IJB Performance Update Q1 2025/26
North Lanarkshire Council · 22 October 2025
Back to IJB Performance, Finance and Audit Committee — 22 October 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 7 SUBJECT: Performance Update – 01st April 2025 to 30th June 2025, Quarter 1 2025/26 TO: Integration Joint Board Performance, Finance & Audit Committee Lead Officer for Report: Morag Dendy, Head of Planning, Performance and Quality Assurance Author(s) of Report Stephen Forrest, Performance Manager DATE: 22 October 2025 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☐ Prepared by: Performance Manager Reviewed by: Senior Manager, Strategy & Performance
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2 3. RECOMMENDATIONS It is recommended that the IJB/IJB PFA Committee: (1) Note the contents of the report and the appendix. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES The Chief Officer has joint quarterly performance review meetings with the Chief Executives of NHS Lanarkshire and North Lanarkshire Council. These meetings are supported by a Chief Executives Performance Framework comprising a range of performance measures taken from across both the health and social work systems, including relevant targets and trajectories for the measures presented. Each quarter there are areas for improvement identified within the performance framework; these are identified using a RAG rating and those measures that are flagged as Red or Amber are subject to improvement or corrective action. The performance review meetings are used as a means for jointly agreeing these actions. 6. CONCLUSIONS The areas for improvement and corrective action identified as RAG Red and Amber are attached as Appendix 1. The areas for improvement identified in Appendix 1 are being progressed as a matter of priority, and progress updates will be reported at future meetings of the Board and the Performance, Finance & Audit Committee. 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 ☒ Yes ☐ No ☐ N/A ☒
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3 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) None. 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 11.21 - Oversight of Performance Activity Low Claire Rae NLC RIA0000460 – Performance & planning High NLC – Social Work/Social care 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 Yes ☐ No ☐ N/A ☒
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4 ☐ 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 The performance information, with the corresponding improvement and corrective actions will enable stakeholder representatives to participate in wider discussion about performance. ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership The performance information, with the corresponding improvement and corrective actions supports locality planning. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
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5 None. 9. APPENDICES Appendix One - Areas for Improvement – 01st April 2025 to 30th June 2025, Quarter 1 2025/26 CHIEF ACCOUNTABLE OFFICER (or Depute) Head of Planning, Performance and Quality Assurance Members seeking further information about any aspect of this report, please contact the following; Stephen Forrest – Performance Manager Stephen.Forrest@lanarkshire.scot.nhs.uk
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6 1. Alcohol Brief Interventions Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Alcohol Brief Interventions North 3047 *annualised 501 482 RED Narrative & Corrective Action The overall Lanarkshire position remains on trajectory to meet annual delivery expectations but performance in North continues to fall short of the targeted level. Four hundred and eighty-two (482) ABI were delivered in Q1, reflecting the ongoing challenges with both activity levels and data capture. A significant difficulty is inconsistent recording across different systems and services. The lack of a single, reliable method of logging activity means that reported figures are almost certainly an undercount. Internal discussions have highlighted the need to improve alignment of reporting processes. At the same time, there is recognition that the overall prevalence of hazardous or harmful drinking has declined at population level and that this is likely to manifest in reduced opportunities to deliver ABIs. While this contextualises the downward trend, it does not negate the need for accurate, consistent data to demonstrate the current level of delivery. Work will therefore continue through Q2 to see how a more robust recording approach can be developed, linking with the national guidance for ABI. 2. Cervical Screening Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Cervical Screening 80% 69.6% 69.7% RED Narrative & Corrective Action Performance remains well below target in all localities and not achieved nationally, which has been the position for several years. Barriers include limited appointment availability, system recording discrepancies between SCCRS and GP systems, and persistent non-attendance. The Inequalities in Screening Steering Group continues to lead improvement work, with targeted awareness events, training for staff, and expanded engagement in early years and community settings. Cervical screening uptake continues to fall short of the national target across all six North Lanarkshire localities. While Airdrie, Bellshill, and Coatbridge demonstrated marginal improvements in Quarter 1, North and Wishaw maintained previous levels, and Motherwell experienced a slight decline. These figures reflect broader national trends, as outlined in the recent Public Health Scotland annual update. Locality Uptake Rate Change from Previous Quarter Airdrie 66.8% ↑ 0.3% Bellshill 68.9% ↑ 0.1%
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7 Coatbridge 67.8% ↑ 0.1% Motherwell 69.6% ↓ 0.2% North 73.2% ↔ No change Wishaw 68.8% ↔ No change The Scottish Cervical Screening Programme Annual Update (published 29 July 2025) confirms a sustained national decline in screening coverage. Scotland-wide coverage has dropped to 63.3% in 2023/24, down from 72% in 2016/17. Lanarkshire mirrors this trend, with coverage falling to 66.4% from 73% over the same period. Key concerns include: A 16% disparity in coverage between the most and least deprived SIMD areas in Lanarkshire. Low engagement among 25–29-year-olds, with uptake at 48.4% in Lanarkshire and 38.2% nationally. Milan data for 2024/25 indicates average uptake of 70% in North Lanarkshire and 72.7% in South Lanarkshire, though variation persists across localities. These figures reinforce the need for sustained, system-wide efforts to improve uptake, particularly among younger and more deprived populations. Locality-Level Improvement Activity A range of initiatives were delivered during Quarter 1 to support cervical screening engagement: In Bellshill, Motherwell & Wishaw/Shotts, Health Improvement teams developed locality-specific action plans, delivered via LPGs. Key actions included: Use of digital screens in public venues to promote screening programmes. Training for Health Visitors using culturally informed resources. Treatment Room staff trained to deliver screening messages. Quarterly data shared with clinical and operational leads. Airdrie locality delivered a coordinated programme of activity during Cervical Screening Awareness Week (19–24 June), which included: Dissemination of information via newsletters and social media. Inclusion of screening materials in “Condoms by Post” packs. Delivery of inequalities training to seven participants. Bellshill locality delivered targeted engagement activity to support cervical screening awareness including: • Submission of the Culture Junction Project resource to Public Health for inclusion in the Scottish Government’s Cervical Cancer Elimination Plan. • Promotion of screening information during the NHSL staff Health and Wellbeing event at the Coddington site. Coatbridge locality implemented a series of communication and outreach initiatives to promote cervical screening: Inclusion of cervical screening messaging in Health Improvement newsletters and delivery of community workshops.
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8 Engagement with CLD groups and Dunbeth Family Learning Centre to share resources and raise awareness. Support for Treatment Room staff to embed screening conversations into chronic disease clinics, resulting in engagement with nearly 40 patients since May. Motherwell & Airdrie localities delivered a coordinated programme of culturally tailored engagement activity to support cervical screening awareness. Initiatives included: Launch of a suite of three educational videos at Bellshill Central Mosque during Cervical Screening Awareness Week (Thursday 26 June), attended by over 70 women. Development of the video resources in partnership with NHS Lanarkshire Public Health, Health Improvement teams, and diverse South Asian communities from Airdrie and Motherwell. Inclusion of cancer screening information at the Motherwell Locality Wellbeing Event on 8 May, hosted at Forgewood Community Centre. The event brought together residents from Motherwell and wider North Lanarkshire to promote positive engagement with health and social care services and was supported by the Airdrie Health Improvement Senior. Wishaw locality focused on embedding screening conversations into routine clinical practice: • Training of the Chronic Disease Management team to deliver cancer screening messages during patient consultations. • A total of 130 screening-related conversations were held this quarter, including 34 specifically focused on cervical screening. Performance Reporting and System Integration Clarification of cervical screening performance reporting continues to be a national discussion point, particularly regarding discrepancies between multiple data recording systems. This issue was raised with Consultant in Public Health for Cancer Screening, who supported the proposal for a single percentage achievement rate that excludes all but defaulters. It was agreed that this recommendation should be escalated nationally to determine whether an existing report could meet this need or if a bespoke report could be developed. Feedback from the SCCRS Senior Programme Manager and National SCCRS Lead confirmed that while the issue has been recognised for several years, system changes are costly and constrained by existing contractual arrangements. The SCCRS system contract is due for review in 2027, at which point this recommendation may be considered. In the interim, Lanarkshire Public Health continues to support practices with lower uptake rates by promoting effective use of defaulter lists. A practical guide has been developed and shared to assist other practices in implementing this approach. HPV Immunisation Programme – Protective Impact Scotland’s national HPV Immunisation Programme, introduced in 2008 and offered to all 12- and 13-year-olds, continues to demonstrate strong protective benefits. A recent study has shown that no cases of cervical cancer have been detected among fully vaccinated women, reinforcing the long-term value of early immunisation. 3. Childhood Immunisations Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same RAG Status
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9 Quarter Previous Year Immunisations – %s of 5 year olds 95% 88.7% 89.6% RED Immunisations – %s of 2 year olds 95% 94.8% 94.8% AMBER Narrative & Corrective Action Uptake of childhood immunisations in North Lanarkshire has historically compared well to the national position, however both immunisation rates are below the performance standard, reflecting a wider downward trend across Scotland. The Q1 results reflect the gradual but sustained fall in uptake. Whilst the result for the 2-year old immunisations metric is below target, there is evidence of sustained performance at the targeted level in the recent past. This position is concerning given the importance of maintaining high coverage to protect population health and ensure herd immunity. The decline is attributable to a combination of factors, including persistent vaccine hesitancy among a small minority of families, access issues linked to missed appointments, and the lasting impact of pandemic-related disruption on routine contact with services. Community vaccination teams continue to work intensively to address the shortfall. Improvement actions include strengthening reminder and recall systems, improving coordination with health visiting teams to promote vaccination at every opportunity, and targeted outreach to families who have not attended. Tailored communication for communities where uptake is lower, with additional support offered to address barriers should also help to improve the position. Sustained effort will be required to reverse the downward trajectory and safeguard the progress made over previous years. To combat the declining trend, NHS Lanarkshire has undertaken the following actions: Streamlined Process: The North East Sector pilot to streamline appointment times and improve cross-cover arrangements. Targeted Clinics: Additional vaccination clinics, including home visits to address accessibility issues. Enhanced Engagement: Health visitors actively discuss vaccinations during pathway visits and use targeted scripts to support consistent messaging. Data Analysis and Oversight: The newly established Area Oversight Vaccination and Immunisation Committee (AOVIC) is conducting comprehensive data reviews and identifying systemic changes required to maintain uptake above 95%. These efforts reflect a continued focus on improving immunisation uptake, reducing inequalities, and preventing outbreaks to safeguard the health of Lanarkshire’s population. 4. 6 – 8 Week Reviews Target 2025/26 2024/25 Q2 2024/25 Q3 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Percentage of people who have completed 6-8 week review 90% 83.4% 85.4% ... RED
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10 Narrative & Corrective Action Please note that the data for this metric is presented in arrears, two quarters behind. Performance for 6-8 week child health faces continued challenges in meeting the target of 90%. Whilst there appears to be some stability in the level of performance, it is significantly below the consistently high levels achieved pre-pandemic. The main pressures continue to be capacity within health visiting services, alongside the complexity of engaging families who face socio-economic barriers. Some missed reviews also relate to parental choice or difficulties in arranging attendance within the required timeframe. In response, services have focused on strengthening recall and follow-up processes, with local teams undertaking more proactive contact with families to encourage engagement. Targeted support in areas of lower uptake, in the form of community-based interventions designed to make access easier and reduce non-attendance, is ongoing. Recruitment and retention of health visitors also remain a priority, with efforts continuing to stabilise the workforce and support delivery capacity. Improvement work will continue during Q2, with an expectation that a combination of enhanced recall systems, workforce stabilisation, and stronger community engagement will lead to some incremental gains. However, the service acknowledges that sustained effort will be required to restore performance to the standards targeted. Action Timescale Expected Impact on Indicator Implement notification process for missing forms TBC Reduce incomplete records Test and evaluate Elsie App TBC Reduce DNAs, improve attendance recording Maintain GP practice engagement programme Ongoing Increase form return rates Embed SOP across all localities TBC Standardise processes, reduce variation Complete UHVP digital recording scoping TBC Improve timeliness and accuracy of reporting 5. Assistive Technology Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status
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11 Assistive Technology - Number Of People With Technology (0-17 yrs) 1452 33 22 RED Assistive Technology - Number Of People With Technology (18-64yrs) 622 270 RED Assistive Technology - Number Of People With Technology (65+) 912 673 RED Narrative & Corrective Action This indicator is currently RAG-rated red. However, the significant decrease in the reported number of individuals with Assistive Technology does not reflect an actual reduction in provision. Instead, it is due to a substantial change in how the data is recorded. Previously, the figure of approximately 1,500 recipients was derived using a methodology developed several years ago. With the transition to using ELMS2 and Mosaic, this legacy method is no longer appropriate, as it does not align with current data recording practices. While ELMS2 is now the primary data source, it must be linked with data held in Mosaic for reporting purposes. Additionally, historical data remains in legacy systems such as SWIS and MICES. Our initial analysis revealed that not all recipients of Assistive Technology are captured in the ELMS2 data, and several cases have been identified where individuals receiving Assistive Technology are missing from ELMS2. It is unclear whether this is due to issues with data migration, and further work is underway to assess the scale of the problem. We have also identified that individuals receiving Assistive Technology through Self-Directed Support (SDS) budgets are unlikely to be recorded in ELMS2, despite receiving equipment. For internal reporting, the legacy methodology consistently identified around 1,500 recipients. A new method has now been developed to interpret ELMS2 data, resulting in a revised figure of approximately 970. This new approach excludes deceased individuals and care home residents; groups that could not be reliably excluded using the legacy data. However, this introduces challenges in terms of comparability and accuracy, as we know that some recipients are still not captured in the data. To improve the reliability and completeness of reporting, several actions are required. A priority action is to ensure that IEAS records include either the SWIS/Mosaic number or CHI as a mandatory data field. External reporting requires the ability to index and match individuals across multiple services, which depends on a unique identifier. Currently, ELMS2 does not mandate inclusion of SWIS/Mosaic or CHI numbers, and addressing this gap is essential. Further work is also needed to understand how Assistive Technology provided through SDS is recorded internally, and to clarify what should be included or excluded in future reporting. 6. Reablement and Rehabilitation Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same RAG Status
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12 Quarter Previous Year Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 1788 317 ... RED Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 63.0% 62.4% RED Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 62.5% 65.3% RED IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 73.4% RED Narrative & Corrective Action The indicators for Reablement presented in the CE Scorecard have not met the targeted levels of performance. During 2023/24, the number of people completing the Reablement process increased, however in 2024/25 there has been a reversal of this trend. The percentage of new or increased Home Support packages that are Reablement is relatively stable in a range, around but below, the targeted level of 70%. However, the percentage of people with no, or reduced Home Support at the end of the Reablement process has failed to meet the targeted level of performance for some time. Home Support Redesign The Home Support Redesign Programme is focussed on Home Support that achieves individual outcomes for people using the service and their families. The redesign is based on core principles that are aligned with B2B, SDS and developments in Hospital Flow. It is supported by several products that have been produced to progress the work, including service specifications, a workforce profile and an analysis of demand/capacity data. The proposal is for a “Living Well” service that provides Home Support to achieve individual outcomes for the people using the service and a distinct “Assessment & Planning” service, to include Rehabilitation and Reablement services, ensuring that people receive a holistic assessment of their need and are provided with the most appropriate services to meet the individual outcomes. IEAS - % Deliveries Achieved Within 7 Working Days Quarterly Performance improved in Q4, rising to 73.4% from 60.1% in Q3. While this marks a positive trend, it remains below the 80% target. The improvement reflects ongoing efforts to embed service transformation and fully implement the new priority-based delivery framework. Since December 2024, the service has operated under a four-level prioritisation model, which has shifted focus toward higher-priority deliveries (P1 and P2). Consequently, P3 orders have significantly reduced, and backlogs in lower-priority categories are now being addressed in a more structured and consistent manner. The service continues to engage with teams to support appropriate ordering and effective signposting. Service capacity remains under pressure due to vacancies, absence and holiday cover, impacting on the ability to process new orders. Despite these operational challenges, the service continues to advance its transformational agenda. ELMS2 is now live and in use, however there are ongoing refinements in process aimed at improving reporting capabilities and system integration. The availability of ELMS2 data supports the development of new KPIs that align with the priority model. However, as noted in the earlier commentary on Assistive Technology, significant work is still required to ensure that data recording processes enable linked reporting across systems, particularly the recording of a Mosaic ID, or CHI as a unique reference for index/match of data across systems.
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13 7. Adult Mental Health Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status 18 Week RTT Performance – Psychology (NHSL) (NORTH HOSTED) 90% 75.0% 75.6% RED Consultant Outpatient WT - Adult Mental Health - 12wks (NHSL) (NORTH HOSTED) 90% 21.8% 20.8% RED Consultant Outpatient WT - Older Adult Psychiatry - 12wks (NHSL) (NORTH HOSTED) 90% 66.2% 71.5% RED Narrative & Corrective Action 18 Week RTT Performance – Psychology (NHSL) (NORTH HOSTED)
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14 The current performance is consistent with the DCAQ modelling produced by the PHS Analyst; the current modelling suggests that the RTT position will be within a range of between 70% and 80%, based on the overall position for the service. The RTT performance reflects the refreshed criteria, with self-referral digital interventions now excluded from the calculation. Were digital therapies to be included, an approximate 10% increase in performance would be realised. The total number of patients waiting over 18 weeks has decreased significantly over the last 12 months (there has been a 22% reduction in the total waiting list and 37.2% reduction in over 18 week waits). The total queue is less that the anticipated trajectory, indicating sustained progress in reducing the waiting. Referrals for Neuropsychology continue to increase; our modelling indicates that if current trends continue, the volume of referrals will result in the waiting list reaching 175.1% of its current size by November 2026. To meet the RTT (Referral to Treatment Time) target under these conditions, an additional 4.25 WTE (Whole Time Equivalent) clinician capacity would be required. An SBAR detailing potential options and the management of risk in this area is in escalation through the appropriate governance structures. Consultant Outpatient WT - Older Adult Psychiatry - 12wks (NHSL) (NORTH HOSTED) Since August 2023, the service has been operating with limited Consultant capacity in Older Adult Psychiatry. This is due to maternity leave and vacancies across the team. Recruitment to Specialty Doctor posts is a significant challenge, despite persistent effort to fill these roles. Whilst vacancies remain, existing staff continue to providing best cover for rota sessions to maintain service continuity.
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15 To reflect the reduced availability of Community Consultants for routine outpatient work, the service made a series of internal rota adjustments. These changes have contributed to longer patient waiting times, as Consultants have necessarily had to scale back community clinical activity to support rota coverage for vacant posts. Increased demand; driven by changing community demographics, impacts on the service’s ability to meet targets. However, as staffing capacity improves, waiting times should improve in-line with the increased capacity. To help manage current pressures, local teams are running closely monitored ad-hoc clinics to ensure the best possible balance between demand and available capacity. Consultant Outpatient WT - Adult Mental Health - 12wks (NHSL) (NORTH HOSTED) Staff recruitment, retention, and development continue to present the most significant challenges for the Adult Mental Health service, particularly within General Adult Psychiatry (GAP). The ongoing imbalance between demand and capacity, alongside staffing instability, severely affects the service’s ability to meet waiting time targets. As noted in previous reporting, a review of the Clinical Director model highlighted that General Adult Psychiatry (GAP) has been operating with an approximate 50% vacancy rate, demonstrating the scale of the challenge. The Programme Board for Mental Health, Learning Disabilities & Addictions (MHLD&A) services is actively working on addressing medical staffing shortages while simultaneously considering changes to traditional psychiatry working practices. This includes exploring new models of practice such as the introduction of Advanced
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16 Nurse Practitioner (ANP) roles within the community to support Community Mental Health Teams (CMHTs) and reduce reliance on medical staff. While the primary focus remains on tackling staffing gaps, these innovative approaches could also help attract new talent to the service. Several initiatives are underway to address these staffing challenges, including: Ongoing recruitment efforts in partnership with HR and wider advertising for vacant posts. Collaborations with the Centre for Workforce Supply in Scotland, recruitment agencies, and exploration of pathways for International Medical Graduates (IMGs), alongside novel marketing strategies. Discussions with Medical Education regarding additional higher trainee placements. Increased use of Extra Planned Activities to enable current staff to cover service gaps. However, given the current workforce situation, most of these initiatives are expected to produce medium to long-term improvements rather than immediate results. These actions are crucial for ensuring the future stability of the service. The service has written an Options Appraisal (OA) to guide the future direction of General Adult Psychiatry Services. The OA paper offers various solutions that can be adapted based on integrated, cross-disciplinary tests of change and outlines six key recommendations to drive service transformation: Formation of a Programme Board to review the GAP service model and develop a sustainable, cross-discipline workforce aligned with the Scottish Government’s Adult Secondary Mental Health Services Quality Standards. Maximisation of recruitment and retention efforts by supporting the current workforce and absorbing high-cost locums into permanent NHS roles. A comprehensive workforce review across all disciplines within GAP services, including expansion of the ANP pilot into CMHTs and a review of Psychological Therapy Teams. Engaging with referrers, patients, and carers to ensure appropriate access to services. Creation of clear guidance for transitions between primary and secondary care GAP services, and between different sub-specialities within Mental Health & Learning Disability Services. Reliable statistical modelling to support longer-term workforce planning to ensure services meet population demand. In parallel, the General Manager is working closely with the Clinical Directors on a focused piece of work to assess Demand, Capacity, Activity, and Queue (DCAQ) within GAP and Older Adults Psychiatry. The preferred model for GAP services in North Lanarkshire involves a functional split between inpatient and outpatient care, with dedicated consultants for each ward. This model, which is favoured by stakeholders and aligns with broader trends in Scotland, aims to provide psychiatrists with protected time to focus on either inpatient or CMHT responsibilities, improving consistency, responsiveness, and stability within these services. It also simplifies job planning and reduces the need for the Duty AMP
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17 role, improving service efficiency. As the OA is still under review, these recommendations may evolve, however the service will communicate the development of this widely with stakeholders as the work progresses. 8. Medical Paediatrics Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Medical Paediatrics WT - 12 wks (NHSL) (NORTH HOSTED) 90%* 80.3% 76.0% RED Narrative & Corrective Action The SCHSU Service Manager represents the unit at the Acute Weekly Planned Care Group that has a focus on longest waits (more than 52 weeks). A Plan on a Page Report is updated weekly to reflect progress to date. Going forward, this will be shared with Chief Officer. This is complemented by the SCHSU’s newly established Paediatric Service Improvement Group that reports into the Unit Performance Meeting. This group has representation from medical, professional nursing leadership and admin colleagues. It will be responsible for the delivering improvements in performance. The service improvement group has identified several areas of focus that should collectively expedite process. These include: Clearance of backlogs –Support to discharge for identified groups (melatonin, 16). Release capacity for T21 annual reviews, neonatal transfers. Review ratios of new: return patients including a review of Registrar Clinic (increase of new apt capacity with supervisory oversight from Consultant) Review of Registrar clinic. Review of Child not Brought Policy – Offer Tel Triage post first non-attendance. Only rebook if family engages and/or there is another identified vulnerability. Clarity and consistency in vetting process. To support this: Booking to be centralised to SCHSU Waiting List Team- additional scheduler will be required for delivery of ToC. Good housekeeping/reporting via WL Team/Weekly planned care meeting and Unit Performance Management meeting. Trakcare build – WLI. Trajectories for Community Paeds in progress of being built to evidence delivery of new process model. Validation process planned for September 2025. Professional Support required to:
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18 Identify scope and span of new roles that will support wider changes to model (in particular for continence and sleep referrals). Consultants reviewing current capacity against job plan. Review of apt times and length for new and return patients. 9. SLT Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status SLT - Paediatrics - 12wks (NORTH HOSTED) 90%* 17.6% 42.7% RED SLT - Adult - 12wks (NORTH HOSTED) 90%* 79.2% 82.8% RED Narrative & Corrective Action SLT - Adult - 12wks (NORTH HOSTED) Performance for Q4 again improved from the previous quarter (rising to 82.8%) but remains below the 90% target. As previously reported, the end of post-COVID recovery funding continues to have an impact. Although no posts were lost, due to recruitment challenges overall staffing levels in the Adult Acquired service remain reduced compared to the previous year. The service continues to experience long-term sickness absence, further constraining capacity. Referral demand remains elevated, with high levels of referral demand sustained for several quarters. Recruitment efforts are progressing, with a focus on restoring lost capacity. Opportunities for longer-term system improvement, such as the administrative skills matrix and digital system alignment (notably Trakcare), are progressing in line with broader SLT transformation work. SLT - Paediatrics - 12wks (NORTH HOSTED) Although the performance remains significantly below the 90% target, in Q1 of 2025/25 there was a significant improvement, with compliance with the twelve-week standard increasing from 17.6% to 42.7%. The long-standing performance challenges reflect ongoing capacity constraints and structural workforce issues. As a result, the service will deliver a modernisation programme to deliver sustainable change. The well-established SLT CYP Service Improvement Programme has multiple work streams in place to address equity, efficiency, and quality of care: Digital – developing e-referral processes, improved clinical documentation, and text-based communication with families to reduce DNAs and improve access. Waiting List – reviewing and amalgamating lists, standardising pathways, and ensuring that children and young people (CYP) receive universal input while waiting for targeted or specialist input.
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19 Workforce & HR – aligning job plans and skill mix, supporting a confident, skilled workforce through structured learning plans. Administration – this work stream has completed a skills matrix and implemented targeted training, with Admin now integrated into the other improvement groups. Communication – supporting the production of a Communication and Engagement Strategy and Equalities Impact Assessment to underpin change. These efforts are designed to release clinical capacity, strengthen data quality, and ensure a consistent, evidence-based approach to care delivery. Importantly, the revised model reflects a broader ambition to reconfigure teams across North and South Lanarkshire, reduce variation, and improve the responsiveness of the service. Recruitment and retention remain critical to delivery, however activity continues to impact positively on vacancy management and contributes to the improvements in performance for this quarter. The service is also preparing trajectory-based forecasts for each tier of intervention to support planning and demonstrate progress toward the 90% target. 10. Dietetics Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Dietetics - 12wks (NORTH HOSTED) 90%* 62.5% 69.8% RED Narrative & Corrective Action A structured improvement programme is now underway to enhance service delivery and waiting list management. This includes a recent waiting list validation exercise, followed by the implementation of a rolling three-monthly validation process to ensure ongoing accuracy and a more effective oversight of the waits. The service is actively addressing data inaccuracies within TrakCare, and previously discontinued waiting list coordination practices have been reinstated. Standard Operating Procedures (SOPs) are currently in development, with staff training planned to support the implementation of these changes. To increase capacity, a Waiting List Initiative has been introduced, providing an additional 12 adult clinic appointments and 8 domiciliary telephone consultations per week. This is complemented by an expanded paediatric provision. In parallel, the service is progressing a broader transformation agenda, which includes: Modernising systems and processes Streamlining referral pathways Embedding new ways of working to support sustainable service delivery
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20 An interim target of seeing 70% of patients within 12 weeks was set for June 2025 and was almost achieved (69.8%). However, workforce resilience remains a key risk, with the service’s highly specialised configuration vulnerable to staff turnover. To support long-term sustainability, work is ongoing to explore the potential of a more generalist model of dietetic provision, which may offer greater flexibility and resilience across the service. 11. Complaints Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Complaints Processed 20 Working Days (NHSL) 50% 38% 34% RED Narrative & Corrective Action As previously reported, the performance targets for processing complaints have been revised for both Stage 1 and Stage 2 complaints. While the response timescales remain unchanged, the compliance targets have been adjusted. Specifically, the new target for Stage 2 complaints is for 50% of them to be responded to within 20 working days. As performance is measured as a percentage compliance metric, it can be significantly impacted by a small number of complex or non-compliant cases. For NHS Lanarkshire overall, performance has improved but remains below the 50% target. The majority of delays are attributed to system-related issues, with the late receipt of statements being the most significant contributing factor. To support improvement, additional permanent resource has been added to the NHSL Patient Affairs team as of June 2025, which is expected to enhance response times in future quarters. Within the partnership, the Senior Management Team continues to promote early resolution of complaints at Stage 1. Stage 2 delays are actively monitored, with escalation triggered where necessary. As a balancing measure, University Health and Social Care North Lanarkshire published 46 patient stories in May 2025, of which 38 (83%) reflected a positive experience. 12. Smoking Cessation Target 2025/26 2024/25 Q2 2024/25 Q3 Performance Compared to Previous Quarter Performance Compared to Same RAG Status
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21 Quarter Previous Year Sustain and embed successful smoking quits, at 12- weeks post quit, in 40% of SIMD areas. (AOP) (NORTH HOSTED) 902 110 166 ... ... RED Narrative & Corrective Action Please note that the data for this metric is presented in arrears, two quarters behind. All - North locality data April to December 2024/25 Q1-3 (40% most deprived) Locality Number of Quit Date Set (QDS) Number of 12 week quits 9 month target +/- RAG on Target % 12 week quit success % Lanarkshire rate Airdrie 118 16 68.3 -52.3 23% 14% 22% Coatbridge 120 40 56.3 -16.3 71% 33% 22% North 102 24 60.8 -36.8 40% 24% 22% Bellshill 146 20 68.3 -48.3 29% 14% 22% Motherwell 132 18 47.3 -29.3 38% 14% 22% Wishaw 132 22 61.5 -39.5 36% 17% 22% Please note: Table 1 includes both specialist and community pharmacy services The table above shows the number of successful 12 week quits against the target for North localities. A six-month time lag is present, per the reporting schedule. Based on the most recent data, NHS Lanarkshire as a whole is projected to achieve 49% of its Local Delivery Plan (LDP) target set by Scottish Government (438 of 902 successful 12 week quits). Specialist - North locality data April to December 2024/25 Q1-3 (40% most deprived) Locality Number of Quit Date Set (QDS) Number of 12 week quits 9 month target +/- RAG on Target % 12 week quit success % Lanarkshire rate Airdrie 20 9 21 -12.0 43% 45% 53%
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22 Coatbridge 28 17 21 -4.0 81% 61% 53% North 14 8 17.3 -9.3 46% 57% 53% Bellshill 16 6 14.3 -8.3 42% 38% 53% Motherwell 21 11 18.8 -7.8 59% 52% 53% Wishaw 22 13 18.8 -5.8 69% 59% 53% Please note: Table 2 includes community, pregnancy and mental health only The Specialist table above shows the number of successful 12 week quits against the target for the QYW Specialist service only. Again, a six-month time lag is present, per the reporting schedule. Table 3: Pharmacy - North locality data April to December 2024/25 Q1-3 (40% most deprived) Locality Number of Quit Date Set (QDS) Number of 12 week quits 9 month target +/- RAG on Target % 12 week quit success % Lanarkshire rate Airdrie 98 7 47.3 -40.3 15% 7% 15% Coatbridge 118 3 47.3 -44.3 6% 3% 15% North 106 32 39.0 -7.0 82% 30% 15% Bellshill 116 12 33.0 -21.0 36% 10% 15% Motherwell 81 13 42.0 -29.0 31% 16% 15% Wishaw 110 9 42.8 -33.8 21% 8% 15% Key Issues for Q1 2025/2026 QYW Stop Smoking Service In Q1, significant reduction in staff capacity due to high levels of both short and long-term sickness absence continued, which has affected the completion of the mentoring programme intended to increase service delivery capacity. The number of referrals into the Specialist Community QYW service remains low and of those referred, the number of those that then go onto set a quit date, is also low. North Lanarkshire localities have seen a 12.9% drop in referrals (excluding self-referrals) for Q1, Q1 2024/25 (139) vs Q1 2025/26 (121). QYW Community Pharmacy Service
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23 The main issues identified from visits by the pharmacy support team to community pharmacists during Q1 concern Patient Care Record (PCR) entries and logins, staff training and Nicotine Replacement Therapy product (NRT) queries. There are discrepancies in the completeness and accuracy of data entered into the PCR system and these gaps may be affecting the accuracy of performance reporting submitted to the Scottish Government. In 2024/25 (Q1-3), for all pharmacies residing in North localities, there were 1047 QDS (All SIMD): Four-hundred and ninety-four - (494) clients (63%) had no smoking status recorded at their 4-week follow-up (i.e., a blank follow-up). Seventy - (70) clients (23%) who had a successful quit at their 4-week follow-up had no smoking status recorded at their 12-week follow-up (i.e., blank follow- up). Key Actions for Q2 2025/26 QYW Stop Smoking Service- The Lanarkshire’s Tobacco and Vaping Programme Plan (2024–2026), starting on 1st April 2025, is supported by detailed Tobacco and Vaping Action Plans. The priority areas including: Pregnancy, Secondary Care, Mental Health and communities within the 40% most deprived areas. The Tobacco and Vaping Steering Group have reviewed the content of the plans. The redesigned Quit Your Way (QYW) went live on 1st April 2025. The services has approval to recruit two full-time, fixed-term Health Improvement Practitioner posts for a duration of 23 months. These posts will focus on supporting inpatients and individuals living in the 40% most deprived areas of Lanarkshire. Health Improvement staff continue to maintain a visible presence across the three secondary care sites. This has contributed to an increase in the conversion rate from referrals, to patients setting a quit date while in hospital, compared to quarter one of the previous year. Uptake of the Smoke-free app by staff remains low. However, promotional efforts are ongoing and the opportunity to engage with the app remains available. A productive meeting with Health and Social Care Partnership (HSCP) colleagues took place on 17th April 2025 to explore ways to increase referrals to the QYW service from Allied Health Professionals in North Lanarkshire. As a result, further meetings with Integrated Rehab Teams and Service Manager Team Meetings in Wishaw and Coatbridge will take place. These meetings aim to raise awareness of the QYW service, clarify referral pathways and identify training needs. QYW Community Pharmacy Service
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24 QYW Pharmacy Support Team will continue to carry out visits to community pharmacies across Lanarkshire to improve data recording and service performance across the QYW Community Pharmacy Service. The service prioritises visits to Community pharmacies where our data analysis has highlighted poor performance. Following a successful commissioning process, JRS, a research consortium comprising Jump Research, RedTree Research, and the Social Marketing Gateway, secured funding to lead a research project that includes a desktop review and the development of research tools. The project will launch in partnership with community pharmacies in August 2025. A briefing document is being finalised to serve as an internal briefing to direct consultation with clients who have used the QYW Pharmacy service in order to understand when, why and how clients use pharmacies to quit, and their expectations and experiences of the service. Discussions will continue to take place with the Community Pharmacy Lead in relation to a shared care agreement between Community Pharmacy and NHS Lanarkshire QYW specialist services. 13. Sickness Absence Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Sickness Absence (NHSL, North) 4% 7.45% 7.09% RED Narrative & Corrective Action Despite ongoing efforts, sickness absence remains an issue and the wider NHSL Board remains above the national average for this metric. Sickness absence remains above the 4% standard, consistent with wider national pressures across the health system. The main drivers continue to be musculoskeletal conditions and stress-related absence, both of which likely reflect the sustained operational pressures faced by frontline services. Improvement activity during Q1 centred on supporting early interventions and return-to-work processes. Managers are encouraged to use occupational health services proactively and ensure early referral where appropriate. Targeted wellbeing initiatives also remain in place, with ongoing promotion of resources such as the Staff Wellbeing Hub and psychological support services. While improvement will be gradual, the Partnership will continue to prioritise sickness absence reduction through enhanced management action, robust monitoring, and targeted interventions.
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25 14. Addictions Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Addictions – Ongoing Waits NHSL 90% 94.4% 89.7% … AMBER Narrative & Corrective Action In May 2021, the Drug Deaths Taskforce introduced ten standards of care for Medication Assisted Treatment (MAT), forming the foundation for Scotland’s National Mission on Drugs (2022) and the National Strategy for Community Justice (2022). A national benchmarking report published by Public Health Scotland tracks progress across all 29 Alcohol and Drug Partnership (ADP) areas as of April 2025.A DPs submitted evidence across process, numerical, and experiential domains, which informed a composite RAGB (Red, Amber, Green, Blue) rating. The 2024/25 report shows continued national improvement: 91% of ADPs fully implemented MAT standards 1–5 (up from 17% in 2021/22) 75% achieved full implementation of standards 6–10, with 16% nearing completion. This reflects a strong national commitment to innovation, collaboration, and continuous improvement. RAGB Colour | Definition Colour Definition Red There is no or limited evidence of implementation of the standard in MAT services Provisional amber There is no or limited evidence of implementation of the standard in MAT services Amber There is evidence of partial implementation of the standard in MAT services including benefit to people Provisional green There is evidence of implementation and benefit to people, however, full implementation is not confirmed by all three evidence streams – usually the experiential stream is lacking Green There is evidence of full implementation and benefit to people in all unique combinations of setting and service that offer MAT and opioid substitution therapy (OST) across the ADP area
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26 ADP Reporting Year MAT 1 MAT 2 MAT 3 MAT 4 MAT 5 MAT 6 MAT 6 & 10 MAT 7 MAT 8 MAT 9 MAT 10 North Lanarkshire 2022 2023 2024 2025 North Lanarkshire has made significant strides in delivering effective Medication Assisted Treatment (MAT). The Urgent Response Team has enabled rapid access to care, with 81% of referrals assessed and prescribed within 24 hours, surpassing national benchmarks. Treatment options have diversified, with a notable reduction in methadone and oral Buprenorphine prescribing, and a 27% increase in long-acting injectable Buprenorphine, reflecting a more patient-centred approach. Assertive outreach, led by Turning Point Scotland, has been particularly impactful, with 341 crisis interventions - the highest in Scotland, meeting national standards. Harm reduction efforts have also expanded, with over 4,000 interventions recorded using a bespoke tool that allows for locality-specific service tailoring. Retention in care is another area of strength, with 94% of Alcohol Response Team (ART) service users remaining engaged for over six months, supported by the NEO system for pharmacy monitoring. Psychological and trauma-informed care is well embedded, with clear implementation plans and comprehensive training across commissioned services and ART teams that exceed national expectations. Advocacy and social support have been enhanced through increased team awareness and expanded service capacity, contributing to a more holistic support system. However, challenges remain. Integration with primary care is limited, as no OST prescriptions have been issued through general practice, unchanged from the previous year, restricting access to MAT via general health services. Mental health support is available only to a small cohort, and joint care pathways are still under development by a Pan-Lanarkshire steering group. The sharp rise in long-acting Buprenorphine prescribing, while beneficial, may place strain on resources and requires strategic planning to ensure sustainability. Additionally, the absence of a formal system to record when advocacy is offered limits visibility into service uptake and impact, highlighting the need for improved data capture mechanisms. The true impact of ongoing implementation will be demonstrated through measurable outcomes. Encouragingly, a reduction in drug-related deaths has already been observed this year. These figures will be reflected next year as we always report a year behind. The data presented at 1.10 reflects a pan-Lanarkshire overview, which indicates that regional services are currently falling short of meeting the prescribed waiting time targets. However, a more focused analysis of North Lanarkshire, specifically the Alcohol Response Team (ART), reveals a markedly different picture. Drawing on performance data from IM and DAISy (1.9), North Lanarkshire has consistently exceeded the 90% compliance threshold for waiting times. This success is underpinned by a revised engagement strategy, which includes a clinic-based service delivery model and the introduction of weekly audits to monitor adherence to the 21-day standard across all teams.
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27 15. Unscheduled Care Target 2025/26 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status A&E Attendances - NL Residents 116,456 30,541 28,896 … AMBER Emergency Admissions - NL Residents 44,001 11,974 Quarterly/ 2 quarters behind … AMBER Narrative & Corrective Action Please note that the data is presented in arrears; for A&E Attendances, one quarter behind and Emergency Admissions, two quarters behind. Both UHM and UHW continue to experience challenges that impact on length of stay, delays to admission and delays to first assessment. The issues include a high number of patients not meeting the criteria to reside, a high volume of patients with a length of stay in excess of 14 days, a continued reduction in bank and agency fill rates and unplanned staff sickness absence. Performance against the targets for the four, eight and twelve hour breaches remain below the local improvement trajectory and the national targets for these metrics. A number of actions are either complete, or work in progress to improve the overall position for A&E and wider capacity and flow. Surge capacity is now in use at all three acute sites. Criteria to Reside Audits, Flow navigation, oversight and virtual ward pathways are in place to support a more consistent delivery of the Target Operating Model. The significant reduction in homecare delays and general improvement in both discharge processes and flow have contributed to an overall reduction in occupied bed days and number of patients over 14 days. 16. Training and Development Target 2025/26 2024/25 Q4 2025/26 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Employee Code of Conduct 80% 84.5% 78.4% AMBER Introduction to Risk Management 80% 82.2% 79.2% AMBER Prevent 80% 82.1% 79.8% AMBER
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28 Records and information management 80% 79.3% 75.8% AMBER Fire Safety Training 90% 90.0% 89.6% AMBER Hand Hygiene Training 90% 88.6% 87.5% AMBER TURAS compliance (NHSL, North) 80% 71% 79% AMBER Narrative & Corrective Action Mandatory training and TURAS compliance remain a priority across the Partnership, with continued close monitoring at SMT level and monthly circulation of management data to identify individuals requiring additional support. Improvement efforts remain focused on enhancing access to e-learning and in-person training opportunities, with particular emphasis on LearnPro modules where uptake continues to lag. During Q1, local Performance and Quality Coordinators provided targeted team-level analysis to highlight areas of low compliance and support remedial action. Managers continue to review compliance as part of routine performance discussions, with a focus on early escalation of risks and ensuring that new staff complete mandatory modules promptly during their induction period. The emphasis for 2025/26 is on embedding a more proactive approach to appraisal planning, ensuring appraisals take place throughout the year to avoid a spike in activity at year-end. Preparatory work has begun on developing standardised objectives tailored to role and level, to improve consistency across appraisals and strengthen alignment to the service priorities. Next steps include further development of the management information system to improve accessibility of compliance data, alongside continued partnership with OD and training colleagues to ensure adequate opportunities for staff to complete required learning.
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29 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