Combined IJB Pack 27.9.23
North Lanarkshire Council · 27 September 2023
Back to Health and Social Care Integration Joint Board — 27 September 2023 and its agenda
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A meeting of the IJB will be held on Wednesday 27th September 2023 at 2pm-4.30pm via MS Meetings If anyone would like to join this meeting, please contact Stacey Connor on 01698 752594 or by email at Stacey.Connor@lanarkshire.scot.nhs.uk for the relevant information. Chair: AGENDA No Item Action Attachment Reporting 1. Welcome and Apologies 2. Declaration of Interests Members are invited to declare any interest in relation to any of the agenda items Board Members 3. Minutes IJB -17th May 2023 For Approval Attachment Chair 4. Minutes IJB PFA-21st June 2023 For Approval Attachment Chair 5. Matters Arising/IJB Action Log For Approval Attachment Ross McGuffie 6. Chief Officer Update For Noting Verbal Ross McGuffie STRATEGIC PLANNING & DEVELOPMENT 7. Strategic Commissioning Plan 2023 – 26: Programme of Work For Approval Attachment Graeme Cowan 8. Prescribing Efficiencies For Noting Attachment Dr Lucy Munro PERFORMANCE & FINANCE 9. Risk Management Report For Approval Attachment Stacey Anderson 10. Quality Assurance Annual Report For Endorsement Attachment Maria Williamson 11. Financial Monitoring For Noting Attachment Amanda Kilburn GOVERNANCE & POLICY 12. IJB Membership Proposal For Endorsement Attachment Ross McGuffie 13. Whistleblowing Update For Noting Attachment Stacey Anderson
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2 14. Privacy Notice For Approval Attachement Stacey Anderson 15. New Strategy and Child Poverty Annual Report For Endorsement Attachment Alison Gordon 16. North Lanarkshire Children’s Services Plan 2023-26 For Approval Attachment Alison Gordon FOR NOTING 17. Community Solutions Update For Noting Attachment Maddy Halliday 18. Tackling Poverty Team Report 2022/2023 For Noting Attachment Alison Gordon 19. Risk Consider whether, from the business discussed, any new, emerging risks need to be added to the Risk Register, or whether the discussion materially alters the assessed level of risk/risk tolerance and/or the mitigating controls 20. Date of Next Meeting 22nd November 2023 2-4.30pm For Noting
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1 ITEM 3 Integration Joint Board Committee Minutes from a meeting held on Microsoft Teams on Wednesday 17th May 2023 at 9.30am-10.40pm Present: Voting Members: Ally Boyle NHS Lanarkshire Nominated Non Exec Director Councillor Claire Barclay North Lanarkshire Nominated Councillor Councillor Bob Burgess North Lanarkshire Council Nominated Councillor Philip Couser NHS Lanarkshire Nominated Non Exec Director Councillor Paul Kelly North Lanarkshire Council Nominated Councillor Councillor Ayeshah Khan (Chair) North Lanarkshire Council Nominated Councillor Brian Moore NHS Lanarkshire Nominated Non Exec Director James Muir NHS Lanarkshire Nominated Non Exec Director Non-Voting Members: Professional Advisors Amanda Kilburn Chief Finance Officer North HSCP Ross McGuffie Chief Officer, North Lanarkshire HSCP Stakeholders Cathy McGinty Staff Side Representative NHSL Elizabeth Seaton Partnership for Change User Rep Harry Robertson Carer Representative Officer in Attendance: Stacey Anderson Support Services Project Manager Stacey Connor Minute Secretary Dr Kenneth Dagg Secondary Care Medical Practitioner Mark Dell Communications Manager Jann Gardner Chief Executive NHS Lanarkshire Alison Gordon Head of Children & Families & Justice Services CSWO of NLC Dr Lucy Munro Medical Director NL Des Murray Chief Executive NLC Dr Tyra Smyth General Practitioner (GP) Maggs Thomson Head of Health North HSCP Paul Carey Audit Scotland APOLOGIES: Morag Dendy Head of Planning, Performance & Quality Diane Fraser Head of Adult Social Work Services Maddie Halliday Chief Exec, VANL Third Sector Rep Trudi Marshall Nurse Director NLHSCP
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2 Fiona Owens Audit Scotland John Watson Employee Representative NLC Unison ACTION 1. Welcome and Apologies The chair welcomed everyone to the meeting and introductions were made; apologies were as noted above. 2. Declaration of Interests There was no declaration of interest made. 3. Minutes of IJB (22nd March 2023) The previous minutes were approved as an accurate reflection of the discussion. 4. Matters Arising/ IJB Action Log There were no matters arising. Ross McGuffie shared an updated action log to reflect the progression of work since the last committee. He drew attention to the below updates: Action log actions are mainly centred around IJB Liaison sessions. 5. IJB Risk Register The purpose of this report is to provide a summary to the Integration Joint Board on risk management activity, noting any amendments or additions to the current risk register. A full review of the risk management reporting within the IJB is currently in progress as part of the risk strategy review and in line with the dynamic developments and changes the new NHS Lanarkshire Risk Manager is implementing within the board. These developments will include review of how risk reporting is managed and presented at IJB and a further evaluation of the improvement methodology aligned with the risk actions. In order to provide a robust overview of these developments, a risk management session has been scheduled for the next IJB Liaison Session and a full report of changes/ developments will be provided to the IJB PFA and IJB at the next meeting. Following discussions at the last meeting of PFA on 19th April 2023, the risk register has been updated and additional controls/actions added to: 1. IJB 01/21 – Financial Challenges 2. IJB 04/21 – Set Aside
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3 3. IJB 06/21 – Prescribing 4. IJB 11/21 – Performance 5. IJB 13/21 – Care Homes 6. IJB 14/22 – CAMHS 7. IJB 17/22 – Unscheduled Care There are currently two risks rated as Very High on the IJB risk register. 1. IJB 06/21 – Prescribing Activity and Costs 2. IJB 17/22 – Unscheduled Care There are eight high rated risks on the IJB risk register. ▪ IJB 01/21 - Financial Challenges ▪ IJB 04/21 - Notional Set Aside Budget ▪ IJB 12/21 - Staff Health & wellbeing ▪ IJB 14/22 – CAMHS ▪ IJB 15/22 – Cost of Living ▪ IJB 16/22 – National Care Service ▪ IJB 19/23 – Service sustainability ▪ IJB 20/23 – Workforce sustainability Ally Boyle queried how will the prescribing risk progress, can we make the saving efficiencies required. Ross McGuffie noted month 1 has gone well got roughly £600k in savings but it is still early days that can change throughout the year; so it will remain as a high risk. Brian Moore asked are there any update in terms of local care home financial sustainability plans. Ross McGuffie replied it will depend on National Care Service negotiations which are still on going, there have been some care homes already gone into administrations which has created challenges. If this continues it will increase financial challenges for the board. Philip Couser queried for prescribing should this be a future agenda item as it is a high risk. Ross McGuffie confirmed a performance report will come to a future committee. Dr Lucy Munro confirmed work is ongoing already but reports will offer the committee some assurance. Dr Tyra Smyth added drugs are getting more expensive and more advanced. The board has a responsibility to promote medication usage. North Lanarkshire is underspent in comparison to South Lanarkshire which is linked to inequalities. The IJB agreed the following recommendation: They note the contents of the report which includes the latest version of 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. 6. Governance Report The report provides an overview of the recently reviewed/updated governance documents in regards to reporting for the North Lanarkshire
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4 Integration Joint Board. It is a requirement of the Integration Joint Board to ensure that they are compliant with The Public Bodies (Joint Working) (Prescribed Health Board Functions) (Scotland) Regulations 2014). A continuous review of the IJB governance documents/policy will commence across the financial year with updates regularly being provided to the IJB. The report focuses on the governance surrounding the IJB Programme of Reports, EQIA Process, Code of Conduct and Declaration of Interest, Directions, IJB Risk Reporting Process and Risk Reporting Template. Update on the governance arrangements will come to the committee on a quarterly basis. Recommendations agreed by the IJB: Review the updated IJB Governance documents and approve the documents and associated templates for IJB use during the 2023-24 period. 7. Resilience Update NHS Lanarkshire stood down its Live Covid Incident in January 2023, however, the operational pressures emanating from the pandemic recovery have been pronounced, with NHS Lanarkshire in Black status since 27th July 2022. The IJB received an update on Operation Flow at its meeting on 22nd March 2023 and again at the PFA meeting on 19th April 2023. Operation Flow is the whole system strategic planning approach in Lanarkshire aimed at supporting a sustained recovery of the entire health and social care system. The next stage of operation flow is being planning with 5 task and finish groups up and running to progress the work. For delayed discharges there were some challenges over the Easter weekend relating to increase in staff absence and an increase in demand. Through Covid have been able to stay within upper and lower confidence levels for beds. Philip Couser queried should we be changing the wording of the risk relating to winter pressures as we are now in Summer. Ross McGuffie advised pulling together winter plan for 2023/24 nationally so this will be picked up as part of that but will also review our risk register. Ally Boyle asked with face mask requirements being stood down how are we going to manage staff sickness levels. Ross McGuffie noted will continue to monitor staff absence and if see any spikes still got resilience structures in place. Dr Lucy Munro noted still have national infection control manual which has a number of measures which should be undertaken regularly. RMcG
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5 Brian Moore asked what are the issues around progressing planned date of discharge. Ross McGuffie noted the earlier we are involved in a patients case the better the outcome as staff are involved and can offer expertise when required as part of multi-disciplinary teams. The IJB agreed: (1) Note that NHS Lanarkshire stood down its Covid Live Incident down in January 2023, though command structures have been adapted to continue to focus on ongoing wider resilience challenges, specifically around service pressures (2) Note that NHS Lanarkshire was able to move from black to red status on 6th March 2023, following a successful ‘firebreak’ as part of Operation Flow 8. Delayed Discharge and Site Occupancy Plans The paper sets out Scottish Government’s action plan to improve delayed discharge and hospital occupancy. Winter 2022/23 was an incredibly challenging period for health and social care systems across Scotland, managing a number of complex factors including increased seasonal demand for unscheduled care and critical care due to the combined incidence of flu, Covid-19 and other respiratory infections. Throughout this period, local systems have tried to manage through these competing demands with whole system actions such as Discharge Events and substantial developments such as Operation Flow within Lanarkshire. This has led to a greater understanding of the issues being faced and what works, with the greatest challenge facing all systems being how to turn this into plans that can create a sustainable difference. The action plan brings together 12 whole system actions across the areas of Good Practice, Data Management and Workforce, that are essential in reducing pressure on staff and the system and in ensuring people receive the right care in the right place at the right time. Have agreed increase in payment cost to £10.90 which will be back dated to 1st April for providers. Brian Moore asked is there any significant updates around Adults with Incapacity (AWI) reforms. Ross McGuffie advised there is a national group up and running to review this but there is little potential of a short term impact. In Lanarkshire got 16 AWI cases in the system there are 1920 bed days between these patients which provide some context to delays data. The IJB: (1) Note the Scottish Government action plan on delayed discharge and hospital occupancy;
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6 (2) Note that the actions contained within are being built into the phase 1 action plan for Operation Flow, to ensure a whole system approach is fully embedded in Lanarkshire; (3) Request sight of the Operation Flow phase 1 action plan and associated task and finish groups once finalised. 9. Winter Plan Business Case Progress Report The Scottish Government allocated additional funding in 2021/2022 and 2022/2023 to increase capacity across the health and social care system. In February 2022, the Integration Joint Board approved a business case for the commitment of the additional funding, while also taking the opportunity to target nonrecurring reserves to implement a series of proposals, including the development of a Home First model in North Lanarkshire, additional community nursing capacity, enhanced care at home capacity, and additional infrastructure supports. This report provides an update on the progress made with implementing these proposals. The original aims of the business case were to increase assessment and planning capacity across the system and enhance direct provision of supports and services across a range of organisations. Workstreams have been established to implement plans and proposal against the following headings: Home Assessment Team & Enhanced Integrated Rehabilitation Provision Community Nursing Increased Capacity Across Home Support Service, Equipment and Adaptations Service, Community Alarms Service & Assistive Technology Hospital at Home Building Capacity of Independent Sector Providers Investment in Communities Philip Couser asked have we got the appropriate risks around the workforce challenges noted for this and he also asked do we have sufficient evaluation mechanisms in place to review what is working and what is not. Ross McGuffie advised got programme board and each service area is starting to coordinate the data from the additional posts they have so show improvements. Ally Boyle noted it would be useful to have some key points summarised for each work stream to show why they remain at amber and allow mitigations to be considered. Ross McGuffie acknowledged this comment and can make this more apparent in future reports. Noted working with national teams to progress creating band 4 nursing roles, Cathy McGinty confirmed unions are involved in these discussions.
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7 The IJB endorse and support the progress reports of each of the workstreams which comprise the Winter Planning & Enhance Supports Business Case 10. Fairer Scotland Duty The purpose of this report is to update the committee on progress made on embedding Fairer Scotland Duty requirements into routine business of the HSCP. The Fairer Scotland Duty (FSD) came into force in Scotland on 1st April 2018 and aims to protect those most affected by poverty in communities. The duty places a legal responsibility on particular public bodies to actively consider (pay ‘due regard to’) socio-economic inequalities of outcome when making strategic decisions. The duty is enshrined in Section 1 of the Equality Act 2010 and places a legal responsibility on particular public bodies, including Integrated Joint Boards, NHS Boards and Councils. The duty does not override other considerations such as equality or best value. The 2010 Act specifies that in deciding how to fulfil the duty, organisations must take into account any guidance issued. The Scottish Government published interim guidance for public bodies in March 2018 which was refreshed in October 2021 to incorporate learning from the implementation plan. The implications of the updated guidance for the FSD were reported to this committee in February 2022. It was agreed that robust governance processes required to be implemented to assure the Integrated Joint Board that the FSD was being met and review processes were embedded into the project management of the Programme of Work. Additionally, professional and operation leads required support to undertake these assessments. Discussions with key personnel in NHSL and NLC have progressed to ensure that robust processes are in place to meet the requirements of the FSD as well as equalities mainstreaming. IJB committee papers have been amended to include specific reference to Equality Impact Assessments and FSD assessments so members can be assured that the needs of specific populations have been considered and action taken where required to meet these. The IJB Committee: (1) acknowledge the amendments that have been made to committee templates to embed reporting on Fairer Scotland Duty assessments. (2) approve the project management approach being taken through the Strategic Commissioning Plan Programme of Work which will monitor the actions that arise from the Fairer Scotland Duty assessments.
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8 11. Implementation of National Trauma Framework The Transforming Psychological Trauma: Knowledge and Skills Framework (The Framework) has been developed by NHS Education Scotland (NES) to support the delivery of Scottish Government and COSLA’s joint policy intention to create a trauma-informed workforce. The purpose of this paper is to set out for the Integrated Joint Board the actions being taken to embed the Framework in North Lanarkshire, highlight areas of practice where a trauma informed approach is already making a positive difference for children and individuals and outlining next steps, in ensuring North Lanarkshire becomes a leading trauma informed HSCP and council. The North HSCP nominated Margaret Flavell, Senior Manager Adult Social Work as the champion. As requested by COSLA and Scottish Government, Ministers have been advised of this, who are working with national leads in Scottish Government and the Improvement Service, as well as local leads in NHS Lanarkshire in relation to implementation. Section 5.4 within the report outlines what is being done to embed trauma in practice and the links to the strategic commissioning plan. It has been a key feature in developing community hubs. Embedding sustainable trauma-informed ways of working is about long-term culture change. The steering group has identified key priorities below linked to the 5 strategic drivers for a Trauma Informed organisation outlined in 1.3: Leadership: Appoint an elected member as Trauma Champion to support the work of the steering group develop plans for North Lanarkshire becoming a trauma-informed Council to support the fulfilment of the ambition of the Plan for North Lanarkshire and the new Programme of work. Health Board members would assist this also. Likewise further SLT to support the SCP ambitions and embed trauma informed practice across the partnership. Re-fresh governance and membership of the of steering group. Workforce Wellbeing: The actions to deliver the NHSL and Council’s Mental Health Strategy for staff are underpinned by the 5 principles of a trauma-informed organisation. Workforce knowledge and skills: Each service across the partnership should assess the level at which staff need training and a base line is established in order to update the training strategy for trauma informed practice. Experts by experience: Individuals, families and communities drive our approach to becoming a trauma informed organisation using existing structures for participation and engagement.
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9 Data and Feedback Loops: Base lines and outcome data for trauma informed practice are integrated and aligned with measures of success within the SCP and the Council’s new Programme of Work. It was agreed Ross McGuffie, Brian Moore, Alison Gordon and Cllr Khan will meet to discuss further. IJB Committee: (1) Endorse the approach to the implementation of Trauma Informed Practice across the Health and Social Care Partnership as set out in this report. (2) Agree that the workforce should be trained at the ‘informed level’ as part of the suite of mandatory training. (3) Consider IJB members and/or Health Board members being a Trauma Informed Champion 12. Our Health Together The engagement to inform NHS Lanarkshire’s new healthcare strategy ‘Our Health Together’ launched on 21st April and gives our communities and those who work in the service the chance to shape how we deliver healthcare for future generations. The aim is to deliver a wide-ranging stakeholder engagement programme involving patients, unpaid carers, our staff and local communities (including children and young people), working together to inform the development of our new strategy ‘Our Health Together – Living Our Best Lives in Lanarkshire’. In February the NHS Lanarkshire Planning, Performance and Resource Committee signed off the Our Health Together (OHT) Public Engagement Pack, with approval to finalise and move to engagement thereafter. Since February a number of actions have been completed by the Our Health Together team as detailed below which has resulted in the formal of Stakeholder Engagement Programme which took place on Friday 21st April 2023. The IJB note the contents of this report. 13. Risk Ross McGuffie noted updates to winter business case and workforce risks in terms of review but no new risks have been identified. 14. Date of Next Meeting 27th September 2023 2pm
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1 ITEM 3 Integration Joint Board Performance, Finance & Audit Committee Minutes from a meeting held on Microsoft Teams on Wednesday 21st June 2023 9.30am-11.30am Present: Voting Members: Councillor Claire Barclay North Lanarkshire Council Nominated Councillor Phillip Couser (Left 10.40am) NHS Lanarkshire Nominated Non Exec Director Councillor Ayeshah Khan North Lanarkshire Council Nominated Councillor Brian Moore (Chair) NHS Lanarkshire Nominated Non Exec Director Non-Voting Members in Attendance Professional Advisors: Amanda Kilburn Section 95 Finance Officer Ross McGuffie Chief Officer, North Lanarkshire HSCP Stakeholders: Harry Robertson North Lanarkshire Carer Together In Attendance: Stacey Anderson Support Services, Project Manager Stacey Connor (Minutes) Minute Secretary Mark Dell Communications Manager Dr Lucy Munro Medical Director North HSCP Elizabeth Seaton Partnership for Change User Rep Maria William (Deputy for Morag Dendy) Interim Head of Planning, Performance & Quality Apologies: Ally Boyle NHS Lanarkshire Nominated Non Exec Director Councillor Bob Burgess North Lanarkshire Council Nominated Councillor Paul Carey Audit Scotland Morag Dendy Head of Planning, Performance & Quality Diane Fraser Head of Adult Social Work Services Maddy Halliday Chief Exec, VANL Third Sector Rep Councillor Paul Kelly North Lanarkshire Council Nominated Councillor Trudi Marshall Nurse Director North HSCP Cathy McGinty Unison Staff Side Rep (NHSL) James Muir NHS Lanarkshire Nominated Non Exec Director Maggs Thomson Head of Health NHSCP John Watson Unison Rep
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2 ACTION 1. Welcome and Apologies The chair welcomed everyone to the meeting and introductions were made; apologies were as noted above. 2. Declaration of Interests There were no declaration of interest made. 3. Minutes (19th April 2013) The previous minutes were approved as an accurate reflection of the discussion. 4. Matters Arising/ Action Log There were no matters arising and the action log was noted. 5. PF & A Risk Register The purpose of this report is to provide a summary to the PFA committee on risk management activity, noting any amendments or additions to the current risk register. The PFA committee considered the finance and performance risks at its last minute on 19th April 2023. The register was also reviewed at the IJB on 17th May 2023. Following discussions at the last meeting of PFA on 19th April 2023, the risk register has been updated and additional controls/actions added to: IJB 01/21 – Financial Challenges IJB 04/21 – Set Aside IJB 06/21 – Prescribing IJB 11/21 – Performance IJB 13/21 – Care Homes IJB 14/22 – CAMHS IJB 17/22 – Unscheduled Care There are currently two risks rated as Very High on the IJB risk register. IJB 06/21 – Prescribing Activity and Costs IJB 17/22 – Unscheduled Care There are eight high rated risks on the IJB risk register. IJB 01/21 - Financial Challenges IJB 04/21 - Notional Set Aside Budget IJB 12/21 - Staff Health & wellbeing IJB 14/22 – CAMHS IJB 15/22 – Cost of Living IJB 16/22 – National Care Service
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3 IJB 19/23 – Service sustainability IJB 20/23 – Workforce sustainability Brian Moore noted the committee would like to review the prescribing risk in more detail. Ross McGuffie advised it was planned to discuss at a future liaison session, there is a paper being drafted for the next IJB committee to provide a fuller update. Cllr Barclay proposed having an elected members briefing session to raise awareness on the prescribing agenda, this was noted and also Cllr Khan noted community solutions is looking at our lives work which could be linked to this. Decision The IJB PFA noted the contents of the report which includes the latest version of 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. 6. Unaudited Annual Accounts This report provided an overview of the unaudited North Lanarkshire IJB Annual Accounts for the financial year 2022/2023, in line with the legislative requirements and was presented for approval. Thereafter the accounts will go to Audit Scotland for them to carry out their own external audit. By 12th September should have a draft letter of recommendation from auditors. Then on 27th September final accounts will come to IJB committee for sign off. Philip Courser noted on p6 of the narrative cost of living is mentioned but we haven’t got details in relation to applying to the IJB directly. Amanda Kilburn advised the challenges have been lifted from the strategic commissioning plan and are as they appear within the plan but consideration will be given if the wording needs to change to be more inclusive. Ross McGuffie added a suite of documents have been created to read across for NHS Lanarkshire as a whole. He will check if there is scope to include some additional wording within the strategic commissioning plan. Brian Moore noted on pages 23-24 the detail around committee governance. It is clear that reasonable assurance can be placed on the adequacy and effectiveness of the IJB governance arrangements. The PFA Committee: (1) Approved the Annual Governance Statement and associated reports for inclusion in the statutory accounts; (2) Approved the unaudited North Lanarkshire IJB Annual Accounts 2022/2023 at Appendix 1; (3) Approved the submission of the unaudited annual accounts to Audit Scotland; and RMcG
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4 (4) Acknowledge the arrangements for publications of the North Lanarkshire IJB Annual Accounts 2022/2023 in line with the legislative requirements. 7. Internal Audit The report provided an update on the results of the planned Internal Audit assignment to follow-up the status of the recommendations agreed in respect of previous internal and external audit reports. It presented the results of the recently completed internal audit work undertaken by North Lanarkshire Council (NLC) and provided an update on the results of follow-up work which reviewed the extent to which management have implemented those actions previously committed to in response to recommendations contained in previous internal and external audit reports. Brian Moore asked on behalf of Philip Couser in relation to the SLA for hosting children and families and justice services; is there a timeline to provide an update to the IJB. Ross McGuffie advised this has been paused largely due to the development of the National Care Service. The outcome of the follow-up audit concluded the following: (1) 19 agreed actions have been completed. (2) 8 agreed actions are partially implemented (4 of these actions being the same risk) (3) 1 agreed action is not yet due. (4) 3 agreed actions are no longer relevant. The PFA acknowledge the contents of the report. 8. Financial Monitoring The report provided a summary of the year-end position of the North Lanarkshire Health and Social Care Partnership (HSCP) for the financial year 2022/2023 and to seek approval for the transfer of funds to reserves. Budget monitoring throughout 2022/23 has shown the IJB projecting an underspend, prior to the transfer of year-end balances to General Reserves at the financial year-end. As detailed in the table at para 6.4, the IJB final outturn was an underspend of £35.495m. Once all ring-fenced balances have been transferred to the relevant reserve in line with Scottish Government guidance, the revised outturn was an underspend of £14.084m. Subject to IJB approval, this underspend will be allocated to manage, on a non-recurring basis, ring-fenced commitments, additional commitments relating to the Strategic Commissioning Plan and any funding gap which is highlighted in the North Lanarkshire IJB Medium Term Financial Plan 2023- 2026.
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5 The reasons for the operational underspend of £14.084m (excluding ring- fenced funding), were detailed as : Employee Costs net underspend of £9.107m: as previously highlighted there are ongoing challenges in terms of recruitment and retention issues across all service areas. For a wide range of posts recruitment has been unsuccessful due to the availability of the skills mix required or the competition being offered by other private and public sectors. These are issues that are being faced by IJBs across Scotland. Payments to Other Bodies net underspend of £1.511m: the underspend is primarily due to the staff shortages and vacancies within the Care at Home sector who provide services to individuals via the self-directed support commissioning framework. There is also an underspend in package costs due to slippage in Self-Directed Support (SDS) start dates. It is anticipated these are in-year underspends only and the full budget will be required in future years. Admin Costs net underspend of £1.431m: within the carers funding there is currently an unallocated budget of £1.8m. Work is continuing to allocate this is relevant carers package in 2022/23. This has been transferred to a dedicated earmark reserve to fund carers pressures in 2023/24. Income over recovery of £6.031m: for social care is due to the drawdown of earmark reserves to offset expenditure relating to winter planning, adaptations, digital and IT and staffing costs associated with services within Muirpark. Supplies and Services net overspend of £2.531m: the overspend is due to additional purchases of PPE and staff uniform due to the increase in home support staff and costs associated with winter planning. There has also been additional expenditure in relation to aids and adaptations to meet current demand. £1.550m additional income was drawn down from earmarked reserves to offset some of this overspend and is showing in the over recovery of income. Prescribing net overspend of £1.750m: activity and cost per item within prescribing is 3.19% higher compared to 2021/2022. Due to the uncertainty around costs and prescribing activity and the three-month time lag in receiving the data, the volatility experienced within prescribing is likely to continue for the foreseeable future. Amanda Kilburn noted under 7.3 asking the PFA to approve 2 new additional earmarked reserves. The first was for the replacement of mental health windows that's due to Health and Safety Notice that we received from health and safety executive and the second one is due to the re grading of social work posts.
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6 Philip Couser asked if we should have something in the risk register to keep an eye on the spend in relation to the re-grading of social work posts. Ross McGuffie replied we should be reviewing this as part of the broader financial plan; although this will be picked up with the team to consider how best to include on the risk register. Brian Moore noted the committee would welcome an annual update in terms of progress regarding the financial implications of the regrading as the IJB funding is time limited. The PFA Committee agreed the following recommendations: (1) Acknowledge the year-end financial position for 2022/23; and (2) Approve the proposed transfers to General Reserves at para 7.2 and 7.3 of this report. RMcG 9. Resilience Update The IJB received an update on Operation Flow at its meeting on 22nd March 2023 and again at the PFA meeting on 19th April 2023. Operation Flow is the whole system strategic planning approach in Lanarkshire aimed at supporting a sustained recovery of the entire health and social care system. Following two further face to face planning sessions that brought together leaders from across the whole system, a Task and Finish structure has now been developed to take forward the key actions agreed for Operation Flow 2, this is included within appendix 1 of the report. There are 5 work streams progressing the work which are meeting weekly. Brian Moore noted future version of the report should be focusing on the progression and the benefits of each of the initiatives. Ross McGuffie confirmed pulling together a scorecard against each of the work streams aligned to the key matrix’s in place. There is a whole system national group to benchmark against other Boards and looking at other models which have worked well, this information will feed into future progress reports. The PFA: (1) Recognise the whole system Operation Flow 2 plans and implementation structures set out in the report; (2) Request future updates on progress. 10. Prisoner Healthcare
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7 This paper sets out an overview of the Prisoner Healthcare service within North Lanarkshire. Responsibility for the provision of healthcare in prisons transferred from the Scottish Prison Service (SPS) to the NHS in November 2011 and for HMP Shotts in Lanarkshire, it is now the responsibility of the North Lanarkshire H&SCP. HMP Shotts, a 538 place, maximum security prison for convicted adult males serving a sentence of four years or longer has a healthcare team that comprises of three sub-team’s teams of Primary Care team, Addictions Team and Mental Health Team. Over the last 24 months the healthcare team has experienced significant and sustained staff shortages across all disciplines. This has impacted on the team’s ability to provide adequate staffing and maintain a safe skill mix. This included the lack of GP cover from 1:30pm onwards. Due to the apparent challenges, the Nurse Director commissioned a ‘deep dive Service Review to be undertaken. This was completed in March 2022 and an action plan was developed identifying planned improvement actions. There were 12 examples of good practice and 22 recommendations for improvement which include 6 priority recommendations identified; the Inspection Report is listed in Section 8 of the report. Ross McGuffie advised we have recruited a fixed term service improvement manager to oversee and coordinate the improvement work; there is a programme boards in place to support that. Dr Lucy Munro advised there is 0.6 GP resource within the service to manage approximately 500 patients in comparison to general practices in the community who manage roughly 2000 patients. Cllr Barclay asked whether having the enhanced nursing role on site reduces the need for GP call outs. Dr Lucy Munro advised there is some area of cross over but overall it does reduce the call outs. Philip Couser noted the report states we are at the end of quarter 1 and HIS are due to review in quarter 3. To seek a degree of assurance, do HIS review the rating at quarter 3 and produce a new report or a statement of assurance at this point. Dr Lucy Munro replied that inspectors are understating of the environmental challenges the service faces. We are moving away from the poor rating and progressing the actions required. There are mitigations in place for the urgent care pathways to assist this. Unsure that another report will be issued or if HIS will note the progress. Brian Moore noted the PFA would welcome a further update of the HIS feedback and update of the work; this was noted. Recommendations supported by the PFA committee are:
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8 (1) The creation of a Project Board, overseeing the implementation of improvement plans relating to HIS recommendations, internal Service Review actions and MATS Standards. (2) The ongoing funding and support for the Fixed Term Senior Improvement Manager position. (3) The work associated with locally identified Milestones for the service, as noted in the Annual Delivery Plan for 2023/24 as per summary table in the report. 11. Alcohol & Drug Partnership Annual Report The North Lanarkshire Alcohol & Drug partnership (NLADP) Strategic Lead has been working closely with key partners through the five ADP sub- groups (below) to develop key actions and support in keeping with national evidence, regional scoping work and learning from commissioned services including the voices of lived experience. The ADP sub-groups oversee and support decision making on local investments linked to delivering on 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 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. The purpose of the Annual Report Survey to give local ADPs a tool to engage and discuss opportunities and barriers to delivery. The Annual report survey sets out the range of work in place to scope strengths and challenges in current arrangements. NLADP place the experience of people with lived experience and families at the centre of developments and engagement with all stakeholders. 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. Ross McGuffie advised received positive feedback from Scottish Government around our progress for MAT standards; moving at pace over the last 6 months working with South Lanarkshire in tandem. Cllr Khan asked for question 29a it talks about treatment and support services within the list it mentions employability support for 13-15year older would that be more career advice. Ross McGuffie confirmed it will link to existing programmes in place. Cllr Khan added we need reassurance that they're working with other third sector partners to link in particularly with
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9 those with lived experience and the families through carers organisations or the disability forums; this was noted. Philip Couser noted on question 16 this is blank was there a reason for this. Ross McGuffie noted this is an area where we have identified a work plan so not sure why blank. Brian Moore there are 50 WTE listed is this number correct as it seems low, Ross McGuffie confirmed this is a mainstream service though additional staff are working within commissioned services. The PFA committee: (1) Note the content of the report; (2) Note the content of the Annual Reporting Survey to the Scottish Government and approved submission to the Scottish Government. (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 NLADP Annual report completion setting out the appropriate supports and governance is in place to deliver the National Mission priorities and The Partnership Delivery Framework objectives. 12. Equality Outcomes & Mainstreaming Report Update The paper was presented to the PFA committee to provide a progress update on the actions set out in the Equality Outcomes and Mainstreaming Report 2022-24 reported to IJB in June 2022. A mainstreaming report was submitted to IJB in June 22 (see appendix 1), with equality outcomes based on the commissioning intentions of the 2020- 23strategic commissioning plan. At that time participation and engagement work had already commencing around the next 2023-26 Strategic Commissioning Plan. Progress against the equality outcomes and the action plan was agreed to be monitored via the Performance, Finance and Audit sub-committee. An update has been added to appendix 2 from the Mainstream report. North Lanarkshire Council has established an Equalities Delivery Board, with engagement from all council services including Adult Health & Social Care. The council is reviewing its EQIA arrangements and a revised and improved approach will be co-ordinated and progressed via the Equalities Delivery
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10 Board. The service has identified an Equalities lead (Senior Manager, Strategy & Performance), responsible for ensuring the effectiveness of EQIA use within the service. A revised programme of EQIA training is being developed to support the roll out of the new process. Working with the council’s Equalities Manager, the Equalities lead will develop a process for the periodical review of compliance. NHS Lanarkshire continues to ensure the ongoing importance of embedding equalities into the organisation through the use of equality impact assessment, with the EQIA tool recently being adapted to incorporate socioeconomic impact in line with the Fairer Scotland Duty and to give consideration to the articles of the United Nations on the Convention of the Rights of the Child (UNCRC). With the Equality and Diversity Steering Group continuing to provide Bi-annual reports on the delivery of Equality strategy actions. Philip Couser noted the report showed high level information. He asked as a committee do we need to see information sitting underneath this work to offer assurance. Maria Williamson stated we have a whole programme of work to link to for the engagement and participation agenda which will develop more within future reports shared. The PFA committee note the progress update to the actions set out in the Equality Outcomes and Mainstreaming Report 2022-24. 13. Q4 Performance Report The report provided an update to the Committee on the areas for improvement which have been identified as part of the Quarterly Performance Review for the period 1 January 2023 to 31 March 2023 (Quarter 4). The Chief Officer has joint quarterly performance review meetings with the Chief Executive of NHS Lanarkshire and the Chief Executive of North Lanarkshire Council. These meetings are supported by a Chief Executive Performance Framework comprising a range of performance measures from across both health and social work systems, including relevant targets and trajectories. For the areas listed for improvement they are all rated as either red or amber and have programme boards supporting progressing the work. Area for improvement are: Alcohol Brief Interventions Cervical Screening Immunisations 6-8 week reviews Delayed discharge, home support, reablement
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11 Reablement / Integrated Equipment & Adaptation Service / Home Assessment Team CAMHS Psychological Therapies Adult mental health Waiting Times Performance - Medical Children & Young People (Consultant Led) Waiting Times Performance – AHP and Community Services Stop Smoking Service Sickness Absence Brian Moore asked for more information on Alcohol Brief intervention. Ross McGuffie noted it’s an area which has been well invested in. Since we have moved across to Morse not getting the same amount of referral forms through. Previously had a process in place to review nursing caseloads as referrals came through, going back to this at a local level to check. The Committee note the contents of the report and its appendix. 14. Risk Ross McGuffie will consider how to include the cost of living risk linking to strategic commissioning plan and the risk relating to the re grading of social work posts discussed today. 15. Date of Next Meeting 18th October 2023 9.30am-12.30pm
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1 ITEM 5 North Lanarkshire Integration Joint Board 2023-24 ROLLING ACTION LOG NO DATE ITEM NO DESCRIPTION ACTION BY ACTION & PROGRESS DUE DATE COMPLETION STATUS 1. 22.6.22 Item 12 Strategic Commissioning Plan M Dendy/T Marshall Detailed report on community nursing to be brought back to future meeting and included within SCP On March 23 IJB agenda. Strategic Commission Plan Approved by IJB Feb 2023. PoW on Sept 23 agenda 2. 31.8.22 Item 6 IJB Self-Assessment Report R McGuffie Consider hosting a development session to further explore the self-evaluation work Ongoing – future Liaison session topic 3. 14.2.23 Item 13 MH Strategy R McGuffie Consider dedicating liaison session for a more in- depth discussion Discuss wider thematic work with Brian Moore and Cllr Ayeshah Khan
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2 4. 14.2.23 Item 5 Risk Management Strategy R McGuffie A review of the IJB Risk Management process following the introduction of the new Risk Management Strategy Winter plan will be reviewed in line with risk register May 2023 Planned for Nov IJB liaison session 5. Improving Cancer Journey R McGuffie Bring back a further update to the Board on the roll out of the programme and
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1 REPORT Item No: 7 SUBJECT: Strategic Commissioning Plan 2023 – 26: Programme of Work TO: Integration Joint Board Lead Officer for Report: Morag Dendy, Head of Performance, Planning & Quality Assurance Author(s) of Report Graeme Cowan, Senior Manager, Strategy & Performance DATE: 27 September 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☒ For endorsement ☐ To note ☐ The purpose of the report is to set out the partnership’s Programme of Work which supports the delivery of the priorities within the Strategic Commissioning Plan 2023- 2026. 2. ROUTE TO THE BOARD This paper has been: Prepared By: Senior Manager, ☒ Reviewed By: Head of Performance, Planning & ☒ Endorsed By: ☐
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2 Strategy & Performance Quality Assurance 3. RECOMMENDATIONS The IJB is asked to: 1) Note and approve the Programme of Work included in appendix 1, and its associated scope and timescales for reporting 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES The Strategic Commissioning Plan 2020-2023 was approved and published in March 2023 on the assumption that a more detailed Programme of Work would be presented to the Board thereafter. The Programme of Work has been compiled following consultation and engagement with stakeholders across the Health & Social Care Partnership and beyond. It is aligned with the key strategic drivers across both NHS Lanarkshire and North Lanarkshire Council, dovetailing with the developments associated with Operation Flow, the strategic developments in relation to Our Health Together, and the Council’s refreshed Programme of Work (as part of the Plan for North Lanarkshire). The Programme of Work seeks to include those programmes and activities which are intended to help transform and change the health and social care system. It is acknowledged that the partnership, and the organisations of which it is comprised, delivers a range of services and supports, many of which are not featured within the overall programme. These services/supports will still be subject to various governance requirements (e.g. financial, performance, quality, etc.) and will continue to feature in reports outside of the Programme of Work. Members will be kept informed of progress against each of the items within the Programme of Work, with timescales identified in further detail in the appendix. Future reports will provide the Board with assurance of delivery and implementation against agreed timescales and inform of any developments to the shaping of any future items within the overall Programme of Work. The Programme of Work will continue to evolve and flex during the three year period, and as part of its ongoing review and reporting cycle outlined on page 17 any proposed changes or updates to the programme will be reported via the Integration Joint Board. Yes ☐ No ☒ N/A ☐
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3 The Health & Social Care Partnership is seeking to adopt a Learning as Management Strategy (often called Human Learning System) approach, working with partners from Healthcare Improvement Scotland to make learning and experimentation the key force driving our work. While we engage in a range of programmes and redesign activity as part of this overall Programme of Work, we will seek to enact a process of understanding and experimenting with complex systems to try and get those systems to produce a different pattern of results and better outcomes. This approach will be developed and embedded as far as possible within each of the Programme of Work items, to ensure we learn from our tests of change. 6. CONCLUSIONS The Programme of Work is a comprehensive plan of action for the partnership to deliver against the priorities within its Strategic Commissioning Plan 2023-26. It seeks to deliver programmes designed to transform and reshape health, social care and social work services in North Lanarkshire and meet the ongoing and future needs of North Lanarkshire’s communities. 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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4 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 ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership Yes ☐ No ☒ N/A ☐
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5 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 https://mars.northlanarkshire.gov.uk/egenda/images/att100339.pdf 9. APPENDICES Appendix 1- Strategic Commissioning Plan 2023-26 –Programme of Work CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Graeme Cowan CowanG@northlan.gov.uk Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
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6 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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7 Appendix 1 Strategic Commissioning Plan 2023-26 Programme of Work
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8 Introduction This document provides an overview of the Programme of Work to deliver the Health & Social Care North Lanarkshire Strategic Commissioning Plan. It sets out the scope and objectives for each of the strands within the programme of work; the workstreams that make up the programme; the proposed governance structure and the duration and reporting timescales for each item. Strategic Commissioning Plan 2023-26 The Strategic Commissioning Plan 2023-26 approved by the Integration Joint Board in March 2023 sets out 5 key priorities: Increased focus on prevention, early intervention and tackling inequalities by working with people and communities Do the right thing first time Develop and support a workforce for the future Improve mental health and wellbeing Support people through a whole family approach All programmes of work link to these priorities, with many contributing to several of the strategic priorities. The Integration Joint Board is responsible for the strategic planning of the functions delegated to it, and therefore plays a crucial role in the strategic oversight of the entire programme of work and its interdependencies. The programme sets out the timetable for reporting to provide clarity to the Board, the progress reports it can expect to receive and when. Programme Management Approach We are putting in place a robust programme management structure to ensure that each of the many initiatives and transformations being developed is fully defined and that there is clarity on the changes and new capability that each will deliver and how this will contribute to reshaping the future of health and care services in North Lanarkshire.
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9 The key principles which will support this programme management approach are: Identifying and managing programme interfaces and dependencies; Maintaining communications between programmes; Establishing adherence to programme and project management standards, including effective, consistently applied approaches to identifying and managing benefits, stakeholder engagement, risk and issue management and monitoring and control; Coordinating reporting to the Strategic Commissioning Plan Programme Board, Strategic Leadership Team and IJB on progress and the delivery of benefits. The Programme of Work seeks to include those programmes and activities which are intended to help transform and change the health and social care system. It is acknowledged that the partnership, and the organisations of which it is comprised, delivers a range of services and supports, many of which are not featured within the overall programme. These services/supports will still be subject to various governance requirements (e.g. financial, performance, quality, etc.) and will continue to feature in reports outside of the Programme of Work. The Programme of Work will continue to evolve and flex during the three year period, and as part of its ongoing review and reporting cycle outlined on page 17 any proposed changes or updates to the programme will be reported via the Integration Joint Board. This will assist in ensuring alignment with the emerging priorities of Operation Flow 3, the Council’s Programme of Work (as part of The Plan for North Lanarkshire), NHS Lanarkshire’s Our Health Together, and any other priorities which may develop in the coming months and years. Human Learning System The Health & Social Care Partnership is seeking to adopt a Learning as Management Strategy (often called Human Learning System) approach, working with partners from Healthcare Improvement Scotland to make learning and experimentation the key force driving our work. While we engage in a range of programmes and redesign activity as part of this overall Programme of Work, we will seek to enact a process of understanding and experimenting with complex systems to try and get those systems to produce a different pattern of results and better outcomes. This approach will be developed and embedded as far as possible within each of the Programme of Work items, to ensure we learn from our tests of change.
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10 Governance Diagram
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11 Getting It Right For Everyone (GIRFE) As part of a national GIRFE pathfinder programme, to establish a multi-agency approach of support and services for older people and adults living with frailty To work with Wishaw Locality Planning Group to establish a local pathfinder in to develop and test North Lanarkshire GIRFE model To define the person’s journey through individualised support and services, respecting the role that everyone involved has in contributing to shared care and support planning, review and personalised interventions. To create a single point of access within localities to ensure holistic assessment of people and coordination of system wide services to support them achieve their outcomes, enable them to be as independent as possible and live their best lives. To ensure that, when people are admitted to secondary care (planned or unscheduled) their journey meets GIRFE principles To embed a Home First approach to enable timely discharge from hospital and prevent unnecessary admission to hospital or premature admission to long term care through the establishment of multi-disciplinary assessment and coordinated care, rehabilitation and support at home or closer to home: o Rapid access to the treatment, rehabilitation and support that people require to enable them to return home from hospital at the right time or receive their acute care and rehabilitation at home or closer to home as an alternative to emergency admission to hospital; o Time-limited support and rehabilitation to enable an assessment of each person’s immediate and longer-term support needs in their own home, optimising use of personal and community networks and reablement to support recovery and optimise wellbeing and independence; o A designated workforce, equipped with the appropriate education, competence and capability, focussed on maximising functional ability in the home environment by providing proactive anticipatory care, timely multi-disciplinary assessment and a rapid community response are opportunities presented with the implementation of the Newmains & St Brigid’s Governance GIRFE Steering Group GIRFE Facilitation Group Wishaw GIRFE Programme Duration 2023 – 2026 Reporting Timescales Annual reporting to IJB (November) Current Status Scoping/programme definition Establishing GIRFE programme organisation and governance Identifying and analysing stakeholders
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12 Community Nursing Review Develop a Vision for Community Nursing in Lanarkshire. Map demography, local need and current service provision Engage the community, staff and service users Develop a revised clinical model Develop a workforce plan Develop a training and development plan to support the new staffing model Review Governance for Community Nursing Identify and implement any quick wins Implement recommendations of review and monitor impact on patient outcomes Governance GIRFE Steering Group GIRFE Facilitation Group Wishaw GIRFE Programme Duration 2023 – 2026 Reporting Timescales Annual reporting to IJB (November) Current Status Scoping/programme definition Establishing GIRFE programme organisation and governance Identifying and analysing stakeholders Development and Implementation of the Frailty Strategy Develop a system wide strategy to prevent and manage frailty at home and in all care settings across Lanarkshire; Ensure a flexible and inclusive approach; Forecast and undertake capacity planning on a system-wide basis; Coordinate agreed changes with related workstreams – e.g. Mental Health, Dementia; Palliative and End of Life Care, Rehabilitation, Falls; TEC; Compile system-wide change plans with agreed priorities, programme and resources; Governance Our Health Together Frailty Strategy Group Programme Duration 2023 - 26 Reporting Timescales Annual reporting from November 2023 Current Status
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13 Carers Strategy Governance SCP Programme Board Programme Duration 2023 - 2026 Reporting Timescales Annual reporting from May 2024 Refresh of the Carers Strategy Develop a short breaks statement Introduce Joint Partnership Statement around Adult Carer Support Plans. Explore ways to improve access to Carer budgets linked to low/medium Adult Carer Support Plans and look further develop Anticipatory Care Planning arrangements Further development of carers support for Post Diagnostic Support (PDS) for dementia Provide better reach to under-represented carers Reintroduced Hospital Discharge Carer Payment project following positive feedback. To develop and enhance break support options. Expanded carer breather project. Increase support to people caring for someone with profound and complex needs. Enhanced funding for PAMIS. To introduce additional supports to carers caring for someone with dementia. Enhanced support for carers of people with Autism. Increased accessibility and availability of Carer Individual Budgets to meet low or moderate caring related need. Current Status In progress Home Support Redesign Develop a whole system approach to home support, including the interface with localities, acute, community nursing, independent sector and third sector partners. Develop a whole system approach to care and support adopting self directed principles which incorporates Home Support clearly within that. Work with the DigitalNL programme to implement the best dynamic scheduling solution, not solely for home support, but fit for purpose for all council services that would need to make use of this resource. Governance Home Support Redesign Project Board reporting to the Home Support and Discharge Without Programme Duration 2023 - 2025 Reporting Timescales Annual reporting from May 2024 Current Status Timescales for implementation extended due to pandemic. Workstreams and delivery plan revised. New plan on track
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14 Development of Home Assessment Team To enable timely discharge from hospital and prevent unnecessary admission through the establishment of a multi-disciplinary Home Assessment Team that will provide: Rapid access to the support that people require to enable them to return home or avoid admission to hospital; Time-limited support to enable an assessment of each person’s immediate and longer-term support needs in their own home, taking into account and optimising use of personal and community networks; A designated workforce focussed on enabling discharge and maximising function in the home environment by providing timely post-discharge multi-disciplinary assessment and a rapid community response An agreed care plan; and Governance HAT Steering Group reporting to the Home Support and Discharge Without Delay Programme Programme Duration 2023 - 2025 Reporting Timescales Annual reporting from May 2024 Current Status In progress. Focus to date on hospital discharge. Scoping underway with H@H leads re admission avoidance pathways Community Alarm Service Review To agree a vision for North Lanarkshire’s Community Alarm and Telecare Services To review the current operating model and demand on the service to understand its strengths and weaknesses from the point of view of both service users and staff. To engage communities, service users, families, carers and other key stakeholders in the development and appraisal of options for the future service model and develop a business case for the preferred option. To empower individuals and communities by involving them in the design and delivery of the services they use. Governance Steering Group to be established reporting to Home Support and Discharge Without Delay Programme Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from May 2024 Current Status Scoping/project definition Finalising project organisation and governance Some work underway in support of Analogue to Digital Transition
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15 Review of Care Home Assurance & Support Establsih and renew arrangements for providing continuing enhanced support to adult and older people’s care homes Ensure assurance and support to care home sector continues in context of Excellence in Care, including IPC direct Support and embedding of the National Infection Prevention and Control manual Oversee whole system support to care homes to improve health and wellbeing of adults living in care homes through implementation of My Health, My Care, My Home – healthcare framework for adults living in care homes and Health and Social Care Standards in Scotland Ensure collaborative improvement model is utilised in all developments with care homes Ensure systems and processes are in place to share intelligence between agencies to identify and allow support to be provided to care homes at risk. Ensure systems and processes are in place to provide immediate response to serious concerns to mitigate risks Monitor overall capacity of sector – identify risks and mitigate where possible Ensure contingency plans are in place for the sector and regularly updated. Governance Healthcare Quality, Assurance & Improvement Committee (HQuAIC) (NHSL) Reporting Timescales Current Status Hospital at Home Rapid Review Governance Unscheduled Care Programme Steering Group Programme Duration 2023 – 2024 Reporting Timescales Recommendations report in November 2023 Current Status Review of H@H service commenced January 2023 Terms of Reference agreed Programme of workshop sessions, data gathering/analysis, process mapping and scoping of potential Participation in Operation Flow (Firebreak) with report and data on results of expanding service across 7 days and later into the evenings. Winter additionality funded by STAR chamber to expand service into evenings and across 7 days, with improved pathways. Bid made for additional funding (permanent) submitted in August 2023, for permanent expansion as above and for a separate (sideways) expansion into Heart Failure services. Permanent expansion of current serve into Clydesdale area commenced on 28 August 2023.
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16 Self Directed Support Transformation Personalisation : SDS maximising our support and targeting it most effectively Reviewing and redesigning systems and processes To review all systems and processes and redesign the process to reflect the principle that self-directed support is everything that we do. The new processes will be reflective of a shift towards more local decision making, autonomy and accountability. To develop a portal/system that will record provider capacity and allow this information to be shared with frontline workers. Public Information and Marketing To review and update all current public information and marketing resources thus ensuring that materials deliver a clear, consistent, and meaningful message around SDS that is widely accessible, easily understood, user friendly, transparent, dispels myths and supports informed choice and control. Performance Information To review current performance information and indicators to allow us to determine what information we want to capture and in what format. To devise a mechanism/system as a central point that will allow this information to be collated and presented in a variety of formats. To show trends, patterns, and projections. To gather feedback and views from those using services or support to shape our plans going forward. Complex Care Reduce the delayed discharges of people with complex care. Repatriate those people inappropriately placed out-of-area. Review the way services are provided for people with complex care. Digital / IT Systems Workstream To contribute to the design and implementation of the new information recording system with a focus on how we can record and measure outcomes, impact, and good conversations. The aim is that the new Mosaic system will reflect the self-directed support strategy. Reviewing the Guided Self-Assessment Training and Development Ensure that we have a skilled, trained workforce who are able to deliver a quality service. Aim for citizens and partners to have a full understanding of the SDS Transformational Agenda. Develop comprehensive training plans for citizens, partners and Social Work staff. – – Governance SDS Transformation Board Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from May 2024 Current Status Board established Implementation Plan live
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17 Mental Health & Wellbeing Strategy Governance Mental Health and Wellbeing Strategy Board Mental Health and Wellbeing Exec Group Programme Duration Current strategy 2023-24 New Strategy from 2024 Reporting Timescales Annual reporting from Current Status Existing Strategy nearing the end of its lifecycle. Refresh underway to develop 2024-29 Strategy which will align with new national Mental Health and Wellbeing Strategy The joint strategic aims, aligned with partner organisations, of Getting It Right for Every Person (GIRFEP), a Mental Health and Wellbeing Strategy for Lanarkshire, are to: Improve healthcare and wellbeing; Strengthen effective leadership and governance for mental health services across all sectors; Reduce health inequalities and improve health and healthy life expectancy; Support people to live independently at home through integrated health and social care services; Provide comprehensive, integrated and responsive mental health and social care services and supports in community based settings; Support all children and young people to live as full and healthy a life as possible and to realise their full potential; End mental health stigma and discrimination The aim is that people in Lanarkshire live in a community where everyone understands that there is no good health without mental wellbeing, where we know how to support and improve our own and others’ mental well Prisoner Healthcare Governance Prisoner Healthcare Programme Board Programme Duration 2023 - 2025 Reporting Timescales Annual reporting from March 2024 Current Status Bringing together existing workstreams - scoping/programme definition underway Establishing programme organisation and governance Identifying stakeholders and Undertake a review of prisoner healthcare at Shotts Prison. Develop and implement an action plan to address concerns raised by Healthcare Improvement Scotland in relation to the Prison Health and Wellbeing Standard in the course of the HMIPS inspection of Shotts Prison. Establish baseline and monitor action to comply with Medication Assisted Treatment
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18 Support the delivery of the North Lanarkshire Alcohol & Drugs Partnership Strategy Governance NL Alcohol & Drugs Partnership Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from March 2024 Current Status Implementation plans live People have early access to support for problem substance use –early intervention strategies will be put in place to prevent problem use with support offered through a range of community-based responses. North Lanarkshire Alcohol & Drugs Partnership (NLADP) will facilitate efforts to embed a Whole Systems Approach – including families and a broader range of stakeholders to reach those not already known to services. Strengthen the links between physical/mental health & substance use taking a ‘No wrong door approach’ focussed around the needs of the individual and not solely focussed on the substance use or disorder/s. As part of this there should be trauma informed care, and a clear understanding of people's emotional and psychological needs at the heart of all recovery plans and evidence-based low intensity psychosocial interventions should be routinely available. Young people and families receive evidence based, effective education on substances, harm reduction and how to access help when problems develop. Through the provision of effective, evidence-based education both within and beyond school. Workforce capability is increased through learning via a strategic workforce development plan including needs analysis to identifying gaps and opportunities to strengthen the workforce knowledge, skills and confidence to respond. Drawing on local experience, knowledge and assets to support quality improvement and best value. A rapid review commissioned by the ADP highlighted trauma informed care and a holistic assessment and careplan as being key to future service provision. There is recognition that there are workforce development needs around delivering psychologically informed and trauma informed care People are supported to make informed decisions about their own care through a range of treatment options including residential rehabilitation for all those who will benefit. Including all those who want, and for whom it is deemed clinically appropriate, to access residential and/or community rehabilitation. People are supported to remain in treatment for as long as requested – MAT standard 5, individuals are supported to remain in the treatment that is right for them, for as long as they want or need. Improved early identification, assertive outreach & increased engagement (MAT standards – opiate/benzo with rapid access) so people at high risk are proactively identified and offered support – MAT standard 3 targeting at-risk groups. Overdoses are prevented from becoming fatal – increasing provision of naloxone, strengthening proactive outreach for at-risk groups improving near fatal overdose pathways. All people are offered evidence based harm reduction – MAT standard 4. Provision of harm reduction materials such as injecting equipment, BBV and wound care for those who need it. People who use drugs have access to information about risks and harm reduction – in person, digital and via phone information on drugs and harm reduction including WAND, EIP and DBST. –
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19 CAMHS Recovery & Renewal Governance CAMHS Recovery & Renewal Programme Board Programme Duration Under review Reporting Timescales Review CAMHS referral and assessment pathways and implement the Choices and Partnership Approach (CAPA) service transformation model for CAMHS. Full implementation of the national CAMHS Specification to include extension of age range, requirements for eating disorder patients, intensive home treatments and closer working relationships with regional centres for children and young people who require inpatient care and/or additional support due to complex level of support needed (forensic and learning disability). Robust planning for transition of care. Elimination of long waits for CAMHS. Agree a workforce model to utilise the funding provided by the Mental Health Recovery Fund to enable the effective implementation of CAPA Implement the Neurodevelopmental Pathway Engage all key stakeholders to achieve consensus and clarity and enhance communication of new ways of working across all CAMHS teams and Neurodevelopmental Pathway. Delivery of an electronic documentation system that is capable of sharing information across the service and with other partner health care colleagues who are sharing care. Delivery of appropriate psychologically informed environments for children, young people and families to be seen. Current Status Current Board has been meeting for 18 months. 3 of the 5 work streams are moving towards a business as usual Speech & Language Therapy Service Improvement Governance SLT Service Improvement Steering Group Programme Duration 2023 - 2025 Reporting Timescales Monthly reports available, annual reporting to IJB from September 2024 Work streams have been established. Work planned to be progressed: - Implementation of Trakcare Waiting List management processes including support of a Waiting List Initiative that will progress a positive improvement in treatment time trajectory Implementation of a clinical documentation platform that is capable of sharing information internally within the Speech & Language Therapy service and with wider health colleagues. Development of links with further education to support a positive pathway between NHS Lanarkshire Speech & Language Therapy and associated academic partners. Upgrade of Speech & Language Therapy website that will host support materials Review of administration process Review accommodation against future need Engagement and communication process to be established with children, young people and families Current Status Scoping/programme definition underway Establishing programme organisation and governance Identifying and analysing stakeholders A Steering Group has been established, chaired by the General Manager for Specialist Children’s Health Services Unit
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20 Paediatrics Modernisation Governance Paediatrics Modernisation Board Programme Duration 2023 - 2025 Reporting Timescales Annual reporting from September 2024 Current Status Scoping/programme definition underway Establishing programme organisation and governance Identifying and analysing Aim To review and, where appropriate, redesign Paediatric clinical and service models, including pathways between Community and Acute Paediatrics to ensure an effective whole systems approach. Objectives · Develop a Vision for Acute and Community Paediatrics in Lanarkshire. · Assess current provision against the Royal College of Paediatrics and Child Health (RCPCH) standards for Short Stay Paediatric Assessment Units. · Develop models for Acute and Community Paediatrics that keeps the young person at the centre. Use a 3 horizons model to address immediate challenges, while aligning a longer term plan which aligns to the RCPCH standards, setting out workforce, clinical models of care, service models, accommodation, information management, performance management and governance arrangements. · Engage children, young people and their families, and staff in redesigning services. · Develop a Transition Programme and Operating Procedures to allow those using Paediatric Services to smoothly transition into Adult Care
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21 Digital Technology & Systems Development Governance Various, including: NLC Digital NL PoW Board New Social Care Management System Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from November 2023 Current Status Deliver and implement the HSCP elements of the NHS Lanarkshire Digital Plan and the NLC Digital NL programme Implement Mosaic, the new social work/social care case management system Develop and implement project to deliver a new dynamic scheduling tool for care at home services Continue support for analogue to digital switchover for community alarms Further develop assistive technology offer Implement a digital first approach where appropriate. Explore and implement new models of care that enhance pathways and improve access. Integration of systems to assist in enabling people to optimise the management of their own health and care Joining up systems to ensure appropriate sharing of electronic information Use technology to support people to remain well and independent in the place they call home, for as long as possible Community Solutions Strategy and Investment Plan Governance SCP Programme Board Community Solutions Governance Sub Programme Duration 2023 – 2025 Reporting Timescales Annual reporting from May 2024 The Community Solutions Programme takes a holistic and integrated approach to health, wellbeing, quality of life and equality encompassing: mental and physical health and wellbeing and their connection the social, economic, and environmental influences on health, wellbeing, and equality and the actions needed to tackle these A strategic investment approach prioritises the following in line with HSCNL’s ambitions: investment in health improvement, prevention, and early intervention activities, which reduce inequalities and protect human rights investment in crisis and ongoing support, with a focus on recovery and reablement, self-directed support, and self-management. cost-effective, community-based support and services provided by CVS organisations. capacity building within the CVS and wider community by supporting key CVS ‘anchor’ organisations and volunteering to build the community infrastructure and capacity to support provision of good community-based support over time Current Status
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22 Engagement & Participation Strategy Governance HSCNL Engagement & Participation Group [NLC Resilient People PoW Board] Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from May 2024 Current Status Strengthen engagement, participation, and empowerment across communities to develop an integrated service offer that meets needs of communities, with communities directly involved in the delivery of supports and services. Develop a host organisation approach to engagement and participation to ensure activity is well planned and co-ordinated. Implement a governance structure to support transparency, fairness, and accountability Implement a robust monitoring, evaluation, and reporting framework with both qualitative and quantitative measures of success Develop a broad approach that works to reach supported people including minority and underrepresented groups.
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23 Governance North Trauma Informed Practice Group NHSL Implementation Group Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from September 2024 Current Status Deliver Trauma Informed Roadmap 2023-25 Develop a comprehensive local Trauma Plan to ensure that trauma informed practice and systems are embedded Implement the Trauma Plan with a focus on creating the culture and conditions to enable staff to respond in ways which recognize the impacts of trauma, promote recovery, prevent retraumatisation and ensure services and supports are accessible and effective to those who need them most Leadership: Appoint an elected member as Trauma Champion to support the work of the steering group develop plans for North Lanarkshire becoming a trauma-informed Council to support the fulfilment of the ambition of the Plan for North Lanarkshire and the new Programme of work. Health Board members would assist this also. Likewise further SLT to support the SCP ambitions and embed trauma informed practice across the partnership. Re-fresh governance and membership of the of steering group. Workforce Wellbeing: The actions to deliver the NHSL and Council’s Mental Health Strategy for staff are underpinned by the 5 principles of a trauma-informed organisation. Workforce knowledge and skills: Each service across the partnership should assess the level at which staff need training and a base line is established in order to update the training strategy for trauma informed practice. Experts by experience: Individuals, families and communities drive our approach to becoming a trauma informed organisation using existing structures for participation and engagement and, where possible, develop other opportunities and structures for meaningful participation and aim to embed influence of experts by experience across all service delivery. Data and Feedback Loops: Base lines and outcome data for trauma informed practice are integrated and aligned with measures of success within the SCP and the Council’s new Programme of Work. Staff Health & Wellbeing Programme Governance SCP Programme Board Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from March 2024 Current Status The partnership working group had the first meeting in August 2023 Both NHSL and NLC have staff health and wellbeing Establish a NL HSCP working group to agree priorities for the staff health and wellbeing agenda for the partnership, whilst aligning with the key wellbeing strategies from our partners (NHSL / NLC) Promote wider support services that are available through NHSL and NLC Further development of Trauma-informed Practice
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24 Further Develop Lanarkshire Care Academy Governance Care Academy Steering Group [NLC Brighter Futures PoW Board] Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from September 2024 Current Status Agree Memorandum of Understanding with the University of Strathclyde, setting out commencement of close collaboration in projects between the partnership (HSCNL) and the university, building on the multiple honorary positions in place with University of Starthclyde and University of Glasgow Agree a process for identifying, defining and progressing potential opportunities for engagement through collaboration Scope of MoU to include research collaborations, honorary appointments, Graduate Apprenticeships, student placements, jointly funded posts, secondments of staff, student recruitment, student projects, education and continuing professional development and policy and practice. Pursue university status for the partnership (HSCNL) Develop partnership agreements with Glasgow Caledonian University and the University of the West of Scotland. Partnership with Universities Governance To be established Programme Duration 2023 – 2026 Reporting Timescales Annual reporting from March 2024 Current Status Memorandum of Understanding has been drafted, with approval being sought from all parties in 2023. Care Academy Objectives Evidence Take an evidence-based approach to identify the short, medium and long term supply and demand profile for the health and social care sector in North Lanarkshire Recruitment Further develop recruitment strategies with university and college campuses to discover and inspire upcoming talent and generate more qualified applications to fulil current and future demand needs Reach Develop a plan to reach and inspire passive candidates or potential career changers and returner, with the right values to take their first steps towards exploring a career in social care. Ensuring an inclusive approach to reaching those who are furthest removed Identity Build the Health and Social Care Partnership employer identity and improve how the enttire reward and compensation package is marketed for all roles Presence Create a social media strategy to build a stronger online presence around the Care Academy, breaking down any misconceptions around the sector and providing practical tools and resources for people to discover potential future roles Next gen Inspire the next generation by taking the in-school academy education to the next phase, creating pathways from school to employment and looking at new digital delivery models to inspire young people with the right values to pursue a career in the sector Pathways Establish career pathways and underpin these with qualifications and development routes, influencing further and higher education strategies to secure and maximise available funding.
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25 Reporting Timescales Date/Timeline Programme of Work Items for Reporting September 2023 IJB signs off Programme of Work November 2023 GIRFE Community Nursing Review Frailty Strategy Hospital @ Home Rapid Review CHAT Review Digital Technology & System Developments March 2024 Mental Health Strategy Prisoner Healthcare Alcohol & Drugs MAT Standards Staff Health & Wellbeing Partnership with Universities May 2024 Home Support Redesign Home Assessment Team Community Alarm Service Review SDS Transformation Carers Strategy Engagement & Participation Strategy Community Solutions Strategy & Investment Plan September 2024 CAMHS Recovery & Renewal Paediatrics Modernisation SLT Improvement Trauma Informed Practice Care Academy November 2024 GIRFE Community Nursing Review Digital Technology & System Developments
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26 Frailty Strategy Hospital @ Home Rapid Review CHAT Review March 2025 Mental Health Strategy Prisoner Healthcare Alcohol & Drugs MAT Standards Staff Health & Wellbeing Partnership with Universities May 2025 Home Support Redesign Home Assessment Team Community Alarm Service Review SDS Transformation Carers Strategy Engagement & Participation Strategy Community Solutions Strategy & Investment Plan November 2025 CAMHS Recovery & Renewal Paediatrics Modernisation SLT Improvement Trauma Informed Practice Care Academy
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1 REPORT Item No: 8 SUBJECT: Prescribing Efficiencies Programme TO: Integration Joint Board Lead Officer for Report: Dr Lucy Munro Medical Director for Health & Social Care North Lanarkshire Author(s) of Report Julie Russell Deputy Lead Prescribing Management (North HSCP) Dr Lucy Munro Medical Director for Health & Social Care North Lanarkshire DATE: 27 September 2023 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: Julie Russell ☒ Reviewed By: Dr Lucy Munro ☒ Endorsed By: Dr Lucy Munro ☒
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2 3. RECOMMENDATIONS The IB is asked to note progress to date and background. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Costs and Quality 5.1.1 Medication is the single most common healthcare intervention and is one of the highest health expenditure costs. NHS Lanarkshire annual prescribing costs are approximately £140 million/year. The Prescribing Team is set an annual target for efficiencies and in 22/23 achieved a total of £2.24 million across Lanarkshire in cost mitigation, £1.2 million of which was in North Lanarkshire. To note, the prescribing efficiencies work is undertaken on a pan Lanarkshire basis with local adaptation at partnership, locality and practice level. This provides consistency of communication with prescribers and the clinical governance required across the interface with secondary care colleagues with regard to medicines changes. The aim is to change prescribing while either improving the quality and appropriateness of medicines or leaving the quality of care unaffected. 5.2 Data and Finance 5.2.1 Data which describe prescribing efficiencies can be difficult to understand and can seem anomalous with current financial data. In 23/24 the savings target from the combined community prescribing budget is £5.4 million for NHS Lanarkshire, this is ambitious but we believe achievable. 5.2.3 PRISMS, the prescribing information system for Scotland, is the most reliable data for actual costs of medications in Scotland. These data sets run three months behind and are used to describe our current and predicted financial position. 5.2.4 Prescribing efficiency savings, on the other hand, are an estimated calculation of the annual saving which will be made over the coming financial year as the result of a particular action/set of actions. Example is thus; if medication A is changed to medication B in April of 2023 with a cost saving of £10/month, the resultant saving of £120 in financial year 2023/24 will not be seen in the PRIMS data until July 2024. Yes ☐ No ☐ N/A ☒
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3 5.2.5 This explains why the actions taken in the first quarter of 2023 in relation to prescribing will not be evident in the financial predictions at all until July 2023 at the earliest and not in full until July 2024. 5.2.6 The actions already taken in this financial year 2023/24 are projected to save circa £2 million in NHS Lanarkshire which is more in a single quarter than has been saved in a whole year for most of our recent years but the effect of the data streams is those savings will not be visible at present. Additionally, the unpredictably increasing cost of medicines could outstrip even these ambitious savings. 5.2.7 NHS Lanarkshire has higher costs/patient than other board areas (Graph 1) with items number being a specific issue in North Lanarkshire (Graph 2). 5.2.8 These patterns are typical of those we expect in deprived areas and when Graph 1 is adjusted for deprivation the unfavourable comparison with other boards disappears. This is important information as it helps us understand that our prescribers are not behaving in a way which is out of keeping with other similar areas and also helps us know what and how to target interventions most effectively. It is important to avoid any sense of ‘blame’ towards either prescribers or patients while still challenging prescribing habits and explaining the reasons why some medications are not being prescribed. Graph 1 – Annualised Gross Ingredient Cost per 1000 patients Graph 2 – Annualised items per 1000 patients
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4 5.3 Operations and Governance 5.3.1 In 23/24 the savings target from the combined community prescribing budget is £5.4 million. This is to be achieved by the Prescribing Team and the newly established Prescribing Operational Group which aims to achieve recurrent and sustainable efficiencies using a collaborative approach involving process and system changes. £2.5 million of this overall target applies to the North Lanarkshire Health and Social Care Partnership. 5.3.2 The Prescribing Operational Group is chaired by Dr Veronica Rainey - Associate Medical Director South Lanarkshire, as part of the Sustainability and Value programme of NHS Lanarkshire. All of the North Lanarkshire Locality Lead GPs and Prescribing Advisors sit on the Prescribing Operational Group. The Prescribing Operational Group reports into the Partnerships’ Medicine Management Board chaired by the North Lanarkshire Medical Director, Dr Lucy Munro, as well as the Sustainability and Value programme. 5.3.3 There are 3 strands to cost mitigation; individual practice plans (these are specific to each practice), central prescribing actions (these apply to all practices) and Scriptswitch savings (software installed on GP systems as a decision making aid to prompt prescribers to choose cost effective options). 5.3.4 Current central work streams include switches of specific inhalers, mucolytic and analgesic medications. The aim of central switches is to gain ‘quick wins’ for cost efficiencies without affecting quality of care. For all central switches there is a clinical governance process through various groups including the 0 6000 12000 18000 24000 Apr 2021 May 2021 Jun 2021 Jul 2021 Aug 2021 Sep 2021 Oct 2021 Nov 2021 Dec 2021 Jan 2022 Feb 2022 Mar 2022 Apr 2022 May 2022 Jun 2022 Jul 2022 Aug 2022 Sep 2022 Oct 2022 Nov 2022 Dec 2022 Jan 2023 Feb 2023 Mar 2023 Apr 2023 Annualised Items per 1,000 patients NHS LANARKSHIRE Scotland NORTH LANARKSHIRE SOUTH LANARKSHIRE SOUTH LANARKSHIRE Central Services NHS Lanarkshire (Minus Central Services)
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5 Partnerships’ Medicines Management Board and Area Drug and Therapeutics Committee as well as authorisation from specialists within the therapeutic areas. Both this board and this committee have stakeholder involvement from the GP Sub-Committees. 5.3.5 The practice plans are identified by analysing prescribing data for each individual practice allowing for differences in prescribing amongst localities and practices to be addressed with the aim of reducing unwarranted variation, spreading good practice and reducing costs. 5.4 The Drug Tariff 5.4.1 The Scottish Drug Tariff is published for and on behalf of the Primary and Community Care Directorate, Scottish Government by Public Health Scotland (PHS). The Tariff contains information regarding the prescribing, dispensing and reimbursement of medicines and appliances on primary care NHS prescriptions 5.4.2 Historically the Prescribing Team’s efficiencies have been from switching medicine to equivalent but more cost effective options. This includes switching brands, formulations (e.g. liquids to tablets) and to other drugs within the same therapeutic class. This is in line with work streams in other Health Boards. 5.4.3 PHS has recently announced that that there is an unprecedented pressure in the Drug Tariff expected to last for at least the next 2 years. This is the result of drug shortages and increasing costs of medicines and means that prices may fluctuate in a much more inconsistent way than previously, this, in turn, has an impact on our ability to save through ‘switches’. 5.4.4 This fragility in the drug tariff accompanied by an increasing number of prescription items means that the traditional way of achieving efficiencies is no longer viable long term. This includes a move to tackling polypharmacy using realistic medicine principles and creating a health board list of low therapeutic value medications which could be stopped. 5.4.5 In addition, North Lanarkshire is an outlier in its prescribing of respiratory medicines and pain medicines. The latter is an indicator that we could be managing chronic pain differently locally. The North Lanarkshire Medical Director has facilitated a programme of activities aimed at managing chronic pain in North Lanarkshire differently beginning in North East sector involving localities as a whole. 6. CONCLUSIONS 6.1 The fragility of drug costs and supply has presented an opportunity to move from traditional cost efficiency switches to a more holistic polypharmacy review model and avoidance of drugs of low therapeutic value.
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6 6.2 Of note, 11% of all unplanned hospital admissions are attributable to medicines related harm and the World Health Organisation (WHO) has made polypharmacy one of its top 3 health priorities. 6.3 This will improve quality and safety of prescribing in line with the principles of Realistic Medicine. Decreasing the number of items prescribed will result in a more sustainable way to manage prescribing costs and culture change. Many other Health Boards have already made the move to this way of working. This correlates well with prescribing stewardship and the aim of the work on chronic pain. 7. IMPLICATIONS 7.1 As the cost of living, transport and raw materials rise so does the cost of medications. Despite being ambitious and successful against target, it may be difficult for the prescribing efficiencies programme to keep pace with those increasing costs. The most effective and sustainable way to mitigate costs long term will be to prescribe less in an ever demanding environment thus a collaborative culture or prescribing stewardship will have to be created. A new focus on polypharmacy reviews, the work on chronic pain and the list ‘low therapeutic value’ drugs are the start of that change. 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 ☒
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7 7.2 ASSOCIATED MEASURE(S) N/A 7.3 FINANCIAL This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Risk will be updated and reviewed in coming quarter. 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 Yes ☐ No ☒ N/A ☐
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8 ☐ 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: Currently being completed for Prescribing Operation Group EQIA added to website: Currently being completed for Prescribing Operation Group 8. BACKGROUND PAPERS None. 9. APPENDICES Appendix 1 - NHS Lanarkshire primary care prescribing efficiencies project presentation Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☒ N/A ☐
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9 CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Dr Lucy Munro Medical Director
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10 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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11 Appendix 1 - NHS Lanarkshire primary care prescribing efficiencies project presentation Slide 1 NHS LANARKSHIRE PRIMARY CARE PRESCRIBING EFFICIENCIES PROJECT SOUTH HEALTH AND SOCIAL CARE FORUM Dr Veronica Rainey Associate Medical Director South Lanarkshire HSCP
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12 Slide 2 GROSS ANNUAL BUDGET - £141.3M OVERSPEND AT MARCH 23 - £5.5M COST PER ITEM – UPWARD TREND ITEMS DISPENSED – UPWARD TREND
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13 Slide 3 NHS Lanarkshire prescribing spend is significantly higher than the national average. This has been compounded by recent high inflation and an increase in waiting lists for procedures resulting in a significant overspend which is unsustainable. It is essential that we act now to improve quality and efficiency and drive down costs in line with the Prescribing Quality & Efficiency Strategy (PQES). This is also a great opportunity to review our prescribing practice and culture across Lanarkshire in order to make good quality, sustainable changes
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14 Slide 4 Prescribing Efficiencies workshop March 22nd 2023 Attended by 11Prescribing Advisors Attended by 8 Locality Lead GPs Prescribing leads Head of Finance Primary Care Improvement Advisor
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15 Slide 5 Many areas across Lanarkshire have been identified where improvements can be made and where projects which were paused during the pandemic can be restarted. We are adopting a whole systems approach in order to ensure that the improvements being made across NHSL are shared, scaled and consistently embedded as normal practice. Areas for change which have been identified are mapped to the key improvement themes. This project involves all prescribers and many services across Primary Care.
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16 Slide 6 REDUCE WASTE, INEFFICIENCIES AND VARIATION QUALITY PRESCRIBING PRESCRIBING CULTURE
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17 Slide 7
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18 Slide 8 PRIMARY CARE PRESCRIBING EFFICIENCIES PROJECT
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19 Slide 9 Develop and test Health Board guidance to prescribers to avoid prescribing specific drugs of low therapeutic value.
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20 Slide 10
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21 Slide 11
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22 Slide 12 Comments and Suggestions please
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REPORT Item No: 9 SUBJECT: Risk Management Report TO: Integration Joint Board Lead Officer for Report: Ross McGuffie , Chief Officer North HSCP Author(s) of Report Stacey Anderson, Support Services Project Manager DATE: 27 September 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☒ For endorsement ☐ To note ☐ The purpose of this report is to provide a summary to the Integration Joint Board on risk management activity, noting any amendments or additions to the current risk register. 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐ By: The Support Services, Project Manager and Chief Officer North HSCP. 1
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3. RECOMMENDATIONS 3.1 The IJB is asked to note the contents of the report which includes the latest version of 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. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 From a good practice and sound governance perspective, all public bodies are required to identify and take account of the impact of any potential risks in delivering their business. BACKGROUND/SUMMARY OF KEY ISSUES (CONT.) 5.2 The PFA Committee has delegated oversight and responsibility for financial and performance risks associated with the remit of the Integration Joint Board and the PFA committee considered the finance and performance risks at its last meeting on 21st June 2023. 5.3 A full review of the risk management reporting within the IJB is currently in progress as part of the risk strategy review and in line with the dynamic developments and changes the new NHS Lanarkshire Risk Manager is implementing within the board. These developments will include review of how risk reporting is managed and presented at IJB and a further evaluation of the improvement methodology aligned with the risk actions. In order to provide a robust overview of these developments, a risk management session has been scheduled for the next IJB Liaison Session and a full report of changes/ developments will be provided to the IJB PFA and IJB at the next meeting. 5.4 Following discussions at the last meeting of PFA on 23rd June 2023, the risk register has been updated and additional controls/actions added to: IJB 01/21 – Financial Challenges IJB 04/21 – Set Aside IJB 06/21 – Prescribing IJB 11/21 – Performance Yes ☐ No ☒ N/A ☐ 2
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IJB 13/21 – Care Homes IJB 14/22 – CAMHS IJB 17/22 – Unscheduled Care 5.5 There are currently two risks rated as Very High on the IJB risk register. IJB 06/21 – Prescribing Activity and Costs IJB 17/22 – Unscheduled Care 5.6 There are eight high rated risks on the IJB risk register. IJB 01/21 - Financial Challenges IJB 04/21 - Notional Set Aside Budget IJB 12/21 - Staff Health & wellbeing IJB 14/22 – CAMHS IJB 15/22 – Cost of Living IJB 16/22 – National Care Service IJB 19/23 – Service sustainability IJB 20/23 – Workforce sustainability 5.7 There are a number of high/very high rated operational risks that have been identified as having or potentially having an impact on IJB objectives and/or delivery of services and these are highlighted within the Risk Register (Appendix 1) and Risk Dashboard (Appendix 2) 6. CONCLUSIONS 6.1 The IJB currently has 17 risks identified on its IJB risk register with 10 risks rated as high or very high. 6.2 Risks identified by H&SC NL as potentially impacting on IJB business are highlighted in 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 ☐ 3
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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: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner IJB Risk Register Choose an item. Multi 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 Yes ☐ No ☒ N/A ☐ 4
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☐ 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: 8. BACKGROUND PAPERS None. Yes ☐ No ☒ N/A ☐ Yes / Date added ☐ No ☐ N/A ☒ 5
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9. APPENDICES Please include a glossary of terms if not already included. Appendix 1 – Risk Register Appendix 2 – Risk Overview Dashboard CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Stacey Anderson Stacey.Anderson3@lanarkshire.scot.nhs.uk 6
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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 7
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Appendix 1 North Lanarkshire Integrated Joint Board Risk Register (Accurate as 22nd March 2023) IJB ID Category Opened Date Description of Risk Risk level (initial) Mitigating Controls Risk level (Current) Risk level (Target) Risk Owner Risk Register Lead Assurance Source Next Review Date Closed Date IJB02. 21 Financial Reputational 01/04/2021 Ineffective Governance Arrangements There is a risk that the IJB is unable to prevent and detect fraud and corruption within services because of inadequate governance arrangements and inadequate internal control systems which could lead to financial and reputational damage. LOW CONTROLS 1. Fraud awareness e‐learning. 2. National Fraud initiative. 3. Locality/SW Enablement Groups. 4. Segregation of duties in relation to authorising and processing direct payments. 5 Whistle blowing policies. 6. Procurement processes and standing orders. 7. Oversight via NLC Audit and Scrutiny Panel and NHSL Audit Committee. 8. Effective governance arrangements are in place and subject to internal and external audit review. 9. IJB and IJB PFA meetings established ensuring effective oversight of financial performance. 10. The IJB does not maintain its own policies relating to the prevention and detection of fraud and error but instead depends on those in place at its partner bodies. . The IJB has a Code of Conduct in place to which members subscribe and the Members’ Registers of Interests are publicly available on the IJB’s website. ACTIONS 1. Continue to raise fraud awareness through team briefings. 2. Annual planned Procurement and Standing Financial Instructions presentations. 3. Annual review of Code of Conduct 4. Review of how Members' Decleration of Interests are collated and reviewed. 5. IJB to request Fraud prevention and detection reports from both partners for oversight at the IJB PFA. LOW LOW Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 31.03.24 Previously IJB6. Reviewed and updated on March 2023. Previously IJB2, IJB7, IJB10 and IJB12. Reviewed and Updated May 2023. Reviewed and Updated Sept 2023. HIGH M EDIUM Amanda Kilburn Amanda Kilburn SLT, IJB PFA, IJB 31.12.23 HIGHIJB.01/ 21 Financial Strategic 01/04/2021 Financial Challenges There are a range of financial challenges which will impact on the IJB's ability to deliver the Strategic Commissioning Plan intentions within the financial envelope available. These include: 1. The absence of a unique IJB financial settlement from the Scottish Government. 2. The IJB is dependent on funding from both partners. 3. Late Scottish Government financial settlement. 4. Budget reductions due to insufficient Scottish Government financial settlements and/or partner contributions. 5. New Scottish Government policy commitments e.g. Carers (Scotland) Act 2016. 6. Demographic growth. 7. Competing service priorities. 8. Conflicting partner efficiency savings programmes which adversely impact on the HSCP's ability to deliver services. 9. In‐year cost pressures emerging due to the underachievement of planned savings, pandemics and other emerging risks which may lead to an overspend. 10. Each partner may be unable to maintain their financial contributions to the IJB in future years which would impact on frontline health and social care services. 11. The agreed transformational plans and service redesigns are not implemented in full and in line with the original implementation plan and/or do not secure the intended improvement outcomes in both performance standards and financial efficiency targets. 12. Future savings targets will continue to be challenging and are likely to impact on essential core services. 13. The IJB Financial Plan cannot be adhered to and budget recovery plans fail to achieve financial balance for both partners. 14. The impact of the pandemic on the financial sustainability of external providers in particular social care providers. 15. The financial implications of the impact of the pandemic on the workforce e.g. increase in sickness absence, early retirement requests and recruitment challenges. The above factors would lead to a failure to achieve the desired strategic aims and would also impact on service delivery. CONTROLS 1. IJB PFA Committee. 2. IJB Chief Officer is a member of each partner's key decision‐making forums. 3. Effective joint working between Chief Financial Officer and both Council and NHS Finance Departments. 4. Regular budget meetings with Chief Executives and Directors of Finance. 5. Regular HSCP budget monitoring meetings across Senior Leadership Team. 6. The IJB Financial Plan 2023/2024 has been agreed and is being reviewed regularly. 7. IJB medium term financial plan 2023‐25 and reserves strategy 2023‐24 approved at March 23 IJB 8. Capacity plans in place to maximise efficiency. 9. IJB Integration Scheme setting out the budget recovery processes. 10. IJB Financial Regulations and financial procedures. 11. Consultation and involvement with key stakeholders including service users and carers. 12. Prescribing Quality and Efficiency Programme, SWEG, ARG and Home Support monitoring groups are in place. 13. Joint Strategic Needs Assessment and ongoing move towards preventative and anticipatory approaches. 13. Strategic Planning Group, Locality engagement sessions and Partnership Boards. 14. Effective and ongoing service user engagement, staff consultation and Trade Union liaison at strategic and local levels. 15. Financial sustainability payment arrangements in place to 31 March 2023 to support external social care providers. 16. The Scottish Government announced on 5 October 2021 an additional £300m for winter health and social care pressures. 18. Work is ongoing with both partner organisations to confirm the final 2023/24 budget. Once complete, a new risk will be created to reflect the final 2023/24 financial plan. ACTIONS 1. Annual budget setting processes within each of the partners. 2. HSCP participating in NHSL Sustainability and Value process 3. Partnership will also be connected to new national whole system groups around budget Report Prepared by Stacey Anderson on behalf of the Chief Officer 8
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Appendix 1 North Lanarkshire Integrated Joint Board Risk Register (Accurate as 22nd March 2023) IJB ID Category Opened Date Description of Risk Risk level (initial) Mitigating Controls Risk level (Current) Risk level (Target) Risk Owner Risk Register Lead Assurance Source Next Review Date Closed Date IJB04. 21 Financial Strategic 01/04/2021 Notional Set‐Aside Budget There is a risk that resources will not be transferred from Acute Services to the HSCP in line with the shift in the balance of care from residential and acute settings to community based alternatives as expected in terms of the notional set‐aside concept. This includes the ongoing development of locality pathways to support maintaining people at home e.g. transitional care models. VERY HIGH CONTROLS 1.There is complete transparency and ongoing dialogue between the IJB and the Health Board on the challenges associated with the implementation of the notional set‐aside concept. 2. Bed modelling and capacity planning arrangements are in place. 3. Effective working relationships between both partners and the IJB have been established. 4. Since the inception of the IJB, an agreement is in place whereby the NHSL Health Board will manage the overspend or underspend across the notional set‐aside budget. This arrangement continues to be in place for 2022/23 ACTIONS 1.The Chief Officer and the Chief Financial Officer continue to raise this concern at a national level. 2. Discussions ongoing with NHSL Director of Finance around unscheduled care spend in 2023/24 and potential carry forward from 22/23 budget HIGH M EDIUM Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 31.05.23 Reviewed and Updated May 2023. IJB05. 21 Financial Strategic 01/04/2021 Hosted Services There is a risk of dispute between the North Lanarkshire IJB and the South Lanarkshire IJB in respect of the financial allocations underpinning the Hosted Services particularly as a result of the budget changes linked to the implementation of devolved locality models. This could impact on the ability of each IJB to achieve its commissioning intentions and may also have an adverse impact on service users across Lanarkshire. VERY HIGH CONTROLS 1. North and South IJBs aim to co‐operate to ensure a pan‐Lanarkshire approach is achieved across all hosted services. 2. Financial and budgetary controls. 3. Performance reports on service delivery. 4. The Hosted Services principles in respect of the management of the overspends and underspends are agreed for each financial year. M EDIUM M EDIUM Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 30.06.23 IJB06. 21 Financial Operational 01/04/2021 Prescribing Activity and Costs The cost of prescribing is growing due to issues in supply chains driving increased wholesaler cost of medicines, advance treatment developments resulting in the need for more expensive medications, aging population and increase in patients requiring regular medication. Medication availability has been impacted following the EU withdrawal the UK 's membership of the common regulatory bodies and EU agencies, such as the European Medicines Agency, (EMA), European Centre for Disease Prevention and Control and the European Atomic Energy Community. The risk is that this could impact on the availability of medicines, healthcare techniques and technology and in respect of the supply of medicines and medical devices, additional checks are now required at ports in the UK and the EEA before goods, including medical products, can cross the border. New customs checks are required when moving medicines between the EEA and the UK. M edium CONTROLS 1.. Prescribing Quality and Efficiency Programme. 2. Prescribing Management Board functions and membership. 3. Deputy Lead Pharmacist supporting HSCP Senior Leadership Team. 4. Locality Pharmacist input. 5. Earmarked reserve established to address prescribing costs. 6. Regular HSCP monitoring. In respect of the regulation of medicines and medical devices, the Medicines and Healthcare products Regulatory Agency (MHRA) became the UK’s sovereign regulator. 7. The new trade deal contains specific clauses that mean both the UK and EEA states formally recognise each other’s good practice in medicine manufacturing. 8. To reduce the risk of divergence from the EU rules, there are three interrelated factors; the technical annexes of the new trade deal, the Northern Ireland protocol and the UK Internal Market Act. 9. The effectiveness of the Border Operating Model to import and export goods to and from the EEA, which was being implemented in stages from 2020 to minimise any risk of disruption, is still being assessed. The risk of border delays is still evident. Other measures were also implemented specifically to mitigate the risk of supplies of medicines and medical devices being disrupted. In August 2020 the UK government instructed medicine suppliers to maintain a stockpile equivalent to six weeks’ supply though the first three months of 2021. In addition, the Department of Transport has secured additional freight capacity to bring medicines into the country via other routes. ACTIONS 1. Review of Locality Prescribing Action Groups. 2. Prescribing part of NHSL Sustainability and Value structures 3. Continuation of Scriptswitch. VERY HIGH LOW Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 31.09.23 Previously IJB11. Reviewed and updated June 2023. IJB07. 21 Financial Strategic 01/04/2021 Third and Voluntary Sector There is a risk that Third Sector organisations in North Lanarkshire are vulnerable because of the lack of certainty in respect of long‐term funding security. This uncertainty has the potential to lead to service instability, recruitment and retention challenges and an increasing reliance on statutory services. HIGH CONTROLS 1. Third Sector Interface represented on key strategic groups. 2. Community capacity building and carer support infrastructure embedded across North Lanarkshire. 3. Community capacity building is regularly reviewed. 4. Maximising funding opportunities for the third and voluntary sector will continue to be progressed. ACTIONS 1.The annual HSCP funding which is directed to the third sector is recurring funding. Funding will be confirmed each year in line with the agreement of the IJB Financial Plan and subject to the Scottish Government financial settlements for future years. 2. Updated SLA with VANL nearing completion LOW LOW Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 31.12.23 Previously IJB16. Report Prepared by Stacey Anderson on behalf of the Chief Officer 9
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Appendix 1 North Lanarkshire Integrated Joint Board Risk Register (Accurate as 22nd March 2023) IJB ID Category Opened Date Description of Risk Risk level (initial) Mitigating Controls Risk level (Current) Risk level (Target) Risk Owner Risk Register Lead Assurance Source Next Review Date Closed Date IJB.10. 21 Financial Strategic 01/04/2021 Ineffective Governance Arrangements Due To the Covid‐19 Pandemic 1. There is a risk that the intensity of the required response to Covid‐19 could result in a failure of governance impacting on the effectiveness of the IJB decision‐making, IJB directions to partners and IJB oversight of operational service delivery. Routine governance processes could be overwhelmed. 2. New or amended Covid‐19 legislation and Scottish and UK Government guidance may not be adopted effectively and timeously. 3. There is no / limited public access to IJB and PFA meetings during the period of the pandemic, in line with Public Health advice. 4. Ineffective information governance controls could lead to data breaches and an impact on the General Data Protection Regulations. 5. Communications with employees, patients and service users may be ineffective. 6. There will require to be changes to the working environment including remote working and working from home. 7. There is a reduced ability to protect the wellbeing of employees, patients and service users. 8. There may be adverse media coverage locally, a loss of public confidence and reputational damage. M EDIUM CONTROLS 1. National Networks are established which are providing the framework to support a national approach where appropriate. 2. Public Health advice and support is in place. 3. Increased numbers of agile workers and increased number of laptops/tablets. 4. Continued working from home arrangements supported by the roll out of MS Teams / Zooms. Regular updates on the guidance for the use of MS Teams / Zoom Meetings is circulated. A blended approach to home/work‐based working is being developed going forward. 5. Risk registers are in place for the IJB and each partner. Each partner has a specific HSCP Covid‐19 Risk Register in place. 6. The IJB and both partners aim to comply with the European Working Time Directive (WTD) and minimise the risk of all staff working beyond 48 hours per week, in particular front‐line service delivery. As a result of the withdrawal from the European Union, the WTD ceased to apply to the United Kingdom at the end of the transition period (31 December 2020). However, the UK's Working Time Regulations which implement the EU Working Time Directive will continue to apply unless and until amended by UK law. 7. Back to Basics exercise has helped to focus on the underpinning governance requirements across the whole HSCP ACTIONS 1. Staff health and well being is a key priority for both partners and all key stakeholders. The commitment to staff health and well being is being actively promoted through all available forums. 2. Work is being carried out to embed governance processes within the H&SCP including risk review, complaints, patient feedback, adverse M EDIUM LOW Ross M cGuffie Amanda Kilburn SLT, IJB PFA, IJB 30.09.23 Reviewed and updated June 2023 IJB.11 21 Performance 30/07/2021 Oversight of Performance Activity There is a risk that the IJB is not provided with adequate or sufficient performance information to enable it to discharge its scrutiny and oversight role; make informed decisions and recommend remedial actions to address any performance concerns. LOW CONTROLS 1. Regular (quarterly) reports on the IJB performance framework, providing updates on areas for improvement, remedial actions (and timescales) and updates on performance issues previously reported. 2. Chief Executive Performance Review arrangements. 3. Hosted Services Performance Review arrangements. 4. Sector/Locality Performance Review arrangements. ACTIONS 1. Request detailed topic based performance reports on specific areas of concern e.g. CAMHS & Psychological Therapies. 2. Face to face Q3 performance reviews taking place throughout May 23 with sectors/units LOW LOW Ross M cGuffie M orag Dendy SLT, IJB PFA, IJB 31.12.23 IJB.12. 21 Performance 30/08/2021 Staff Health & Wellbeing There is a risk to the delivery of the Strategic Commissioning Plan as a result of sustained pressures on staff availability due to additional pressures associated with Covid 19, current sickness abscence levels and potential for further staff redeployment due to winter planning contingency arrangements. medium Controls 1. Strategic Staff Health & Wellbeing Committee established reporting to NLC & NHSL corporate management teams. 2. Range of support services available both nationally and locally e.g Occupational Health, Spiritual care, Psychological Services, national wellbeing hub (www.PRoMIS.scot.uk). 3. Rest & Recuperation areas identified. 4. Peer Support Networks established 5. Well established Occupational Health supports available to support staff sickness. Actions 1. Short Life Working Group for wellbeing with targeted approach for immediate actions including Staff Health & Wellbeing Champions, access to online supports, access to Occupational Health Services, helpline established and dedicated resource identified for wellbeing officers to be recruited. 2. Funding recieved by Scottish Government specificaly targeting staff well being programmes and supports. Local plans for use of funding being developed. 3. Managers supporting & encouraging staff to take planned leave/use full leave allocation 4. Audits of adherence to sickness absence policy being undertaken HIGH low Ross M cGuffie Ross M cGuffie SLT, IJB PFA, IJB, SC&CG, AH&SC 31.08.23 Reviewed and Updated May 2023 IJB.13. 2021 Performance 30.08.21 Care Homes Inability of care homes to sustain service due to staffing or Covid outbreaks resulting in closure to new placements. This may increase delayed discharge numbers putting additional pressure on acute site capacity and impacting on recovery. The financial support for social care providers during the Covid‐19 pandemic is being reviewed. Payments in respect of under‐occupancy in care homes were extended to 31 October 2021. High Controls 1. Establishment of Care Home Assurance Team. 2. Escalation Process in place. 3. National protocol to support discharge of Covid 19 patients in place. Actions 1. Public Health teams providing guidance on infection control. 2. Care Home assurance team undertaking support visits to all care homes & action plans in place for each care home. 3. Staff and visitor testing in place. 4. All care homes advised to use PPE in line with national addendum. 5. Development day on 12th May 23 to agree structures and approach for year ahead medium medium Ross M cGuffie Trudi M arshall IJB, PF&A, SLT, SC&SC, A H &SC 31.09.23 Report Prepared by Stacey Anderson on behalf of the Chief Officer 10
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Appendix 1 North Lanarkshire Integrated Joint Board Risk Register (Accurate as 22nd March 2023) IJB ID Category Opened Date Description of Risk Risk level (initial) Mitigating Controls Risk level (Current) Risk level (Target) Risk Owner Risk Register Lead Assurance Source Next Review Date Closed Date IJB.14. 2022 Strategic & Performance 30.04.22 CAMHS ‐ There is a risk that the CAMHS service cannot meet the increasing clinical demands due to a significantly high number of cumulative staff vacancies for both clinical and non‐clinical posts and challenges recruiting to new posts identified through the national recovery and renewal fund. This is impacting on community, in‐ patient and out‐ patient care with the potential to adversely affect response time to referrals; longer waiting times; poorer outcomes; delays in redesign and reputation of the IJB. Very High Controls ‐ 1. Prioritisation of referrals; all referrals 1vetted daily with urgent referrals prioritised 2. Commenced programme of work and implementation of a more structured partnership approach through Choices & Partnership Approach (CAPA) service model, with tier 1 & 2 referred through 3rd sector and interfacing with North & South Education Departments 3. Secured significant national investment to fully implement new service model 4. Active review of skill mix to utilise medical staff only when required for highly complex patients 5. Vacancy gap analysis with active recruitment commenced. Expected to have recruited 75% of gap by end of May 2023 6. Continuous review and validation of the waiting list Action 1. Incremental implementation of the new service model 2. CAPA appointments begin on 1st May 2023 ‐ first cycle (16wks) nearing completion 3. Refurbishment of North Lanarkshire facilities commences early summer 2023 High medium Ross M cGuffie M orag Dendy IJB,PF&A, SLT 31.08.23 Reviewed and Updated May 2023. IJB.15. 2022 Strategic & Performance 05.09.22 Cost of Living There is a risk that the IJB's Strategic Commissioning Plan will be unable to be delivered or not have the desired impact due to the cost of living rises being faced by residents across North Lanarkshire, leading to a further widening of the inequality gap, reduced quality of life and increased health and social care demand due to individuals and families having insufficient funds to support basic requirements such as food and heating. High CONTROLS 1. NLC Silver command group stood up focused on cost of living 2. NHSL commenced review through CMT 3. Population Health Committee to review activity around cost of living 4. NLC approved cost of living contract increases in May 2023 ACTIONS 1. Survey of NLC hybrid workers to see if home working remains financially viable 2. Business case being developed to expand 'support for people' arrangements used in pandemic to support resident access to welfare rights and other supports 3. 3% increase in individual budgets to support service users to maintain current levels of supports at higher cost 4. Recommendation from adult social work, care and wellbeing committee to review all charges to service users and wider cost of living supports that could be offered High M edium Ross M cGuffie Ross M cGuffie SLT, IJB 31.08.23 Reviewed and Updated May 2023. IJB.16. 2022 Strategic 05.09.22 National Care Service There is a risk that the ongoing work around a National Care Service could destabilise current service delivery due to significant change activity, time demands around the co‐design process, staff uncertainty and partner organisations having to focus inwardly due to the impact of change leading to an impact on the ability to deliver the significant ongoing change programmes already approved by the IJB and the Strategic Commissioning Plan for 2023‐26. High CONTROLS 1. NLC establishing NCS working groups 2. Key HSCP leads involved in national developments 3. Ongoing progress updates to IJB and IJB PFA ACTIONS 1. IJB response submitted on proposed Bill 2. Strong partnership links into working groups at Chief Officers, Chief Finance Officers and Social Work Scotland groups 3. SG/COSLA working groups being established ‐ local reps nominated for each High Low Diane Fraser Ross M cGuffie SLT, IJB PFA, IJB, ASW C&W B 31.08.23 Reviewed and Updated May 2023. IJB.17. 2022 Strategic & Performance 05.09.22 Unscheduled Care There is a risk that we cannot sustain whole system patient flow through peak winter pressures due to increased front door demand; hospital workforce capacity; delays in onward movement of patients due to care home capacity/outbreaks and care at home capacity; and community health and social care workforce capacity leading to reduced ability to meet 'routine' and increasing bed demand for more unwell patients, deteriorating delayed discharge performance and an inability to recover services. Very High CONTROLS 1. Care Home Assurance Group and associated supports for care homes through liaison service, IPC advice and support, risk assessment for onward movement of patients etc 2. Care at Home Assurance group and associated activity to try to support and sustain independent sector provision 3. NHS CMT and Covid response group oversight of performance 4. Daily PDD meetings to review every planned supported discharge and delayed discharge 5. Operation Flow now underway to ensure whole system approach to unscheduled care/delayed discharge challenges ACTIONS 1. Expansion of Home Support service 2. Roll out of Home Assessment Teams across all 6 Localities by Feb 3. New CSW roles in District Nursing teams to proactively support Care Managed patients 4. Additional Nursing capacity in District Nursing Teams 5. Expansion of Equpiment and Adaptation Service to support rapid access in community 6. Expansion of H@H service (hours of provision as well as moving to support discharges as well as admission prevention) 7. Expansion of Integrated Rehabilitation Teams in all six Localities to support rehab in the community and reduce long‐term service demand 8. 5 Task and Finish groups now established to roll out the key actions agreed through the Operation Flow programme (Phase 2 to be completed by Sept 23) 9 2023 Winter resource plans submitted to the health board via Task and Finish Groups Very High M edium Ross M cGuffie Ross M cGuffie SLT, IJB PFA, IJB 28.09.23 Reviewed and Updated in June 2023. Report Prepared by Stacey Anderson on behalf of the Chief Officer 11
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Appendix 1 North Lanarkshire Integrated Joint Board Risk Register (Accurate as 22nd March 2023) IJB ID Category Opened Date Description of Risk Risk level (initial) Mitigating Controls Risk level (Current) Risk level (Target) Risk Owner Risk Register Lead Assurance Source Next Review Date Closed Date IJB.18. 2022 Strategic and Performance 05.09.22 Community Alarms There is a risk that the community alarm system will be destabilised due to the national change from analogue to digital telephony by 2025, leading to community alarm users not getting a response when required. High CONTROLS 1. Working group established to coordinate all activity 2. Oversight through Home Support Programme Board 3. Reporting to Adult Social Work, Care and Wellbeing Committee 4. Reporting to IJB ACTIONS 1. NLC Committee approval to purchase 1000 digital alarms so the service can support any imminent changes over to digital in individual areas 2. NLC part of SG once for Scotland procurement process for a new digital alarm receiving centre 3. Communication out to all community alarm service users 4. Instructions issued to all community alarm service users on how to do test calls to ensure alarms are operational 5. Engagement with telecommunication suppliers to ensure sight of roll out plans across NL M edium Low Diane Fraser Ross M cGuffie SLT, IJB PFA, IJB, ASW C&W B 30.09.23 Reviewed and updated June 2023. IJB.19. 2023 Performance 27/02/2023 Service Sustanability Due to competing service priorties and workforce/ operational and finacial challenges there is a risk that the IJB will be unable to implement the strategic plan/commision plan . Failure to achieve the desired strategic aims of the IJB poses a risk on operational service delivery and the achievement of financial balance and patient safety High Controls 1. IJB PFA Committee. 2. IJB Chief Officer is a member of each partner's key decision‐making forums. 3. Effective joint working between Chief Financial Officer and both Council and NHS Finance Departments. 4. Regular budget meetings with Chief Executives and Directors of Finance. 5. Regular HSCP budget monitoring meetings across Senior Leadership Team. 6. The IJB Financial Plan is regulary reviewed and agreed. 7. Capacity plans in place to maximise efficiency. 8. Consultation and involvement with key stakeholders including service users and carers. 9. Joint Strategic Needs Assessment and ongoing move towards preventative and anticipatory approaches. 10. Strategic Planning Group, Locality engagement sessions and Partnership Boards. 11. Effective and ongoing service user engagement, staff consultation and Trade Union liaison at strategic and local levels. Actions 1. Sustainability plans to be reviewed regulalry 2. Re‐introduction of scruity panels 3. Improve linkage across all risk registers (tiers 1 to 3, council and NHS) to help ensure areas of concern are identified and reviewed regularly. 4. Review of reporting process into IJB to ensure contionus review of services/ service developments. 5. Development of the programme of work to ensure regular reporting structure in place for service review. 6 Development of Task and Finish Group to review services consider service sustanability and implement development work High Low Ross McGuffie Ross McGuffie SLT, IJB PFA, IJB 31.08.23 Reviewed and Updated May 2023 IJB.20. 2023 Workforce Sustanability It is becoming increasingly difficult to recruit to particular roles across Health and Social Care. Gaps in the workforce can result in reduction of service provsion, increase in staff workload and inability to deliver the strategic plan. Following EU withdrawl there is no longer the free movement of labour between the UK and EEA countries. All workers arriving from the EEA and non‐EEA countries are subject to the same immigration rules. The new points‐based immigration system makes exceptions for the majority of health care professionals with an NHS job offer and for qualified social workers via a new fast‐track visa route, known as the Health and Care Worker Visa. There are however no exceptions made for other social care roles, such as care workers. The Mutual Recognition of Professional Qualifications Directive is an EU‐wide directive that allows professional regulators in all member states to automatically recognise professional qualifications. The UK government has decided to continue recognising qualifications gained in the EEA for at least two years after the transition period ends. This however is not a reciprocal and there is no guarantee that qualifications gained in the UK will be accepted by professional regulators in EEA nations. High CONTROLS 1. All successful Health and Care Worker Visa applicants are exempt from the Immigration Health Surcharge, a one‐off charge levied against arriving migrant workers as part of the visa application process. The system has been designed to make international recruitment into health and social care roles more straightforward for employers and employees alike. These changes to immigration rules are in law as part of the Immigration and Social Security Co‐ordination (EU Withdrawal) Act 2020. As such, from 1 January 2021, they apply to all workers arriving to work in the NHS or adult social care. All workers from EEA nations who are already resident in the UK had until 30 June 2021 to apply for the EU Settlement Scheme which will guarantee their right to work in the UK indefinitely. 2. In respect of the mutual recognition of professional qualifications, professional regulatory bodies are working with the UK government to review future registration requirements for those with qualifications gained in the EEA and decide what they will be from January 2023. 3. Development of the Care Academy 4. Dedicated HR support identified in NHSL and NLC to support key priority areas of recruitment such as Mental Health and Home Support ACTIONS 1. Annual workforce plan being prepared 2. NHSL programme underway to support international recruitment 3. On the day recruitment events being trialled in Home Support 4. Use of university status being explored following positive gains in Podiatry and Psychological Therapies recruitment 5. Recruitment of 15 Modern Apprenticeships within the H&SCP working within Business Admin, Comms and Health Care Support. High Medium Ross McGuffie Ross McGuffie SLT, IJB PFA, IJB 31.08.23 Reviewed and Updated May 2023 Report Prepared by Stacey Anderson on behalf of the Chief Officer 12
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NORTH LANARKSHIRE IJB RISK REGISTER OVERVIEW Sept 2023 13
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North Lanarkshire IJB Risks – Dashboard Executive Summary • Following an agreement of the IJB Risk Strategy at the IJB held in May 2023, a full review of the IJB risk register was undertaken • Any emerging or new risks are discussed at the IJB PFA and presented for information at IJB • All risks on the IJB Risk Register are consistently reported to relevant assurance committees to provide oversight and assurance Highest Scoring Risks IJB Risk Score Trend IJB 06/21 – Prescribing Activity and Costs Very High Started as Medium Risk (April 2021) IJB 17/22 – Unscheduled Care Very High IJB 01/21 ‐ Financial Challenges High IJB 04/21 ‐ Notional Set Aside Budget High Started as Very High Risk (April 2021) IJB 12/21 ‐ Staff Health & wellbeing High Started as Medium Risk (Aug 2021) IJB Risk movement since last report No Change Risk Level Increase Risk Level Decrease New Risks Closed Risks Risks with Action Updates 10 0 0 0 0 7 Risk Registers Number of Risks IJB 17 NL Council 3 NHS Lanarkshire 21 14
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IJB 14/22 – CAMHS High Started as Very High Risk (April 2022) IJB 15/22 – Cost of Living High IJB 20/23 – Workforce sustainability High IJB 19/23‐ Service Sustainability High IJB 16/22‐ National Care Service High NL Council Risk Score Trend RIS0000569 -Data Migration and Information Governance Service delivery or business operations are interrupted. Very High RIS0000584-Potential Enforcement Action to Home Support Services High RIS0000704-Proposals to Create a National Care Service Very High NHS Lanarkshire Risk Score Trend 1882‐ Acute Sector Bed Capacity ‐ availability of acute beds due to delays experienced for onwards movement of patients 'fit for transfer' to care homes, those Very High 15
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requiring care at home, exacerbated by rising cases of Covid and high demand 2085 ‐ Capacity within NHSL to respond to ongoing challenges due to Covid 19 and associated variants Very High 1379‐ Delayed Discharge Performance and Impact High 1984‐ Impact From Stepping Down Non‐Urgent Services High 1710 ‐ Public Protection: There is a risk that NHSL could fail to identify harm to any vulnerable person, child or adult, or prevent harm to others resulting from the complexities of opportunity lost due to the current reprioritising of services in response to COVID‐19. High 659‐ Failure to deal effectively with major emergency Very High 2039 ‐ Staff Fatigue, Resilience, Wellbeing & Safety – Effects of prolonged Covid response is adversely impacting on staff, increasing staff absence and consequently reducing workforce capacity. Very High 1992 ‐ Continuous Covid Response & impact on routine PH Screening & surveillance programmes High 1587 ‐ Sustainability of the two‐site model for the Out‐of‐Hours Service Very High 16
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2004 ‐ Potential Impact on patients resulting from disruption of day to day clinical care in response to Covid pandemic Very High 1989 ‐ Ability to maintain a workforce commensurate with the need to suppress Covid, deliver Vaccination Programme, Recover & Remobilise Very High 2014 ‐ Recovery of Performance 2021/22 Very High 2086‐ Sustaining GP Services Very High 17
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Details of IJB Risk Movement/ Update of Actions Risk (Reference and Title) Date Risk Added to Register Review Date Current Score Trend Target Score Commentary Actions for the risk IJB.01/21 Financial Strategic Financial Challenges 01/04/2021 31/05/23 High Medium 'CONTROLS 1. IJB PFA Committee. 2. IJB Chief Officer is a member of each partner's key decision‐making forums. 3. Effective joint working between Chief Financial Officer and both Council and NHS Finance Departments. 4. Regular budget meetings with Chief Executives and Directors of Finance. 5. Regular HSCP budget monitoring meetings across Senior Leadership Team. 6. The IJB Financial Plan 2023/2024 has been agreed and is being reviewed regularly. 7. IJB medium term financial plan 2023‐25 and reserves strategy 2023‐24 approved at March 23 IJB 8. Capacity plans in place to maximise efficiency. 9. IJB Integration Scheme setting out the budget recovery processes. 10. IJB Financial Regulations and financial procedures. 11. Consultation and involvement with key stakeholders including service users and carers. ACTIONS 1. Annual budget setting processes within each of the partners takes place before the start of each financial year. 2. HSCP participating in NHSL Sustainability and Value process 3. Partnership will also be connected to new national whole system groups around budget 18
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12. Prescribing Quality and Efficiency Programme, SWEG, ARG and Home Support monitoring groups are in place. 13. Joint Strategic Needs Assessment and ongoing move towards preventative and anticipatory approaches. 13. Strategic Planning Group, Locality engagement sessions and Partnership Boards. 14. Effective and ongoing service user engagement, staff consultation and Trade Union liaison at strategic and local levels. 15. Financial sustainability payment arrangements in place to 31 March 2023 to support external social care providers. 16. The Scottish Government announced on 5 October 2021 an additional £300m for winter health and social care pressures. 18. Work is ongoing with both partner organisations to confirm the final 2023/24 budget. Once complete, a new risk will be created to reflect the final 2023/24 financial plan. IJB04.21Financial Strategic Notional Set‐ Aside Budget 01/04/2021 31.05.23 High Medium CONTROLS 1.There is complete transparency and ongoing dialogue between the IJB and the Health Board on the challenges associated with the implementation of the notional set‐ aside concept. ACTIONS 1.The Chief Officer and the Chief Financial Officer continue to raise this concern at a national level. 19
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2. Bed modelling and capacity planning arrangements are in place. 3. Effective working relationships between both partners and the IJB have been established. 4. Since the inception of the IJB, an agreement is in place whereby the NHSL Health Board will manage the overspend or underspend across the notional set‐aside budget. This arrangement continues to be in place for 2022/23 2. Discussions ongoing with NHSL Director of Finance around unscheduled care spend in 2023/24 and potential carry forward from 22/23 budget IJB05.21 Financial Strategic Prescribing Activity and Costs 01/04/2021 31/06/23 Very High Low CONTROLS 1.. Prescribing Quality and Efficiency Programme. 2. Prescribing Management Board functions and membership. 3. Deputy Lead Pharmacist supporting HSCP Senior Leadership Team. 4. Locality Pharmacist input. 5. Earmarked reserve established to address prescribing costs. 6. Regular HSCP monitoring. In respect of the regulation of medicines and medical devices, the Medicines and Healthcare products Regulatory Agency (MHRA) became the UK’s sovereign regulator. 7. The new trade deal contains specific clauses that mean both the UK and EEA states formally recognise each other’s good practice in medicine manufacturing. 8. To reduce the risk of divergence from the EU rules, there are three interrelated ACTIONS 1. Review of Locality Prescribing Action Groups. 2. Prescribing part of NHSL Sustainability and Value structures 3.Continuation of Scriptswitch. 20
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factors; the technical annexes of the new trade deal, the Northern Ireland protocol and the UK Internal Market Act. 9. The effectiveness of the Border Operating Model to import and export goods to and from the EEA, which was being implemented in stages from 2020 to minimise any risk of disruption, is still being assessed. The risk of border delays is still evident. Other measures were also implemented specifically to mitigate the risk of supplies of medicines and medical devices being disrupted. In August 2020 the UK government instructed medicine suppliers to maintain a stockpile equivalent to six weeks’ supply though the first three months of 2021. In addition, the Department of Transport has secured additional freight capacity to bring medicines into the country via other routes. IJB.1121 Performance Staff Health & Wellbeing 30/08/2021 31.05.23 High Low Controls 1. Strategic Staff Health & Wellbeing Committee established reporting to NLC & NHSL corporate management teams. 2. Range of support services available both nationally and locally e.g. Occupational Health, Spiritual care, Psychological Services, national wellbeing hub (www.PRoMIS.scot.uk). 3. Rest & Recuperation areas identified. 4. Peer Support Networks established Actions 1. Short Life Working Group for wellbeing with targeted approach for immediate actions including Staff Health & Wellbeing Champions, access to online supports, 21
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5. Well established Occupational Health supports available to support staff sickness. access to Occupational Health Services, helpline established and dedicated resource identified for wellbeing officers to be recruited. 2. Funding received by Scottish Government specifically targeting staff wellbeing programmes and supports. Local plans for use of funding being developed. 3. Managers supporting & encouraging staff to take planned leave/use full leave allocation 4. Audits of adherence to sickness absence policy being undertaken 22
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5. Findings of the audit to be shared with IJB. IJB.13.2021 Performance Care Homes 30.08.21 31.12.23 Medium Medium Controls 1. Establishment of Care Home Assurance Team. 2. Escalation Process in place. 3. National protocol to support discharge of Covid 19 patients in place. Actions 1. Public Health teams providing guidance on infection control. 2. Care Home assurance team undertaking support visits to all care homes & action plans in place for each care home. 3. Staff and visitor testing in place. 4. All care homes advised to use PPE in line with national addendum. 5. Development day on 12th May 23 to agree structures and approach for year ahead 23
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IJB.14.2022 Strategic & Performance CAMHS 30.04.22 31.05.23 High Medium Controls ‐ 1. Prioritisation of referrals; all referrals 1vetted daily with urgent referrals prioritised 2. Commenced programme of work and implementation of a more structured partnership approach through Choices & Partnership Approach (CAPA) service model, with tier 1 & 2 referred through 3rd sector and interfacing with North & South Education Departments 3. Secured significant national investment to fully implement new service model 4. Active review of skill mix to utilise medical staff only when required for highly complex patients 5. Vacancy gap analysis with active recruitment commenced. Expected to have recruited 75% of gap by end of May 2023 6. Continuous review and validation of the waiting list Action 1. Incremental implementation of the new service model 2. CAPA appointments begin on 1st May 2023 3. Refurbishment of North Lanarkshire facilities commences early summer 2023 4. Progress report will be submitted to IJB approx. Nov 23. IJB.17.2022 Strategic & Performance Unscheduled Care 05/09/22 28/06/23 Very High Medium CONTROLS 1. Care Home Assurance Group and associated supports for care homes through liaison service, IPC advice and support, risk assessment for onward movement of patients etc. 2. Care at Home Assurance group and associated activity to try to support and sustain independent sector provision 3. NHS CMT and Covid response group oversight of performance ACTIONS 1. Expansion of Home Support service 2. Roll out of Home Assessment Teams across all 6 Localities by Feb 3. New CSW roles in District Nursing teams to proactively 24
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4. Daily PDD meetings to review every planned supported discharge and delayed discharge 5. Operation Flow now underway to ensure whole system approach to unscheduled care/delayed discharge challenges support Care Managed patients 4. Additional Nursing capacity in District Nursing Teams 5. Expansion of Equipment and Adaptation Service to support rapid access in community 6. Expansion of H@H service (hours of provision as well as moving to support discharges as well as admission prevention) 7. Expansion of Integrated Rehabilitation Teams in all six Localities to support rehab in the community and reduce long‐ term service demand 8. 5 Task and Finish groups now established to roll 25
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out the key actions agreed through the Operation Flow programme (Phase 2 to be completed by Sept 23) 26
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1 REPORT Item No: 10 SUBJECT: Quality Assurance Annual Report TO: Integration Joint Board Lead Officer for Report: Maria Williamson, (Acting) Head of Performance, Planning & Quality Assurance Author(s) of Report Elaine McIntyre, Service Manager, Quality Assurance DATE: 27 September 2023 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: Elaine McIntyre, Service Manager, Quality Assurance ☒ Reviewed By: Maria Williamson, (Acting) Head of Performance, Planning & Quality Assurance ☒ Endorsed By: Adult Care and Social Work Committee ☒
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2 3. RECOMMENDATIONS The Integration Joint Board is asked to endorse the contents of the report. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Quality Assurance have a wide and varied function including monitoring and evaluating key aspects of social work practice and performance. A central activity is the on-going contract monitoring of external social care providers. The environment in which we operate currently is complex and sharing of best practice and solution focused ideas are integral to ensure the people of North Lanarkshire receive good quality support to help meet their outcomes. 5.2 Our commitment is to provide an annual report on activity carried out in the preceding year. 5.3 This report highlights Quality Assurance activity over the period 1 April 22 to 31 March 23 and covers Contracts & Contract Management, Regulatory Activity, Procurement, Complaints, Duty of Candour, Information Governance, Communications, Adult Support & Protection, In House Monitoring, Participation & Engagement, Carer Developments and Risk Management. 5.4 Full detail of these activities is included in Appendix A. Contracts 5.5 The Quality Assurance Team work cohesively with Corporate Procurement colleagues to implement robust contract arrangements, which balance quality against cost, to achieve overall Best Value for services provided to vulnerable people living in North Lanarkshire. A range of organisations are commissioned through a variety of arrangements and a methodical and systematic approach has been developed, resulting in 95% of services purchased by social work now having contractual agreements in place with clearly defined terms and conditions. These agreements range from national framework arrangements to individual service agreements. Contract Management Framework 5.6 All organisations from whom North Lanarkshire Council social work purchase services are required to adhere to contract monitoring arrangements. Quality Assurance have Yes ☐ No ☒ N/A ☐
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3 a key role in the application of these arrangements to ensure that the terms and conditions of the contract are met. Information gathered from contract monitoring also informs continuous strategic planning and commissioning, improvement identification and enables early intervention and support should difficulties in providing and sustaining services become apparent. 5.7 During this reporting period the Contract Management Framework has been refined following evaluation. As a result, some of the processes and procedures have been amended to enhance performance reporting, data collection and the overall experience. The agreed changes are effective from 1 April 2023. Regulatory Activity 5.8 Care Inspection activity during the reporting period of 2022/23 was spread across all key questions within North Lanarkshire older people’s care homes. North Lanarkshire care homes performance measures slightly lower than Scotland wide care homes in that 55.6% of grades of 4 and above were awarded. Scotland wide care homes achieved 63.9% of grades of 4 and above. 5.9 During the reporting period 52 SDS contractors were inspected. 45 contractors were awarded grades of good (4) and above. This is a percentage of 86.5%, which reflects delivery of high-quality care and support across SDS contractors supporting people in North Lanarkshire. In House Monitoring 5.10 The Quality Assurance team have been working on the development of an In-House Monitoring Framework during 2022/23. The suite of documents included within this Framework are awaiting approval from the Senior Leadership Team. Market Facilitation 5.11 Our approach to market facilitation means we are responsive to the changing needs and aspirations of people living in North Lanarkshire, whilst also reflecting the changing social care landscape. 5.12 One of the biggest challenges currently, is the lack of capacity available to choose from when a care and support package is required. There are many factors contributing to these challenges, including workforce retention and recruitment, cost of living increases, increased demand, complexity of support required and quality of care falling below expected standards. Quality Assurance continue to liaise with internal and external partners to identify solutions to the challenges. Procurement 5.13 In collaboration with Corporate Procurement colleagues and Locality Social Work Teams, Quality Assurance assist in the planning, coordination, and implementation of processes to ensure that when contracting new or existing work, the requirements of the Procurement Reform Scotland Act 2014 and the Procurement (Scotland) Regulations 2016 are adhered to. By doing so there can be confidence that the care & support services commissioned are legal, safe and outcomes focused whilst demonstrating Best Value.
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4 Fair Work 5.14 In 2021/22, we reported that most contractors had indicated they were either already accredited as or were willing to become Scottish Living Wage employers. This year 100% of providers on our Self-Directed Support including Care at Home framework, reported paying the Scottish living Wage. Complaints 5.15 Quality Assurance retains an overview role in terms of complaints made about Social Work service provision. Regular quarterly reports on complaints activity are reported through our governance structures. The annual summary and analysis of complaints received over the period 2022/23 is available at appendix 1. Duty of Candour 5.16 Duty of Candour is a statutory duty on Scottish organisations providing health and social care. The responsibility is to remain open and honest when something goes wrong, that is not related to the course of the condition for which the person is receiving care. An annual report capturing Duty of Candour activity is available is attached as appendix 2. 6. CONCLUSIONS n/a 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 ☒
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5 7.2 ASSOCIATED MEASURE(S) None. 7.3 FINANCIAL This paper has been reviewed by Finance: There are no direct financial impacts in relation to this report. 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. Risks are identified and reported on via the relevant risk register. 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 Yes ☐ No ☐ N/A ☒
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6 ☐ 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 Residents across North Lanarkshire who access services, their families/carers and the community, third and independent providers operating in North Lanarkshire and wider stakeholders with a link to North Lanarkshire. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: Fairer Scotland – As part of the council’s commitment to Fair Work and social works drive to adopt an ethical commissioning approach, Fair Work practices have been embedded in procurement processes to ensure contractors are paying the Scottish Living Wage and are committed to providing community benefits. Equality Impacts are considered as part of procurement and contract monitoring. 8. BACKGROUND PAPERS N/A Yes ☒ No ☐ N/A ☐ Yes / Date added ☐ No ☐ N/A ☒
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7 9. APPENDICES 9.1 Appendix A: Quality Assurance Annual Report 2022/23. 9.2 Quality Assurance Annual Report 2022/23 - Appendix 1Complaints 9.3 Quality Assurance Annual Report 2022/23 - Appendix 2Duty of Candour CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Maria Williamson: (Acting) Head of Performance, Planning and Quality Assurance) WilliamsonM@northlan.gov.uk
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8 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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9 Appendix A Quality Assurance Annual Report 2022/23
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10 1. Introduction Quality Assurance have a wide and varied function including monitoring and evaluating key aspects of social work practice and performance. A central activity is the on-going contract monitoring of external social care providers. The environment in which we operate currently is complex and sharing of best practice and solution focused ideas are integral to ensure the people of North Lanarkshire receive good quality support to help meet their outcomes. The Quality Assurance Team work collaboratively with our internal Health and Social Care Partnership colleagues and with external stakeholders to ensure the delivery of services that are underpinned by human rights, inclusion, achieving potential, choice and control. The activities reported in this 2022/23 annual report reflects the commitment to a creative and dynamic approach that helps reduce resource barriers and promotes good outcomes for people. Our priorities are directed towards the Scottish Government’s nine national health and wellbeing outcomes, the ambitions of the Plan for North Lanarkshire and the Strategic Commissioning Plan. This report outlines activity over the period 1 April 22 to 31 March 23 and includes updates on our work in the areas of Contracts & Contract Management, Regulatory Activity, Procurement, Complaints, Duty of Candour, Information Governance, Communications, Adult Support & Protection, In House Monitoring, Participation & Engagement, Carer Developments and Risk Management. 2. Contracts The Quality Assurance Team work cohesively with the Corporate Procurement colleagues to implement robust contract arrangements, which balance quality against cost, to achieve overall Best Value for services provided to vulnerable people living in North Lanarkshire. A range of organisations are commissioned through a variety of arrangements and a methodical and systematic approach has been developed, resulting in 95% of services purchased by social work now having contractual agreements in place with clearly defined terms and conditions. These agreements range from national framework arrangements to individual service agreements. Tables 2a and 2b below illustrate graphically the extent of the work that has been carried out in engaging with providers from the community & voluntary sector, the independent sector and private contractors in a proportionate and balanced way to ensure service provision is provided safely and is of a high quality throughout the team of the contract. As of 31 March 23, 95% of all social work spend had the provision of a formal contracting arrangement. This is an increase from 93%, reported in year 2021/22. Work is in progress for the remaining 5%, which are awaiting formalisation of Individual Service Agreements. Quality Assurance continue to progress with the necessary arrangements to ensure all spend has robust contractual and legal agreements in place; however, it should be noted that due to the fluidity of contracting and commissioning, achievement of 100% compliance may not always be possible.
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11 Table 2a Table 2b We currently purchase services from 305 different provider organisations, which is a slight increase of 2 from 2021/22 when we reported purchasing services from 303 provider organisations. The biggest shift to note is in the number of providers operating as part of our Self-Directed Support, including Care at Home Framework, which has increased to 61 providers from 52 reported 2021/22. It is anticipated that this increase on the SDS Framework will create greater capacity with more choice available to people who access services. 3. Contract Management Framework (CMF) All organisations from whom North Lanarkshire Council social work purchase services are required to adhere to contract monitoring arrangements. Quality Assurance have a key role in the application of these arrangements to ensure that the terms and conditions of the contract are met. Information gathered from contract monitoring also informs continuous strategic planning and commissioning, improvement identification and enables early intervention and support should difficulties in providing and sustaining services become apparent. 160 14 0 12 0 10 Spread of Contractors 2022/2023 148 61 28 7 4 9 3 11 2 3 5 1 6 13 4
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12 North Lanarkshire Council value the services delivered by contractors and Quality Assurance Senior Officers link closely with contractors to establish transparent and honest relationships, through the application of regular monitoring activity as agreed within the Contract Management Framework. During this reporting period the Contract Management Framework has been refined following evaluation. Following consultation through workshops and provider forums, feedback from Quality Assurance Senior Officers and commissioned social care contractors was collated on the various tools within the Framework. As a result, some of the processes and procedures have been amended to enhance performance reporting, data collection and the overall experience. Consideration was also given to the resource implications for social care contractors; therefore, the revised approach has been streamlined to avoid duplicate reporting where possible. The agreed changes effective from 1st April 2023 are listed below: - The development of a Participation and Engagement Toolkit to support the inclusion of direct stakeholder feedback and engagement by Senior Officers, as part of Contract Monitoring arrangements. Contractors are central to the method of engagement implemented by Senior Officers to ensure feedback is collated in a person centred, responsive and flexible way. A 5% sample of people using the service being monitored has been defined. Creation of Key Performance Indicators to inform sampling areas during monitoring visits by Senior Officers. A monitoring report will ensue with a copy being provided to the contractor. Enhanced financial monitoring of block funded services. Modifications to qualitative and quantitative data being requested from contractors on a quarterly basis including reporting on notifiable and non-notifiable accidents and incidents and the achievement of supported people meeting outcomes. Addition of a ‘purple’ tier rating for if there is an on-going Large-Scale Investigation or there is significant risk of closure in the immediate 6-month period (See Table 3a) Risk rating criteria changed on Monitoring Prioritisation Assessment to better reflect level of monitoring activity required in turn effectively targeting resources. The Monitoring Prioritisation Assessment (MPA) is the key component of the Contract Management Framework. The MPA is the up-to-date position statement on the performance of commissioned contractors. The processes of monitoring and the accompanying report build evidence of real time accessible information regarding the quality-of-service provision, performance and outcomes over the life of a contract/framework. Table 3a – MPA Tier Levels & Monitoring Frequency STATUS INDICATED MONITORING LEVEL Purple Large Scale Investigation (LSI) or Service Closure Processes that are imminent within 6 months Red Significant concerns in relation to service performance, contract compliance. TIER 4 Contract monitoring visit frequency – 1 to 4 weekly. Amber (high) Moderate concerns in relation to service performance, contract compliance TIER 3 Contract monitoring visit frequency – variable, at least quarterly but no more than monthly. Amber (low) Minor concerns identified in relation to service performance and contract compliance TIER 2 Contract monitoring visit frequency – variable, at least bi-annually but no more than quarterly.
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13 Green Service performance, contract compliance and engagement are satisfactory. TIER 1 Contract monitoring visit frequency – annually in most cases. Each Tier suggests a minimum monitoring frequency (Table 3a). The basis of monitoring considers the commitments made by the contractor as part of their agreement with the Council including, but not limited to, Standard Terms and Conditions, Data Protection Terms and Conditions, Special Terms and Conditions, commitments made in relation to Fair Work Practices and Community Benefits and relevant national standards. Table 3b below highlights Tier Levels for the reporting period 2021/22 and for the reporting period 2022/23. It is positive to see that Tier 1 services had increased from 72% to 85%. Due to the increase all other tiers show a reduction. Despite this, contractors continue to face increasing demands due to workforce recruitment and retention issues, higher level of Care Inspectorate scrutiny and challenges with financial sustainability. Contractor’s have reported the benefit from the monitoring role of Senior Officers and the early interventions and solutions offered. Table 3b 4. Regulatory Activity Care Inspection activity during the reporting period of 2022/23 was spread across all key questions within adult and older people’s care homes. Key Question “How good is our care and support during the COVID 19 pandemic” was embedded into the Key Question “How well do we support people’s wellbeing” by the Care Inspectorate. However, care homes for children and young people and school care accommodation continued with the COVID specific key question included within their specific Care Inspectorate quality framework. This is reflected in Table 4a whereby 5 care homes were inspected in this area. 4 care homes were awarded grades of 4 (Good) and 1 care home was awarded a grade of 3 (Adequate). Table 4b shows 83 Care Inspections assessing Key Question “How good is our care and support during the COVID 19 pandemic” haven taken place across Scotland and from this most care homes were awarded grades of adequate (3) and good (4) highlighting an equivalent position to North Lanarkshire.
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14 Care Inspection Grades - North Lanarkshire Based Care Homes As At 31/03/2023 16 14 12 10 How good is Table 4a below details an analysis of the key question “How well do we support people’s wellbeing”. The data has been extracted from Tables 4b and 4c below. North Lanarkshire Care Homes performance measures slightly lower than Scotland wide care homes in that 55.6% of grades of 4 and above were awarded. Scotland wider care homes achieved 63.9% of grades of 4 and above. Table 4a How well do we support people’s wellbeing Number of Care Homes Assessed Grades Awarded Percentage North Lanarkshire Care Homes (Table 4b) 27 0 x Excellent 4 x Very Good 11 x Good 10 x Adequate 2 x Weak 0 x Unsatisfactory 0% 14.8% 40.8% 37% 7.4% 0% Scotland Wide Care Homes (Table 4c) 97 3 - Excellent 23 x Very Good 36 x Good 33 x Adequate 2 x Weak 0 x Unsatisfactory 3.1% 23.7% 37.1% 34% 2.1% 0% Care Homes in North Lanarkshire: 2 care homes were the subject of Large-Scale Investigations, under Adult Support and Protection legislation, with significant support provided by the Care Inspectorate and Senior Council Officers to address and improve quality improvement measures. Although there have been short term improvements there is little evidence of these improvements being sustained over a longer timeframe. Continuous monitoring and intensive engagement with each of these care homes continues. Table 4b How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? our care and support during the COVID-19 pandemic? Adequate 2022/2023 10 5 5 3 4 1 Good 2022/2023 11 15 10 6 8 4 Very Good 2022/2023 4 1 1 3 0 0 Weak 2022/2023 2 1 0 0 2 0
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15 During the reporting period 2021/22, 14 out of 22 care homes were assessed as adequate for the key question “How well do we support people’s wellbeing”. This was 66.6% in comparison to the reporting period 2022/23 when adequate grades achieved under the same key question were 37%. This change highlights a significantly improved overview of the quality of care being provided with 55.5% of grades being higher than adequate. Care Homes in Scotland (excluding North Lanarkshire): North Lanarkshire Council currently has people placed within 148 care homes that are located elsewhere in Scotland. North Lanarkshire Council retains care management responsibilities for the people living in out of authority care homes. The host authority where the care home is geographically located is responsible for care home contract monitoring, however, not all local authorities operate in the same way. The Quality Assurance Team receives regular updates from host authority contacts in relation to out of authority care homes. Table 4c Self-Directed Support (SDS) including Care at Home: Prior to the pandemic, the Care Inspectorate changed their quality inspection themes for registered services. It was reported in 2021/22 that this was fully implemented for Care Homes and some self- directed support contractors, but 40 SDS contractors were still to be inspected using the new themes as of 31 March 22. Although there remain some self-directed support contractors who have not been inspected using the new quality framework, the majority have now been inspected. Table 4d below illustrates activity.
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16 Care Inspection Grades- Self Directed Support including Care 20 18 16 14 12 10 8 6 4 2 0 How How How good Table 4d well do we support people's wellbein g? How good is our leaders hip? How good is our staff team? How good is our setting? well is care and support planned ? our care and support during the COVID- Care & Support Environ ment Staffing Manage ment & Leaders hip 19… Adequate 2022/2023 7 7 2 0 3 0 0 0 0 0 Excellent 2022/2023 1 0 0 0 0 0 3 0 0 1 Good 2022/2023 8 9 5 1 4 0 3 0 3 8 Very Good 2022/2023 11 6 3 1 3 0 19 1 9 10 Weak 2022/2023 0 0 1 0 0 0 0 0 0 0 From the 52 SDS contractors that have been inspected, 45 have been awarded grades of good (4) and above. This is a percentage of 86.5%, which reflects delivery of high-quality care and support across SDS contractors supporting people in North Lanarkshire. It should be noted that the percentage above is calculated from the grades awarded under “How well do we support people’s wellbeing” and Care and Support, reflecting the two different inspection methodologies. 5. In House Monitoring During this reporting period the Quality Assurance team have been working on the development of an In-House Monitoring Framework. The suite of documents included within this Framework are awaiting approval from the Senior Leadership Team and it is intended that a test of change across Home Care services will commence in August 2023. This test of change will inform any further refinements and modifications prior to roll out across all In House services including Locality Support services, Children’s Houses, and Integrated Day Services. The aim of the In-House Monitoring Framework is to support implementation of best practice and a culture of continuous improvement. Progress on the implementation will be reported in future reports. 6. Market Facilitation Sustainability arrangements remined in place to ensure social care services continued to operate in a financially secure and viable manner following the impact of the COVID pandemic. The criteria for which
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17 Social Care Providers were reimbursed was phased out gradually, with the arrangements ending on 31st March 2023. However, due to contractors reporting significant increases in their costs., there continues to be a requirement to provide support and guidance to ensure they remain financially sustainable, to enable the continuation of service delivery across the authority.
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18 We recognise that services provided by external organisations make an important contribution to our ability to offer choice in supporting the health and well-being of people who use social care services. Therefore, our approach to market facilitation means we are responsive to the changing needs and aspirations of people living in North Lanarkshire, whilst also reflecting the changing social care landscape. One of the biggest challenges currently, is the lack of capacity available to choose from when a care and support package is required. There are many factors contributing to these challenges, including workforce retention and recruitment, cost of living increases, increased demand, complexity of support required and quality of care falling below expected standards. Quality Assurance continue to liaise with internal and external partners to identify solutions to the challenges. Provider Recruitment Event – A co-designed large -scale recruitment event is planned to be held in April 2023 to promote the sector and attract and encourage new people to work within social care. The event will support our commissioned contractors to recruit suitable staff and in turn maximise their capacity to provide care to the people of North Lanarkshire. Building Capacity – A programme of activity to build capacity across the sector enabled us to work with providers over two phases. This approach was in recognition of the pressures contractors face due to ongoing recruitment and retention issues across the social care sector. Through non-recurring funding from the Scottish Government, proposals were invited from contractors on the Self-Directed Support including Care at Home Framework, to build capacity and upskill staff teams to support our communities across North Lanarkshire. 40 proposals were submitted to be considered, including requests to support recruitment drives, staff training and development, incentives including joining bonuses, driving lessons and IT investments. 7. Carer Developments To ensure robust and ongoing support for Carers, we have, in conjunction with South Lanarkshire Council and Lanarkshire Carers, developed a Joint Partnership Statement to build on existing trust and partnership working between the named organisations. It provides a common reference point; useful to guide collaboration on a daily basis, avoid confusion and provide clarity as and when required. The agreement supports mutual understanding and expectations between partners (Lanarkshire Carers; North Lanarkshire Social Work and South Lanarkshire Social Work) in relation to the delivery of Adult Carer Support Plans (ACSPs). The roles, responsibilities and boundaries of all partners are defined and agreed. The agreement also provides a staff information and awareness raising tool and ensures that carers have access to accurate information and are signposted and referred appropriately. 8. Participation and Engagement There is a strong history of engagement and participation within North Lanarkshire. To strengthen our approach and progress our next Participation and Engagement Strategy, over the reporting period we have proactively linked with a range of key stakeholders to explore options and agree a model that ensures supported people, including underrepresented groups or communities, can play as active a role as they choose, in helping shape services. This approach ensures that supports and services are informed and led by people with lived and/or relevant experience of support, and that policy and strategy reflects the views, wishes, needs and aspirations of supported people.
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19 9. Communications To actively promote services and support for people, we have been working with the Communications Manager to develop a robust communication plan that provides clear and timely information, provides easy access to publications, showcases good news stories and promotes the sector. Members of the quality assurance team have undergone training to enable them to populate the revised Health and Social Care North Lanarkshire website: https://hscnl.org.uk/ Development of this website will be continuous and additional resources will continue to be made available. 10. Information Governance Our Information Governance Framework enables the safe and secure use of sensitive and other information to support the health and wellbeing of the people across our communities. It ensures that we meet our legal and ethical duties in relation to handling and managing information to a high standard. The role of Quality Assurance in information governance includes, but is not limited to: 1. Advice, monitoring and supporting the processing of: Subject access requests (SARs) including Information Commissioner’s Office (ICO) reviews and complaints. FOISA (Freedom of information requests) including Scottish Information Commissioner reviews and complaints. GDPR breach notifications Data protection impact assessments (DPIAs) DSAs/ISAs and data protection terms and conditions in contracts Schedule 2 requests for information relating to criminal activity (usually from the police) Work with other services to support the information governance function for social work (risk assessments, legal data protection team, legal FOI team). 2. Manage and support: Corporate reporting of KPIs for Information Governance HSCNL contributions to the Corporate Data Management Team (DMT) HSCNL contributions to the Lanarkshire Data Sharing Partnership (LDSP) Development and maintenance of recording and reporting systems for information governance. Development and review of policies and procedures for information governance, both for social work and corporately via DMT. The Information Governance function in social work has undergone significant changes over the reporting year. Many of these changes have contributed to the improvement of how we process information requests and the reporting functions. Activities have included the following: - Development of a core group within Quality Assurance to support and maintain the functions of information governance. Enhanced promotion of skills and awareness of information governance within social work, including training of staff and awareness of the online mandatory training courses and development of service specific training in Subject Access Requests (SAR’s) Development of additional training for social work staff. Review and update of Subject Access Requests (SAR’s) recording systems.
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20 Review and update of GDPR breach notification process. 11. Procurement In collaboration with Corporate Procurement colleagues and Locality Social Work Teams, Quality Assurance assist in the planning, coordination, and implementation of processes to ensure that when contracting new or existing work, the requirements of the Procurement Reform Scotland Act 2014 and the Procurement (Scotland) Regulations 2016 are adhered to. By doing so there can be confidence that the care & support services commissioned are legal, safe and outcomes focused whilst demonstrating Best Value. Throughout 2022/23 this partnership approach has enabled our Commercial Pipeline to be further developed. Transparency is a fundamental principle of public procurement, helping to ensure best value and proper scrutiny of contract awards. The Commercial Pipeline brings valuable insight to support the planning and delivery of public procurements, whilst enabling the widest possible- population of potential suppliers to be sighted on upcoming public sector contracting opportunities. Further refinements have also been made to our Contract Mobilisation processes, to embed timescales and key stages from the award of contracts to contracts going live. Over the period, we have focused on stakeholder communication plans, regular implementation meetings and the roles and responsibilities of key social work staff throughout the term of contracts, which are integral to effective service delivery. This approach helps to minimise contract implementation delays & barriers and promotes effective partnership working and the achievement of successful outcomes for the people of North Lanarkshire. We have also introduced the inclusion of Contract Exit Strategies and defined this within the contracting terms and conditions. This approach will ensure clarity when terminating contracts during their term (if required), contracts coming to a natural end and contracts at risk of early termination. This improved guidance is helpful during the period when provider sustainability features on the Social Work Risk Register. Early in 2023 there was representation from Quality Assurance to support the Corporate Procurement team at Lanarkshire’s Meet the “Real” Buyer Exhibitor. This event enabled potential contractors to ask specific care related questions. There were 337 attendees on the day and the feedback from the supply base was very positive. Representation from the Quality Assurance team will attend future events. Quality Assurance leads on procurement activity for all social work services, including those focussed on children, families, justice services and adults. There are close links between departments to ensure joined up planning, clear procurement processes and subsequent contract monitoring arrangements.
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21 Table 11 describes a sample of procurement activity undertaken in 2022/23. Table 11 Contract Comments and Benefits Flexible Framework for Self- Directed Support and Care at Home Services £900M value, 10 years, will result in less frequent re-tenders. follows the ‘Light Touch Regime’ / Regulation 74 of PCSR2015 Annual entry and exit points for Contractors currently in Year 3 Secured an increase in the number of contracted providers, improving the choice and control for supported people Flexible Framework for Non- Traditional Respite £4M, 10-year agreement, will result in less frequent re- tenders. follows the ‘Light Touch Regime’ / Regulation 74 of PCSR2015 Covers an existing gap within National ‘Respite’ Frameworks Annual entry and exit points for Contractors currently in Year 2 Secured an increase in the number of contracted providers, improving the choice and control for supported people Digital Counselling Service and Online Platform of Support £120,000 funding had been allocated from within Scottish Government’s Mental Health Services allocation to the Council to pay for the solution in year 1. Follows the ‘Light Touch Regime’ / Regulation 74 of PCSR2015 Anticipate that further years funding can be secured should the solution prove to be successful. Counselling Service for Care Experienced Young Funding available year 1 via Scottish Government (initial year £50k) subject to annual review. Options years included to give option to extend agreement. Follows the ‘Light Touch Regime’ / Regulation 74 of PCSR2015 Based within Intensive Services Hub, Cecil Street, Coatbridge and work with 16–25-year-olds who have experienced trauma and adversity. Lifelong Links £8000 plus VAT for the first year. Proposal for Funding Children in local authority care including children in residential care and care leavers ADL SmartCare £291,268.92 whole life budget over 4 years. (£71,041.20) GCloud 13, cloud software solutions GCloud 13 allows searching of software solutions. Hoists and Adaptations £12,000,000 whole life budget over 5 years. Split into Lot 1 and Lot 2 Supply, Installation, Removal and Servicing of Straight and Curved Stairlifts Supply, Installation, Removal, Servicing and Maintenance of Ceiling Track Hoists
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22 12. Fair Work The Fair Work Convention has been in place since April 2015 and acts as an independent advisory body to Scottish Ministers. The Convention’s vision is that by 2025, people in Scotland will have a world leading working life where fair work drives success, wellbeing and prosperity for individuals, businesses, organisations and society. As part of the council’s commitment to Fair Work and our ambition to adopt an ethical commissioning approach, Fair Work practices have been embedded in procurement processes to ensure contractors are paying the Scottish Living Wage and are committed to providing community benefits. Tracking Contractor progress has been included in the Social Work Contract Management Framework. Contractors report on community benefits activity and Scottish Living Wage compliance. The information provided contributes to the overall assessment of contract compliance. Community Benefits - During 2022/23 Quality Assurance increased focus on the delivery of community benefits, following new contract awards and implementation. Our approach means link senior officers meet with contractors to review, promote and encourage new initiatives that offer employment to people in the local community, youth training and training for people from disadvantaged groups, traineeships, apprenticeships, and volunteering opportunities. Scottish Living Wage - In 2021/22, we reported that most contractors had indicated they were either already accredited as or were willing to become Scottish Living Wage employers. This year 100% of providers on our Self-Directed Support including Care at Home framework, reported paying the Scottish living Wage. Across all contractors of commissioned services, 94% are now paying employees the Scottish Living Wage. The remaining 6% of contractors provide non-care related services or are within the cross-border category whereby the Scottish Living Wage does not apply. Table 12 13. Children, Families and Justice Quality Assurance monitors most Children’s Services where a contract status has been secured either on an Individual Placement basis or as part of a Framework Agreement, generally through Scotland Excel. Contractors Paying Scottish Living Wage 6%
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23 Improved links and processes in joint working between Quality Assurance and Children & Families mean that the noted development areas reported in 2021/22 have been progressed and all children and young people placements are conveyed to the appropriate teams. Quality Assurance have been supporting the development of Children, Families and Justice risk management arrangements, whereby attendance at the Social Work Risk Forums and membership of same is promoted across these teams. The Governance arrangements for Children and Families risk arrangements have been defined within the Adult Health and Social Care Risk Management Local Strategy. 14. Complaints Quality Assurance retains an overview role in terms of complaints made about Social Work service provision. Regular quarterly reports on complaints activity are reported through our governance structures. The annual summary and analysis of complaints received over the period 2022/23 is attached as appendix 1. 15. Duty of Candour Duty of Candour is a statutory duty on Scottish organisations providing health and social care. The responsibility is to remain open and honest when something goes wrong, that is not related to the course of the condition for which the person is receiving care. An annual report capturing Duty of Candour activity is a requirement of the Council and the report for 2022/23 is attached as appendix 2. 16. Adult Support & Protection The lead for Adult Support and Protection sits within the Adult Headquarters Social Work team; however, Quality Assurance have a key function to monitor the performance of social care contractors including care homes, so we work closely with our Adult colleagues. Adult Support & Protection activity can highlight patterns/trends and/or contract compliance concerns. Maintaining an overview allows for early intervention and support for contractors if required. A Senior Officer from Quality Assurance is identified as the Adult Support & Protection Link Person, which supports robust monitoring. Quality Assurance have representation on the Pan Lan Adult Support & Protection Care Home Task Group. The aim of this group is to identify and respond to feedback and address any inconsistencies that may arise in key messages being communicated by various professionals in relation to when an ASP referral should be made to the Local Authority. Adult Support & Protection Coordinators from North and South Lanarkshire Council and representation from both the Care Inspectorate and Scottish Care also participate in this group. To ensure a co-produced and partnership approach, a nominated care home manager participates the views of the wider care home population. Work is ongoing to support care home managers to have confidence in their decisions about when to make an ASP referral. We continue to promote attendance and participation with contractors, in North Lanarkshire Council Adult Support and Protection training. 17. Adult Health & Social Care Risk Management There is a nominated Risk Champion and depute for Adult Health & Social Care, as we all as range of risk facilitators across the service. A key function over the past months has been the implementation
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24 of the new Corporate Risk Management Strategy and the associated Adult Health and Social Care Risk Management Strategy. Significant progress has been made to update the risk register for Adult Health & Social Care. Quality Assurance have taken a lead role in coordinating the reviews of risks in partnership with risk owners. Throughout the reporting year several Risk Forums and a Risk Identification meeting have taken place. The current membership of the Risk Forum is under review at this time. Work continues to review individual risks, wordings and assessment to ensure they are clearly articulated in a way that means identification of controls and actions is more focussed and meaningful. 18. Quality Assurance Planned Developments 2023/24 There are several developments in progress or planned for the period 2023/24, which will be conveyed in future reports. Details of some of the planned developments are noted below: Roll out of In-House Monitoring Social Work Self Evaluation Chief Social Work Officer Report Quality Assurance Newsletter Review of Contract Management Framework & associated data analysis Development of Engagement & Participation Strategy Establish membership of Risk Forum & streamline current risks. Ethical Commissioning Self-Assessment & Action Plan Recommence Care Home Provider Forum Support Succession Planning Refine Induction Pack Establish systems around Contractor Capacity Reporting Embed the role of Locality Senior Officer Links Agree and implement post covid care home arrangements/forums. Further development of market facilitation plan Continued Large Scale Investigation involvement. This report has covered Quality Assurance activity undertaken during the period 1 April 2022 to 31 March 2023 and highlights progress made in key activities noted in the last reporting period. The additional resource of two Senior Officers to the team in January 2023 has had a positive impact on outcomes achieved in developing creative and solution focused approaches to performance and compliance both internally and externally.
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25 Appendix 1 Social Work Complaints Annual Report 2022/23
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26 Introduction This report provides an overview of Social Work’s performance in terms of handling complaints received between 1 April 2022 and 31 March 2023 and covers Adults and Education, Families & Justice. This report describes how complaints have been managed by social work services, details the number and nature of complaints received during the year and demonstrates our commitment to learning and improvement. There remained a residual effect of the Covid 19 pandemic in terms of the numbers of complaints received in 2022-2023, underlining the impact this unprecedented global event had upon service provision and the lives of those who use our services. Complaint activity Overall, complaint activity rose by 81% from 2021-2022. A significant increase: however, complaints are still slightly less than they were pre-pandemic. In terms of complaints per population, they stand at 0.35 per 1000. Overall complaints received for the reporting period were 221, an increase of 99 [58%] from former reporting period. A breakdown is provided below. Education and Families 81 complaints were received in relation to Education & Families services this year, 49 received last year, an increase of 32 [65%]. The chart below is a summary of locality complaint activity for Education and Families services. Of the 81 complaints received, 80 were assigned. One complaint couldn’t be assigned to any locality or service due to lack of information. Adult Social Work Services 140 complaints for adult services this year, 73 received last year, an increase of 67 [92%]. The chart below is a summary of locality complaint activity for Adult Social Work Services. 16 14 12 10 8 6 4 2 Locality/Service 15 11 10 6 6 6 5 4 4 2 1 1 0 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw HQ
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27 Complaint Process We always aim to provide the highest possible quality of service across our communities and are committed to ensuring accountability and transparency. We recognise there are times when we get things wrong and fail to meet the expectations of those who use our services. We welcome feedback as it provides information that helps us to learn from complaints and shape and improve the way services are delivered. Complaints are viewed as a positive communication tool and are actively encouraged. As per the Scottish Public Services Ombudsman [SPSO] definition, we regard a complaint as any expression of dissatisfaction, by one or more members of the public, about our action or lack of action, or about the standard of service provided by us or on our behalf. Anyone can make a complaint, either verbally or in writing, face to-face, by phone, letter or email. People are directed and encouraged to use the North Lanarkshire Council online portal to make a complaint but retain the right to use any of the aforesaid options. A two-stage statutory social work complaints process was introduced on 1 April 2017, which harmonised complaint handling processes across all council services. The process is as follows: • Stage one – ‘frontline resolution’: we will always try to resolve complaints quickly, within five working days, and in exceptional circumstances extend for a further five days. • Stage two – ‘investigation’: if people remain dissatisfied with our stage one response, they can escalate their complaint to stage two. Complaints that are complex or need detailed investigation from the outset can be looked at immediately at stage two. These complaints will be acknowledged within three working days and a written response provided within twenty working days; this can be extended in exceptional circumstances. Following completion of the complaints process, if the person remains dissatisfied, they can ask the SPSO to consider their complaint further. We always advise of this entitlement and provide contact details. Performance Indicators The Complaints Standard Authority developed a suite of four mandatory performance indicators in association with the Local Authority Complaint Handlers Network on which we are represented. These indicators [undernoted] are a valuable source of information as they help to identify recurring or Locality/Servic e 30 25 24 22 20 15 15 12 11 10 10 9 10 6 5 4 5 3 5 4 0 Airdrie Bellshil l Coatbridge Cumbernauld Motherwell Wisha w H Q Stage 1 Stage 2
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28 underlying issues, derive/drive learning from complaints and highlight potential areas for improvement. Indicator One: the total number of complaints received. Indicator Two: the number and percentage of complaints at each stage that were closed in full within the set timescales of five and 20 working days. Indicator Three: the average time in working days for a full response to complaints at each stage. Indicator Four: the outcome of complaints at each stage. Education and Families – Performance Information Compliance with statutory timeframes to complete complaint 23.7% not within timeframes 22.7% not within timeframes 59.4% within timeframes 54.6% within timeframes 16.9% met with extension 22.7% met with extension Average S.1 – 6.2 working days Average S.2 – 23.3 working days
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29 Cause of Complaints Complaint Outcome
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30 Adult Social Work Services– Performance Information Compliance with statutory timeframes to complete complaint 24% not met within timescales 16% not met within timescales 52% met within timescales 63% met within timescales 24% met with extension 21% met with extension Average S.1 – 5.4 working days Average S.2 – 23.2 working days Cause of Complaints
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31 Complaint Outcome Learning from Complaints The learning from all social work complaints this year have highlighted: The importance of good communication. The need to ensuring that those who use our services and their carers are informed from the outset that they may need to contribute towards the cost of their care. The need to improving information and advice for those who need to contact and seek support from social work services. That people have the right to use their Self-directed Support (SDS) individual budgets as creatively as necessary to reach their agreed outcomes, as long as the use of public funds are legal and do not bring the council into disrepute. Outcomes are often specific to the complaint, but when there are organisational learning points that influence policy or procedure, we need to ensure these are acted upon. Individual learning is dealt with directly with the complainant and through supervision, and more general issues are managed through supervision with team members and reminders at team meetings. Learning from Complaints Communication Safe Driving Conduct Support Planning Importance of PPE Importance of ID N/A
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32 47% of all social work complaints recorded did not highlight any learning, while 33% were attributed to communication failure as the singular cause of complaints. Other issues cited were safe driving/parking, wearing appropriate PPE and ID badges, quality of service and conduct of staff. We recognise the importance of learning from complaints and acknowledge that having a learning outcome recorded is an area that requires immediate attention. We understand that complaints help organisations learn more about the experiences of people who use their services, and that complaints can be helpful to enable us to work in a better way. At present, learning from complaints is a non-mandatory performance indicator. However, the Scottish Public Services Ombudsman are interested in the systemic changes that are made following complaints. Going forward, we will work directly with our central and locality teams to ensure better recording and learning from complaints is embedded in practice to ensure quality services are delivered. Comment and compliments Across social work, seven compliments were made 2022-2023 in relation to complaint handling – all referred to quick actions by responsive staff to provide resolution. 5 other comments were logged but were mapped as neutral and non-critical. Training Training on the Dynamics system, where complaints are recorded, is offered as required. The licence allocation system has recently been reviewed, and licence permissions granted only to management support team members and to system administrators. Rationalisation of licence holders will increase opportunities to have closer collaboration and training across the service. Colleagues in Chief Executive’s office lead on training on system issues, and Quality Assurance Senior Officer leads on complaint handling training. The Scottish Public Services Ombudsman offer training on topics such as investigating complaints. Currently, this is only offered virtually, but there are plans to introduce in person training and to increase the number of training opportunities offered. We actively encourage participation in training on complaint handling and management. Scottish Public Services Ombudsman The SPSO considered seven complaints of which two are subject to ongoing enquiry, one had recommendations made for resolution, with the remaining four no actions taken.
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33 Child Friendly Complaints Procedure The SPSO are introducing a new Child Friendly Complaints Procedure, which will go live on 1 April 2024. This procedure will ensure that children’s rights under the United Nations on the Rights of the Child [UNCRC] are met through a child-centred complaint process. Their aim is to co-design and implement a public sector complaints service that meets children’s rights and needs. They are working in co- operation with children, young people, public bodies and wider stakeholders. Initially, it was envisaged that the new procedure would be fully implemented by 1 April 2023. However, following feedback from engagement and testing work, a more targeted pilot has been agreed. The pilot will focus on key services provided to children and young people, such as schools, social work services and children’s health services. The aim of this work will be to test the new approach in practical settings, both to ensure it results in the right outcomes for children, and that it is efficient, practical, and workable for the public sector bodies managing the process. Full guidance on the new process should be made available by summer 2023, with a soft launch of the new process in April 2024. Quality Assurance Quality Assurance senior officers provide training and support to social work managers and teams in relation to the complaint handling process. A suite of letter templates are available, which provide guidance on model answers and best practice when engaging with complainants. Complaints are often routed directly through the Quality Assurance officer who acknowledges receipt and assigns complaints to the relevant team manager. Guidance on response times and content is provided. Complaints that relate to both health and social work/social care services are routed through the relevant lead organisations complaints process, but there is an integrated approach to resolution and any joint learning outcomes are shared. Care Opinion Care Opinion is a non-profit organisation, funded mainly through subscriptions from health and care organisations. At present, 500 health and social care organisations use Care Opinion across the UK. Care Opinion have been sharing people’s experiences of health and care services online in Scotland since 2013 and have built a national and international reputation for their innovative and value-led approach to online feedback. Feedback is considered integral to quality improvement and for staff it is an opportunity to see the system and the service provided through the person’s eyes. Subscription to Care Opinion gives a further platform for people who use social work services to comment on the quality of the service that we provide but may also encourage people to make formal complaints. Usage of Care Opinion has been slow – however, there has been marked increases in comments posted about social care services over the course of the preceding quarter. Anecdotal information from our partners in NHS Lanarkshire suggests that in the early stages, uptake can be poor, but that sustained promotion will drive traction and momentum. There is a Care Opinion implementation group who meet regularly to agree plans for increased promotion and shared learning . To support the use of Care Opinion as a vehicle to promote feedback on services, our revised Contract Management Framework requires all contracted providers, through their quarterly monitoring return, to report on their use and promotion of Care Opinion as a method of seeking feedback.
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34 Conclusion The principal cause of complaints continue to identify poor staff communication, staff attitudes and quality of service. This is further reflected within the learning outcomes, which indicate the need to improve communication, practice and approach to those using social work services. As a partnership we are committed to improving learning from complaints which is also one of the key performance indicators that are reportable to the SPSO. We will, over the course of 2023-2024 place further emphasis on identifying and applying learning from complaints, recording learning outcomes and evidencing subsequent improvements. We will also emphasise the need to ensure that all complaints are dealt with in the identified timeframes, with clear communication of outcomes. Although 100% of complaints that were sent directly to social work were acknowledged by the due dates, only 58% overall were completed within statutory timeframes. Complexity of issues, new processes, staffing, IT systems and very tight time frames for resolution were the contributory factors in failure to complete all complaints within time. Improvement in these areas are expected in 2023-2024. Further actions – 2023-2024 Several key actions have been identified to strengthen our approach when dealing with complaints including using the learning to improve the quality of experience for those who use our services. The actions are: 1. We ensure a robust log and learning from complaints is implemented to support the improvement of services that support people across our communities. 2. We develop a programme of reflective learning sessions across teams - Complaint activity and learning remains an agenda item in team meetings and links across services and localities are maintained with Quality Assurance Senior Officer who will review complaint activity as required. 3. We continue to promote Care Opinion as one of the key mechanisms for engaging with members of the public and to generate meaningful feedback. 4. We provide system training to all members of the management support teams who now have responsibility for logging and tracking complaints. 5. We provide complaint handling training sessions on at least a quarterly basis as a refresher session, or for training for new staff. 6. We support the implementation of Child Friendly Complaints Handling Procedures.
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35 Appendix 2 Duty of Candour Annual Report 2022/23
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36 Introduction North Lanarkshire Health and Social Care Partnership recognises that when adverse events occur during the provision of treatment or care, openness and transparency is fundamental. The duty of candour arrangements which we have implemented reflect the Scottish Government’s commitment to place people at the heart of health and social care services in Scotland. When harm occurs the focus must be on personal contact with those affected; support, and a process of review and action that is meaningful and informed by the principles of learning and continuous improvement. The Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 was implemented on 1st April 2018 placing an organisational duty (Duty of Candour) on health, care, and social work services to be open and honest with people in their care. The overall purpose of this duty is to ensure organisations are open, honest, and supportive when there is an unexpected or unintended incident resulting in death or harm as defined in the Act. All health and social care services in Scotland have a duty of candour, a legal requirement which means that when things go wrong and mistakes happen, the people affected understand what has happened, receive an apology, and that organisations learn how to improve for the future. A key part of this duty is that Health and Social Care publish an annual report about the duty of candour in our services. This short report describes how the services we commission, and our own services have operated the duty of candour during the time between 1 April 2022 and 31 March 2023. Information about policies and procedures All social care organisations have a Duty of Candour policy. All staff who are employed in the sector should be aware that all instances that necessitate implementation of Duty of Candour must immediately be reported. In such instances, a manager will then take the appropriate action, ensuring relevant bodies [depending on the sector] such as Social Work and Care Inspectorate are notified of the event. Where an incident occurs that triggers the duty of candour, managers have responsibility for ensuring that the duty of candour procedure is followed. Information on Duty of Candour and reportable incidents is described in detail within Appendix A. 82 commissioned organisations were asked to provide information in relation to Duty of Candour activity in the reporting period. Of the 34 [41%] that responded, there were six reported incidents. Details of those who responded are noted in Appendix B. All North Lanarkshire Council social work in- house services - home support, integrated day services, locality support services and children services were also asked to provide information. There were no Duty of Candour incidents reported from any of the council provided services. Reporting of Duty of Candour incidents are an integral part of our Contract Monitoring Framework and all should be reported on quarterly contract monitoring returns. How many incidents happened to which the duty of candour applies? In the reporting period, six incidents have been reported to which the duty of candour applied, one in relation to maladministration of paracetamol, and five where a person fell and sustained physical
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37 harm. All incidents reported were from a commissioned care home service. No Duty of Candour incidents were reported by North Lanarkshire Council in-house social work services. The low number and type of reported incidents indicate that there may be some uncertainty over situations where Duty of Candour responsibilities should be invoked. Refresher sessions on Duty of Candour duties will be delivered to our in-house teams over the course of 2023-2024. Reminders and information slides will be sent to all our commissioned services to ensure that they are fully aware of the duties under the Act. Details of incidents where Duty of Candour applied. Nature of incident: Duty of Candour raised for accident where resident fell and fractured his femur. Incident fully investigated and reported. Relative invited to a Duty of Candour meeting but declined to attend. Nature of incident: Duty of candour raised for incident whereby a resident received an overdose of Paracetamol. No lasting harm occurred. Incident fully investigated and reported. Relative invited to Duty of Candour meeting but declined to attend. Nature of incident: Duty of Candour raised for an incident where a resident had staples to a wound in her head following an unwitnessed fall. No lasting harm occurred. Incident fully investigated and reported. Relative declined invite to attend Duty of Candour meeting. Nature of incident: Duty of Candour raised for incident where a resident had sutures to head wound following a witnessed fall. No lasting harm occurred. Incident fully investigated and reported. Family were invited to attend a Duty of Candour meeting but declined to attend. Nature of incident: Duty of Candour raised for incident concerning a resident who sustained a fracture due to witnessed fall. Incident fully investigated and reported. Family were invited to attend a Duty of Candour meeting but declined to attend. Nature of incident: Duty of Candour raised for incident concerning a resident who sustained a fracture due to an unwitnessed fall. Incident fully investigated and reported. Relatives were invited to a Duty of Candour meetings but declined to attend. Unfortunately, there were incidents where Duty of Candour duties should have been invoked but were not. Reasons for failure were inexperienced management and lack of familiarity with Duty of Candour procedures. Another factor was due to Police involvement in two serious incidents, where it was understood that Police involvement superseded Duty of Candour. Conclusion Within the reporting period, there were no Duty of Candour incidents reported from in-house home care or social work services and only six from commissioned care home providers. From those reported, none had lasting consequences for the person to whom the duty applied - appropriate action taken, lessons learned, procedures and training revised, and where applicable, families informed, and invited to discuss in more detail. In future, if any incidents occur that invoke Duty of Candour proceedings, there will be a review process to identify lessons learned, with the result of the review
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38 shared with the relevant person/persons. This approach will minimise the impact on the organisation and the vulnerable people that we strive to support. Appendix A – Definition of Harm and appropriate level of response Grading of Harm Definition of Harm Level of Response No harm, incident prevented Any service user safety incident that had the potential to cause harm but was prevented. These incidents are outside of the scope of the duty of candour. Social work professionals may however feel it is appropriate to inform the person involved if it is in their best interest. No harm, incident not prevented Any service user safety incident that occurred but no harm was caused to the person involved. These incidents are outside of the scope of the duty of candour policy. Being open in a discussion between staff involved and the service user and their family is usually undertaken locally. Low Harm Any service user safety incident that led to the extra observation or minor treatment such as first aid or additional medication for the person involved. These incidents are outside of the scope of the duty of candour policy. Being open in a discussion between staff involved and the service user and their family is usually undertaken locally. Moderate Harm A level of harm that is not permanent but has led to a moderate increase in treatment or prolonged psychological harm of more than 28 days. For example, a return to theatre, an unplanned readmission to hospital, unexpected admission to critical care, a prolong hospital stay or additional out service user visits. Duty of candour is a statutory requirement. Notification should be given to the person affected or their representative in person including an explanation of the incident, the process for investigation and an apology. This will be followed up in writing and on conclusion of the investigation the findings and outcome will be available to the service user of their representative. Serious Harm Any service user safety incident that has resulted in permanent harm that is directly related to the incident and not the natural course of an illness or the underlying condition of the person affected. Examples of severe harm are permanent lessening of bodily functions, sensory, motor, physiological or intellectual function, removal of the wrong organ or limb or brain damage. Duty of candour is a statutory requirement – see above. Death Any service user safety incident that directly resulted in the death of a person and is not related to their illness or underlying condition. Duty of candour is a statutory requirement – see above.
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39 Appendix B Organisations who provided a response: all but one returned a nil response. All New Beginnings Angels Aspire Beechwood Care Home Capability Scotland Care One Professional Care Solutions C- Change Cera Care Corners tone Deanston Care Home Enable Scotland Enhance Supported Living Services HRM Inclusion Scotland Invercare Keane Premier Support Services Key Housing Lanarkshire Association for Mental Health Lanarkshire Care Partners Local Lanarkshire Care Lochside Manor Love Partners in Play Penumbra PHEW Potential Living Quarriers Scottish Autism Support for Ordinary Living The Richmond Fellowship Scotland Thera Care Turning Point Scotland Wheatley Care
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1 REPORT Item No: 11 SUBJECT: Financial Monitoring Report 2023 2024 TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Amanda Kilburn, Chief Finance Officer DATE: 27 September 2023 1. PURPOSE OF REPORT 1.1 This paper is coming to the Integration Joint Board (IJB) for: For approval For endorsement For noting 1.2 This report provides a summary of the financial position of the North Lanarkshire Health and Social Care Partnership (HSCP) for the period 1 April 2024 to 30 June 2023. 2. ROUTE TO THE PERFORMANCE, FINANCE AND AUDIT COMMITTEE 2.1 This paper has been: Prepared By: Chief Finance Officer ☒ Reviewed By: Chief Officer ☒ Endorsed By: ☐ 3. RECOMMENDATIONS 3.1 It is recommended that the IJB: (1) Acknowledge the contents of the report; and (2) Acknowledge the projected outturn for 2023/24 is an underspend of £3.182m. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 This report is based on the financial monitoring reports received from NHS Lanarkshire Director of Finance and North Lanarkshire Council Head of Financial Solutions. The position detailed in these reports is therefore based on the Yes No N/A
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2 information contained in each partner’s respective financial systems and includes accruals and adjustments in-line with their financial policies. 6. CONCLUSIONS 6.1 As detailed in the following table, the IJB year to date position is an underspend of £0.969m and the projected outturn for 2023/24 is an underspend of £3.182m, assuming the current trajectory of spend continues throughout the financial year. There is no ring-fenced funding included in this reported projected outturn. Service Year to Date Position £m Projected Year End Outturn £m Health Care Services 0.042 0.169 Social Care Services 0.927 3.014 Total North Lanarkshire HSCP 0.969 3.182 Ring-Fenced Funding - - Revised Outturn Total 2023/2024 0.969 3.182 6.2 Subject to IJB approval, in-year underspends will be allocated to manage, on a non-recurring basis, ring-fenced commitments, additional commitments relating to the Strategic Commissioning Plan and any funding gap which is highlighted in the North Lanarkshire IJB Medium-Term Financial Plan 2023-2026. 6.3 A summary of the current financial challenges and key pressures are highlighted in the table below: Area Projected Outturn under/(over) £m Main Factors Employee Costs 10.439 As highlighted through 2022/2023, there are ongoing challenges in terms of recruitment and retention issues across all service areas. For a wide range of posts recruitment has been unsuccessful due to the availability of the skills mix required or the competition being offered by other private and public sectors. During this financial year, various planning groups will work to address and provide solutions to help mitigate shortages in line with staffing availability. Payments to Other Bodies (PTOB) (1.930) There are two main areas of overspend within PTOB which are independent care homes and self-directed support (SDS) costs. The independent care homes have a yearly budget of 1,361 care plans but at present the number of projected care plans is 1,440 resulting in a projected overspend of £1.014m. SDS is similarly overspent due to a budget of 2,312 care plans against 2,860 estimated care plans for 23/24. This increase in demand was forecast and reported in the Medium-Term Financial Plan. As per the IJB strategy to address the demand pressures within the plan, a drawdown of £3m from the social care demand reserve is being used to offset the current projection reducing the overspend to £1.356m.
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3 Current projections do not take account of any slippage to start dates or cancelled packages which will reduce costs further as the year progresses. Additional work is underway within the service and the finance team to further analyse this projection. Prescribing (5.399) This overspend is attributable to the number of medicines being prescribed and dispensed in community pharmacies resulting in an increase in costs. The current projection is based on April data and 2022/2023 trends due to the 2-month time lag in receiving current data. Additional information on the on-going prescribing saving plan is at para 7. North Lanarkshire Hosted Services (0.428) The two main areas of overspends within North Lanarkshire hosted services, relate to continence service and children services. Continence Service overspend is due to an increase in costs relating to continence products. Children Services overspend relates to diabetic equipment including diabetic glucose monitoring machines and insulin pumps. 6.4 Throughout the year, adjustments are made to the original budget due to additional budget allocations and budget transfers. Appendix 4 provides a reconciliation of the main budget adjustments applied this financial year and the table below shows the current funding allocations received from Scottish Government: Scottish Government Allocations 2023/24 £m Additional Staffing Band 2-4 1.093 Alcohol and Drug Partnership 2.800 Child Death Review 0.024 Distress Brief Intervention 3.070 District Nursing 0.610 Family Nurse Practitioner Funding 1.150 Long Covid Support Fund 0.224 Mental Health Action 15 3.930 Mental Health Community Perinatal 0.505 Mental Health Infant and Maternity 0.476 Mental Health Outcomes Framework 3.380 Multi-Disciplinary Teams 1.740 Neonatal Psychological Interventions 0.138 Outcomes Framework 2.770 School Nursing Posts 0.730 TOTAL 22.640 7. SAVINGS
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4 7.1 Within 2023/2024 prescribing budget, a savings target of £2.7m has been set by NHS Lanarkshire to help reduce the continuing increasing overspend. 7.2 A wide range of work has commenced from March to ensure the balance of the savings target is achieved, ranging from reducing waste and inefficiencies and changing prescribing practices and culture. The impact of this work has recorded savings at the end of June totalling £0.239m and if this continues the forecast annual savings expected by March 2024 is £1.170m. 7.3 Work on savings programmes for Scriptswitch and medicine reviews continues from last financial year along with a wide variety of other work which has commenced from March 2023. Allowing a period of time for communication and implementation of changes to practice and efficiency programmes to embed, the impact of this work is expected to achieve the required savings target by March 2024. 7.4 The table below shows the volatility in cost per item within prescribing. As at April 2023, average cost per item was £10.23 compared to April 2022 when the average cost was £9.38: 7.5 Table 1 below shows the cost of prescribing from April 2022 to April 2023 and table 2 shows the data by items dispended for the same period: 2.700 1.170 0.239 Savings Target Savings Expected Savings Achieved 0.000 0.500 1.000 1.500 2.000 2.500 3.000 £m 2023/24 Prescribing Savings £m 2023/2024 £8.80 £9.00 £9.20 £9.40 £9.60 £9.80 £10.00 £10.20 £10.40 £10.60 Cost Per Item Cost Per Item April 2022 - March 2023
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5 7.6 It should however be noted that due to the volatility within this area and the time lag in receiving up to date information from the recording system, the current projection is likely to change month on month. Additional monitoring is in place with the data being analysed by a dedicated working group and regular updates on progress will be reported to the IJB throughout the year. 8. GENERAL RESERVES 8.1 It is important for the long-term financial stability and the sustainability of the IJB that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statue and is part of a range of measures in place to ensure that s106 public bodies do not over-commit themselves financially. 8.2 The current IJB reserves position for 2023/2024 after adjustment for the drawdown of reserves, is a revised balance of £84.211m and is summarised in the table below: 0.000 1.000 2.000 3.000 4.000 5.000 6.000 7.000 8.000 £m Table 1: Prescribing Cost £m April 2023 - April 2024 540,000 560,000 580,000 600,000 620,000 640,000 660,000 680,000 700,000 720,000 No. of Items Dispensed Table 2: Prescribing Items Dispensed April 2022 - April 2023
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6 8.3 The IJB risk-based and contingency reserves currently equate to 2.6% of the financial envelope. Appendix 5 shows a detailed list of all reserve movement during 2023/24. 8.4 Regular updates will be provided to the IJB throughout 2023/24 as analysis and reviews of all reserves are monitored to ensure they continue to meet on-going pressures and remain fit for purpose. 9. CURRENT VACANCY POSITION 9.1 As highlighted throughout this report, employee costs are projecting a significant underspend within all services. Recruitment continues to be progressed for vacant posts in all areas. 9.2 The table below shows the current full time equivalent (FTE) vacancy numbers within each service against their budgeted establishment: 9.3 To help cover the vacant posts, agency staff, bankaide, overtime and excess part time hours are used, the cost of which is included within the financial position reported. A detailed analysis of these costs is at appendix 6. Opening Balance As At 1 April 2023 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Ring-Fenced Reserves 23.936 0.000 (2.760) 21.176 NHSL & NLC Earmarked Reserves 44.497 0.084 (1.248) 43.333 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (3.000) 11.648 NHSL Contingency Reserves 8.060 (0.006) 0.000 8.054 NHSL & NLC Closed Reserves 6.552 0.175 (6.727) 0.000 97.946 0.000 (13.735) 84.211 LEAD SUMMARY Total Establishment Actual Vacancies FTE FTE FTE North West Locality 384.46 336.88 47.58 North East Locality 323.88 285.52 38.36 Adult Services 273.75 268.87 4.88 Children Services 570.49 529.42 41.07 Mental Health 1,127.15 1,121.32 5.83 Social Care Services 972.60 736.70 235.90 Home Support 1,000.17 1,008.84 -8.67 Other 85.01 207.57 -122.56 TOTAL 4,737.51 4,495.12 242.39 Service
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7 10. DELEGATED SERVICES 2023/2024 10.1 The following table shows the costs of other North Lanarkshire Council services delegated to the IJB during 2023/2024. The projected outturn position for 2023/2024 is breakeven: Service Expenditure £m Income £m Projected Year End Outturn £m Housing 1.945 (1.945) Breakeven Transport 0.551 (0.551) Breakeven Total 2.496 (2.496) Breakeven 11. IMPLICATIONS 11.1 NATIONAL OUTCOMES People are able to look after and improve their own health and wellbeing and live in good health for longer ☐ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☐ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☐ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care, and treatment they provide ☐ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 11.2 ASSOCIATED MEASURE(S) Each partner is required to remain within their approved budgetary provision. 11.3 FINANCIAL Overtime Excess Part Time Bankaide Agency TOTAL £m £m £m £m £m North West Locality 0.043 0.014 0.198 0.133 0.387 North East Locality 0.017 0.009 0.067 0.005 0.099 Adult Services 0.022 0.021 0.081 0.037 0.161 Children Services 0.073 0.018 0.163 0.008 0.262 Mental Health 0.129 0.024 0.723 1.201 2.078 Social Care Services 0.283 - - 0.109 0.393 Home Support 1.015 - - - 1.015 Other 0.012 0.006 0.015 - 0.033 TOTAL 1.595 0.092 1.247 1.493 4.428 SERVICE Year to Date Cost
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8 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 has been updated where necessary and are included in a separate report to the IJB. Relevant Risk Register Details Current Risk Level Risk Owner Financial Challenges High Amanda Kilburn Prescribing Activity and Costs Very High Ross McGuffie 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 Head of Financial Solutions of NLC both continue to be consulted on the financial position of the NL IJB. ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design, and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery Financial information is shared with stakeholders on a regular basis and is provided to the PFA and IJB on a quarterly basis. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership IJB Financial Plan and Reserves Strategy aligns and supports the IJB Strategic Commissioning Plan to ensure robust financial monitoring and scrutiny. 11.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed and EQIA added to website:
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9 Yes No N/A 12. BACKGROUND PAPERS None. 13. APPENDICES Appendix 1- North Lanarkshire Health and Social Care Partnership Budget Appendix 2 - Hosted Services Led by North Lanarkshire Appendix 3- Hosted Services Led by South Lanarkshire Appendix 4- North Lanarkshire IJB Budget Reconciliation 2023/2024 Appendix 5- North Lanarkshire IJB General Reserves 2023/2024 Appendix 6- Analysis of Additional Employee Costs Chief Finance Officer Members seeking further information about any aspect of this report, please contact Amanda Kilburn on telephone number 07816 126362.
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10 Appendix 1 North Lanarkshire Revenue Budget Position 1 April 2023 to 30 June 2023 Appendix 1 Annual Year To Date Variance Projected Year End Outturn Budget Budget Actual Total Total 2023/2024 June 2023 June 2023 June 2023 2023/2024 £m £m £m £m £m Health Care Services Locality and Other Services 58.031 15.032 14.233 0.799 3.196 Addiction Services 7.054 0.534 0.536 (0.002) (0.008) Medical and Nursing Directorate 4.982 1.414 1.337 0.078 0.311 Prescribing 70.973 17.743 19.093 (1.350) (5.399) Out of Area Services 4.571 1.144 1.012 0.131 0.526 Area Wide Services 7.064 1.841 1.750 0.091 0.364 Hosted Services 165.185 45.904 45.609 0.295 1.179 Family Health Services 116.617 28.041 28.041 0.000 0.000 Set-Aside Budget 70.502 17.626 17.626 0.000 0.000 Total Expenditure - NHSL 504.978 129.279 129.236 0.042 0.169 Social Care Services Social Care Services Gross Expenditure 251.389 77.350 76.363 0.988 3.061 Social Care Services Gross Income (4.379) (1.348) (1.287) (0.061) (0.197) Social Care Services Net Expenditure 247.009 76.003 75.076 0.927 2.864 Housing Revenue Account 1.945 0.598 0.598 0.000 0.150 Transport Services Account 0.551 0.169 0.169 0.000 0.000 Social Care, Housing and Transport Services Net Expenditure 249.505 76.771 75.844 0.927 3.014 Total Expenditure - NHSL and NLC 754.483 206.049 205.080 0.969 3.182 Annual Budget 2023/2024 £m NHS Lanarkshire Funding (497.419) Social Care Funding (22.964) Resource Transfer (23.421) Commissioned Services (6.721) Transfer from Reserves (Approved) (7.559) Total Funding - NHSL (558.084) NLC Funding - Social Care Services (190.727) NLC Funding - Housing Services (1.945) NLC Funding - Transport Services (0.551) Transfer from Reserves (Approved) (3.176) Total Funding - NLC (196.399) Total Funding - NHSL and NLC (754.483) Year To Date Care Group Funded By:
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11 Appendix 2 Appendix 3 Hosted Services Appendix 2 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 £m £m £m £m £m £m £m £m £m £m £m £m Sexual Health Services 2.949 0.778 0.768 0.010 1.533 0.404 0.395 0.010 1.415 0.373 0.373 0.000 Continence Services 2.402 0.617 0.835 (0.218) 1.249 0.321 0.539 (0.218) 1.153 0.296 0.296 0.000 Immunisation Services 1.918 0.502 0.554 (0.052) 0.997 0.261 0.313 (0.052) 0.920 0.241 0.241 0.000 Speech and Language Therapy Services 6.454 1.802 1.835 (0.032) 3.356 0.937 0.970 (0.032) 3.098 0.865 0.865 0.000 Children and Adolescents Mental Health Services 8.504 3.594 3.182 0.412 4.422 1.869 1.457 0.412 4.082 1.725 1.725 0.000 Childrens Services 12.099 3.233 3.383 (0.149) 6.291 1.681 1.831 (0.149) 5.807 1.552 1.552 0.000 Integrated Equipment and Adaptations Store 0.567 0.142 0.137 0.004 0.295 0.074 0.069 0.004 0.272 0.068 0.068 0.000 Dietetics Services 3.930 1.074 1.052 0.023 2.044 0.559 0.536 0.023 1.887 0.516 0.516 0.000 Podiatry Services 4.552 1.274 1.244 0.031 2.367 0.663 0.632 0.031 2.185 0.612 0.612 0.000 Prisoner Healthcare Services 1.781 0.475 0.524 (0.049) 0.926 0.247 0.296 (0.049) 0.855 0.228 0.228 0.000 Blood Borne Viruses Services 1.560 0.409 0.482 (0.072) 0.811 0.213 0.285 (0.072) 0.749 0.196 0.196 0.000 Hospital at Home 2.326 0.640 0.654 (0.014) 1.210 0.333 0.347 (0.014) 1.117 0.307 0.307 0.000 Mental Health and Learning Disability Services 78.242 21.137 20.735 0.402 40.686 10.991 10.589 0.402 37.556 10.146 10.146 0.000 TOTAL 127.284 35.678 35.383 0.295 66.188 18.553 18.258 0.295 61.096 17.125 17.125 0.000 Led by the North Partnership South Lanarkshire IJB - 48% Share Year to Date Annual Budget 2023/2024 Annual Budget 2023/2024 Year to Date North Lanarkshire IJB - 52% ShareYear to DateAnnual Budget 2023/2024 Hosted Services Appendix 3 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 June 2023 Budget Actual Variance Budget Actual Variance Budget Actual Variance 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 2023/2024 £m £m £m £m £m £m £m £m £m £m £m £m Community Dental Services 7.204 2.051 1.826 0.224 3.746 1.066 1.066 0.000 3.458 0.984 0.760 0.224 Brain Injury Unit 1.220 0.545 0.540 0.005 0.635 0.283 0.283 0.000 0.586 0.261 0.257 0.005 Out of Hours Services 9.079 2.362 2.346 0.017 4.721 1.228 1.228 0.000 4.358 1.134 1.117 0.017 Palliative Care Services 7.133 1.902 1.836 0.067 3.709 0.989 0.989 0.000 3.424 0.913 0.846 0.067 Physiotherapy Services 10.845 3.037 3.205 (0.168) 5.639 1.579 1.579 0.000 5.206 1.458 1.626 (0.168) Primary Care Services 0.804 0.229 0.207 0.021 0.418 0.119 0.119 0.000 0.386 0.110 0.089 0.021 Occupational Therapy Services 8.381 2.354 2.283 0.072 4.358 1.224 1.224 0.000 4.023 1.130 1.058 0.072 Diabetic Services 3.999 1.130 1.150 (0.020) 2.079 0.588 0.588 0.000 1.919 0.543 0.563 (0.020) Telehealth 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Sub Total 48.666 13.610 13.393 0.217 25.307 7.077 7.077 0.000 23.360 6.533 6.316 0.217 Ring Fenced Funding Primary Care Improvement Fund 24.220 6.055 5.243 0.813 12.595 3.149 3.149 0.000 11.626 2.907 2.094 0.813 Primary Care Transformation Fund 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Sub Total 24.220 6.055 5.243 0.813 12.595 3.149 3.149 0.000 11.626 2.907 2.094 0.813 TOTAL 72.887 19.665 18.636 1.029 37.901 10.226 10.226 0.000 34.986 9.439 8.410 1.029 Annual Budget 2023/2024 Year to Date South Lanarkshire IJB - 48% Share Led by the South Partnership Annual Budget 2023/2024 Year to Date Annual Budget 2023/2024 Year to Date North Lanarkshire IJB - 52% Share
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12 Appendix 4 North Lanarkshire IJB Budget Reconciliation 2023/24 Appendix 4 2023/24 NHSL Financial Allocation to North Lanarkshire HSCP £m 2023/24 NLC Financial Allocation to North Lanarkshire HSCP £m 2023/24 North Lanarkshire HSCP Financial Allocation 333.065 2023/24 North Lanarkshire HSCP Financial Allocation 190.727 Set-Aside Budget 70.502 NLC Funding - Housing Services 1.945 South Hosted @ 52% 37.901 NLC Funding - Transport Services 0.551 Family Health Service South @ 52% 116.616 Pay Award Drawdown from Reserves 3.176 NHSL Financial Allocation at 30 June 2023 558.084 NLC Financial Allocation at 21 July 2023 196.399
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13 Appendix 5 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NLC Long Covid Contingency 1.949 (1.199) 0.750 NHSL Prescribing Fund 4.361 4.361 NLC Social Care Demand 8.591 0.946 (3.000) 6.537 14.901 (0.253) (3.000) 11.648 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Contingency Balance Held By NHSL 8.060 (0.006) 8.054 8.060 (0.006) 0.000 8.054 LEAD RISK-BASED RESERVES TOTAL RISK-BASED RESERVES LEAD CONTINGENCY FUND RESERVES TOTAL CONTINGENCY FUND RESERVES North Lanarkshire IJB APPENDIX 5 Movement on Reserves Audit Trail NHSL & NCL Opening Balance As At 1 April 2023 Proposed Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Ring-Fenced Reserves 23.936 0.000 (2.760) 21.176 NHSL & NLC Earmarked Reserves 44.497 0.084 (1.248) 43.333 NHSL & NLC Risk-Based Reserves 14.901 (0.253) (3.000) 11.648 NHSL Contingency Reserves 8.060 (0.006) 0.000 8.054 NHSL & NLC Closed Reserves 6.552 0.175 (6.727) 0.000 97.946 0.000 (13.735) 84.211 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Alcohol and Drug Partnership - Long Acting Buprenorphine 0.255 0.255 NHSL Area Wide Services - Refugees and Displaced Persons 0.250 0.250 NHSL Blood-Borne Viruses Services 0.171 0.171 NHSL Children and Adolescent Mental Health Services 4.101 (0.108) 3.993 NHSL Community Living Change Fund 1.298 1.298 NHSL Covid-19 Funding 0.007 0.007 NHSL District Nursing - Scottish Government Funded 0.376 (0.164) 0.212 NHSL Hospital at Home Services - Support Development 0.621 (0.012) 0.609 NHSL Learning Disabilities Health Checks 0.246 0.246 NHSL Long Covid Pathways 0.764 (0.155) 0.609 NHSL Medical Director - Child Death Review Funding 0.012 (0.010) 0.002 NHSL Mental Health and Learning Disability Services - Action 15 3.930 (0.930) 3.000 NHSL Mental Health and Learning Disability Services - Distress Brief Intervention 3.155 (0.570) 2.585 NHSL Mental Health - Diagnostic Support Service Dementia Post 0.751 0.751 NHSL Mental Health Eating Disorders 0.070 0.070 NHSL Mental Health Neurodevelopmental Pathways 0.100 0.100 NHSL Mental Health Perinatal, Infant, Maternity and Neonatal 0.005 0.005 NHSL Mental Health Psychology Posts 0.670 (0.432) 0.238 NHSL Mental Health Recovery Renewal - Facilities Projects 1.840 1.840 NHSL Mental Health Wellbeing in Primary Care Services 0.148 0.148 NHSL North Planning Band 2-4 Posts 0.933 (0.377) 0.556 NHSL Staff Wellbeing 0.254 0.254 NHSL Test and Protect Funding 0.520 0.520 NHSL Third Sector Initiatives To Improve Health 0.306 0.306 NHSL Unscheduled Care Funding 3.120 3.120 NHSL Upper GI Dietetics Band 4 0.033 0.033 23.936 0.000 (2.760) 21.176 LEAD SUMMARY 2023/24 TOTAL RING-FENCED RESERVES LEAD RING-FENCED RESERVES Total
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14 Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Adult Social Care Winter Preparedness Fund 1.941 1.941 NLC Adaptations Fund 0.289 0.099 0.388 NLC Adult Protection (share with C&F and NHSL) 0.050 0.050 NLC Advocacy Services 0.118 0.118 NHSL Area Wide Services - Health Promotion - North Lanarkshire Leisure agreement 0.123 0.123 NHSL Area Wide Services - Primary Care Corporate (iHUB Project - NES funding) 0.034 0.034 NHSL Breast Feeding Team (2 year funding) 0.828 0.828 NHSL Business Case - Health Care Support Workers, Multi-Disciplinary Teams 1.797 (0.595) 1.202 NLC Business Case - Non-Recurring NLC Costs 3.811 0.001 3.812 NHSL Care Homes Allocation 0.318 0.318 NLC Carers Act 2018 - Support 2.643 0.058 2.701 NHSL Champions Board Funding 0.172 0.172 NHSL Children and Adolescent Mental Health Services - Udston Top Up Funding 0.346 0.346 NHSL Childrens Services - Paediatric Band 7, Band 6 x 4.12 WTE, Band 2 x 9.59 WTE 0.414 (0.045) 0.369 NHSL Development of Chryston Community Health Clinic 0.212 0.212 NHSL Dietetics Services - Double Running Costs 0.110 (0.005) 0.105 NLC Digital and IT Strategy Technology Improvements - Community Alarms 0.588 0.588 NLC Digital and IT Strategy Technology Improvements - Home Support Scheduling System 3.776 3.776 NLC Digital and IT Strategy Technology Improvements - Other 0.566 0.566 NLC Digital and IT Strategy Technology Improvements - SWIS 0.700 0.700 NHSL Discharge Support Workers Band 4 x 2 WTE 0.107 0.107 NHSL Distinction Awards 0.036 0.036 NLC Financial Strategy - Changes to LA Services Muirpark 1.099 (0.499) 0.600 NHSL Forensic Band 3 x 5 WTE 0.147 (0.030) 0.117 NHSL GPIT Reprovisioning Gap 0.181 0.181 NHSL Health Inequalities - Screening 0.071 (0.007) 0.064 NHSL Health Visiting Students/Trainees 0.484 (0.079) 0.405 NLC Home Support Resilience (2 year funding) 3.498 0.148 3.646 NHSL HR Employability Team (2 year funding, 50:50 split between North and South) 0.187 0.187 NLC IJB Helpline (2 years funding) 0.575 0.575 NHSL Integrated Authority Support 4.926 4.926 NHSL Kylepark Works 1.578 1.578 NLC Mental Health Social Workers 2 x NL10 x 24 months 0.069 0.120 0.189 NHSL Mental Health Wards Window Replacement 0.650 0.650 NHSL Minor Capital Works 1.162 (0.088) 1.074 NHSL Neonatal & Paediatrics Dieteics Intervention (3 year funding) 0.550 0.550 NHSL Organisational Development Fund 0.260 0.260 NHSL Paediatric Diabetes Insulin Pumps and Additional Staff 0.881 (0.021) 0.860 NLC Planned Date of Discharge - Discharge To Assess 0.304 0.304 NLC Planned Date of Discharge - Locality Social Work Manager Post 0.077 0.077 NHSL Podiatry Services - Foot Screening 0.426 (0.023) 0.403 NHSL Prisioner Healthcare - Transitional Project Band 8A 0.070 0.070 NHSL Psychology Posts 2 x Band 6 0.098 0.098 NHSL Regrading of Posts Including Backpay 0.250 0.250 NHSL Scottish Clinical Leadership Fellowship 0.100 (0.005) 0.095 NHSL Sexual Health Services - Forensic Medical 0.175 0.030 0.205 NHSL Sexual Health Services - Long-Acting Reversible Contraception (LARC) 0.491 0.491 NLC Social Care Contracting Staff within Quality Assurance Services 0.003 0.157 0.160 NLC Social Care Regrading of Staff (SSW, SP, SW, OT, TL and TM) 3.169 (0.346) 2.823 NLC/NHSL Staff Training Academy 2.400 2.400 NHSL Stigma Free Lanarkshire (3 year funding) 0.450 0.450 NHSL Supervisor Training 0.065 0.065 NLC Violence Against Women (Joint Initiative with SLC and C&F) 0.030 0.030 NHSL Vulnerable and Complex Cases - Test of Change 1.092 (0.035) 1.057 44.497 0.084 (1.248) 43.333 LEAD EARMARKED RESERVES TOTAL EARMARKED RESERVES Opening Balance As At 1 April 2023 Transfers To / From Reserves Drawdown from Reserves Revised Balance As At 31 March 2024 £m £m £m £m NHSL Alcohol and Drug Partnership Funding 2.926 (2.926) 0.000 NHSL Alcohol and Drug Partnership - Local Implementation Plan 0.167 (0.167) 0.000 NHSL Area Wide Services - NES Training 0.132 0.006 (0.138) 0.000 NHSL Assistive Technology Contract x 12 months (ATC) 0.008 (0.008) 0.000 NHSL Learning Disabilities Band 3 x 4 FTE 0.118 (0.118) 0.000 NLC Local Government Pay Award 23/24 2.653 0.177 (2.830) 0.000 NHSL Mental Health Covid Clinicians (Cossette) 0.200 (0.200) 0.000 NHSL Mental Health Pharmacy Recovery Plan 0.175 (0.175) 0.000 NHSL NES SLA Pharmacy Training 0.173 (0.173) 0.000 6.552 0.175 (6.727) 0.000 CLOSED RESERVES TOTAL CLOSED RESERVES LEAD
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15 Analysis of Additional Employee Costs 2023/2024 Appendix 6 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 63,500 21,000 29,000 54,500 250,000 5,000 423,000 2 63,500 21,000 29,000 54,500 250,000 5,000 423,000 3 71,000 24,728 23,000 54,000 223,198 5,000 400,926 4 0 5 0 6 0 7 0 8 0 9 0 10 0 11 0 TOTAL 198,000 66,728 81,000 163,000 723,198 15,000 1,246,926 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ TOTAL £ 1 42,416 - 2,717 1,571 406,062 -13,522 439,244 2 62,289 2,876 25,213 6,576 389,942 32,744 519,640 3 27,805 2,262 9,143 - 405,161 36,290 480,661 4 53,866 53,866 5 0 6 0 7 0 8 0 9 0 10 0 11 0 12 0 TOTAL 132,510 5,138 37,073 8,147 1,201,165 109,378 1,493,411 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Social Care Services £ Home Support £ Other £ TOTAL £ 1 15,591 5,617 9,055 25,740 47,690 4,691 87,355 5,664 201,403 2 13,874 6,412 7,221 23,070 40,800 86,847 309,302 4,051 491,577 3 13,617 5,469 5,833 24,261 40,383 105,859 304,161 2,651 502,234 4 85,974 314,146 400,120 5 0 6 0 7 0 8 0 9 0 10 0 11 0 12 0 TOTAL 43,082 17,498 22,109 73,071 128,873 283,371 1,014,964 12,366 1,595,334 North West Locality £ North East Locality £ Adult Services £ Children Services £ Mental Health £ Other £ TOTAL £ 1 6,273 4,839 7,436 7,174 11,599 2,093 39,414 2 3,055 1,717 5,869 5,494 6,373 2,626 25,134 3 4,200 2,878 7,399 5,563 6,369 972 27,381 4 0 5 0 6 0 7 0 8 0 9 0 10 0 11 0 TOTAL 13,528 9,434 20,704 18,231 24,341 5,691 91,929 BANKAIDE COSTS YEAR TO DATE OVERTIME COSTS YEAR TO DATE EXCESS PART TIME COSTS YEAR TO DATE Period Period Period Period AGENCY COSTS YEAR TO DATE Appendix 6
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1 REPORT Item No: 12 SUBJECT: IJB Membership TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Stacey Connor, Governance Support Manager DATE: 27 September 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☒ To note ☐ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐ Prepared on behalf of the integration joint board chair.
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2 3. RECOMMENDATIONS 3.1 The Integration Joint Board (IJB) is asked to: 3.1.1 Endorse the proposed membership of Dr Josephine Pravinkumar as a professional advisor to the board on public health related matters. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 The Public Bodies (Joint Working) (Scotland) Act 2014, set out a range of requirements around IJB membership, which supported the North Lanarkshire IJB in preparation of the Integration Scheme. 5.2 At present, the Integration Scheme does not include any Public Health specialist in the membership of the IJB. Given the significant current focus, as set out in the Strategic Commissioning Plan, around tackling inequalities and developing our role as an anchor institution, it feels timely to review the Board membership to fill this gap. 5.3 It is therefore proposed that following discussion with colleagues in NHS Lanarkshire, that Dr Josephine Pravinkumar, Director of Public Health, be added as an additional professional advisor to the IJB. 6. CONCLUSIONS 6.1 Given the continued focus on population health and inequalities, it is felt that there is an ongoing gap in IJB membership in relation to Public Health. Inviting the NHS Lanarkshire Director of Public Health to join the IJB as an additional professional advisor would provide expertise to the IJB to support its strategic decision making. 7. IMPLICATIONS N/A 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes Yes ☐ No ☒ N/A ☐
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3 People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) N/A 7.3 FINANCIAL N/A 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 Yes ☐ No ☐ N/A ☒
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4 ☐ 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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5 8. BACKGROUND PAPERS None 9. APPENDICES Please include a glossary of terms if not already included. None. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Ross McGuffie Ross.McGuffie@lanarkshire.scot.nhs.uk
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6 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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1 REPORT Item No: 13 SUBJECT: Whistleblowing TO: Integration Joint Board Lead Officer for Report: Ross McGuffie Chief Officer North HSCP Author(s) of Report Stacey Anderson, Support Services Project Manager Lesley McDonald, Non-Executive Director DATE: 27 September 2023 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 Board is asked to note the update and the content of each Whistleblowing report and seek assurance that whistleblowing standards are being followed and learning shared. 4. VARIATIONS TO DIRECTIONS? Yes ☐ No ☒ N/A ☐ 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 “Whistleblowing” refers to the act of reporting concerns or wrongdoing in the public interest either within an organisation or externally, for example to a regulator. The law on whistleblowing is contained within the Employment Rights Act 1996 as amended by the Public Interest Disclosures Act 1998. 5.2 The Public Interest Disclosures Act 1998 gives protection to workers who have blown the whistle, but only if their disclosure meets statutory requirements. There are other steps an employer can take not mandated by the law to encourage effective internal whistleblowing and to protect whistle blowers; the most important of which is to develop and implement an effective and appropriate whistleblowing policy. 5.3 Both the North Lanarkshire Council and NHS Lanarkshire’s Whistleblowing Policy each provides a mechanism for employee within the Council and the NHS to report a concern about serious wrongdoing within the Council or NHS and to do so with security and in confidence. 5.4 The annual review of both the North Lanarkshire Council and the NHS Lanarkshire Whistleblowing Policy has been undertaken on the use of the Whistleblowing Policies and on any amendments required to the Policies. Copies of each report is attached within the Appendices. 5.5. The North Lanarkshire Annual Review of Whistleblowing Procedure 2022-23 details that the North Lanarkshire Council’s Whistleblowing Procedure has been reviewed with the following key findings: No amendments requiring approval are considered necessary at this time. This is on the basis that the principal objectives of the policy and procedure remain. Since the last review in 2022, Health and Social Care received one whistleblowing report.
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3 The report remains under investigation and is expected to conclude shortly. 5.6 The National Whistleblowing Standards and Once for Scotland whistleblowing policy (the Standards) were introduced on 1 April 2021. NHS Lanarkshire’s performance against the Key Performance Indicators included in the Standards has been reported to the Staff Governance Committee and the board on a quarterly basis. In addition to quarterly reporting boards are also required to prepare an annual report The key findings of the NHS Lanarkshire Whistleblowing Annual Report for April 2022- March 2023 include: 3 concerns were investigated under the Standards during 2022/2023 All 3 of the concerns related to independent primary care contractors None of the concerns were upheld. All 3 of the investigations were granted an extension. Learning from the concerns include reviewing clinical supervision in line with best practice and reviewing the hybrid model of appointments, communication and organisational structures and TURAS training compliance. 4 concerns originally raised as potential whistleblowing concerns were dealt with under HR procedures. A review by the Internal Audit Consortium of Lanarkshire of the introduction of the Standards was positive in its findings. 6. CONCLUSIONS Regular review of the Whistleblowing Procedures and Annual Reports from both North Lanarkshire Council and NHS Lanarkshire will be provided to the IJB to help provide assurance that good Whistleblowing standards are being upheld across the Health and Social Care Partnership. 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 ☐
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4 Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ 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: Yes ☐ No ☒ N/A ☐ 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner NA 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
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5 outcomes ☒ Provide stakeholders with information on how to get involved Information on Whistleblowing is shared across both organisations □ 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: Yes ☐ No ☐ N/A ☒ EQIA added to website: Yes / Date added ☐ No ☐ N/A ☒ 8. BACKGROUND PAPERS
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6 None. 9. APPENDICES Please include a glossary of terms if not already included. Appendix 1– North Lanarkshire Council Annual Review of Whistleblowing Procedure. Appendix 2– NHS Lanarkshire Whistleblowing Annual Report – April 2022 to March 2023. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Stacey Anderson Stacey.Anderson3@lanarkshire.scot.nhs.uk
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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 7
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8 Appendix 1 North Lanarkshire Council Report ☒ No From Archie Aitken, Chief Officer (Legal and Democratic) E-mail aitkena@northlan.gov.uk Telephone Executive Summary North Lanarkshire Council’s Whistleblowing Policy provides a mechanism for employees of the Council and other workers within the Council to report a concern about serious wrongdoing within the Council and to do so with security and in confidence. The annual review of the Whistleblowing Policy has been undertaken on the use of the Whistleblowing Policy and on any amendments required to the Policy. Recommendations It is recommended that Committee gives consideration to the contents of the report. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (14) Ensure the highest standards of public protection 1. Background 1.1 “Whistleblowing” refers to the act of reporting concerns or wrongdoing in the public interest either within an organisation or externally, for example to a regulator. The law on whistleblowing is contained within the Employment Rights Act 1996 as amended by the Public Interest Disclosures Act 1998. 1.2 The Public Interest Disclosures Act 1998 gives protection to workers who have blown the whistle, but only if their disclosure meets statutory requirements. There are other steps an employer can take not mandated by the law to encourage effective internal whistleblowing and to protect whistleblowers; the most important of which is to develop and implement an effective and appropriate whistleblowing policy. 2. Report 2.1 There is no positive obligation on an employer to encourage whistleblowing or to implement a whistleblowing policy. The law does provide that employers refrain from dismissing workers or subjecting them to any other detriment because they have made Annual Review of Whistleblowing Procedure Policy and Strategy Committee Does this report require to be approved? ☐ Yes Ref AA/REB Date 16/03/ 23
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9 a protected disclosure.
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10 2.2 As a public body, North Lanarkshire Council is expected to have a whistleblowing policy as our whistleblowing arrangements are considered as part of our annual audit process. Whistleblowing plays an important role in safeguarding effective delivery of public services and ensuring best value. North Lanarkshire Council is committed to a culture which views raising concerns of malpractice as a valuable contribution towards its efficiency and long-term success, and assuring workers that they will be treated fairly and that their concerns will be properly addressed. Annual Review of the Whistleblowing Procedure 2.3 North Lanarkshire Council’s Whistleblowing Procedure has been reviewed and no amendments requiring approval are considered necessary at this time. This is on the basis that the principal objectives of the policy and procedure remain: 2.3.1 to convey the seriousness and importance that North Lanarkshire Council attaches to identifying and remedying wrongdoing; 2.3.2 to encourage workers to raise concerns internally as soon as possible and to give them the confidence to do so; 2.3.3 to remind workers of the standards of behaviour expected of them; 2.3.4 to ensure workers know who to approach with a concern, and to enable them to bypass the person, management level or part of the organisation to which the concern relates; 2.3.5 to outline the procedures for investigating disclosures and what steps might be taken if wrongdoing is uncovered; and 2.3.6. to make it clear what will happen to those who victimise genuine whistleblowers or abuse the system by making malicious allegations. 2.4 North Lanarkshire Council’s Whistleblowing procedure sets out the legal protections available to whistleblowers. There are further sources of help and guidance; 2.4.1 Chief Officers are designated as advisers to whistleblowers in identifying whether the concern falls under one or more of the categories or should be better dealt with under a different procedure; 2.4.2 There is access to an external counselling hotline in terms of the Employee Assistance Programme; and 2.4.3 Protect, the whistleblowing charity who provide a confidential independent helpline for whistleblowers is referred to in the procedure. Annual Review of the use of the Whistleblowing Procedure 2.5 Since the last review in 2022, Health and Social Care received one whistleblowing report. 2.6 The report remains under investigation and is expected to conclude shortly.
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11 3. Measures of success 3.1 Further review of the application of the Whistleblowing Procedure will ensure that the Council’s resources and reputation are being safeguarded and that the Council’s good governance standards are being maintained. 4. Supporting documentation Whistleblowing Policy. Name Archie Aitken Title Chief Officer (Legal and Democratic)
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12 5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts have been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☒ No ☐ If Yes, have all relevant HR impacts have been discussed and agreed with People Resources? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☒ No ☐ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact?
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13 Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services.
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14 Public Interest Disclosures “Whistleblowing” Date 8 February 2023 Version number Document status Final Governance Committee Policy & Strategy Date approved 17 March 2022 Review date April 2023 Strategic Alignment Improving the Council’s Resouce Base – Ensure the highest standards of public protection. aitkena@northlan.gov.uk aitkena@northlan.gov.uk Contact details Archie Aitken Archie Aitken Author Owner
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15 Consultation process Consultation with stakeholders carried out February 2022 Stakeholders Contacts identified for each service Joint Trade Unions JNC for Teaching Staff Distribution Change record ral changes. Date 8 February 2023 Author Rachel Blair Change made
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16 Preamble The purpose of this procedure is to provide a mechanism for employees, officers, consultants contractors and workers to report to the Council a concern which they have that there is serious wrongdoing within the Council – and to do so with both security and confidence. It draws on the rights and obligations contained within the Employment Rights Act 1996, the Public Interest Disclosure Act 1998, and the Enterprise and Regulatory Reform Act 2013. This procedure for reporting concerns at work is based on the following principles: • fair and reasonable treatment at work; • the right to report concerns reasonably believed to be in the public interest; • confidentiality; • openness and accountability, and • honesty and integrity. 1. Introduction 1.1 In the course of your employment you may become aware of serious wrongdoing in the Council or you may have information regarding malpractice. This procedure outlines the steps you should take to bring serious situations to the attention of the Council, and has been designed to provide guidance to employees on reporting incidents of malpractice or wrongdoing. It indicates how matters can be expedited thoroughly, discreetly and, so far as possible, in a confidential way if that is necessary. This procedure outlines:- • what sort of concerns may be reported; • the employees covered by this procedure; • the nominated individuals in the Council who can be contacted regarding your concerns; • the appropriate steps to be taken to report serious wrongdoing or malpractice; • how a matter may be raised in confidence when that is appropriate; • the rights of employees who are the subject of disclosures; • any obligations placed on an employee in terms of bearing witness; • the interest of the Council; • the right to raise matters of concern and not be subject to any detriment, and • the protection which is available to an employee. 1.2 The disclosure of information in the public interest involves the reporting of serious concerns about illegal or unethical conduct or behaviour which could be described as serious malpractice in the workplace. The kinds of concerns are those set out at paragraph 2.2 of this procedure.
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17 1.3. The principles and guidance outlined in this procedure have been developed against the background of the Council’s wish to be open and honest, to encourage high standards of conduct in the workplace and to develop the statutory protections available to employees. 1.4. Any employee who has a concern over what they consider is serious wrongdoing within the Council may wish to seek support and advice from their trade union which may be in a position to assist the employee in preparing and making a disclosure report under this procedure. 1.5 The title given to this procedure is Public Interest Disclosures. It may also be referred to as the “Whistleblowing” Procedure. 2. Reporting Concerns 2.1. Most personal concerns at work can be adequately dealt with using other procedures or mechanisms. For instance, if there is an issue about your working conditions which you cannot resolve through other means, you may wish to use the Council’s Grievance Procedure. The procedure outlined in this document is designed to deal with issues of illegality or serious malpractice. 2.2. The public has a right to expect high standards of service. However, there may be occasions when, due to individual acts, omissions or failings, it may be necessary to bring certain matters which give cause for serious concern to the attention of your employer. If you are concerned about an aspect of individual behaviour or Council practice it may fall under one (or more) of the following categories: • a criminal offence; • a failure to comply with a legal obligation; • a miscarriage of justice; • danger to the health and safety of an individual; • damage to the environment, and • the deliberate concealment of information tending to show any of the matters above is being deliberately concealed. 2.3. Under the terms of this procedure an employee can report a matter which they reasonably believe to be in the public interest, on a confidential basis to their employer regarding any of these six categories. The categories are by no means mutually exclusive. For instance, you may be aware of a health and safety failure that is also a criminal offence. If you are not sure whether the concern you wish to raise falls into one of the above categories then you may contact one of several Council Officers who will try to assist you in identifying whether the concern which you have falls under one or more of these categories or whether your concern should be better dealt with under a different procedure or route. The officers available to advise on this are the Council’s Chief Officer (Legal and Democratic), Chief Officer (Finance) and Chief Officer (People Resources).
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18 2.4 An employee may also be a resident in the Council’s area or have other good reason to approach a local councillor. Such an employee is free to raise an issue with their councillor. However, advising a local councillor of a concern over serious wrongdoing is not a substitute for advising the Council formally by following the Disclosure Report Procedure set out in Section 4. The onus rests on the employee to make the Public Interest Disclosure by following the defined reporting procedure. This will ensure that the Council deals with the matter formally, and in terms of both the legislation and this Procedure. 3. Confidentiality and Anonymity 3.1. One of the principles of this procedure is that an employee has the right to report a matter they consider to be in the public interest and the report will be treated on a confidential basis. For the reporting process to have credibility, employees must have confidence that any matter they draw to the attention of their employer will be handled with discretion and tact. 3.2. The Council hopes that all staff will be able to voice whistleblowing concerns openly under this policy. If an employee wishes to raise their concern confidentially, the Council will make every effort to ensure the employee’s identity is kept a secret. If it is necessary for anyone investigating the employee’s concern to know their identity, this will be discussed with the employee. 3.3. The Council does not encourage staff to make disclosures anonymously. Proper investigations may be more difficult or impossible if the Council cannot obtain further information. It is also more difficult to establish whether any allegations are credible. Whistleblowers who are concerned about possible reprisals if their identity is revealed should come forward to the officers identified at 2.3 and appropriate measures can then be taken to preserve confidentiality. If an employee is any doubt, they can seek advice from Protect (https://protect-advice.org.uk/), the independent whistleblowing charity, who offer a confidential helpline. 3.4. It has to be recognised, however, that in some cases it may not always be possible to preserve total confidentiality, for instance, if the matter reported has to involve agencies such as the police or the Health and Safety Executive. If, in such a situation, the Council can no longer preserve total confidentiality, the employee will be advised of that fact. 4. Reporting Procedure 4.1. An employee wishing to report a matter that is covered by the categories covered in this procedure should contact the appropriate designated officer in the employing Service in the Council. The designated officers are those identified in Annex 1 to this document. This report should, preferably, be in writing and in order to avoid any doubt, should be described as a “Public Interest Disclosure”.
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19 4.2 This procedure requires that disclosure reports should be made to the designated officers. Those designated offers are required to be alert to such disclosures and ensure that, as far as it is possible, the confidentiality of such reports is maintained. This will normally involve the report having the personal attention of the designated officer. 4.3 If a disclosure report is made which alleges wrongdoing by a Council Chief Officer (the Deputy Chief Executive or Chief Officer) that report should be made directly to the Chief Executive. 4.4 Once a report has been submitted the appropriate officer will advise you of the next steps and any expected timescale. This will be done within 5 working days. 4.5 At this stage of the process it is important that confidentiality is maintained by both parties where that is required to ensure that the matter can be dealt with in the appropriate way, avoid prejudice and protect individual rights. 4.6 The report will then be considered and a decision taken as to whether, and in what way, the matter should proceed. 4.7 Should the appropriate officer decide not to take any action you will be notified and given the reason(s) for this decision. 4.8 If the appropriate officer decides that further action is required on the basis of your report, then you will be notified of the decision, subject to the appropriate investigation and the likely timescale, if possible to do so. 4.9 Once the matter has been concluded and the appropriate action taken in response to your report, you will be notified of the outcome. However, sometimes the need for confidentiality may prevent the Council from giving you specific details or any disciplinary action taken as a result. You should treat any information about the investigation as confidential. 4.10 Under the terms of this procedure, you may seek a progress update from the appropriate officer regarding the status of your report, although it has to be understood that the response may have to be qualified in order to protect other interests. 4.11 While the Council cannot guarantee, the outcome you are seeking, the Council will try to deal with your concern fairly and in an appropriate way. By using this procedure, you can help the Council achieve this. 4.12 If you are not satisfied with the way your report has been dealt with, you can raise this with the Chief Executive. 5. Safeguards 5.1 Under the terms of this procedure, any employee making a Public Interest Disclosure report is safeguarded against any detriment in the course of their employment, provided that the report is made in the reasonable belief that it is in the public interest.
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20 5.2 For the purpose of this procedure, detriment is defined as any act or omission that penalises the employee for submitting the report. For example, dismissal, harassment, victimisation or any other form of punitive sanction which would not have arisen were it not for the report having been made are prohibited under the terms of this procedure. If you believe that you have been subjected to a detriment, you should immediately report that to the officer who received your disclosure report. If the matter is not remedied, you should raise it formally through the Council’s Dignity at Work procedure. 5.3 An employee must not threaten or retaliate against another employee making a Public Interest Disclosure Report. Any employee involved in such conduct, may be subject to the Councils’ disciplinary procedure. In addition, if an employee is subjected to such detriment by another employee then that other employee could be personally liable. 6. Wrong Reports 6.1 There may be instances when a report is submitted, based on a genuine belief by the employee that something is wrong at a particular time, which is subsequently demonstrated to be false or inaccurate. In such circumstances, employees will be informed of the discrepancy between their report and the facts at hand. Provided that the Council is satisfied that the employee acted in good faith and had a genuine belief that such a situation should be reported and no personal gain was involved, no further action will be taken against the reporting employee. 6.2 If an employee has deliberately submitted a report that they know to be not true or unfounded or with a view to personal gain then they may be subject to the Council’s disciplinary procedure. 7. Reporting Outwith the Council 7.1 The aim of this procedure is to provide an internal mechanism for reporting, investigating and remedying any wrongdoing in the workplace. In most cases you should not find it necessary to alert anyone externally. 7.2 The law recognises that in some circumstances it may be appropriate for you to report your concerns to an external body such as a regulator. It will very rarely if ever be appropriate to alert the media. You are strongly encouraged to seek advice before reporting a concern to anyone external. Protect’s confidential helpline is available for this. In addition, Protect has a list of prescribed regulators for reporting certain types of concern. 7.3 Whistleblowing concerns usually relate to the conduct of our staff, but they may sometimes relate to the actions of a third party, such as a supplier or service provider. In some circumstances the law will protect you if you raise the matter with the third party directly. However, you are encouraged to report such concerns internally first. You should contact one of the other key contacts set out in paragraph 2.3 for guidance. 7.4 Employees within Health and Social Care can access the National Whistleblowing Standards in relation to NHS Services. Further information can be obtained from the Chief Accountable Officer or accessed here.
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21 ANNEX 1 CHIEF OFFICERS TO WHOM PUBLIC INTEREST DISCLOSURES MAY BE REPORTED – WHISTLEBLOWING PROCEDURE 1. Chief Executive’s Service Des Murray, Chief Executive 2. Enterprise and Communities Service Derek Brown, Deputy Chief Executive 3. Education and Families Service Derek Brown, Deputy Chief Executive 4. Adult Health and Social Care Services Ross McGuffie, Chief Officer (Health and Social Care)
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22 Appendix 2 Whistleblowing Annual Report – April 2022 to March 2023 1. Introduction The National Whistleblowing Standards and Once for Scotland whistleblowing policy (the Standards) were introduced on 1 April 2021. NHS Lanarkshire’s performance against the Key Performance Indicators included in the Standards has been reported to the Staff Governance Committee and the board on a quarterly basis. In addition to quarterly reporting boards are also required to prepare an annual report, the contents of which are outlined in the Standards. 2. Key findings 3 concerns were investigated under the Standards during 2022/2023 All 3 of the concerns related to independent primary care contractors None of the concerns were upheld. All 3 of the investigations were granted an extension. Learning from the concerns include reviewing clinical supervision in line with best practice and reviewing the hybrid model of appointments, communication and organisational structures and TURAS training compliance. 4 concerns originally raised as potential whistleblowing concerns were dealt with under HR procedures. A review by the Internal Audit Consortium of Lanarkshire of the introduction of the Standards was positive in its findings. 2. Key Performance Indicators 2.1 Cumulative total – Whistleblowing Concerns Raised 2022/23 Quarter Appropriate for whistleblowing Stage 1 Stage 2 Outcome Comments 1 1 0 1 Not upheld Outcome confirmed to individual concerned. 2 0 n/a n/a n/a 3 1 0 1 Not upheld Concern related to primary care provider 4 1 0 1 Not upheld Concern related to primary care provider
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23 Total 3 0 3 See above See Above
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24 2 The Standards require stage 1 concerns to be completed within 5 working days and Stage 2 concerns to be completed within 20 working days. The table below shows the number and percentage of concerns at each stage which were closed in full within the set timescales of 5 and 20 working days, for 2022/23. This reflects any extensions agreed. Nos received % closed in 5 working days Nos received % closed in 20 working days Stage 1 0 n/a Stage 2 3 0 The table below shows concerns raised in 2022/23 where an extension was authorised. Concern Nos received Extension authorised As % of all concerns Stage 1 0 0 n/a Stage 2 3 3 100 None of the three cases raised were investigated within 20 working days. All three cases related to concerns about issues within independent primary care practices and the latter two cases were about the same practice. The individuals who raised the concerns were kept appraised of the timescales and reasons for the delays, which included sickness absence, annual leave, diary commitments and the complexity of the investigations. In light of these delays it has been decided to refresh communication with independent primary care practitioners, in conjunction with the appropriate medical director and head of primary care. 3. Analysis of numbers of concerns raised Three concerns were raised during 2022/23 and this compares to three during 2021/22, two during 2019/2020, one during 2018/19, three during 2017/18 and none during 2016/17, so numbers remain fairly constant. Figures recently published by the INWO indicate that a total of 106 concerns were handled by 22 Boards during 21/22 which would suggest that NHS Lanarkshire received slightly fewer than the national average during that year. Figures have not yet been published for 2022/23. 4. Further information on the 3 concerns raised during 2022/23, including service improvements and shared learning. 4.1 The first complaint raised in April 2022 was reported to the Staff Governance Committee in September 2022. The concern related to an independent primary care contractor and included allegations of financial impropriety and references to behaviours which would be more appropriately addressed under the primary care contractor’s HR policies. The concern was investigated at Stage 2 by three managers from NHS Lanarkshire, including the then Deputy Director of Finance and the Primary Care manager. The complaint was not upheld and the individual was notified and informed of their right to go to the Independent National Whistleblowing Officer (INWO).
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25 3 4.2 The second complaint was raised directly with the INWO by an individual who had resigned from the practice. The nature of the concern included training, clinical supervision, continuous professional development, skill mix, use of locums and prescribing practices. A lengthy and detailed investigation into the concerns was led by a director from the group of practices in question and HR support was provided by NHS Lanarkshire (NHSL). The individual who raised the complaint was also provided with support from one of NHSL’s confidential contacts. Although the complaint was not upheld a number of improvements are being made as a result of the investigation. These include a review of best practice in clinical supervision, engagement with the Board’s pharmacy team to look at clinician specific reporting, review of the hybrid model of appointments, ensuring clarity around organisational structures, escalation processes and contingency arrangements and ensuring that senior team and site managers have undertaken the TURAS whistleblowing training modules. 4.3 The third complaint was also raised directly with the INWO in January 2023 by an individual who had left the same group of practices. The complaint covered allegations of poor and unsafe clinical practices, including lack of skill mix, inadequate support and poor management procedures including a lack of employer duty of care. Although the complaint was not upheld a number of improvements are being made as a result of the investigation, including a review of clinical supervision, review of hybrid model of appointments, and identification of mental health first aid training. 5. Whistleblowing themes, trends and patterns The analysis of themes from whistleblowing concerns aids identification of any shared causes and helps to progress learning and improvement in a targeted manner. The categories/classification for whistleblowing concerns are listed in Part 2 of the Standards and are outlined below for information: Patient Safety Patient Care Poor practice Unsafe working conditions Changing or falsifying information on performance Fraud Breach/breaking any legal obligation Abusing authority Concealment of any of the above The three concerns raised would be classified as relating to patient care and safety, poor practice and fraud. Two of the concerns relate to the same independent primary care practice and, although not upheld, share the same themes of patient care and safety and poor practice. The learning and improvements resulting from the investigation are therefore being targeted and progressed in these areas. As all three whistleblowing concerns raised during 2022/2023 related to independent primary care practices, a review of the implementation of the Standards in these areas will be considered. Follow
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26 4 up will be arranged in six months with the practices involved in order to seek reassurance that safe and effective systems of clinical governance are in place. Whilst it is anticipated that the practices in question will fully cooperate with any such requests, Board members should be reassured that, ultimately, independent primary care practices can be compelled to provide such information under the requirements of Schedule 6 of The NHS (GMS Contracts) (Scotland) Regulations 2018. 6. Independent primary care contractors Three concerns were raised about primary care contractors, the details of which are included above. No other concerns were received. The Primary Care department requests quarterly information from all independent primary care contractors regarding the number of whistleblowing concerns raised. There are 455 primary care contractors in NHS Lanarkshire, including medical practices, pharmacists, dentists and optometrists. The table below provides more information and efforts are underway to improve return rates. Primary Care Whistleblowing Returns 2022/2023 Medical (%) Dental (%) Optometry (%) Pharmacy (%) Response 82 60 48 17 No Response 18 40 52 83 7. Experience of Individuals Raising Concern/s during 2022/23 The individuals who raised the concerns have left the practices in question and were not employees of NHS Lanarkshire. Regarding the second two complaints, the group of practices are involved in separate legal issues and further comments around experiences would be inappropriate at this stage. A further indicator of the satisfaction of those who raise concerns can be derived from the number of concerns escalated to the INWO after having been considered by NHS Lanarkshire. No referrals were made to the INWO after having been investigated but two concerns were raised directly with the INWO and these are detailed above. 8. Concerns raised as whistleblowing which were dealt with through other HR policies In addition to the cases outlined above which were dealt with through the whistleblowing Standards, four other concerns were logged via uMatter. After carefully considering the cases against the checklist and definitions in the Standards and using the protocols developed locally for this purpose, it was concluded by the HR and NMAHPs directors that these cases should be more appropriately dealt with using other HR policies. The individuals concerned were advised of this in writing and referred to more appropriate
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27 5 policies including Grievance and Bullying and Harassment. They were also advised of their right to contact the INWO about this decision. 9. Review of Whistleblowing 2022-2023 by the Internal Audit Consortium of Lanarkshire The systems in place to ensure compliance with the Whistleblowing Standards were reviewed during the summer and autumn of 2022. The review was undertaken in accordance with the 2022/2023 Operational Audit Plan and the final report was issued on 8th November 2022. A copy of the report is attached for information. Based on the examination of the control structure and the procedures in place, the report concluded that the system provides “substantial” assurance that objectives are met and that a “robust framework of controls ensures objectives are likely to be achieved, with controls being applied continuously or with minor lapses”. As a result of this review a communications plan has been developed, the format of the HR Standard Operating Procedure for whistleblowing has been amended. 10. Communication, Awareness and Training Since the soft launch of the Standards at the beginning of 2021 regular items have appeared in the staff briefing and in the Pulse on-line. Details of confidential contacts have been publicised and a separate briefing has also been sent to all primary care contractors, along with supporting documentation to enable independent contractors to record and report cases. The non-executive whistleblowing champion has presented to the two Health & Social Care Partnerships and Acute management teams and presentations have also been made to both the GP and GDP Sub Committees. Meetings have also been held with both PFI contractors to confirm that the Standards will be made available to their staff who provide services to NHS Lanarkshire patients and the non- executive whistleblowing champion has delivered presentations to the PFI management teams at University Hospitals Hairmyres and Wishaw. Managers in PSSD have been asked to circulate leaflets on whistleblowing for staff who do not have easy access to email. National Speak Up Week took place between 3rd and 10th October 2022 and NHS Lanarkshire’s approach focussed on awareness raising about the Standards, promotion of the role of the confidential contacts, using the annual report to evidence improvement as a result of whistleblowing and focussed work with managers and leaders. Staff side colleagues played a key role in promoting the week and examples of how we engaged with the campaign include: Articles appearing in the staff briefing and the Pulse, a banner on FirstPort as well as “footers” on emails and MS Teams. One of the articles was based on a concern raised through a confidential contact in 2021 and the confidential contact highlighted her role in receiving and taking forward the complaint. The Chief Executive also referenced Speak Up Week in her weekly video to staff. In addition to sharing INWO posts the main NHS Lanarkshire Twitter banner was updated to promote the week and a video from the whistleblowing champion was shared on the Wednesday to coincide with the INWO’s promotion of the role on that day.
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28 6 An email was sent to all in NHS Lanarkshire using content from the Pulse article and speaking up was also promoted across sites by circulating posters and leaflets. Staff side colleagues discussed at branch and other trade union meetings how best they could raise awareness during the week and when they were out in the service discussing the pay ballot. The whistleblowing lead and champion attended a leadership development programme and presented on speaking up and the role of the manager and leader. Participants had previously read an article from the Harvard Business Review and also watched a Ted Talk on whistleblowing. Communication has continued since Speak Up Week with regular articles in the staff briefing. In response to a recommendation contained in the review of whistleblowing carried out by the Internal Audit Consortium of Lanarkshire a communication plan has been developed and is attached to this report. Further awareness raising will take place across University Hospital Wishaw through the focus groups which will meet following completion of the Just Culture survey. It has also been confirmed that the following statements will be included in the iMatter staff engagement survey this year: “I am confident that I can safely raise concerns about issues in my workplace” and “I am confident that my concerns will be followed up and responded to”. It is anticipated that responses to these questions will enable us to further focus on specific departments where further awareness raising might be necessary. Training on the Standards is available through TURAS via three modules which provide an overview, a module for line managers and one for senior managers. NHS Education for Scotland (NES) provides monitoring information on the uptake of the training. During 2022/2023 216 modules were completed and since the introduction of the Standards, in April 2021, 427 modules have been completed. 11. Confidential Contacts There are six confidential contacts in NHS Lanarkshire, all of whom have completed the training modules. Their contact details are regularly publicised in briefings and in the Pulse on line and they are also available on NHS Lanarkshire’s intranet. Two of the confidential contacts are designated for private contractors, including PFIs and one is designated specifically for independent primary care contractors. A network for the confidential contacts has been established to enable them to meet with the Non- Executive Whistleblowing Champion and the HR Director on a bi-annual basis. They are also encouraged to engage with the Scottish Speak Up Network. 12. Priorities for 2023/24 During 2023/24 it is intended to focus on the following areas: 1. Implementation of the communication plan 2. Improving uptake of TURAS whistleblowing training. 3. Use the INWO’s Speak Up week in October to further promote and celebrate speaking up. 4. Review of responses to iMatter questions about whistleblowing.
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29 7 5. Improving return rates and raising awareness in independent primary care contractors. 13. Concluding remarks by Whistleblowing Champion Whistleblowing is intended to reassure staff that, where they have a concern about practices in their workplace that they don’t feel comfortable discussing with their manager, they can raise their concern with confidence that it will be investigated and addressed. My role as NHS Lanarkshire’s Whistleblowing Champion is to monitor and support the effective delivery of its whistleblowing policy, providing assurance to the Board that the organisation has appropriate systems in place and raising any issues of concern. I have been supported in this role by the Executive Lead, Kay Sandilands, HR Director and Eddie Docherty, Director of NMAHPS who worked with Kay to discuss concerns received, identify those which fell within the whistleblowing policy and ensuring that any concern was directed to an appropriate policy or process to be addressed. Our strong, enthusiastic and active network of confidential contacts supported the implementation of the Standards and were invaluable in supporting those raising concerns. Ruth Hibbert, Head of HR, Policy & Governance, held everything together in coordinating the implementation of the Standards and monitoring concerns from receipt to Board report as well as promoting the Standards. Staff side colleagues were also integral in promoting whistleblowing with their members, I am grateful to every one of them for their wise counsel and contribution. Work continues to ensure that the Standards are fully embedded across the healthcare system and I endorse the recommendations in this Report in relation to increasing awareness of the Standards across the primary care sector in particular and dealing with concerns timeously and appropriately. I would also encourage increased uptake of the TURAS training module. I consider that NHS Lanarkshire has made satisfactory progress to date. 14. Conclusion The Board is asked to note the implementation update and the content of this performance report and seek assurance that whistleblowing standards are being followed and learning shared. Director of Human Resources August 2023 Appendices Internal Audit Report Communications Plan
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1 REPORT Item No: 14 SUBJECT: Privacy Notice TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Stacey Anderson, Support Services, Project Manager DATE: 27 September 2023 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: Stacey Anderson ☒ Reviewed By: Paul Corrigan, Solicitor ☒ Endorsed By: ☐
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2 3. RECOMMENDATIONS Approve IJB Privacy Notice IJB Privacy Notice to be added to the NL H&SCP Website 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES NL IJB are committed to protecting the privacy and confidentiality of any personal information that we hold. This privacy notice will tell you how we look after your personal information and tell you about your rights. In line with the UK General Data Protection Regulation (“UK GDPR”) and the Data Protection Act 2018 a privacy notice for the IJB has been developed to ensure that personal information is kept secure (Appendix 1). This notice is for all members of the community who may receive services from NL HSCP or give support to other persons who receive those services. It covers those who participate in research, consultations, surveys or community events relating to the work of NL IJB and its development of strategic plans. It is also for any person who makes representations directly to NL IJB, whether in the form of general enquires, complaints or formal information requests. It is, finally, for voting and non-voting members of the Integration Joint Board itself, whose own details may be held either by NL IJB or on behalf of NL IJB. 6. CONCLUSIONS As handling personal data is generally unnecessary in order to devise strategies and monitor of services, NL IJB does not process a large amount of personal data and does not generally process sensitive personal information about users of community health and social care services, or any individuals other than its own Board members. NL IJB will tend to rely upon anonymised, aggregated or statistical data provided by the partner agencies (North Lanarkshire Council and NHS Lanarkshire). One or both of these statutory bodies would generally hold the individual personal data about service users from which the general data reported to NL IJB is derived. However the privacy notice provides assurance to the Board and the public that any data collected by the IJB follows legal guidelines. Yes ☐ No ☒ N/A ☐
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3 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 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. Yes ☐ No ☐ N/A ☒
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4 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: EQIA added to website: Yes ☐ No ☐ N/A ☒
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5 8. BACKGROUND PAPERS None. 9. APPENDICES Appendix 1 – Privacy Notice CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Stacey Anderson Stacey.Anderson3@lanarkshire.scot.nhs.uk Yes / Date added ☐ No ☐ N/A ☒
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6 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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7 Appendix 1 Privacy Notice 1. North Lanarkshire Integrated Joint Board In North Lanarkshire, NHS Lanarkshire and North Lanarkshire Council have integrated the planning and delivery of all community health and social care services. This work is led and directed by the North Lanarkshire Integration Joint Board (NL IJB), with the council and health board working together to deliver those health and social car services through its Health and Social Care Partnership, Health & Social Care North Lanarkshire. The main functions of the NL IJB is to strategically plan and commission the services delegated to it by the two partner bodies. NL IJB is a statutory body established under the Public Bodies (Joint Working) (Scotland) Act 2014. The NL IJB is based at NHS Lanarkshire Head Quarters, Kirklands, Fallside Road, Bothwell, G71 8BB. North Lanarkshire Council is the data controller and responsible for your personal information. North Lanarkshire Council head office is at Civic Centre, Windmillhill Street, Motherwell, ML1 1AB. 2. Commitment to Privacy NL IJB are committed to protecting the privacy and confidentiality of any personal information that we hold. This privacy notice will tell you how we look after your personal information and tell you about your rights. NL IJB will ensure that your personal information is kept secure, in line with the General Data Protection Regulation (“GDPR”) and the Data Protection Act 2018. We will only collect the minimum information necessary to fulfil a particular purpose; when we don't have a need to keep information about you, it will be disposed of in a secure manner. 2.1 Information Commissioner’s Office
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8 You have the right to make a complaint at any time to the Information Commissioner’s Office, the UK data protection regulator who can be contacted via the contact details below, however, we would welcome the opportunity to discuss your concerns with you before you do so: Information Commissioner’s Office Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Phone: 0303 123 1113 (local rate) or 01625 545 745 or visit their: website 3. Data Protection Officer The appointed data protection officer (DPO) within North Lanarkshire Council has also been appointed as the data officer for NL IJB and is responsible for overseeing questions in relation to this privacy notice. If you have any questions about this privacy notice, including any requests to exercise your legal rights, you can contact the DPO via the contact details below: Data Protection Officer Email: DataProtection@northlan.gov.uk North Lanarkshire Council Telephone: 01698 302554 Civic Centre Windmillhill Street Motherwell ML1 1AB 4. The Personal Information We Hold About You and What We Do with It. This notice is for all members of the community who engage with the IJB, covering those who participate in research, consultations, surveys or community events relating to the work of NL IJB and its development of strategic plans. It is also for any person who make representations directly to NL IJB, whether in the form of general enquires, complaints or formal information requests. It is finally for voting and non- voting members of the Integration Joint Board itself, whose own details may be held either by NL IJB or on behalf of NL IJB.
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9 As handling personal data is generally unnecessary in order to devise strategies and monitor of services, NL IJB does not process a large amount of personal data and does not generally process sensitive personal information about users of community health and social care services, or any individuals other than its own Board members. NL IJB will tend to rely upon anonymised, aggregated or statistical data provided by the partner agencies (North Lanarkshire Council and NHS Lanarkshire). One or both of these statutory bodies would generally hold the individual personal data about service users from which the general data reported to NL IJB is derived. On any occasion when NL IJB does process limited personal information relating to a limited number of individuals to conduct NL IJB business (e.g. responding to representations made directly to NL IJB by members of the community, consulting or liaising with partner organisations and individuals to plan and deliver services). NL IJB will use information relating to NL IJB board members and partner organisations and individuals with whom we work with in order to ensure the effective administration of the business of the IJB. NL IJB will also use information to verify the identity of enquires where requires, contact relevant individuals by post, email or telephone, maintain our records and to demonstrate to internal auditors and external regulators that NL IJB are providing proper services in accordance with the law. Your personal information may also be used: • for the prevention and detection of crime • for the apprehension or prosecution of offenders • for the assessment or collection of taxes or duties • to prevent or detect unlawful acts • to protect the public against dishonesty, malpractice or other seriously improper conduct • to prevent fraud (including data matching under local and national fraud initiatives and the Housing Benefit Matching Service). 5. Legal Basis for Using Your Information
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10 NL IJB will use the information referred to above to deliver the functions described in the North Lanarkshire Integration Scheme which has been developed as directed by The Public Bodies (Joint Working) (Scotland) Act in 2014. There are additionally specific statutory requirements in relation to responding to complaints, Freedom of Information requests and Subject Access Requests. The policies on these matters and their legal basis are set out on the website of NL HSCP: Health and Social Care North Lanarkshire (hscnl.org.uk). When personal information is processed, it is because this is necessary for the performance of tasks carried out in the public interest by NL IJB, as set out in the policies and legislations referred to above. In the case of specific enquires requiring responses, if you do not provide the NL IJB with particular information that they have asked for then the NL IJB may not be able to provide these services to you. NL IJB will only process more sensitive personal information about you were absolutely necessary for the purpose of the effective planning and oversight of social care services and the management of health and social care systems as set out in the Data Protection Act 2018. As above, this will seldom be necessary, as personal information will mainly be held by the partner agencies (North Lanarkshire Council or NHS Lanarkshire). NL IJB will not usually ask for sensitive personal data about any identifiable individuals to be submitted directly to them. 6. Keeping Your Information up to Date It is important that the personal information NL IJB hold about you is accurate and current. Please keep NL IJB informed if your personal information changes during your relationship with us. NL IJB don't rent or trade email lists with other organisations and businesses. 7. Purposes for Which NL IJB Will Use Your Personal Data NL IJB will only use your personal information when it is lawful to do so. NL IJB will use your personal information to comply with our legal responsibilities and [insert particular activity to which the privacy notice relates]. 7.1 Change of Purpose
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11 NL IJB will only use your personal information for the purposes for which we collected it, unless NL IJB reasonably consider that we need to use it for another reason and that reason is compatible with the original purpose. If NL IJB need to use your personal information for an unrelated purpose, NL IJB will notify you and will explain the legal basis which allows them to do so. Please note that NL IJB may process your personal information without your knowledge or consent, in compliance with the above rules, where this is required or permitted by law. 8. Sharing your Personal Information As per the guidance for public bodies in Scotland, NL IJB will generally comply with requests for specific information from regulatory and law enforcement bodies where this is necessary and appropriate. However, the main agencies with whom NL IJB will share information are the partner agencies (North Lanarkshire Council and NHS Lanarkshire). This information sharing is covered by a data sharing agreement created by the Lanarkshire Data Sharing Partnership which is publically available: Lanarkshire Data Sharing Partnership North Lanarkshire Council currently holds and processes records on behalf of NL IJB, as set out in the NL IJB Records Management Plan, under the terms of the memorandum of understanding. This means that if enquires or information requests submitted to NL IJB, or work with NL IJB in respect of consultations and development of strategic plans, then contact details of the enquirer and any other relevant information will be held on the North Lanarkshire Council information system on behalf on NL IJB. This Records Management Plan has been approved in terms of the Public Records (Scotland) Act 2011. This data sharing will be done in accordance with the terms of this privacy statement and the specific terms set out in the Data Sharing Agreement and Records Management Plan referred to above. 9. How Long Will We Hold Your Information? NL IJB will only retain your personal information for as long as necessary to fulfil the purposes of which they collected the information for, including for the purposes of satisfying any legal, accounting, or reporting requirements. To determine the appropriate retention period for personal information, NL IJB consider the amount, nature, and sensitivity of the personal information, the potential risk of harm from unauthorised use or disclosure of your personal information, the purposes for which NL IJB process your personal information and whether those purposes can be achieved through other means, and the applicable legal requirements.
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12 Because of the special arrangements for records management between NL IJB and North Lanarkshire Council, the records retention and disposal schedule for NL IJB records is part of the retention schedule of North Lanarkshire Council. Details of retention schedules [665kb] for different aspects of your personal information are available to download. In some circumstances NL IJB may anonymise your personal information (so that it can no longer be associated with you) for research or statistical purposes in which case we may use this information indefinitely without further notice to you. 10. Your Legal Rights Under certain circumstances, you have rights under data protection laws in relation to your personal information. You have the right to: • Request access to your personal information (known as a "data subject access request"). This enables you to receive a copy of the personal information we hold about you and to check that we are lawfully processing it. • Request correction of the personal information that we hold about you. This enables you to have any incomplete or inaccurate data we hold about you corrected, though we may need to verify the accuracy of the new data you provide to us. • Request erasure of your personal information. This enables you to ask us to delete or remove personal information where there is no good reason for us continuing to process it. You also have the right to ask us to delete or remove your personal information where you have successfully exercised your right to object to processing (see below), where we may have processed your information unlawfully or where we are required to erase your personal information to comply with local law. Note, however, that we may not always be able to comply with your request of erasure for specific legal reasons which will be notified to you, if applicable, at the time of your request. • Object to processing of your personal information where we are relying on a legitimate interest (or those of a third party) and there is something about your particular situation which makes you want to object to processing on this ground as you feel it impacts on your fundamental rights and freedoms. You also have the right to object where we are processing your personal information for direct marketing purposes. In some cases, we may demonstrate that we have compelling legitimate grounds to process your information which override your rights and freedoms. • Request restriction of processing of your personal information. This enables you to ask us to suspend the processing of your personal information in the following scenarios: (a) if you want us to establish the data's accuracy; (b) where our use of the data is unlawful but you do not want us to erase it; (c) where you need us to hold the data even if we no longer require it as you need it to establish, exercise or defend legal claims; or (d) you have objected to our use of your data but we need to verify whether we have overriding legitimate grounds to use it.
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13 • Request the transfer of your personal information to you or to a third party. We will provide to you, or a third party you have chosen, your personal information in a structured, commonly used, machine-readable format. Note that this right only applies to automated information which you initially provided consent for us to use or where we used the information to perform a contract with you. • Not be subject to a decision based on solely automated processing if that produces a legal effect concerning you or similarly significantly affects you. Note that this right does not apply if the decision is (i) necessary for entering into, or performance of, a contract between us and you; (ii) authorised by law; or (ii) based on your explicit consent • Withdraw consent at any time where we are relying on consent to process your personal information. However, this will not affect the lawfulness of any processing carried out before you withdraw your consent. If you withdraw your consent, we may not be able to provide certain services to you. We will advise you if this is the case at the time you withdraw your consent. If you wish to exercise any of the rights set out above, please contact NL IJB or the DPO. 11.No Fee Usually Required You will not have to pay a fee to access your personal information (or to exercise any of the other rights). However, we may charge a reasonable fee if your request is clearly unfounded, repetitive or excessive. Alternatively, NL IJB may refuse to comply with your request in these circumstances. 12. What May Be Needed from You NL IJB may need to request specific information from you to help confirm your identity and ensure your right to access your personal information (or to exercise any of your other rights). This is a security measure to ensure that personal information is not disclosed to any person who has no right to receive it. NL IJB may also contact you to ask you for further information in relation to your request to speed up our response. 13. Time Limit to Respond NL IJB try to respond to all legitimate requests within one month. Occasionally it may take longer than a month if your request is particularly complex or you have made a number of requests. In this case, you will be notified and kept updated.
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1 REPORT Item No: 15 SUBJECT: Towards a Fairer North Lanarkshire – Tackling Poverty Strategy 2023 to 2026/ Local Child Poverty Action Report 2022/23 TO: Integration Joint Board Lead Officer for Report: Alison Gordon, Chief Social Work Officer Author(s) of Report John Campbell DATE: 27 September 2023 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: ☐ By: The report was prepared by the Chief Social Work Officer in consultation with the Tackling Poverty Officers Action Group.
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2 3. RECOMMENDATIONS It is recommended that the Board: 1) Endorse the ‘Towards a Fairer North Lanarkshire’ Tackling Poverty Strategy and its associated Action Plan as set out in Appendix 1 of this report, noting that it will be submitted to the Council’s Policy & Strategy Committee for approval. 2) Note the 2022 to 2023 Local Child Poverty Action Report as set out in Appendix 2 of this report, noting this will also be submitted to Council’s Policy and Strategy Committee for approval. 3) Note that this report will also be submitted to the NHS Lanarkshire Health and Population Board for approval of the Local Child Poverty Action Report 2022 to 2023 in line with statutory requirements. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES Background 5.1 The ‘Towards a Fairer North Lanarkshire’ Tackling Poverty Strategy 2020-2023 and its associated Action Plan was approved at the Policy and Strategy Committee Meeting on 11th June 2020. This merged four of the original Plan for North Lanarkshire programme of work priorities for action in order to ensure a better integrated approach which maximised impact and outcomes for our communities. In view of the clear link between child poverty and wider drivers of poverty across our communities the strategy encompassed the statutory requirement to prepare and publish an annual Local Child Poverty Action Report for North Lanarkshire. 5.2 Annual updates on achievements and challenges of The Tackling Poverty Strategy and the Action Plan were submitted to the Policy and Strategy Committee in September 2021 and 2022. With the conclusion of the 2020 to Yes ☐ No ☐ N/A ☐
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3 2023 Towards a Fairer North Lanarkshire Tackling Poverty Strategy being submitted and approved by the Wellbeing and Tackling Poverty Committee on 5th May 2023. 5.3 Amongst the many achievements throughout the lifespan of the 2020 to 2023, Tackling Poverty Strategy: • We saw a reduction in the proportion of children in poverty – from 25.2% to 23.2%, against a very challenging context. Nonetheless one in four children in North Lanarkshire remain living in poverty, which is higher than the national average of one in five children. • The Tackling Poverty Team in partnership with services generated over £99 million in additional benefit income for the residents of North Lanarkshire during this 3-year period. This together with the £22.6 million generated via the Citizens Advice Bureaux, means that over £121 million has been generated by supporting people through the benefits system. • In addition, a key achievement supported by investment, business support and employability initiatives are that for the first time ever the gross weekly pay for local residents is now higher than the national average – an increase of 10%. Further notable achievements are that from our baseline of 5 employers achieving accreditation for paying the living wage, we now having 123 employers accredited. 5.4 In April 2022 the Scottish Government published its new Tackling Child Poverty Delivery Plan 2022-26, Best Start Bright Futures, as the second of 3 delivery plans required by the Child Poverty (Scotland) Act 2017. Best Start Bright Futures sets out a vision for Scotland of the changes that are needed and associated actions required by the Scottish Government and partners. Recognising both the wider determinants and levers which can impact on poverty this new delivery plan adds a focus on holistic supports to the other key drivers of anti-poverty activity: increasing income via employment; maximising income via social security benefits; and reducing the cost of living. 5.5 This holistic and integrated approach is fundamental to the Plan for North Lanarkshire and whilst maintaining strong links with other elements of the Council’s Programme of Work, Tackling Poverty will be a core strand of the ‘Resilient People’ Programme, whose principal aim is to deliver whole family support locally, when families need it, in a way that is consistent with The Promise Principles and The Tackling Poverty Strategy. This will involve an integrated approach, working with partners, to provide an earlier and more effective response to need. This includes promoting the strengths and skills of individuals and families, increasing economic activity, and providing practical and emotional support, integrating this family with the roll out of town and community hubs to maximise opportunities for community-led and strengths- based approaches.
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4 Key Issues Towards a Fairer North Lanarkshire - Tackling Poverty Strategy 2023-2026 Context - Framing the North Lanarkshire Approach 5.6 In May 2023, the Scottish Government held a cross party summit including representation from Scotland’s political parties, campaigners, public and private sector leaders and people with lived experience of poverty. The First Minister stated that “Tackling poverty and inequality is the single biggest challenge facing Scotland and requires continued, urgent and sustained action.” COSLA President Councillor Shona Morrison said: “The initiative from the Scottish Government is a good one and one which Local Government can get fully behind. Tackling poverty is a core objective for Local Government working in partnership with the Scottish Government, the third sector and public and private sector partners. "The cost- of-living crisis we are living through at present is being tackled head- on by Councils the length and breadth of Scotland and partnership working is vital to achieving positive outcomes for individuals, families and our communities across Scotland.” 5.7 The Poverty and Inequality Commission recognise the following four levers in respect of Poverty:- • work and earnings; • social security; • housing costs; and • costs of living. 5.8 As noted above Scottish Government’s second Child Poverty Delivery Plan – Best Start Bright Futures extend the focus to four key drivers to tackle poverty: • Income from Social Security Benefits • Income from Employment; and • Reduce the Cost of Living • Holistic Supports 5.9 In addition it sets out Scotland’s offer to families in 3 parts: • Providing the opportunities and integrated support parents need to enter, sustain and progress in work;
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5 • Maximising the support available for families to live dignified lives and meet their basic needs; and • Supporting the next generation to thrive What do we mean when we talk about Poverty? 5.10 The dictionary defines poverty simply as; “the state of being extremely poor”. This, however, does not reflect the impact of poverty on all aspects of an individual’s and family’s life. In 2020, North Lanarkshire Council adopted the Joseph Rowntree Foundation definition of poverty, as this addresses not only the lacking sufficient money aspect of poverty but goes further by defining what being “extremely poor” actually means to people. “Poverty means not being able to heat your home, pay your rent, or buy the essentials for your children. It means waking up every day facing insecurity, uncertainty and impossible decisions about money. It means facing marginalisation – and even discrimination – because of your financial circumstances. The constant stress it causes can lead to problems that deprive people of the chances to play a full part in society.” North Lanarkshire Fairness Commission 2018 5.11 Whilst low income and material deprivation are issues rightly at the forefront of the poverty debate, the commission recognised that poverty should not merely considered in terms of income or material well-being alone. Importantly, it is also a matter of health and well-being. The commission highlighted that there is a complex, interlinking relationship between the factors that influence poverty therefore, these cannot be considered in isolation. Currently alongside the legacy impacts of the COVID – 19 and the Cost of Living Crisis, there are number of issues causing or exacerbating the effects of poverty on people in North Lanarkshire such as National Insurance increase, price increases on energy, soaring fuel and food increases, real term cuts in wages, benefits and pensions, core price inflation is at a 30 year high (inflation as eased, but food inflation remains near 20%) and the conflict in Ukraine, which continue to acutely affect inequality and poverty in North Lanarkshire, impacting the most vulnerable in North Lanarkshire’s communities, along with other economic factors; the impact of reforms to the welfare system and patterns of employment. The North Lanarkshire Approach 5.12 The new Tackling Poverty Strategy will continue the commitment to the recommendation of the North Lanarkshire Fairness Commission to not only ensure that tackling poverty has sufficient focus, but also to reflect the fact that poverty is a significant feature of Scottish society affecting many people in many different ways. 5.13 The Plan for North Lanarkshire sets out the committed to focus on the things that will significantly improve the quality of life and well-being for all our
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6 residents, but the supporting evidence base highlights that challenges remain. The Programme of Work to 2028 has been developed to ensure a heightened and more strategic focus on not only sustaining the economic and community aspects that will enable local people and communities (and the place that is North Lanarkshire) to thrive, but also on ensuring a more targeted approach to improving social, health, and economic conditions and maximising opportunities to escalate the delivery of improved outcomes for those that need it most, thus turning the vision of inclusive growth and prosperity into a reality. 5.14 The refreshed Tackling Poverty Strategy is a key component of this Programme of Work and key contributor to ensuring that our residents are offered opportunities, support, advice, and information The Strategy seeks to embody a collaborative approach to maximise effective action building on achievements to date. As outlined above, incorporating the Tackling Poverty Strategy within the Resilient People programme of work recognises the importance of a holistic approach reflected also in the addition of holistic support within the national framework set by Best Start, Bright Futures and that often the most direct, efficient and effective way of helping families is to provide responsive financial support and economic opportunities to achieve lasting change. The new Strategy will reflect this in being structured around the four key drivers of: - • Increasing income via employment; • Maximising income via social security benefits; • Reducing the cost of living; and • Holistic Supports. 5.15 Our new Tackling Poverty Strategy also continues the approach of incorporating the Local Child Poverty Action Report (Action Plan), aligning both Plans into the same lifespan from 2023 to 2026. Both the local authority and NHSL have agreed that the Local Child Poverty Action Reports should be an integral part of the overall strategy enabling also our statutory duty to report to Scottish Government on an annual basis and recognising that child poverty is integrally linked with poverty and wellbeing within the wider community. To support reporting and measuring impact amongst targeted groups the action plan will detail which “strategy/plan” each action relates to, identifying those actions that are specifically aimed at the child poverty priority groups. 5.16 The Action Plan within the Tackling Poverty Strategy details the key elements and priorities of the new Towards a Fairer North Lanarkshire – Tackling Poverty Strategy 2023 to 2026. Partnership Working and Tackling Poverty 5.17 Tackling poverty and its impact on people and communities does not fall on the shoulders of one agency or service. It is recognised that securing long term successful change requires a balance between economic and social
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7 wellbeing. The Joseph Rowntree Foundation identified that some of the consequences of poverty can include: 5.18 A collective approach across the North Lanarkshire Partnership, Community Boards and communities informed by people with lived experience is therefore fundamental to tackling poverty and the barriers to inclusive growth by:- • unlocking the potential of people living in communities with lived experience; • breaking the cycle of poverty; and • opening up opportunities to create more equal communities. 5.19 The strategy, together with the actions identified within the Local Child Poverty Action Report 2022/23, will ensure that there is concerted collaborative work involving key partners including:- • North Lanarkshire Council; • NHS Lanarkshire; • Police Scotland; • Scottish Fire and Rescue Service; • Voluntary Action North Lanarkshire (VANL); • Department of Work & Pensions (DWP); • Scottish Social Security Agency; • New College Lanarkshire; • Registered Social Landlords; • Skills Development Scotland; • The Community and Voluntary Sector; and • Communities and in particular those with lived experience. 5.20 The approach within North Lanarkshire is underpinned by The Fairer Scotland Duty to reduce the inequalities of outcome caused by socio-
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8 economic disadvantage. Our approach seeks to move people, families and whole communities from dependence to independence through enabling them to be part of the decisions that affect them and through our cash first approach. From a partnership perspective it also seeks to break down referral pathways built around the needs of systems rather than people which are at best confusing and at worst stigmatising. Our tackling poverty measures therefore also need to empower individuals and communities and to build on the desire of our communities to address this issue as reflected in its prioritisation in Local Outcome and Improvement Plans across our Community Board Areas. The Tackling Poverty Officers Action Group (TPOAG) remains our key vehicle for bringing statutory and community and voluntary sector partners together to co-ordinate and drive actions and has been critical to the development of our refreshed Strategy. Stakeholder Engagement and Consultation 5.21 The TPOAG and the Tackling Poverty Team have used different vehicles for ensuring that our residents’ voices are heard and shape our Strategy and accompanying action plan: The Council’s Cost of Living Survey (Support and local information to help cope with rising costs), with over 4,500 online surveys completed by residents and 300 paper copies and the latter, “three questions”, has been used at all events the Tackling Poverty Team have been attending, and has included the following key questions; • How is the cost-of-living crisis affecting you? • How is the cost of living affecting others in our community? • What do you want us to do about it? 5.22 Whilst survey response will help direct our resources accordingly, these responses are traditionally from adults. In order to shape both the Tackling Poverty Strategy and the Local Child Poverty Action Report, it was also important to the Team that our children and young people’s voices were heard. The Team has therefore also engaged with a number of schools, ensuring that we had a mix of primary and secondary schools with a mix also of those within or close to our towns and others in outlying villages. 15 schools have taken part so far and the responses from the children, young people and their teachers have been extremely informative and insightful. The children and young people were given a short presentation about poverty figures in North Lanarkshire and its impacts, and then provided with post it notes to allow them to write their thoughts on this. In doing this it allowed for some anonymity in their answers. 5.23 The Tackling Poverty Officer Action Group are also continuing to work with the Community Partnership Team, to look at the role of the Community Boards and the Local Outcome Improvement Plans in supporting the
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9 engagement/lived experience strand of the strategy and how we ensure this is delivered/reported on appropriately. Key priorities within the refreshed Strategy 5.24 Towards a Fairer North Lanarkshire Tackling Poverty Strategy 2023-26 is an ambitious strategy supported by a comprehensive action plan as reflected in the attached document at Appendix 1. Areas which are new or have enhanced focus in this refreshed and updated strategy include: • The introduction of the fourth driver of Holistic Support to ensure a fully integrated approach as outlined above and the linkage with other key programmes such as those associated with the Promise, Whole Family Support, SAC (Scottish Attainment Challenge) and PEF (Pupil Equity Fund). • A new approach to lived experience and user/community engagement building on the role of our Community Boards. • An increased focus on engagement programmes to increase access to parental employment support, particularly for those in priority groups who are in or at risk of poverty to access and maintain opportunities for volunteering, skills development and work • Creative approaches to enhance access to service though new initiatives and joint resourcing for example growing the Welfare Advice and Health Project (WAHP) in GP practices. 6. CONCLUSIONS 6.1 North Lanarkshire Council Towards a Fairer North Lanarkshire Tackling Poverty Strategy will be delivered in a way that is consistent with the Councils’ Programme for Work – Resilient People delivering the whole family support locally when families need it, ensuring that a “no wrong door” approach is adopted across all our services, meaning that no matter where someone presents there will be a referral gateway to the services that a person or family require to help them out of poverty. 6.2 The successful delivery and outcomes of 2023- 2026 Towards a Fairer North Lanarkshire – Tackling Poverty Strategy – Action Plan. 7. IMPLICATIONS
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10 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: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Yes ☐ No ☒ N/A ☐
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11 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
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12 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 9.1 Appendix 1 - Draft Towards a fairer North Lanarkshire Tackling Poverty Strategy 2023/26 9.2 Appendix 2 - Local Child Poverty Action Report 2022/23 9.3 Appendix 3 - Equality Impact Assessment 9.4 Appendix 4 - Children’s Rights and Wellbeing Impact Assessment (CRWIA) CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; John Campbell, CampbellJohn@northlan.gov.uk Yes ☒ No ☐ N/A ☐ Yes / Date added ☐ No ☒ N/A ☐
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13 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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Appendix 1 “Towards A Fairer North Lanarkshire” Tackling Poverty Strategy 2023 - 2026
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Document control Title Toward A Fairer North Lanarkshire – The Tackling Poverty Strategy Document status (final or draft version) Draft Owner Alison Gordon e-mail address gordonal@northlan.gov.uk Governance group Tackling Poverty Officers Action Group Author John Campbell e-mail address campbelljohn@northlan.gov.uk Revision history Number Originator Date Revision description / record of change 1.0 AGC 08June2023 First draft 2.0 AGC 05July2023 Second draft (added financial education on 12th July 2023) 3.0 Writers group 14July2023 Third draft -editing / updating 3.1 AGC 24th July 2023 Survey questions included Document approvals Number Governance group Date approval granted Date approval to be requested (if document still draft) 1.0 2.0 Consultation record (for most recent update) Status of document consulted upon Stakeholders consulted / date Foreword
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In North Lanarkshire we recognise that all sectors and agencies must come together to tackle poverty, this Strategy not only reflects the commitment from each sector but also the voices of our residents, which will shape service delivery across our communi�es. Tackling Poverty Strategy Foreword 2023 to 2026 North Lanarkshire’s Tackling Poverty Strategy 2020-23 reflected a concerted commitment across the Community Planning Partnership to drive inclusive growth and achieve prosperity for the people and communi�es of North Lanarkshire. We wanted to ensure that North Lanarkshire will be the place where everyone has equality of opportunity, a place where individuals and communi�es are poverty free. During the three-year period the council and its partners were able to meet a number of ac�ons, however, the impact of Covid cannot be ignored in achieving the goals we set out at the beginning of 2020. The Council and its partners had to react quickly to the pandemic and the impact this had on our communi�es and ci�zens, this means that some ac�ons in the Strategy had to be re-thought with some being delivered quicker than previously expected and others having to be reconsidered. The global pandemic, a cost-of-living crisis and high levels of deprivation, con�nues to acutely affect inequality and poverty in North Lanarkshire, impac�ng the most vulnerable in North Lanarkshire’s communi�es. Against this landscape we now bring a refreshed Tackling Poverty Strategy for 2023-2026, which sets out our ambi�on to tackle poverty and child poverty, building on our previous plans in this area which have been progressed despite the pandemic. Our refreshed Tackling Poverty Strategy encompasses an integrated mul� service approach within the Council, alongside an increased focus on working externally with all community planning partners, communi�es, and people with lived experience of poverty. A new programme of work was agreed by the council which sets out projects and activity that goes much further, moves faster and in a more joined-up way to improve health and wellbeing and impact on regeneration, the economy, and communities.” However, with one in four children in North Lanarkshire living in poverty, we cannot be complacent and while there are significant improvements, considerable challenges remain and it’s vital that we continue to work with partners to address the unacceptably high levels of child poverty, deprivation, and inequality in North Lanarkshire. Councillor Jim Logue Leader of North Lanarkshire Council Following the Council Elec�ons in 2022, North Lanarkshire Council created its very first Wellbeing and Tackling Poverty Commitee to oversee and direct the Councils Towards a Fairer North Lanarkshire Tackling Poverty
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Strategy 2020 to 2023, the development of the new Tackling Poverty Strategy 2023 to 2026 and the produc�on of the annual Local Child Poverty Ac�on Report in partnership with NHS Lanarkshire. As the Convener of the new Wellbeing and Tackling Poverty Commitee, I am delighted to endorse the achievements of the Towards a Fairer North Lanarkshire Tackling Poverty Strategy 2020 to 2023 and the Local Child Poverty Ac�on Report 2022. Our new Towards a Fairer North Lanarkshire Tackling Poverty Strategy 2023 to 2026, sets out our overarching approach to tackling poverty in our communi�es, with the Ac�on Plan providing the detail as to how the partners will do this. The Strategy will work in conjunc�on with the Local Child Poverty Ac�on Report which will provide supports to children and young people. The Strategy and Ac�on Plan iden�fy work being done and being planned under the drivers to tackle poverty; increase income via employability, reduce the cost of living, increase income via social security benefits and new to this strategy, holis�c supports. The Wellbeing and Tackling Poverty Commitee will strive to ensure that the aims and objec�ves of the Strategy/Ac�on Plan are met and address the challenges that our residents, Council Services, the third sector and other partners over the next 3 years. Wellbeing and Tackling Poverty Commitee – Convener Councillor Geraldine Woods This is the second North Lanarkshire Tackling Poverty Strategy to be produced. The Strategy reflects our commitment to ensuring equity of opportunity for all of our residents.
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Significant progress has been achieved against the ambi�ons of the first Tackling Poverty Strategy, to make North Lanarkshire the place to Live, Learn, Work Invest and Visit. Progress made has focussed on both developing North Lanarkshire as a place and on improving the individual lives of North Lanarkshire’s people. Achievements to date have been pivotal in maximising the poten�al of North Lanarkshire as a place to improve the condi�ons within which residents live. Expanding the provision of high quality housing, crea�ng mul�purpose community hubs that support a much wider integrated service offering in the heart of the local community (and bring educa�on together with other local services, local businesses, and partnership organisa�ons), transforma�ons to town centres, enhancements to ac�ve green spaces to bring physical and mental health benefits, and atrac�ng investment to expand employment opportuni�es have been a catalyst to beter suppor�ng improved economic and community outcomes and improving the quality of life for all. In terms of improving individual lives, recent successes include an increase in posi�ve des�na�ons for young people leaving school, an increase in gross weekly pay for residents, a reduc�on in school exclusion rates, and a reduc�on in the number of people claiming employment related benefits. These successes, delivered against a backdrop of high levels of depriva�on, a cost-of-living crisis and during a global pandemic, have led to more sustained posi�ve outcomes for children, communi�es, and the economy across North Lanarkshire, transforming lives and prospects. The Plan for North Lanarkshire sets out the commited to focus on the things that will significantly improve the quality of life and well-being for all our residents, but the suppor�ng evidence base highlights that challenges remain. A Programme of Work to 2028 has therefore been developed to ensure a heightened and more strategic focus on not only sustaining the economic and community aspects that will enable local people and communi�es (and the place that is North Lanarkshire) to thrive, but also on ensuring a more targeted approach to improving social, health, and economic condi�ons and maximising opportuni�es to escalate the delivery of improved outcomes for those that need it most, thus turning the vision of inclusive growth and prosperity into a reality. This refreshed Tackling Poverty Strategy is a key area of ac�vity in the Programme of Work and a major step in ensuring that our residents are offered opportuni�es, support, advice, and informa�on that will address the drivers of poverty through: - Increasing income via employment; Maximising income via social security benefits; Reducing the cost of living; and Holistic Support Our community planning partners, and voluntary and community sector colleagues are commited to tackling poverty and inequality and our ac�on plan sets out our approach to this. The close involvement of our communi�es in shaping our approach will ensure that we are mee�ng the differing needs in all of the communi�es of North Lanarkshire. Des Murray Chief Execu�ve – North Lanarkshire Council
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Suppor�ng The Strategy NHS Lanarkshire welcomes this strategy and recognises the important role it plays in tackling poverty within our communi�es. The impact of poverty and the cost of living crisis is well documented and is evident within our communi�es. Rising inequali�es also con�nue to prove a challenge. A recent popula�on health impact assessment on the rising cost of living crisis in Scotland, conducted by Public Health Scotland, noted several ways in which rising costs and poverty can affect health including; living in damp homes, worsening of mental health issues and being unable to afford a nutri�ous and varied diet. NHS Lanarkshire plays a par�cular role in tackling poverty, in part, simply by exis�ng to provide care for everyone, free at the point of use. It also has a role as an ‘anchor organisa�on’ within communi�es, offering accessible employment and opportuni�es around economic s�mula�on. However, the partnership ac�vity that is documented in this plan has shown to be the most effec�ve way to meet the challenges facing individuals and families. By ensuring that the services our communi�es use are equipped to recognise when people and struggling and enabling referrals and support to be put in place, jointly we aim to prevent poor health and stop health inequali�es from worsening. Professor S. Josephine Pravinkumar Director of Public Health and Health Policy Voluntary Ac�on North Lanarkshire (VANL) and the wider community and voluntary sector (CVS) welcome North Lanarkshire’s updated Poverty Strategy, which sets out the ways in which different sectors – public, business and CVS - are working together across North Lanarkshire to tackle the complex mix of social and economic factors which cause poverty in our communi�es. Given the challenge of poverty con�nues to nega�vely affect the wellbeing and life chances of many local people - with one in four children in North Lanarkshire living in poverty – successful implementation of this strategy is essential, and the CVS play a key role in this ambition. There are over 850 unique CVS organisa�ons in North Lanarkshire ranging from small, volunteer-led community groups to chari�es and social enterprises of all sizes with many providing wide-ranging and vital support to people experiencing or at risk of poverty. VANL and the CVS also work together and with our statutory partners to provide informa�on on sources of support for people experiencing or at risk of poverty – for example by encouraging use of “ALISS” – A Local Informa�on System for Scotland and help raise public awareness and understanding of the scale, causes and impact of poverty and links between poverty and ac�vi�es to support community wealth building, health, and wellbeing. VANL and the CVS reaffirm our commitment to help tackle poverty, working in partnership with colleagues in North Lanarkshire Council and NHS Lanarkshire. Maddy Halliday Chief Execu�ve Officer Voluntary Ac�on North Lanarkshire
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Contents Page No Title Execu�ve Summary Introduc�on Our Ambi�on – A Fairer North Lanarkshire Resilient People Purpose of the Strategy The North Lanarkshire Profile Talking About What Poverty Means The Three Questions Suppor�ng People – Our Achievements and Challenges The Impact of Covid 19 Covid Recovery The Drivers of Tackling Poverty Increase Income Via Employment Reduce the Cost of Living Affordable Credit Informing Our Residents Advising and Assisting Providing Free Period Products Helping to Quit Your Way Promoting Travel For Under 22s Reducing Fuel Poverty Affordable Homes Income Via Social Security Benefits How Will We Do This NHS Lanarkshire The Third Sector Holistic Supports Whole Family Support North Lanarkshire Alcohol & Drug Partnership Justice Services Financial Education in North Lanarkshire How Will We Know We Are Making A Difference Ac�on Plan Appendix One – North Lanarkshire Profile Appendix Two – Cost of Living Survey Ques�ons Appendix Three – North Lanarkshire Poverty Premium
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Execu�ve Summary The long-term plan for North Lanarkshire is for inclusive growth and prosperity for all, by tackling poverty in our communi�es we will ensure we are working Toward a Fairer North Lanarkshire. In North Lanarkshire we recognise that tackling poverty and inequality does not fall to one Service, or one Sector, we must therefore work together to use our resources effec�vely and efficiently to ensure that all our communi�es have access to opportuni�es that will lead to beter outcomes for people in terms of employment, wellbeing and inclusive growth. This second strategy has been developed in partnership with the Tackling Poverty Officers Ac�on Group – a group with members from the Council, NHS Lanarkshire and the Third Sector, and will assist in delivering key priori�es within The Plan for North Lanarkshire and NHS Lanarkshire's developing healthcare strategy "Our Health Together". In the life�me of the first strategy, we saw a reduc�on in the propor�on of children in poverty – from 25.2% to 23.2%, this however, remains a concern as one in four children in North Lanarkshire are living in poverty, which is higher than the na�onal average of one in five children. This three year Strategy will set out our overarching approach to tackling poverty in our communi�es, with the Ac�on Plan providing the detail as to how the partners will do this. The Strategy will work in conjunc�on with the Local Child Poverty Ac�on Report which will provide supports to children and young people. The Strategy and Ac�on Plan iden�fy work being done and being planned under the drivers to tackle poverty; increase income via employability, reduce the cost of living, increase income via social security benefits and new to this strategy, holis�c supports. The Programme of Work under the Plan for North Lanarkshire, embraces this approach via the Resilient People Programme, the aim of which is to deliver whole family support locally, when families need it, in a way that is consistent with the principles of The Promise and this Tackling Poverty Strategy. Recognising the impact the cost of living crisis is having on our communi�es, the Community Boards have iden�fied tackling poverty as a priority within their Local Outcome Improvement Plans, the work we and our Partners are commited to doing within the Ac�on Plan together with the newly developed programmes within the Programme of Work will support and enhance our communi�es and help us work Toward a Fairer North Lanarkshire.
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Introduc�on Tackling poverty and inequality is the single biggest challenge facing Scotland and requires con�nued, urgent and sustained ac�on. Tackling poverty is a core objec�ve for Local Government working in partnership with the Sco�sh Government, the third sector and public and private sector partners. Whilst low income and material depriva�on are issues rightly at the forefront of the poverty debate, the strategy recognises that poverty should not merely be considered in terms of income or material well-being alone. Importantly, it is also a mater of health and well-being. There is a complex, interlinking rela�onship between the factors that influence poverty therefore, these cannot be considered in isola�on. The 2023-26 strategy has been created against a backdrop of recovery from the pandemic, the cost of living crisis and a number of issues causing or exacerba�ng the effects of poverty on people in North Lanarkshire. Issues such as; Na�onal Insurance increase, price increases on energy, fuel and food increases, real term cuts in wages and welfare reforms con�nue to acutely affect inequality and poverty. Together with other economic factors, this will impact the most vulnerable in North Lanarkshire’s communi�es. Tackling poverty and its impact on people and communi�es does not fall on the shoulders of one agency or service. This Strategy, together with the ac�ons iden�fied within the Local Child Poverty Ac�on Report 2022- 2023, will ensure that there is concerted collabora�ve work involving key partners including: North Lanarkshire Council; NHS Lanarkshire; Police Scotland; Scottish Fire and Rescue Service; Voluntary Action North Lanarkshire (VANL) and the Community and Voluntary Sector (CVS); New College Lanarkshire; Skills Development Scotland; Scottish Enterprise; Job Centre Plus; Communities and in particular those with lived experience A collabora�ve approach is required across North Lanarkshire to secure real ac�on on the biggest issues facing our people, council and our local economy and is at the heart of a fully integrated delivery plan. “Can only afford to exist, not live. Can't treat my kids to days out/ treats like we could before or social events like going out with friends etc” “There’s nothing left after bills are paid. Working to pay bills and nothing else”
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Our Ambi�on – A Fairer North Lanarkshire The Tackling Poverty Strategy has its roots within the Plan for North Lanarkshire, there has been significant and far-reaching progress achieved against the ambi�on to make North Lanarkshire The place to Live, Learn, Work, Invest and Visit. The Plan for North Lanarkshire sets the strategy direc�on not just for the council and partners, but for North Lanarkshire as a place. It outlines the shared ambi�on to make North Lanarkshire the place to Live, Learn, Work, Invest and Visit. The long-term vision in The Plan for North Lanarkshire provides a very clear focus and compelling narra�ve in terms of what the council is working toward, it has been shaped by the local demographic, social and economic profile which is informed by the 28 Health Check Indicators. The vision of inclusive growth and prosperity for all aims to bring equal benefits to all North Lanarkshire’s communi�es and ensure a fairer distribu�on of wealth. Improving outcomes within North Lanarkshire cannot be achieved by delivering single programmes or projects, or by organisa�ons working alone, rather they require many overlapping factors interac�ng together. To maintain the focus on the long-term vision, while ensuring a more integrated and holis�c suite of services and supports in a con�nuously challenging and complex landscape, a new approach to strategic planning has been developed. This approach seeks to sustain the successful strategies from the Programme of Work to date, while tackling the many challenges that remain by further evolving and re-envisioning the councils’ policy direc�on in order to turn the vision for inclusive growth and prosperity for all into reality. The new programme of work will enhance the scale, impact and coherence of all work areas. The newly developed programmes are interdependent; the outcomes delivered within each will support and enhance all the others.
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Resilient People The principal aim of resilient people is to deliver whole family support locally, when families need it, in a way that is consistent with the principles of The Promise and the Tackling Poverty Strategy. The aim is to provide an integrated whole council approach, working with partners to provide an earlier and more effec�ve response to need, that includes promo�ng the strengths and skills of individuals and families, improving economic ac�vity as well as providing prac�cal and emo�onal support. Through this, children, young people and their parents/carers will have increased resilience and ambi�on. O�en the most direct, efficient and effec�ve way of helping families to provide responsive financial support and economic opportuni�es to achieve las�ng change. Resilient People will integrate family support with the roll out of community hubs to provide financial, prac�cal, emo�onal and economic opportuni�es including volunteering, to reduce and tackle inequali�es. Resilient People will ensure that there is a No Wrong Door approach to tackling poverty and inequality across all our community.
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Purpose of the Strategy The Tackling Poverty Strategy will establish an approach that will ensure that the Council’s vision of inclusive growth and prosperity for all is achieved. It is recognised that securing long term successful change requires a balance between economic and social wellbeing. The Joseph Rowntree Founda�on iden�fied that some of the consequences of poverty are: health problems; housing problems; being a victim or a perpetrator of crime; drug or alcohol problems; lower educational achievement; poverty itself - poverty in childhood increases the risk of unemployment and low pay in adulthood and lower savings later in life; homelessness; teenage parenthood; relationship and family problems; and biological effects – poverty early in a child’s life can have a harmful effect on brain development. A collec�ve approach across the Community Planning Partnership, Community Boards and communi�es informed by people with lived experience is therefore needed to tackle the barriers to inclusive growth by: unlocking the potential of people living in communities with lived experience; breaking the cycle of poverty; and opening opportunities to create more equal communities. The approach ensures there is a focus on building on the strengths of individuals and families to improve outcomes for children and their parents, it requires to move people, families and whole communi�es from dependence to independence through enabling them to be part of the decisions that affect them. Families will receive the right support when they ask for it and receive it in their own local community. The approach will break down referral pathways built around the needs of systems rather than people which are at best confusing and at worst s�gma�sing. Addressing challenges through integrated solu�ons, rather than through fragmented approaches that meet one goal at the expense of another supports sustainable empowered communi�es. Tackling poverty measures must therefore follow this same route. Statutory services, the third sector and the community must come together to tackle this issue.
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The North Lanarkshire Poverty Profile Within North Lanarkshire there are s�ll unacceptably high levels of depriva�on and child poverty and clear areas of inequity and inequality. As a result, there are varying levels of social exclusion across our diverse communi�es of place and interest. North Lanarkshire is the fourth largest authority area within Scotland, with a popula�on of 341,400. It is situated in the heart of Scotland with connec�vity to the rest of Scotland, the UK and the world. As the fi�h most densely populated council area, North Lanarkshire is divided into 21 wards which are represented by 77 elected members. Historically, the local authority has experienced higher than average levels of deprivation. The Scottish Index of Multiple Deprivation (SIMD) 2020 identified across North Lanarkshire 50,897 people are income deprived, equating to 15% of the population. The Scottish average is 12%. Around 22,426 of the 50,897 income deprived people mentioned above, live in neighbourhoods, spread across North Lanarkshire, that are not classed within the 20% most deprived. Income deprivation is defined as those of working age (and their dependants) who are on low incomes. North Lanarkshire remains 6th in terms of its share of datazones in the 20% most deprived in Scotland, sitting behind; Inverclyde, Glasgow, North Ayrshire, West Dunbartonshire and Dundee. North Lanarkshire has five datazones within the 1% most deprived areas of Scotland. This strategy will ensure resources are directed to these areas as a priority. Approximately 2.1% of North Lanarkshire’s popula�on are people from Black or minority ethnic groups. 828 people use Bri�sh Sign Language at Home and 6,678 use a language other than English. Our popula�on is ge�ng older with the over 65 age group set to increase by over 11,000 by 2026. Those in BME groups are more likely to experience higher rates of unemployment. The Fairer Scotland Duty places a legal responsibility on us to ac�vely consider how we can reduce inequali�es of outcome caused by socio-economic disadvantage, when making strategic decisions. We know that poverty is experienced disproportionately by particular groups of people: Older women are more likely to be poor. In 2015-18, after housing costs are accounted for, 24% of children, 20% of working age adults and 15% of pensioners in Scotland were living in relative poverty. Disabled people are more likely to live in poverty. In 2015-18, the poverty rate after housing costs for people in families with a disabled person was 24%. This compares with 17% of people in a family without a disabled person who were in poverty. Disabled people are twice as likely to be out of work and earn less than non- disabled people o Women are more likely to live in poverty. o 90% of lone parents are women o More likely to work part time in low wage jobs o Greater impact from Welfare reform o In 2016 to 2017 women earned on average £1.90 an hour less than me
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Note: Many of the statistics under economy were taken from the 2011 Census. We will look closely at the unemployment rates when the 2021 Census Results are available. People from minority ethnic (non-white) groups were more likely to be in poverty, both after and before housing costs, compared to those from the 'White - British' group. After housing costs 38% of people from 'Mixed, Black, Black British and Other' ethnic groups and 34% of 'Asian or Asian British' ethnic groups were in relative poverty after housing costs. In comparison 18% of 'White British' people were in relative poverty. Gay men are more likely to experience poverty than heterosexual men. Muslims most likely to be living in poverty. In 2015-18, 41% of people who identified their religion as Muslim were living in poverty after housing costs. We must ensure that all groups within our communities particularly those who are disproportionately affected by poverty have equal access all of the services and initiatives outlined in our tackling poverty strategy. A profile of North Lanarkshire is set out in Appendix 1.
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Talking About Poverty and What It Means “Poverty means not being able to heat your home, pay your rent, or buy the essentials for your children, it means waking up every day facing insecurity, uncertainty and impossible decisions about money. It means marginalisation – and even discrimination – because of your financial circumstances. The constant stress it causes can lead to problems that deprive people of the chances to play a full part in society.” In addi�on to the facts and figures about North Lanarkshire, it is important that we dig much deeper and con�nue to listen and learn from the lived experience of the people living in poverty in our communi�es. In the previous strategy a survey was carried out asking people “what makes life more difficult for you financially?”. Following the impact of the covid 19 pandemic and in the middle of the cost of living crisis, the survey was carried out again, asking the same ques�ons. The council developed and re-issued the survey in March 2023. Both an online and paper version asked what makes life financially difficult for the people of North Lanarkshire. The results have helped shape and inform this Tackling Poverty Strategy and our response to addressing poverty. The survey went live on 15th March 2023. It was published on the NLC consulta�on page of our website, adver�sed on social media and sent by text message to parents and carers. NHSL, One Parent Families Scotland, Routes to Work, Voluntary Ac�on North Lanarkshire and North Lanarkshire Advice Network partners disseminated the survey via their own pla�orms. Paper surveys were supplied to those who could not access the online version and in par�cular to English for Speakers of Other Languages (ESOL) groups. This was useful in reaching those within our communi�es who otherwise may not have their views represented. A total of 3,369 responses were prepared for analysis, with a representa�on from all Community Board Areas.
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Broad themes were immediately apparent. 23% of respondents reported that they were not aware of what benefits to claim. In addi�on, comments from respondents informed us that they were employed but just missed out on benefits or were unable to survive even though they were fully employed. “Benefits are too complicated to apply for” “Everything cos�ng more, have 2 wages coming into the house but finding we have no disposable income when bills are paid” “I work a 60-hour week and have had to opt out of pension contribu�ons because I can’t afford them and hea�ng/ea�ng at the same �me” This led us to plan a campaign for Summer 2023 to encourage those who were employed to seek advice to check their en�tlement to Universal Credit, par�cularly considering recent changes widening en�tlement to the benefit. You asked: We did: Improved information on benefit entitlement Universal Credit Campaign (summer 2023) When looking at reducing the cost of living 43% of respondents reported that repaying debts contributed to their financial difficul�es – 20% also reported high interest debt repayments were an issue. This will inform our work around affordable credit and forming closer links with local credit unions. “Ge�ng into further debt to simply afford basics because minimum repayments are so high there’s nothing le� to buy necessi�es/pay bills” “Debt is a real issue – overwhelming” Childcare remains a barrier to employment with a third of respondents repor�ng that childcare is not affordable, while 22% found childcare did not meet their needs. “Better provision for free after school care for full time working parents. My childcare costs last year were £10,000 with one child in full time childcare and another in school and having to be collected by after school care. This does not encourage people to go out and work” “Small age children in school hours limit work ability, must be available to care for needs, sick days, drop off and pick up times” The Parental Employability Support Fund (PESF) helps parents with support in sourcing child care and can even pay child care costs for the first few weeks to remove what can often be an insurmountable barrier for parents looking to make the transition to employment or training. Promotion of PESF to those in the seven priority groups is key in helping people into employment. You asked: We did: Help with Child Care Promotion of Parental Employability Fund
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When asked if they thought their situa�on will get beter or worse, 57% thought it would worsen – yet only 24% of people have asked for help with their financial difficul�es. Comments gave insight into how people want to be able to access advice. We will concentrate our efforts on a place-based approach delivery of advice within the heart of our communi�es. “was directed to help but too overwhelming to try to do anything myself” “provide different methods of accessing advice e.g. libraries, one stop shops, community centres or credit unions” You asked: We Did: More advice and assistance • Cost of Living Telephone freephone telephone • Newmains HUB advice clinic in the heart of the community • Partners funded to provide advice including outreach advice clinics in lowest SIMD neighbourhoods The informa�on from the Survey will con�nue to be further scru�nised to give more detailed informa�on and iden�fy trends and themes. This will be invaluable in guiding our approach through the life�me of the Strategy. (full results of the survey are available at appendix 2) The Three Ques�ons The Tackling Poverty Team have embarked on a communica�ons programme called “The Three Ques�ons” across all our communi�es, this will be a con�nuous programme which will become the heartbeat of our Strategy, shaping and underpinning everything we are doing across the local authority. The “Three Ques�ons” have been shaped around the cost of living crisis, we simply ask; “How is the cost of living impac�ng you?” “How is the cost of living impac�ng others in the community?” “What would you like us to do about it?” Posters together with post it notes have been taken out to community events, schools, supermarkets, libraries, sheltered housing complexes, hospitals – anywhere we can meet members of the public. The post it notes were introduced to avoid s�gma�sing anyone who wanted to have their voice heard but did not want to speak out, but welfare rights officers and debt advisors are also on hand, not just to provide advice but take note of comments anyone wishes to make. The format used has proven to be very successful in giving a voice to all sectors of our community from primary school children to older people.
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The Three Ques�ons have been taken to schools, both Primary and Secondary, as it is important that our children and young people’s voices are heard in the shaping of our Strategy. The young people gave an insight into how the cost of living crisis is affec�ng them and their families, together with what they would like to be done around this. When asked how the cost of living affected them, the impact on socialising was a major issue for the children and young people, whilst 21% stated that they could no longer afford a�er school ac�vi�es and socialising with friends, 56% stated that they could no longer play their consoles, charge their phones as much, all forms of socialising for younger people. The children and young people told us that the cost of living crisis was having an impact in their home and on themselves; “Buying things causes arguments in my house” “I get anxious when I go to the shop to buy food. My dad is off work and is on sick pay. In the next couple of months he will be on half pay and im worried how we will be able to afford things” “my mum panics about money now” “I am poor now” When asked what the children and young people wanted us to do about it, the top two answers from the children and young people were: Free School Meals for everyone and financial educa�on. The children and young people expressed that they wanted to learn about money “make everyone feel equal and understand 45% 21% 11% 10% 10% 3% Unable to charge my phone/ games as often as I did Unable to afford out of school activities/ socialising… Can't play on my consoles so much I am unable to afford driving lessons Less time watching TV Less or no money to buy things for the house How does cost of living affect you - activities A number of responses from the community were in rela�on to not being eligible for the government’s fuel poverty payment as they “just missed out” due to their income. As a result of this the Councils’ response to fuel poverty was to create a fund targeted at those who were on low income but not receiving means tested benefits.
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more about poverty and money….learn about money, how to pay bills, budgeting and money management”. (further details – Holistic Supports) The Tackling Poverty Ac�on Plan will reflect the steps that the Council and its Partners are taking to meet the needs of our children and young people. The Three Ques�ons will con�nue to inform the Tackling Poverty Ac�on Plan and will promote discussions across Services and Sectors at how we best deliver services to our communi�es.
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Suppor�ng People – Our Achievements and Challenges Achievements Throughout the life�me of 2020-23 Tackling Poverty Strategy there have been some significant achievements made, the Tackling Poverty Team, Housing Solu�ons and Social Work Services generated over £99 million in addi�onal benefit income for the residents of North Lanarkshire during this 3-year period. This together with the £22.6 million generated via Ci�zens Advice Bureaux, means that over £121 million has been generated by suppor�ng people through the benefit system. The establishment of a Wellbeing and Tackling Poverty Committee in North Lanarkshire was a clear indication of the Councils’ commitment to the Strategy and working toward a fairer North Lanarkshire for everyone in our communities. Net migration to North Lanarkshire has picked up again after a small dip in the trend and projections. Estimates predict that North Lanarkshire’s population will grow and remain favourable up to 2028. Recent figures show the local economy continues to grow, reflecting a positive position in North Lanarkshire compared to a negative growth position nationally. The gross weekly wage for North Lanarkshire residents is now higher than the national average for the first time ever – an increase of 10% (£63.90 per week) from 2021 The number of people claiming employment related benefits has decreased by almost 48% from 14,195 as at December 2020 to 7,420 as at December 2022 and this claimant count is now lower than pre-pandemic levels. The Furniture Fund utilising RRTP funding provides good quality furniture items beyond the provisions of the Scottish Welfare Fund allowing homeless households to personalise their home and create a stronger feeling of belonging. During 2021/22, Housing First households were assisted at an average figure of £861.39 and has been extended during 2022/23 to include households experiencing homelessness across localities, rather than just Homes First customers. Feedback highlighted that improved personalisation impacted positively on tenancy sustainment and an overall stronger feeling of wellbeing.’ The Mortgage to Rent Scheme’ assists homeowners who are in financial difficulty and unable to meet their mortgage payments by arranging with North Lanarkshire to buy the owner's home and for the owner to continue to live there as a tenant. Just over £260,000 of the Scottish Government allocation has been utilised to assist homeowners with financial difficulties in the 3-year period 2020-2023. Within our schools there have been considerable achievements; educational attainment rates for all pupils gaining 5+ awards at level 6, and for pupils living in the 20% most deprived areas, have seen a steady year on year improvement.
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Improvements can also be evidenced in the number of leavers achieving a positive post school destination with North Lanarkshire achieving a high level of 94.2%. This reflects a drop in pupils not entering a positive destination from 8.2% to 5.5% (around 100 pupils). Overall school exclusion rates and exclusion rates for looked after children both show significant improvement with overall exclusion rates dropping by 56% and rates for looked after children dropping by almost 70%. Throughout the life�me of the Strategy, our communi�es have experienced the impact of Covid 19, the recovery from this and the cost of living crisis, during this �me a North Lanarkshire Child Payment has been made to families; £125 payment to families for each child who are in receipt of free school meals and/or school clothing grant, including nursery children. A total of 11,979 children from 7396 families were assisted. A fuel hardship payment was developed to provide financial support to low-income households who would only receive the UK Government universal payment, payments of £150 were made with applica�ons exceeding 6000. A Pensioner Fuel Grant was paid to over 8000 households with each receiving a payment of £100 to assist with the increasing fuel bills. Recognising the impact the cost of living crisis is having on our communi�es, the Integrated Joint Board funded a Cost of Living Helpline hosted by the Tackling Poverty Team, giving our communi�es access to advice and support. Challenges There is a need to build on these successes and minimise the impact poverty has on people and communi�es. Whilst there has been a 2-percentage point reduc�on in the propor�on of children living in poverty (from 25.2% to 23.2%), we s�ll have significantly high levels of child poverty. With 61,452 children aged 15 and below in North Lanarkshire, 14,256 of those children live in poverty, 5,455 children live in areas where the poverty figure is over the na�onal average of 24% and 3,185 of those children live in areas where poverty levels are over 30%. The North Lanarkshire Local Child Poverty Ac�on Plan details the ac�ons the council and other services are undertaking to support the Sco�sh Government to achieve its stated targets for reducing child poverty by 2030. Although there is a downward trend in the number of working age popula�on with no qualifica�ons, there remains 12.8% of North Lanarkshire’s working age popula�on (around 27,600) who are restricted from accessing employment opportuni�es. The propor�on of the working age popula�on who are economically ac�ve had shown signs of improvement in the a�ermath of the pandemic, however, this has stalled and will con�nue to be monitored closely for signs of stability. Other factors will require further inves�ga�on in terms of employability, as 69,100 people are currently recorded as being economically inac�ve, with 41% of these recorded as long term-sick and 84% recorded as not wan�ng a job. Breas�eeding rates have improved slightly from the 2017/18 baseline and the rate of increase mirrors na�onal trends, however, nearly three quarters of babies in North Lanarkshire are not breas�ed at their 6-8 week review. In 2021 NHS Lanarkshire and partners adopted a mul�-strand approach to promote breas�eeding in
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the community and support mums who want to breas�eed, and this indicator provides a baseline against which partners can measure impact. Life expectancy for men and women in North Lanarkshire remains below the na�onal average and while this indicator had shown signs of improvement, the gains have started to stall and fall back. Equally, for North Lanarkshire residents, the percentage of their lives where the individuals enjoy good health is also lower than the na�onal average. Within the Ac�on Plan of the 2020 -23 Tackling Poverty Strategy, Funeral Poverty was iden�fied as an issue for people within our community. There was a lack of engagement from Funeral Directors and as a result, this issue will be addressed in terms of accessing bereavement and funeral payments. Within North Lanarkshire there are other challenges which will impact upon our strategy and approach, a key factor being the continued impact of welfare reform from the UK and Scottish Government’s with the migration of Personal Independent Payments to Adult Disability Payment and Disability Living Allowance to Child Disability Payment. Whilst the UK welfare reform changes estimates are that 20% of people won’t remain on benefit following migration, the Scottish versions of the benefits have a more favourable qualification criterion. However, the migration process will have a significant impact on disabled people, their families and carers and will take at least until late 2024 to be completed. Whilst we had been able to reduce referrals to foodbanks by using the Food Poverty Referral Gateway in North Lanarkshire, evidence from the foodbanks indicate that referrals have started to increase again. Work carried out with the foodbanks has identified that the timescales and process around the administration of universal credit remains to be impacting on this, as well as the pandemic, recovery of the pandemic and the cost-of-living crisis. The Cash First approached adopted by North Lanarkshire in 2015, continues to lead the way across the country with the Scottish Government, Trussell Trust and other Local Authorities adopting the model. An example of how well the Cash First approach works is outlined by a resident who was assisted with the model; “I thought my only option was a foodbank the welfare rights officer helped me get a grant and I could choose what I wanted for my family….When they checked my benefits I didn’t know that I could get help with looking after my daughter……it has made a big difference” Mother with 3 children (Coatbridge) Across Scotland, there are also some early reports of the impact of the Scottish Child Payment benefit on referrals to foodbanks reducing for families, since its introduction in November 2022, for all children under 16. Over the next two years, North Lanarkshire Council are working in partnership with the Trussell Trust and the Third Sector Advice Services in a pilot to The strategy and ac�on plan 2023-26 will build on our achievements and work towards mee�ng the challenges our communi�es face.
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The Impact of Covid 19 The Covid 19 pandemic had a devasta�ng impact on families and communi�es across North Lanarkshire, with an increasing number of people falling into poverty with further financial challenges for those that were already in poverty. People faced issues such as redundancy, loss of income due to lockdown/furlough or shielding, the availability of childcare had an impact on some people’s availability for work. Whilst the council and its partners in both NHS Lanarkshire and the Third Sector took many steps to mi�gate the impacts of covid, there were also some ac�vi�es within the first Tackling Poverty Ac�on Plan that could not be achieved. Some ac�ons will be brought forward to this Strategy, whilst others will be removed or realigned due to changes in service delivery. The Health Hub for Informa�on and Advice – prior to Covid the tackling poverty team delivered services within 3 health centres, the service was therefore limited to these health centres and the prac�ces that use them. The impact of covid meant that the Tackling Poverty Team were no longer able to work in the Health Centre se�ngs. This however, presented an opportunity to promote the service throughout NHS Lanarkshire, crea�ng easier referral routes. The Ac�on Plan for the 2023-26 Strategy reflects the new opportuni�es provided by NHS Lanarkshire for their pa�ents to tackle poverty and inequality. Financial Educa�on – Due to restric�ons within the schools the financial educa�on programme, MACA was put on hold. Investment is required to develop the MACA programme and this is something we hope to take forward into the 2023-26 Ac�on Plan (see holis�c supports). Establishment of Involvement Group to help shape the strategy and services – The Lead Organisa�on for this, VANL, lost a number of volunteers due to the pandemic and the need for shielding/isola�on etc. In the 2023- 26 Strategy the Tackling Poverty Officers Ac�on Group have taken a different approach to this, using a number of routes to ensure that we hear as many voices across North Lanarkshire as possible. . Covid Recovery On 21 February 2022 the First Minister announced a new £80m Covid Economic Recovery Fund targe�ng support for Businesses and communi�es with the move to a new phase in the Covid pandemic with fewer restric�ons. The policy intent of this funding is to support local economic recovery and cosy of living impact on low-income households. North Lanarkshire received £5.149min funding, the council topped this up with over £3 million to make a budget of £8.613 million. The funding was used to mi�gate the impacts of covid and the then emerging cost of living crisis, with a plan that would ensure a dignified approach to talking the food, energy and fuel crisis by providing, where possible, a cash first response. The plan included;
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The release of £450,000 in grant funding for voluntary and community initiatives to enhance their existing drop-in spaces and premises across North Lanarkshire. The availability of welcome hubs in existing council facilities such as libraries, community and leisure centres where residents can get tea/coffee where possible, recharge digital devices and get a heat and a chat in a stigma-free environment. Taking a ‘cash first’ approach to tackling poverty by encouraging partners and third-sector organisations who provide emergency food to sign up to a ‘pledge’ to work with the Scottish Welfare Fund to access crisis grants as a first response (with food banks being the last port of call). A Living With Less roadshow across the region with the council’s Tackling Poverty Team and partner agencies where people can apply for grants on site and access support for benefits checks, grant eligibility and debt advice. Discussions around setting up a dedicated cost of living helpline in collaboration with the Health and Social Care Partnership to provide advice to residents in need. Frontline council workers will be able to access local heat hubs in a range of council facilities such as schools, libraries, community centres and leisure centres, where they can get a tea/coffee and break from the cold outside. Other staff will also be able to work more locally to their home to reduce commuting costs or domestic heating rates for those who work at home. The release of a £2.161m fuel hardship fund – a £150 payment to eligible low-income households – which can be applied for online. (Further payments of £125 Child Payment and £100 Pensioner Fuel Grant will be paid directly to those eligible). A Living With Less digital and online promotional campaign, targeting a range of residents and signposting them to crisis support such as financial assistance, grants, an online benefit and household budget calculator as well as advice on keeping good mental health and ways to make small savings, household changes and concessions to reduce the cost of living. The cost of living crisis con�nues to impact our communi�es, and all partners are commited to suppor�ng and assis�ng people during this �me, this Strategy and Ac�on Plan reflects the commitment and work done within the four drivers to tackle poverty across North Lanarkshire.
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The Drivers to Tackle Poverty Almost anyone can experience poverty; unexpected events such as bereavement, illness, redundancy, relationship breakdown can be enough to push someone into poverty which can then be difficult to escape. What Are the Drivers to Tackle Poverty? There are four drivers that we can use to tackle poverty in our communi�es; Maximise income via employment Reduce the cost of living Maximise income via social security benefits Holistic Supports North Lanarkshire Council and NHS Lanarkshire together with our partners in the Third Sector are delivering on these drivers to tackle poverty and inequality in our communi�es. Maximise Income Via Employment Driving up income from employment remains one of the mechanisms in North Lanarkshire which offers real opportuni�es to support unemployed and underemployed residents out of poverty. Employability is integrated within Educa�on & Families and contributes to the Brighter Future Programme of Work within the Plan for North Lanarkshire. It has the aim of transforming how we prepare young people and other residents for the world of work by delivering an interconnected programme of educa�on, volunteering, and entrepreneurship throughout various stages of their life. The aims and objec�ves of this are to: • Drive the recovery of North Lanarkshire’s labour market to pre-covid levels • Deliver significant jobs growth • Shape innovative employment pathways in key growth industry sectors • Provide inclusive and accessible support to boost entrepreneurship • Embed volunteering programme as a normal part of life • Transform how young people experience learning and teaching The post pandemic labour market that has emerged is characterised by low unemployment levels but increased economic inac�vity and within North Lanarkshire the employment rate is s�ll below the pre-pandemic levels. The North Lanarkshire claimant count, which acts as a measure of unemployment, was 14,415 (6.6%) people in March 2021 compared with 8,225 (3.8%) in March 2020, a 75% increase on the pre-pandemic level. However, in May 2023 it had decreased to 7,640 (3.5%) and average earnings in North Lanarkshire are now above the Sco�sh and UK averages for the first �me. This is good news, but real challenges remain due to levels of economic inac�vity. The number reported as ‘long term sick’ in North Lanarkshire has increased from 14,900 in the 12 months up to December 2019 to 26,300 in the 12 months up to December 2022. While unemployment is lower
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than pre-pandemic levels the number of people in the workforce in North Lanarkshire has reduced from 174,000 (78.1%) in December 2019 to 157,100 (70.1%) in December 2022. As we begin this strategy, the forecast for unemployment is uncertain as the UK remains within a period of high infla�on and with further expected rises in interest rates which will have an impact on business. From an employability perspec�ve this simply reinforces the long-term strategy of con�nuing to support those further from the labour market in North Lanarkshire to gain the skills needed to get a job and be part of the economic growth of the area. Alongside this we will con�nue to work with local employers to create opportuni�es for our unemployed residents, including those who are economically inac�ve. All employability programmes delivered by or on behalf of North Lanarkshire Council are based on the No One Le� Behind policy which is aimed at inclusive growth, economic transforma�on and tackling child poverty; and aims to deliver a system that is more tailored and responsive to the needs of people of all ages who want help and support on their journey towards, into and in work - par�cularly people with health condi�ons, disabled people and others who are disadvantaged in the labour market. Case Study Aged 21 and living at home with her parents, Jade has a learning disability, and her educa�on was in supported learning establishments and courses. Jade was referred to Project SEARCH in April 2022 as she knew she wanted a job and required support to find the right opportunity for her. Jade worked really hard in her placement within a health se�ng and received £89pw bursary. She was able to demonstrate her ability to learn tasks with rou�ne and structure built around them. Jade was delighted when she was successful in gaining a posi�on as a Porter with Serco in University Hospital Wishaw in February 2023. She now works 35 hours a week and earns £391.30, making her £302.30 a week beter off. Jade said "Starting my job has helped me build up my confidence and my communication skills and well as show me the ability I have in learning new skills. Having a wage is fantastic, it gives me extra money to spend, I don't have to borrow from my parents now, and this makes me feel great." Managed and co-ordinated by the Council’s Employability team, key worker support is provided by partner agency, Routes to Work Ltd. Their support is community based and person centred and focused on iden�fying fair and sustainable employment for their clients. The Council also fund other third sector ac�vi�es, and these are aimed at suppor�ng specialist employability support, again using the person-centred approach which treats our residents with respect and dignity. An important strand of the work carried out throughout the employability service is that of income maximisa�on. Partners within all Projects and Services make referrals to an iden�fied Welfare Rights Officer early in the job search journey. “Beter off” benefit calcula�ons equip people with the correct informa�on on the financial benefits of work. The council also provides a comprehensive Supported Employment service that focuses support on people with disabili�es, mental health issues and care experienced young people. The team has two strands: Supported employment and the supported business North Lanarkshire Industries. Supported employment aims to secure around 100 jobs for its service users per annum. The service supports disabled and disadvantaged people who are facing challenging barriers to find employment and provides in work support to enable the individual to sustain their employment. In work support is person centred and tailored to each individual’s and employer’s needs and makes a significant contribu�on in North Lanarkshire to reducing the disability employment gap.
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Case Study Bobby is 43 lives and with his elderly Mum. Autism means Bobby is very vulnerable and has increasingly become isolated, only leaving home if his Mum is with him. Bobby’s Mum contacted the supported enterprise service to refer Bobby for help in finding a job as she believed that this would give him a reason to go out and meet people and gain some independence. The employability welfare rights officer (WRO) carried out a benefit check and established that Bobby was only receiving the standard rate of universal credit. To maximise his income, the WRO provided support to obtain a fit note from the GP, upload this onto Bobby’s journal and complete a capability for work questionnaire. Bobby was awarded work related activity component, increasing his UC amount by £354.28 per month. A claim for Personal Independence Payment was also made and enhanced rates for care and mobility were awarded. Maximising Bobby’s income gave him a bit more motivation to want to go out to work and the job coach soon found Bobby some voluntary work in a catering environment. This led onto a part time job which has boosted Bobby’s confidence and made him a lot more independent. Figures below illustrate how Bobby is better off in work: Income at point of referral Income after initial maximisation by WRO Income when employed Universal Credit £77.28 £159.04 £159.04 Personal Independence Payment N/A £61.85 Care £24.45 Mobility £61.85 Care £24.45 Mobility Wage N/A N/A £82.50 TOTAL WEEKLY INCOME £77.28 £245.34 £327.84 WEEKLY INCREASE N/A £168.06 £250.56 In 2023 there are major changes in the external funding environment around employability in North Lanarkshire with significant new investments from the UK Shared Prosperity Fund and the Sco�sh Government’s No One Le� Behind fund bolstering the significant contribu�on from the Council to employability in North Lanarkshire. In targe�ng employment support on those at the margins of the labour market and on low incomes, our aspira�on is that they will have a posi�ve impact when delivered in tandem with the other tackling poverty ac�vi�es across our communi�es. The projects being delivered include: - Area based programmes to tackle economic inactivity with an additional focus on parents on low incomes - Support across all communities for unemployed residents to access work opportunities - Broad range of employment programmes for low-income parents including engagement activities, and support with childcare, training, skills development and in-work support - Continued focus on supporting our young people into sustained positive destinations in their transition from school to the labour market, including those with additional support needs and care experienced - Supported employment activities to all residents with significant barriers - North Lanarkshire Industries Supported Business
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- Specialist support to thematic groups that is tailored to their needs The work of employability in North Lanarkshire is integrated na�onally and locally with strategic plans and the community planning process through its Local Employability Partnership as well as with the Tackling Poverty Strategy. It also contributes to the area’s community wealth building ac�vi�es. Reduce The Cost of Living There is much work to do but with a clear ac�on plan we can reduce the impact of the Cost of Living Crisis on the people of North Lanarkshire and in turn, create financial resilience within our communi�es. In 2023, UK households are facing the steepest increases in living costs in a genera�on. The Sco�sh Fiscal Commission expects that Sco�sh households will see the biggest fall in disposable income since records began in 1998. The Office for Na�onal Sta�s�cs also shows a basic shopping basket has increased by an average 23% on last year’s figures. Even the cheapest value ranges in budget supermarkets have experienced increases as high as 46% meaning those with lower incomes are spending a higher propor�on of their income on food. It comes as no surprise that fuel poverty rates have increased in line with soaring energy costs. The Fuel Poverty (Scotland) Act 2019 established a new two-part defini�on whereby a household is considered fuel poor if: • Fuel Poverty - After housing costs, when more than 10% of the household net income is required to pay for reasonable fuel needs • Extreme Fuel Poverty - After housing costs, when more than 20% of net income is required to pay for reasonable fuel needs A Sco�sh Government report on the Cost-of-Living Crisis (January 2023) expects the Fuel poverty rate in April 2023 to be 39% of households in Fuel Poverty, 34% of these to be in extreme fuel poverty. In North Lanarkshire 59, 634 households will be in Fuel Poverty and 51, 989 of these will be in extreme Fuel Poverty. The social rented sector will have the highest rate of fuel poverty at 61%. The poorest in our communi�es o�en have to pay extra costs for essen�al products and services, o�en referred to as the “poverty premium”. This can include everything from using prepayment meters for fuel, paying to access their own cash at ATMs or being pushed towards High-cost credit. The University of Bristol’s Personal Finance Research Centre’s “Fair by Design” Campaign to end the poverty premium found that almost 23% of households in North Lanarkshire have significantly higher costs due to the poverty premium, as the figures for each of North Lanarkshire’s UK parliamentary cons�tuencies below show. The full table is available at appendix three.
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*Na�onal Records of Scotland: UK Parliamentary Cons�tuency (UKPC) Household and Dwelling Es�mates (2011 Data Zone Base Promo�ng Affordable Credit Op�ons Research shows that people in North Lanarkshire paid an extra £2,085,957 last year due to high costs of credit. It is not acceptable that the poorest people in our communi�es are forced to pay the highest costs for credit. Credit unions no longer deserve the "poor man’s bank" label attached to them – this only creates stigma and discourages people from joining. Instead, we must encourage the financially astute to become members of the credit union in their area. Credit unions are ethical financial institutions that offer free life insurance and loan protection to our members. This is unique in the Financial Sector. We need the whole community to be members so we can lend to all of our members, including those who are financially stressed or aspire to a better standard of living as we will then have the finances to do so. Julie Reddin, Director of Associa�on of Bri�sh Credit Unions Ltd (Scotland) There are 21 affiliated credit unions in North Lanarkshire (5 credit unions affiliated to Scottish League of Credit Unions & 16 Credit Unions affiliated to Association of British Credit Unions Ltd) and we have an important role to not only promote them but to work in partnership. One way to do this is to recruit local employers who will promote the benefits of Credit Unions within their workforce. NLC Tackling Poverty Team is developing a model of working with local employers to promote credit unions and other aspects of Financial Educa�on, with the aim of employers then encouraging their workforce to sign up to payroll deduc�ons with a local credit union. Illegal money lending is known to take place in North Lanarkshire with loan sharks targe�ng the most vulnerable in our communi�es. Those who use them are o�en desperate and don’t know where else to turn for help. North Lanarkshire Advice Network, an umbrella organisa�on for all advice agencies opera�ng in the area will work in partnership with Sco�sh Illegal Money Lending Unit to increase its reach within our communi�es to stamp out loan sharks. NLC tackling Poverty Team are also working towards achieving the “Stop the Loan Sharks” Chartermark and will soon appoint an illegal money lending Champion to take forward this work. Informing our Residents The huge impact of the Cost of Living Crisis called for large scale co-ordinated informa�on distribu�on in order to inform and educate about help available: - • Over 36,000 page views on newly developed NLC and NHSL Cost of Living Web pages • 2,521 Benefit Calculations carried out by residents on our newly developed online benefits calculator • 87 personal budget plans completed on our Budget planner tool • Co-production of the North Lanarkshire “Money Worries” leaflet with independent Food Aid Network and distribution of 27, 000 leaflets • Money Worries Training delivered to 46 attendees from North Lanarkshire’s identified “Warm Spaces” Motherwell and Wishaw Cumbernauld, Kilsyth and Kirkintilloch East Coatbridge, Chryston and Bellshill Airdrie and Shotts Total cost of poverty premium £ 5,034,499 £ 3,743,300 £ 4,518,868 £ 4,439,222
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Advising and Assis�ng We will con�nue to provide Advice, Support and Representa�on to those experiencing Problems with Debt. The Cost of Living Crisis has saw an increase in the numbers of people seeking advice across both local authority and Ci�zens Advice Network. Health staff including NHSL Link Workers based within GP surgeries provide a crucial role in referring those experiencing Physical and Mental Health impacts caused or worsened by Debt Worries and referred 181 people over the last year (an increase of 64 on the previous year when the GP link worker scheme started) A total of 6,725 referrals for debt advice were received over the life�me of the Strategy by both NLC and CAB Debt Advisers. Number of Referrals Received Apr 20 – Mar 21 1937 Apr 21 – Mar 22 2199 April 22 – Mar 23 2589 Amount of Debt Dealt With Apr 20 – Mar 21 £10,267,242 Apr 21 – Mar 22 £10,023,578 April 22 – Mar 23 £11,875,983 Amount of Debt Writen Off Apr 20 – Mar 21 £2,032,758 Apr 21 – Mar 22 £1,292,445 April 22 – Mar 23 £1,741,159 Providing free Period Products In 2022/23, 399,140 products were delivered in North Lanarkshire; 78,396 of these were in schools. We will work to expand and improve provision of Period Products to ensure that everyone who needs them can access them freely. We will con�nue to grow our network of 117 local access points within North Lanarkshire through council buildings local community groups with the aim of products being readily available within a 20 min journey. To help us achieve this we have partnered with Community Groups including those who provide emergency food provision. In 8 local areas e-bikes are used to deliver product to the doorstep for women who would not otherwise be able to access them and for those using food banks, products are made available there. We have also supplied dispensers and period products to Accident and Emergency Departments in Both University Hospital Wishaw and University Hospital Monklands and provide products to Health Centres across North Lanarkshire.
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We recognise that s�gma remains a barrier to access, par�cularly amongst younger women and girls and to address this educa�on is key. A peer support programme is planned and will see senior pupils and community group members develop and deliver an educa�on programme to their peers promo�ng dignity, equality and an end to period poverty. Helping people to “Quit Your Way” Research by Ash Scotland showed that 63,000 households in Scotland would no longer experience relative poverty if people were empowered to successfully give up tobacco. 42% of all households in Scotland containing people who smoke are currently living in relative poverty, a figure which could be reduced by around 10% if tobacco was not a factor. Reducing smoking prevalence in Scotland by just one percent could lift more than 3,700 households out of relative poverty. A training module has been developed by ASH Scotland and NHSL Tobacco Control Team which will be used by ASH Scotland to facilitate training on smoking and poverty. The NHSL Tobacco Control team have already offered this training locally to advisors within the Tackling Poverty Team, so that Welfare Rights Staff and Debt Advisers can promote the “Quit your way” programme and signpost people to the service. “I’ve been putting this cash by in a tin that I would spend on cigarettes. My Grandson wanted a football strip which I thought was too much money to buy him, but after 10 days of quitting smoking I was able to buy it for him. I’m also keeping the money I’m saving for Christmas and other bills. That was just a part of it though, my health was the main reason and I now have more energy and my house doesn’t smell of smoke anymore.” (Quit Your Way – successful participant)
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Promo�ng Free Travel for under 22s Since its launch in January 2022, the scheme has been promoted widely and con�nually through schools, within the community, on NLC and NHSL websites, by social media (Corporate and youthwork, CLD channels), and by colleagues working with children, young people, and families. Parents and Carers have received text messages direct to parents and Community Learning & Development Staff con�nue to engage with applicants. Efforts have been made to encourage applica�ons from disadvantaged groups such as care experienced young people, refugees, families living in poverty, social work service users, and young job seekers, students and those working with partner agencies. Uptake varies widely amongst different age groups with. At either end of the age spectrum 5 year olds and 21 year olds have taken up fewest travel cards but 80-90% of 10-12yrs have obtained a travel card. Reducing Fuel Poverty Fuel Poverty rates are es�mated to be at 39% in North Lanarkshire with Social Housing Tenants faring even worse with rates as high as 61%. Whilst some financial help is s�ll available from UK and Sco�sh government, this will only par�ally address the problem and only some will be eligible for help. North Lanarkshire Energy Advice Service was commissioned in early 2023 to provide mentoring, support and advocacy to our most vulnerable households to ensure no one has to struggle between choosing to heat or to eat. Energy Mentors will empower and equip households with the skills and knowledge to reduce energy and achieve sustainable outcomes. Ci�zens Advice Network in North Lanarkshire Delivered Energy Advice via a number of ini�a�ves from 2020- 2023. Motherwell & Wishaw CAB partnered with Airdrie CAB to provide a single point of contact for vulnerable energy consumers across North Lanarkshire experiencing nega�ve energy usage and debt situa�ons. Tenants and homeowners accessed mul�-channel support for energy issues and nearly 7,000 people were assisted in the last three years and assisted in wri�ng off over £500,000 of energy debt.
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Home Energy Scotland are Key partners for agencies in North Lanarkshire to refer to for both expert Energy Advice and practical measures to combat fuel poverty. Over the year 1st April 2022- 31st March 2023; • Home Energy Scotland engaged with 6,427 households in North Lanarkshire • 998 of those households had at least one child under 16 • 1,000 of those households were 65years or over • 1,473 of those households had a disability • 450 Households in Fuel Crisis were referred to National Fuelbank and assisted with emergency vouchers • 1,168 referrals were received from partner agencies through Home Energy Scotland’s online portal Provide Affordable Homes for our Residents The council are commited to delivering 5000 affordable new homes by 2035, reducing the cost of living by increasing the supply of affordable, energy efficient homes. To date (end of December 2022), a total of 1,566 affordable homes delivered comprising of 970 new build homes and 596 Open Market Purchase Scheme/Empty Market Purchase Scheme homes. OMPS was expanded during 2022/23 to acquire homes that would enable common works to move forward in priority blocks and allow the only remaining owner occupier to remain in their proper�es as a social tenant, with a further later expansion to alleviate homelessness. North Lanarkshire Council will aim to con�nue to meet Energy Efficiency Standards for Social Housing (EESSH) at band C and D for NLC Proper�es. Government Funding Schemes will be fully u�lised to make energy efficient upgrades including central hea�ng and insula�on. Wider Area based Schemes will also fund energy efficiency of NLC Housing Stock. The Council achieved 99.4% of our proper�es with an EPC ra�ng of D (SAP 55 or above), which is slightly above last year’s figure of 99.2%. By 2025, social landlords will be unable to rent proper�es rated below an EPC ‘D’. A new EESSH standard requires that all social housing meet EPC band B or is as energy efficient as prac�cally possible by the end of December 2032, within the limits of cost, technology and necessary consent. Wider Area based Schemes con�nue to be u�lised to also fund energy efficiency of NLC Housing stock.
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Food Poverty – The Pledge Maximise Income Via Social Security Benefits There have been considerable achievements in the 2020-23, Tackling Poverty Strategy under Income from Social Security, the most notable being genera�ng addi�onal income of nearly £100 million for our residents within the three years of this strategy. Covid impacted on service delivery and some of the ac�ons detailed within the Plan, this was due to the way services had to be delivered, therefore for example the training programme for Health Staff was delayed with many health staff being redirected to other services to ensure the health service was able to meet the demands put upon them. This ac�on will feature in the 2023-26 Ac�on Plan together with some new ini�a�ves that are now taking place in health se�ngs. This includes the investment for the Cost of Living Helpline, demonstra�ng the recogni�on of the links between poverty and health inequali�es. North Lanarkshire Food Poverty Referral Gateway was introduced in 2015, leading the way in Cash First approaches to tackling food poverty and insecurity in our communi�es. An approach now adopted by the Sco�sh Government. To affirm the approach an event was held in 2022 asking emergency food providers to sign up to “The Pledge” where we will ensure that no one is le� without food, and they will have access to income maximisa�on and budge�ng services. As we move through 2023, the Food Poverty Ac�on Group are working to cement this approach, Trussel Trust and the Ci�zens Advice Bureau have atracted funding to augment the Gateway.
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Therefore, a major founda�on of our work to tackle poverty in North Lanarkshire remains a strong commitment to income maximisa�on. Since 2011, the Tackling Poverty Team, Social Work Service and Housing Solu�ons have carried out 263,000 benefit checks, genera�ng £383 million in addi�onal benefit income for the most vulnerable residents of North Lanarkshire. Rising living costs and historically low benefit levels mean that many families on low and middle incomes now struggle to meet their basic outgoings. New research from Policy in Prac�ce – Missing Out April 2023, finds that £18.7 billion of benefits intended to help these families remains unclaimed. Therefore, maximising household income through the take up of benefits is essen�al to support families and reduce harm from homelessness, debt or other crises. Policy in Practice – Missing Out Report – Unclaimed Benefits April 2023 From these findings it is important that our Ac�on Plan for Tackling Poverty ensures the “no wrong door” approach is embedded into our prac�ce across all internal services together with our partners in NHS Lanarkshire and the Third Sector. How will we do this? The Tackling Poverty Team has produced Poverty Awareness Sessions, which can be tailored not just to the Services we are delivering to, such as social work, health, educa�on, addic�on etc, but can also be drilled down to impacts in each Community Board area. In doing this we can look at referral gateways and solu�ons that are bespoke to each service and locality, therefore suppor�ng referrals to income maximisa�on services. A Cumbernauld resident contacted the Tackling Poverty Team advising that he had tried mul�ple �mes to claim his state pension without success. The Tackling Poverty Team supported him to get his pension into payment and backdated to the day he reached pension age. They iden�fied that he also had an en�tlement to Pension Credit and Council Tax Reduc�on. The man received a backdated pension payment of £6000, together with pension credit of £73 per week together with full council tax reduc�on. An annual increase of £3796 addi�onal income for the man. The man stated, “he couldn’t be happier he was getting nowhere himself.”
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The Poverty Awareness Sessions have now been delivered to over 200 staff, prac��oners and community members, the programme will con�nue and be adapted to ensure relevance for each organisa�on delivered to. The feedback has been really posi�ve; “informative session and great examples shared today” “I learned lots from the session that I didn’t know” “Seeing the information for my locality was hard hitting, but we were then told about the referral routes for us……I feel more confident to approach the issue of money now” The Tackling Poverty Awareness sessions are designed to ensure that the ethos within the Programme of Work where we muster our resources and recognise that poverty is not something that we can look at on its own is reflected in this. Poverty impacts all areas of life, the Joseph Rowntree defini�on the Strategy has adopted reflects this; “Poverty means not being able to heat your home, pay your rent or buy the essentials for your children. It means waking up every day facing insecurity, uncertainty and impossible decisions about money. It means facing marginalisation, and even discrimination, because of your financial circumstances. The constant stress it causes can lead to problems that deprive people of the chance to play a full part in society.” In recognising this, it is important to acknowledge that in working to achieve our goal to reduce and tackle poverty in North Lanarkshire this is not something that one service can do on its own. Referral pathways ensure that services have access to specialised advisors, inves�ng in internal and external services ensure that people have access to those advisors. NHS Lanarkshire The Health Founda�on in 2020 stated that Income is associated with health; people in the botom 40% of the income distribu�on are almost twice as likely to report poor health than those in the top 20%. Poverty in par�cular is associated with worse health outcomes. Income and health can both affect each other – lower income is associated with more “stressors” which can harm health and allow fewer opportuni�es for good health. Poor health can limit the opportunity for good and stable employment and so affect income. NHS Lanarkshire has made significant investment in tackling poverty measures in North Lanarkshire including within income maximisa�on services. Recent investments include the funding of a Cost of Living Helpline hosted by the Councils’ Tackling Poverty Team giving people access to both income maximisa�on and money advice services. Referral pathways have been established to make it easy for health staff to refer pa�ents into the team to get the supports they need; “As a Health Visitor it is reassuring to know that the Tackling Poverty Team have the knowledge and skills to assist the families we work with both by providing advice and practical support.
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“As a Health Visitor it is very easy to make a referral to ensure our families receive the best support in maximising their incomes.” NHS Lanarkshire have established “GP Link Workers” with a referral route to their partners in both the councils’ Tackling Poverty Team and the Ci�zens Advice Bureaux. The Link Workers are available in various GP surgeries across North Lanarkshire, over the last two years the link workers have referred 860 people for help with welfare rights and 252 people for help with money/debt advice. The total income generated to date from these referrals is £330,260. The Improvement Service have also funded a project within North Lanarkshire; Welfare Advice and Health Partnership, where we are improving access to money and welfare rights advice in health care se�ngs. This is achieved by embedding advice workers in health se�ngs and providing consensual access to medical recorBased in three surgeries across North Lanarkshire this project has proven to be extremely successful, with 357 referrals received in one year genera�ng £715,865. The feedback received from the medical prac�ces has been nothing but posi�ve for this service; “The welfare rights officer joined the practice once a week to help with our patients and has been a great help to the patients not only from a financial point of view but also from a mental health and wellbeing perspective, some people are in a situation where they don’t know what to do or who to turn too, the welfare rights officer goes over and above to help sort out their affairs or tries to make sure they are getting what is right, in turn patients seem relieved and feel light is at the end of the tunnel which often lifts the anxiety they have been living with” Waverley Medical Practice, Coatbridge “The welfare rights officer has been an amazing addition to our practice MDT. She is very hard working, approachable and a great team member. The project has been helping our patients greatly and easing their financial pressures, which has a very positive impact on their mental and physical health. This is more important than ever whilst in the midst of a cost of living crisis. The project has been welcomed fully at Old Mill, patients are engaging well and getting the help they need due to their poor health and mobility. I would honestly say this project has been the most helpful and useful addition we have ever had, and patient feedback has been excellent.”
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Dr Aimee McGinness – Old Mill Practice, Bellshill The Third Sector The Tackling Poverty Team are responsible for the commissioning of external advice services to provide welfare rights and debt advice. The successful candidates for 2023-25 have been 5 local Ci�zens Advice Bureaux. The Ci�zens Advice Bureaux (CABx) are commited to working with the Tackling Poverty Officers Ac�on Group in implemen�ng the Strategy and Ac�on Plan. The CABx have contributed to maximising income across the local authority genera�ng £22.6 million in addi�onal income for residents during the three year period (2020-23) of the last Tackling Poverty Strategy. The CABx are also commited to tackling food poverty by implemen�ng the councils’ Food Poverty Referral Gateway which promotes the Cash First approach. Trussel Trust are working in conjunc�on with the local CABx over the next 2 years focussing on enhancing access and engagement with the North Lanarkshire Food Poverty Referral Gateway. Augmen�ng the exis�ng Gateway as the preferred route for cash first support and ensuring a dignified and holis�c approach to tackling food poverty and insecurity. The pilot will be delivered in communi�es with Motherwell, Wishaw and Airdrie in local community hubs working alongside community organisa�ons in both one to one and group se�ngs, providing advice, support and training. The case studies and the tes�mony from the GP prac�ces highlight the rela�onship between poor health and poverty, and the need for the important joint work with NHS Lanarkshire to con�nue across our communi�es. Case Study from Waverley Prac�ce – Welfare Advice and Health Partnership The GP made a referral to the Welfare Advice and Health Partnership for a man who had completed an applica�on for Personal Independence Payment which was refused. A�er lodging an appeal, the man was seeking representa�on, the Welfare Rights Officer asked the man to sign a mandate authorising North Lanarkshire to act on his behalf. The Welfare Rights Officer was able to access the man’s medical records from the NHS system and enclosed the evidence with the mandate. On receipt of this evidence the decision was overturned within a week, with an award of both Enhanced Rate Mobility and Daily Living. As with all cases the man was given a benefit check and the Welfare Rights Officer iden�fied that he was missing the Sco�sh Child Payment for his two children, aged 12 and 13. The man was unaware that this could be claimed. As a result of the referral from the GP the man’s income has now been increased by £206.90 per week (£10,758.80 per annum)
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HOLISITIC SUPPORTS In North Lanarkshire we recognise that to deliver sustained reduc�ons in child poverty over the long term, and to break that cycle of poverty, ensuring that our children living in poverty do not grow up to be adults living in poverty, we will work with our partners to provide the integrated and holis�c support parents need to enter employment, improve their wider wellbeing and engage with the drivers of poverty. In North Lanarkshire we are commited to delivering a “No Wrong Door” approach to our services to ensure that all residents, including those in poverty and those at risk of falling into poverty receive the right support at the right �me. Ensuring all families have the support they need, regardless of what those supports may be, is essen�al if we are to enable families to thrive in all aspects of their wellbeing. Whole Family Support The aim of the Whole Family Wellbeing Fund is to provide addi�onal resource to support the transforma�on of the system of support to children and families in line with the Na�onal Principles of Holis�c Family Support and ambi�on of The Promise to provide flexible family support, enabling more children to remain loved and supported within their own families. The Promise places a requirement on Local Authori�es and their partners to transform whole systems and culture to ensure all children, in any aspect of care, thrive through nurturing and loving rela�onships with access to support that strengthens communi�es and families. The Promise places preven�on and family support at the heart of its vision. The Promise Plan 2021-24 published on 31st March 2021 sets out 5 key priori�es for the first phase of implemen�ng The Promise including a focus on ‘Whole Family Support’ with an expecta�on that the 10 key principles of family support outlined within the Promise are embedded into prac�ce by 2024 and that there is a place in every community for families with children ‘to stay and play with their children and get support and CITIZENS ADVICE BUREAU – COATBRIDGE A 41 year old man with 4 children presented to Coatbridge Ci�zens Advice Bureau, he himself had health issues. He contacted the Ci�zens Advice Bureau explaining he had a £12,000 benefit overpayment which had resulted as a clerical error by the DWP five years previous. The man himself had tried to dispute this himself with DWP but was ge�ng nowhere, he asked the CAB to help him. The case worker took the man’s case to appeal and was successful in their argument meaning that the overpayment was writen off. The man stated, “if it wasn’t for the CAB service especially the welfare rights team, my mental health would have been so poor that I would have gone down a dark path”.
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advice’. This aligns closely with the Tackling Poverty strategy and the aspira�ons of the Plan for North Lanarkshire; and in par�cular plans to develop community hubs as a central vehicle to deliver support, enhance community capacity and support every child to reach their poten�al. Research has shown there is a rela�onship between poverty and longer-term nega�ve outcomes for children (Lewer et al, 2019) and that while the rela�onship between poverty and child abuse and neglect is complex, studies have also shown that financial support and increased income lead to lower levels of child maltreatment (Bywaters et al, 2016). North Lanarkshire Council, as part of the Covid-19 Tackling poverty plan, adopted a ‘cash first’ approach to suppor�ng the most vulnerable families to address basic needs, which proved effec�ve in promo�ng improved outcomes. By providing money directly to families North Lanarkshire’s strength based and collabora�ve approach offered welcomed financial relief. In order to provide holis�c family support that truly aligns with the Promise and Tackling Poverty ac�on plan, there is a clear need to join up services so that people can experience a seamless transi�on into addi�onal and intensive level supports and services. This improves access to exis�ng exper�se within our services. These na�onal policy aims align with the Plan for North Lanarkshire and the Council’s new Programme of Work which makes family support central to its opera�ng model through the Resilient People workstream. North Lanarkshire Alcohol and Drug Partnership North Lanarkshire Alcohol and Drug Partnership (NLADP) is a mul�-agency strategic partnership focused on understanding and mi�ga�ng the impact of problema�c alcohol and drug use in the local area. The purpose of the ADP is to co-ordinate and lead a collec�ve response to tackle harms and improve the lives of people who use alcohol and drugs, and those around them. The ADP is made up of key agencies and stakeholders with an interest in tackling harms and improving lives. This includes the wider community and those who have lived experience and families. Much of the work carried out by the ADP involves bringing people together to plan and improve services whilst se�ng out what needs to be put in place to support change and keep people safe and well. The strong links between drug and alcohol related harms and poverty, inequality and trauma are widely acknowledged. Depriva�on has been linked as a significant factor in drug and alcohol problems developing. The ADP are tasked by Sco�sh Government to ensure the implementa�on of na�onal policy and evidence- based prac�ce. Improving Choice, Quality and Connec�ons are key drivers underpinning the work of the ADP. The ADP have 5 key priority areas of focus for our work which includes; Preven�on, Educa�on and Early interven�on, Whole Family Approach, Treatment and Care, Public Health Approach to Jus�ce and Reducing Alcohol Harms. Each of the sub-groups are tasked with understanding and mi�ga�ng harms from substances, and poverty, and have a linked programme of work to support change and keep people safe and well across our communi�es. Jus�ce Services Whilst The Tackling Poverty Team and other services will support Services by providing income maximisa�on, debt and money advice, employment advice, services themselves such as the Restora�ve Jus�ce Service also contribute to tackling poverty and inequality through a number of ini�a�ves, such as;
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Individuals who are subject to Unpaid Work can undertake work with the Bike Recycling Project. During the last reporting year over 650 bicycles were retrieved from recycling centres in North Lanarkshire. Some were scrapped for parts, however, over 320 bicycles have been reconstructed. These recycled and repaired bikes are donated to the Councils’ Christmas Toy appeal as well as being donated low income families. Bikes are also donated to local schools to ensure that all pupils can take part in Cycle Safety Awareness Courses and the healthy living programme. A craft workshop has been developed to repair clothing and soft furnishings for low income families. A kitchen workshop has been developed to deliver a programme consisting of food hygiene, nutrition, budgeting and basic meal preparation. The workshop performs a platform to undertake placements in foodbanks and community cafes such as Shotts Healthy Living Centre and Newmains Community Trust. A laundry workshop has been created that provides a service to charity shops collecting clothing for laundering and returning to the shops for sale. In an effort to reduce poverty, a laundry service is provided to Craigneuk Family Centre and two charitable groups; “Cool School Uniforms” and “Airdrie School Clothing Bank”, this involves the collection, laundering and distribution of recycled school uniforms to low-income families. These indirect supports contribute to suppor�ng the Tackling Poverty Strategy and our communi�es across North Lanarkshire. Community Connectors North Lanarkshire Health and Social Care Community Solu�ons programme will support the pilo�ng of 10 Community Connectors from autumn 2023 – autumn 2025 who will support people in local communi�es to access the help they need which will include referral to sources of financial support. The connectors will be based in loca�ons across North Lanarkshire working closely with Community Solu�ons Locality Hosts, the wider community and voluntary sector, the council and NHS. The pilot is funded through a mix of funding from North Lanarkshire Health and Social Care Partnership, NHS Lanarkshire/NHS Chari�es Together and MacMillan. Voluntary Ac�on North Lanarkshire is managing the funding awards on behalf of funders and will be suppor�ng evalua�on and repor�ng on the pilot. Community Wealth Building Community Wealth Building is an interna�onally recognised approach to economic development designed to tackle long-standing economic challenges. It seeks to transform local and regional economies by considering the ways in which the public sector, in partnership with the private, third and community sectors, can ensure more wealth is generated, circulated and retained in communi�es and locali�es.
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The approach is focussed on growing the influence communi�es have on the economy and ensuring communi�es receive more of the benefits from the wealth they help to generate. The council and local partners are currently mapping ac�vity to iden�fy areas for further development and improvement, and are considering and consul�ng on the approach which will be adopted in North Lanarkshire to embed Community Wealth Building. Community wealth building is a progressive approach for the benefit of the local population. This is achieved by harnessing the economic and social power of locally rooted organisations, often referred to as local anchors. Anchor organisations are big and locally rooted organisations including the NHS, local authorities, colleges and universities, and private businesses with local HQs. Because they employ many people, spend substantial amounts of money, own and manage land and assets and often deliver crucial services, they have a considerable impact on local communities and economies. Further, they are historically rooted in the physical area, intrinsically connected to the local community and are pivotal to wellbeing. Alongside its main func�on, NHS Lanarkshire recognises its role in making a strategic contribu�on to the local economy. Anchor organisations are pivotal to community wealth building as a result of the scale at which they operate. After a benchmarking exercise, NHS Lanarkshire has developed an ac�on plan to maximise its role and are now working with other community planning partners in North Lanarkshire to maximise the collec�ve impact, share best prac�ce and iden�fy areas where local anchors can work together. It is proposed that this will be through the adop�on of a Community Wealth Building Commitment Statement early in 2024 whereby any relevant projects, Programmes of Work, Strategies and ac�on plans must demonstrate how Community Wealth Building principles and approaches are applied. Financial Educa�on in North Lanarkshire Financial Educa�on helps people develop the knowledge, skills and a�tudes needed to manage money well and make informed decisions. North Lanarkshire has the goal to ensure that financial educa�on is available to everyone in our community regardless of age. The ambi�ous aim is to produce and deliver financial educa�on packages that will be suitable for children in early years and primary school, our young people in secondary school and to adults of all ages in the community. Working together with educa�on the Tackling Poverty Team will create packages suitable to early year, primary and secondary pupils together with packages specifically for Addi�onal Support Needs pupils. The packages will be jointly delivered to ensure that our children and young people are given the grounding needed to make informed decisions around spending and saving. Adults in the community will be able to access financial educa�on through the Mul�ply Project. The Mul�ply Project is a government ini�a�ve helping adults to improve their numeracy skills, people can access numeracy qualifica�ons with the access of the Community Learning and Development Service and will be able to access financial educa�on from the Tackling Poverty Team. Financial Educa�on is a key holis�c support for our communi�es to make informed decisions about their money and to know what supports are available, how to access them and the importance of early interven�on if it is necessary.
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“Education on managing money and spending/cooking on a budget” “Teach folk the value of money and how to make it stretch” How Will We Know We Are Making a Difference? We have to know that the measures we are taking are making a difference in our communi�es – how will we know this? An improvement in the health and wellbeing of our residents Fewer households living in poverty Reduc�on in child poverty Fewer people unemployed and in receipt of out of work benefits Reduc�on in the number of people economically inac�ve An increase in the number of people paid at least the real living wage An increase in the number of affordable homes Fewer young people who are not in educa�on, employment or training Improved educa�on atainment Fewer people with no qualifica�ons or skills training Fewer households in fuel poverty Maximise income through social security benefits Maximise income via new Sco�sh social security benefits for children More people with numeracy skills enabling them to manage their money Reduce number of people in debt Increase number of people who have access to affordable credit Effec�ve heat maps to inform residents of access to services Increase community consulta�on
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Pqtvj "Ncpctmuj ktg Rtqɗng Appendix One - North Lanarkshire Profile
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Appendix Two – Cost of Living Survey
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Power BI Desktop University of Bristol’s Personal Finance Research Centre’s “Fair by Design” Campaign to end the poverty premium found that people almost 23% of households in North Lanarkshire are paying an average of £480 per year due to the poverty premium. Motherwell and Wishaw Cumbernauld, Kilsyth and Kirkintilloch East Coatbridge, Chryston and Bellshill Airdrie and Shotts Total cost of poverty premium £ 5,034,499 £ 3,743,300 £ 4,518,868 £ 4,439,222 *Number of households experiencing any premium 18, 623 (24.4%) 13,856 (21.6%) 16,768 (22.7%) 16,337 (23.2%) Prepayment meter premium £456,205 £ 345,872 £ 405,035 £ 387,902 Non-standard billing premium £734,721 £ 624,117 £ 695,143 £ 671,100 Non-switching premium £ 1,677,203 £ 1,283,483 £ 1,507,324 £ 1,402,565 Area-based insurance premium £ 1,046,669 £ 610,781 £ 886,538 £ 1,010,319 Single item insurance premiums £ 454,145 £ 400,708 £ 439,489 £ 392,368 Access to money premium £ 62,966 £ 48,465 £ 55,108 £ 51,707 Higher-cost credit premium £ 602,590 £ 429,874 £ 530,231 £ 523,262 Average cost to households in poverty £ 483 £ 453 £ 480 £ 507 *Na�onal Records of Scotland: UK Parliamentary Cons�tuency (UKPC) Household and Dwelling Es�mates (2011 Data Zone Bas Appendix Three - North Lanarkshire Poverty Premium
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Appendix 2
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Document control Title Local Child Poverty Action Report 2022 23 Document status (final or draft version) Draft Owner Alison Gordon e-mail address gordonal@northlan.gov.uk Governance group Tackling Poverty Officers Action Group Author John Campbell e-mail address campbelljohn@northlan.gov.uk Revision history Number Originator Date Revision description / record of change 1.0 AGC 30 june 2023 First draft 2.0 AGC 20th July 2023 Additional Sections added 2.1 AGC 24th July 2023 Case study added 2.2 AGC 31st July 2023 Appendix – the three questions quotes 2.3 AGC 8th Aug 2023 Nhsl update to foreward Document approvals Number Governance group Date approval granted Date approval to be requested (if document still draft) 1.0 2.0 Consultation record (for most recent update) Status of document consulted upon Stakeholders consulted / date
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Foreword Tackling child poverty in our communi�es remains a priority for North Lanarkshire Council, for NHS Lanarkshire and for our third sector partners. We have demonstrated that through a number of measures we have taken over this past year reflected, in this Local Child Poverty Ac�on Report. For our families with children, who are living on low incomes and were already struggling, the onset of the cost-of-living crisis has caused even more difficult financial circumstances and for some families, this will have deepened their experience of poverty. This Report will highlight the work that has been carried out across our communi�es by all the partners to ensure that we are tackling poverty, using all the drivers and resources available, including the fourth driver; Holis�c Supports, introduced in Sco�sh Government’s Child Poverty Delivery Plan “Best Start, Bright Futures”. We are delighted that this report and its ac�on plan have been greatly influenced by the children and young people of North Lanarkshire who have taken part in “The Three Ques�ons”, a programme in itself, which will con�nue to be developed throughout our educa�on clusters to ensure that our approach does not falter but con�nually develops to meet the needs of our young popula�on. Together with this report is the Councils’ second Tackling Poverty Strategy which embraces the Plan for North Lanarkshire’s Programme of Work, where Whole Family Support is a prevalent theme. The three-year strategy will ensure that our shared ambi�on for North Lanarkshire to be the place to live, learn, work, invest and visit will be realised for the benefit of our whole popula�on. Councillor Jim Logue Mar�n Hill Councillor Geraldine Woods Leader of the Council Chair, NHS Lanarkshire Convenor Wellbeing & Tackling Poverty Commitee
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Contents Page Number Title Introduc�on North Lanarkshire Child Poverty Profile Priority Groups North Lanarkshire Children’s Services Partnership The Drivers of Tackling Poverty Increase Income Via Employment Prospects for Parents Reducing The Cost of Living Helping People To “Quit Your Way” Promoting Free Travel For Under 22s The Pledge Income Via Social Security Benefits It Starts With A Benefit Check How Will We Do This? NHS Lanarkshire The Third Sector Promoting Uptake Of Benefits For Children In Education The Improvement Service Holis�c Supports Infant Minds Matter Whole Family Support North Lanarkshire Alcohol and Drug Partnership Justice Services Let’s Talk……. The Three Questions What’s Next For The Three Questions Financial Education Additional Support Needs Schools Achievements and Challenges Appendix One – Cost of Living Survey Quotes
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Introduc�on “Poverty means not being able to heat your home, pay your rent or buy the essentials for your children. It means waking up every day facing insecurity, uncertainty and impossible decisions about money. It means facing marginalisation – and even discrimination – because of your financial circumstances. The constant stress it causes can lead to problems that deprive people of the chance to play a full part in society.” The Child Poverty (Scotland) Act 2017 places a duty on Local Authori�es and NHS Boards to jointly develop and publish an annual Local Child Poverty Ac�on Report (LCPAR). North Lanarkshire took the approach to embed the local child poverty ac�on report into its overall Tackling Poverty Strategy to help ensure that tackling poverty is an area that is considered in decision making across the Partnership. North Lanarkshire Tackling Poverty Officers Ac�on Group (TPOAG) has representa�ves from Council Services, NHS Lanarkshire and the Third Sector and this is the fi�h LCPAR produced by the group. This report will iden�fy work that is being carried out across North Lanarkshire using the drivers to tackle poverty and inequality across our communi�es. Increasingly, in North Lanarkshire, we are taking a rights-based approach and giving considera�on to the rela�onship between children’s rights and poverty. This report aligns with the Best Start, Bright Futures; tackling child poverty delivery plan 2022 – 26 and using this approach we have introduced “holis�c supports” as the fourth driver to tackle poverty and inequality. In recognising Holis�c Supports as a driver, we will ensure that people and families do not exist in siloes, o�en unaware of the kinds of support that are available given the mul�ple channels through which this support can be delivered. The holis�c support driver to tackle poverty embeds the “no wrong door” approach to ensure that those in poverty and those at risk of falling into poverty, receive the right support at the right �me. Increase Income from Employment Reduce the cost of living Income from Social Security Benefits Holis�c Supports
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North Lanarkshire Child Poverty Profile Historically, the local authority has experienced higher than average levels of depriva�on. The Sco�sh Index of Mul�ple Depriva�on (SIMD) 2020 iden�fied across North Lanarkshire 50,897 people are income deprived, equa�ng to 15% of the popula�on. The Sco�sh average is 12%. Around 22,426 of the 50,897 income deprived people men�oned above, live in neighbourhoods, spread across North Lanarkshire, that are not classed within the 20% most deprived. Income depriva�on is defined as those of working age (and their dependants) who are on low incomes. North Lanarkshire remains 6th in terms of its share of datazones in the 20% most deprived in Scotland, si�ng behind, Inverclyde, Glasgow, North Ayrshire, West Dunbartonshire and Dundee. Ward No of children living in poverty % of children living in poverty Airdrie Central 679 23.4% Airdrie North 772 20.4% Airdrie South 616 16.3% Bellshill 535 20.8% Coatbridge North 541 22.9% Coatbridge South 708 21.2% Coatbridge West 545 20.3% Cumbernauld East 595 20.8% Cumbernauld North 324 10.6% Cumbernauld South 547 19.7% For�ssat 576 20.7% Gartcosh, Glenboig & Moodiesburn 360 11.7% Kilsyth 491 18.4% Mossend and Holytown 493 21.1% Motherwell North 697 19.0% Motherwell South East & Ravenscraig 790 22.5% Motherwell West 497 18.9% Murdostoun 667 17.4% Stepps, Chryston & Muirhead 251 10.6% Thorniewood 464 19.1% Wishaw 549 19.2%
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North Lanarkshire has five datazones within the 1% most deprived areas of Scotland. This strategy will ensure resources are directed to these areas as a priority. Priority Groups The Sco�sh Government iden�fied “priority groups” where evidence indicated that it was children in these groups that were at the highest risk of experiencing child poverty. To help measure the impact and support provided to these priority groups, adjustments were made to North Lanarkshire’s Tackling Poverty Team recording system where all financial assessments/benefit checks are recorded. Within these screens the following groups were added; Lone Parent Families Minority Ethnic Families Families where a member of the household is disabled Families with a mother under 25 Families with 3 or more children Families where the youngest child is under 1 This then allows us to track any work we are doing with the priority groups. In 2022/23 the Team carried out over 22,700 benefit checks, 6207 benefit checks were completed for families within the priority groups; 2886 for lone parent families 218 for ethnic minority families 1774 for families where a member of the household is disabled 232 for families where the mother is aged under 25 742 for families with three or more children 355 for families where the youngest child is under one Referral routes to the Tackling Poverty Team set up with One Parent Families Scotland, may account for 46% of the referrals from the priority groups coming from lone parent families. Further work has to be done to ensure that services to tackle child poverty are directed to priority family groups within North Lanarkshire. The Sco�sh Index of Mul�ple Depriva�on (SIMD) is a rela�ve measure of depriva�on across 6976 small areas in Scotland known as datazones. SIMD measures on seven domains; income, employment, health, educa�on, housing, crime and access to services. North Lanarkshire with a popula�on of 341,400 (2021 mid year estimate) has 447 datazones, 144 (35%) of those datazones are within 20% of the most deprived communi�es in Scotland.
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North Lanarkshire Children’s Services Partnership In North Lanarkshire, our vision is to support all children and young people to achieve their potential, ensuring they are loved, nurtured and empowered to thrive in all aspects of their lives, including upholding each and every child and young person as stated in the UNRC. We will work collaboratively with children, young people, their families and our partners to ensure they get the best start in life and support families to provide loving care. We will do this by making sure we have the right supports available, at the right time, for as long as needed, and delivered in the right places to ensure equity for all and reducing inequalities throughout. North Lanarkshire Children's Services Partnership is where they key agencies and organisa�ons work together to iden�fy shared priori�es and to plan, deliver and improve services and supports for children, young people and their families. Partners include children, young people and families, key public sector agencies, independent sector organisations and the community and voluntary sector. Key to this Partnership, members of the Tackling Poverty Officers Ac�on Group (TPOAG) are represented on this group and likewise members of the Children’s Service Partnership are represented on the TPOAG, this ensures a crossover at an opera�onal level and shared ambi�ons, workstreams and outcomes and that tackling poverty is seen not only as a measure to li� people out of poverty but also as a preventa�ve measure in ensuring we have resilient communi�es. All task groups progressing the work of the Children’s Service Partnership have an impact on child poverty. The priority to embed children’s rights, as stated in the United Na�ons Conven�on on the Rights of the Child, includes ac�ons to make clearer the rela�onship between poverty and UNCRC and to develop and apply a ‘poverty proofing’ tool. There are close links with the Family Support Task Group, with the Partnership aim to strengthen the ethos of Whole Family Support, working with families in a preventa�ve way and suppor�ng parents and carers to build on their strengths. Tackling poverty will be a central feature of the approach to family support; providing help to maximise income; develop skills for employment and taking a cash first approach where necessary. The principles of family support outlined in The Promise, will underpin the work to improve outcome for our families, children and young people within North Lanarkshire.
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Staff from all sectors involved in providing support and services to children and young people will be provided bespoke Poverty Awareness sessions which promote discussion about the impact of poverty together with easy referral routes to ensure people have access to professional support to help maximise their income and reduce the cost of living, whilst receiving the holis�c supports which builds on the strengths of the family. The Drivers of Tackling Poverty INCREASE INCOME VIA EMPLOYMENT Driving up income from employment remains one of the mechanisms in North Lanarkshire which offers real opportuni�es to support unemployed and underemployed residents out of poverty. Employability is integrated within Educa�on & Families and contributes to the Brighter Future Programme of Work within the Plan for North Lanarkshire. It has the aim of transforming how we prepare young people and other residents for the world of work by delivering an interconnected programme of educa�on, volunteering, and entrepreneurship throughout various stages of their life. The aims and objec�ves of this are to: Drive the recovery of North Lanarkshire’s labour market to pre-covid levels Deliver significant jobs growth Shape innovative employment pathways in key growth industry sectors Provide inclusive and accessible support to boost entrepreneurship Embed volunteering programme as a normal part of life Transform how young people experience learning and teaching The post pandemic labour market that has emerged is characterised by low unemployment levels but increased economic inac�vity and within North Lanarkshire the employment rate is s�ll below the pre- pandemic levels. The North Lanarkshire claimant count, which acts as a measure of unemployment,
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was 14,415 (6.6%) people in March 2021 compared with 8,225 (3.8%) in March 2020, a 75% increase on the pre-pandemic level. However, in May 2023 it had decreased to 7,640 (3.5%) and average earnings in North Lanarkshire are now above the Sco�sh and UK averages for the first �me. This is good news, but real challenges remain due to levels of economic inac�vity. The number reported as ‘long term sick’ in North Lanarkshire has increased from 14,900 in the 12 months up to December 2019 to 26,300 in the 12 months up to December 2022. While unemployment is lower than pre- pandemic levels the number of people in the workforce in North Lanarkshire has reduced from 174,000 (78.1%) in December 2019 to 157,100 (70.1%) in December 2022. The forecast for unemployment currently is uncertain as the UK remains within a period of high infla�on and with further expected rises in interest rates which will have an impact on business. From an employability perspec�ve this simply reinforces the long-term strategy of con�nuing to support those further from the labour market in North Lanarkshire to gain the skills needed to get a job and be part of the economic growth of the area. Alongside this we will con�nue to work with local employers to create opportuni�es for our unemployed residents, including those who are economically inac�ve. All employability programmes delivered by or on behalf of North Lanarkshire Council are based on the No One Le� Behind Policy which is aimed at inclusive growth, economic transforma�on and tackling child poverty; and aims to deliver a system that is more tailored and responsive to the needs of people of all ages who want help and support on their journey towards, into and in work - par�cularly people with health condi�ons, disabled people and others who are disadvantaged in the labour market. Case Study Joe was 17 and under the care and supervision of the authority when his support worker referred him into Roots. His only income was £15 per week pocket money. Joe received bespoke 1:1 support from his job coach, who introduced him to a number of work tasters and opportuni�es. Joe then gained his full �me Roots placement in June 2021, working in an area he felt very passionate about (Gym and fitness) earning modern appren�ceship rate of pay. Joe gained independence and confidence and could purchase items for himself and go out for meals with friends. He became a valued member of the team within his workplace and received fantas�c feedback. Roots con�nued to work closely with Joe and his employer to create a paid opportunity within the business. He is now a fully qualified personal trainer working in a full-�me posi�on, earning £9.50 per hour for 30 hours per week. In addi�on, he already has a few of his own clients which increases his wage further. Joe’s support worker says “It’s made a huge difference to his life in every way imaginable. Joe keeps in touch with us and will happily come along and speak to future Roots clients to share his journey with them. He has gained so many skills on the programme including formal qualifica�ons and leaves roots a far more confident young man than when he first walked through the door. Joe says “I feel from everything I have learned I am a lot more confident now, I love helping others and working hard. I have my own flat now and I am doing well. I want to help others feel happier and healthier”.
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Prospects for Parents The aim of Prospects for Parents is to help families in North Lanarkshire become beter off, by suppor�ng parents to get into work or by helping those in low paid work to increase their wages. The programme is supported by a Welfare Rights Officer who ensures that any parent entering the programme has their income fully maximised prior to entering employment and during employment, the welfare rights officer is also able to offer money/debt advice and refer on if more in depth support is required in this area. The Prospects for Parents programme also provides access to child care advice and access to funds such as the child care development fund and the discre�onary fund, as well as health interven�ons and access to training/work experience. The Prospects for Parents programme is specifically for the priority groups; Lone Parents Disabled parent, or the parent of a disabled child Parent with more than three children Parent with a child under 1 year old Parent under the age of 25 Parents from an ethnic minority The programme is a key tool in tackling poverty and inequality for our children and young people in our communi�es. Case Studies from Parental Employment Support The welfare rights officer met with a woman who was living in refuge following domestic abuse. She had two young children, one starting nursery, she wanted to go back to work but didn’t think due to her benefits she would be able to do this. The welfare rights officer completed a “better off” calculation to show what the impact would be on her income were she to take a 16 hour pw job. The woman was delighted with this, and explained to the welfare rights officer that she also had debt issues with catalogues, housing, loans and council tax. The WRO advised of the service that could be provided to remove the burden of creditors harassing at a difficult time and contact was made with creditors on her behalf. The woman is currently working with a Debt Advisor to manage her debts. A woman was referred to the welfare rights officer seeking a “beter off” calcula�on and advice around the minimum income floor for universal credit if she became self employed. Following the advice and reassurances that the welfare rights officer was always there to assist, she took up employment as a self employed delivery driver for Just Eat. A�er one year, the DWP implemented the minimum income floor, meaning she could lose essen�al income. She advised the welfare rights officer that universal credit were refusing to offset her tyre repair costs to her car as an expense, sta�ng that her car was essen�al to allow her to do her job. The welfare rights officer successfully argued that this should be an allowable expense and her Universal Credit amount was protected.
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REDUCE THE COST OF LIVING Helping People To “Quit Your Way” Research by Ash Scotland showed that 63,000 households in Scotland would no longer experience relative poverty if people were empowered to successfully give up tobacco. 42% of all households in Scotland containing people who smoke are currently living in relative poverty, a figure which could be reduced by around 10% if tobacco was not a factor. Reducing smoking prevalence in Scotland by just one percent could lift more than 3,700 households out of relative poverty. The percentage of pregnant women smoking at booking appointment in North Lanarkshire is 12.6% for year ending December 2022. This is above the Scotland figure of 11.9%. The Quit Your Way service targets pregnant women who live in areas of higher depriva�on and between April 2022 and December 2022, 24 pregnant women living in the 40% most deprived areas successfully quit smoking at 12 weeks. Collabora�ve work has commenced in Airdrie, Motherwell and Wishaw locali�es. Referral prompt cards have been developed to enable a more simplified referral route using a QR code. This referral route can be used by clients, staff, third sector organisa�ons or community partners. Very brief advice for smoking on smoking for pregnant women will be promoted via na�onal centre for smoking cessa�on training for external partners. Promo�ng Free Travel For Under 22s Since its launch in January 2022, the scheme has been promoted widely and con�nually through schools, within the community, on NLC and NHSL websites, by social media (Corporate and youthwork, CLD channels), and by colleagues working with children, young people, and families. Parents and Carers have received text messages direct to parents and Community Learning & Development Staff con�nue to engage with applicants. Efforts have been made to encourage applica�ons from disadvantaged groups such as care experienced young people, refugees, families living in poverty, social work service users, and young job seekers, students and those working with partner agencies. A training module has been developed by ASH Scotland and NHSL Tobacco Control Team which will be used by ASH Scotland to facilitate training on smoking and poverty. The NHSL Tobacco Control team have already offered this training locally to advisors within the Tackling Poverty Team, so that Welfare Rights Staff and Debt Advisers can promote the “Quit Your Way” programme and signpost people to the service. “I’ve been putting this cash by in a tin that I would spend on cigarettes. My Grandson wanted a football strip which I thought was too much money to buy him, but after 10 days of quitting smoking I was able to buy it for him. I’m also keeping the money I’m saving for Christmas and other bills. That was just a part of it though, my health was the main reason and I now have more energy and my house doesn’t smell of smoke anymore.”
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Uptake varies widely amongst different age groups with. At either end of the age spectrum 5 year olds and 21 year olds have taken up fewest travel cards but 80-90% of 10-12yrs have obtained a travel card. What difference does free travel for under 22s mean? Free travel can make a big difference to a families income, the table below shows some examples; A 14 year old pupil uses the bus daily to commute to school A saving of £442 per annum A 17 year old student from North Lanarkshire commutes to New College Lanarkshire by bus A saving of £711.10 per annum An 18 year old student from North Lanarkshire commutes to University of Glasgow by bus £863.20 per annum THE PLEDGE
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INCREASE INCOME VIA SOCIAL SECURITY BENEFITS It Starts with a Benefit Check “I don’t think I’m entitled to anything else”, “I tried before and didn’t get that” are all too common phrases for the Tackling Poverty Team. With over £99 million generated in the last 3 years, the Tackling Poverty Team’s response is always “let’s start with a benefit check.” Through discussion with the person a benefit check identifies if there is entitlement to any other benefits and the Tackling Poverty Team will assist people to help make a claim, in the last 3 years the Team have assisted with 40,178 claims for benefit. The case study below is a great example of how a benefit check can make a significant difference to people; Increasing income via social security benefits is a key driver to tackling poverty in our communities, we know from recent analysis by Policy in Practice that the total amount of unclaimed income- related benefits and social tariffs is now £18.7 billion a year throughout the UK. The tackling poverty team received a referral from an MSP, the referral was for a family where a member of the household is disabled, who had received a bill for a sink repair and they were struggling to pay it. A welfare rights officer from the First Point of Contact Team contacted the family who advised that the situa�on had been resolved, the WRO asked; “Do you want me to check your benefits”?, and they agreed to this. The welfare rights officer found that the family were short a premium in their Employment and Support Allowance claim and sought to get this put into payment. The work carried out resulted in the family receiving an addi�onal £76.40 per week (£3,972.80 per annum) but through the diligence of the WRO, en�tlement for the previous 4 years was also established, meaning the family received a backdated payment of £13,000. The family were delighted with the service they received and stated; “The service from the Tackling Poverty Team is definitely worthwhile, they really know what they are talking about and they have done a grand job for my family”.
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From these findings it is important that our Ac�on Plan for Tackling Poverty ensures the “no wrong door” approach is embedded into our prac�ce across all internal services together with our partners in NHS Lanarkshire and the Third Sector. How will we do this? The Tackling Poverty Team has produced Poverty Awareness Sessions, which can be tailored not just to the Services we are delivering to, including; social work, health, educa�on, addic�on etc, but can also be drilled down to impacts in each Community Board area. In doing this we can look at referral gateways and solu�ons that are bespoke to each service and locality, therefore suppor�ng referrals to income maximisa�on services. The Poverty Awareness Sessions have now been delivered to over 200 staff and prac��oners to date, and the feedback has been really posi�ve; “informative session and great examples shared today” “I learned lots from the session that I didn’t know” “Seeing the information for my locality was hard hitting, but we were then told about the referral routes for us……I feel more confident to approach the issue of money now” The Tackling Poverty Awareness sessions are designed to ensure that the ethos within the Programme of Work where we muster our resources and recognise that poverty is not something that we can look at on its own is reflected in this.
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Poverty impacts all areas of life, the Joseph Rowntree defini�on the Strategy has adopted reflects this; “Poverty means not being able to heat your home, pay your rent or buy the essentials for your children. It means waking up every day facing insecurity, uncertainty and impossible decisions about money. It means facing marginalisation, and even discrimination, because of your financial circumstances. The constant stress it causes can lead to problems that deprive people of the chance to play a full part in society.” In recognising this, it is important to acknowledge that working to achieve our goal to reduce and tackle poverty in North Lanarkshire is not something that one service can do on its own. Referral pathways ensure that services have access to specialised advisors, investing in internal and external services ensure that people have access to those advisors. NHS Lanarkshire The Health Founda�on in 2020 stated that Income is associated with health; people in the botom 40% of the income distribu�on are almost twice as likely to report poor health than those in the top 20%. Poverty, in par�cular, is associated with worse health outcomes. Income and health can both affect each other – lower income is associated with more “stressors” which can harm health and allow fewer opportuni�es for good health. Poor health can limit the opportunity for good and stable employment and so affect income. NHS Lanarkshire has made significant investment in tackling poverty measures in North Lanarkshire including within income maximisa�on services. Recent investments include the funding of a Cost-of- Living Helpline hosted by the Councils’ Tackling Poverty Team giving people access to both income maximisa�on and money advice services. Referral pathways have been established to make it easy for health staff to refer pa�ents into the team to get the supports they need; A grandmother in the Wishaw area was referred to the Tackling Poverty Team a�er the DWP had applied the two child limit to her Universal Credit therefore she was receiving no payment for her grandson who was in her care. This was an informal kinship arrangement, the Welfare Rights Officer escalated the case with DWP who then agreed that the two child limit should not apply in this case. The Universal Credit Child Element was backdated and a lump sum of £1200 was awarded, in addi�on to an ongoing £62.21 per week. The Welfare Rights Officer also made applica�ons for child benefit and the Sco�sh Child Payment these payments will increase the grandmother’s income by £212.33 per week, this is a total increase in annual income of £11,041.16. The woman stated that the assistance from the Tackling Poverty Team “helped really a lot, made a difference for her grandson as they can now do things”.
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“As a Health Visitor it is reassuring to know that the Tackling Poverty Team have the knowledge and skills to assist the families we work with both by providing advice and practical support. “As a Health Visitor it is very easy to make a referral to ensure our families receive the best support in maximising their incomes.” NHS Lanarkshire have established “GP Link Workers” with a referral route to their partners in both the councils’ Tackling Poverty Team and the Ci�zens Advice Bureaux. The Link Workers are available in various Health Centres and Surgeries across North Lanarkshire, over the last two years the link workers have referred 860 people for help with welfare rights and 252 people for help with money/debt advice. The total income generated to date from these referrals is £330,260. The Glasgow Royal Hospital for Children Project supports families and children who are either inpa�ents or outpa�ents. In 2022-23 the service supported 32 North Lanarkshire families, who received support with a total financial gain of £169, 074.91 Most of the beneficiaries were families caring for children with a disability under the age of 19 years. The Improvement Service have also funded a project within North Lanarkshire; Welfare Advice and Health Partnership, where we are improving access to money and welfare rights advice in health care se�ngs. This is achieved by embedding advice workers in health se�ngs and providing consensual access to medical records. Based in three surgeries across North Lanarkshire this project has proven to be extremely successful, with 357 referrals received in one year genera�ng £715,865. CASE STUDY A 39 year old lone parent was referred to the Tackling Poverty Team via her GP. Her physical health limita�ons, financial challenges and being a single mum of two children (aged 16 and 10), one with disabili�es was having a significant impact on her mental health and she was finding it a struggle to work. The woman had her claim for Personal Independence Payment (PIP) refused and the GP referred to the Tackling Poverty Team to help her. The Team challenged the decision, and she was awarded Standard Rate Daily living component of PIP, the welfare rights officer then assisted to have the disability element added to her working tax credit. The woman received £8643.88 in backdated payments of PIP and Working Tax Credit, her weekly income was increased by £132.42 (an annual increase of £6885.84 for the woman and her family). The woman has returned to work and is able to deal with those financial challenges she was facing.
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The Third Sector The Tackling Poverty Team are responsible for the commissioning of external advice services to provide welfare rights and debt advice. The successful candidates for 2023-25 have been 5 local Ci�zens Advice Bureaux. The Ci�zens Advice Bureaux (CABx) are commited to working with the Tackling Poverty Officers Ac�on Group in implemen�ng the Tackling Poverty Strategy and Ac�on Plan. The CABx have contributed to maximising income across the local authority genera�ng £22.6 million the last three years in addi�onal income for residents. The CABx are also commited to tackling food poverty by implemen�ng the councils’ Food Poverty Referral Gateway which promotes the Cash First approach. Trussel Trust are working in conjunc�on with the local CABx over the next 2 years focussing on enhancing access and engagement with the North Lanarkshire Food Poverty Referral Gateway. Augmen�ng the exis�ng Gateway as the preferred route for cash first support and ensuring a dignified and holis�c approach to tackling food poverty and insecurity. The pilot will be delivered in communi�es with Motherwell, Wishaw and Airdrie in local community hubs working alongside community organisa�ons in both one to one and group se�ngs, providing advice, support and training. Promo�ng Uptake of Benefits for Children in Educa�on Promo�on and maximisa�on of those benefits which North Lanarkshire Council administers, including Free School Meals remains a priority detailed in the accompanying Ac�on Plan. However, that is not the end of the story, we also need to look at whether those who are en�tled to a free meal are actually taking up this offer. Uptake of Free School Meals, whether children qualify for universal provision or due to their family’s income, is at 65-70%. This is certainly lower than we would want but is a trend which is being experienced in other areas across the Country. The reasons why take up is low are many are varied and not en�rely understood, par�cularly at a �me when household budgets have never been �ghter. The challenge for us is to fully understand the reasons why children are not taking up the offer of a free meal. A new management informa�on system has recently been implemented to give insights into trends amongst different age groups, most popular menu choices etc. CITIZENS ADVICE BUREAU – COATBRIDGE A 41 year old man with 4 children presented to Coatbridge Ci�zens Advice Bureau, he himself had health issues. He contacted the Ci�zens Advice Bureau explaining he had a £12,000 benefit overpayment which had resulted as a clerical error by the DWP five years previous. The man himself had tried to dispute this himself with DWP but was ge�ng nowhere, he asked the CAB to help him. The case worker took the man’s case to appeal and was successful in their argument meaning that the overpayment was writen off.
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Changing the culture and s�gma around free school meals is key to increasing take up and work is already underway: • invitations to children and their parents to come along and sample a school meal together as they move from Nursery to Primary • taster sessions across Nursery, Primary and Secondary Schools • a targeted exercise to educate parents who choose to provide packed lunches rather than take up a similar offering provided at school The Improvement Service North Lanarkshire was chosen to host one of the Improvement Service’s Welfare Advice and Health Partnerships (WAHPs) that will provide access to welfare rights and money advice in health care se�ngs. The approach by the Improvement Service is to embed advice workers in health se�ngs and provide consensual access to medical records. GP prac�ces were selected by iden�fying those where the pa�ents from SIMD 1 and 2 were highest; 6 prac�ces were iden�fied in North Lanarkshire, with 4 agreeing to take part in the project, however, only 3 prac�ces came on board; Old Mill Prac�ce, Bellshill, Waverley Surgery, Coatbridge and Coatbank Surgery, Coatbridge Welfare Advice and Health Partnerships provide a simple, effec�ve, person centred approach to tackling health inequali�es, improving individual health and well-being. Providing advice in GP se�ngs is one approach to delivering services out with the tradi�onal routes ensuring that we can meet the needs of all our community. In one year the project has dealt with 357 referrals and generated £715,865 in addi�onal benefit income. The GP prac�ces recognise the impact the Project is having on their pa�ents; “The welfare rights officer joined the practice once a week to help with our patients and has been a great help to the patients not only from a financial point of view but also from a mental health and wellbeing perspective, some people are in a situation where they don’t know what to do or what to turn too, the welfare rights officer goes over and above to help sort out their affairs or tries to make sure they are getting what is right, in turn patients seem relieved and feel light is at the end of the tunnel which often lifts the anxiety they have been living with” Waverley Medical Practice, Coatbridge “The welfare rights officer has been an amazing addition to our practice MDT. She is very hard working, approachable and a great team member. The project has been helping our patients greatly and easing their financial pressures, which has a very positive impact on their mental and physical health. This is more important than ever whilst in the midst of a cost-of-living crisis.
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The project has been welcomed fully at Old Mill, patients are engaging well and getting the help they need due to their poor health and mobility. I would honestly say this project has been the most helpful and useful addition we have ever had, and patient feedback has been excellent.” Dr Aimee McGinness – Old Mill Practice, Bellshill Case Study – Waverley Prac�ce – Welfare Advice and Health Partnership Ken was referred to the Welfare Rights Officer (WRO) based in the Waverly Prac�ce as his claim for Personal Independence Payment had been refused. The WRO using the medical records submited an appeal which was successful with Ken receiving enhanced rate of both mobility and daily living, Ken received a backdate of £5020.80 and an annual income of £8983. When carrying out the benefit check for Ken and his family, the WRO iden�fied that the Sco�sh Child Payment was not in payment for his two children, the WRO assisted with this claim meaning the family had an addi�onal £2600 per annum. The welfare rights officer maximised the family income by £11,583 per annum, making an incredible difference to them.
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HOLISTIC SUPPORTS In North Lanarkshire we recognise that to deliver sustained reduc�ons in child poverty over the long term we need to break that cycle of poverty, ensuring that our children living in poverty do not grow up to be adults living in poverty. We will work with our partners to provide the integrated and holis�c support parents need to enter employment, improve their wider wellbeing and engage with the drivers of poverty. In North Lanarkshire we are commited to delivering a “No Wrong Door” approach to our services to ensure that all residents, including those in poverty and those at risk of falling into poverty receive the right support at the right �me. Ensuring all families have the support they need, regardless of what those supports may be, is essen�al if we are to enable families to thrive in all aspects of their wellbeing. Infant Minds Mater A new Infant Mental Health service has been established in Lanarkshire. The aim of this service is to provide an infant centred approach to Infant Mental Health in Lanarkshire through direct clinical interven�on with infants and their families, and support to professionals working across Lanarkshire, who contribute to the mental health and emo�onal well-being of infants. Infants are the most vulnerable group in society; however, they have o�en been omited from mental health services and policies. There is a con�nued lack of awareness and understanding that infants can suffer from serious mental health difficul�es and disorders, when in fact epidemiological research indicated that approximately 16% of 18-month-olds in the general popula�on have serious mental health difficul�es. The Infant Mental Health Team is mul�-disciplinary and mul�-agency, and each discipline and agency brings its par�cular training and perspec�ve to addressing the mental health of infants. Our team consists of: Lead for NHSL Infant Mental Health Service; Consultant in Infant Mental Health Psychiatry; Child & Adolescent Psychotherapist; Clinical Psychologist; Social Worker (North and South Lanarkshire); Early Years Prac��oner; and Admin support. The Tackling Poverty Team will deliver Poverty Awareness Sessions to the mul�-disciplinary team and implement a referral route for parents to ensure parents and carers have access to income maximisa�on and money advice services. Breas�eeding NHS Lanarkshire have been working in partnership with North Lanarkshire Council to pilot the na�onal Breas�eeding Friendly Scotland Local Authority award - a 1st for Scotland. This sees every department within the council receiving training, have staff policies in place for staff breas�eeding and returning to work and includes the educa�on schemes within Early learning and Schools amongst others. Roll out of the Breas�eeding Friendly Scotland scheme ensures premises and buildings signing up to the scheme create a suppor�ve, welcoming environment for breas�eeding families when out and about as one of the main reasons many cite for not ini�a�ng breas�eeding or stopping before they wanted to, is feeding out with the home. We have many local authority
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premises such as libraries and leisure signed up as well as many private cafes, third sector groups and other businesses. Whole Family Support The aim of the Whole Family Wellbeing Fund is to provide addi�onal resource to support the transforma�on of the system of support to children and families. This is in line with the Na�onal Principles of Holis�c Family Support and ambi�on of The Promise to provide flexible family support, enabling more children to remain loved and supported within their own families. The Promise places a requirement on Local Authori�es and their partners to transform whole systems and culture to ensure all children, in any aspect of care, thrive through nurturing and loving rela�onships with access to support that strengthens communi�es and families. The Promise places preven�on and family support at the heart of its vision. The Promise Plan 21-24 published on 31st March 2021 sets out 5 key priori�es for the first phase of implemen�ng The Promise including a focus on ‘Whole Family Support’. There is an expecta�on that the 10 key principles of family support outlined within the Promise are embedded into prac�ce by 2024 and that there is a place in every community for families with children ‘to stay and play with their children and get support and advice’. This aligns closely with the Tackling Poverty strategy and the aspira�ons of the Plan for North Lanarkshire; and in par�cular plans to develop community hubs as a central vehicle to deliver support, enhance community capacity and support every child to reach their poten�al. Research has shown there is a rela�onship between poverty and longer-term nega�ve outcomes for children (Lewer et al, 2019) and that while the rela�onship between poverty and child abuse and neglect is complex, studies have also shown that financial support and increased income lead to lower levels of child maltreatment (Bywaters et al, 2016). North Lanarkshire Council, as part of the Covid-19 Tackling poverty plan, adopted a ‘cash first’ approach to suppor�ng the most vulnerable families to address basic needs, which proved effec�ve in promo�ng improved outcomes. By providing money directly to families North Lanarkshire’s strength based and collabora�ve approach offered welcomed financial relief. In order to provide holis�c family support which truly aligns with the Promise and Tackling Poverty ac�on plan, there is a clear need to join up services so that people can experience a seamless transi�on into addi�onal and intensive level supports and services. This improves access to exis�ng exper�se within our services. These na�onal policy aims align with the Plan for North Lanarkshire and the Council’s new Programme of Work which makes family support central to its opera�ng model through the Resilient People workstream. North Lanarkshire Alcohol and Drug Partnership North Lanarkshire Alcohol and Drug Partnership (NLADP) is a mul�-agency strategic partnership focused on understanding and mi�ga�ng the impact of problema�c alcohol and drug use in the local area. The purpose of the ADP is to co-ordinate and lead a collec�ve response to tackle harms and improve the lives of people who use alcohol and drugs, and those around them. The ADP is made up
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of key agencies and stakeholders with an interest in tackling harms and improving lives. This includes the wider community and those who have lived experience and families. Much of our work involves bringing people together to plan and improve services whilst se�ng out what needs to be put in place to support change and keep people safe and well. The strong links between drug and alcohol related harms and poverty, inequality and trauma are widely acknowledged. Depriva�on has been linked as a significant factor in drug and alcohol problems developing. The ADP are tasked by Sco�sh Government to ensure the implementa�on of na�onal policy and evidence-based prac�ce. Improving Choice, Quality and Connec�ons are key drivers underpinning the work of the ADP. We have 5 key priority areas of focus for our work which includes; Preven�on, Educa�on and Early interven�on, Whole Family Approach, Treatment and Care, Public Health Approach to Jus�ce and Reducing Alcohol Harms. Each of our sub-groups are tasked with understanding and mi�ga�ng harms from substances, and poverty, and have a linked programme of work to support change and keep people safe and well across our communi�es. Jus�ce Services Whilst The Tackling Poverty Team and others will support Services by providing debt and money advice, income maximisa�on and employment advice, the services themselves such as the Restora�ve Jus�ce Service also contribute to tackling poverty and inequality through a number of ini�a�ves, such as; Individuals who are subject to Unpaid Work can undertake work with the Bike Recycling Project. During the last reporting year over 650 bicycles were retrieved from recycling centres in North Lanarkshire. Some were scrapped for parts, however, over 320 bicycles have been reconstructed. These recycled and repaired bikes are donated to the Councils’ Christmas Toy appeal as well as being donated low income families. Bikes are also donated to local schools to ensure that all pupils can take part in Cycle Safety Awareness Courses and the healthy living programme. A craft workshop has been developed to repair clothing and soft furnishings for low income families. A kitchen workshop has been developed to deliver a programme consisting of food hygiene, nutrition, budgeting and basic meal preparation. The workshop performs a platform to undertake placements in foodbanks and community cafes such as Shotts Healthy Living Centre and Newmains Community Trust. A laundry workshop has been created that provides a service to charity shops collecting clothing for laundering and returning to the shops for sale. In an effort to reduce poverty, a laundry service is provided to Craigneuk Family Centre and two charitable groups; “Cool School Uniforms” and “Airdrie School Clothing Bank”, this involves the collection, laundering and distribution of recycled school uniforms to low income families. “We got your delivery of the balance bike and the guys were very helpful. THE CHILDREN LOVE IT and have been having great fun on it today. Thank you so much again” – Allanton Primary School
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These indirect supports contribute to suppor�ng the Tackling Poverty Strategy and our communi�es across North Lanarkshire. Community Wealth Building Community Wealth Building is an interna�onally recognised approach to economic development designed to tackle long-standing economic challenges. It seeks to transform local and regional economies by considering the ways in which the public sector, in partnership with the private, third and community sectors, can ensure more wealth is generated, circulated and retained in communi�es and locali�es. The approach is focussed on growing the influence communi�es have on the economy and ensuring communi�es receive more of the benefits from the wealth they help to generate. The council and local partners are currently mapping ac�vity to iden�fy areas for further development and improvement and are considering and consul�ng on the approach which will be adopted in North Lanarkshire to embed Community Wealth Building. Community wealth building is a progressive approach for the benefit of the local population. This is achieved by harnessing the economic and social power of locally rooted organisations, often referred to as local anchors. Anchor organisations are big and locally rooted organisations including the NHS, local authorities, colleges and universities, and private businesses with local HQs. Because they employ many people, spend substantial amounts of money, own and manage land and assets and often deliver crucial services, they have a considerable impact on local communities and economies. Further, they are historically rooted in the physical area, intrinsically connected to the local community and are pivotal to wellbeing. Alongside its main func�on, NHS Lanarkshire recognises its role in making a strategic contribu�on to the local economy. Anchor organisations are pivotal to community wealth building as a result of the scale at which they operate. After a benchmarking exercise, NHS Lanarkshire has developed an ac�on plan to maximise its role and are now working with other community planning partners in North Lanarkshire to maximise the collec�ve impact, share best prac�ce and iden�fy areas where local anchors can work together. It is proposed that this will be through the adop�on of a Community Wealth Building Commitment Statement early in 2024 whereby any relevant projects, Programmes of Work, Strategies and ac�on plans must demonstrate how Community Wealth Building principles and approaches are applied.
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LET’S TALK….. THE THREE QUESTIONS The Tackling Poverty Team have embarked on a communica�ons programme called “The Three Ques�ons” across all our schools, this will be a con�nuous programme which will become the heartbeat of our approach to tackling child poverty, shaping and underpinning everything we are doing across the local authority. The “Three Ques�ons” have been shaped around the cost-of-living crisis, we simply ask; “How is the cost of living impac�ng you?” “How is the cost-of-living impac�ng others in the community?” “What would you like us to do about it?” The children and young people are invited to put their experiences and thoughts on how to make things beter by using post it notes and posters. The post it notes were introduced to avoid s�gma�sing anyone who wanted to have their voice heard but did not want to speak out, but welfare rights officers and debt advisors are also on hand, not just to provide advice but to write down any comments children and young people wish to make. The format used has proven to be very successful in giving a voice to our children and young people. The young people gave an insight into how the cost-of- living crisis is affec�ng them and their families, together with what they would like to be done around this. When asked how the cost of living affected them, the impact of socialising was a major issue for the children and young people, whilst 21% stated that they could no longer afford a�er school ac�vi�es and socialising with friends, 56% stated that they could no longer play their consoles or charge their phones as much, all forms of socialising for younger people. Welfare Rights Officers have met with pupils from both Primary and High School. The presenta�on starts with “poverty awareness” le�ng the children know the extent to which it is affec�ng their local area – and the children and young people are then presented with The Three Ques�ons.
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The children and young people told us that the cost-of-living crisis was having an impact in their home and on themselves; “Buying things causes arguments in my house” “I get anxious when I got to the shop to buy food. My dad is off work and is on sick pay. In the next couple of months he will be on half pay and im worried how we will be able to afford things” “my mum panics about money now” “I am poor now” When asked what the children and young people wanted us to do about it, the top two answers from the children and young people were; Free School Meals for everyone and financial educa�on. The children and young people expressed that they wanted to learn about money “make everyone feel equal and understand more about poverty and money….learn about money, how to pay bills, budgeting and money management”. (all findings available at appendix one) What Next For The Three Ques�ons? Following the response from The Three Ques�ons, we will build upon the work we have done and ensure that the responses and ideas from the children and young people are at the heart of what we will be delivering. The Team have been to 13 schools to date, speaking to 277 pupils however, in the next semester it is our inten�on to co-ordinate our three ques�ons in line with the Cluster Model that is in place in North Lanarkshire. The cluster model iden�fies each Secondary School with their feeder primary schools and nurseries. The Tackling Poverty Team will meet with children and young people from each establishment within the Cluster. Following the work they will do with the children, the welfare rights officers from the Tackling Poverty Team will iden�fy each Clusters priori�es. Together with the Tackling Poverty Team, the schools will iden�fy not only these priori�es but how they plan to address them in the Tackling Poverty Plan each school has. 21% 10% 10%11%3% 45% How Does Cost of Living Affect You - Activities I am unable to afford out of school activities/ socialising with friends I am unable to afford driving lessons Less time watching TV cant play on my consoles as much less or no money to buy things for the house unable to charge my phone/games as often as I did
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Financial Educa�on In response to the children and young people, the Tackling Poverty Team and Educa�on will develop a financial educa�on package for all ages; early years, primary and secondary school pupils. The package will be developed, evaluated and reviewed by the Tackling Poverty Team with delivery in the main being done by educa�on staff. To involve the young people more in this, educa�on will iden�fy pupils in 4th, 5th and 6th year who are interested in delivering the programme in conjunc�on with the Tackling Poverty Team to early years and primary schools. This will give the young people an excellent opportunity to develop important lifeskills, such as those pupils from Coltness High School iden�fied when they answered; “learning about money within schools, how to pay bills, budgeting and manage money”, when asked what do you want us to do to help? The financial educa�on package will be a reviewed and renewed version of the exis�ng MACA programme; Money Advice / Consumer Advice providing pupils with the skills they need for the future. The package will have an addi�onal part to it where we can offer parents advice on the impact of family income when a child leaves school. Parents and other adults can access financial educa�on through the Mul�ply Project, which can provide up to 5 sessions taking adults through money management, budge�ng and savings �ps. North Lanarkshire recognise that financial educa�on is key in helping tackling poverty and inequality in our communi�es, offering packages from early years to any age across all of the authority. “Taught about money” – Cathedral Primary School “Teach pupils how to manage our money” – Clydevalley High School “Get taught more about money in school” – Kildrum Primary School “Learn about money and how to budget for when we leave school” – Kilsyth Academy “How to budget and handle money as part of the WPS course” – St Aidan‛s High School “Learn about money management at school” – St Margaret‛s High School ADDITIONAL SUPPORT NEEDS SCHOOLS North Lanarkshire’s Supported Enterprise Team, work with our Addi�onal Support Needs schools providing support to 5th and 6th year students who are ready to leave school and want to find employment opportuni�es. Our Job Coaches start working in the schools around September/October to prepare the students for leaving the following summer. The job coaches will work with the young people to create a voca�onal profile with them, observe how they are in classroom se�ngs and take them out of school for job tasters, giving them an opportunity to taste the world of work. Students are also offered the opportunity to work in Sunnyside Café in Volvo Construc�on’s staff restaurant where young people will gain valuable work experience in aspects of catering. Young
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people will be supported by job coaches from the Supported Enterprise Team to build skills and confidence in a real work se�ng and gain qualifica�ons in catering and hospitality. To ensure that the young person and their family are aware of the impact of leaving school, a Welfare Rights Officer (WRO) from the councils’ Tackling Poverty Team links in with the job coach to set up mee�ngs with the students to offer advice and support to the families. Leaving school can have a huge impact on the families’ income, to prepare for the student leaving school, the WRO will atend the school in December to carry out a general talk to ensure families are prepared. This is followed by the offer to all students and their families of a benefit check which will give them the full picture of the impact when the student leaves educa�on. The WRO will support the family with all forms / correspondence and advocacy to ensure that their income is fully maximised. Belle Belle is a summer leaver from an ASN school and has been given a place on the No Limits Project via Supported Employment and will work 25 hours a week and paid at an appren�ce wage. The No Limits programme is for ASN school leavers with the placement including more intensive support (including links to all other support services) with further training and development. The WRO met Belle and her mother at their family home, where it became apparent that Belle’s mum was going to lose money from her Universal Credit when Belle entered employment. During the home visit it was highlighted that Belle’s mum had mental health issues and that neither Belle nor her mum were receiving any disability benefits. The WRO also iden�fied that Child Benefit had also stopped as Belle went into 6th year. The WRO assisted both with a claim for Adult Disability Payment and with evidence from the school sought to have the child benefit reinstated. The discussions also revealed that there were also £2000 of debt from rent arrears, mum had been trying hard to maintain payments but was struggling to do this, the thought of losing some addi�onal Universal Credit when Belle le� school was an addi�onal worry to Belle and her mum. The WRO worked with the Debt Advisor, and they were able to make a claim to the Rent Assistance Fund and had the debt cleared off through this, this took an immense pressure off the family. The WRO successfully assisted in ge�ng the child benefit backdated and reinstated, this together with the debt cleared has enabled Belle’s mum to feel beter about things, the mother and daughter are awai�ng the outcome of the ADP claims.
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Achievements and Challenges With the country facing the perfect storm of increasing prices, ever increasing bills, tax rises and mortgage increases; the cost-of-living crisis is having a substan�al knock on effect on families and children, with those who were previously “just ge�ng by” experiencing financial difficul�es and others plunging deeper into poverty. North Lanarkshire Council, NHS Lanarkshire and our Third Sector Partners have worked to try and minimise the impact the crisis is having on our communi�es. Since the first Local Child Poverty Ac�on Report was produced, over £139 million in addi�onal benefit income has been generated by the Councils’ Tackling Poverty Team, Social Work Services and Housing Solu�ons, this together with over £22 million generated via Ci�zens Advice Bureaux, means that over £161 million has been generated by suppor�ng people through the benefit system. Other notable achievements have been; North Lanarkshire Child Payment has been made to families; £125 payment to families for each child who are in receipt of free school meals and/or school clothing grant, including nursery children. A total of 11,979 children from 7396 families were assisted. A fuel hardship payment was developed to provide financial support to low-income households who would only receive the UK Government universal payment, payments of £150 were made with applications exceeding 6000. North Lanarkshire Energy Advice Service was commissioned in early 2023 to provide mentoring, support and advocacy to our most vulnerable households to ensure no one has to struggle between choosing to heat or to eat. Energy Mentors will empower and equip households with the skills and knowledge to reduce energy costs and achieve sustainable outcomes. Recognising the impact, the cost-of-living crisis is having on our communities, the Integrated Joint Board funded a Cost of Living Helpline hosted by the Tackling Poverty Team, giving our communities access to advice and support. educational attainment rates for all pupils gaining 5+ awards at level 6, and for pupils living in the 20% most deprived areas, have seen a steady year on year improvement. Improvements can also be evidenced in the number of leavers achieving a positive post school destination with North Lanarkshire achieving a high level of 94.2%. This reflects a drop in pupils not entering a positive destination from 8.2% to 5.5% (around 100 pupils). Overall school exclusion rates and exclusion rates for looked after children both show significant improvement with overall exclusion rates dropping by 56% and rates for looked after children dropping by almost 70%.
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The establishment of a Wellbeing and Tackling Poverty Committee in North Lanarkshire was a clear indication of the Councils’ commitment to the Strategy and working toward a fairer North Lanarkshire for everyone in our communities Net migration to North Lanarkshire has picked up again after a small dip in the trend and projections. Estimates predict that North Lanarkshire’s population will grow and remain favourable up to 2028. Recent figures show the local economy continues to grow, reflecting a positive position in North Lanarkshire compared to a negative growth position nationally. The gross weekly wage for North Lanarkshire residents is now higher than the national average for the first time ever – an increase of 10% (£63.90 per week) from 2021 The number of people claiming employment related benefits has decreased by almost 48% from 14,195 as at December 2020 to 7,420 as at December 2022 and this claimant count is now lower than pre-pandemic levels. Challenges There is a need to build on these successes and minimise the impact poverty has on people and communi�es. Whilst there has been a 2-percentage point reduc�on in the propor�on of children living in poverty (from 25.2% to 23.2%), we s�ll have significantly high levels of child poverty. With 61,452 children aged 15 and below in North Lanarkshire, 14,256 of those children live in poverty. 5,455 children live in areas where the poverty figure is over the na�onal average of 24% and 3,185 of those children live in areas where poverty levels are over 30%. The North Lanarkshire Local Child Poverty Ac�on Plan details the ac�ons the council and other services are undertaking to support the Sco�sh Government to achieve its stated targets for reducing child poverty by 2030. Although there is a downward trend in the number of working age popula�on with no qualifica�ons, there remains 12.8% of North Lanarkshire’s working age popula�on (around 27,600) who are restricted from accessing employment opportuni�es. The propor�on of the working age popula�on who are economically ac�ve had shown signs of improvement in the a�ermath of the pandemic, however, this has stalled and will con�nue to be monitored closely for signs of stability. Other factors will require further inves�ga�on in terms of employability, as 69,100 people are currently recorded as being economically inac�ve, with 41% of these recorded as long term-sick and 84% recorded as not wan�ng a job. Within the Ac�on Plan of the 2020 -23 Tackling Poverty Strategy, Funeral Poverty was iden�fied as an issue for people within our community. There was a lack of engagement from Funeral Directors and as a result, this issue will be addressed in terms of accessing bereavement and funeral payments. Within North Lanarkshire there are other challenges which will impact upon our strategy and approach, a key factor being the continued impact of welfare reform from the UK and Scottish Government’s with the migration of Personal Independent Payments to Adult Disability Payment and Disability Living Allowance to Child Disability Payment. Whilst the UK welfare reform changes estimates are that 20% of people won’t remain on benefit following migration, the Scottish versions of the benefits have a more favourable qualification criterion. However, the migration process will
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have a significant impact on disabled people, their families and carers and will take at least until late 2024 to be completed. Whilst we had been able to reduce referrals to foodbanks by using the Food Poverty Referral Gateway in North Lanarkshire, evidence from the foodbanks indicate that referrals have started to increase again. Work carried out with the foodbanks has identified that the timescales and process around the administration of universal credit remains to be impacting on this, as well as the pandemic, recovery of the pandemic and the cost-of-living crisis. The Cash First approached adopted by North Lanarkshire in 2015, continues to lead the way across the country with the Scottish Government, Trussell Trust and other Local Authorities adopting the model. An example of how well the Cash First approach works is outlined by a resident who was assisted with the model; “I thought my only option was a foodbank the welfare rights officer helped me get a grant and I could choose what I wanted for my family….When they checked my benefits I didn’t know that I could get help with looking after my daughter……it has made a big difference” Mother with 3 children (Coatbridge) Across Scotland, there are also some early reports of the impact of the Scottish Child Payment benefit on referrals to foodbanks reducing for families, since its introduction in November 2022, for all children under 16. Over the next two years, North Lanarkshire Council are working in partnership with the Trussell Trust and the Third Sector Advice Services in a pilot to augment the exis�ng Food Poverty Gateway, this together with embedding The Pledge and Sco�sh Government and North Lanarkshire’s commitment to “cash first” approaches will ensure no one is left without food. The strategy and ac�on plan 2023-26 will build on our achievements and work towards mee�ng the challenges our communi�es face.
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LOCAL CHILD POVERTY ACTION REPORT – ACTION PLAN 2023 - 2026 Appendix One – Cost of Living Survey – Quotes From Children and Young People In North Lanarkshire
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How is the Cost of Living Affecting You? Comments Made In Respect of Food Number of Comments Comments Regarding Activities Number of Comments Comments Re Energy/ Fuel Number of Comments Comments on clothing & Other Issues Number of Comments I cant really afford as much food as I used to, I must ration and save some 3 I am unable to afford out of school activities/socialising with friends 8 Being told to switch off lights and appliances to use less electricity 50 Cannot afford to buy clothing / buy clothing that I would like 7 Affording school meals is tough with how much everything costs 7 I am unable to afford driving lessons 5 Increase in heating prices and heating is on less 40 Less treats / treats are too expensive 4 I am unable to get the things I want in a weekly shop, like snacks or branded foods 22 Less time watching TV 5 Waking up cold and going to bed cold 40 Tutoring is expensive 2 Unable to heat food 2 Can’t play on my consoles as much 21 Using more blankets to stay warm 1 I never get the treats that I used to get 5 Less money is given to me for lunch 2 Less or no money to buy things for the house 19 Being told to be quicker in the shower 45 Unable to replace things (school clothing/equipment) 3 Harder to afford food and electricity as I now have a brother 1 Unable to charge my phone/games as often as I did 20 I need to put on more clothes rather than using the heating 6 My pet food is really expensive 2 I am told not to waste food as it costs too much now 1 Less or no money when I am going out 1 Not able to travel as petrol costs too much 6 The strawberry and chocolate milk has been taken away at school 1 My food costs more 5 Prices have gone up at football 1 Energy saving hour 1 Vet bills are expensive 2 School dinners are too expensive 7 Travel costs to and from school are increasing 1 Put less water in the bath 1 I am not allowed to spend money in shops 4 There is not a lot of food in my house 14 Having less friends because you can’t afford to go out 1 Told to always close the door to keep the heat in 11 More arguments at home 7 Food and drink is more expensive 13 Can’t afford to do sports 1 No longer use heaters or dryers to dry clothing 1 More worry in the household to keep everything working 1 Not getting the food I want as it is getting dearer 2 I am not allowed to have the heating on 20 Cost of lunch is rising 5 Buying cheaper food, not branded, not good quality 7 More cautious about using electricity and lights 4 Travel too expensive 1 Buying less food and fridge rarely stocked 3 I am told that gas and electric is expensive 2 Not able to go out with friends 6 Food prices are rising 11 Wary about using heating 2 Less going out for meals 6 Takeaway food costs rising 3 Cant afford to heat home 4 Things cost a lot of money/ price increase 2 Smaller portion sizes 1 Lack of opportunities at school 6 How Does The Cost Of Living Affect Others In The Community?
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Comments Made In Respect of Food Number of Comments Comments Regarding Activities Number of Comments Comments Re Energy/ Fuel Number of Comments Comments on clothing & Other Issues Number of Comments People cannot afford to feed family and have 3 meals a day 31 People cannot afford to socialise 8 People cannot heat their homes 41 Unable to afford dental care 3 Students unable to concentrate on learning as they have not eaten 2 People cannot afford to pay for clubs 2 Elderly unable to heat their homes/bills 2 People are unable to purchase new clothing to keep warm 7 More people relying on foodbanks and having to choose whether to eat or heat their homes 17 House prices and rent increasing, so its harder to buy or keep houses, leading to more poverty 1 Unable to travel to work which leads to unemployment (maintain / fix a care or afford travel) 2 People cannot afford to pay for their house or their rent 23 People are unable to heat their food 1 More unemployment 1 People are unable to heat their food 1 People are unable to give their kids treats 1 Hungry at school because the breakfast club has stopped 1 People are without jobs and cant pay for things 4 Too expensive to travel (public transport / petrol) 16 Unable to socialise due to costs of gas and electricity / petrol 3 Unable to help feed family members due to cost of food 1 Community no longer open 1 People cant heat their homes or their food 16 People can’t afford school supplies 2 People are going days without food 2 House prices and rent increasing, so its harder to buy or keep houses, Can’t afford to wash themselves 1 People can’t afford pet bills 2 People are unable to afford food or hygiene products 6 Cost of travel means unable to see family/friends 7 People are going to bed cold 2 More people becoming homeless 18 People can’t feed themselves or their children 14 Unable to heat or feed themselves which makes the unwell and unable to work 10 More strikes 3 People losing jobs 3 People are having to buy in cheaper shops 3 Costs more for fuel 16 Rise in crime 1 No money to buy lunch 5 Going cold 1 Not a lot of money 1 Rising food prices / branded foods are too expensive 4 Bills increasing 3 Shops closing 3 People unable to afford food and relying more on foodbanks 18 More people taking on second jobs 3 People becoming stressed 2 Unable to help feed family members due to cost of food 1 Making people poorer 3 Debt increasing 1 What Can We Do To Help?
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The Cost Of A School Number of Comments Financial Education Number of Comments Transport, Fuel and Food Number of Comments Other Comments Number of Comments Lower the cost of school meals 39 Financial Education 36 Free transport 18 Free child care 2 Ensure students get a free meal (Breakfast during or after school) 16 Learning about money within school (how to pay bills, budgeting and managing money) 36 Free electric car charges 1 Reincorporate the library its critical part of the school and gives people a space to read 2 Free after school activities 18 Taught about money / managing money in school 7 Cheaper trains 1 Ask for opinions from school pupils on new developments before implementing things that don’t get used 2 Free school uniforms 22 How to budget and handle money as part of the WPS course 2 Face problems in front of us and reduce stress, such as school buses arriving on time 1 Clubs for families to get food and heat 1 Free clubs 9 Make everyone feel equal and understand more about poverty and money 2 Help kids with cooking so we can make meals on basic food as opposed to buying pre-made expensive 1 Give people money 1 Free school meals for everyone 67 More foodbanks / food donations 10 Lower prices 25 Free/lower price of school trips 32 Clubs for families to get food and heat 1 Advertise more help 3 Borrow laptops from school to use at home 6 More food donations 8 More homeless places 3 Free after school clubs to allow people to work longer 13 Lower prices of electricity / gas 3 Pay less rent 6 More fundraising 2 Free breakfast clubs 18 Have emergency money to give people for heating 1 Ensure that poverty proofing is in place in all schools 1 Make after school clubs more affordable 7 Cheaper gas prices 2 Lower costs for basic needs 2 All equipment/stationary needed for school should be free 4 Give additional money to those struggling 2 Wages are enough to afford things 4 Give money for school lunches to let us choose what we want 12 More money from government 1 Make a uniform bank 4 More grants to assist with costs 1 Stop school uniform as it costs a lot 1 Reduced days in the school week so people can afford to come to school 1 Lower the price of football parks 1 Lower locker charges 3 Free Glasses 2 Change the requirements for free school meals as salaries are not changing but food is 1 Allow people longer to pay back loans and their rent 1 Lower price of clubs outside school 2 Increase wages and lower taxes 3 Increase our EMA 4 “The Three Questions” Sessions – General Comments From Children and Young People Across North Lanarkshire
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My mum panics and cries about money Harder to afford food and electricity as I now have a brother I worry about if we can afford my needs now rather than my wants Buying things causes arguments in my house More worry / stress for adults at home I only have one meal per day as its too expensive I am poor now I get anxious when I go to the shop to buy food. My dad is off work and is on sick pay. In the next couple of months, he will be on half pay and I am worried how we will be able to afford anything. Dad is usually out of money when is on full pay. I’m worried what will happen if he runs out of money half way through the month Buying things causes arguments in my house My clubs cost to much You need to think about trips and how much they are My brother needs help to pay for his electricity Money is becoming a controversial subject between friends Granpa who has grandchildren staying at his home has had to stop them staying as he cant afford to feed them Our gas isn’t las�ng as long as it used to, needing topped up more o�en I go to bed cold My house is cold I am cold in my room People are being bullied My gran has went for surgery and needs hea�ng on all the �me which is very expensive My aunty needs to stay over or wash at ours because she cant afford her bills or cousins needs My neighbour is very sick and he is worried about the cost of his rent My neighbour is very sick and he is worried about the cost of his rent During the strikes, students taking exams were struggling because teachers were off so much to get paid more because of rising costs
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Appendix 3 NLC Interim Impact Assessment form Public Sector Equality Duty and Fairer Scotland Duty Section 1. About the Policy 1.1 Name of the policy / strategy / function / procedure: Tackling Poverty Strategy – Forward to a Fairer North Lanarkshire/Action Plan Is this a: - A new policy /strategy / function / procedure / service Budget saving Review of policy /strategy / function / procedure Review of Service Other (please specify) Is this is a key strategic decision subject to the Fairer Scotland Duty Yes No 1.2 Person Responsible for the policy etc. Name: Job Title and Service / Team: John Campbell Business Manager Tackling Poverty 1.3 What is the scope of the assessment? Detail where appropriate Whole of the organisation All Council Services, CPP’s and External Services Service specific Discipline specific Other Wider Partners including Third Sector, Community Groups and residents. 1.4 What is the policy/ strategy/ function/ saving trying to achieve / do? Poverty is a significant feature of Scottish society and affects many people in different ways. Whilst low income and material deprivation are issues rightly at the forefront of the poverty debate, we recognise that poverty should not merely be reduced to a question of income or material well-being alone; it is also a matter of health and well-being. There is a complex, interlinking relationship between factors that define and influence poverty and these cannot be considered in isolation.
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The Plan for North Lanarkshire sets out the committed to focus on the things that will significantly improve the quality of life and well-being for all our residents, but the supporting evidence base highlights that challenges remain. A Programme of Work to 2028 has been developed to ensure a heightened and more strategic focus on not only sustaining the economic and community aspects that will enable local people and communities (and the place that is North Lanarkshire) to thrive, but also on ensuring a more targeted approach to improving social, health, and economic conditions and maximising opportunities to escalate the delivery of improved outcomes for those that need it most, thus turning the vision of inclusive growth and prosperity into a reality. Moving forward, the Tackling Poverty Strategy is a key area of activity in the Programme of Work and a major step in ensuring that our residents are offered opportunities, support, advice, and information that will address the drivers of poverty through: - • Increasing income via employment; • Maximising income via social security benefits; • Reducing the cost of living; and • Holistic Supports. The Action Plan within the Tackling Poverty Strategy details the key elements and priorities of the new Towards a Fairer North Lanarkshire – Tackling Poverty Strategy 2023 to 2026. In addition, the Strategy encompasses the statutory requirement to prepare and publish a Local Child Poverty Action Report for North Lanarkshire for 2022/23. (Appendix 2) and reflects the ambition of the national Tackling Child Poverty Delivery Plan 2022-26 – Best Start/Bright Futures published by the Scottish Government in April 2022 as the second of 3 delivery plans required by the Child Poverty (Scotland) Act 2017. In delivering these priorities we will ensure that our policies and procedures have been “poverty proofed” to ensure maximum impact and avoid unintended consequences in line with our Fairer Scotland duties and effective and co-ordinated approach to tackling poverty. 1.5 If this is a budget saving, how will the saving be achieved? N/A Section 2. What do I know now? 2.1 Who are the stakeholders and beneficiaries? All Residents in North Lanarkshire, All Council Services, NHS Lanarkshire, Community Planning Partners, Third Sector and Private Businesses. 2.2 What data, consultation, research and other evidence or information is available relevant to this assessment? (This is a desktop exercise) North Lanarkshire is the fourth largest authority area within Scotland, with a population of 340, 180. It is situated in the heart of Scotland with connectivity to the rest of Scotland, the UK and the world. As the fifth most densely populated council area, North Lanarkshire is divided into 21 wards which are represented by 77 elected members. Historically the local authority has experienced higher than average levels of deprivation with the Scottish Index of Multiple Deprivation (SIMD) published in January 2020 identified that across North Lanarkshire, 50,897 people are income deprived, that equates to 15% of
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our population as opposed to the Scottish average of 12%. Of the 50,897-income deprived population; 28,426 live in the 20% most deprived datazones and 18,251 live in the 15% most deprived datazones 22,426 income deprived people live outside the 20% most deprived datazones 32,646 income deprived people live outside the 15% most deprived datazones. North Lanarkshire is ranked 6th in terms of its share of datazones in the 20% most deprived, sitting behind; Inverclyde, Glasgow, North Ayrshire, West Dunbartonshire and Dundee. 5 North Lanarkshire datazones are within the 1% most deprived areas of Scotland. Two of these datazones have moved into the worst 1% from their position in the 2016 SIMD; Greenend (SO1011609) and Coatbridge Time Capsule (SO1011561) Other data considered were, Child Poverty Rates, Housing data, educational data, Employability data, internal data for income maximisation, economic data and Health and Wellbeing data. Over the past number of years, progress in developing local approaches to tackling poverty and reducing inequality in North Lanarkshire, have been strengthening with activity focused on the key drivers of poverty, via the ‘Towards a Fairer ‘North Lanarkshire Tackling Poverty Strategy. We know that poverty is experienced disproportionately by particular groups of people: • Older women are more likely to be poor. In 2015-18, after housing costs are accounted for, 24% of children, 20% of working age adults and 15% of pensioners in Scotland were living in relative poverty • Disabled people are more likely to live in poverty. In 2015-18, the poverty rate after housing costs for people in families with a disabled person was 24%. This compares with 17% of people in a family without a disabled person who were in poverty. Disabled people are twice as likely to be out of work and earn less than non-disabled people o Women are more likely to live in poverty. o 90% of lone parents are women o More likely to work part time in low wage jobs o Greater impact from Welfare reform o In 2016 to 2017 women earned on average £1.90 an hour less than me • People from minority ethnic (non-white) groups were more likely to be in poverty, both after and before housing costs, compared to those from the 'White - British' group. After housing costs 38% of people from 'Mixed, Black, Black British and Other' ethnic groups and 34% of 'Asian or Asian British' ethnic groups were in relative poverty after housing costs. In comparison 18% of 'White British' people were in relative poverty.
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• Gay men are more likely to experience poverty than heterosexual men. Muslims most likely to be living in poverty. In 2015-18, 41% of people who identified their religion as Muslim were living in poverty after housing costs This Tackling Poverty strategy focuses on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living and increase income from social security benefits 2.3 Considering the information in Section 1 and 2.1 and 2.2 2.3.1 If this policy is subject to the FSD what does it suggest about the impact or potential impact on socio-economic disadvantage? (please refer to FSD Interim Guidance) Low income The Strategy aims to increase the income of unemployed and employed residents of North Lanarkshire Low wealth The Strategy will provide financial inclusion and improve residents ability to deal with the cost of living Material deprivation The Strategy will reduce material deprivation among residents Area deprivation The Strategy will target areas of deprivation 2.3.2 Are any of the people/communities listed below likely to be more affected by this policy than others? People who share one or more of the protected characteristics of the Equality Act 2010 Yes Details No Details Don’t Know Age (a particular age or range of ages) Older People and Children and Young People can be more affected by poverty than other age groups e.g. Older women experience poverty worse than older men, underemployed young people and those on zero hours contracts etc. Disabled people and people with long term health conditions Approximately, 30,000 people in North Lanarkshire are in receipt of a disability benefit and the cost of living with a disability costs on average £550 per month than a non- disabled person. All of this means that 47.5% of disabled people live in poverty. Women and men, girls and boys The welfare reforms changes and cost of living crisis, in particular
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Universal Credit, 2 child rule and under occupancy rules, can have a worse impact on women. People defined by their race, colour and nationality, ethnic or national origins. Unemployment rates for BME people is higher in NL than for white people. Married people and civil partners The welfare reforms changes and cost of living crisis, in particular Universal Credit, can have on people. Pregnant women and new mothers The welfare reforms changes and cost of living crisis, in particular Universal Credit, 2 child rule and under occupancy rule, can have an impact on women. Lesbian, gay and bisexual people The welfare reforms changes and cost of living crisis, in particular Universal Credit and under occupancy rule, can have an impact on lesbian, gay and bisexuals. Gay men are known to experience greater poverty than straight men. People transitioning from one gender to another The welfare reforms changes and cost of living crisis, in particular Universal Credit and work commitments/sanctions, can have an impact people transitioning. People of different religions or beliefs or non-beliefs Muslim people are more likely to experience poverty than other religious groups. Other groups Children and families The welfare reforms changes and cost of living crisis, in particular Universal Credit, 2 child
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rule and under occupancy rule, can have an impact on children and families. Homeless people The welfare reforms changes and cost of living crisis, in particular Universal Credit, work commitments and under occupancy rule, can have an impact on homeless people. Looked after and accommodated people The welfare reforms changes and cost of living crisis, in particular Universal Credit, can have an impact on looked after and accommodated people. Care leavers The welfare reforms / changes and cost of living crisis, in particular Universal Credit, can have an impact on Care leavers. Carers – paid / unpaid, family members It is well documented that many carers are living in poverty. Asylum seekers People seeking asylum are very limited in their ability to access benefits and employment with limited rights so are at great risk to extreme poverty. Employees – full and part time. Including SES, MAs etc. Some of our employees may be experiencing in work poverty. Others 2.4 Do you have evidence or reason to believe that this policy will, or may potentially affect the Council’s duty to: (Please tick all that apply). Yes No Don’t Know 1. Eliminate unlawful discrimination, harassment and victimisation and any other conduct prohibited by the Equality Act 2010? 2.Advance equality of opportunity between people who share a relevant protected characteristic and those who do not
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3. Foster good relations between people who share a protected characteristic and those who do not? 4. Protect and promote human rights? 5. Reduce socio-economic disadvantage Please provide details. The purpose of the Tackling Poverty Strategy is to ensure that there is an overall strategic approach to tackling poverty and inequality across North Lanarkshire. There has been and is good work being done by all services and partners, however, this is fragmented and at times duplicated or in fact at odds with other policies and approaches we are taking. The Tackling Poverty Strategy will ensure the one council approach within the Plan for North Lanarkshire is being delivered, with all tackling poverty initiatives falling under the umbrella of this strategy and associated policies and plans; Economic Regeneration Delivery Plan Community Engagement Strategy Education and Families Improvement Plan Children Services Partnership Plan Local Housing Strategy Equality Strategy Section 3. What else do I need to know /find out? 3.1 Further consultation – Please use the table directly below to say who you will consult with (tick Yes or No). Consider those groups from section 2.3 where you ticked yes or don’t know. Once consultation has taken place provide the details below. People and communities Yes No Describe what you did, with whom and when. Please provide a brief summary of the responses gained and links to relevant documents, as well as any actions Age (a particular age or range of ages) Please see section Other Groups about the consultation and engagement process. 43% of the respondents were aged between 25 and 39, followed closely by 39% aged between 40 and 49. Only 2% of those responded were aged 65 and over The main household types responding were: • 35% were couple living with child(ren) in education and/or working age children • single adults living with dependent child(ren) (20%) • single adults living alone (13%) • working age couples (16%) Disabled people and people with long term health conditions Please see section Other Groups about the consultation and engagement process The main concern for this group pressures of paying household bills (fuel), transport, cost of food,
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employment for disabled people, mental health impact and benefits, in particular disability benefits Women and men, girls and boys Please see section Other Groups about the consultation and engagement process People defined by their race, colour and nationality, ethnic or national origins. Please see section Other Groups about the consultation and engagement process. 3,369 respondents less than 5% told us their ethnicity. Married people and civil partners Please see section other groups about the consultation and engagement process. We do not know if there were married and civil partners who responded, however, of the respondents: • 50% were couple living with child(ren) in education and/or working age children • working age couples (16%) Pregnant women and new mothers Please see section Other Groups about the consultation and engagement process. We do not know if there were any pregnant or new mothers who responded. However, of the respondents 20% were single adults living with dependent child(ren). Lesbian, gay and bisexual people Please see section Other Groups about the consultation and engagement process We do not know the sexual orientation of the respondents People transitioning from one gender to another Please see section Other Groups about the consultation and engagement process. We do not know the transgender status of the respondents People of different religions or beliefs or non-beliefs Please see section Other Groups about the consultation and engagement process. We do not know the religions or belief of the respondents. Other groups / general consultation √ In addition to the facts and figures about North Lanarkshire, it is important that we dig much deeper and continue to listen and learn from the lived experience of the people living in poverty in our communities.
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In the previous strategy a survey was carried out asking people “what makes life more difficult for you financially?”. Following the impact of the covid 19 pandemic and in the middle of the cost of living crisis, the survey was carried out again, asking the same questions. The council developed and re-issued the survey in March 2023. Both an online and paper version asked what makes life financially difficult for the people of North Lanarkshire. The results have helped shape and inform this Tackling Poverty Strategy and our response to addressing poverty. See Appendix 2 of the Tackling Poverty Strategy. The survey went live on 15th March 2023. It was published on the NLC consultation page of our website, advertised on social media and sent by text message to parents and carers. NHSL, One Parent Families Scotland, Routes to Work, Voluntary Action North Lanarkshire and North Lanarkshire Advice Network partners disseminated the survey via their own platforms. Paper surveys were supplied to those who could not access the online version and in particular to English for Speakers of Other Languages (ESOL) groups. This was useful in reaching those within our communities who otherwise may not have their views represented. A total of 3,369 responses were prepared for analysis, with a representation from all Community Board Areas. 50% of people who responded to the survey were from families of a couple living with child(ren) in education and/or working. 34% were from families of a single adult living with dependent child(ren). Of the 3,369 respondents over 90% said they were ‘White/Scottish or White British’. With less than 5% indicated they were people defined by their race, colour and nationality, ethnic or national origins. When looking at reducing the cost of living 43% of respondents reported that repaying debts contributed to their financial difficulties – 20% also reported high interest debt repayments were an issue. This will inform our work around affordable credit and forming closer links with local credit unions. Childcare remains a barrier to employment with a third of respondents reporting that childcare is not
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affordable, while 22% found childcare did not meet their needs. The Tackling Poverty Team have embarked on a communications programme called “The Three Questions” across all our communities, this will be a continuous programme which will become the heartbeat of our Strategy, shaping and underpinning everything we are doing across the local authority. The “Three Questions” have been shaped around the cost of living crisis, we simply ask; “How is the cost of living impacting you?” “How is the cost of living impacting others in the community?” “What would you like us to do about it?” The Three Questions have been taken to schools, both Primary and Secondary, as it is important that our children and young people’s voices are heard in the shaping of our Strategy. Children and families Please see section Other Groups about the consultation and engagement process. When asked what the children and young people wanted us to do about it, the top two answers from the children and young people were: Free School Meals for everyone and financial education. The children and young people expressed that they wanted to learn about money “make everyone feel equal and understand more about poverty and money….learn about money, how to pay bills, budgeting and money management”. When asked how the cost of living affected them, the impact on socialising was a major issue for the children and young people, whilst 21% stated that they could no longer afford after school activities and socialising with friends, 56% stated that they could no longer play their consoles, charge their phones as much, all forms of socialising for younger people. Homeless people Please see section Other Groups about the consultation and engagement process We do not know if any of the respondents were homeless. Looked after and accommodated people Please see section Other Groups about the consultation and engagement process We do not know if any of the respondents were looked after and accommodated.
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Care leavers Please see section Other Groups about the consultation and engagement process We do not know if any of the respondents were care leavers Carers – paid / unpaid, family members Please see section Other Groups about the consultation and engagement process 10% of respondents stated that they were a carer. Trade Unions Employee Equality Forum Others 3.2 What additional research or data is required? The Council is about to undergo an extensive community engagement exercise into the lived experiences of the BME communities of North Lanarkshire and this will inform our strategy. This engagement will also have the added benefit of being disaggregated by age, sex and religion. 3.3 What does the additional research and data tell you about potential or known effects? The research into the lived experiences of NLs BAME people and communities confirmed the following: >Language is a key barrier in making effective use of services especially for those who have little or no proficiency in the English language. >There are concerns about the ability of the older generation to cope with the increase in services provided online since the pandemic. Older BAME women in particular lack digital skills and experience exclusion. >The cost of living crisis is of great concern to the Afro-Caribbean community – Black African males in NL have the highest rates of unemployment of all ethnicities. This tells us that any actions to tackle poverty need to: • Recognise that where language is a barrier people may be excluded from accessing support and information. • Where people are excluded digitally, information and access to support will need to be provided in ways that meet needs. • Recognise that poverty among some ethnicities will further reduce their access to digital inclusion. • For some groups the exclusion can be tripled because of all of the above - language barriers, lack of digital access and lack of wealth. We will include the recommendations for action from the community engagement and research into the Tackling Poverty Strategy Action Plan.
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Section 4. Assessing the impact and strengthening the policy Considering all the evidence you now have from section 1-3, how will the policy affect different people and communities in relation to equality, socio-economic disadvantage and human rights? 4.1 How does/will the policy and resulting activity affect those with the characteristics listed below (including employees)? Please use the table below to provide details. Detail any Positive impact Detail any adverse impact If adverse how can we mitigate this? Where no mitigating action is planned please say why not Age (a particular age or range of ages) We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Disabled people and people with long term health conditions We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social
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security benefits and assisting them to reduce their cost of living, given them more disposable income. Women and men, girls and boys We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. People defined by their race, colour and nationality, ethnic or national origins. We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Married people and civil partners We have focused on the key drivers to reduce poverty
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which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Pregnant women and new mothers We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Lesbian, gay and bisexual people We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to
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see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. People transitioning from one gender to another We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. People of different religions or beliefs or non-beliefs We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them
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more disposable income. Other groups Children and families We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Homeless people We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, Holistic supports and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Looked after and accommodated people We have focused on the key drivers to reduce poverty which are; Income
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from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Care leavers We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Carers – paid / unpaid, family members We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living, holistic support and increase income from social security benefits. Therefore we would expect to see peoples income
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increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Employees – full and part time. Including SES, MAs etc. We have focused on the key drivers to reduce poverty which are; Income from employment, reduce the cost of living holistic support, and increase income from social security benefits. Therefore we would expect to see peoples income increase either via employment, income from social security benefits and assisting them to reduce their cost of living, given them more disposable income. Others N/A 4.2 What measures could be taken to strengthen the policy / strategy to help advance equality of opportunity, foster good relations, promote human rights and reduce socio-economic disadvantage. It is clear that North Lanarkshire need to address poverty, additional research will be needed through the period of the strategy to ensure that the planned outcomes are being met. We would also require any additional update research from a national basis. Internal Audit carried out an audit of the adequacy and effectiveness of the Council approach to progressing the Tackling Poverty and the associated key corporate risk. Internal Audit assessed the audit as providing ‘reasonable assurance’ as they considered that the Tackling Poverty Strategy and action plan have been appropriately integrated into the Council’s wider plans and appropriate governance and risk management arrangements in place and identifying a small number of areas where scope for improvement exists. Consideration will need to be given to target particular groups in ways that meet their needs. For instance – Connect with local Mosques and Muslim Women’s Groups/ DPOs / Older people’s organisations etc. to ensure they are targeted as part of any campaigns /
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income maximisation efforts, / opportunities etc. Make sure information is accessible to different people. 4.3 Considering questions 4.1 and 4.2 what actions / measures will be put in place before introducing this policy please provide details. Action Timescales Responsible Officer Review details (include timescales) The Strategy will have an Action Plan that outlines the actions required to reduce poverty in North Lanarkshire 2023 - 2026 John Campbell Business Manger Tackling Poverty Yearly (March 2024) Section 5. Monitoring, evaluating and reviewing 5.1. How will you monitor the impact and effectiveness of the new policy? The Strategy has a number of key measures which we will work together to fulfil, with the responsibility for monitoring this detailed. Our communities and protected groups will know we are getting things right by having; An improvement in the health and wellbeing of our residents Fewer households living in poverty Reduction in child poverty Fewer people unemployed and in receipt of out of work benefits Reduction in the number of people economically inactive An increase in the number of people paid at least the real living wage An increase in the number of affordable homes Fewer young people who are not in education, employment or training Improved education attainment Fewer people with no qualifications or skills training Fewer households in fuel poverty Maximise income through social security benefits Maximise income via new Scottish social security benefits for children More people with numeracy skills enabling them to manage their money Reduce number of people in debt Increase number of people who have access to affordable credit Effective heat maps to inform residents of access to services Increase community consultation Section 6. Making a decision and sign-off Recommendation Tick Comment (where applicable, please give more information e.g. where to pilot, what modifications, etc.) Timescales
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Introduce the policy September 2023 Adjust the policy then introduce Introduce the policy with justification regarding potential adverse impact Stop and withdraw the policy Name of Policy Tackling Poverty Strategy – Forward to a Fairer North Lanarkshire Head of Service /Senior Manager sign-off: Name Job title and division/ team Date Signature Alison Gordon Chief Officer - Education & Families - Integrative Practice (CSWO) For further information please contact: Name: John Campbell Job title: Business Manager Tackling Poverty Service: Education and Families Contact details: campbelljohn@northlan.gov.uk 01698-332566
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council If having read the Report template guidance you have identified that your report has an impact on children and young people’s rights and wellbeing, the following Children’s Rights and Wellbeing Impact Assessment (CRWIA) template should be completed. Where an impact has been identified, a summary of the impact identified following completion of the impact assessment (and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC)) requires to be included in the Report at section 5.11. Where an impact has been identified, a copy of the last section in this template (i.e. the CRWIA - Stage 3 Publication Template summary) should be as an Appendix to your report. If you require further support or guidance in order to complete this section of the report template - or to complete the Children’s Rights and Wellbeing Impact Assessment (CRWIA) template - please e-mail the Community Learning and Development team at CLD@northlan.gov.uk 1. Name the policy and describe its overall aims. North Lanarkshire Tackling Poverty Strategy “Toward a Fairer North Lanarkshire” This is a high level plan outlining the focus and priorities for NL and its partners for 2023 – 26 ; • To tackle poverty across our communities using the 4 drivers; Increase income from employment, reduce the costs of living, increase income from social security benefits and holistic supports • To reduce child poverty across North Lanarkshire 2. What aspects of the policy/measure will affect children and young people up to the age of 18? The Articles of the UNCRC and the child wellbeing indicators under the Children and Young People (Scotland) Act 2014 apply to all children and young people up to the age of 18, including noncitizen and undocumented children and young people. The Tackling Poverty Strategy is relevant to all children, young people and families in North Lanarkshire. This includes non citizen and undocumented children and young people. The Tackling Poverty Strategy incorporates the Local Child Poverty Action Report and the work being done across North Lanarkshire to eradicate poverty in our communities, working with partners in NHSL and the third sector to achieve the outcomes detailed within the Action Plan.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council 3. What likely impact – direct or indirect – will the policy/measure have on children and young people? ‘Direct’ impact refers to policies/measures where children and young people are directly affected by the proposed changes, e.g. in early years, education, child protection or relevant to care experienced children. ‘Indirect’ impact refers to policies/measures that are not directly aimed at children but will have an impact on them. Examples include: welfare reforms, parental leave, housing supply, or local transport schemes. The priorities and actions seek to improve the experience of services and outcomes for all children and young people. Although relevant to all children and young people, in the most part, target those who are identified as disadvantaged or in need of additional support. Through the fourth driver “holistic supports” there is clear legislative and strategy links with the Childrens Services Plan. Direct Impact – work identified within the action plan in relation to income maximisation and financial education will have a direct impact on children and young people Indirect Impact – the tackling poverty strategy identifies areas within the action plan, such as parental support to employment initiatives, house building programmes which are not directly aimed at children but will have an impact on them. 4. Which groups of children and young people will be affected? Under the UNCRC, ‘children’ can refer to: individual children, groups of children, or children in general. Some groups of children will relate to the groups with protected characteristics under the Equality Act 2010: disability, race, religion or belief, sex, sexual orientation. ‘Groups’ can also refer to children by age band or setting, or those who are eligible for special protection or assistance: e.g. preschool children, children in hospital, children in rural areas, looked after children, young people who offend, victims of abuse or exploitation, child migrants, or children living in poverty. All children and young people in North Lanarkshire, and a small number of children and young people who live outside of NL that have connections e.g. through family, placement or education. We know that children and young people who have protected characteristics under the Equalities Act are more likely to require additional or intensive supports at stages in their lives or throughout their lives. An Equalities Impact Assessment process has taken place alongside the development of the planning process. There is information in the JSNA about particular groups of children and young people that are known to encounter barriers to their wellbeing and realising their rights. This is not exhaustive or exclusive and children and young people can associate with multiple ‘groups’ or experience disadvantage. Local research and data tell us that there are persistent and pronounced inequalities in some health and wellbeing outcomes among children and young people in North Lanarkshire. Poor outcomes in
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council one area of wellbeing are often accompanied – and potentially compounded – by poor outcomes in another. All children and young people including ‘groups’ of children and young people are supported by our GIRFEC approach and keeps children at the heart. As part of this approach the Tackling Poverty Strategy works to ensure that the systems, processes and pathways that are in place (and continually improving) in universal servicers to identify at the earliest possible stage if the needs of a child are core, additional or intensive. When support is planned each child is considered within their individual circumstances. 5. Will this require a CRWIA? Explain your reasons. CRWIA Declaration-Tick the relevant section and complete the form CRWIA required. YES- the plan will impact on children and young people in NL CRWIA not required. Authorisation-Policy lead Name, title, division (or equivalent) Date Alison Gordon, Chief Social Work Officer, Education and Families July 2023 Person or group completing paperwork. John Campbell, Manager Tackling Poverty Team On behalf of Tackling Poverty Officers Action Group July 23 CRWIA Stage 2 The CRWIA – key questions 1. Which UNCRC Articles are relevant to the policy/measure? List all relevant Articles of the UNCRC - All UNCRC rights are underpinned by the four general principles: non-discrimination; the best interests of the child; the right to life, survival and development; and the child’s right to have their views given due weight. The articles can be viewed here: UNCRC_summary-1_1.pdf (unicef.org.uk) Article Four – The state must do all it can, through passing legislation and creating administrative systems, to promote and protect children’s rights. With regard to economic social and cultural rights. Parties shall undertake such measures to the maximum extent of their available resources. Article Six – Right to life, survival and development Article Eighteen - Parties shall take all appropriate measures to ensure that children of working parents have the right to benefit from child care services and facilities for which they are eligible.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council Article Twenty Four – Right to the highest attainable standard of health Article Twenty Six – Right to benefit from social security Article Twenty Seven – Right to a standard of living adequate for a child’s physical, mental, moral and social development Article Thirty One – Right to rest and leisure and to engage in play and recreational activities and to participate freely in cultural life and the arts Article Thirty Two – The right to be protected from economic exploitation and performing any work that is likely to be hazardous or to interfere with the child’s education or be harmful to the child’s health 2. What impact will the policy/measure have on children’s rights? Positive/negative/neutral. The Tackling Poverty Strategy will have a positive impact on children’s rights. The Tackling Poverty Strategy incorporates the principles of the Best Start, Bright Futures policy to reduce child poverty across Scotland by 2030. The Strategy augments the commitments made in The Promise and Whole Family Support to ensure that children will not grow up in poverty. Implementation of the Tackling Poverty Strategy will be progressed by task groups and working groups. We will continue to ask these groups to consider the articles most relevant to their actions and the impact on children’s rights as part of the planning and reporting process. Where appropriate, Children’s Rights and Wellbeing Impact Assessments will be undertaken. As a partnership we promote the use of Children’s Rights and Wellbeing Impact Assessments (CRWIA) to support partners and partnerships to apply these in all areas of policy, strategy and development. 3. Will there be different impacts on different groups of children and young people? Which groups of children will be affected by the policy/measure? Are there competing interests between different groups of children and young people, or between children and young people and other groups? There is potential for competing interests and exclusions. The priorities and actions seek to improve outcomes for all children and young people, and, although relevant to all children and young people, on the most part, target those who are identified as disadvantaged or in need of additional support.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council Getting it Right for Every Child (GIRFEC) is the national approach that is embedded in practice across the Tackling Poverty Officers Action Group. This approach includes preventative measures and working to identify those who may need additional support at the earliest possible stage. In identifying the priorities that are included in the Strategy there are completing demands on what should be included and finite capacity and resources to deliver. The processes to arrive at the priorities encourage broad representation and consultation. Despite best efforts, not all groups and voices will be represented and reflection on the process will identify improvements. The children and young people that are most vulnerable are often least visible and seldom heard. Although the Tackling Poverty Officers Action Group recognises and applies practices to promote inclusion there remains unmet and hidden needs. 4. If a negative impact is assessed for any area of rights or any group of children and young people, what options have you considered to modify the proposal, or mitigate the impact? If options to modify the policy/measure are included here, include associated resource implications where relevant. The Tackling Poverty Strategy includes priorities and actions that will amplify the incorporation of children and young people’s voices in the planning and decision-making processes for individual children and young people and representative groups. Members of the Tackling Poverty Officers Action Group are represented on the Childrens Services Partnership and work together in raising awareness and making sure everybody is aware of UNCRC and children’s rights, this will lead to an increased awareness of where children’s rights are not being upheld and therefore opportunities to act on this. Where issues arise these will be monitored through the Childrens Services Partnership Continuous Improvement Group and reporting on children’s rights. 5. How will the policy/measure contribute to the wellbeing of children and young people in Scotland? Outline how the implementation of the policy/measure will support our duties to safeguard, support and promote the wellbeing of children in their area, with wellbeing defined by eight wellbeing indicators. The indicators are: Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible, and Included. More information is available via the link below. SHANARRI+-+Wellbeing+wheel+-+full+text.pdf (www.gov.scot)
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council The Tackling Poverty Strategy directs resources and supports to tackle child poverty and in doing this this will promote the wellbeing of children. Tackling poverty in our communities will help achieve the eight well being indicators for the children of North Lanarkshire. 6. How will the policy/measure give better or further effect to the implementation of the UNCRC in Scotland? This will inform the duty to report what has been done to further and better children’s rights under the Children and Young People (Scotland) Act 2014. The Tackling Poverty Strategy will assist in both the prevention and lifting children out of poverty, the Action Plan will be updated on an annual basis and reported on. 7. What evidence have you used to inform your assessment? What does it tell you? The evidence base may include demographic information, academic research, service monitoring/inspection reports, service evaluation reports, user surveys, etc. In particular, look at what existing evidence tells you about children and young people’s views and experiences of the relevant service(s); and/or what it tells you about children and young people’s views of the policy proposal. Identify any gaps in the evidence base and set out how you will address these. The Tackling Poverty Strategy considered the following information and evidence to update the Strategy and Action Plan; Our population and emerging needs DWP information Economic activity The voice of the community via the Three Questions The voice of our children and young people via the Three Questions School Initiative What is currently working well The evidence base is continually evolving and will develop further during the lifetime of the Tackling Poverty Strategy. 8. Have you consulted with relevant stakeholders? This would include public or targeted consultations with children and young people, their parents/carers and the children’s workforce. Consultation has taken place in the community and with children and young people within our schools, asking the Three Questions; “how is cost of living affecting you”, “how is cost of living affecting others in the community” and “what would you like us to do about it”.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council 9. Have you involved children and young people in the development of the policy/measure? Is there enough information on the views of the children and young people who will be affected by the policy/measure that enables you to make an informed assessment of impact? Children and young people have been consulted on the Three Questions; “how is cost of living affecting you”, “how is cost of living affecting others in the community” and “what would you like us to do about it”. With a programme being developed to ensure that this is a continual process throughout the school clusters.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council CRWIA – Stage 3- cannot complete until final copy – draft from pervious CRWIA below Publication Template CRWIA title: North Lanarkshire Children’s Services Plan 2023-26 Publication date: Summary of policy aims and desired outcomes. The Tackling Poverty Strategy 2023-26 outlines the priorities for the next three years, to tackle poverty in our communities. It includes actions under the drivers to tackle poverty; Increase income via employment Reduce the costs of living Increase income via social security benefits Holistic Supports Executive summary In North Lanarkshire we recognise that tackling poverty and inequality does not fall to one Service, or one Sector, we must therefore work together to use our resources effec�vely and efficiently to ensure that all our communi�es have access to opportuni�es that will lead to beter outcomes for people in terms of employment, wellbeing and inclusive growth. This CRWIA was undertaken alongside an Equalities Impact Assessment. Background The Tackling Poverty Strategy 2023-26 is the current plan. It builds on the previous plan, with the Action Plan reviewed annually. Scope of the CRWIA, identifying the children and young people affected by the policy, and summarising the evidence base. The priorities and actions seek to improve outcomes for all children, young people and families, and although relevant to all children and young people and families, on the most part,our priorities target those who are identified as disadvantaged or in need of some support. Children and young people’s views and experiences These are included through the Three Questions asked of the children and young people in schools across North Lanarkshire.
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Children’s Rights and Wellbeing Impact Assessment, North Lanarkshire Council Key findings, including an assessment of the impact on children’s rights, and how the measure will contribute to children’s wellbeing. The Tackling Poverty Strategy will help tackle the impact poverty has on children and young people. The Action Plan within the Strategy brings together shared priorities and actions that will impact positively on children, young people and families. Monitoring and review The Action Plan will be updated on an annual basis by the Tackling Poverty Officers Action Group, with regular updates being provided to the Wellbeing and Tackling Poverty Committee. CRWIA Declaration Authorisation Lead John Campbell Manager – Tackling Poverty Date July 2023 Chief Officer Date
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1 REPORT Item No: 16 SUBJECT: North Lanarkshire’s Children’s Services Plan 2023-26 TO: Integrated Joint Board Lead Officer for Report: Alison Gordon, Chief Social Work Officer Author(s) of Report Mark Kay, Senior Health Promotion Officer and Lynn Brennan Senior Officer – Planning, North Lanarkshire Council DATE: 27th September 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☒ For Endorsement: ☐ To Note: ☐ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☒ Prepared by Mark Kay, Senior Health Promotion Officer and Lynn Brennan Senior Officer – Planning, North Lanarkshire Council, reviewed by Improving Children’s Services Group & Children’s Services Partnership Board
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2 3. RECOMMENDATIONS (1) IJB is asked for approval of the North Lanarkshire Children’s Services Plan 2023-26 4. VARIATIONS TO DIRECTIONS? This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required Yes ☐ No ☐ N/A ☒ 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1. The Children and Young People’s (Scotland) Act 2014 introduced requirements for each Local Authority and linked Health Board to prepare and publish the following (attached separately): - (a) A Children’s Services Plan (CSP) covering the period April 2017– March 2020 (and then in a continuing three-year cycle); and (b) A Children’s Rights Report by March 2020 (and then in a continuing three- year cycle). 5.2. The final CSP Draft 2023-26 (attached separately) was endorsed by the North Lanarkshire Improving Children’s Services Group and the Children’s Services Partnership Board in August this year. 5.3. Following the impact of the COVID-19 pandemic, our local children’s services partnership followed Scottish Government guidance to allow a ‘roll over’ of our 2017-20 CSP for an additional year and subsequently produce a two-year CSP for 2021-23. 5.4. We have now returned to the expected three year planning and reporting cycle as made explicit in the act. 5.5. The final draft report for 2022-23 contains a summary of the key achievements of our children’s services partnership activity for this period, attached above.
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3 5.6. A CSP ‘Writing Group’ worked with all partners to build the content of the 2023- 26 plan. The content of the plan had been informed by our Joint Strategic Needs Assessment process, reflecting relevant data, the voice of children, young people and families and the perspective of the wider workforce. This plan has now been completed and is attached above. 5.7. Each priority area identified in the previous plan has associated working groups that led on gathering and analysing available data to identify themes where data trends suggest areas for improvement are required. These groups subsequently outlined the priority areas and agreed to maintain the format and structure from the previous plan. 5.8. The tables below show the priority areas identified by this process: UNCRC We will continue to develop and embed our rights based approach, supported by children and young people in NL. It is anticipated that the UNCRC (Incorporation) (Scotland) Bill will be enacted and we are making progress in preparation of this. 1. Everybody, ( staff, partners, and the public), is aware of these rights and understands what they are, as expressed in the United Nations Convention of the Rights of the Child. 2. We embed a rights based approach across all services and making children’s rights visible in policy, culture and practice. Voice 3. Through engagement and participation, we want to know and understand the collective views, needs and aspirations of children, young people, parents and families. 4. We use a range of methods and collaborate with other services to engage with children, young people and families. 5. Task groups and working groups plan for engagement and create opportunities to ensure participation in planning of delivery of the priorities and the co design of services. 6. We engage with children, young people and their families on what is working for them and what improvements to services they think are needed. 7. We want the voices of children, young people, parents and families to be at the centre of the CS Partnership and ensure those with protected characteristics and intersectionality have the same opportunities to have their voices heard. 8. We want to support the participation of individual children, young people and families that we are working with to gather their views, tell us their interests and needs and ensure these are represented and acted upon. D Each Child’s Plan will include all relevant views and how they will be implemented and reviewed. D We will develop and apply a range of tools and resources and ensure inclusion of diverse communication needs.
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4 Family 9. Use the community hub programme in all localities as a key enabler of earlier intervention, moving and integrating services upstream to improve outcomes, through preventative approaches. 10. Ensure equity of access to services for all children, young people and families including care experienced people up to and beyond the age of 26yrs. 11. Strengthen family supports where children have additional support needs, including those with a Neurodevelopmental profile. 12. Build and develop the mental health and resilience of our children, young people and their families promoting early intervention, establishing community supports, and self-care. 13. Tackle the impacts of poverty to support children, young people and their families to thrive and gain access to economic opportunities. 14. NLC are working towards achieving the Breastfeeding Friendly Scotland Local Authority award and aim to support, promote and protect breastfeeding in our communities for an increased amount of women to initiate and sustain breastfeeding at 6-8 weeks. 15. Children and families affected by alcohol and drug use will be safe, healthy, included and supported. Care 16. Develop a systemic approach to involve care experienced children, young people and their families in how all services are designed and/or re-designed to meet all health needs. 17. Provide support to parents that is available when they are ready and tailored to their needs. 18. In our balance of care, reduce the trend of children and young people being removed from and rehabilitated to their families by strengthening opportunities to provide early help and prevent escalation. 19. Support to parents whose children have been removed on a permanent basis helps to sustain or build relationships with their children and maintain direct or indirect contact. 20. Consider the support that could be provided to unaccompanied asylum seekers and children and young people who are in NL through the National Transfer Scheme 21. Continue to close the educational attainment gap for our care experienced children and young people. Continue to improve their attendance and provide help to parents and carers to support their children and young people to meet their educational needs. 22. Further development of the Virtual School, building on its success in improving children and young people’s attendance and educational attainment and support to enable them to have positive destinations. 23. Care experienced children, young people and their families are involved in the development and redesign of health services. 24. There is a smoother transition from children to adult health services for those who need ongoing support. 25. Use additional funding streams proportionately to develop community supports and therapeutic interventions to enable tailored responses to meet individual needs.
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5 People 26. Continue to advance and develop our children’s services workforce. We will provide opportunities for career advancement and promote collaborative working across the children’s services partnership and adult services. 27. Continue to develop workforce skills, confidence and competence developed in GIRFEC methodology, pathways, assessment planning and interventions. 28. Continually evaluate and update training and learning in line with legislation, strategy and policy 29. Ensure that staff are routinely consulted on service improvements, change and redesigns. 30. Make sure that staff supporting kinship, foster, adoptive families provide additional support when they need it, recognising that they too may need early help and preventative support to feel confident in caring for their children and young people who have experienced trauma. 31. Provide early help and preventative support to all families who need it and when they need it. 32. Build on progress to develop community hubs informed by consultations. 33. Consult with communities to identify gaps in service provision, how and where they want to access services, what is working well and what they think needs to change. 34. Work collaboratively across the range of strategic partnerships. 35. Work within our strategic frameworks to promote wellbeing within and across our communities ensuring equity of opportunities to improve life choices and chances. 36. Communicate effectively with our children, young people, families and communities. 37. Further develop our use of technology for families and the wider community to access and engage with services. 38. Promote a ‘no wrong door’ approach, for access to services, using our community Hubs as appropriate. Scaffolding 39. Our vision is shared across the partnership and each partner is actively participating in leadership and delivery of our shared priorities. 40. Further the implementation of GIRFEC and Pathways for all children and young people. 41. Implement changes in legislation and national guidance. 42. The CS Partnership is aligned with and contributing to NL Tackling Poverty strategy and actions. 43. Through information and research, we are aware of need, changing drivers, policy and connections. 44. We are aware of the impact of our work we are continuing to improve wellbeing for children, young people and families. 45. This is integrated into our planning and reporting.
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6 5.9. The governance structure has remained from the previous plan with the thematic groups of: Voice, Care, Family, People, and Scaffolding to continue to align with the foundations of The Promise, and include the United Nations Convention on the Rights of the Child. These groups will continue to lead on the actions for the priorities as with the previous structure. 5.10. An Equality Impact Assessment and a Children’s Rights Wellbeing Impact Assessment have been carried out as part of the planning process for the plan. 5.11. The final report and plan for 2023-26 will be published and submitted to the Scottish Government as per statutory duty and cascaded across the North Lanarkshire partner organisations. 6. CONCLUSIONS The North Lanarkshire Children’s Services Plan 2023-26 requires approval as this is submitted to the Scottish Government as per statutory duty and cascaded across the North Lanarkshire partner organisations. 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 ☐
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7 7.2 ASSOCIATED MEASURE(S) The Continuous Improvement Task Group is common to both the CS Partnership and the Child Protection Committee, leading on a shared continuous improvement framework and self-evaluation to direct and inform continuous improvement activity across the CS Partnership and Child Protection. The performance framework will support the implementation, monitoring and reporting of progress against each of the agreed priorities. 7.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner N/A Choose an item. 7.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details □ Involve stakeholders in the development work aimed at achieving the national outcomes □ Provide stakeholders with information on how to get involved ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs Face to face and online engagement sessions were held during the consultation phases of both the Joint Strategic needs assessment, that informed the priorities and the draft consultation for the Plan 2023-26. Groups of staff from across the partnership, children, young people and families were engaged through online survey and through existing organised groups.
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8 □ 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 A consultation report is being produced with a summary of actions taken to develop the plan. □ 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 Data gathered through the Joint Strategic Needs Assessment included data from the Strengths and Difficulties Questionnaire for North Lanarkshire Schools. Engagement was also taken to the groups that were already in place and delivered with participants where best suited their needs. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY An Equality Impact Assessment and a Children’s Rights Wellbeing Impact Assessment have been carried out as part of the planning process for the plan. EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes No N/A Not at present EQIA added to website: Yes No N/A Not at present
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9 8. BACKGROUND PAPERS Appendix 1 Draft CSP 2023-26 attached separately. 9. APPENDICES Please include a glossary of terms if not already included. N/A CHIEF ACCOUNTABLE OFFICER (or Depute) Alison Gordon, Head of Children Families & Justice/CSWO, NLC Education & Families gordonal@northlan.gov.uk Members seeking further information about any aspect of this report, please contact the following; Mark Kay, Senior Health Promotion Officer: Children and Young People NHS Lanarkshire Mark.kay@lanarkshire.scot.nhs.uk Lynn Brennan, Senior Officer - Planning North Lanarkshire Council brennanl@northlan.gov.uk
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Appendix 1 North Lanarkshire Children’s Services Plan 2023-26 Final draft July 2023 Contents 1. Introduction 01 2. Our vision and values 02 3. Our children’s services planning 04 4. Context 05 Covid-19 recovery and beyond 09 5. Joint strategic needs assessment 10 Identifying our priorities 6. Our governance and structure 14 7. Our plan 19 United Nations Convention on the Rights of the Child 19 Voice 24 Family 30 Care 37 People 48 Scaffolding 57
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1 1. Introduction Our Children’s Services Plan brings together our vision and ambition about how we best deliver services and supports for children, young people and families in North Lanarkshire and outlines what we want to achieve. In North Lanarkshire we do this through North Lanarkshire Children’s Services Partnership (CS Partnership). The partnership brings together key partners and stakeholders and the plan identifies and outlines shared priorities. Partners include children, young people and families, key public sector agencies, independent sector organisations and the community and voluntary sector. Rather than oversee the full breadth of work that directly or indirectly relates to children, young people and families, the focus of the CS Partnership is on the shared priorities identified in this Plan for the period 2023-26. Each partner has duties and responsibilities beyond the scope and work of the CS Partnership.
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2 2. Our vision and values Our vision In North Lanarkshire, our vision is to support all children and young people to achieve their potential, ensuring they are loved, nurtured and empowered to thrive in all aspects of their lives, upholding each and every child and young person’s rights as stated in the UNCRC. We will work collaboratively with children, young people, their families, and our partners to ensure they get the best start in life and support families to provide loving care. We will do this by making sure we have the right supports available, at the right time, for as long as needed, and delivered in the right places to ensure equity for all and reducing inequalities. Our values We are committed to keeping The Promise, working with the principles of Getting It Right for Every Child and ensuring the voices of children, young people and families are included. All the work of partners and key stakeholders in the delivery of supports and services to children, young people and families supported by our underpinning values: 1. Children, young people, and families are at the heart of the planning and delivery of children’s services. 2. All children, young people and families are included, irrespective of health, sex, gender, ethnic origin, age, sexual orientation, economic circumstances, religion, or belief. 3. We promote and safeguard the rights of children and young people and make sure everybody is aware of these rights and understand what they are, as expressed in the United Nations Convention of the Rights of the Child. 4. We seek to identify difficulties and solutions as early as possible to prevent more or bigger problems in the future. 5. We work collaboratively to ensure children, young people and families get the support they need when they need it, and for as long as they need it. 6. Our approach recognises and builds on the strengths that already exist within children, young people, their families, and communities. 7. We take time to develop caring and nurturing relationships with children and their families and carers. Our approach is trauma-informed and has nurture at its heart with a focus on developing strong, positive relationships between and amongst all those who are part of the children’s services partnership community.
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3 8. We promote resilience in those experiencing adversity. 9. We work together to reduce inequalities and the impact of poverty on children, young people, and families. 10. We work as a partnership with children, young people, and families in North Lanarkshire, to identify their needs, determine what is important, decide where we target our resources, and identify how we can improve, to provide the best outcomes achievable for our children, young people, and their families.
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4 3. Our children’s services planning Our Children’s Services Plan 2023-26 Allpartnershavebeenactive in the work of the Children’s Services Partnership and in the development of this Plan that builds on the plan for the period 2021-23. We have reviewed with our task groups and working groups our work, development and progress over the 2 years of our previous plan, supporting our strategic needs analysis which is detailed further Section 5. There has been engagement with young people and families to inform our priorities. In developing this plan, we also gathered what children, young people and families have told us through research, engagement and direct involvement during the 2021-23 planning cycle. There has been consultation on a final draft, engaging young people, parents and carers, staff and community and voluntary sector representatives. Their views and comments have been fundamental in helping us communicate our vision, values and priorities and ensure we represent the staff, volunteers, communities, children, young people and families in North Lanarkshire for whom this Plan is written. The consultation has also prompted a commitment to produce a version that is for children and young people.
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5 4. Context A key reference point for all our plans in North Lanarkshire is the National Performance Framework Outcomes. These outcomes reflect the Scottish Government’s values and aspirations for the people of Scotland and are aligned with the United Nations Sustainable Development Goals to help to track progress in reducing inequality. All these outcomes are relevant and there is one with a particular focus on our children and young people; We grow up loved, safe and respected so that we realise our full potential. The Scottish Government also: 1. Refreshed the national approach to work with children, young people and families; Getting it right for every child (GIRFEC). 2. Committed to incorporating United Nations Convention on the Rights of the Child (UNCRC) into Scots Law. 3. Committed to keeping the Promise 2030. Driving this forward is the Plan 2021-24. 4. Introduced Whole Family Wellbeing Funding (WFWF) to contribute to preventative whole family support measures. 5. Ensured young children and young people’s voices are heard through the Children’s P arliament and Youth Parliament. 6. Taken actions to further the Child Poverty (Scotland) Act 2017 and Best Start, Bright Futures: tackling child poverty delivery plan. GIRFEC, UNCRC, The Promise, Tackling Poverty and Whole Family Support are key to children’s services in North Lanarkshire and will be talked about throughout this plan. The wellbeing outcomes for all children and young people are: Safe, healthy, active, nurtured, achieving, respected, responsible and included. We grow up loved, safe and respected so that we realise our full potential
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6 North Lanarkshire Partnership and The Plan for North Lanarkshire The North Lanarkshire Partnership (NLP) is where community planning partners come together to progress the shared ambitions set out in The Plan for North Lanarkshire. The Plan sets out the shared ambition where North Lanarkshire is a place for inclusive growth and prosperity for all to Live, Learn, Work, Invest and Visit. The Plan for North Lanarkshire has 5 priorities, 25 ambition statements and 28 health check indicators which together improve the wellbeing of children, young people, and their families. These strands are all reflected in the Programme of Work that brings together strategic planning and community investment. At a local level there are nine Community Boards across North Lanarkshire. Each board has a Local Outcome Improvement Plan that sets out key priorities identified through a range of engagement processes and based on the needs of our local communities. To realise the ambitions of the Plan and deliver the Programme of Work, community and town hubs are being established across North Lanarkshire; comprising shared spaces that, alongside school clusters, supports partnership working and integration. With investment in prevention, early intervention, and positive transitions this development is key to providing whole family support and improving the wellbeing of our children, young people and families. Other Strategic drivers and plans The other strategic drivers and plans which are linked and connected to the work of NL CS Partnership are set out and explained in a document that sits alongside this CS Plan. This is reviewed annually and brings together relevant information across the partnership to help us make sense of the complexities and relationships impacting on our plan and priorities. In the document these are grouped into four main categories and there is a description of each element. National drivers - This includes National legislation that places a responsibility on partners either individually or collectively Local links - these are the main strategic plans and policies in North Lanarkshire Improvement programmes - these are the key pieces of work we have identified and are involved in which we believe will improve our services and supports Planning, delivery and ongoing work - this is how we currently plan for and deliver our existing services and supports LINK to updated landscape document (Last updated August 22- to be updated again with new front page) Current link https://www.northlanarkshire.gov.uk/social-care-and-health/children-and-families/childrens-service-plan
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7 The diagram below brings together the key elements of our Children’s Services Partnership in NL. In the diagram, we have the high-level National Outcomes and The Plan for North Lanarkshire that overarches all the work across North Lanarkshire Partnership. The Children’s Services Partnership and Plan, and the Child Protection Committee and Plan are in the next layer These partnerships are driven by GIRFEC, UNCRC, The Promise, Tackling Poverty and Whole Family Support. The delivery of the Children’s Services Plan centres on community hubs and school clusters where partnership staff work together with children, young people and families. We apply strength and relationship-based practices and ensure what we do is trauma informed. All of this is to improve outcomes for children, young people and families ensuring they are safe, healthy, achieving, nurtured, active, respected, responsible and included. Getting it right for every child in North Lanarkshire The national GIRFEC refresh has maintained commitment to the GIRFEC National Practice Model as the framework for how we practice with an alignment to key policy areas, for example: The Promise and a continued commitment to eradicate child poverty. To meet the diversity of needs of all children and young people, early intervention and prevention are at the centre of planning and delivery of children’s services.
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8 Universal services have a role to identify and support children, young people and families who may need additional support at the earliest possible stage. There is a single pathway that supports agencies and organisations to work together to assess, plan and assist children, young people and their families and ensure the most timely and proportionate support is available. In North Lanarkshire our GIRFEC Delivery Group lead on improvements in this area. For GIRFEC in North Lanarkshire more information and resources can be accessed at www.girfecinnl.com
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9 Post Covid-19, Recovery and Beyond It is clear that the Covid-19 pandemic has had, and continues to have, far-reaching impacts on our children, young people and their families. There have been significant challenges for children, young people and families in our communities and partners have been challenged in their individual and collective responses. Some of these have been positive e.g. increased opportunities for many families to spend time together, getting outdoors, and accessing our greenspaces more and there have been collective actions across the Children’s Services Partnership to mitigate, prevent and negate the adverse impacts from the pandemic. Fortunately, when compared to other age groups and causes of childhood illness, the specific health consequences of COVID-19 on children have been relatively minimal. However, the pandemic and the implementation of necessary health protection measures have greatly affected the lives of our children, young people, and their families. Over the past few years, we have witnessed significant disruptions in our social interactions, economic activities, education systems, and healthcare services. These disruptions have disproportionately impacted individuals and communities that were already facing disadvantages and inequalities (both structural and relational) prior to the pandemic. It is important to acknowledge that some of these adverse effects are likely to persist. 'While children are not the face of this pandemic, the broader impacts on children risk being catastrophic and amongst the most lasting consequences for societies as a whole. While they have thankfully been largely spared from the direct health effects of COVID-19 at least to date – the crisis is having a profound effect on their wellbeing.' (United Nations. Policy brief: the impact of COVID-19 on children; 2020. Available at: https://unsdg.un.org/resources/policy-brief-impact-covid-19-children ) It is anticipated that the full impact of the virus and restrictions implemented during the pandemic will continue to unfold. We are yet to see the extent of this on our children, young people and families however, we know factors important to educational attainment suggest that the existing inequalities have worsened and exacerbated the poverty-related attainment gap. Further details on the impacts of the pandemic for our children, young people and their families can be found here in the Ensuring our future: addressing the impact of COVID-19 on children, young people and their families discussion paper produced by Public Health Scotland. The challenges of the pandemic for individuals and our communities have been compounded by the national cost of living crisis. The cost of everyday essentials like food and energy has risen faster than household incomes. This is having a significant impact on families and our communities. In many communities across North Lanarkshire there are high levels of poverty and budgets are already stretched. Tackling poverty remains a primary driver for our Children’s Services Partnership.
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10 5. Joint Strategic Needs Assessment (JSNA) In our JSNA we gathered information and evidence to inform our strategic direction, priorities and actions. We reviewed and analysed this and it helps us to know and better understand: What it is like to live in North Lanarkshire Our population and emerging needs What people think about services and supports Our best practice and what is working well What we should be working to improve Information comes from many sources including data gathered, research and evaluation and lived experience, feedback and views. You can access the full Joint Strategic Needs Assessment document. https://sway.office.com/pSAyWclq01N0aO5z Living in North Lanarkshire North Lanarkshire is the 4th largest local authority in Scotland. The population of NL is 341,400. 69,751 (20%) of the population is under 18 and 35,953 (11%) are aged 18-26. In 2021 there were 3296 births in NL. There are 38,840 households in receipt of child benefit. Since 2020 there has been an 2% reduction in child poverty in NL There are six locality areas: Airdrie, Coatbridge, Wishaw and Shotts, The Northern Corridor, Bellshill and Motherwell. For each of these, a locality profile provides information and statistics about the population, poverty, deprivation, health and benefits. The wellbeing of children and young people in NL One significant source in the JSNA is the North Lanarkshire Strengths and Difficulties Questionnaire (SDQ) 2021-22. The SDQ gathered information from 85% (41,324), children and young people in NL schools between January and June 2021. The following reports have background information and highlights from the SDQ. Reporting and analysis of the data has been undertaken on specific areas rather than through the provision of a single comprehensive report. att96796.pdf (northlanarkshire.gov.uk)
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11 att97794.pdf (northlanarkshire.gov.uk) An SDQ was part of Realigning Children’s Services in 2018 and we can compare and analyse information for trends and changes. We are revisiting the SDQ in 2023 and will build on our understanding of wellbeing across our school population in North Lanarkshire. Quality indicators and self-evaluation We continually engage in self-evaluation activities, reviewing, gathering information, evidence, reflections and feedback. We challenge our actions and seek to demonstrate that what we are doing impacts positively on outcomes for children, young people and families. During 2022-23 we updated our self- evaluation to assess our strengths and areas for improvements in relation to working with children, young people and families in need of care and protection. Our self-evaluation draws from continuous improvement activity such as an annual multi-agency file audit and a staff survey undertaken in 2022 It is closely linked to the Quality Improvement Framework and during 2023 we will work with the Care Inspectorate, who will lead a joint inspection of services for children and young people in need of care and protection. Poverty We know that there are some circumstances where families are more likely to experience poverty and we are aware that children, young people and families living in poverty are more likely to encounter barriers to wellbeing and their rights. Local research and data tell us that there are persistent and pronounced inequalities in some health and wellbeing outcomes among children and young people in North Lanarkshire. Poor outcomes in one area of wellbeing are often accompanied – and potentially compounded – by poor outcomes in another. (Realigning Children’s Services 2018, Scottish Attainment Challenge reporting, Strengths and Difficulties Questionnaire 2021). There are a number of circumstances that indicate it is more likely children, young people and families are living in poverty. The NL Child Poverty Action Plan and Report has details about this. The local child poverty priority groups are; lone parents, ethnic minority parents, families with a disabled member – parent, child or adult member, mothers under 25, families with a baby under 1 year, families with more than 3 children. Department for Works and Pensions figures for Children in Relative Low Income Families 2020/21 show that 13,966 children live in low- income families across all our communities in North Lanarkshire. This is 18% of the 0-19 years population, higher than the Scottish average of 15%. In November 2022 of 48,835 children and young people, 10,004 (20%) were recorded to be in receipt of free school meals and 11,243 (23%) in receipt of the Clothing Grant. Scottish Attainment Challenge (SAC) and Pupil Equity Funding (PEF) There has been a significant amount of data generated through this programme, which is designed achieve equity in educational outcomes by closing the poverty related attainment gap for children and young people. There has been an upward trend that reflects the shift to empowering clusters. This phase
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12 has now concluded, replaced by the Strategic Equity Fund. There is emphasis on wellbeing as well as literacy and numeracy, and strengthening the work of the empowering clusters, building strong linkages between services and supporting locality-based integration. Prevention and early intervention Across partners there are a range of processes to assess and identify children, young people and families who may be in need of additional supports to achieve their potential. It is important that we are aware of these children, young people and families who may require additional support. The GIRFEC approach and pathway is the key approach to delivering improvements in children’s wellbeing. The three-stage model of intervention promotes the development of early intervention approaches. The model is based on the following stages: Universal – reflecting the services available to all children Additional – where early intervention supports are introduced for targeted children and families Intensive – where multi-agency planning, and intervention become the basis for support to meet significant need The Universal Health Visiting Pathway (UHVP)and Family Nurse Partnership information, collated for pre-birth to 5 years, identifies children with a Health Plan Indicator (HPI) of core or additional. These are defined as follows: Core - Health Visitors (HV) are confident that needs will be met with minimal support or without additional support. Additional - Indicates that the child (and/or their carer) requires sustained (more than 3 months) additional input from professional services to help the child attain their health or development potential. Any services may be required such as additional Health Visiting support, parenting support, enhanced early learning and childcare or specialist medical input. On 24 January 2023 the figures from NHS Lanarkshire were Core - 13,816 and Additional - 2, 824 There is the routine collection of data and, within our JSNA, we gathered information from local and national research, service review and redesign as well as highlighting the experiences of children, young people and their families. Within the JSNA we have highlighted children and young people who may be in need of additional supports e.g. young carers, housing and homelessness, transitions, young people in conflict with the law, families affected by imprisonment and families affected by drug misuse. We also highlight those who need intensive support such as children and young people experiencing care or care experienced or have a compulsory supervision order.
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13 Involving children and young people Our priorities have been informed by children and young people. Though a survey for our Youth Strategy we are aware of the issues that are most important to young people and we engaged children and young people to explore these further to gain insight into their experiences, concerns and solutions. Health including mental health Cost of living Voice Climate emergency This has influenced the direction of travel for our task groups. The questions for cost of living were explored by primary and secondary children and young people in a programme of workshops. This will influence the NL Tackling Poverty Strategy and Report.Thank you to all the children and young people involved. Their inputs have introduced ideas and solutions that had not previously been considered. Identifying our priorities We recognise we are not starting from scratch but building on previous and current work. Before identifying our priorities, we have: Looked back at our progress and achievements in the previous plan Considered national strategies and frameworks, the context of our work and the links to other areas Gathered learning and conclusions from our self-evaluation activities Gathered information in a joint strategic needs assessment as outlined in the previous section Engaged children and young people to explore priorities that they had identified As a partnership we considered what the information told us and we applied it to challenge our governance, our task groups and working groups and the framework of the plan. Asking ‘What have we done?’ ‘What difference has this made?’ ‘What has changed?’ ‘What does this tell us?’ ‘What have children, young people and families told us?’ Each of our task groups gathered, analysed and reflected on information pertinent to the priorities they had been working on and presented new priorities for the period 2023-2026. A formal consultation took place with staff, children, young people and families. Feedback from this resulted in changes to the draft plan and priorities.
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14 Thank you to all who contributed.
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15 Our ambitions Building on the Scottish Government’s ambition for Scotland ‘to be the best place in the world to grow up’ so that children are ‘loved, safe, and respected and realise their full potential’; within The Plan for North Lanarkshire one of our key priorities, shared across all partners, is ‘to support all children and young people to realise their full potential. Everyone has a part to play in achieving our ambitions for children and young people in North Lanarkshire. We will provide a broad range of services and supports to meet the needs of all children. For the majority, this will be within our universal services. Some children will require additional supports and a small number will need specialist or intensive services to meet their needs. All of this will be supported by our agreed Programme of Work and our Children’s Services Plan.
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16 6. Our framework and governance The partners within North Lanarkshire are conscious of the ever-changing external environment within which we deliver our services and supports to our children, young people, and their families. Within this context the Children’s Services Partnership recognise the significance of the ‘The Promise’. Whilst focused on how we support children, young people, and families in crisis, the partnership recognises that the foundations in The Promise apply to all our children and young people: This plan, our priorities and the task groups that lead and deliver on the priorities are framed around the foundations of The Promise. Voice: Children must be listened to and meaningfully and appropriately involved in decision-making about their care, with all those involved properly listening and responding to what children want and need. There must be a compassionate, caring, decision-making culture focused on children and those they trust. Family: Where children are safe in their families and feel loved they must stay - and families must be given support together to nurture that love and overcome the difficulties which get in the way. Care: Where living with their family is not possible, children must stay with their brothers and sisters where safe to do so and belong to a loving home, staying there for as long as needed. People: The children that Scotland cares for must be actively supported to develop relationships with people in the workforce and wider community, who in turn must be supported to listen and be compassionate in their decision-making and care. Scaffolding: Children, families and the workforce must be supported by a system that is there when it is needed. The scaffolding of help, support and accountability must be ready and responsive when it is required. Source: The Promise - Independent Care Review - February 2020
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17 Children’s services in NL are provided by a broad range of agencies and organisations. They come together as the North Lanarkshire Children’s Services Partnership Board (CSPB) to co-ordinate their services to ensure the best outcomes for children and young people making the best use of resources available. The CSP’s purpose is to: • Identify and progress shared priorities • Provide strategic direction to the planning of children’s services • Act as a forum for partners to communicate about key developments and develop proactive responses to change, and • Share responsibility and be accountable to our communities linking to North Lanarkshire Partnership. The structure to support the work of the CSPB includes the Improving Children’s Services Group which delivers and reports on the range of plans whose actions are taken forward through the task groups and linked networks. The CSP also links with North Lanarkshire Child Protection Committee (NLCPC), each with their own agenda for delivery but shared responsibility for delivery of combined actions focusing on continuous improvement and workforce development. Within this structure, community and voluntary sector involvement is supported by the Community and Voluntary Sector Children, Young People and Families Network, facilitated by Voluntary Action North Lanarkshire (VANL). At a local level partners come together to deliver on priorities in Locality Planning Groups.
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18 The representation across the Children’s Services Partnership includes: Partners North Lanarkshire Youth Council Elected members Non-executive member of the Health and Social Care Integrated Joint Board Links to Champions Board and Today not Tomorrow Champion for children and young people including those who are experiencing care or are care experienced
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19 We have the following focussed task groups to identify and take forward the priorities in the plan Voice (includes UNCRC) Whole Family Support Care, The Promise and Me Mental Health Wellbeing and Resilience Scaffolding- GIRFEC Delivery Group and Continuous Improvement Group People – Cross cutting rather than a specific task group
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20 7. Ourplan Thefollowingpagesshowwhatweplanto achieve as North Lanarkshire Children’s Services Partnershipduringtheperiod 2023-26. As previously stated, we have structured these around the five foundations of The Promise. In each of the foundations we provide a brief summary of our achievements in this area during the previous plan and background information followed by diagrams to outline the thinking behind each one. This is followed by a table of priorities, actions and measures. Although children’s rights are threaded through the Promise and each of the foundations, we have included an additional section on children’s rights, UNCRC. In anticipation of the enactment of the UNCRC (Incorporation) (Scotland) Bill there will be a particular focus in this area across the Children’s Services Partnership. Outcomes UNCRC- Children and young people’s rights are promoted and protected. Voice- The voice of children, young people and families are heard and included in planning, decision making and delivery of children’s services. Family- Our children, young people and families get the right support, at the rights time, for as long as it is needed. Care- Care experienced children, young people and their families are engaged and supported as early as possible, ensuring they are able to thrive, live healthy lives and experience nurturing, loving and stable relationships. People- Our workforce are confident and competent in their practice, understand the needs of our communities and work together to improve the wellbeing of children, young people and their families. Scaffolding- Our staff are empowered to support infants, children, young people, and families to realise our shared vision as a result of our leadership, governance and organisational culture Reporting our progress Each task group collates a report every 6 months on their progress against the priorities Each year we will add to our JSNA work to review feedback, trends and changes Annually there will be a full report on our CS Plan
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21 UNCRC In developing our children’s services plan we recognise that children’s rights, as stated in United Nations Convention on the Rights of the Child, underpin each of the foundations of The Promise. The following section outlines the progress we have made towards a rights-based approach and the actions we will take over the period of this plan. Children’s rights are not a new area of focus. They are already embedded into training, practice and professional standards, providing a good foundation to build upon. The delivery of actions in this plan will support us to ‘further and better’ children’s rights as part of the Children and Young People (Scotland) Act 2014. The Scottish Government are committed to incorporating children’s rights into Scottish Law. We have been working on this with young people and preparing for the enactment of the UNCRC (Incorporation) (Scotland) Bill. What do we want to achieve in this area? We will further develop a rights-based approach to children’s services in North Lanarkshire as well as advocate and promote, across and beyond the CS Partnership, the responsibilities of partners as duty bearers. Why do we want to achieve this? A rights-based approach means that children’s rights are at the centre of policy and practice. It means integrating rights into policies and how we operate as agencies, organisations, and individuals. Putting children’s rights into practice lies with every adult citizen, particularly those that work with and for children and young people. The Children’s Services Partnership workforce have a duty to promote, respect and protect children’s rights. However, this responsibility extends beyond children’s services to all partners, sectors and areas of service. All of our workforce that includes staff, carers, volunteers, elected members and board members are duty bearers in relation to UNCRC. North Lanarkshire Youth Council (NLYC) identified and worked with us to progress actions in the previous plan some of which are developed further in this plan. From a local survey we have a baseline about views and awareness of children’s rights. This has been revisited to assess progress and we will revisit again as we progress the actions further. Achievements 2021-23 The co-produced #Makeitright campaign was launched in February 2022 and is promoted and shared with partners and the public. #Makeitright campaign assets have been used in the development of workshops for children and young people that have been co-produced with young people. We have been preparing for the enactment of UNCRC (Incorporation) (Scotland) Bill being enacted, sharing briefings and updating our workforce.
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22 We developed and applied Children’s Rights and Well-being Impact Assessments in key areas of policy and service development. We applied a rights based lens to service reviews, development and redesign. There are examples from across the partnership. We initiated workforce training, led by Community Learning and Development, and delivered a programme of workshops to staff. UNCRC Priorities 2023-26 We will continue to develop and embed our rights based approach, supported by children and young people in NL. It is anticipated that the UNCRC (Incorporation) (Scotland) Bill will be enacted and we are making progress in preparation of this. 1. Everybody, ( staff, partners, and the public), is aware of these rights and understands what they are, as expressed in the United Nations Convention of the Rights of the Child. 2. We embed a rights based approach across all services and making children’s rights visible in policy, culture and practice.
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23 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? Children and young people’s rights are promoted and protected. 1. Everybody, (including, staff, partners, and the public), is aware of these rights and understands what they are, as expressed in the United Nations Convention of the Rights of the Child. 2. We embed a rights based approach across all services and making children’s rights visible in policy, culture and practice. From our research in 2021 and 2023 we are aware that most young people in NL know they have rights but they are not as aware of UNCRC Promote awareness of UNCRC Re-run the #Make it Right campaign when the UNCRC (Incorporation ) (Scotland) Bill is enacted Develop briefings and information to ensure the workforce and other stakeholders are kept up to date with legislation and policy relating to UNCRC. Support consideration of the relationship between UNCRC and poverty. Co-deliver a co-produced workshop programme with young people in youth work and school settings. The CS Partnership will advocate and support the application of Children’s Rights and Wellbeing Impact Assessments Monitor the application of assets from the 2022 UNCRC campaign. Rights Respecting Schools being assessed at gold, silver and bronze. Monitor campaign assets. Revisit baseline from 2021 survey and 2023 update Briefings are shared across partnership. Development and application of ‘poverty proofing tool’ (see Scaffolding) Participation in workshops delivered and evaluation of each workshop. Increasing numbers of CRWIA are undertaken and published. Collate CRWIAs to inform reporting and assess quality and areas for improvement.
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24 (CRWIA) across the partnership. Individual partners will develop their approach and procedures to further the application of CRWIA. Increase the capacity and deliver UNCRC training for the CS Partnership workforce. Roll out a broader training programme beyond the CS Partnership workforce. The CS Partnership will report every 3 years on what is being sone across the CS Partnership to further and better children’s rights. Number of staff trained to deliver and range and number of training sessions delivered. Collate evaluation from each of the training sessions. Updates in the published Annual Report on this Children’s Services Plan 2023-26.
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25 Voice: Children’s Services Partnership 2023 – 2026 It is important that we listen and respond to the views of children, young people, parents, and families and this is included in the planning of integrated children’s services. Those affected by decisions will be engaged and their views included in decision making processes. We will create opportunities for participation in all aspects of services and supports, from assessment and planning to activities, programmes of work and service design. We do this best if we: Know and understand the needs and aspirations of the children, young people, parents, and families. Seek views, listen and respond to what is said individually and collectively and this is included, represented and acted upon. Use a range of approaches to reach the diversity of children, young people, parents, and families, including those considered marginalised or vulnerable, whose voices and opinions often go unheard. Examples of the methods and approaches are: • Looking at existing research and collecting data about what we do • Gathering views through tailored surveys and consultation • Seeking feedback about the experience of services and supports - e.g., Mind of my Own • Incorporating co production into developments and service design • Representation of young people on decision making groups and partnerships • Ensuring staff have the skills and support they need to engage, develop relationships, and plan with children at the centre Our achievements 2021-23 • We reaffirmed our partnership agreement with young people in North Lanarkshire to demonstrate continuous improvement on how we engage with those who access or may access children’s services and supports. • A revised youth participation and engagement infrastructure was agreed via Council Committee and a new Transformational Board called FutureNL has been formed. We have increased our commitment and capacity to ensure quieter voices are heard. There are examples of new posts to support participation and existing staff have been enrolled to champion engagement and discrete groups of young people such as those with care experience. • A Champions Board for care experienced young people continue to meet with key decision makers to amplify their voice in decisions that affect the experiences of care and opportunities for care experienced children and young people.
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26 • We have strengthened links with the Community and Voluntary Sector, through the children, young people and families Network. This network reaches the diversity of children, young people, and families in the communities they are based in or work with. • In keeping the Promise we have a team of care experienced development workers with a focus to include the voices of children, young people and families We will be building on work to strengthen engagement and participation during 2023-26. We continue to improve the co-ordination of the range of engagement activities through the Children’s Services Partnership including sharing information, learning from people’s experiences, and planning changes with those who will be affected. We have worked to improve engagement with children and young people and recognise that we need to do more to engage with parents and families. Voice Priorities 2023-26 3. Through engagement and participation, we want to know and understand the collective views, needs and aspirations of children, young people, parents and families. 4. We use a range of methods and collaborate with other services to engage with children, young people and families. 5. Task groups and working groups plan for engagement and create opportunities to ensure participation in planning of delivery of the priorities and the co design of services. 6. We engage with children, young people and their families on what is working for them and what improvements to services they think are needed. 7. We want the voices of children, young people, parents and families to be at the centre of the CS Partnership and ensure those with protected characteristics and intersectionality have the same opportunities to have their voices heard. 8. We want to support the participation of individual children, young people and families that we are working with to gather their views, tell us their interests and needs and ensure these are represented and acted upon. Each Child’s Plan will include all relevant views and how they will be implemented and reviewed. We will develop and apply a range of tools and resources and ensure inclusion of diverse communication needs.
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27 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? VOICE The voice of children, young people and families are heard and included in planning, decision making and delivery of children’s services. 3. Through engagement and participation we want to know and understand the collective views, needs and aspirations of children, young people, parents and families. 4. We use a range of methods and collaborate with other services to engage with children, young people and families. 5. Task groups and working groups plan for engagement and create opportunities to ensure participation in planning of delivery of the priorities and the co design of services. To ensure a coordinated approach across the CSP task groups and working groups to engage with children, young people, parents and families in their planning and delivery of the priorities and actions the co-design of services. To support improvement and best practice. To ensure that the views and information gathered influence planning and decision making. Guidance on steps to engagement and participation and closing the feedback loop will be produced and shared by the Voice task group. We will work with our partner, North Lanarkshire Youth Forum, to review and refresh our Partnership Agreement. All CSP task groups will include representation of the views of children, young people, parents and families. This will be through a range of engagement methods. The plans outputs and outcomes of engagement and participation activities with children, young people, parents and families are reported, evaluated. A working group is established to take this forward, reporting to the Voice task group. Refreshed Partnership Agreement. Direct involvement of representatives. Included in 6 monthly reports to the Improving Children’s Services Group and annual reporting on this CS Plan. Included in 6 monthly reports to the Improving Children’s Services Group and annual reporting on this CS Plan.
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28 6. We engage with children, young people and their families on what is working for them and what improvements to services they think are needed. The Voice task group maintain an overview of developments and practice relating engagement and participation across the CS Partnership Development of a Young Inspectors Framework that will empower young people to formally evaluate and report on children’s services and areas of improvement. All partners and representatives from other task groups are engaged in the quarterly meetings of the Voice task group. Highlights of developments and practice will be included in 6 monthly reports to the Improving Children’s Services Group and annual reporting on this CS Plan. Evaluation and reports. Feedback from young people involved. 7. We want the voices of children, young people, parents and families to be at the centre of the CS Partnership and ensure those with protected characteristics and Every child, young person, parent and family should have the opportunity to be involved in the planning of children’s services and methods should reflect the diversity of North Lanarkshire The team of development workers supporting partners to deliver The Promise gather views and experiences as part of the process to redesign services and supports for care experienced children and young people. Evaluation and reports.
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29 intersectionality have the same opportunities to have their voices heard. Promote awareness of advocacy services across the CS Partnership tasks groups and working groups. Task groups to monitor engagement activities to ensure diversity of the children, young people, andfamilies we are working with. Advocacy services uptake will be included in the annual report and use of case studies. Terms of reference for each task group to ensure representation and inclusion Evaluation and reports on engagement activities across the partnership
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30 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? VOICE The voice of children, young people and families are heard and included in planning, decision making and delivery of children’s services. 8. We want to support the participation of individual children, young people and families that we are working with to gather their views, tell us their interests and needs and ensure these are represented and acted upon. This is a component of our GIRFEC approach. Each child’s plan will include all relevant views and how they will be implemented and reviewed. We will develop and apply a range of tools and resources and ensure inclusion of diverse communication needs. In adopting a rights based approach we promote UNCRC. In relation to Voice there is a focus on Article 12 ; Every child has the right to have a say in all matters affecting them, and to have their views taken seriously. Within the GIRFEC approach we will continue to develop our processes and apply a variety of tools and resources to engage children, young people, and families in planning and decision making. The quality assurance process in relation to the child’s plan will share learning and areas for improvement. We share information, practice and learning opportunities about tools and resources in use. E.g. All about me Mind of my own What I think Outcome star Talking mats Practice and resources will be monitored and regularly reviewed as part of the cluster model The annual multi-agency file audit highlights if the voice of children, young people and families is evident. Reporting and self evaluation processes.
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31 Family The overall aim is that children feel safe and loved in their families and are supported to thrive there. This will include: Making the early years of parenting a positive experience regardless of the adversity that families face Giving every family that needs support the right help at the right time, in the right place, for as long as it is needed Placing families, children and young people at the heart of our development of community hubs Supporting good mental health, building emotional resilience, and developing Trauma recovery for families, children and young people We will strengthen our ethos of Whole Family Support, working with families in a preventative way and supporting parents and carers to build on their strengths. Tackling poverty will be a central feature of the approach to family support; providing help to maximise income; develop skills for employment and taking a cash first approach where necessary. The ten principles of family support outlined in The Promise, will underpin all our work to improve the outcomes for families, children and Young People within North Lanarkshire. In developing the priorities outlined below, careful consideration was given to the previous achievements from the CS Plan 2021-2023, assessment of data gathered and presented in the Joint Strategic Needs Assessment, and combined with the Strengths and Difficulties Questionnaire. Analysis was carried out that informed discussion around the priorities as well as comparisons drawn through the national averages as detailed in The Plan for North Lanarkshire, Report 2023. The Family Task Group works with the Mental Health, Wellbeing and Resilience Task Group to achieve our collective ambitions. Achievements 2021-23 Investment in Solihull training. To date well over 3,000 practitioners have been trained and nearly 5,000 families have accessed the on-line training. This plan restates the on-going commitment to delivering Solihull training to ensure that we take a trauma informed approach to supporting our children, young people, and their families through early intervention. 50% schools having achieved the Breastfeeding Friendly Scotland Schools Award and over 80% of schools have a breastfeeding champion, have submitted their membership and are implementing the scheme within their settings. 92% of early learning settings have achieved the Breastfeeding Friendly Early Learning Award.
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32 Breastfeeding rates have increased to 27.8% and we are committed to driving towards the national average. Infant Mental Health indicator set was developed and is in use across the partnership by different disciplines. Pathways, underpinned by GIRFEC, are in place to plan for the wellbeing of children and young people, with Empowering Clusters driving coordinated work to meet needs and improve wellbeing of all school age children. Development and implementation of a Community Mental Health and Wellbeing Support and Services Framework with a focus on early support within the context of families and communities. Results have seen improved wellbeing through easier access to community based support and a reduction in referrals at intensive levels e.g. CAMHS. Family Priorities 2023-26 9. Use the community hub programme in all localities as a key enabler of earlier intervention, moving and integrating services upstream to improve outcomes, through preventative approaches. 10. Ensure equity of access to services for all children, young people and families including care experienced people up to and beyond the age of 26yrs. 11. Strengthen family supports where children have additional support needs, including those with a Neurodevelopmental profile. 12. Build and develop the mental health and resilience of our children, young people and their families promoting early intervention, establishing community supports, and self-care. 13. Tackle the impacts of poverty to support children, young people and their families to thrive and gain access to economic opportunities. 14. NLC are working towards achieving the Breastfeeding Friendly Scotland Local Authority award and aim to support, promote and protect breastfeeding in our communities for an increased amount of women to initiate and sustain breastfeeding at 6-8 weeks. 15. Children and families affected by alcohol and drug use will be safe, healthy, included and supported.
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33 Outcome What is it we want to do? Why do we want to do this? Actions How did we do this/evidence? Family Our Children, young people and their families get the right support, at the right time for as long as it is needed. 9. Use the community hub programme as a key enabler of earlier intervention, moving and integrating services upstream to improve outcomes, through preventative approaches. To reduce the demand for, crisis and intensive services ensuring a strong emphasis on early intervention, and continued support so that positive change is sustained. Outline how the integrated offer of early practical, emotional and financial support accessed directly via community hub will be created. Use the Scottish Approach to Service Design to involve parents, carers and ICYP to develop local support in each hub based on Lived experience DATA led needs analysis to agree local priorities based on local needs. Identify single points of contact for requests for early help through community hubs. Provide early intervention that comprises practical and emotional support. Gathering views of children, young people and families through inclusion in service design and evaluation of pilots. Establish key performance measures in line with community hub development plan Measure the number of referrals made to Social Work for early intervention within a Hub site against baseline data. Multiagency feedback from Staff groups 10. Ensure equity of access to services for all children young people To ensure there are no barriers to access for all Providing a single point of contact for all care experienced young people Gathering views of IICYP families.
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34 and families including care experienced people up to and beyond the age of 26yrs. our IICYP and their families. No wrong door approach who have left care to access the right support at the right time in the right place Health/ education/ employment and wellbeing outcomes for care experienced young people 11. Strengthen family supports where children have additional support needs, including post diagnostic supports for those with Neurodevelopmental diagnosis. Ensure families are listened to and supported. Develop and sustain pre and post diagnostic supports and community/family supports for ICYP with a Neurodevelopmental diagnosis through early and multiagency approaches Families report that they feel supported. Gathering data from CAHMs/Health Needs Assessments 12. Build and develop the mental health and resilience of our ICYP and their families promoting early intervention, establishing community supports, and self-care. Prevent need for children accessing intensive supports and CAMHS. Reduce anxiety and improve school attendance enabling children and young people to flourish. Address impacts of COVID pandemic Creating direct access to support. Ensure that there are accessible and flexible digital, community and individual supports at each level of need within staged intervention model. Increased School Attendance Reducing referrals to CAHMS Gather evidence of improvement through use of outcome star. 13. Tackle the impacts of poverty to support ICYP and their families to thrive and gain access to economic To reduce poverty - one in four children in NL living in poverty - higher than the national average of just over one in five Support and increase awareness of the poverty referral pathways and actively encourage uptake. Number of benefit checks for families and ICYP
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35 opportunities. children. Adopt a “Cash First” stance in relation to tackling food and fuel poverty. Cascade and deliver training on poverty awareness and the impact of poverty to staff across all agencies. Create volunteer and employment pathways for parents and carers through the community hubs View from families ICYP. Number of staff/agencies attended training Numbers of volunteers; parents carers achieved employment 14. NLC are working towards achieving the Breastfeeding Friendly Scotland Local Authority award and aim to support, promote and protect breastfeeding in our communities for an increased amount of women to initiate and sustain breastfeeding at 6- 8 weeks. Supporting mothers to initiate breastfeeding for as long as they want to will have a positive impact on the physical and mental health of both mothers and babies. It will also have a positive impact on family finances. The Scottish Government have set a target to reduce drop off in breastfeeding between birth and 6-8 weeks from 50.2% in 2016/17. The target is to achieve 45.2% by 2024-25 Increase Schools achieving the Breastfeeding Friendly Schools Award. Continue to support achieving and maintaining Breastfeeding Friendly Local Authority Gold Award’ across North Lanarkshire, to ensure North Lanarkshire is a community where this is supported and enabled Provide continued support and information to mothers for breastfeeding . Data on breastfeeding rates and qualitative feedback from workforce and families. Information Services Division figures on initiation of breastfeeding rates at 6-8 weeks. Drop off rates between birth and 6-8 weeks. Maintenance of ‘Baby Friendly’ standards measured through interviews with women and staff.
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36 (lower is better). Current drop off is 42.2%. 73.4% of babies in NL are not breastfed at their 6-8 week review. 14. Children and families affected by alcohol and drug use will be safe, healthy, included and supported. Evidence has shown that families feel ‘hidden in plain sight’ across our communities. We want to ensure children, young people and families are listened to and are supported, ensuring a no wrong door approach and that there are no barriers to access for ICYP and their families. Holistic Whole Family Approach Framework (2021) is the national guide for what we do, local evidence will direct how we do this with the voices of families embedded in ADP processes/structures including the Whole Family Approach (WFA)/Early Intervention sub-groups. Increase family Involvement the design, delivery and evaluation of support, by listening to the experience of families, involving families as key contributors. o Families have access to meaningful support that is not dependent on their loved one’s treatment o Raise awareness of the various sources of support available for families and for those affected by substance use o Tackle stigma faced by families across our communities o Provide diversionary activities for children and young people, Gathering views of children, young people and families. Performance data through commissioned services around number of families access available services. Stigma work developed/campaign work. Performance data around young people engaged in diversionary activities. More families (including ICYP) involved in the Lived and living experience panels to be established in 2023 Increase in whole family support provision available across NL More young people at risk identified sooner through increase diversionary activities and targeted support in keeping with the Planet Youth model
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37 providing information and workshops with upto date accurate information around substance use and risk taking - family as a protective factor with appropriate information/campaign s.
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38 Care There will always be some children who cannot stay with their families. Some will need to live away from their family for a short time, others will never live with their family again, while many return later and as young adults. Children and young people experiencing care at home, are those who can remain with their families but who need support which is compulsory, through an order by the children’s hearing system. There is a presumption that children will stay together with their brothers and sisters if they must be removed from their parents. The approach for our care experienced children and young people is rights based and priorities for 2023-26 are built around the Promise and the GIRFEC principles. This section outlines the progress we have made to support care experienced children, young people and their families and identifies the actions we will take over the period of this plan. What do we want to achieve in this area? We want our care experienced children and young people to belong to a loving home, staying there for as long as needed. To enable long-term, loving relationships to develop, we want to recognise the support residential staff and carers need to care for children who have experienced trauma and to support parents who have experienced trauma to enable them to care for their children. We want to provide early help and preventative support so that children and young people who are care experienced can reach their potential. Why do we want to achieve this? We want to be good parents to our care experienced children and young people and to support parents of care experienced children and young people at home, to be good parents. We do not want the experience of care to be stigmatising. We want to promote a broad and diverse understanding of care experience, to ensure a collective recognition that care represents a part of our communities across North Lanarkshire. Supporting children and young people to overcome trauma, requires a foundation of stable, nurturing, loving relationships, we will support those caring for children to be trauma informed and to know that the most important thing they do is to provide a loving, stable, safe relationship – above everything else. Transforming the care system will take time. North Lanarkshire Children’s Services Partnership has started the journey to make the necessary changes to ensure the system meets the needs of our care experienced children, young people and their families who will inform the design and development of services. We have made progress in the actions identified in the previous plan, some of which continue to be developed in this plan.
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39 Achievements 2021-23 Established the Promise Development Team, young people with lived experience of care, to help us redesign our care system. Staff and Today not Tomorrow, the forum for care experienced young people, co-designed a language leaflet. Improvements in permanency planning and avoidance of unnecessary transitions for children and young people who cannot return to their families. Connections were strengthened and Permanency Planning Champions established. Care Leavers Financial Guidance implemented, to support young people at the point of transition. Developments in kinship care to strengthen links and support to kinship families as necessary to sustain placements. Family time arrangements were reviewed and a family time assessment and development framework was agreed. A review of aftercare included lived experience and resulted in the pathway process and plan, My Future Plan. A Housing and Education and Families Joint Protocol for Care Leavers was implemented, offering improved flexibility and choice. Life Long Links developed and Family Group Decision Making was further developed. Continued development of the Virtual School to reduce attainment gap and improve life choices for care experienced children and young people. “Keeping the promise award” for our education establishments developed. This is recognised as best practice and being adapted by other Local Authorities. The MHWR Task Group considered services and supports for 16-26 year olds recognising a gap for care leavers. Research and consultation took place informing a workshop to design a therapeutic post. The MHWR Task Group are driving forward a range of community supports developed in partnership through the Community Mental Health and Wellbeing Supports and Services Framework, links to family support. Care: Children’s Services Partnership 2023-2026 Improving the experiences and life chances for care experienced children and their family continues to be a priority across the CS Partnership. The CS Partnership will continue to provide leadership and direction, taking forward priorities to ensure improvement in children, young people and their families wellbeing. The Partnership will support priorities to further develop the workforce to be trauma informed and to develop relationship based practice. Supporting carers including kinship and foster carers by providing access to advice and networks of support, making sure they have time to focus on developing relationships, and to reflect on whether these are delivering what the child needs. We do this best if we: Know and understand the needs of the care experienced community, children, young people, parents, carers, families and the workforce Learn from those with lived experience to inform developments and transformational change to the system
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40 Care experienced children and young people, carers and parents voices are listened to and they collaborate in decision making within the partnership and other relevant groups We will be building on work to strengthen our services to support care experience during 2023-2026. This will be detailed in a strategy, published in 2023 and annual action plans. The Champions Board will provide leadership and The Corporate Parenting Strategy and Improvement Plan- The Promise and Me, Families and Professionals Together, 2023-27 will detail the ambitions and actions Further develop our approach to whole family support, including kinship and foster families, support families to stay together, early help and prevention The agreed priorities in this plan will be taken forward by the NL Promise and Me Partnership (Corporate Parenting in North Lanarkshire) Priorities 2023-2026 16. Develop a systemic approach to involve care experienced children, young people and their families in how all services are designed and/or re-designed to meet all health needs. 17. Provide support to parents that is available when they are ready and tailored to their needs. 18. In our balance of care, reduce the trend of children and young people being removed from and rehabilitated to their families by strengthening opportunities to provide early help and prevent escalation. 19. Support to parents whose children have been removed on a permanent basis helps to sustain or build relationships with their children and maintain direct or indirect contact. 20. Consider the support that could be provided to unaccompanied asylum seekers and children and young people who are in NL through the National Transfer Scheme 21. Continue to close the educational attainment gap for our care experienced children and young people. Continue to improve their attendance and provide help to parents and carers to support their children and young people to meet their educational needs. 22. Further development of the Virtual School, building on its success in improving children and young people’s attendance and educational attainment and support to enable them to have positive destinations. 23. Care experienced children, young people and their families are involved in the development and redesign of health services. 24. There is a smoother transition from children to adult health services for those who need ongoing support.
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41 25. Use additional funding streams proportionately to develop community supports and therapeutic interventions to enable tailored responses to meet individual needs.
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42 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? Care experienced children, young people and their families are engaged and supported as early as possible, ensuring they are enabled to thrive, live healthy lives, and experience nurturing, loving and stable relationships. 15. Develop a systemic approach to involve care experienced children, young people and their families in how all services are developed and or re- designed to meet all their health needs. This includes those who are care experienced at home with kinship and foster families, in continuing care, supported in after care Unaccompanied Asylum Seekers Those in NL through the National Transfer Scheme We have a whole system approach to service redesign, making sure To improve our approach to service re-design and make sure it is informed by those with lived experience. Provide support for all care experienced children, young people and their families, to enable them to participate in service re- design. Cascade the knowledge and skills of those managers, practitioners and care experienced young people who attended the national re-design training in 2022, to ensure better consistency of approach. A review of the social work corporate parenting services will be carried out and will involve partners from across children’s services and those with lived experience. The review will inform service improvement and or re- design. Monitoring and evaluation of participation in service redesign activities is included in 6 monthly reports to Improving Children’s Services Group. Engagement in the review process Recommendations are developed and shared The review informs service improvement and or re- design
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43 services are flexible and accessible. 16. Provide support to parents that is available when they are ready and tailored to their needs. 17. In our balance of care, reduce the trend of children and young people being removed from and rehabilitated to their families by strengthening opportunities to provide early help and prevent escalation. 18. Support to parents whose children have been removed on a permanent basis helps to sustain or build relationships with their children and maintain direct or indirect contact. There is early help and preventative support to all families so that care experienced children and young people have stable, loving and nurturing lifelong relationships which help them achieve their potential. To ensure equity of support to all families, equity of spend of the whole family support fund, proportionately applied to care experienced families including direct payments to those most in need, e.g., children experiencing care at home and parents who are care experienced. Carry out a needs analysis of additional support needed for care experienced families, including parents who are care experienced. Identify the gaps and what will make a difference and improve outcomes. Link with ongoing planning reporting and review of whole family support fund. As part of the review of corporate parenting, review post adoption/post permanency (foster and kinship), support to families, identifying what is working well and what needs to improve to ensure early help is available to prevent escalation and family breakdown. Review support offered to parents whose children have been removed on a permanent basis children and young people who are rehabilitated to their Engagement in the needs analysis. Gaps and recommendations are developed and reported. An action plan is developed Engagement of those involved in post adoption/post permanency. Recommendations and actions are included in forward planning. Monitor outcomes and balance of care. Reporting and recommendations Engagement of lived
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44 parent’s care parents who have had children removed from their care where rehabilitation has been ruled out and who are again pregnant. Further develop intensive supports to inform assessment and planning for them and their unborn child. experience in review process. Monitoring of empowering cluster model, GIRFEC pathway and whether planning for wellbeing is universal, additional or intensive.
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45 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? Care experienced children, young people and their families are engaged and supported as early as possible, ensuring they are enabled to thrive, live healthy lives, and experience nurturing, loving and stable relationships. Build on the work already progressed to continue to develop our approaches to sustain nurturing relationships for our care experienced children and young people- family relationships with parents, carers and those significant to children and young people. 19. Consider the support that could be provided to unaccompanied asylum seekers and children and young people who are in NL through the National Transfer Scheme. To support children and young people experiencing care to reach their potential. Recognise the importance of nurturing relationships, particularly for children and young people are unable to be cared for by their natural, adoptive or permanent family. For children living away from their families, we recognise the support carers need to care for children who have experienced trauma. Identify what support is needed for carers to help them understand their contribution to developing and sustaining nurturing relationship, this will include training and upskilling. Accelerate actions if gaps in support are identified. Identify measurements of success so far, listening to children and young people, to further improve family time including with brothers and sisters who are not together. Further development of Life Long Links, including consideration to what support could be provided to unaccompanied asylum seeking/NTS children and young people. Continue to develop our After care provision, flexible approaches, support available when it is needed. Further develop the aftercare hub to include those with lived experience and partners. Ongoing engagement with carers Learning opportunities available to carers. Participation and evaluation Awareness of what is important to children, young people and families. Feedback that identifies improvement Monitoring of engagement in Life Long Links. Engagement, feedback and evaluation from Family Group Decision Making. Recommendations and plan of work
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46 20. Continue to close the educational attainment gap for our care experienced children and young people. Continue to improve their attendance and provide help to parents and carers to support their children and young people to meet their educational needs. 21. Further development of the Virtual School, building on its success in improving children and young people’s attendance and educational attainment and support to enable them to have positive destinations. To improve the life choices and chances for our care experienced children and young people, positive destinations, training, further education, apprenticeships. Continued focus on the Virtual School, monitoring and sharing further improvements and success. Continue to develop alternative engagement and educational support and interventions for care experienced children and young people, for example outdoor learning approaches, vocational activities, holiday activities for them and their families. Analysis of data to inform practice including planning for children and young people who are no longer experiencing care but who may need ongoing support, empowering cluster planning for children and young people’s wellbeing, with a focus on educational support. Existing evaluation and monitoring framework and reports Range of interventions available and outcomes for those engaged. Monitoring of attendance and exclusions Data is gathered, analysed and recommendations are made
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47 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? Care experienced children, young people and their families are engaged and supported as early as possible, ensuring they are enabled to thrive, live healthy lives, and experience nurturing, loving and stable relationships. 22. Care experienced children, young people and their families are involved in the development and redesign of health services. 23. There is a smoother transition from children to adult health services for those who need ongoing support. 24. Use additional funding streams proportionately to develop community supports and therapeutic interventions to enable tailored responses to meet individual needs. Assessment and planning for care experienced children and young people is holistic to improve their wellbeing, life choices and chances. All health needs are met and we are aware of and can act upon unmet need as it becomes apparent. Take forward the review of CELL 16 initial assessment to ensure it is robust and services are available to meet any unmet need for care experienced children and young people. Review health needs assessment and interventions for parents who have been care experienced including mental health and addictions as key areas for consideration and identify improvements. Review and streamline the transition from children to adult health services for care experienced children and young people. Quality improvement and outcome information from CELL 16 assessments. Review is complete and improvement areas are progressing. Included in Whole Family Support monitoring and evaluation.
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48
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49 People ‘The children that Scotland cares for must be actively supported to develop relationships with people in the workforce and wider community, who in turn must be supported to listen and be compassionate in their decision-making and care.‘ The Promise 2021 Those involved in the lives of children, young people and their families have a primary purpose to develop nurturing, compassionate, trusting and respectful relationships that keep children, young people and their families safe. The workforce across children’s services in North Lanarkshire will be supported to be trauma informed and relational. Our approach is to support the workforce, managers and practitioners, to be confident in their work to support children, young people and their families. Our ‘workforce’ includes staff, volunteers and carers. We keep people at the centre of all we do. Our GIRFEC approach, with its focus on keeping children, young people and their families at the heart of assessment, planning and decision making, is supported by ongoing workforce development activities such as resources, briefings and review. The workforce must be given time to focus and reflect on relational and trauma informed practice. We work together to strengthen supportive networks and value the roles of varied people in children’s lives, including their families, those in education, health and the wider community. We want to continue to support developments which realise and sustain a competent and confident workforce across children’s services. Each partner supports staff through a range of approaches e.g. reflective supervision, personal development planning and annual reviews. We will take a partnership approach to co-ordinate workforce development, including trauma informed organisations with a focus on people’s wellbeing. Our reach goes beyond our workforce and into the wider context of our communities, supporting people’s wellbeing and helping children, young people and their families to achieve in all aspects of their lives. Achievements 2021-23 Maintaining effective GIRFEC practice for children, young people and families. Review and improvements to single/multi-agency learning and development relating to GIRFEC. Application of refreshed national GIRFEC resources e.g., information sessions/materials/links for practitioners. A multi-agency and sector workforce development programme updated and distributed annually. We have strengthened links with communities through engagement with Community and Voluntary Sector, children, young people and families Network and North Lanarkshire Community Boards. We have delivered a programme on Nurture and resilience to promote attachment and develop trauma informed practice. Solihull and parenting programmes continue to be delivered for staff, parents and carers. Development of the GIRFECNL website, providing accurate and up to date information, including signposting, about children’s services for the workforce, parents and carers and our communities.
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50 Co-produced information to support the workforce to reframe language and use terms that children and young people find to be more positive and understandable. In October 2022 inputs were delivered to staff from across the children’s services partnership to launch the Empowering Clusters Page Tiger resource for GIRFEC pathways in NL. 2023-26 The CS Partnership will continue to provide leadership and direction, taking forward priorities to ensure improvement in children, young people and their families wellbeing. The Partnership will support priorities to ensure the wellbeing of the workforce. Through our partnership working there will be ongoing leadership and support to ensure GIRFEC practice is maintained and consistent. Relationship based practice and our trauma informed approach will be furthered ensuring everyone’s experience of services and supports is trauma informed. There is crossover with whole family support and through this we strive for improvements for all families’ wellbeing. We will be building on our work to strengthen our services and support to children, young people and families. We will ensure our workforce is confident and competent in their practice. We do this best if we: Engage with communities and work collaboratively across children’s services, keeping children, young people and their families wellbeing at the heart of what we do. Engage and respond to the needs of the workforce, recognise their strengths, provide support and training and development opportunities. Communicate our vision, our shared priorities, key messages and information to support the workforce, our communities and children, young people and families. People-Priorities 2023-26 - 26. Continue to advance and develop our children’s services workforce. We will provide opportunities for career advancement and promote collaborative working across the children’s services partnership and adult services. 27. Continue to develop workforce skills, confidence and competence developed in GIRFEC methodology, pathways, assessment planning and interventions. 28. Continually evaluate and update training and learning in line with legislation, strategy and policy 29. Ensure that staff are routinely consulted on service improvements, change and redesigns.
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51 30. Make sure that staff supporting kinship, foster, adoptive families provide additional support when they need it, recognising that they too may need early help and preventative support to feel confident in caring for their children and young people who have experienced trauma. 31. Provide early help and preventative support to all families who need it and when they need it. 32. Build on progress to develop community hubs informed by consultations. 33. Consult with communities to identify gaps in service provision, how and where they want to access services, what is working well and what they think needs to change. 34. Work collaboratively across the range of strategic partnerships. 35. Work within our strategic frameworks to promote wellbeing within and across our communities ensuring equity of opportunities to improve life choices and chances. 36. Communicate effectively with our children, young people, families and communities. 37. Further develop our use of technology for families and the wider community to access and engage with services. 38. Promote a ‘no wrong door’ approach, for access to services, using our community Hubs as appropriate.
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52 Outcome What is it we want to do? Why do we want to do this? Actions How will we know? Our workforce are confident and competent in their practice, understand the needs of our communities, and work together to improve the wellbeing of children, young people, and their families. 25. We will continue to advance and develop our children’s services workforce. Provide opportunities for career advancement and promote collaborative working across the children’s services partnership and adult services. 26. We will continue to develop workforce skills, confidence and competence developed in GIRFEC methodology, pathways, assessment planning and interventions. 27. We will continually evaluate and update training and learning in line with legislation, strategy and policy. A competent and confident workforce will deliver quality services to improve the wellbeing of children, young people and their families. When staff are supported to experience positive health and wellbeing, they are enabled to provide the best for our communities. Continue to deliver and develop single and joint workforce development programmes for GIRFEC Trauma informed practice Nurture programmes- Solihul Child protection Contextual safeguarding Safe and Together Develop multi agency capacity and roll out UNCRC workforce training, led by Community Learning and Development. Develop programmes and resources to promote relational practice. Evaluation of workforce development programme. Monitoring and reporting of activity through GIRFEC delivery group, Child Protection Committee and ICSG. Evaluation and reporting through Voice task group. Plan is developed and progressed.
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53 28. We will ensure staff are routinely consulted on service improvements, change and redesigns. Value the experience and knowledge of all staff and their role in delivering our vision. Workforce development plans are based on analysis of need. Nurture positive relationships across the workforce. Support participation in the CSPartnership task and working group structure. Involvement in our programme of self- evaluation activities e.g. roadshows, multi-agency file reading, quality improvement sessions, gathering of evidence All task groups and working groups consider workforce development and engage staff in workforce development plans. Apply the multi-agency Mental Health Strategy for staff. Review of membership. Engagement in meetings and activities Staff survey and self- evaluation activities. Six monthly reporting through the Continuous Improvement Group. Annual reporting. Review and reporting. 29. We will make sure that staff supporting kinship, foster, adoptive families provide additional support when they need it, recognising that they too may need early help and preventative support to feel confident in caring for their children and Whole family support is available to all families including kinship, foster, adoptive families. There are fewer transitions for children and a decrease in care experienced family breakdown. Identify the gaps in support for care experienced families. Evaluate the current training, development and support to carers to ensure it is accessible and equitable and meets the needs of carers. 6 monthly reports from The Promise and Me and Whole Family Support Task Groups. Feedback from families. Monitoring information that sits behind our balance of care.
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54 young people who have experienced trauma.
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55 What is it we want to do? Why do we want to do this? Actions How will we know? 30. Provide early help and preventative support to all families who need it and when they need it. 31. Build on progress to develop community hubs informed by evaluation/consultations. 32. Consult with communities to identify gaps, how they want to access services, what is working well and what they think needs to change. 33. Work collaboratively across the range of strategic partnerships. To improve the wellbeing of children, young people and their families, improve their engagement in their communities/ community networks, improve their feeling of worth and wellbeing. We can respond to change by reorganising staff and supports. The Community and Voluntary Sector, children, young people and families Network are supported in their role within the CS Partnership. Work alongside the developing Community Hubs to identify how we can develop and increase the availability of community based supportive networks for families. Work alongside other strategic partnerships and community boards to share information relating to community needs and priorities. Evaluation of the CVS, CYP&FNetwork role in Empowering Clusters. There is representation from the CS Partnership engaged in these developments. Review of participation and representation of CS Partnership in range of forums. Engagement with CS Partnership Evidence that information has been shared.
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56 What is it we want to do? Why do we want to do this? Actions 34. Work within our strategic frameworks to promote wellbeing within and across our communities ensuring equity of opportunities to improve life choices and chances. To make sure opportunities are available for all children, young people and their families to support their wellbeing. Create opportunities which support positive destinations in training, apprenticeships and employment for young people and parents. Make sure our services are accessible and available when needed. Work collaboratively with the Employability, Support and Skills Development Service, to help parents and young people access the support they need to develop the skills which will help them into sustainable employment. Continue to deliver GIRFEC to assess and plan for children and young people’s wellbeing, ensuing they and their families are involved in decision making. Continue to develop support to improve children’s mental health including transition from children’s to adult mental health services. Information from range of partnership forums. High level performance information. Annual returns and performance information.
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57 What is it we want to do? Why do we want to do this? Actions 35. Communicate effectively with our children, young people, families and communities. 36. Further develop our use of technology for families and the wider community to access and engage with services. 37. Promote a ‘no wrong door’ approach, for access to services, using our community Hubs as appropriate. Key messages about services and supports are clear and consistent. We want to reduce barriers for children, young people and their families, accessing services, to ensure they get the right help and support at the right time, when they need it. Children and young people’s mental health has improved by access to services when they need it. Seek opportunities and develop capacity to find digital and technology options and solutions as appropriate in the delivery of our services. Promote NL websites which provide accurate and updated information about services and where to get help and support, including the GIRFECNL website. Raise awareness and explore opportunities to support a ‘no wrong door’ approach across services to ease access and engagement for people who need advice, guidance, support and signposting. Promote the Kooth App which provides information on mental health for children and young people. Task groups and working groups develop and report on actions to apply technology. Website monitoring. Actions develop in workplans to support this. Monitoring of use of Kooth App
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58 Scaffolding ‘Children, families, and the workforce must be supported by a system that is there to provide support when and where it is needed. ‘The scaffolding of help, support and accountability must be ready and responsive when it is required.’ The Promise 2020 The challenge presented here requires leadership and coordination at both a national and local level. As in other areas, the change is significant and will extend beyond the period of this Plan. We look to the Scottish Government to make further changes that support and enable partnerships to learn and develop, negotiate the legislative and policy framework for children’s services, implement initiatives, plan and report. Across the CS Partnership, during the lifetime of this plan, we will work together with our own values, framework and priorities to realise our vision. We want to ensure the that our governance, culture, systems, and processes empower the workforce to support children, young people, and families to realise our shared vision. We have begun by developing this CS Plan in collaboration with partners and other stakeholders. Getting it Right for Every Child, the national approach designed to improve outcomes and supporting wellbeing of our children is embedded across the CS Partnership and we continually develop and improve this approach. We work towards achieving the wellbeing outcomes for children and young people: safe, healthy, active, nurtured, achieving responsible, respected, included. We have implemented our empowering clusters model to ensure that GIRFEC practice is further embedded across the partnership and that every infant child, young person and their families participate in care planning with the professionals closest to them. In North Lanarkshire community hubs are establishing or developing as an operational model that will further capacity and opportunity for collaboration and improved access to informal and formal supports for children, young people and families in our communities. Also, part of our scaffolding, supporting our shared approach is: What we do to ensure our approach is rights based, strengths- based and trauma informed. How we engage with partners through Towards a Fairer North Lanarkshire, Tackling Poverty Strategy and Action Plan to mitigate the impacts of poverty. How we gather knowledge and understanding of the impact of the services, supports and activities across the partnership. This is to assist us to understand the outcomes and how the work we do together can make a meaningful difference for children, young people, and families. Our continuous improvement activity. This is an ongoing process via self-evaluation, gathering of data, seeking views and feedback. This will assist in the joint inspection of children’s services being undertaken in 2023.
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59 Achievements 2021-23 The Health Visiting Pathway for pre-birth to preschool has been fully implemented. Empowering clusters were launched. Schools and school leaders, supported by central staff, will work together to enable real change on behalf of the families and communities they serve. The school nursing programme was expanded to support clusters. GIRFEC is further embedded by health vising pathway and the empowering cluster model. Partners work together to achieve good planning for children’s wellbeing, integrative practice guidance for empowering clusters has been shared across the CS Partnership. GIRFEC pathways for planning and support have been refreshed. Pathways for 0-5 years will inform how we move forward. Pre-birth planning for vulnerable women has been refreshed to ensure a consistent approach. The Family Nurse Partnership for young parents was positively evaluated. Contextual safeguarding has been implemented for assessment and risk management for young people when risk is extra familial. A young people’s safeguarding panel was established and the first evaluation was positive. Trauma informed environments are being implemented across services and organisations are increasingly trauma informed. This was supported by research to develop our approach. We gathered information, data, research and feedback into a joint strategic needs assessment. Self-evaluation work has been undertaken and includes- Audit of child protection cases, secure cases and Care and Risk Management Staff survey and focus groups Position statement and self-evaluation document We will build on this work supported by our shared continuous improvement framework and actions Scaffolding- Priorities 2023-26 39. Our vision is shared across the partnership and each partner is actively participating in leadership and delivery of our shared priorities. 40. Further the implementation of GIRFEC and Pathways for all children and young people. 41. Implement changes in legislation and national guidance. 42. The CS Partnership is aligned with and contributing to NL Tackling Poverty strategy and actions. 43. Through information and research, we are aware of need, changing drivers, policy and connections.
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60 44. We are aware of the impact of our work we are continuing to improve wellbeing for children, young people and families. 45. This is integrated into our planning and reporting.
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61 Outcome What is it we do? Why do we do it? Actions How will we know Our staff are empowered to support infants, children, young people, and families to realise our shared vision as a result of our leadership, governance and organisational culture. 38. Our vision is shared across the partnership and each partner is actively participating in leadership and delivery of our shared priorities. Partnership working continues to add value to improving outcomes for children, young people and families. Streamline delivery and improve the experience for those accessing services and supports. All partners actively contribute to the range of workstreams. Seek and develop further opportunities for joint commissioning Whole Family Support Mental health and wellbeing Work with adult services and justice to ensure consistent response to young people and smoother transitions. Develop a programme of events to bring together staff from the wider partnership to share practice, information about their roles and areas of development. Monitor membership, participation and reach. We evidence a partnership approach to new funding streams or planned realignment. National reporting and evaluation Evidence of shared intelligence and priorities with adult and justice services. Feedback on transitions. Agreement and forward plan for events. Numbers of staff participating from each partner. Evaluation of events.
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62 39. Further the implementation of GIRFEC and Pathways for all children and young people. Practice is consistent and staff are confident in applying the core components. ICYP of NL though integrated approach to health and wellbeing have needs identified at earliest possible stage, including those requiring statutory intervention to achieve improved outcomes and timeously appropriate referrals to supporting agencies. To ensure a strengths- based approach. Children are at the heart of planning and this is in partnership with parents and carers. All people receive support in a trauma informed way. Further development of Empowering Clusters model. Continue progressing the Universal HV Pathway Prebirth – 5 Pathway: The established working group will consider the best method of pre birth planning for vulnerable women and progress this work. Implement model for screening using existing GIRFEC processes and linking to cluster model. For 16 +: Continue to develop partnership responses to risk including Extra Familial Harm. Utilise the GIRFEC Ongoing monitoring and evaluation Incorporate into performance framework – information gathered from developing MORSE platform supporting a development of a shared dashboard to include SCRA referrals. Established pathway, guidance and monitoring and evaluation of application. GIRFEC Delivery Group to continue to review and monitor progress. Further evaluation of the young people’s safeguarding panel, including assessing if young people are safer in their communities. Monitoring and analysis of data collated by SCRA.
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63 planning pathway and statutory criteria to identify those requiring statutory intervention and progress timeously by referral to Scottish Children’s Reporter Administration.(SCRA) Implement recommendations from Innovate research to develop our trauma informed approach Reflective practice and review. Ongoing engagement with Innovate. 40. Implement changes in legislation and national guidance. Legislation and guidance is applied to ensure improvements in practice and wellbeing. Implement new national Child Protection Guidance. Implement changes in preparation for the enactment of UNCRC (Incorporation) (Scotland) Bill. (See UNCRC and Voice) Updated guidance is available and in use. Reports from Voice Task Group. 41. The CS Partnership is aligned with and contributing to NL Tackling Poverty strategy and actions We are aware of the impact of poverty on our children and families. We are able to consider how our priorities and action will help to mitigate child Cross representation on forums and task groups. Annual review of CSP participation and reach. Contributions to child poverty reporting
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64 poverty in NL. Develop and apply tools and resources that support awareness and ‘poverty proofing’ our priorities and actions. Testing and evaluation of developing tool. Reported application and changes made to actions as a result. 42. Through information and research we are aware of need, changing drivers, policy and connections. 43. We are aware of the impact of our work we are continuing to improve wellbeing for children, young people and families. 44. This is integrated into our planning and reporting We are aware of our strengths and areas for improvement. Improve how we assess needs and how we respond to change and identify priorities. Our programmes and decisions are informed by evidence and best practice. We can compare information and identify trends. We know what is working well and why. Improvements in well- being and in our practice. This contributes to confidence across the workforce and in our communities. Continue to gather and share data and information about developments in this area. Update context and connections Update service map Conclude our Human Economic Cost Modelling research in Care Joint Strategic Needs Assessment activity is ongoing. There is reflective review and the approach is refined year on year. Self evaluation 2023- then ongoing Application of SDQ and analysis of the comparative data Update is published. Comparisons and reflections are noted. Report and recommendations . Information is shared across the CS Partnership and apparent in our planning and reporting.
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65 Continue to meet the planning and reporting requirements as set out by Scottish Government and North Lanarkshire Partnership. Work with the Care Inspectorate to support the joint inspection of children’s services in 2023. Plan the application of partner funding to Develop high level indicators and dashboard Support performance and measurement of our CSPLan Improve outcome measurement CS Plan Annual reporting Reporting on children’s rights 6 monthly reporting from task groups and working groups Inspection activities undertaken and published report. Action plan and reporting to CSPB
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1 REPORT Item No: 17 SUBJECT: Community Solutions Update TO: Integration Joint Board Lead Officer for Report: Maddy Halliday, CEO, Voluntary Action North Lanarkshire Author(s) of Report Maddy Halliday, CEO; Nick Brown and Thomas Moan Senior Managers Community Solutions - Voluntary Action North Lanarkshire DATE: 27 September 2023 1. PURPOSE OF REPORT To provide an update on the Community Solutions Programme including a summary annual report for 2022-23. 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 IJB members comment and note the contents of this report and appendices. 4. VARIATIONS TO DIRECTIONS? Yes ☐ No ☒ N/A ☐ 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 This report provides an update of the Community Solutions programme progress and achievements for 2022-23, including a summary report on the reach and impact of funded projects during this period (See Appendix One). 5.2 As can be seen in Appendix One, during 2022-23, 233 unique projects were funded which collectively supported 43,100 individuals, achieving positive outcomes for the majority. This was achieved with a total of £3.1 million in funding awards to 98 community and voluntary sector organistions. 5.3 In addition, the following work was achieved during 2022-23. Development and agreement of the new, Community Solutions Strategy and Investment Plan 2022-25. (Will be available to download from the new Community Solutions website from Oct. 2023.) Development and agreement of a proposal for a Community Solutions Improving Lives pilot initiative (ILI) (see further information on new Community Solutions website from Oct. 2023.) with implementation in phases from April-autumn 2023 for delivery for two years. , which will support the following. o Piloting of the “three conversations” approach to assisting people in the community with health and related challenges to access community supports provided by the community and voluntary sector (CVS) and access appropriate formal support if needed. This will include supporting people affected by cancer in collaboration with MacMillan which is providing part-funding. o Building capacity of local CVS organisations generally through provision of support and guidance from Voluntary Action North Lanarkshire, the six Community Solutions Locality Hosts and other sources.
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3 o Increasing the amount of funding available to the six Community Solutions Locality Consortia to award to CVS organisations through the rough the Community Solutions (Improving Lives) Local Activity Fund. Review and improvement of the Community Solutions Performance Management, Evaluation, Learning and Improvement Framework and supporting resources, including online surveys for funded projects and preparation of an introductory-level online Evaluation Toolkit. (See new Community Solutions website from Oct. 2023 for more details.) 6. CONCLUSIONS During 2022-23, Community Solutions funded projects delivered vital support to 43,100 people in North Lanarkshire which helped them to improve their health and wellbeing. The programme’s partnership working was also strengthened, helping us to achieve more; govern the programme effectively and plan our exciting ILI initiative. 7. IMPLICATIONS In addition to supporting delivery of our HSCNL’s Commissioning Plan, the Community Solutions programme plays a vital role in supporting delivery of the Plan for North Lanarkshire and six Local Outcome Improvement Plans (LOIPs). 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒
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4 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL This paper has been reviewed by Finance: Yes ☐ No ☒ N/A ☐ 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Community and Voluntary Sector funding insufficient and insecure High ?? 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 Community Solutions supports engagement of the key stakeholders as follows. 1. Service Users and Carers: ongoing engagement with service users and carers regarding their needs, priorities, views and experiences is supported by CS funded projects, Locality Hosts and consortia and informs design of projects and services.
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5 2. Community and Voluntary Sector (CVS) funded projects: are actively involved in designing, delivering and evaluating CS funded projects/services. 3. CVS generally: VANL supports CVS capacity building and engagement in the CS programme, including representation on HSCNL SLT, PFA and IJB the six CVS Locality Hosts support CVS engagement in the programme in their locality, including participation in Locality Consortia Locality hosts and other CVS orgs are involved in development of (Improving Lives) Locality Development Plans and management of Local Activity Funds (LAF) through Locality Consortia Locality Hosts and Consortia are represented on the CS Governance Group. ☒ Provide stakeholders with information on how to get involved. The Community Solutions programme provides information to stakeholders about involvement opportunities through: Funded projects Locality Hosts Locality Consortia VANL – including a regular online CS bulletin HSCNL structures The new CS website to be launched in Sept. 2023 will assist further.
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6 ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs. Engagement opportunities in the programme are diverse and include those offered through funded projects, locality hosts and consortia and VANL. These include direct engagement with service users and carers about their views and needs; public consultation through surveys and focus groups; participatory events. ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services CVS organisations applying for funding through Community Solutions need to indicate in their application how they have to date and/or will involve community stakeholders in design and delivery of their projects. The Locality Consortia need to set out in the Locality Development Plans how they are and will continue to support community engagement. ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery. From 2023 projects receiving funding through Community Solutions are asked to provide information about their support for service user, carer and public engagement in informing services. ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings VANL staff support CVS engagement and representation in locality and NL-wide partnership meetings of HSCNL and through Community Planning. ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff. VANL staff support development of participation guidance, understanding and expectations for the Community Solutions Programme and more widely through Community Planning, along with CVS and public sector colleagues. ☒ Support engagement planning and participation in localities, taking account of Community Solutions Locality Hosts and Consortia members support engagement planning at locality
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7 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes ☐ No ☒ N/A ☐ EQIA added to website: Yes / Date added ☐ No ☒ N/A ☐ 8. BACKGROUND PAPERS The following information are attached to this report and will also be available online through the new Community Solutions website in October 2023. Community Solutions Programme Briefing Community Solutions Logic Model 9. APPENDICES 2022-23 Annual Report Summary CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following: maddy.halliday@vanl.co.uk 7 other engagement activity and local plans across the Community Planning Partnership level. Locality Hosts are required to support links between Community Solutions and community planning, complemented by VANL staff.
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8 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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9 21/07/2023 Community Solutions Programme Logic Model 1 4.4 Increased capacity and effectiveness of wider CVS 2.4 Performance Management, Evaluation, Learning and Improvement (PMELI) Support 4.3 Improvements to CS Funds and overall programme 3.3 New Evidence and Learning 2.3 Capacity Building 1.3 Funds 4.2 For funded projects/organisations 3.2 Improving Lives Locality Development Plans and Locality Activity Funding awards 2.2 Locality Stakeholder Engagement 1.2 Strategy, Plans and Tools 4.1 For people receiving support 3.1 Services and support to local people and communities 2.1 Funding Development and Management 1.1 Existing Evidence on What Works and data on Needs and Priorities 4. Outcomes 3. Outputs 2. Processes 1. Inputs The Community Solutions Programme: Summary Logic Model See Community Solutions and VANL Working Together for a Better North Lanarkshire Websites 4.5 Improvements to health and social care services/system and community planning 2.5 Representation and Influencing
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10 21/07/2023 2.4 PMELI Support tools and guidance – provided by VANL to funded projects 1.3 Funds 1.2.1 Provided by funders through VANL 1.2.2 Supported by funding agreements/SLAs between VANL and funders 2. Processes 1. Inputs The Community Solutions Programme: Logic Model See Community Solutions and VANL Working Together for a Better North Lanarkshire Websites 2.1 Funding Development and Management 2.1.1 NL Wide: development facilitated by VANL with funders, partners and stakeholders; management provided by VANL 2.1.2 Locality Action Fund– development and management led by Locality Consortia and Hosts with support from VANL 2.2 Locality Stakeholder Engagement – led by Locality Hosts and Consortia with support from VANL (SH = residents, service users, carers, CVS, public sector) 2.3 Capacity Building 2.3.1 General CVS – provided by VANL (see organisational review guidance) and Locality Hosts • CVS Children, Young People and Family CVS support orgs – provided by VANL and Locality Hosts • • Carers – provided by NL Carers Together and Network Volunteering - provided by VANL with partners and CVS 1.2 Strategy, Plans and Tools 1.1.1 CS Strategy and Investment Plan: developed collaboratively with co-ordination from VANL (supports delivery of HSCNL Commissioning Plan; Plan for North Lanarkshire and Local Outcome Improvement Plans (LOIPS) 1.1.2 Delivery Schedule – prepared and managed by VANL 1.1.3 Performance, Evaluation, Learning and Improvement (PMELI) Framework – developed collaboratively with co-ordination from VANL 1.1.4 PMELI resources - developed and managed by VANL 1.1 Existing Evidence and What Works, Needs and Priorities Including carer and user views 2.5 Representation and Influencing through - Heath and Social Care NL; Children’s Services Partnership; Community Planning – North Lanarkshire Partnership (NLP)
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11 4.1 For people receiving support: • Improved mental and physical health • People feel more connected, included and safe • People feel more informed and aware 4. Outcomes 3. Outputs The Community Solutions Programme: Logic Model See Community Solutions and VANL Working Together for a Better North Lanarkshire Websites 4.2 For funded projects/organisations: • increased capacity and effectiveness • matched/additional funding • improved services 4.3 Improvements to CS Funds and overall programme 3.1 Services and support to local people and communities - provided by funded projects 3.2 Improving Lives Locality Development Plans and Locality Activity Funds - Plans developed by Locality Consortia and Hosts informed by community engagement - plans guide management of LAF and support delivery of CS Strategy, HSCNL Commissioning Plan and LOIPS 4.4 Increased capacity and effectiveness of wider CVS
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12 21/07/2023 Community Solutions Programme Logic Model 3 3.3 New Evidence and Learning - generated through funded projects and programme processes 3.2.1 data gathered by funded projects 3.2.2 data analysis undertaken by VANL 3.2.3 learning and improvement events – organised by VANL for funded projects and others 3.2.4 Learning and Impact Reports for each fund and overall Programme – prepared by VANL 4.5 Improvements to health and social care services/system and community planning
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13 1 Community Solutions Achievements 2022-23
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14 Programme Funding Summary The Community Solutions programme manages a number of funding streams from a variety of funders to provide grant funding to the Community and Voluntary Sector. Anticipatory Care £40k Carer Breather £248k Home Visiting & Befriending £195k Community Transport £72k Locality Host Fund 6 CVS Anchor Organisations 6 x £40k Programme Delivery £300k Thematic Funding £2.2 Million 10 Thematic Funds Capacity Building £208k 2 proj deli Total Funding: £3.1 Million 33 ects vered by 98 CVS Organisations Carers £40k Carers Network £40k Children and Young People & Families £30k CVS General £60k Locality Activity Funds 6 x £30k 66 projects funded £995k Community Mental Health and Wellbeing Fund was paid in March 2023, however, it is for project delivery in 2023-24. Reporting and outcomes will follow in 23-24 report. Volunteering £38k Hospital Discharge £77.5k Physical Activities £40k CYP Community Mental Health & Wellbeing£465k Substance Misuse Fund £50k Community Mental Health & Wellbeing£955k Support in the Right Direction £100k
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15 Summary of Unique Individuals Supported and Services Provided through the Community Solutions Programme 22-23 Carers support sitter service, wellbeing therapies and breaks Community engagement projects Outdoor activities Community cafes and lunch clubs Physical activity and exercise Befriending Mental health and wellbeing support and holistic therapies Bereavement and grief support Support and Services Provided Arts, play and drama Healthy eating, nutrition and cooking classes 43,100 unique individuals supported
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16 Summary of Reported Outcomes for Services Provided Through the Community Solutions Programme 2022-23 u 14,007 people felt more connected, included and safe people have improved health and wellbeing people felt more informed and aware 4,215 children, young people or families’ health and wellbeing was improved families relationships were strengthened children young people and families have become more resilient 3,364 carers felt more informed and aware 3,770 carers health and wellbeing was improved 2,027 carers were more able to have a life outside of caring 16,050 8,422 941 1,141 n
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17 Community Solutions Programme Overview 2023 Programme Overview 2023
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18 Introducing Community Solutions Community Solutions is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire, established in 2012, which is improving people’s health, wellbeing, quality of life and equality by investing in community-led initiatives which build community, family and individual strengths and resources - with a focus on prevention and early intervention. Community Solutions Programme Overview 2023
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19 ntegrated approach lutions Programme integrated approach , quality of life and sing: ical health and eir connection. omic, and fluences on health, quality and the actions these. rview 2023 Community Solutions Approach Holistic and i The Community So takes a holistic and to health, wellbeing equality encompas • Mental and phys wellbeing and th • The social, econ environmental in wellbeing, and e needed to tackle Community Solutions Programme Ove
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20 Strategic investment approach Community Solutions takes a strategic investment approach which prioritises the following in line with HSCNL’s ambitions. • Investment in health improvement, prevention, and early intervention activities, which reduce inequalities and protect human rights • Investment in crisis and ongoing support, with a focus on recovery and re-enablement, self-directed support, and self-management. • Cost-effective, community-based support and services provided by CVS organisations • Capacity building within the CVS and wider community by supporting key CVS ‘anchor’ organisations and volunteering to build the community infrastructure and capacity to support provision of good community-based support over time. Community Solutions Programme Overview 2023
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21 ues nity Solutions also takes a sed approach. he person at the centre of ce, helping them to live life and supporting their ghts by: Programme Overview 2023 Val Commu value-ba Placing t the servi their best human ri Community Solutions
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22 Collaborative working and co-production To achieve goals and improvements where we develop equal relationships between people who use services and people who provide services – with support provided ‘with people’ rather than ‘to them’. This means involving local people - including those receiving support - and service providers in the CVS and statutory sectors to facilitate a positive and participatory cycle of planning, delivery, evaluation, learning and continuous improvement. Community Solutions Programme Overview 2023
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23 ality Community Solutions Governance & Management Community Solutions is governed through a “triple-lock” approach and supported and managed at both loc and North Lanarkshire wide levels. Community Solutions Programme Overview 2023
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24 y Community Solutions and Community Planning Links Community Solutions is governed through a “triple-lock” approach and supported and managed at both localit and North Lanarkshire wide levels. Community Solutions Programme Overview 2023
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25 Performance Management, Evaluation, Learning and Improvement Framework Overview The new Community Solutions (CS) Performance Management, Evaluation, Learning and Improvement (PMELI) Framework was launched in April 2023. The new Framework, which was approved by the CS Governance Group in November 2022, supports the following: Community Solutions Programme Overview 2023
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26 Community Solutions Programme Overview 2023
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27 mmunity Solutions Achievements 2022-23 mme funding summary rogramme Overview 2023 Co Progra Community Solutions P
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28 Provided through the Community Solutions Programme 2022-23 Summary of Unique Individuals Supported and Services Community Solutions Programme Overview 2023
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29 Summary of Reported Outcomes for Services Provided Through the Community Solutions Programme 2022-23 Community Solutions Programme Overview 2023
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30 Community Solutions Custodian Funds Summary Fund Title Fund Purpose Fund Launched Awards Made Funded Projects Delivery Funder Cancer Screening Inequalities Fund To encourage and improve uptake of cervical and breast screening within Airdrie and Bellshill localities due to very low uptake levels in those areas. February 2023 May 2023 Jun 23 - Jun 24 NHS Lanarkshire Carer Breather Phase 2 To enable community and voluntary organisations which receive funding through this scheme to enhance and extend regular and locally based support for carers January 2023 (Phase 2) March 2023 Apr 23 - Mar 25 Health and Social Care North Lanarkshire Carer Network Phase 2 Facilitation of the North Lanarkshire Carers’ Support Network March 2023 March 2023 Apr 23 - Mar 24 Health and Social Care North Lanarkshire Children and Young People Mental Health and Wellbeing Fund Phase 3 To enable funded projects to work with schools to deliver tailored support to children and young people (age range of 5-24 & up to 26 for care experienced young people) in their local communities. May 2022 Ongoing Jun 22 - Apr 23 Aug 22 - Jun 23 Scot Govt via North Lanarkshire Council Children and Young People Mental Health and Wellbeing Fund Phase 4 To enable funded projects to work with schools to deliver tailored support to children and young people (age range of 5-24 & up to 26 for care experienced young people) in their local communities. May 2023 Ongoing Jun 23 - Apr 24 Aug 23 - Jun 24 Scot Govt via North Lanarkshire Council Community Mental Health and Wellbeing Fund Phase 1 To enable funded projects to deliver a wide variety of community-based mental health and wellbeing supports Nov 2021 March 2022 Apr 22 - Mar 23 Scottish Government Community Mental Health and Wellbeing Fund Phase 2 To enable funded projects to deliver a wide variety of community-based mental health and wellbeing supports Nov 2022 March 2023 Apr 23 - Mar 24 Scottish Government Hospital Discharge Fund (Core) To support patients and their carers around hospital discharge, signposting to immediate and longer-term sources of community support April 2020 April 2020 Ongoing from Apr 20 Health and Social Care North Lanarkshire Hospital Discharge Fund (Extension) To support patients and their carers around hospital discharge, signposting to immediate and longer-term sources of community support September 2021 September 2021 Ongoing from September 2021 Health and Social Care North Lanarkshire Community Solutions Programme Overview 2023
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31 Fund Title Fund Purpose Fund Launched Awards Made Funded Projects Delivery Funder Improving Cancer Journeys To support the employment of a number of Community Connector posts to pilot “three conversations” and deliver other prevention and early intervention projects TBC TBC TBC Health and Social Care North Lanarkshire Improving Lives Initiative To enable 6 Locality Host organisations to improve engagement with their local CVS, support the work of new Community Connector posts and strengthen links with Community Planning Summer 2023 Autumn 2023 Autumn 2023 - Autumn 2025 Health and Social Care North Lanarkshire Locality Health and Care Activity Fund To provide small grants to community groups and voluntary organisations to deliver a new or improved activity to improve local wellbeing Ongoing since 2012 Recurrent Funding Ongoing Health and Social Care North Lanarkshire Locality Hosting To enable 6 Locality Host organisations to act as principle local point of contact for all Community Solutions related activity Ongoing since 2012 Recurrent Funding Ongoing Health and Social Care North Lanarkshire Positive Smoke Free Role Models To enable 6 Locality Host organisations to carry out health promotion activities targetted at smoking reduction/cessation Spring 2021 Spring 2021 Spring 2021 - Sept 2023 (delivery impacted by COVID 2020-22) NHS Lanarkshire Social Prescribing To improve processes and networks to make social prescribing more efficient and capable of effectively linking people with the appropriate services to live independent lives. Autumn 2022 TBC TBC NHS Charities Together Substance Misuse Fund To enable funded projects to support individuals and families to overcome some of the challenges they face in their life, while living with the impact of substance misuse in our communities. January 2023 TBC TBC North Lanarkshire Alcohol and Drug Partnership Support in the Right Direction People and carers who are assessed as not requiring an SDS budget feel empowered and positive about their futures and able to work towards leading healthier more independent lives. April 2019 March 2023 (extension funding) Apr 23 - Apr 24 (extension funding) Scot Govt via Inspiring Scotland Thematic Funds (Under Review) To enable funded CVS organisations to deliver activities addressing identifed needs under agreed Themes Ongoing since 2012 Recurrent Funding (under review) Ongoing Health and Social Care North Lanarkshire Community Solutions Programme Overview 2023
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32 Community Solutions Programme Overview 2023 Thanks Any questions? For more information visit: www. Email: info@communtysolutions@vanl.co.uk
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REPORT Item No: 18 SUBJECT: Tackling Poverty Team Report 2022/2023 TO: Integration Joint Board Lead Officer for Report: Alison Gordon, Chief Social Work Officer Author(s) of Report Alison Gordon, Chief Social Work Officer DATE: 27 September 2023 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: ☒ Wellbeing and Tackling Poverty Committee 1
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3. RECOMMENDATIONS The Integration Joint Board note the paper remitted from the tackling poverty committee. 4. VARIATIONS TO DIRECTIONS? Yes ☐ No ☒ N/A ☐ 5. BACKGROUND/SUMMARY OF KEY ISSUES Due to the complexity of the benefits system, general and specialist welfare rights services are crucial to individuals and families dependent on out of work and in-work benefits. The Tackling Poverty Team provide support, advice and assistance to staff on the range of state benefits and directly assist service users and residents to claim all benefits to which they are entitled. The main thrust of all welfare rights work is the maximisation of income for individuals, with consequential benefits for the council and for the community as a whole. Given the poverty levels within North Lanarkshire, it is important that the council mobilises its resources to tackle poverty amongst both users of key council services and in the wider community. 6. CONCLUSIONS This report provides details of the income maximisation work carried out by the Tackling Poverty Team and council services during 2022/23 which generated £35,480,020 in additional benefit income for the residents of North Lanarkshire. It also highlights the activity of the external services commissioned by the Council under the new commissioning model which started in April 2018 which generated £5,267,650 in additional benefit income for the residents of North Lanarkshire during the same period. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes 2 People are able to look after and improve their own health and wellbeing and live in good health for longer ☐
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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: Yes ☐ No ☒ N/A ☐ 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. There is a potential impact on the Council’s Corporate Tackling Poverty Risk(which is already a high risk), and the service risks in respect of the Council’s capacity to respond to the challenges arising from the Tackling Poverty (Child Poverty), Welfare Reform Act 2012, the impact of coronavirus and the cost of living crisis, in the terms of Council priorities and Services' activities and assisting residents of North Lanarkshire, principally those currently in receipt of benefits (out of work and in work) and welfare assistance. This risk and the controls which support its management is regularly reviewed and will be supported by the new Tackling Poverty Strategy for 2023-26 3
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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: Yes ☒ No ☐ N/A ☐ 4
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EQIA added to website: Yes / Date added ☒ No ☐ N/A ☐ https://www.northlanarkshire.gov.uk/your-community/equalities/equality-impact- assessments-eqias/enterprise-and-communities/tackling 8. BACKGROUND PAPERS None. 9. APPENDICES Appendix 1Tacking Poverty Team Activity 2022 2023 Please include a glossary of terms if not already included. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Alison Gordon 5
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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 6
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Report Appendix 1 North Lanarkshire Council □ No From Alison Gordon, Chief Social Work Officer (Education, Families, Justice and Integrated Practice) E-mail gordanal@northlan.gov.uk Telephone 01698 332001 Executive Summary This report provides details of the income maximisation work carried out by the Tackling Poverty Team and council services during 2022/23 which generated £35,480,020 in additional benefit income for the residents of North Lanarkshire. It also highlights the activity of the external services commissioned by the Council under the new commissioning model which started in April 2018 which generated £5,267,650 in additional benefit income for the residents of North Lanarkshire during the same period. Over this period legacy issues of the coronavirus pandemic alongside the impact of the cost-of-living crisis have impacted disproportionately on the most vulnerable in driving poverty and inequalities in our communities and bringing the importance of income maximisation and wider work to tackle poverty into sharp focus, highlighting the impact of low paid and insecure work in particular. Local approaches to tackling poverty and reducing inequality in North Lanarkshire, continue to be driven by the Towards a Fairer North Lanarkshire Tackling Poverty Strategy with activity focused on the key drivers of poverty. This report focuses in particular on the key area of income from welfare benefits and therefore also updates on the continued programme of welfare reform and its impact, including on the introduction of benefits devolved and now provided through Social Security Scotland as well as the challenges which the Council, partners and our communities will face over the next three to four years. Recommendations It is recommended that the Wellbeing and Tackling Poverty Committee: (1) Approves the content of the report; and (2) Remits the report to the Integration Joint Board for information. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (11) Increase economic opportunities for adults by understanding, identifying, and addressing the causes of poverty and deprivation and barriers to financial inclusion Tackling Poverty Team Report 2022/2023 Wellbeing and Tackling Poverty Committee Does this report require to be approved? ☒ Yes Ref AG/JC Date 18/08/ 23
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1. Background 1.1 Due to the complexity of the benefits system, general and specialist welfare rights services are crucial to individuals and families dependent on out of work and in-work benefits. The Tackling Poverty Team provide support, advice and assistance to staff on the range of state benefits and directly assist service users and residents to claim all benefits to which they are entitled. The main thrust of all welfare rights work is the maximisation of income for individuals, with consequential benefits for the council and for the community as a whole. Given the poverty levels within North Lanarkshire, it is important that the council mobilises its resources to tackle poverty amongst both users of key council services and in the wider community. 1.2 The Tackling Poverty Team, Social Work Services and Housing Services provides service users and members of the public with advice and assistance on a wide variety of benefit-related issues. A full benefits check is offered to all new service users. Income maximisation also plays a vital role in longer term Social Work services such as Adult Social Work, Children and Families, Kinship Care, Justice Services, Mental Health and Addictions. 1.3 A key role of the Tackling Poverty Team is to support the income maximisation service through the First Point of Contact Team directly to residents in addition to providing support services for fieldwork staff, supporting specialist Social Work Services, Education Services and Housing Services and through the Resolution Team representing clients at tribunals and hearings. Successful welfare rights intervention, where individuals are awarded extra benefit, frequently means that, as a result of increased income, they are better able to manage their own affairs and, in some instances, may not require further social work services. 1.4 Since 2011, the council has succeeded in securing financial contributions from a number of partner organisations to help fund programmes aimed at reducing the impact of welfare reform. These additional resources, which to date amount to approximately £3.3m, have been used to enhance capacity to deal with the significant increase in demand for representation, training, advice, information and support. 1.5 The Coronavirus pandemic brought inequality into sharp focus, highlighting the impact of low paid and insecure work in particular. The impact of the measures to combat the pandemic have had an unequal impact across Scotland and North Lanarkshire, in particular with a greater impact on people living in socio-economic disadvantage and with a number of specific impacts on children who were already living in poverty, or whose families have now been pushed into poverty. 1.6 Progress in developing local approaches to tackling poverty and reducing inequality in North Lanarkshire, have continued to be strengthened with activity focused on the key drivers of poverty, via the Towards a Fairer North Lanarkshire Tackling Poverty Strategy. 1.7 In addition to the challenges already referenced relating to the Coronavirus pandemic and the extended Cost-of-Living Crisis, the context of the continuing programme of Welfare Reform led by the UK Government but also the roll out of changes to areas of benefit support now devolved to the Social Security Scotland have required continual review and targeting of activity to meet evolving needs.
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2. Report Income Maximisation 2.1 North Lanarkshire Council is the largest local authority landlord in Scotland with circa 36,315 houses. In addition, the local Registered Social Landlord sector owns and manages approximately 9,000 properties. It is estimated that around 58.5% of social tenants are in receipt of Housing Benefit (57.3% in the council housing sector). 2.2 Early intervention with income maximisation assists in the prevention of rent arrears and the sustainability of tenancies. 2.3 Housing advisors provide basic information and advice to vulnerable tenants and homeless people, concentrating on housing benefit to ensure people can pay their rent. They receive welfare rights training and are supported by Welfare Rights Officers from the Tackling Poverty Team (TPT). 2.4 From 1 April 2022 to 31 March 2023, Housing Services generated £15,041,770 in benefits for 4,007 new and existing tenants, making 6,663 claims for benefits of which 4,542 were claims for Housing Benefit (including Supported Accommodation), Discretionary Housing Benefit and Council Tax Reduction Scheme (which is a direct income for the Council and in the longer term contributes to the sustainability of tenancies). 2.5 Similarly, the TPT, together with Social Work Services completed 18,521 Benefit Checks in 2022/23 generating an income to local residents of £17,930,624, with additional financial gains of £97,294, (benefits, charities, and energy suppliers etc.) generated via Debt Advisors within the FIT. 2.6 The MacMillan Lanarkshire Advice Service is provided by North Lanarkshire Council and provides home visits, telephone interviews, office visits and surgeries in local hospitals. The TPT manages this service. Between 1 April 2022 and 31 March 2023, there were 700 referrals to the service, of which 387 were for DS1500/BASRiS cases (relating to those coping with terminal illness). It should be noted that this is a reduction from previous years, due mainly to cancer services pausing due to coronavirus nonetheless £2,410,332 of income was generated for those residents referred affected by cancer. 2.7 The table below summarises the income maximisation work undertaken throughout the year: Social Work / TPT £17,930,624 Housing Services £15,041,770 Macmillan Lanarkshire Service £2,410,332 Charities, and energy suppliers £97,294 Total £35,480,020 2.8 The TPT and Social Work Service generated 54.38% of the council total, with Housing Services making up the remaining 45.62%. In cost/benefit terms, it is worth noting that
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every £1 invested by the council in income maximisation during 2022/23 generated £27.81 for residents and the local economy. 2.9 The TPT also received 10,337, referrals from Elected Members, MSP’s/MP’s, NHSL and other agencies, for welfare rights advice and information. Appeals 2.10 The TPT restructured in October 2022 and again in March 2023. One of the main changes was the establishment of a Resolutions Team which would provide representation for residents at mandatory reconsideration stage and appeals which is a core element of a Welfare Rights Officer’s work. During 2022/23, Welfare Rights Officers represented at 293 individual claims at the mandatory reconsideration stage with a success rate of 64% and represented residents at 139 appeals (a significant decrease on previous years due to decrease in DWP activity, mandatory reconsiderations, and the impact of coronavirus). 2.11 The overall success rate for Social Security Appeal Tribunals by the Tackling Poverty Team was 81%, which is an improvement on last year and above the national average of 66%. 2.12 Service Users Questionnaires/Surveys to monitor customer satisfaction did not take place during 2021/22 due to coronavirus however the Business Intelligence Team have advised they are currently developing an online consultation tool called SNAP, where surveys can be emailed to a client’s email address / put onto the council website. It is anticipated that this will support this activity going forward and ensure that feedback from customers supports quality assurance and is influential in the continued development of the services. Debt Advice 2.13 The TPT received 1744 referrals for Money Advice/Debt Advice during 2022/23 from residents, elected members, CABx, Health and Social Care Services, Housing Services, NHS Lanarkshire and other Advice and Information agencies. 2.14 The Tackling Poverty Team dealt with 18 Debt Payment Programmes (DPP) and 36 Bankruptcies were awarded. Whilst there has been an increase in the number of Debt Payment Programmes and Bankruptcies, the cost-of-living crisis and people’s circumstances continuing to be unstable has impacted on the number of formal debt solutions being accessed. This year saw a further increase in the number of payment/crisis breaks, variations and revocations being dealt with by the team for current Debt Payment Programme’s. The total debt dealt with was £5,912,307 which was an increase of £827,536. 2.15 The Money Advice, Consumer Advice Project (MACA project) for first and second level primary school pupils is currently being reviewed and updated therefore no sessions were carried out during 22/23. The Future Fridays project for S4-S6 secondary pupils carried out 14 sessions with 46 pupils attending. 2.16 As the Money Advice casework system is being reviewed and updated, the Customer Satisfaction Surveys did not take place in 2022/23 however the new casework system will have a survey facility built in.
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Training 2.17 Throughout 2022/3, the TPT has provided training to Council and External Partners, via online video tools, face to face covering tackling poverty awareness sessions, updates on benefits, welfare reforms and legislation, financial assessments, employment and support allowance, Migrant Workers and other welfare benefits- related subjects. 2.18 The TPT also maintains and updates online e-learning training packages for the Scottish Welfare Fund, Personal Independence Payments and Universal Credit, which are available to all council services, elected members and partners via their online platforms. External Services 2.19 The Tackling Poverty Team commissions and monitors the external services and has carried out monitoring visits of each Citizen Advice Bureaux as outlined in the funding agreement and can provide assurances that each provider is meeting the outcomes agreed in the funding agreement and are providing a quality advice and information service in line with the Scottish National Standards for Advice and Information Providers, their locality profiles and the council’s 5 Strategic priorities. 2.20 The External Services have had 6,532 welfare rights enquiries, 2,708 Housing Advice enquiries with 1,351 referred to other agencies, 6,475 Money Advice enquiries with 2,684 referred to other agencies and completed 4,784 Benefit Checks in 2022/2023, generating benefit income to local residents of £5,267,650m. 2.21 In cost/benefit terms, every £1 invested by the council in External Services during 2022/23 generated £14.36 for residents and the local economy. 2.22 It is important to reaffirm that the council commissions the External Services to provide specific advice and information services (not CAB Services) and that these providers also receive funding from other funders, the above information relates only to activity associated with the funding that these external services receive from the council. Legislative/Policy Changes (Welfare Reforms) 2.23 The UK Government/DWP have now resumed the welfare reform programme, as has the Scottish Government. 2.24 As previously reported, the full impact of the UK Government welfare reform agenda is not yet known as the reforms are still being embedded into the system whilst the number of claimants being migrated from legacy benefits on to Universal Credit increases on an ongoing basis. Full service Universal Credit went live in North Lanarkshire in April 2018. 2.25 DWP have announced that Migration Notices issued will be issued to tax credit claimants from April 2023 and this will be expanding into additional parts of the country by September 2023, with moves to Universal Credit activity taking place in all regions
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of Great Britain, by the end of the financial year, with plans to undertake Move to Universal Credit in all Jobcentre Districts nationwide. 2.26 Migration Notices to tax credit claimants in North Lanarkshire will start from August 2023. 2.27 The UK Government Budget Statement for 2023, introduced some further reforms as set out below: Interventions focus on removing barriers to work for people at any age and career stage. Parents on Universal Credit will be further supported with upfront childcare costs. Boost to employment support for disabled people and those with health conditions building on reforms. Parents, over-50s, disabled people and those with long-term health conditions will have opportunities arising from changes announced in the Budget set to be delivered by the Department for Work and Pensions. 2.28 Overall, DWP measures at Budget represent an investment of £3.5 billion over five years to boost workforce participation and grow the economy. That includes: £2 billion investment in support for disabled people and people with long-term health conditions. £900 million investment in support for parents on Universal Credit. £70 million investment in support for over-50s. £485 million investment in support for unemployed people and people who are on Universal Credit and working fewer than full time hours. 2.29 Further reforms as set out below were announced by the UK Government on, principally to address the impact of fuel price rises: Windfall Tax on Oil and Gas Companies (Levy) of 35% on profits. The tax will be expanded to electricity generators with a levy of 45%. Low Income Families to receive £900 in three payments, £301 in May 2023, £300 during autumn 2023 and £299 in spring 2024 administered by DWP. Pensioners to receive an additional payment of £150 or £300, on top of the Winter Fuel Payment. Disabled people to receive a one off £150 payment in summer 2023. Energy Price Guarantee will remain at £2,500 for the next three months. State Pension and benefit will increase by 10.1 per cent in line with inflation (March 2023). Scottish Social Security Agency and devolved benefits 2.30 A number of benefits have now been devolved to Scotland and the Scottish Social Security Agency are in the process of gradually rolling these out, as detailed below:
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Job Start Payment Implemented 2020 Scottish Child Payment for under 6’s Implemented February 2021. Disability Assistance for Children & Young People Implemented Summer 2020 Children who receive the highest care component of Disability Assistance become entitled to Winter Heating Assistance Implemented January 2021 Disability Assistance for Working Age People Roll out Nationally will be August 2022 Additional payments to carers who look after more than one disabled child Implemented early 2021 Pension Age Disability for Older People Implemented 2021 Winter Heating Assistance (to be called Low Income Winter Heating Assistance) Implemented Winter 2022/23 Cold Spell – Heating Assistance Implemented Winter 2021 Scottish Carer’s Allowance Full national rollout Spring 2024 Employment Injury Assistance Implemented Autumn 2022 Scottish Child Payment for under 16s Implemented November 2022 2.31 Many of these benefits are replacing existing DWP benefits, but with eligibility criteria being broadened and payments amounts increased, in addition to a number of brand- new benefits being created, this is an import raft of reforms which will have the potential to provide a positive impact on the income of the residents of North Lanarkshire. The TPT will continue to maximise the income of residents, ensuring to check eligibility for these new benefits and support applications where appropriate. Scottish Government - Cost of living crisis – Assistance 2.32 The Scottish Government has identified funding of £35 million for a range of new measures, including: doubling the value of the December Scottish Child Bridging Payment to £260 per eligible child. a new £1.4 million Island Cost Crisis Emergency Fund. establishing a joint taskforce with business, COSLA, local authorities and agencies to consider the differing impacts of regulation on business. extending energy advice to businesses by investing £300,000 to expand the services of Business Energy Scotland, while doubling the value of the SME energy efficiency Loan and Cash Back Scheme for energy efficiency to £20,000. new payment break options to help protect those who have agreed to repay debt through the Debt Arrangement Scheme but face unexpected increases in the cost of living. for anyone in receipt of the Scottish Child Payment, an automatic increase to £25 per week will be in place from 14 November. Applications for the Scottish Child Payment will also be open to all eligible under 16s from that date, with all payments backdated to the date of application. the introduction of the new Winter Heating Payment allowance which guarantees a £50 annual payment to around 400,000 low-income households. doubling of the Fuel Insecurity Fund to £20 million in 2022-23, to help households at risk of self-disconnection or self-rationing energy use.
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widening eligibility for the Tenant Grant Fund, to support those struggling with increasing costs. giving local authorities more flexibility to take account of energy bills in their prioritisation of households for Discretionary Housing Payments. We will also increase funding for Discretionary Housing Payments by £5 million. Future Context and Challenges 2.33 In terms of the labour market the story of North Lanarkshire over the last 18 months has closely reflected that of the Scottish and UK markets over that period. Far from the high levels of unemployment and redundancies that were expected to result because of the restrictions placed on the economy by the pandemic, a complete and unprecedented reversal in the labour market occurred in the last 18 months resulting in an inadequate supply of labour and with all sectors struggling to fill existing vacancies and it became clear that a major factor in this shortage of workers was due to people leaving the labour market. 2.34 The North Lanarkshire claimant count, which acts as a measure of unemployment, was 14,415 (6.6%) people in March 2021 compared with 8,225 (3.8%) in March 2020, a 75% increase on the pre-pandemic level. However, in April 2023 it had decreased to 7,940 (3.6%) and average earnings in North Lanarkshire are now above the Scottish and UK averages for the first time. This is good news, but real challenges remain due to levels of economic inactivity. The number reported as ‘long term sick’ in North Lanarkshire has increased from 14,900 in the 12 months up to December 2019 to 26,300 in the 12 months up to December 2022 and the number reported as ‘looking after family/home’ in the council area increased from 8,500 to 9,900 in the same period. While unemployment is lower than pre-pandemic levels the number of people in the workforce in North Lanarkshire has reduced from 174,000 (78.1%) in December 2019 to 157,100 (70.1%) in September 2022. 2.35 Throughout 2023 unemployment is expected to rise again as the UK enters recession and high inflation continues to hinder economic growth. From an employability perspective this simply reinforces the need to continue to support those further from the labour market in North Lanarkshire to gain the skills needed to get a job and continue to work with employers to create opportunities for our unemployed residents, including those who are economically inactive. 2.36 Residents will be migrated to UC full service over the next two years and are expected to fully comply with the UC rules as someone not in employment. This means that they could be sanctioned and lose their UC payments if they fail to follow their Claimant Commitment. 2.37 DWP focus throughout the 2023/24 financial year will be on those households claiming tax credits only (working tax credit and/or child tax credit). Throughout 2024/25, all cases with tax credits (including those on both Employment and Support Allowance and tax credits), all cases on Income Support and Jobseeker’s Allowance (Income Based) and all Housing Benefit cases (including combinations of these benefits) will be required to move to Universal Credit. 2.38 Whilst it is problematic to be absolutely accurate based on DWP information and data with regards to Working Tax Credit from HMRC, it is likely that the minimum number of residents who migrated from their current benefits to UC across the period July 2020 to 2024, will be 49,200, meaning that nearly 65,000 residents will be impacted by Universal Credit and/or other welfare reform changes over the next 2 years with the
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majority being Council tenants in receipt of Housing benefit/Council Tax Reduction Scheme and/or users of IJB Services. 2.39 Despite the potentially positive impact of some of the new benefits listed at 2.2.2 above the biggest emerging issues from April 2023, is the end of the financial measures and supports for coronavirus, along with elements of financial supports for the cost of living crisis and energy costs with fuel prices still higher compared to 2021 and 2022, highest inflation in over 40 years (peaking at 10.1%), real term cuts in wages, benefits and pensions and the National Insurance increase for workers. These have the potential to result in major issues for our community and council services with respect to increased issues with rent/council tax arrears, debt, food poverty, fuel poverty, homelessness, and impact on capacity of Services. 3. Measures of success 3.1 Ensuring and improving the standardised service to all residents and providing a sustainable, responsive, and effective means of quality advice and support to our communities across North Lanarkshire. 4. Supporting documentation N/A Alison Gordon Chief Social Work Officer (Education, Families, Justice and Integrated Practice)
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? No groups will be disadvantaged or excluded through the implementation of the recommendations of the report. Indeed noting, the recommendations presents an opportunity to promote equality and ensure greater access to public services. The current activity of the TPT, Housing Services and North Lanarkshire Health and Social Care Services mitigates the impact of the welfare reform changes within North Lanarkshire and meets the requirements of the Fairer Scotland Duty by reducing inequalities. If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☒ No ☒ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐
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If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? There is a potential impact on the Council’s Corporate Tackling Poverty Risk (which is already a high risk), and the service risks in respect of the Council’s capacity to respond to the challenges arising from the Tackling Poverty (Child Poverty), Welfare Reform Act 2012, the impact of coronavirus and the cost of living crisis, in the terms of Council priorities and Services' activities and assisting residents of North Lanarkshire, principally those currently in receipt of benefits (out of work and in work) and welfare assistance. This risk and the controls which support its management is regularly reviewed and will be supported by the new Tackling Poverty Strategy for 2023-26 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services.
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5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☒ No ☐