Appendix 4 - HSCP Transformation Programme Update - 23 Feb 26
Perth and Kinross Council · 22 April 2026
Back to Finance and Resources Committee — 22 April 2026 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Perth & Kinross Integration Joint Board Audit and Performance Committee Date of Meeting: 23 February 2026 Title of Report: Transformation Programme Update Report Number: G/26/11 Report by: Jacquie Pepper, Chief Officer Report Author: Christopher Jolly – Service Manager Business Planning and Performance Contact: tay.pkijbbusinesssupport@nhs.scot ________________________________________________________________________ 1.0 Executive Summary The HSCP Transformation Programme has delivered significant improvements through the initial phase of transformation projects referred to as “the Big Six” and is now progressing with phase 2. This includes the creation of new projects, the re- scoping of others, and the continuation of others to meet the challenges faced. These are being developed through a ‘Portfolio Management Office’ approach which aligns systematically to the approach taken in Perth and Kinross Council. This will ensure continued strong governance, greater alignment between partners and improved readiness for collaboration. 2.0 Recommendations The Audit and Performance Committee (A&PC) is asked to: Note the achievements delivered through the initial ‘Big Six’ transformation projects. Note adoption of a Portfolio Management Office approach which aligns to that take by Perth & Kinross Council. Request an update on progress made within Phase 2 of the Transformation Portfolio on a six monthly basis. 3.0 Alignment To Strategic Plan Priorities and Ambitions The update and proposal(s) within this report demonstrate progress in delivering on the Perth and Kinross IJB Strategic Plan 2024-27 Priorities and Ambitions as below: Appendix 4
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Our Priorities 1 Target resources to where people and communities need help most. ☒ 2 Make it easier for people to understand where and how to access services. ☐ 3 Provide health and social care supports close to home. ☒ 4 Work with communities to design the health and social care supports they need. ☒ 5 Improved Integrated Working. ☒ 6 Promote Self-management and Living Well. ☐ 7 Value our workforce, support them to keep well, learn and develop. ☐ 4.0 Alignment To Service Renewal Framework Transformation Portfolio development is geared towards tackling current and future service demand and aligns to the principles set out in the Scottish Government’s Health and Social Care Renewal Framework 2025-2035 as follows: Key Principles for Renewal 1 Prevention: Prevention across the continuum of care ☐ 2 People: Care designed around people rather than the ‘system’ or ‘services’ ☒ 3 Community: More care in the community rather than a hospital-focussed model ☒ 4 Population: Population planning, rather than along boundaries ☐ 5 Digital: Reflecting societal expectations and system needs ☐ 5.0 Background - Evolution of the Transformation Programme The HSCP Transformation Programme was established to redesign key areas of health and social care services in Perth & Kinross, responding to rising demand, financial pressures, and sustainability challenges. The programme began with six priority projects—the ‘Big Six’—which focused on critical areas of service delivery. These projects have now concluded or evolved, delivering significant improvements in outcomes and efficiency. In 2025, the programme transitioned to a structured Programme Management Office (PMO) approach, aligned with PKC methodology. This strengthens governance, introduces standardised tools and templates, and ensures agility while maintaining robust oversight. 6.0 Proposal/Main Issues - Achievements to date The initial phase of transformation focussed on areas of highest importance at the time and delivered measurable improvements across key service areas. The following provides a high level overview in respect to each project within Phase 1: 6.1 The Optimising Independence and Quality of Life for Older People at Home Project focused on care at home provision, remodelling and optimising internal
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service delivery, internal processes to improve access, workforce optimisation, and the re-procurement of externally delivered services. This introduced alliance contracting allowing providers greater opportunity to support one another and respond to peoples’ evolving care needs. The project reduced unmet need from around 1,200 hours per week to 350 hours per week. Access to reablement support has also improved with people in hospital waiting under 5 days for reablement support compared to around 9 days in 2024. For people in the community, the wait on average now is 10 days compared to 20 in 2024. The changes made also significantly enhanced assessments with an improvement seen in both the quality of the assessments undertaken and the time taken to process them. 6.2 The Quality Safety and Efficiency in Prescribing Programme (QSEP) supports primary care prescribing by identifying areas of prescribing variance, for example where Perth and Kinross is an outlier compared to other areas or where medicines are being prescribed when cheaper alternatives exist. In 2024, the QSEP programme focused on supporting GP practices to review and switch patients from their current prescriptions where appropriate. The Direct Oral Anticoagulant (DOAC) switch project resulted in 2,161 patients having their medication reviewed resulting in a £590k saving in 2024/25. The Gliptin switch project has been undertaken in 2025 with 20 of the 23 GP practices engaging with the project with an expected/projected saving of £73k. 6.3 The Transformation of Complex Care Project reviewed the provision of services for people with complex needs and made substantial improvements as follows: Workstream 1 – Integrated Multi-disciplinary Hub: The SCOPE team was established as an integrated service for Learning Disability and Autism, now operational and delivering cost avoidance through monitoring care package costs. Workstream 2 – Technology Enabled Care (TEC): The Overnight Responder Service was successfully piloted, has become established, and is generating recurring savings of £45,000 per year. Workstream 3 – Day Opportunities & Respite: A Day Opportunities Steering Group was created with four workstreams to redesign in-house provision and expand inclusive community opportunities. Workstream 4 – Transitions: A new transitions framework and Compass App were launched to improve pathways for young people moving into adulthood. Workstream 5 – Behavioral Support Interventions: Three workshops were undertaken over 2022 and 2023 which provided an opportunity for stakeholders to explore Positive Behavioral Support (PBS) in Perth and Kinross. There is a Short Life Working Group currently looking into developing a P&K PBS pledge which supports this ambition. Psychology colleagues in SCOPE are supporting PBS locally and working directly with providers, as well as offering training when required. Workstream 6 – Independent Living: Five Core and Cluster housing projects are in development, enabling people to
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move from long-stay hospital into community tenancies and reducing costs through economies of scale. Further cost efficiencies have been realised (£205k 2024/25 and projected £210k for 2025/26) through the ongoing SCOPE intervention, the roll out of Technology Enabled Care and Core and Cluster models. 6.4 Primary Care Mental Health / Community Project responded to the need for greater access to mental health support within a primary care community setting. All GP practices now have routine/direct access to a mental health professional. The role is able to provide swift early intervention with this support and patient assessment playing a key part in the mental health system. 6.5 The Optimising Rehabilitation Services Project is assessing the needs of the population in terms of rehabilitative services. It is considering the best way for those services to be delivered and in doing so is reviewing access to current provision within existing establishments. This is a longer-term project with significant complexity which is progressing to options appraisal, consultation, and engagement phases. The project is due for completion in late 2026 and as such forms part of phase 2 of the Transformation Portfolio. 6.6 The Psychiatry of Old Age and enhancing capacity in the Community (POA) Project was included in the portfolio with the intention of shifting existing, hospital- based supports to a more community-based model of delivery, whilst enhancing services for EMI patients. Investment into Inpatient Services was made by the IJB through budget-setting processes to try to address some of these objectives, however recruitment to the proposed model proved challenging, requiring a re-scope of the project. As a result, the project is now being re-scoped to take a longer term, strategic view of the changing needs of the population and the forecasted increase in the need for more community-based service provision. This project will be carried forward into Phase 2. 6.7 Transformation Portfolio – Phase 2 Phase 2 of the portfolio consists of the following projects. Each of these is at a different stage of development and delivery and the following provides a brief overview of the project purpose and the status of each. Further, more detailed, updates on the portfolio will be provided as the portfolio develops. Developing a Person-Centred Approach to Rehabilitation and Reablement: This project carries over from Phase 1 of the portfolio. Please see above for more information in terms of progress. Dementia & Enhancing Capacity in the Community (Psychiatry of Old Age): This project is in the early stages of development with the project proposal scheduled for presentation to the Transformation Board in early 2026. Learning Disability Services review: Similar to above this project is in the early stages of development with a project proposal scheduled for consideration via the Transformation Board in early 2026. Review of Older People Day Care Services: This project seeks to identify a future a model for Day Services which makes best use of resources and addresses the rural geography of Perth and Kinross. The
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aim is to deliver person-centred, sustainable day services which help older people maintain independence and community connections. The project is currently formulating the options appraisal which will be considered by the Transformation Board in early 2026. 6.8 Portfolio Management Office Approach A new governance methodology has been established within the Health and Social Care Partnership to enhance oversight of project initiation and ongoing monitoring through a Portfolio Management Office (PMO) approach. This methodology is informed by the Health and Social Care Service Renewal Framework (SRF) 2025–2035, ensuring alignment with long-term strategic priorities. The approach closely reflects the model adopted within Perth & Kinross Council, while being tailored to support transformation within the Partnership. Although documentation requirements differ to meet the specific needs of each organisation, the methodologies remain aligned in principle and practice and operate on a shared technology platform. This alignment is creating opportunities for cross- organisational learning and increasing the potential for coordinated delivery of desired outcomes. 7.0 Impacts Best Value: There are no direct best value impacts associate with this report however the transformation portfolio is focussed on areas which it is felt can be optimised further. As such the best value characteristics form an integral element of the portfolio. This report provides evidence of the following Best Value Characteristics: Best Value Vision and Leadership ☒ Governance and Accountability ☒ Effective use of Resources ☒ Partnerships and Collaborative Working ☒ Working with Communities ☒ Sustainability ☒ Fairness and Equality ☒ National Health and Wellbeing Outcomes It is expected that the proposal(s) will impact on the achievement of the National Health and Wellbeing Outcomes as below:
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No National Health and Wellbeing Outcome Increase/ Decrease/ No Impact NHW01 People are able to look after and improve their own health and wellbeing and live in good health. Increase NHW02 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. Increase NHW03 People who use Health and Social Care services have positive experiences of those service and have their dignity respected. Increase NHW04 Health and Social Care services are centred on helping to maintain or improve the quality of life of people who use the services. Increase NHW05 Health and Social Care services contribute to reducing health inequalities. Increase NHW06 People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact on their caring role on their own health and wellbeing. Increase NHW07 People using Health and Social services are safe from harm. Increase NHW08 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. Increase NHW09 Resources are used effectively and efficiently in the provision of Health and Social Care services. Increase Financial Implications There are no financial implications arising from this report directly. The Transformation Portfolio however underpins the delivery of the IJB’s financial recovery plan. Scrutiny of this forms part of the PMO approach with projects tracked via the Transformation Board. Equality, Human Rights and Fairer Scotland Duty Implications Each project which is taken forward is required to consider equality, human rights and Fairer Scotland duties throughout the project development, delivery and implementation. Scrutiny of this forms part of the PMO approach. Climate Change, Sustainability and Environmental Implications There are no climate change, sustainability or environmental implications in relation to this report. Each project however, in so far as they relate to service
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change, will make an assessment of any impact in this respect. Scrutiny of this forms part of the PMO approach. Legal and Governance There are no legal implications arising from this report however the adoption of a PMO approach strengths the governance already in place. Other Implications None 8.0 Management of Risk There are no risks arising directly from this report. Risk management however is core element of project, programme and portfolio management. The PMO approach which is now in place supports this with risks raise, managed and reported at each layer of governance appropriately. As Phase 2 projects are developed a new portfolio risk register will be created to manage risks across the portfolio. 9.0 Governance Consultation Route The matters contained within this paper have been considered and/or consulted on by the following group(s) as part of its development: P&K HSCP Senior Management Team ☒ P&K Strategic Planning Group ☐ P&K IJB Audit and Performance Committee ☐ P&K HSCP Integrated Management Team ☐ Update requested by P&K IJB ☐ Other (state below) ☐ ................................................................................................ Not Applicable ☐ Following consideration/decision by the Perth & Kinross IJB Audit and Performance Committee, this report will be shared with: Perth and Kinross Integration Joint Board ☐ NHS Tayside Board ☐ NHS Tayside committee(s) – specify ................................................................................................ ☐ Perth & Kinross Council ☐ Perth & Kinross Council Committee(s) – specify ................................................................................................ ☐ Other (state below) ☒ Perth and Kinross Council Transformation Board................... Not Applicable ☐
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Appendices None NOTE: No background papers, as defined by Section 50D of the Local Government (Scotland) Act 1973 (other than any containing confidential or exempt information), were relied on to any material extent in preparing this report.