snapchat, Instagram, Facebook, and TikTok.
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5 In addition to online engagement, bus shelter digital advertising continues across 17 North Lanarkshire sites, supported by static posters. The FeelWell NL campaign runs seasonally in November, January, and March, promoting mental wellbeing and encouraging use of local amenities such as country parks, leisure centres, and cultural facilities. The Winter Well campaign and booklet will run throughout December 2025 to February 2026. These initiatives aim to engage residents, reduce stigma, promote wellness, and encourage timely access to support services. https://youtu.be/GF9IHOpSU5U, https://youtu.be/hzN8SYZlTPo. The focus is on equipping individuals, along with their families and friends, with the knowledge and confidence to provide support and direct people to appropriate services when needed. This includes signposting to resources such as Samaritans, Breathing Space, Kooth, and Childline. We aim to improve awareness across local communities in North Lanarkshire, and address the stigma attached to talking about suicide. We have launched a ‘Let’s Talk’ badge, which is used as a tool to encourage people to initiate conversation and help to remove barriers to accessing support. We continue to support several joint funding projects, including the Suicide Prevention Football Tournament which took place on 10th September 2025 and the Grassroots Suicide Prevention work with various football clubs throughout NLC Training Learning resources such as Ask, Tell, Respond, safeTALK and ASIST continue to be delivered throughout NHS Lanarkshire (NHSL) and North & South Lanarkshire Council. There are four levels of suicide prevention training offered including Applied Suicide Intervention Skills Training (ASIST), Suicide Talk and Safe Talk. The team works closely with partners including Samaritans, Breathing Space, and Childline. Training is delivered to around 1,500 people including staff and supporters at sport and community clubs and organizations, third-sector groups, schools and colleges. Trauma Informed Training is now available to all staff within North Lanarkshire Council. NHS Lanarkshire Health Improvement has developed a Mental Health Improvement, Self-harm and Suicide Prevention Training Pathway. This pathway aligns with the NHS Education for Scotland Mental Health Improvement and Suicide Prevention Framework:Scotland’s Knowledge and Skills Framework for Mental Health Improvement, Self-harm and Suicide Prevention is a tool to support development of knowledge and skills across all public services and beyond. The framework includes four domains that cover: promotion of good mental health, improving quality of life, tackling mental health inequalities, supporting people in distress or crisis, promoting resilience and recovery, preventing self-harm and suicide.
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6 It also outlines the knowledge and skills required across four levels of practice: informed, skilled, enhanced and specialist. The NHS Lanarkshire Public Mental Health and Health Improvement Team have structured the Mental Health Training Pathway to reflect this framework. It serves as a tool to encourage the public health workforce to progressively build their knowledge and skills relevant to their roles and responsibilities in mental health. Additional Interventions and Supports: Distress Brief Intervention The SG’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. Lifelink is the commissioned service for DBI. Lifelink have been commissioned jointly by NLC, SLC and NHSL to provide support to all Lanarkshire residents. This commissioned service commenced on 1st April 2024. (see Appendix 1) Children and Young People DBI which is available to young people in S3 and above and is being delivered across 4 pilot schools in NLC until 2026. Lifelink is the Provider in place. Lifelines is also in place within the school environment. This is a Pan-Lanarkshire multi-agency guidance tool aimed at supporting children/young people who may be at risk of self-harm and/or suicide. Lifelines Assessment and intervention guidance will mostly be used by those working direct in an enhanced way with children/young people. (see Appendix 2) Kooth & C&YP (see Appendix 3) Time Space Compassion – NHSL The Time Space Compassion approach continues to be rolled out across NHS Lanarkshire (NHSL), with a particular focus on Primary Care, Unscheduled Care, and community settings. This initiative aims to ensure that the risk of suicide is considered in these environments and that individuals can offer compassionate, culturally sensitive support when someone is suicidal. The approach is grounded in valuing and supporting people, addressing gaps and inconsistencies in care, and focusing on individual experiences. It emphasises human connection and relationships, providing a shared language, resources, and actionable strategies for collective support. By embedding the Time Space Compassion approach in key care settings, NHSL aims to foster environments where individuals at risk of suicide feel understood and supported. This culturally sensitive and compassionate framework enhances the ability of healthcare and community professionals to respond effectively and empathetically to those in crisis. https://www.gov.scot/publications/time-space-compassion-support
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7 6. CONCLUSIONS While progress is evident, the higher-than-average suicide rate in North Lanarkshire, combined with socioeconomic and gender disparities, reinforces the importance of sustained investment, cross-sector collaboration, and community engagement to achieve the national ambition of reducing suicide deaths and promoting mental wellbeing. Current initiatives including community engagement campaigns, structured training pathways, and multi-agency interventions such as Distress Brief Intervention and school-based pilots demonstrate progress toward a whole-system approach. However, continued investment in data-driven strategies, cross-sector collaboration, and stigma reduction is essential to achieve Scotland’s long-term ambition of reducing suicide deaths and improving mental wellbeing. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☐ 7.2 ASSOCIATED MEASURE(S)
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8 To ensure progress and alignment with Scotland’s Suicide Prevention Strategy and local action plans, the following indicators will be monitored: 1. Suicide Rate – Annual change in suspected suicides within North Lanarkshire. 2. Training Uptake – Number of individuals completing suicide prevention training (ASIST, safeTALK, Suicide Talk). 3. Community Engagement – Participation levels in suicide prevention campaigns. 4. Distress Brief Intervention (DBI) Access – Percentage of referrals receiving support within 24 hours. 5. Children and Young People Support – Number of schools implementing Lifelines guidance and DBI for S3 and above. 6. Stigma Reduction – Increased public awareness and willingness to discuss suicide, measured through initiatives such as the “Let’s Talk” badge. 7.3 FINANCIAL Successful delivery of these initiatives will require sustained investment to maintain impact and effectiveness. This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Yes ☐ No ☐ N/A ☒
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9 Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
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10 8. BACKGROUND PAPERS 9. APPENDICES APPENDIX 1 DBI level 2 Monthly Submission Summary Lifelink National DBI level 2 Monthly Submission Summary Lifelink South Lanarkshire DBI Level 2 Monthly Submission Summary All Lifelink Lanarkshire Areas APPENDIX 2 Lifelinks Lanarkshire – Background to Guidance and Implentation APPENDIX 3 KOOTH AND C&YP CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Diane Fraser, Chief Officer Social Work (Adults)
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11 APPENDIX 1
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15 APPENDIX 2
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16 Appendix 3 KOOTH Kooth is a Free, safe, anonymous and online mental health support https://www.kooth.com/ C&YP Services & Resources Directory, May 2024 https://www.nhslanarkshire.scot.nhs.uk/services/childrens-services/mental-health-services-and-resources-directory/
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1 REPORT Item No: 15 SUBJECT: Drug Related Deaths and Alcohol Specific Deaths 2024 Report TO: Integration Joint Board Lead Officer for Report: Morag Dendy, Head of Performance, Planning & Quality Assurance Author(s) of Report John Holleran, NLADP Strategic Lead Kerry Taylor, Business Support Manager DATE: 10 December 2025 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: Kerry Taylor, Business Support Manager ☒ Reviewed By: John Holleran; NLADP Strategic Lead ☒ Endorsed By: Senior Management Team, North Lanarkshire Health and Social Care Partnership ☒
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2 3. RECOMMENDATIONS 3.1 It is recommended that the IJB Note the contents of this report 4. Drug Related Deaths 4.1 The National Records Service (NRS) publishes annual statistics on drug- related deaths. The data for 2024 was released on 2 September 2025. In 2024, there were 1,017 deaths across Scotland attributed to the direct effects of drug misuse. This represents a decrease of 155 deaths (13%) compared to 2023 and is the lowest annual total recorded since 2017. However, the rate of drug misuse deaths remains significantly higher than at the start of the data series in 1996. The figure for 2024 in North Lanarkshire was 85, a decrease from the previous year where, 103 people died. While the reduction is notable, every loss of life is significant. Efforts continue in collaboration with communities to enhance services and address the broader inequalities that contribute to drug-related harm. 4.2 The most robust measure for comparing drug-related deaths over time is the five-year age-standardised rate. The following extract from the National Records report provides further detail. Figure 1 - The rate of drug misuse deaths varies across Scotland - Age standardised mortality rate of drug misuse deaths by council area, 2020-2024
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3 4.3 The latest decrease in the number of drug deaths was not seen across all areas of Scotland (Figure 7). The number of drug misuse deaths decreased in 21 council areas, increased in nine areas and was unchanged in two areas. The largest decreases in drug misuse between 2023 and 2024 were in Glasgow City (-61 deaths), City of Edinburgh (-19 deaths) and North Lanarkshire (-18 deaths). These areas also have the highest number of drug misuse deaths, as well as larger populations. With the exception of 2021 and 2022 this is the lowest number of DRDs recorded in North Lanarkshire since 2018. The proportional reduction in drug related deaths is more than triple for females compared to males in North Lanarkshire in 2024. Reduction of 6 deaths (9%) for males (2024 61, 2023 67) Reduction of 12 deaths (33%) for females (2024 24, 2023 36). Lowest number of female deaths in north Lanarkshire since 2019 41 % of all DRDs in north Lanarkshire in 2024 occur in the 35-44 age group, nearly double that of any other age group. Nearly 90% (87%) of DRDs in north Lanarkshire in 2024 occur within SIMD quintiles 1 and 2, with 61% within SIMD 1. This contrasts to Scotland were 74% fall within the 2 most deprived quintiles. In 2024, 4 of 6 localities in North Lanarkshire saw a reduction in the number of DRDs compared to the previous year, 1 stayed the same. Airdrie/Coatbridge/Bellshill came down, Cumbernauld remaining the same and Wishaw saw an increase of 12. Opioids are the most common drug implicated with a slight increase recorded in 2024. The proportion of cocaine implicated for North Lanarkshire fell by 8%. Cocaine was implicated in DRDs in North Lanarkshire in 2024 has changed from being 9% above the national figure in 2023 to 5% below in 2024. Work is continuing via the North Drug Death Review process to identify learning and key actions to support service delivery improvements. Similarly, there is a process in place via the Drug Trend Monitoring Group to respond to new and emerging trends/harms with the NLADP support team working closely with Public Health colleagues to review intelligence and respond appropriately in line with our wider Drug Deaths Prevention work. 4.4 Medication Assisted Treatment Standards The Medication Assisted Treatment (MAT) standards: access, choice, support were published on 31 May 2021. MAT Standards ensure that people receiving treatment for drug use receive a high quality of care and are split into 10 specific standards:
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4 MAT 1: Same Day Access - All people accessing services have the option to start MAT from the same day of presentation MAT 2: Choice - All people are supported to make an informed choice on what medication to use for MAT, and the appropriate dose MAT 3: Assertive Outreach and Anticipatory Care - All people at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT. MAT 4: Harm Reduction at Point of MAT Delivery - All people are offered evidence-based harm reduction at the point of MAT delivery MAT 5: Support to remain in treatment for as long as requested - All people will receive support to remain in treatment for as long as requested MAT 6: Access to psychological therapy - The system that provides MAT is psychologically informed (tier 1); routinely delivers evidencebased low intensity psychosocial interventions (tier 2); and supports individuals to grow social networks MAT 7: Access to MAT in Primary Care - All people have the option of MAT shared with Primary Care MAT 8: Access to Welfare Advice and Advocacy - All people have access to independent advocacy and support for housing, welfare and income needs MAT 9: Mental Health Care - All people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery MAT 10: Trauma Informed Services - All people receive trauma informed care North Lanarkshire successfully implemented MAT standards 1-5. Significant progress was made in 2024 in introducing MAT 1 - 5, including same day access to prescribing via the Urgent Response Team. In total, 247 referrals were made to the Urgent Response Team for same day prescribing linked to Opiate Substitution Therapy (OST). North Lanarkshire continues to deliver on the MAT standards and is on track with the next submission for 2025 benchmarking due in March 2026.
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5 4.5 Harm reduction and Assertive Outreach A targeted crisis response team was commissioned via NLADP in 2022, this is delivered by Turning Point Scotland, in collaboration with housing and treatment service colleagues. The service delivers vital support to reach people in crisis sooner, following a high risk event, connecting people to the most appropriate support following a near fatal overdose. This service supports a large proportion of the MAT 3 and MAT 4 engagement and reporting requirements. High risk events followed up from October 2024 – Sept 2025 Total Assertive outreach: 913 Non-Fatal Overdoses attended: 219 Crisis response: 96 Naloxone Kits- 353 Injecting Equipment Provision - 145 4.6 Residential Rehab Residential rehab continues to be made available to anyone wishing to explore this as part of their treatment and care choices, with 26 placements being made between Apr – Nov 2025. Following a review and thematic analysis of the residential rehab pathway by Healthcare Improvement Scotland, NLADP submitted an action plan in August 2025 that will focus on improvements over the coming years in the following areas: High level Theme 4: Detrimental effects on families/carers and friends in relation to (their loved ones) alcohol and/or drug use High level Theme 2: Vulnerable communities have higher rates of unmet need in relation to substance use. High level Theme 1: Certain demographics are disproportionately affected by substance use. 5. Alcohol Specific Deaths 5.1 The national statistics on Alcohol Specific Deaths are produced annually by the National Records Service (NRS) and the 2024 data was released on 23 September 2025. In 2024, there were 1,185 alcohol-specific deaths registered in Scotland, a decrease of 7% (92 deaths) compared with 2023. This is the lowest number of alcohol-specific deaths registered in any year since 2019. After adjusting for age, North Lanarkshire had higher alcohol-specific mortality rates than the Scottish average in the period 2020-2024.
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6 5.2. The most reliable comparison data for Alcohol Specific Deaths is the 5-year age standardised rate and this is an extract from the National Records report. Figure 1 - The rate of alcohol specific deaths varies across Scotland - Age standardised mortality rate of alcohol specific deaths by council area, 2020-2024 5.3 The latest decrease in the number of alcohol-specific deaths was not seen across all areas of Scotland (Figure 2). The number of alcohol-specific deaths decreased in 21 council areas, increased in nine areas and was unchanged in two areas. The largest decreases in alcohol-specific deaths between 2023 and 2024 were in Glasgow City (-29 deaths) and South Lanarkshire (-20 deaths). These areas also have some of the highest number of alcohol-specific deaths, as well as larger populations. Alcohol-specific death rate in North Lanarkshire is 29.2 per 100,000, significantly higher than the Scottish average of 21.4. North Lanarkshire is the 3rd highest area in Scotland for alcohol specific deaths.
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7 Hospital admissions exceed 700 per 100,000, with Airdrie and Coatbridge being the most affected localities. People in the most deprived areas are 5 times more likely to be admitted for alcohol-related issues. In recognition of these challenges, North Lanarkshire ADP hosted an Alcohol Summit in April 2025 which brought together key voices from public health, government, third-sector organisations, clinical services, and communities to address the increasing concern surrounding alcohol-related harm in North Lanarkshire. In total, 139 people attended the event at the Lantern-house Theatre in Cumbernauld. The final report from the event offers a clear action plan for North Lanarkshire with a range of improvement measures that could have a significant impact on reducing harms and improving care for people impacted by alcohol use, their own of someone else’s. 6. Drug and Alcohol Treatment Waiting Times The drug and alcohol treatment waiting times (standard A11) is defined as ‘90% of people who need help with their drug or alcohol problem will wait no longer than three weeks for treatment and no clients will wait more than 6 weeks’. The target applies specifically to tier 2 tier and tier 3 drug or alcohol specialist service providers. These targets have been consistently Report 1 Weeks waited by Service by Financial Year (Number) all Waits. 2024/25 and 2025/26 YTD 10.11.25 service_user_type (All) Financial Year (Referral received) (Multiple Items) Financial Quarter (Referral received) (All) Text Month (Referral received) (All) Count of eocn weeks_waited service_provider wait_status 0-3 weeks 3-6 weeks > 6 weeks Grand Total North Lan Integrated Addiction(Motherwell)Torrance 448 5 1 454 North Lanarkshire Addiction Service (Airdrie) 539 26 1 566 North Lanarkshire Addiction Service (Bellshill) 296 7 1 304 North Lanarkshire Addiction Service (Coatbridge) 384 4 388 North Lanarkshire Addiction Service (Wishaw) 460 8 468 North Lanarkshire Addiction Services (Cumbernauld) 512 6 518 Grand Total 2639 56 3 2698 weeks waited Service/ team 0-3 weeks 3-6 weeks > 6 weeks Grand Total North Lan Integrated Addiction(Motherwell) 99% 1% 0% 100%
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8 North Lanarkshire Addiction Service (Airdrie) 96% 3% 0% 100% North Lanarkshire Addiction Service (Bellshill) 97% 2% 0% 100% North Lanarkshire Addiction Service (Coatbridge) 99% 1% 0% 100% North Lanarkshire Addiction Service (Wishaw) 98% 2% 0% 100% North Lanarkshire Addiction Services (Cumbernauld) 99% 1% 0% 100% Grand Total 98% 2% 0% 100% Morag Dendy Head of Planning, Performance and Quality Assurance CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact John Holleran, NLADP Strategic Lead. john.holleran@lanarkshire.scot.nhs.uk
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1 REPORT Item No: 16 SUBJECT: North Lanarkshire ADP – Self-Assessment Survey TO: Integration Joint Board Lead Officer for Report: Morag Dendy Head of Planning, Performance and Quality Assurance Author(s) of Report John Holleran – Strategic Lead, North Lanarkshire ADP DATE: 10 December 2025 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: ☐ 3. RECOMMENDATIONS 3.1 The IJB is asked to: (1) Note the content of the report;
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2 (2) Note the content of the Annual Reporting Survey to the Scottish Government that requires approval by the IJB. This was submitted to the Scottish Government via the ADP by June 2025. The survey is designed to collect information on a range of aspects relating to the delivery of the Nation Mission on Drugs, to deliver on the priorities in line with additional investment priority areas; (3) Note the arrangements in place across each priority area; Prevention, Early Intervention and Education Residential Rehab Assertive Outreach and Crisis support Harm reduction – including Naloxone provision Whole Family Approach and Family Inclusive Practice Lived and Living Experience (4) Approve the NLADP Annual report acknowledging the appropriate supports and governance arrangements are in place to deliver the National Mission priorities and The Partnership Delivery Framework objectives. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 The NLADP Strategic Lead has been working closely with key stakeholders across the five ADP sub-groups structures (below) to deliver on the national mission priorities in keeping with the national evidence-base, local scoping work and learning from commissioned services including those with lived experience. The ADP sub-groups oversee and support decisions on local investments linked to the National Mission priorities. 1. Prevention, Early Intervention, & Education 2. Treatment, Care & Recovery 3. Whole Family Approach 4. Public Health Approach to Justice 5. Reducing Alcohol Harms Group 5.2 All thirty of Scotland ADPs are responsible for delivering on the National Mission Priorities. The aim of the National Mission is to improve and save the lives of people who use drugs and their loved ones. Yes ☐ No ☐ N/A ☐
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3 The purpose of the Annual Report Survey to give local ADPs a tool to engage and discuss opportunities and barriers to delivery. Strategic Planning follows a cycle of Assessing need Aligning resources Agreeing delivery plans and priorities Reporting and learning from outcomes 5.3 The annual Report Survey is designed to ensure key measures are in place to support the work of the ADP. The Annual Report Survey should be agreed and signed off with the relevant Chief Officers and stakeholders 5.4 The Annual report survey sets out where the local ADP and relevant partners are in relation to the Partnership Delivery Framework: 1. Strategic planning 2. Financial arrangements 3. Quality improvement and Outcomes 4. Governance and Oversight 5. The relationship between the ADP and the Integration Authority 6. CONCLUSIONS 6.1 The Annual report survey details the range of measures in place across North Lanarkshire in 2024/25 to maximise engagement with people needing support in relation to their alcohol and other drug use. The survey demonstrates the progress being made towards delivering on the National Mission priorities. NLADP places the experience of people with lived experience and families at the centre of developments. This approach has significantly reshaped the commissioning intentions, created a robust response to the challenge of preventable drug deaths in North Lanarkshire and informed the ADP Investment Plans. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒
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4 Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) • Medication Assisted Treatment (MAT) standards – 1-5 implemented and 6- 10 beyond embedded by March 2026 • Residential rehab – assessment and access for anyone who chooses/where appropriate as part of their care and treatment. Each ADP/Health Board should now publish rehab pathways online setting out how people can access residential rehab. • Harm reduction – consistent approaches and increase workforce confidence/capacity to deliver HR. Includes Naloxone provision, Blood-Bourne Virus testing and wound care. • Assertive Outreach – A fully operational crisis response service with assertive outreach and overdose response is in place to support people 356 day per year. • Whole Family Approach – increase/widen Family Inclusive Practice (FIP) across all treatment and care settings • Recovery – Lived and Living Experience (LLE) involved in design, delivery and evaluation of services. LLE Panels have been active since October 2024. • Human Rights – are at the heart of how substance use services and wider supports are designed and offered. 7.3 FINANCIAL This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Yes ☐ No ☐ N/A ☒
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5 Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report:
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6 EQIA added to website: 8. BACKGROUND PAPERS This report sets out the progress made by North Lanarkshire ADP on delivering on Rights, respect recovery, the national performance framework, National mission objectives linked to reducing harm from alcohol and drugs. This report forms the basis of the annual return to the Scottish Government setting out progress made from investments in 2024/25. ADP - Annual Reporting Survey 2024-25 - Questionnaire.docx 9. APPENDICES Please include a glossary of terms if not already included. ADP Annual Reporting Survey 2024-2025 CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; John Holleran via john.holleran@lanarkshire.scot.nhs.uk Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
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7 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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8
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1 Alcohol and Drug Partnership (ADP) Annual Reporting Survey: 2024/25 This survey is designed to collect information from all ADPs across Scotland on a range of aspects relating to the delivery of the National Mission to reduce drug deaths and improve lives, as well as activities relating to alcohol during the financial year 2024/25. This will not reflect the totality of your work but will cover areas where you do not already report progress nationally through other means. The survey is composed of single option and multiple-choice questions with a limited number of open text questions. We want to emphasise that the multiple-choice options provided are for ease of completion and it is not expected that every ADP will have all of these in place. This survey includes questions from across drug and alcohol policy areas. It has been designed to collate as many asks as possible from Scottish Government to minimise requests throughout the year. There is a combination of established questions which enable comparison year on year and new questions that reflect current and anticipated future data needs. We do not expect you to go out to services to respond to questions relating to activities undertaken by them in your area. Where questions refer to service level activities, we are interested in the extent to which you are aware of these as ADP. The data collected will be used to better understand progress at a local level and will inform: National monitoring of the National Mission to reduce drug deaths and improve lives; The work of the ongoing evaluation of the Nation Mission, including the economic evaluation; The work of advisory groups including those supporting the programmes around Whole Family Approach, surveillance, and residential rehabilitation among others; The work of national organisations which support local delivery; and Future policy planning around drugs and alcohol. Findings will be published as Official Statistics in the autumn. The publication reporting on the 2023/24 ADP survey is available on the Scottish Government website. We plan to publish data from closed answer (quantitative) questions at an ADP level to enable best use of the survey data and ensure transparency. Data from closed answer (qualitative) questions will be shared with Public Health Scotland and their commissioned research teams to inform drug and alcohol policy monitoring and evaluation, where excerpts and/or summary data may be used in published reports, and will be subject to FOI requests. You may still wish to publish your return, as in previous years. The deadline for returns is Friday 13th June 2025. Your submission should be signed off by the ADP and the IJB. We are aware that there is variation in the timings of IJB meetings, so if sign off is not possible by the date of submission, please indicate this when you provide your return and advise an expected sign off date if possible. If you require clarification on any areas of the survey or would like any more information, please do not hesitate to get in touch by email at substanceuseanalyticalteam@gov.scot.
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2 Cross-cutting priority: Surveillance and Data Informed Question 1 Which Alcohol and Drug Partnership (ADP) do you represent? Mark with an ‘x’. [single option] Aberdeen City ADP Aberdeenshire ADP Angus ADP Argyll & Bute ADP Borders ADP City of Edinburgh ADP Clackmannanshire & Stirling ADP Dumfries & Galloway ADP Dundee City ADP East Ayrshire ADP East Dunbartonshire ADP East Renfrewshire ADP Falkirk ADP Fife ADP Glasgow City ADP Highland ADP Inverclyde ADP Lothian MELDAP ADP Moray ADP North Ayrshire ADP X North Lanarkshire ADP Orkney ADP Perth & Kinross ADP Renfrewshire ADP Shetland ADP South Ayrshire ADP South Lanarkshire ADP West Dunbartonshire ADP West Lothian ADP Western Isles ADP
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3 Question 2 Which groups or structures were in place at an ADP level to inform surveillance and monitoring of alcohol and drug harms or deaths? Mark all that apply with an ‘x’ – if drug and alcohol deaths are reviewed at a combined group, please select both ‘Alcohol death review group’ and ‘Drug death review group’. [multiple choice] X Alcohol death review group X Alcohol harms group X Drug death review group X Drug trend monitoring group/Early Warning System None Other (please specify): Question 3 3a. Do Chief Officers for Public Protection receive feedback from drug death reviews? Mark with an ‘x’. [single option] X Yes No Don’t know 3b. If no, please provide details on why this is not the case. [open text – maximum 500 characters] Question 4 Please list what local and national structures are in place in your ADP area for the monitoring and surveillance of alcohol and drug harms and deaths. Please describe how these have been used to inform local decision making in response to emerging threats (e.g. novel synthetics) in the past year. [open text – maximum 2,000 characters] North Lanarkshire has both a drug death prevention group (DDPG) structure and reducing alcohol harms groups. These operate on a Pan Lanarkshire basis with local actions and priorities identified for each ADP area within. The two oversight groups are accountable to the ADP Board, meeting and reporting on a quarterly basis. Each structure has a number of workstreams within with representation from a broad range of stakeholders from statutory and community-based services and includes people with lived and living exprience, including families. Reporting is standardised and linked to the national alcohol framework recommendations and actions/guidance published in 'Changing Lives' and the outcomes and indicators developed as part of the drug death task force. In 2024, there was a complete review of both structures with SDF and Alcohol Focus Scotland support. There is also a Drug Trends Monitoring Group in place that was reviewed this year alongside PHS RADAR and SAS colleagues to ensure our early detection and reporting
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4 arrangments are fully aligned with the national approach. This include the dissemination of alerts to all community based supports and a two way reporting structure now in place across North Lanarkshire. Question 5 5a. Have you made specific revisions to any protocols in the past year in response to emerging threats (e.g. novel synthetics, trends in cocaine, new street benzos, etc.) ? Mark with an ‘x’. [single option] X Yes No 5b. Please provide details of any revisions [open text – maximum 500 characters] As highlighted above, we reviewed and updated our early detection SOP, in keeping with new and emerging drug harms including novel synthetics, nitazenes and other emerging trends. We continue to monitor and review intelligence on a week to week basis and have an escalation process for Problem Assessment Groups (PAGs) to be established with further escalation process if needed via Incident Management Team (IMT) in keeping with local and national public health protocols. Question 6 Please describe ways in which you routinely engage with commissioned services in your ADP area (e.g. through online surveys, reporting databases, email or phone communication, ADP representation on governance or advisory structures, events etc.). [open text – maximum 1000 characters] NLADP host an annual stakeholder event shaped and attended by all partners and comissioned services, sharing learning and forming debate around future ADP priorities. All services are well represented across the ADP sub-group structures and report to the ADP on a quarterly basis through standardised reporting templates. These gather numerical and qualitatve feedback aligned to the ADP priority areas. We have ongoing dialogue with commissioned services on a weekly basis. In addition, there's a commissioned service check-in every 6 weeks. We carry out annual reviews with all commisisioned services and the ADP support team is resourced to offer ongoing support. NLADP has a website that's updated on a weekly basis. NLADP support team issues a monthly email news round up with a range of news/training and local developments with a quarterly bulletin distributed to our mailing list, all commission services feed into and feature. The ADP publishes an annual highlights report .
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5 Cross-cutting priority: Resilient and Skilled Workforce Question 7 7a. What is the whole-time equivalent1 staffing resource routinely dedicated to your ADP Support Team as of 31 March 2025? [numeric, decimal] Total current staff (whole-time equivalent including fixed-term and temporary staff, and those shared with other business areas) 8.50 Total vacancies (whole-time equivalent) 0.00 1 Note: whole-time equivalent (WTE) is a unit of measurement that indicates the total working hours of employees in relation to a full-time position. It helps to standardise and compare staffing resource across different teams or organisations. A full-time employee is equal to one whole-time equivalent. For part-time employees, divide their hours by the whole-time equivalent. For example, if a part-time employee is required to work 7.5 hours per week and a ‘full-time’ position is considered to be 37.5 hours, the WTE would be 0.2 (7.5 hours / 37.5 hours).
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6 7b. Please list the job title for each vacancy in your ADP Support Team on the 31 March 2025 (if applicable). [open text – maximum 500 characters] Strategic Lead, Development officer - x 3, Information research Officer, Administrator, Higher Clerical Officer, Peer support worker Drug Death Information Office (0.5 WTE) Question 8 Please select any initiatives you have undertaken as an ADP that are aimed at improving employee wellbeing (volunteers as well as paid staff). Mark all that apply with an ‘x’ [multiple choice] Training and awareness X Promotion of information and support initiatives X Provision of training on issues including trauma awareness and crisis management Other (please specify): Workplace support X Flexible working X Implementation of risk assessment for work at home and in the workplace X Inclusive workplace initiatives (including staff networks and wellbeing champions) X Provision of occupation health services Staff recognition schemes Use of disability passports X Workload management Other (please specify): Institution-provided support X Provision of coaching and supervision for staff and volunteers X Provision of counselling for staff and volunteers Other (please specify): Wellbeing activities Drug and/or alcohol death reflective sessions
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7 X Peer support groups X Provision of mindfulness courses/learning materials Social and physical activities Other (please specify): Engagement Participation in local Clinical Care Governance Meetings Undertaking of staff needs assessments and engagement to understand wellbeing needs x Regular meetings about staff pressures with senior and junior staff Other (please specify): X Other initiatives which don’t fit in these categories (please specify): Staff devepement sessions and 6 weekly support and supervision.
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8 Cross cutting priorities: Lived and Living Experience Question 9 9a. Do you have a formal mechanism at an ADP level for gathering feedback from people with lived/living experience who are using services you fund? Mark all that apply with an ‘x’. [multiple choice] X Engagement with recovery communities X Experiential data collected as part of the Medication Assisted Treatment (MAT) programme X Feedback / complaints process X Lived / living experience panel, forum and / or focus group X Questionnaire / survey No formal mechanism in place Other (please specify): 9b. In the past year, have members of any of the following groups with lived and/or living experience participated in any of the above engagement mechanisms? Mark all that apply with an ‘x’. [multiple choice] X People who are current or former employees or volunteers at the ADP or drug and/or alcohol services X People who are not employed at the ADP or at drug and/or alcohol services X People who are currently accessing treatment or support for problem drug use (may include treatment for problem alcohol use) X People who are currently accessing treatment or support for problem alcohol use X People with living experience of drug and/or alcohol use who are not currently receiving treatment or support X People who are experiencing homelessness X Women X Young people Other (please specify): Question 10 10a. In what ways are people with lived and living experience able to participate in ADP decision-making? Mark all that apply with an ‘x’. [multiple choice] Through ADP board membership X Through a group or network that is independent of the ADP X Through an existing ADP group/panel/reference group X Through membership in other areas of ADP governance (e.g. steering group)
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9 Not currently able to participate Other (please specify): 10b. In what ways are family members able to participate in ADP decision-making? Mark all that apply with an ‘x’. [multiple choice] Through ADP board membership X Through a group or network that is independent of the ADP X Through an existing ADP group/panel/reference group X Through membership in other areas of ADP governance (e.g. steering group) Not currently able to participate Other (please specify): Question 11 What mechanisms are in place within your ADP to ensure that services you fund involve people with lived/living experience and/or family members in their decision-making (e.g. the delivery of the service)? Mark all that apply with an ‘x’. [multiple choice] X Asked about in reporting X Stipulated in our contracts None Other (please specify):
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10 Cross cutting priorities: Stigma Reduction Question 12 Within which written strategies or policies does your ADP consider stigma reduction for people who use substances and/or their families? Mark all that apply with an ‘x’. [multiple choice] X ADP strategy, delivery and/or action plan X Alcohol deaths and harms prevention action plan X Communication strategy Community action plan Drug deaths and harms prevention action plan X MAT standards delivery plan X Service development, improvement and/or delivery plan None Other (please specify): Question 13 Please describe what work is underway in your ADP area to reduce stigma for people who use substances and/or their families. [open text – maximum 2,000 characters] Stigma Free Lanarkshire is a programme that aims to end mental health stigma and discrimination. The North ADP LLE panel members have actively contributed to updating resources around the intersectionality around Mental Health and Substance use with See Me and Stigma Free Lanarkshire bringing training co- produced in by LLE panels back to Lanarkshire to pilot. NLADP LLE Panel have supported the process through several workshops on appropriate content. The ADP LLE support worker is part of the SG stigma working group and has now undertaken training to be a stigma champion. They are now able to deliver stigma training with this being extended to LLE panel members in 2025. The ADP has a draft stigma action plan that is to be consulted on in 2025 with a stigma action fund being agreed to support local activities aimed at tackling stigma.
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11 Fewer people develop problem substance use Question 14 How is information on local treatment and support services made available to different audiences at an ADP level (not at a service level)? Mark all that apply with an ‘x’. [multiple choice] In person (e.g. at events, workshops, etc) Leaflets / posters Online (e.g. websites, social media, apps, etc.) Non-native English speakers (English Second Language) People from minority ethnic groups People from religious groups People who are experiencing homelessness People who are LGBTQI+ People who are pregnant or peri-natal People who engage in transactional sex People who have been involved in the justice system People with hearing impairments and/or visual impairments People with learning disabilities and literacy difficulties Veterans Women None of the above X X X Other (please specify
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12 Question 15 Which of the following education or prevention activities were funded or supported2 by the ADP?3 Mark all that apply with an ‘x’. [multiple choice] 0-15 years (children) 16-24 years (young people) 25 years+ (adults) Campaigns / information X X X Harm reduction services X X Learning materials X X X Mental wellbeing X X X Peer-led interventions X X X Physical health X X X Planet Youth X X Pregnancy & parenting Youth activities X X Other (please specify) None 2 Note: ‘supported’ refers to where the ADP provides resources of some kind (separate from financial, which is covered by “funded”). This could take the form of knowledge exchange, staffing, the supply of materials (e.g. learning templates, lending them a physical location), etc. 3 Note: activities which are not relevant for older age groups have been shaded out to avoid confusion on completion of this question.
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13 Risk is reduced for people who use substances Question 16 16a. Please select in which settings each of the following harm reduction initiatives are delivered in your ADP area. Mark all that apply with an ‘x’. [multiple choice] Supply of naloxone Hepatitis C testing Injecting equipment provision Wound care Community pharmacies X X X Drug services (NHS, third sector, council) X X X X Family support services X General practices Homelessness services X X Hospitals (incl. A&E, inpatient departments) X X X X Justice services X Mental health services Mobile/outreach services X X X X Peer-led initiatives X X X Prison X X x X Sexual health services X X X Women support services X X X X Young people’s service None Other (please specify) 16b. Please provide details about any changes to settings in which harm reduction initiatives have been delivered in the past year. Please describe the changes and any reasons for these changes. [Open text- maximum 2,000 characters] The ADP commisioned a combined Crisis Outreach Team - delivered by Turning Point Scotland (in 2024). This has comprises of 3 key elements; Overdose response, assertive outreach and housing crisis support. This service takes a harm reduction approach to support people to engage in treatment and support at the right moment. The service works closley with SAS, NHSL Harm reduction team and the Urgent Response Team for access to same day prescribing in keeping with MAT standards 1-5. The service operates 365 day a year from 10am to 10pm.
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14 Question 17 17a. Which of the following harm reduction interventions are there currently a demand for in your ADP area? (Either where the intervention is not currently provided or where demand exceeds current supply). Mark all that apply with an ‘x’. [multiple choice] Drug checking X Drug testing strips X Harm reduction advice and support in relation to psychostimulants Heroin Assisted Treatment Naloxone availability in public facilities (e.g. pre-stationed naloxone, naloxone box etc.) X Provision of foil Safe supply of substances Safer drug consumption facility Safer inhalation pipe provision Other (please specify): 17b. Please provide any details (e.g. scale of demand, source of requests, whether current demand exceeds supply etc.). [open text – maximum 500 characters] Since introducing Nitazene testing strip in April 2024, Truning Point Scotland (TPS) our key delivery partner have purchased 800 nitazine testing kits in total. TPS have distributed around 300 and have results for 172, TPS provided 300 to Harm Reduction Team. There is currently 200 in stock. Question 18 18a. Do you have an adequate supply of naloxone in your ADP area to meet general needs? Mark with an ‘x’. [single option] X Yes No Unsure 18b. Within the context of a more toxic and unpredictable drug supply which may require higher doses of naloxone to be administered, do you have adequate supply of naloxone in your ADP area to meet demand if a significant incident were to occur? Mark with an ‘x’. [single option] X Yes No Unsure
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15 People most at risk have access to treatment and recovery Question 19 Which partners within your ADP area have documented pathways in place, or in development, to ensure people who experience a near-fatal overdose (NFO) are identified and offered support? Mark all that apply with an ‘x’. [multiple choice] NFO pathway in place NFO pathway in development Community recovery providers Homeless services X Hospitals (including emergency departments) X Housing services X Mental health services X Police Scotland X Primary care X Prison X Scottish Ambulance Service X Scottish Fire & Rescue Service Specialist substance use treatment services X Third sector substance use services X Other (please specify) Question 20 Which, if any, of the following barriers to implementing NFO pathways exist in your ADP area? Mark all that apply with an ‘x’. [multiple choice] Further workforce training required High staff turnover Insufficient funds X Issues around information sharing Lack of leadership Lack of ownership Lack of physical infrastructure X Lack of staff to support out of hours or extended core business hours X Workforce capacity None Other (please specify):
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16 Question 21 In what ways have you worked with justice partners4? Mark all that apply with an ‘x’. [multiple choice] Strategic level X ADP representation on local Community Justice Partnership X Contributed to strategic planning X Coordinated activities between justice, health or social care partners X Data sharing X Justice organisations represented on the ADP (e.g. COPFS, Police Scotland, local Community Justice Partnership, local Justice Social Work department, prison) x Provided advice and guidance Other (please specify): Operational level X Provided funding or staff for a specialist court (Drug, Alcohol, Problem Solving) X Raised awareness about community-based treatment options (partners involved in diversion from prosecution or treatment-based community orders) X Supported staff training on drug or alcohol related issues X Activities to support implementation of MAT standards Other (please specify): Service level Funded or supported: Navigators for people in the justice system who use drugs X Services for people transitioning out of custody X Services in police custody suites Services in prisons or young offenders’ institutions X Services specifically for Drug Treatment and Testing Orders (DTTOs) X Services specifically for people serving Community Payback Orders with a Drug or Alcohol Treatment Requirement Other (please specify): 4 Note: ‘justice partners’ includes Community Justice Partnerships (CJPs), Justice Social Work departments, Prisons and Young Offender Institutes, Police, Crown Office and Procurator Fiscal Service (COPFS), Scottish Courts and Tribunals Service (SCTS), Sacro, and third sector organisations that specifically serve people involved with the criminal justice system.
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17 Question 22 Which activities did your ADP support at each stage of the criminal justice system? Mark all that apply with an ‘x’. [multiple choice] Pre- arrest5 In police custody6 In courts7 In prison8 Upon release9 Advocacy or navigators X x X Alcohol interventions X X X Drug and alcohol use and treatment needs screening X X X Harm reduction inc. naloxone X X X Health education & life skills X X Medically supervised detoxification x X Opioid Substitution Therapy X X Psychosocial and mental health based interventions X X X Psychological and mental health screening X X Recovery (e.g. café, community) X X Referrals to drug and alcohol treatment services X X X X Staff training X X None Other (please specify) 5 Pre-arrest: Services for police to refer people into without making an arrest. 6 In police custody: Services available in police custody suites to people who have been arrested. 7 In courts: Services delivered in collaboration with the courts (e.g. services only available through a specialist drug court, services only available to people on a DTTO). 8 In prison: Services available to people in prisons or young offenders’ institutions in your area (if applicable). 9 Upon release: Services aimed specifically at supporting people transitioning out of custody.
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18 Question 23 What barriers to accessing support, if any, are there in your area for people who are involved in the justice system? Mark all that apply with an ‘x’. [multiple choice] Lack of accessibility to mainstream alcohol and drug services and support services (such as lack of transport options) Lack of services tailored specifically to people who are on Community Payback Orders, Drug Treatment and Testing Orders, Supervised Release Orders and other community orders Lack of specific pathways for people who are involved in the justice system Lack of support for people who are involved in the justice system after receiving treatment X Services with entry requirements which exclude people convicted of specific offences (such as arson) X Services with entry requirements which exclude people on Community Payback Orders, Drug Treatment and Testing Orders, Supervised Release Orders and other community orders None Other (please specify): Question 24 What types of residential services are available in your area which can be accessed by people who are subject to Community Payback Orders, Drug Treatment and Testing Orders, Supervised Release Orders and other community orders to access support? Mark all that apply with an ‘x’. [multiple choice] Mainstream residential rehabilitation services (i.e. those who are open to anyone) Mainstream residential services other than rehabilitation (e.g. recovery housing) Residential services specifically targeted to people involved in the justice system, such as Turnaround or other service (please specify which services): X Mainstream stabilisation/crisis services Other (please specify): Question 25 25a. Do you have drugs and alcohol testing services in your ADP area for people going through the justice system on an order or licence? Mark all that apply with an ‘x’. [multiple choice] X Yes, for alcohol X Yes, for drugs No
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19 Unsure 25b. Who provides testing services for drugs and/or alcohol? Mark all that apply with an ‘x’. [multiple choice] Alcohol testing Drugs testing Private provider NHS addiction services X X Other local provider (please specify) Other arrangement (please specify) Not applicable 25c. What methods are used for drugs and/or alcohol testing? Mark all that apply with an ‘x’. [multiple choice] Alcohol testing Drugs testing Handheld devices Spit tests X Urine tests X X Electronic monitoring Patches Other (please specify) Not applicable
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20 People receive high quality treatment and recovery services Question 26 What screening options are in place to address alcohol harms? Mark all that apply with an ‘x’. [multiple choice] X Alcohol hospital liaison X Arrangements for the delivery of alcohol brief interventions in all priority settings Arrangement of the delivery of alcohol brief interventions in non-priority settings Fibro scanning Pathways for early detection of alcohol-related liver disease None Other (please specify): Question 27 What treatment options are in place to address alcohol harms? Mark all that apply with an ‘x’. [multiple choice] X Access to alcohol medication (e.g. Antabuse, Acamprase, etc.) X Alcohol hospital liaison X Alcohol-related cognitive testing (e.g. for alcohol related brain damage) X Community-based alcohol detox (including at-home) In-patient alcohol detox X Pathways into mental health treatment X Psychosocial counselling X Residential rehabilitation None Other (please specify):
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21 Question 28 28a. Which, if any, of the following barriers to residential rehabilitation exist in your ADP area? Mark all that apply with an ‘x’. [multiple choice] Availability of aftercare X Availability of detox services X Availability of stabilisation/crisis services Challenges accessing additional sources of funding Current models are not working Difficulty identifying all those who will benefit Further workforce training required Geographic distance Insufficient base funding Insufficient staff Lack of awareness of residential rehabilitation among potential clients Lack of awareness of residential rehabilitation amongst referrers X Lack of bed capacity within ADP area X Lack of specialist providers Lack of transportation to travel to available capacity Scope to further improve/refine your own pathways Variation in prices from different providers X Waiting times None Other (please specify): 28b. What actions are your ADP taking to overcome these barriers to residential rehabilitation? [open text – maximum 500 characters] The Drug Death prevention Group and alcohol harms groups both have a strategic action to consider stabilisation and detox support as an area of need and concerns with a SLWG established by the ADP to take this forward in 2025. The residential rehab oversight group is also responsible for reviewing learning, challenges and supporting improvement actions. Question 29 29a. Have you made any revisions in your pathway to residential rehabilitation in the last year? Mark with an ‘x’. [single option] No revisions or updates made in 2024/25 X Yes - Revised or updated in 2024/25 and this has been published
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22 Yes - Revised or updated in 2024/25 but not currently published 29b. If yes, please provide brief details of the changes made and the rationale for the changes. [open text – maximum 500 characters] A full independent evaluation of the rehab pathway was carried out with recommendations and actions fed into RR oversight group. This concluded the pathway was approrpaite, working well and fully meeeting the needs of those wishing to access rehab as part of their treatment and care. Question 30 Are there any specific groups in your ADP area who do not have their needs met by the current residential rehabilitation provision (for reasons such as lack of appropriate models of care, inadequate capacity, the location of services or any other factors)? Mark all that apply with an ‘x’. [multiple choice] Lesbian, gay or bisexual people People from minority religions People on OST People who are experiencing homelessness People who are involved in the justice system People who are pregnant or perinatal People with child dependents People with co-occurring mental health problems People with council tenancies People with specific physical health condition, including long term illness and disability Trans people Women X None Other (please specify):
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23 Question 31 31a. Which, if any, of the following barriers to implementing the Medication Assisted Treatment (MAT) standards exist in your area? Mark all that apply with an ‘x’. [multiple choice] X Accommodation challenges (e.g. appropriate physical spaces, premises, etc.) X Availability of stabilisation/crisis services Burden of data collection and reporting X Challenges engaging with GPs Difficulty identifying all those who will benefit Further workforce training is needed Geographical challenges (e.g. remote, rural, etc.) Insufficient funds Insufficient staff Lack of awareness among potential clients Lack of capacity X Scope to further improve/refine your own pathways Waiting times None Other (please specify): 31b. What actions is your ADP taking to overcome these barriers to implementing MAT in your ADP area? [open text – maximum 500 characters] There is a dedicated MAT implementation role focussed on delivering all oprational imporvement measures identified. These are reviewed and updated at the North MAT Implementation group that meets every 6 weeks. Question 32 Other than opioids, which substances are currently the highest priority in your ADP area for treatment and support? Please rank the substances of concern in your area in order of priority – add a number to all that apply, with 1 being highest priority. [ranking] x Alcohol Cannabis/cannabinoids X Cocaine, and other stimulants Ketamine Pregabalin/gabapentin Street benzos X Polydrug use (please specify any most common combinations of drugs): Other (please specify):
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24 Question 33 Which of the following treatment and support services are in place specifically for children and young people using alcohol and/or drugs? Mark all that apply with an ‘x’.10 [multiple choice] Up to 12 years (early years and primary) 13-15 years (secondary S1-4) 16-24 years (young people) Alcohol-related medication (e.g. acamprosate, disulfiram, naltrexone, nalmefene) X Diversionary activities X X X Employability support X Family support services X X X Information services X X X Justice services X X X Mental health services (including wellbeing) X X Opioid Substitution Therapy X Outreach/mobile (including school outreach) X X Recovery communities X School outreach X X Support/discussion groups (including 1:1) X X X Other (please specify) 10 Note that treatment and support services which are inappropriate for younger age groups have been shaded out to avoid confusion on completion of this question.
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25 Quality of life is improved by addressing multiple disadvantages Question 34 Do you have specific treatment and support services in place for the following groups? Mark all that apply with an ‘x’. [multiple choice] Yes No Non-native English speakers (English Second Language) X People from minority ethnic groups X People from religious groups X People who are experiencing homelessness X People who are involved in the justice system X People who are LGBTQI+ X People who are neurodivergent X People who are pregnant or peri-natal X People who engage in transactional sex X People with hearing impairments and/or visual impairments X People with learning disabilities and literacy difficulties Veterans X Women X Other (please specify) Question 35 35a. Are there formal joint working protocols in place to support people with co-occurring substance use and mental health diagnoses to receive mental health care? Mark with an ‘x’. [single choice] Yes X No 35b. Please provide details. [open text – maximum 500 characters] In development, following on from the publication of the national Mental Health and Substance Use protocol from Public Health Scotland.
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26 Question 36 What arrangements are in place within your ADP area for people who present at substance use services with mental health problems for which they do not have a diagnosis? Mark all that apply with an ‘x’. [multiple choice] Dual diagnosis teams Formal joint working protocols between mental health and substance use services specifically for people with mental health problems for which they do not have a diagnosis X Pathways for referral to mental health services or other multi-disciplinary teams X Pathways for referral to third sector services for mental health support X Professional mental health staff within services (e.g. psychiatrists, community mental health nurses, etc) Provision of joint appointments for those with co-occurring mental health problems and problem substance use X Provision of mental health assessments for people who are presenting with mental health problems None Other (please specify): Question 37 How do you as an ADP work with support services not directly linked to substance use (e.g. welfare advice, housing support, etc.) to address multiple disadvantages? Mark all that apply with an ‘x’. [multiple choice] X By representation on strategic groups or topic-specific sub-groups X By representation on the ADP board X Through partnership working X Via provision of funding Not applicable Other (please specify):
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27 Question 38 Which of the following activities are you aware of having been undertaken in ADP funded or supported11 services to implement a trauma-informed approach? Mark all that apply with an ‘x’. [multiple choice] X Engaging with people with lived/living experience x Engaging with third sector/community partners X Provision of trauma-informed spaces/accommodation X Presence of a working group X Recruiting staff X Training existing workforce None Other (please specify): Question 39 39a. Does your ADP area have specific referral pathways for people to access independent advocacy? Mark with an ‘x’. [single option] X Yes No Don’t know 39b. If yes, are these commissioned directly by the ADP? Mark with an ‘x’. [single option] X Yes No Don’t know 11 Note: ‘supported’ refers to where the ADP provides resources of some kind (separate from financial, which is covered by “funded”). This could take the form of knowledge exchange, staffing, the supply of materials (e.g. learning templates, lending them a physical location), etc.
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28 Children, families and communities affected by substance use are supported Question 40 Which of the following treatment and support services are in place for children and young people affected by a parent’s or carer’s substance use? Mark all that apply with an ‘x’.12 [multiple choice] Up to 12 years (early years and primary) 13-15 years (secondary S1-4) 16-24 years (young people) Advocacy X X Carer support X X X Diversionary activities X X X Employability support Family support services X X X First aid training X X Information services X X X Mental health services X X X Outreach/mobile services X X School outreach X X Social work services X X X Support/discussion groups X X X Other (please specify) Question 41 Which of the following support services are in place for adults affected by another person’s substance use? Mark all that apply with an ‘x’. [multiple choice] X Advocacy X Commissioned services X Counselling X One to one support X Mental health support X Naloxone training X Support groups X Training None Other (please specify): 12 Note support services which are likely to be inappropriate for younger age groups have been shaded out to avoid confusion on completion of this question.
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29 Question 42 42a. Do you have an agreed set of activities and priorities with local partners to implement the Holistic Whole Family Approach Framework in your ADP area? Mark with an ‘x’. [single option] X Yes No Don’t know 42b. Please provide details of these activities and priorities for 2024/25. [open text – maximum 500 characters] Through detached youth work approaches NLADP is prioritising support for young people at risk of conflict with the law, exploitation, contextual safeguarling and those at risk of developing alcohol and other drugs issues, including their families - all members of the family. this work is led through the ADP Whole Family Approach and Early Intervention and Prevention sub-groups. Question 43 When did your ADP most recently conduct an audit or needs assessment of the support currently available in your area for children, young people and adults affected by a family member’s substance use? Mark with an ‘x’. [single option] 2020/21 X 2021/22 X 2022/23 X 2023/24 X 2024/25 None undertaken in the past 5 years There are plans to undertake one in 2025/26 Unsure Question 44 Which of the following services supporting a Family Inclusive Practice13 or a Whole Family Approach are in place in your ADP area (for people with family members both in and not in treatment)? Mark all that apply with an ‘x’. [multiple choice] X Advice 13 Family Inclusive Practice is a collaborative approach where professionals actively involve a person’s family and social networks in care, proactively ask about the needs of the whole family, to ensure all family members are supported.
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30 X Advocacy X Benefits and debt advice X Mentoring X Peer support X Personal development X Social activities X Support for self care activities X Support for victims of gender based violence and their families X Youth services None Other (please specify): Question 45 What support would be helpful to facilitate the implementation of a Family Inclusive Practice or a Whole Family Approach? Mark all that apply with an ‘x’. [multiple choice] X Additional funding X Additional resources Advice to support setting up of lived and living experience forums/co-production methods Guidance at a national level Information shared from other services X Sharing of participation tools X Workforce training X Analytical support (please specify any details): Other (please specify): Question 46 What mechanisms are in place within your ADP area to ensure that services adopt a family inclusive practice? Mark all that apply with an ‘x’. [multiple choice] X Asked about in their reporting X Prerequisite for our commissioning X Regular training provided to services None Other (please specify): Question 47 In what ways do you work with the Children's Service's Planning Partnership (CSPP) in your area? Mark all that apply with an ‘x’.
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31 [multiple choice] X ADP representation on CSPP Co-location of services X Co-management of projects X Coordinated activities Coordinated living and lived experience co-production approaches Co-ordination around staff training X CSPP representation on ADP X Data sharing X Integrated planning X Joint interpretation of data and evidence at a strategic level X Joint referrals to relevant services X Knowledge sharing X Pooled funding x Shared and joint outcomes X Shared assessment of local needs None Other (please specify):
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32 Finances Question 48 How much funding does the ADP receive from the following sources? Please mark all which apply with an ‘x’ and provide details on the amount of funding which is received. [multiple choice, numeric] Health board: £ Local authorities: £ 0 Funding from other grant funder(s) (such as Corra and Inspiring Scotland Foundation): £ 0 X Other (please specify source and how much funding) Scottish Government to NLADP direct via NHSL, including T1 & T2 allocations : £ 3,040,405 Question 49 49a. How often do you provide financial reports for you ADP area? Mark all that apply with an ‘x’. [multiple choice] Monthly X Quarterly Six monthly X Annually Other (please specify): 49b. Who is financial reporting provided to? Mark all that apply with an ‘x’. [multiple choice] X IJB/IA Chief Financial Officer X IJB/IA Chief Officer X ADP Chair Other (please specify): 49c. Do you have a dedicated finance officer or team within the ADP? Mark with an ‘x’. [single option] Yes No, the ADP coordinator undertakes this as part of their role X No, finances are managed externally to the ADP Other (please specify): Question 50 50. Please describe what financial system(s) are used to manage finances in your area (i.e. Oracle, Efin, Excel spreadsheets). [open text – maximum 500 characters]
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33 Efin/Excel/Buisness Objects/Pecos Confirmation of sign-off Question 51 Has your response been signed off at the following levels? Mark all that apply with an ‘x’. [multiple choice] X ADP IJB X Not signed off by IJB (please specify date of the next meeting in dd/mm/yyyy format): 20/06/2025 Thank you Thank you for taking the time to complete this survey, your response is highly valued. The results will be published in the 2024/25 ADP Annual Survey Official Statistics report, scheduled for publication in autumn 2025. Please do not hesitate to get in touch via email at substanceuseanalyticalteam@gov.scot should you have any questions. [End of survey]
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Wednesday 10 December 2025 Chief Oicer Report Chief Oicer 10 December 2025 Standing Item Chief Finance Oicer Report Chief Finance Oicer 10 December 2025 Standing Item CAMHS Recovery & Renewal Head of Health 10 December 2025 Annual As approved in the Programme of Work at IJB in Sept 23 Paediatric Modernisation Head of Health 10 December 2025 Annual As approved in the Programme of Work at IJB in Sept 23 SLT Improvement Head of Health 10 December 2025 Annual As approved in the Programme of Work at IJB in Sept 23 Care Academy Head of Planning, Performance & Quality Assurance 10 December 2025 Annual As approved in the Programme of Work at IJB in Sept 23 Probable Suicide 2024 Report Head of Adult Social Work 10 December 2025 Annual Moved from September 2025 due to publishing dates from National Records Scotland (NRS) Alcohol Specific Deaths 2024 Report Head of Planning, Performance & Quality Assurance 10 December 2025 Annual Moved from September 2025 due to publishing dates from National Records Scotland (NRS) Drug Related Deaths 2024 Report Head of Planning, Performance & Quality Assurance 10 December 2025 Annual Moved from September 2025 due to publishing dates from National Records Scotland (NRS)
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Coming Home Report Head of Adult Social Work 10 December 2025 Biannual Freedom of Information Requests Business Support Manager 10 December 2025 Quarterly To be included in the Chief Oicer Report. Quarterly reporting submitted to Scottish Information Commissioner. Wednesday 18 March 2026 Chief Oicer Report Chief Oicer 18 March 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 18 March 2026 Standing Item IJB Budget – Medium Term Financial Plan Chief Finance Oicer 18 March 2026 Annual Strategic Commissioning Plan 2026 Head of Planning, Performance & Quality Assurance 18 March 2026 Chief Social Work Oicer Report Chief Social Work Oicer 21 January 2026 Annual Review of IJB Performance, Finance and Audit Committee Business Support Manager 10 December 2025 Moved from December 2025 Hospital @ Home Head of Health 18 March 2026 Biannual As approved in the Programme of Work at IJB in Sept 23 Home Support Head of Adult Social Work 18 March 2026 Biannual As approved in the Programme of Work at IJB in Sept 23
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Pharmacy Savings Approach Pharmacy Lead 18 March 2026 As requested at Board meeting – incorporated to work plan Trauma Informed Practice Head of Planning, Performance & Quality Assurance 18 March 2026 Annual Moved from December 2025 As approved in the Programme of Work at IJB in Sept 23 Freedom of Information Requests Business Support Manager 18 March 2026 Quarterly To be included in the Chief Oicer Report. Quarterly reporting submitted to Scottish Information Commissioner. Wednesday 17 June 2026 Chief Oicer Report Chief Oicer 17 June 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 17 June 2026 Standing Item Unaudited Annual Accounts Report Chief Finance Oicer 17 June 2026 Annual IJB Annual Performance Report Head of Planning, Performance & Quality Assurance 17 June 2026 Annual APR must be published online by 31 July each year Primary Care Improvement Plan (PCIP) Update Chief Oicer / Medical Director 17 June 2026 Annual Public Health Annual Report Director of Public Health 17 June 2026 Annual IJB Self-Assessment Questionnaire (Issue) Business Support Manager 17 June 2026 Annual IJB SAQ approved at IJB in June 2025 to be issued annually
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Coming Home Report – Dynamic Support Register Head of Adult Social Work 17 June 2026 Biannual Freedom of Information Requests Business Support Manager 17 June 2026 Quarterly To be included in the Chief Oicer Report. Quarterly reporting submitted to Scottish Information Commissioner. Wednesday 16 September 2026 Chief Oicer Report Chief Oicer 16 September 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 16 September 2026 Standing Item Audited Annual Report & Financial Statement 2024/25 Chief Finance Oicer 16 September 2026 Annual Audited Annual Accounts must be presented to Board and published online by 30 September each year Audit Scotland - Final Audit Report 2025/26 Chief Finance Oicer 16 September 2026 Annual IJB Self-Assessment Questionnaire (Results) Business Support Manager 16 September 2026 Annual IJB SAQ approved at IJB in June 2025 to be issued annually Probable Suicide 2024 Report TBC 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS)
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Alcohol Specific Deaths 2024 Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS) Drug Related Deaths 2024 Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual To be reported annually – date dependant on publishing dates from National Records Scotland (NRS) Supporting Resilience Head of Planning, Performance & Quality Assurance 26 September 2026 Annual Quality Assurance Annual Report Head of Planning, Performance & Quality Assurance 26 September 2026 Annual Wednesday 16 December 2026 Chief Oicer Report Chief Oicer 16 December 2026 Standing Item Chief Finance Oicer Report Chief Finance Oicer 16 December 2026 Standing Item 16 December 2026 Coming Home Report – Dynamic Support Register Head of Adult Social Work 16 December 2026 Biannual Freedom of Information Requests Business Support Manager 16 December 2026 Quarterly To be included in the Chief Oicer Report.
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NORTH LANARKSHIRE INTEGRATION JOINT BOARD WORK PLAN Item Lead Oicer Meeting Date Recurrence Reason / Notes Quarterly reporting submitted to Scottish Information Commissioner. Future Reports