Agenda Document Pack - Community Wealth Building Commission - 10/09/2024
South Lanarkshire Council · 10 September 2024
Back to Community Wealth Building Commission — 10 September 2024 and its agenda
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Council Offices, Almada Street Hamilton, ML3 0AA Monday, 02 September 2024 Dear Member Community Wealth Building Commission The Members listed below are requested to attend a meeting of the above Board to be held as follows:- Date: Tuesday, 10 September 2024 Time: 14:00 Venue: Hybrid - Committee Room 1, Council Offices, Almada Street, Hamilton, ML3 0AA The business to be considered at the meeting is listed overleaf. Yours sincerely Paul Manning Chief Executive South Lanarkshire Council Councillor Alex Allison Councillor Robert Brown Councillor Margaret Cooper Councillor Joe Fagan (Chair) Councillor Kirsten Robb Councillor John Ross Councillor Margaret B Walker Paul Manning, Chief Executive Jackie Taylor, Executive Director (Finance and Corporate Resources) Soumen Sengupta, Director, South Lanarkshire University Health and Social Care Partnership Jann Gardner, Chief Executive, NHS Lanarkshire Josephine Pravinkumar, Director of Public Health, NHS Lanarkshire Hisashi Kuboyama, Development Manager, West of Scotland, Federation of Small Businesses Steven Sweeney, Chief Executive, VASLan Thomas Adamson, Estates Environment Manager, University of the West of Scotland (UWS) 1
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BUSINESS 1 Declaration of Interests 2 Minutes of Previous Meeting Minutes of the meeting of the Community Wealth Building Commission held on 11 June 2024 submitted for approval as a correct record. (Copy attached) 5 - 10 Item(s) for Consideration 3 Community Wealth Building Annual Report 2023/2024 Report dated 2 August 2024 by the Chief Executive, South Lanarkshire Council. (Copy attached) 11 - 34 4 Community Wealth Building Action Plan 2024 Refresh Report dated 2 August 2024 by the Chief Executive, South Lanarkshire Council. (Copy attached) 35 - 48 5 Context for Community Wealth Building Data Digest Report dated 2 August 2024 by the Chief Executive, South Lanarkshire Council. (Copy attached) 49 - 58 6 Community Wish List Update Report dated 23 August 2024 by the Chief Executive, South Lanarkshire Council. (Copy attached) 59 - 64 7 Marmot Place for South Lanarkshire Briefing Report dated 28 August 2024 by the Chief Executive, South Lanarkshire Council. (Copy attached) 65 - 74 8 Director of Public Health Annual Report 2023 Report dated 2 August 2024 by the Director of Public Health and Health Policy, NHS Lanarkshire. (Copy attached) 75 - 130 9 NHS Lanarkshire Anchor Metrics Performance Report dated 2 August 2024 by the Consultant in Public Health, NHS Lanarkshire. (Copy attached) 131 - 184 10 Forward Programme for Future Meetings Report dated 23 August 2024 by the Chief Executive, South Lanarkshire Council (Copy attached) 185 - 188 Any Other Competent Business 11 Any Other Competent Business Any other items of business which the Chair decides are competent. 2
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For further information, please contact:- Clerk Name: Lynne Hamilton Clerk Telephone: 07385370044 Clerk Email: lynn.hamilton2@southlanarkshire.gov.uk 3
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COMMUNITY WEALTH BUILDING COMMISSION Minutes of meeting held via Confero and in Committee Room 1, Council Offices, Almada Street, Hamilton on 11 June 2024 Chair: Councillor Joe Fagan Present: South Lanarkshire Council Councillors Alex Allison, Robert Brown, Kirsten Robb, John Ross P Manning, Chief Executive NHS Lanarkshire E Russell, Consultant in Mental Health University of the West of Scotland T Adamson, Estates Environment Manager VASLan S Sweeney, Chief Executive Officer Also Attending: South Lanarkshire Council Chief Executive’s Service J Kerr, Community Engagement Manager; T Little, Head of Communications and Strategy; N Reid, Improvement and Community Planning Manager Finance and Corporate Resources N Docherty, Administration Assistant; C Fergusson, Head of Finance (Transactions); L Hamilton, Administration Officer; S Somerville, Administration Manager Community and Enterprise Resources J Gibb, Change and Development Adviser Housing and Technical Resources J Read, Strategy and Policy Adviser Apologies: South Lanarkshire Council Councillors Margaret Cooper, Margaret B Walker S Sengupta, Director, Health, and Social Care J Taylor, Executive Director (Finance and Corporate Resources) NHS Lanarkshire J Gardner, Chief Executive J Pravinkumar, Director of Public Health Federation of Small Businesses H Kuboyama, Development Manager, West of Scotland 1 Declaration of Interests No interests were declared. 2 Minutes of Previous Meeting The minutes of the meeting of the Community Wealth Building Commission held on 12 March 2024 were submitted for approval as a correct record. The Commission decided: that the minutes be approved as a correct record. 2 5
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3 Clydesdale Way A report dated 17 May 2024 by the Executive Director (Community and Enterprise Resources) was submitted providing an update on the Clydesdale Way Project. In 2021/2022, South Lanarkshire Council worked in partnership with Borders and Dumfries and Galloway Councils and developed a joint bid for Round Two of the UK Levelling Up Fund which targeted the Dumfriesshire, Clydesdale, and Tweeddale constituencies. The joint ‘Three Rivers Active Tourism Project’ bid was targeted at promoting tourism, providing significant community benefits, improved culture, and rural economies. The bid comprised of 3 projects, one from each of the 3 local authorities. South Lanarkshire’s project had focused on rural path and cycling networks through the development of the Clydesdale Way. A high-level map was attached at Appendix 1. Detailed path route information was developed through a feasibility commission carried out by Ironside Farrar in 2022, which produced concept drawings, budget costs and maps for the proposed routes. The creation of the Clydesdale Way promoted numerous benefits, which included:- creating connected all user path network(s) that delivered economic, social, and environmental benefits across South Lanarkshire which included links to local and regional visitor attractions. local needs being addressed as well as the major strategic regional gaps and connections to established long-distance path routes and associated networks across South Scotland meaningfully engage with the Third Sector needs addressed for connectivity within disadvantaged and deprived communities, active travel created and recreational leisure choices in areas of poor public transport and low car ownership enhanced connectivity which addressed connections and safeguarded rights of way, and connections to 2 World Heritage sites and local areas of high environmental quality secured improved awareness and education about local routes and long-distance path connections and value of local environmental assets and biodiversity through signage/interpretation In January 2023, South Lanarkshire Council was informed that the Round 2 bid was unsuccessful. The UK Government decided not to run a new competition for Levelling Up Funding (LUF), Round 3 and had instead drawn on bids submitted in Round 2 which were unsuccessful but had been assessed as ‘high quality and were ready to deliver’. Consequently, on 20 November 2023, the UK Government advised that the Three Rivers Active Tourism Project had been provisionally awarded £22,809,416. The 3 councils were contributing £2,534,380 in match funding which brought the total cost to £25,343,796. The Clydesdale Way LUF grant provisionally awarded was £6,795,000. The total project cost for Clydesdale Way was £7,550,000 and the Council had identified the £755,000 match funding as required by LUF. The current programme indicated the £755,000 would be spent, and the overall project completed by September 2026. It was noted that the UK Parliamentary Election might have an impact on some of the indicated timescales. Dumfries and Galloway Council, as lead authority for the joint Three Rivers Tourism Project, had received the formal Memorandum of Understanding on 26 April 2024. The 3 partner local authorities had worked together and developed and implemented appropriate governance arrangements with the required paperwork returned to the UK Government. 6
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The tender to appoint a consultancy team to manage and deliver the Clydesdale Way Project was issued on 13 March 2024, with a closing date of 19 April 2024. An internal project team, External Funding Team had been set up and would continue to meet on a regular basis to progress the project. South Lanarkshire Council project leads would continue to meet regularly with Dumfries and Galloway and Scottish Borders Councils to co-ordinate the works, press and communication and future grant claims. The Change and Development Adviser responded to the Chair’s question in terms of landowners. The Commission decided: that details of the Clydesdale Way Project, including the proposed routes, and current position of the project should be noted. 4 Community Wealth Building Action Plan – Q4 Update A report dated 4 June 2024 by the Chief Executive, South Lanarkshire Council was submitted on the Quarter 4 (Q4) update on the Community Wealth Building (CWB) Action Plan. The CWB Action Plan had been approved by the Commission at its meeting on 5 September 2023. There were 72 actions contained within the Action Plan and progress against those actions, for the 12 month period of April 2023 to March 2024, was detailed in Appendix 1 to the report. Of the 72 actions, 2 were complete and would be removed from the Action Plan. The remaining actions would be reviewed and a refreshed Action Plan brought to the September 2024 meeting of the Commission. In response to Councillor Robb’s question in terms of working with anchor organisations and social enterprise and how spend could be increased in this sector, the Head of Finance (Transactions) advised that he was working with anchor institutions, however, it was still at an early stage of development. He had met with NHS colleagues in March 2024 and information was being gathered in terms of community transport as there was a potential overlap of requirements for both the Council and NHS. He advised that other areas to focus on might evolve through further discussions throughout the year. In relation to the evaluation criteria, he advised that there had been discussions among the CWB Group in terms of opportunities and highlighted that the fact a company was local, could not form the basis as a standalone award criteria in its own right as due regard had to be given to the standard procurement principles of non discrimination. In relation to further questions on whether there was potential for Strathclyde Pension Fund to invest in projects and on an update in terms of community bonds and supply chain initiative, the Head of Finance (Transactions) gave an undertaking to speak to the appropriate Finance lead on those matters and circulate a response to Commission members in due course. In response to a point made by Councillor Ross in respect of attending a CLES seminar and how NHS procurement in England had transformed its buying powers into a more CWB setting, E Russell advised that the NHS was keen to see what was possible, however, NHS Lanarkshire had limited capacity and had also to take into account national contracts. She advised that the matter was being looked at nationally by the Scottish Government to see how it could be facilitated. She further advised that there was also a community benefits plan for the build of the new hospital to replace Monklands. 7
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T Adamson spoke on the geographical issues faced by the University of the West of Scotland due to the number of campuses, therefore, local buy included a wider area. He advised that local suppliers could make their bids much more favourable by focusing on sustainability options. The Commission decided: that the report be noted. [Reference: Minutes of 12 December 2023 (Paragraph 4)] 5 Community Wealth Building through Gypsy/Traveller Site Investment A report dated 23 May 2024 by the Executive Director (Housing and Technical Resources) was submitted providing an overview of Community Wealth Building achieved through South Lanarkshire Council’s investment on the Council’s Gypsy/Traveller sites. The Council currently operated 2 gypsy/traveller sites, one at Larkhall and the other at East Kilbride. A range of improvement work was taking place at both sites, delivering on investment priorities agreed with residents as part of the site-specific masterplans to ensure the sites continued to exceed relevant accommodation standards and meet the cultural needs of the gypsy/traveller community. In line with CWB aspirations to boost local spend, a significant proportion of the investment in those sites had been completed by Lanarkshire based contractors, or internally through Council services. An overview of the key projects, procurement route, location of contractor and banded value across each site was detailed at Section 5 of the report. The Council’s approach had been recognised nationally, with awards from both COSLA and the UK wide Municipal Journal in 2022, and the engagement practices utilised shared across Scotland as a model of best practice. The Commission decided: that the overview of Community Wealth Building achieved through South Lanarkshire’s investment in its gypsy/traveller sites be noted. 6 Keep the Beat Alive A report dated 20 May 2024 by the Chief Executive, VASLan was submitted providing an update on “Keep The Beat Alive”, a campaign that was co-produced by over 100 local Third Sector organisations. One of VASLan’s core functions was to facilitate the range of voices from across the Third Sector. In November 2023, VASLan started to co-produce a campaign alongside over 100 local Third Sector organisations. The aim of the “Keep The Beat Alive” campaign was to influence local and national policy shapers and decision makers on the value and impact of volunteers, community organisations, charities and social enterprises in South Lanarkshire. This was in the form of the following 3 ‘big asks’:- recognise the Third Sector’s value be smarter with funding meaningfully engage with the Third Sector 8
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The Chief Executive, VASLan referred to a motion that was being submitted to South Lanarkshire Council at its meeting on 12 June 2024 on the campaign and how he hoped it would receive cross-party support. He also referred to the fact that NHS Lanarkshire was keen to discuss its anchor responsibilities and how the Third Sector could link in. In terms of spatial planning and town centre masterplans, he suggested there might be merit in considering the inclusion of a Third Sector Hub as there were less places for Third Sector activities to take place. In responding to members’ questions, the Chief Executive, VASLan advised that there were 5 other areas in Scotland which were co-producing a similar campaign. He advised that VASLan was now looking at how the 3 ‘big asks’ could be turned into an action plan and how it could link with MSPs as there was an event at Holyrood on 15 January 2025. The Commission decided: that the asks being made of partners locally through the Community Planning Partnership, as set out in section 5 of the report, be noted. Councillor Brown left the meeting during this item of business 7 Forward Programme for Future Meetings A report dated 3 June 2024 by the Chief Executive, South Lanarkshire Council was submitted advising of the forward programme for meetings of the Commission and inviting members to suggest topics for inclusion in the Commission’s forward programme. The Commission decided: that the report was noted [Reference: Minutes of 12 March 2024 (Paragraph 8)] 8 Any Other Competent Business There were no other items of competent business. 9
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive Subject: Community Wealth Building Annual Report 2023/2024 1. Purpose of Report 1.1. The purpose of the report is to:- present a draft of the Community Wealth Building (CWB) annual report for 2023/2024 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- (1) that the draft annual report, attached as appendix 1, be approved. 3. Background 3.1. The Council approved a CWB Strategy on 10 March 2021. Subsequently, the CWB Commission was set up to engage a wide range of partners and stakeholders in the CWB agenda. 3.2. To support formal reporting of progress against the Strategy, the Commission agreed on 7 February 2022 that annual reports should be produced to highlight progress and showcase examples of significant work under the 5 pillars. The annual reports also provide a vehicle for communicating the purpose of CWB and why the Council and partners believe CWB is an important way of working in South Lanarkshire. Annual reports, covering years one and two of the Strategy, were presented to the Commission in September 2022 and September 2023, respectively. 3.3. This report presents a draft of the third Annual Report, covering 2023/2024, for approval. 4. Annual Report Purpose and Content 4.1. The Commission agreed in August 2021 to monitor the CWB action plan through progress reports at Q2 and Q4, covering the periods April to September and April to March, respectively. 4.2. While the performance reports provide an update on the progress of the action plan, the Commission agreed there was scope to reach a wider audience and to enhance communications around the CWB agenda by presenting progress in a more accessible format. An annual report offers the opportunity to take stock of what has been achieved in the year and to restate the aspirations of the Council and partners to champion CWB across all aspects of service planning and delivery. 3 11
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4.3. The annual report does not replace the formal reporting of Q2 and Q4 progress but allows a more public-facing and accessible presentation of information, using key points and case studies to illustrate CWB in action. 4.4. The draft Annual Report is attached as appendix 1. 4.5. This following table summarises the structure and content of the annual report. Section Content Introduction Written by the Chair of the CWB Commission - this reflects on the importance of CWB as a new approach involving key anchor organisations in South Lanarkshire. What is CWB What is CWB and why are we doing it - this revisits the background to CWB and outlines the 5 pillars. Progress and case studies This section of the annual report takes each pillar in turn and: • reviews the aims of the strategy • highlights progress made; and • provides case studies to illustrate the work of the council and partners under this pillar Conclusion Sums up progress and reaffirms commitment to CWB which we will deliver through the continuation of the 5-year action plan 4.6. A wide range of case studies have been used to illustrate CWB principles and to show where the approach is having an impact in South Lanarkshire. Case studies have been selected to illustrate the benefits of the approach for businesses, communities, and individuals; and also, to illustrate progress across both urban and rural areas in South Lanarkshire. 4.7. The Commission is asked to approve the content of the annual report. 5. Employee Implications 5.1. There are no direct employee implications. 6. Financial Implications 6.1. There are no direct financial implications. 7. Climate Change, Sustainability and Environmental Implications 7.1. There are no climate change implications as a result of this report. 8. Other Implications 8.1. None. 9. Equality Impact Assessment and Consultation Arrangements 9.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function, or strategy and therefore no impact assessment is required. Paul Manning Chief Executive 2 August 2024 12
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Link(s) to Council Objectives/Values/Ambitions • Accountable, efficient, and effective Previous References • CWB Commission 5 September 2023 - CWB Commission Annual Report 2022/2023 List of Background Papers • None Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Tom Little, Head of Communications and Strategy Ext: 4904 (Tel: 01698.454904) E-mail: Tom.Little@southlanarkshire.gov.uk 13
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Appendix 1 South Lanarkshire Community Wealth Building Annual Report 2023 – 24 DRAFT 14
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Contents Introduction What is Community Wealth Building? Progress and case studies • Spending • Workforce • Land and property • Finance • Building the generative economy Conclusion 15
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Introduction In March 2021 South Lanarkshire launched its Community Wealth Building Strategy. The strategy set out an aspiration to work in a new way for the people of South Lanarkshire, to use the power and Influence of the council and other organisations to support communities and the South Lanarkshire economy. The challenges of the last few years continue to underline the importance of local services rooted in local places and communities. South Lanarkshire Council and the South Lanarkshire Community Planning Partners are committed to improving the lives and prospects of everyone in South Lanarkshire. This annual report looks back at the third year of our Community Wealth Building Strategy. It highlights the progress we have made so far and reaffirms our commitment and determination to explore every avenue available to build the wealth, capacity, and resilience of our communities. As in previous years, we have brought together a range of case studies to illustrate Community Wealth Building in action, showing how the council and partners, working alongside communities, can use their energies, influence and resources to make a difference across South Lanarkshire. Chair of the Community Wealth Building Commission 16
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What is Community Wealth Building? Community Wealth Building is an alternative approach to traditional economic development, which seeks to develop resilient, inclusive local economies, with more local employment and a larger and more diverse business base. Community Wealth Building reorganises local economies to be fairer and aims to reduce wealth flowing out of our communities, towns, and cities by helping local investments and assets to generate more and better jobs for local residents and businesses. To achieve this transition, CWB harnesses the power of anchor institutions to enable local economies to grow and develop from within. Anchor institutions are large commercial, public, and social sector organisations which have a significant stake in a place and can exert considerable influence on their local economies. CWB changes how anchor organisations work to maximise local and regional economic opportunities. This includes the goods they buy, the people they employ, the assets they own and the powers they exercise to bring about long-term, sustainable economic change for the benefit of local communities and local businesses. 5 strategy areas are identified relating to the pillars of community wealth building. These are: • Building the generative economy - Develop and grow small, locally owned enterprises which are more financially generative for the local economy - locking wealth into place. • Finance - Increase flows of investment within local economies by harnessing and recirculating the wealth that exists, as opposed to attracting capital. • Land and property - Deepen the function and ownership of local assets held by anchor institutions, so that financial and social gain is harnessed by citizens. • Spending - Utilise public sector procurement and commissioning to develop dense local supply chains of businesses likely to support good employment and retain work locally. • Workforce - Exercise fair employment practices and work to develop a more just labour market to improve the prospects and wellbeing of local people. 17
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Spending The spending pillar is about leveraging public sector procurement and commissioning to develop dense local supply chains of businesses likely to support good employment and retain work locally. Our Strategy set out how we would achieve this, building on close analysis of our spend and a range of actions to make procurement processes simpler and more accessible to local businesses. How we have supported Community Wealth Building • The council co-hosted SLC specific events with Supplier Development Programme, including: - South Lanarkshire Council & Social Enterprises: A Conversation about Public Sector Contracts - Talking Tenders - Care at Home with South Lanarkshire Council X 2 - South Lanarkshire Council, Community Wish List supplier meeting • There were 111 new registrations for SLC suppliers with the Supplier Development Programme over the year. • The Supplier Development Programme continues to update its suite of training, in the last year this has included webinars on community wish lists and the impact of the cenefits system on how businesses will report community benefits. • Since November 2022, there has been a 16.5% increase in SLC registrations with the Public Contracts Scotland tendering portal. • The Council awarded 33 contracts to local companies in 2023/2024, which represents an increase in the proportion of contracts awarded to local companies from 12% to 16%. • In the last year SLC Business Support has delivered new initiatives aimed at supporting businesses with free consultancy support as well as an accelerator programme for food and drink companies. We also changed the criteria for our Business Growth Grant to allow applications that are exclusively for projects that will help businesses on their journey to net zero. • A Market Capacity Assessment was undertaken to understand the capability of the food and drink sector to supply food and drink to the council (see case study below). • The Supplier Development Programme carried out 9 bespoke email campaigns for SLC to SLC registered businesses to promote the various webinars and encourage attendance. SDP also carried out a number of social media campaigns. These included 42 posts (linked In, Twitter and Face Book) promoting SLC, these were viewed 13,093 times and resulted in 343 engagements (click throughs, likes and shares). • Sustainability requirements for contracts have been strengthened. The flexible framework is updated 6 monthly, and the Council has achieved level 2 (from 5) and is working towards level 3 in People, Process, Reporting and Stakeholders and level 4 in Strategy. Achievements this year include implementation of a mandatory 30% sustainability score in the technical envelope for Fair Work, Community Benefits and Climate impacts. All high value contracts within the priority sustainability categories receive a full sustainability test to inform the specification and technical requirements of the tender. • The practice of ensuring half of the suppliers invited to quote are based in the Lanarkshire area was included in the NHS Lanarkshire’s organisational procurement strategy published in 2022 and is now embedded in procurement processes. • The Community Benefits monitoring software "Cenefits" was live, as scheduled, in March 2024, with successful registration and training of all relevant Council contractors 18
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and contract managers. This will enable the Council to improve monitoring and delivery of committed Benefits. • To date, 189 community wishes have been received and 69 answered with a total value of more than £51,000 (see case study below). How it’s working in South Lanarkshire: Case study: Food and drink market capacity assessment Local procurement is one of the key stands of the CWB Strategy. As part of this, South Lanarkshire Council aims to provide suppliers with opportunities to increase the provision of local food and drink. The Markey Capacity Assessment exercise involved research into the food and drink market in South Lanarkshire with a view to identifying actions to increase local spend and overcome potential barriers. The objectives of the research were to:- • assess capacity of local food and drink businesses to supply to SLC Resources • identify local food and drink businesses who can currently meet the Council demand • identify food and drink businesses who could develop to meet demand • identify challenges to local businesses to begin to supply and to the Council in purchasing; and • recommend actions for the Council and partners to address and overcome barriers The research provided insights into what food and drink is being bought by the council and who/where from; as well as analysis of the local food and drink market and engagement with businesses including current suppliers. A review of approaches taken by other Local Authorities in Scotland was also carried out. Key findings All businesses involved in the research indicated a desire to engage further with the Council on local procurement, however, further work is required for a better understanding of their ability to supply food to the Council. Challenges and opportunities The research revealed the challenges of supporting local supply chains in relation to food and drink procurement, the greater cost, and the capacity for businesses to work with the public sector being the main difficulties. However, opportunities were also identified, including: • The practice of splitting lots during the tendering process could potentially be adopted to overcome the issue of local businesses being able to only supply smaller quantities compared to the Council requirements. • the Council cannot award local providers without a competitive process but tendering processes can be tailored with specific criteria that could give higher score to local businesses (e.g., CWB and sustainability criteria). • To meet the Council demand in terms of volume, opportunities for collaboration among businesses could also be explored. • To overcome the issues of accreditations, business support provided by the Council and partners could be targeted to specific businesses, (e.g., Business Grants and Business Gateway). 19
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• Subcontract opportunities are significant with the possibility for local small-scale providers to supply food to larger suppliers. Case study: Community Wish Lists Community Wish Lists have been established across the public sector where communities are enabled to put forward requests for specific needs or benefits that can then be supported by suppliers delivering contracts. This approach encourages and enables a more bottom-up approach to delivering community benefits as part of the public sector procurement process, where communities’ needs are being directly specified by communities themselves and met by contractors. In 2022, the 8 local authorities in the Glasgow City Region agreed to work together to develop a regional web-based Community Benefit Digital interface which would have a shared backroom and individual landing page for each council. It was anticipated this new platform would be able to incorporate the Wish List There was a great deal of preparatory work with communities to introduce the new concept prior to the interface being live, with efforts focused on establishing an in-house platform for wishes to be advertised, promoting the service, and supporting groups to identify their wishes. The South Lanarkshire Wish List launched in July 2023. To date, 189 community wishes have been received and 69 answered with a total value of more than £51,000. 20
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Workforce The Workforce pillar of Community Wealth Building requires anchor organisations to adopt and champion fair employment practices and work to develop a more just labour market to improve the prospects and wellbeing of local people. In our strategy and action plan we set out our intention to promote fair work practices and the living wage, leading by example and encouraging all businesses and third sector organisations in Lanarkshire to follow suit. We said we would use our employability programmes and our training and recruitment activities to maximise opportunities for local people. How we have supported Community Wealth Building • During 2023/24 South Lanarkshire obtained 35 new Living Wage Accredited employers. From this 35 a total of 8 took advantage of the Living Wage Accreditation Discount Scheme with a total payment £522. South Lanarkshire had a total of 175 Accredited employers as of 31 March 2024. • The Council has delivered the NHS Demonstrator programme in partnership with NHS Lanarkshire and plans to deliver a similar programme in 2024/25 through Facilities services to support parents into SLC employment. The NHS Demonstrator programme has provided part-time 6 month paid placements to 39 parents. (See case study below) • The South Lanarkshire Employability Partnership has mapped all employability provision, and an operational sub-group has been established to identify and respond to gaps in service. • A new employer engagement team has been established within the employability team and works closely with Routes to Work South, Business Gateway, and Skills Development Scotland to co-ordinate support to employers and identify opportunities. • The employability service has supported 2640 people across priority groups of young people in the last 6 months of school, young people aged 16-19, adults with barriers to employment, people with learning disabilities. 1481 participants progressed to employment or further learning during the year. • Scottish Government employability funding can be used to provide additional Modern Apprenticeship opportunities to priority groups. Six care experienced young people were supported to access MAs in 2022/23 - 2023/24. The Scottish Government funded Kickstart programme ended in 2022/23 and SLC participants were supported to progress to sustainable employment. • A draft CWB Charter was developed (see case study below). How it’s working in South Lanarkshire: Case Study: NHS Demonstrator 2 Programme The NHS Demonstrator Programme was the result of NHS Lanarkshire and the Local Employability Partnerships working together to help parents back into the labour market by employing them within NHS Lanarkshire for 6 months within a variety of roles. The focus is on offering the parents flexible hours which helps them settle back into a routine and juggle their childcare responsibilities. The aim is to improve the confidence, wellbeing, financial situation, and life opportunities of those in our local community, in line with our commitments as an Anchor Organisation and the Child Poverty Action Plan. Job roles include; clerical assistant, healthcare support worker, porter, domestic assistant, and catering assistant. 21
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Claire - Clerical Officer, based at Beckford Street in Hamilton. What have you enjoyed about your time on the NHS Demonstrator Programme? I have enjoyed returning to work in an office environment and having the social interaction with the office staff as I previously worked remotely which could be lonely at times. All the staff have been very welcoming and happy to have me on board. I’ve also enjoyed learning new skills, completing the relevant training modules/sessions, refreshing my skills, and meeting new people. What support and training have you received within your role? During my time with the NHS, I have carried out all mandatory modules on Learn Pro and completed the mandatory Induction Standards workbook. I also received training from the NHS employability team to create my CV and enhance my interview techniques. The job coaches in the NHS employability team have also met with me in my workplace to provide support and offer guidance if required. Furthermore, I’ve received on the job training in the Tobacco Control Team within Health Improvement, where I am now confidently carry out my clerical role. What have you felt have been the main benefits of the Programme? The main benefits of the programme are that I have now become more confident again in an office-based environment and have been able to upskill from previous experience. I have had the opportunity to earn a wage whilst gaining experience, which has been great. The training and support have also been amazing. Another main benefit that really helped me as a parent is the flexible approach taken with regards to my working hours to account for factors such as, settling back into a routine and childcare responsibilities. What challenges have you overcome along the way? The main challenges are having to familiarise myself with a new team of people along with all of their roles and navigating the new IT systems. However, with training, I have become more confident in these areas. What advice would you give to another parent who is looking to return to the workplace? If I was going to give advice to another parent, I’d say go for it. Being back in the workplace gives you the feeling of self-worth again. If you are having trouble completing a CV or need advice/help with anything such as interview preparation, then help is there. Personally, having returned to office-based employment, I feel that I have now had the opportunity to further develop my skills and offer my future employer a wide breadth of experience and ability to quickly adapt to new situations/tasks. Thomas – a clerical assistant at Law House, Hamilton What have you enjoyed about your time on the NHS Demonstrator Programme? I have enjoyed the fairness of treatment, the friendly environment, and the opportunity to train and develop myself. It has also given me a better routine and it has been great to be able to work around my childcare commitments. What support and training have you received within your role? I have had lots of support from my manager and the Employability team as well as the people I work with on a day to day basis. I have been able to do trakcare training, completed all my role specific mandatory training, Allocate training. It has been great to be able to train and work at the same time and gain additional skills to enable me to complete my role tasks. 22
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What have you felt have been the main benefits of the Programme? I used to be a nurse when I lived in Ukraine and wanted to move into an admin role. By doing the Demonstrator Programme, I have gained skills within the Workforce team such as IT skills, learning how to use Allocate programme and Trakcare. I have also been taught how to use the machines that print off badges. The opportunity to train and develop myself has been very beneficial. My health has improved as it is a supportive environment, and everyone is very helpful. What challenges have you overcome along the way? I have only had one challenge and that was when I first started. I was originally based in a hospital in ICU, I found this quite upsetting due to a previous personal experience and was grateful that I could be moved into a different department at Law House. All managers and Employability team were very supportive of the move. Other than that, I have had no other challenges. What advice would you give to another parent who is looking to return to the workplace? I would say get yourself signed up to Routes to Work South, get all the support you need from them as there is so many opportunities that you might not realise that could help you get into work. Case study: Developing a CWB Charter Starting in early 2023, the CWB Commission began to look at the potential of a CWB Charter for South Lanarkshire. A desk research exercise was carried out to look at examples of Charters elsewhere, to learn lessons and identify good practice. Through this scoping exercise, the Commission noted that: • A charter typically sets out high level commitments which can be couched in terms of pledges, aspirations, and model behaviours. They are less definite and goal-oriented than strategies or action-plans, though they may lead to co-ordinated action through shared plans and strategies. • Charters can be aimed at a range of different audiences from the larger anchor organisations in a locality to local businesses, community groups and even individual residents. By signing or adopting a charter, the organisation, or individual pledges to do their part in supporting CWB. Some charters are couched in terms of a contract or deal, with signatories pledging to “do their bit” and uphold their side of the bargain. • A charter can cover several pillars of CWB or focus exclusively on a single pillar such as procurement or workforce. Even within a charter which covers several pillars, the level of detail contained within the pledges can vary from single, broad pledges to multiple pledges in more detail. • Charters may be used at the start of a CWB process or may be brought in to boost engagement and awareness at a pivotal point as collaborative working is established. In several of the early adopters of CWB ideas in the UK, charter-type agreements were instrumental in co-ordinating support, usually around a single topic or pillar such as procurement or employment. These “proof of concept” agreements pave the way for collaborative working across a broad spectrum of activity. Taking these general observations into account, the Commission developed a Charter for South Lanarkshire that would: 23
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• be easy to understand and not add complexity • be used as a vehicle to engage and aid communication • include all the pillars of CWB and not focus on any specific aspect • not bring in any additional pillars over and above the 5 already present in the strategy • be inclusive, have potential to be used by individuals and community groups as well as anchor organisations The Charter will provide a vehicle for the engaging and communicating about CWB as we seek to embed CWB principles and practices across activities and services. 24
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Land and Property This pillar looks to deepen the function and ownership of local assets held by anchor institutions, so that financial and social gain is harnessed by citizens. Our strategy highlighted the importance of affordable housing and the potential of Community Asset Transfer as a means of giving community more control over local places. The strategy aimed to encourage investment and create thriving places where people can access goods and services on foot or via public transport. How we have supported Community Wealth Building • Target of 120 Open Market Purchase Scheme was set for 2023/24 and 165 acquired. • Community Asset Transfer (CAT) Officer in post until March 2025, supporting in excess of 45 CAT processes at any given time across the year. • Through the existing partnership networks, Housing and Technical Resources continue to support owners and private landlords on opportunities to improve the energy efficiency of their home and reduce costs associated with heating. This includes through the twice annual Private Landlord Forum, with expert presenters attending to provide advice and answer questions on grant funding opportunities to over 80 South Lanarkshire private landlords. • Throughout 2023/24. Housing and Technical Resources have led the development and implementation of South Lanarkshire's ECO4 Scheme (see case study below) that enables the draw down of national energy company funding to be used to improve the energy efficiency of homes across the local authority area. Since launching in July 2023, the scheme has enabled over 330 energy efficiency measures to be installed across 127 privately owned or rented homes by locally based contractors. Particular focus this year has been to support those on low incomes and significant health conditions, aiming to reduces costs associated with heating their home. How it’s working in South Lanarkshire: Case study: Supporting private households to make energy efficiency improvements The South Lanarkshire Local Housing Strategy 2022-27 aims to ensure everyone has access to a home that they can afford and meets their needs. This includes the ability to heat and maintain their home, with the higher cost of energy alongside other cost of living pressures having impacted on the affordability of heating and maintenance. Private tenure households on lower incomes or with residents who are vulnerable to the effects of a cold home may be particularly affected. This could include homes with very young children, older people and people with health problems. Recognising these challenges, in 2023 South Lanarkshire Council was among the first local authorities in Scotland to fully launch a new ‘Energy Company Obligation Scheme’. This allows national energy company funding to be used by locally based contractors to make energy efficiency improvements to eligible homes at no cost to the homeowner. Administered through Ofgem, the current version of the Scheme is known as ECO4 and runs until March 2026. Local authorities who participate have to conduct a significantly enhanced due diligence role than on previous versions, aiming to ensure the funding reaches eligible households. Given the resource implications this would have on an already pressured budget, the council’s Housing and Technical Resources worked to identify opportunities to allow the 25
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scheme to be launched with no impact to other priorities. This included the development of a bespoke MS Teams solution, allowing contractors and the council to share required information as part of the assessment process and the creation of a dedicated administrative post to oversee and manage the scheme. The main functions of the role are to assess eligibility, support contractors comply with the assessment process and undertake audits to ensure the council’s Scheme is compliant, robust, and fit for purpose. Approved contractors participating in the Scheme are well supported in their use of the system and the process through the provision of tailored process guidance and training made available to them, as well as access to a single point of contact for advice and guidance. The South Lanarkshire ECO4 Scheme launched in July 2023 and so far, from the final feedback received from contractors, 127 private tenure households have benefited from the installation of retrofit energy efficiency measures. The final figures to 31 March 2024 will be higher as contractors continue to advise of completed projects. Of those 127 households, 330 measures have been installed over that period, comfortably surpassing the 300 annual target set out in the council’s Local Housing Strategy. The number of measures installed in each property has varied from one, to five. A range of 18 different measures have been installed. The most common installations have been of Solar PV (23% of installations) and of boiler upgrades to a renewable heating system (21% of installations). Twenty properties have benefited from first time central heating and 77 properties have benefited from a variety of home insulation measures (23%). More information on South Lanarkshire ECO4 can be found at www.southlanarkshire.gov.uk. Case Study: Lanarkshire Green Health Partnership – Hospital Garden Programme. The Lanarkshire Green Health Partnership was formed in April 2018 and is helping to connect health & social care with nature. The Partnership has commissioned Clydesdale Community Initiatives (CCI) to offer growing and cooking opportunities in community hospital sites across Lanarkshire, including Biggar, East Kilbride and Kirklands. This project targets individuals experiencing severe mental health issues but also encourages volunteers locally to help out in the weekly sessions. Through the Lanarkshire Green Health Partnership, volunteers working with Clydesdale Community Initiatives are making hospital gardens in Lanarkshire welcoming to both staff and patients, whilst gaining skills and satisfaction from their work. Dave volunteers at the gardening groups run by CCI at several NHS sites throughout Lanarkshire. Since becoming involved in the gardening group, Dave has gained gardening and woodworking skills, been kept busy and found satisfaction in helping others. Dave, a married man in his 50s, has experienced issues with his mental health over the years which have recently stopped him from working. Prior to volunteering with CCI, Dave noted that he was ‘…stuck at home, walking around in circles and not in a very good place’ Dave’s mental health support worker had suggested volunteering with CCI to him. CCI’s work appealed to Dave since he had some background knowledge in woodworking and gardening. He initially helped in the CCI woodshop one day a week making planters and birdboxes before starting an additional day as a volunteer for the gardening groups. Dave assists the gardening group attendees to engage with a range of activities, including: Propagation of crops; Making new and maintaining old pathways; Building birdboxes, raised beds and planters and installing these on site; Tidying up gardens and vegetable patches; Maintaining 26
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existing plants and introducing new plants; Harvesting crops for use by patients or CCI for food donations. Dave has found that volunteering for the gardening groups had been satisfying for a number of reasons, stating ‘…I’m helping myself because I’m able to keep myself focussed on what I’m doing with [the attendees] and at the same time they’re achieving something from it… so, it’s a win-win situation for both of us.’ He further noted that ‘…Since joining the group, I’m out and about – so I’m not stuck in one place, I have freedom. At the same time, I’m working and helping other people…’ Volunteering with the group had also helped Dave learn new skills and revived his love for gardening. He hopes to further increase the number of days he volunteers for CCI in the future. Dave summarised how important the opportunity to volunteer with the gardening group had been for him: ‘…I don’t want to be stuck at home… it’s good that I can get out and about to help other people as well as myself… without that I don’t know where I’d be.’ 27
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Case Study: Gypsy/Traveller site investment South Lanarkshire Council currently operates 2 Gypsy/Traveller sites at Shawlands Crescent in Larkhall, and Springbank Park in East Kilbride. A range of improvement work is taking place at both sites, delivering on investment priorities agreed with residents as part of the site-specific masterplans to ensure the sites continue to exceed relevant accommodation standards and meet the cultural needs of the Gypsy/Traveller community. In line with Community Wealth Building aspirations to boost local spend, a significant proportion of the investment in these sites has been completed by Lanarkshire based contractors, or internally through Council services. The Council’s approach to investment in the sites also aligns with actions contained within the current Community Wealth Building Strategy, aiming to ensure positive outcomes from both internal capital spend and through attracting external funding are maximised to improve housing options across South Lanarkshire. 28
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Throughout all projects completed on the sites to date, residents have not only had the opportunity to prioritise their delivery through the masterplan approach, but also have their say on key elements within each. The Council’s approach has been recognised nationally, with awards from both COSLA and the UK wide Municipal Journal, and the engagement practices utilised have been shared across Scotland as a model of best practice. The investment completed to date across both sites amounts to £1.9m, a significant proportion of which has been completed by Lanarkshire based contractors, or internally through Council services. This has been achieved through a variety of procurement routes, including Quick Quote and mini competitions within frameworks that focus on smaller scale building projects. 29
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Finance The Finance pillar focuses on efforts to increase flows of investment within local economies by harnessing and recirculating the wealth that exists, as opposed to attracting capital. Our strategy aims to encourage and support financial growth for communities, including building and attracting development and investment opportunities and encouraging local spend. How we have supported Community Wealth Building • We are continuing to raise awareness of credit union services in communities and supporting growth through our Financial Inclusion Network activity and our online directory for Money is not the only problem with dedicated web pages this year for each of our local Credit Unions. • Exploratory talks between the South Lanarkshire Credit Union Network and our Education Colleagues on a potential Credit Union entry in the SWAY Newsletter going to schools that builds on the earlier successful Savvy Savers activity on ethical lending with 112 Schools. • Dialogue with our Community Engagement Team is ongoing and potential links with external funds such as Multiply and Community Bonds explored over the last 6 months. • Promotion of democratic finance models to engage organisations in a Community Bond pilot and piloted a supply chain initiative in the CamGlen areas (see case study below) with Healthy n Happy as the community Anchor to increase service delivery and purchasing from the third sector. How it’s working in South Lanarkshire: Case study: Community Wealth Building Exchange – CamGlen Pilot The National Community Wealth Building Exchange (CWE) approach is based on the fundamental premise that community organisations have access to a small budget to purchase activities and services from social enterprises who contribute to improved mental health and wellbeing. The South Lanarkshire CWE CamGlen pilot is a micro-grants project working alongside the rollout of the national programme, with funding from South Lanarkshire Council distributed through Healthy-n-Happy Community Anchor organisation and working in partnership with the third sector interface, VASLan. The pilot aims to ramp up purchasing from CamGlen buyers and to create a baseline of the number of South Lanarkshire suppliers overall, signing up through the National programme. The principles of the programme are as follows: - that micro-investments in community groups can be used creatively to deliver disproportionately significant outcomes. - that groups should be trusted to know what works best in their community and therefore a minimum of prescription should be applied in terms of how they use it. The pilot approach is based on the fundamental premise that CamGlen community organisations have access to a small budget to purchase activities and services from South Lanarkshire social enterprises who contribute to improved mental health and wellbeing. This enables up to 10 buyers in the CamGlen areas who understand the needs of their local 30
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community to tap into services they may previously have been unaware of or able to afford, whilst supporting social enterprise suppliers across South Lanarkshire. 31
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Building the generative economy Action under this pillar seeks to develop and grow small, locally owned enterprises which are more financially generative for the local economy - locking wealth into place. Our strategy outlined how we would work to support local businesses, not-for-profit organisations, and communities to safeguard and create local jobs and address post-Covid recovery. How we have supported Community Wealth Building • A year-long campaign has been launched by VASLan, co-produced by over 100 local third sector organisations, which aims to engage partners around three asks: recognise the value of the third sector; be smarter with funding; and meaningfully engage with the sector. As part of the campaign, Partners are asked to convene conversations with stakeholders at regional and national levels to examine the role and future of the sector. These conversations will inform the future strategic framework for the sector in South Lanarkshire, including its role in the delivery of Community Wealth Building. • A steering group chaired by VASLan and membership made up of NLC, NHSL and third sector reps have reviewed and updated Terms of Reference for the group. This group oversees delivery of actions under the strategy and for this period we have delivered on a Leadership Accelerator and Business Accelerator programme for 23 organisations. • With a focus on young people and entrepreneurship we have signed off a Shark Reef competition which will run across S3 pupils in 20 secondary schools who will receive business support to pitch their business idea to a panel of local business leaders. The winner will be announced at the final in November. How it’s working in South Lanarkshire: Case study: Clydesdale Way South Lanarkshire Council has worked in partnership with Borders Council and Dumfries and Galloway Council to develop a joint bid for UK Levelling Up Fund targeting the Dumfriesshire, Clydesdale, and Tweeddale constituency. The joint ‘Three Rivers Active Tourism Project’ bid was targeted at promoting tourism, providing significant community benefits, improved culture, and rural economies. The bid comprised of three projects, one from each of the three local authorities. South Lanarkshire’s project has focused on our rural path and cycling network through the development of the Clydesdale Way to address the gaps in the regional paths network. The proposed route commences at the end of the Clyde Walkway at Bonnington Lynn, creating a Western spur to Douglas and Eastern spur towards Biggar. From Wolfeclyde at Biggar the route can travel towards John Buchan Way at Broughton in the Scottish Borders or continue south past Coulter, Abington, Crawford, Elvanfoot and Leadhills to join the Southern Upland Way in Wanlockhead in Dumfries and Galloway. The creation of the Clydesdale Way will have multiple benefits for South Lanarkshire communities and local economies. • Creating connected all user path network(s) to deliver economic, social, and environmental benefits across South Lanarkshire’s settlements including links to local and regional visitor attractions. 32
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• Addressing the need for connectivity within disadvantaged and deprived communities, creating active travel and recreational leisure choices in areas of poor public transport and low car ownership. • Addressing local needs and address the major strategic regional gaps and connections to established long-distance path routes and associated networks across South Scotland. • Enhancing connectivity, address connections and safeguard rights of way, and connections to 2 World Heritage sites and local areas of high environmental quality. Securing improved awareness and education about local routes and long-distance path connections and value of local environmental assets and biodiversity through signage / interpretation. Case Study: Hamilton Town Centre Masterplan Town centres across the UK are in transition. The range of issues involved in the challenges town centres are facing are broad and complex. Some of the issues are local and specific to individual towns, however, many are issues seen across the country, influenced by wider economic patterns, consumer behaviour and corporate decisions. Factors such as the economic downturn, internet shopping, the growth of out-of-town shopping malls, changes in retailers’ business models and consumer expectations have resulted in a decline in footfall. Supporting town centres remains a council priority. The contribution town centres make to our communities cannot be overstated. Town centres support and contribute to people’s lives across our communities whether this is to access essential services, visiting for shopping or enjoying leisure time. Around 70% of businesses and jobs in the economy are located in town centres and they are often the main location for leisure and hospitality. They retain vital social importance as a meeting, events, and performance space. Local communities want to see their town centres thrive. The way they use their town centres is, however, very different from a generation ago. It is broadly accepted that the traditional function of a retail town centre needs to change to meet the needs and expectations of modern communities. One example of work underway to support our town centres is the Hamilton Town Centre Masterplan. The masterplan process is a detailed and complex exercise bringing together a range of solutions which balance the ambitions of the community with the challenging commercial environment. The vision for the town centre is to repurpose underperforming areas into high quality, high- density, mixed-use developments which the residents of Hamilton can be proud of. This is an opportunity for innovative place-making solutions which will attract developer interest. The vision and framework produced has identified where investment will have the greatest benefit and demonstrate the ambition for the town centre to the community and investors. It sets the context for public and private sector investment over the next 15+ years. The masterplan reflects aspirations for a resilient, mixed-use economy which repositions the centre to meet the needs of 21st century living in a high quality and sustainable manner. The development of the masterplan is a unique opportunity to deliver transformational change to the town centre. The plan will reduce the centre’s reliance on retail and focus on the needs and wants of the users of today and the future. 33
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Conclusion This annual report has highlighted our progress over the third year of Community Wealth Building. We have strengthened the links between anchor organisations in South Lanarkshire through the work of the CWB Commission and we have continued to focus our combined energies, skills, and resources onto our Community Wealth Building ambitions. We continue to be inspired by examples of what CWB can achieve in the UK and abroad, and we are delighted to be active participants in the growing CWB movement within Scotland. Our strategy looks to achieve results across a five-year period as a starting point. We will continue to refresh our annual action plan in the light of what we have achieved so far. We will extend the reach and scope of our actions by working together – partners, stakeholders, and communities – to generate ideas, pool resources and harness our collective energy to bring about lasting change. Our ambition, as we set out in our strategy, is to develop a resilient, inclusive local economy, with more local employment and a more diverse business base. Moving beyond the third year of our strategy, we will build on the strong foundations we have established so far. Over the coming year we will take co-ordinated action across the five pillars of CWB to develop a fairer, more inclusive economy that works for the people and businesses of South Lanarkshire. Further information To find out more, visit Community Wealth Building - South Lanarkshire Council 34
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive Subject: Community Wealth Building Action Plan 2024 Refresh 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] provide the Commission with the Community Wealth Building (CWB) Action Plan for 2024/2025, following a review of the actions at the end of year three of the Community Wealth Building Strategy [1purpose] 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- [] (1) that the draft CWB action plan, attached at appendix 1, be approved [1recs] 3. Background 3.1. At the first meeting of the CWB Commission on 31 August 2021, the Commission approved an action plan to accompany the CWB Strategy. 3.2. Performance reports detailing progress against the action plan have been presented to the Commission at Q2 and Q4 since the launch of the Strategy. Following presentation of the latest Q4 progress report on 11 June 2024, the action plan has been reviewed to remove completed actions and to refresh the remaining actions under the five pillars. 3.3. This report presents the refreshed action plan for 2024/2025. 4. CWB Action Plan – 2024 Refresh 4.1. All actions within the action plan have been reviewed by lead officers for the CWB pillars to remove completed actions and refresh the remaining actions, adding new actions or rewording actions as required. 4.2. The refreshed action plan will continue to be monitored and reported through the Improve performance management system. Progress updates will continue to be provided to the CWB Commission at Q2 and Q4. 5. Next Steps 5.1. If approved, the draft CWB action plan will be uploaded to the performance monitoring system Improve, which will be used to provide progress reports to the Commission at Q2 and Q4. 6. Employee Implications 6.1. There are no direct employee implications. 4 35
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7. Financial Implications 7.1. There are no direct financial implications. 8. Climate Change, Sustainability and Environmental Implications 8.1. There are no direct climate change, sustainability and natural environment implications arising from this report. 9. Other Implications 9.1. Considering the detail of the report and identifying actions as appropriate contribute towards effective risk management. 10. Equality Impact Assessment and Consultation Arrangements 10.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function, or strategy and therefore no impact assessment is required. 10.2. Consultation was undertaken internally via the officer group for CWB and with partners via the CWB Progress Group. Paul Manning Chief Executive 2 August 2024 Link(s) to Council Values/Priorities/Outcomes • Promote Performance Management and Improvement Previous References • None List of Background Papers • None Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Tom Little, Head of Communications and Strategy Ext: 4904 (Tel: 01698.454904) E-mail: Tom.Little@southlanarkshire.gov.uk 36
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Appendix 1 Spending We will: High Level Actions Steps we will take to deliver this action Timescales Expand the capability of local business and social enterprises to bid for public sector contracts with support from economic development and procurement teams. Provide support to local sectors based on an assessment of current capabilities ensuring support from Supplier Development Programme. Support the delivery of training events on public sector procurement for relevant contracts including quick quote. Annual Increase the level of spend with local companies. Annual Increase the number of registrations with Public Contracts Scotland tendering portal. Annual Increase the number of registrations with Supplier Development Programme. Annual Increase the contracts awarded to local companies. Annual Promotion of free procurement training aligned with the continued support of the SDP ensuring that all Business Gateway advisers are aware of the programme and what it delivers. Annual Supplier Development Programme to assist SMEs to develop the required suite of supporting policy and practical documentation to submit bids for council works contracts. March 2025 Continue to review the range of support provided to businesses wishing to sell to the public sector March 2025 Build on our knowledge of market supply through further analysis of local capacity to identify new Assess local markets, their existing capacity and willingness of business to grow Identify opportunities for local SME's to increase spend working with various agencies. Annual 37
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We will: High Level Actions Steps we will take to deliver this action Timescales opportunities for local business to grow together with the identification of appropriate contract opportunities. Encourage local suppliers to bid for Scotland Excel and HubSW contract opportunities. Annual Promote the council’s contract register as a source of information to interested parties Annual Enact the changes necessary to the council contract terms and conditions to capture levels of sub-contracting spend December 2024 Increase the levels of pre- market engagement before commissioning to shape the preparation of tender requirement and prepare potential local bidders Assess those procurement opportunities where pre-market engagement would be considered beneficial. Utilise support from Supplier Development Programme to facilitate engagement, using their marketing and social media channels, plus webinars and early engagement events. Annual Maintain liaison with Tier 1 contractors to promote SME engagement for sub-contract opportunities and, where possible, obtain details of successful awards. Annual Earlier identification of potential contracts and cascading of this information to the relevant businesses. Annual Increase promotion of tender opportunities to local sectors Use a range of communication methods to advertise opportunities to potential bidders. Support supplier events and continue the use of social media. Annual Supplier Development Programme to raise market awareness of opportunities using their marketing and social media channels, plus webinars. Annual Specific promotion of quick quote opportunities. Annual 38
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We will: High Level Actions Steps we will take to deliver this action Timescales Improve the environmental outcomes from procurement Review sustainability requirements for contracts. Progress the Flexible Framework Sustainability action plan to further embed good procurement practice. March 2025 Work with anchor institutions to explore further opportunities for more local spend Identify those anchor organisations willing to participate and promote contract opportunities to local SMEs and social enterprises. Complete an exercise to identify common areas of interest with other anchor organisations. March 2025 Assessment of tender opportunities and development of collaborative procurement routes. March 2025 For our lower value procurement processes NHS Lanarkshire will ensure, where possible, that at least half of the suppliers invited to quote are based in the Lanarkshire area. March 2025 Maximise our approach to community benefits and social investment Review of the changes to delivering increased levels of community benefits and identification of new opportunities to improve community outcomes. NHSL promotion of NSS Community benefits gateway March 2025 Monitor the wish lists delivered from community benefits. Quarterly Review procurement practices to deliver more local spend where possible Consideration of the changes that could be made to the way contractual opportunities are presented to the market and evaluated in support of community wealth building objectives. Review the contract evaluation criteria for regulated spend and potential for increasing tender opportunities for local business. December 2024 Review standing orders to identify changes that could increase opportunities for local spend December 2024 39
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Workforce We will: High Level Actions Steps we will take to deliver this action Timescales Promote Living Wage and Fair Work practices locally demonstrating this within our own working practices Ensure that all Anchor organisations including South Lanarkshire Council have adopted the Living Wage as well as Living hours and fair work practices We will continue to advocate the Living Wage and work on developing living hours along with our Community Planning Partners and Anchor Organisations. March 2025 Support our local businesses to create fair working practices Continue to ensure that all businesses and third sector organisations who engage with the Council are encouraged to adopt the Living Wage and a fair work approach to employment practices. March 2025 Provide webinars and support to understand impact of Fair Work, for employers and communities. March 2025 Identify employability support staff to provide local employability support to local applicants We will continue to deliver employability programmes which help local residents into work. Our employability projects will work with managers to identify pre-employment training and skills required for entry level jobs as well as building on existing work to prepare our local residents for interview and improve their employability. March 2025 Identify areas of anticipated future demand through workforce planning and put in place training programmes and access to qualifications to match this Work with our own services and public and private sector partners to identify the skills they need to grow and create wealth in the local economy, including skills needed for the transition to a net-zero economy We will develop existing relationships with Scottish Enterprise, Business Gateway, and Skills Development Scotland to ensure that up to date labour market and demand led data is informing our plans and developing our skills and knowledge training March 2025 Be responsive to business and Social Enterprise needs We will further develop our Upskilling programme to ensure it is meeting demand led skills requirements and qualifications from local SMEs and Social Enterprises in particular. March 2025 We will work with new businesses to ensure residents are upskilled prior to launch date through pre-employment March 2025 40
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We will: High Level Actions Steps we will take to deliver this action Timescales training and employability support. Screen vacancies for suitability to local labour market Promote the Council and partners as an ‘Employer of Choice’ highlighting our excellent Terms and Conditions and opportunities for flexible working. Build on work ongoing with Targeted recruitment in Employability Services, ensuring that applicants are supported to apply for vacancies with the council and partners as well as receiving pre-employment training where required. Use available funding to support job opportunities for local people within council. March 2025 Continue to support local residents and businesses through our extensive employability programme of support We will continue to work with local companies and residents to ensure we reach the best fit of local vacancies to skills. Investing in training and employability support where required. March 2025 Identify potential numbers and roles for Modern Apprenticeship opportunities with Managers in the council and work with SDS to reflect these in the contract. Identify suitable Modern Apprenticeship opportunities within the Council over next 2-5 years Work with Resource workforce plans to identify numbers and MA occupational areas and build on MA frameworks to create training which meets the needs of SLC. March 2025 Engage with SDS to agree MA priorities at national and local level Modern apprenticeship opportunities a standing item for discussion at local employability partnership meetings. March 2025 Work with Education Resources to identify suitable Foundation and Modern Apprenticeship journeys Monitor progress of Foundation apprenticeship candidates who are ready/suitable for Modern Apprenticeship opportunities. Put in place any additional supports required. March 2025 Explore with Scottish Government the possibility of using Youth Guarantee funding to support these additional Modern Apprenticeship roles Review the funding streams available to the Council to support training including Modern Apprenticeships Examine the terms and conditions of these funding streams to identify best option for funding or part- funding Modern Apprenticeship programmes and other training opportunities March 2025 Put in place options for trainee positions including modern apprenticeships using workforce plans and Use different funding streams to leverage best available options for sustainable traineeships. Link to work with DYW. March 2025 41
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We will: High Level Actions Steps we will take to deliver this action Timescales funding criteria to maximise effectiveness 42
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Land and property We will: High Level Actions Steps we will take to deliver this action Timescales Continue to deliver an Affordable Housing Supply Programme Increase the supply of affordable housing across South Lanarkshire Deliver the Strategic Local Programme Agreement (SLPA) March 2025 (Annual) Preparation and approval of the Strategic Housing Investment Plan (SHIP) October 2025 (Annual) Implement policy on affordable housing in new private developments in Local Development Plan 2 March 2025 (Annual) Continue to operate and further develop the Open Market Purchase Scheme Identify and purchase appropriate properties to meet specific housing needs Promote and advertise scheme in targeted areas. March 2025 Achieve our target for properties purchased through Market Purchase Scheme. March 2025 Identify opportunities for housing led regeneration projects Continuous assessment of regeneration priorities as part of Local Housing Strategy process. Considered as part of annual review of Local Housing Strategy. March 2025 (Annual) Identified priority projects included as part of SHIP development. October 2025 (Annual) Ensure priority projects are included as part of the preparation of the next Local Development Plan 3 March 2025 (Annual) Support owners of empty homes to bring them back into use Continue to target long- term empty homes to bring them back into effective use and contribute towards meeting housing needs with a target of 15 set for 2023/24. Establish a Matchmaker Scheme to link empty properties with interested buyers. March 2025 (Annual) Set up an empty home grant scheme providing financial support for owners to improve property condition. Provide practical advice and assistance to empty property owners. Promote and support the Community Asset Transfer process Increasing number of asset transfers Support asset transfer through: • Continued promotional work March 2025 (Annual) 43
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We will: High Level Actions Steps we will take to deliver this action Timescales • Continuation of CAT Officer Post to support community interest. • Grow Community Capacity Annual evaluation of the ‘value’ of asset transfers to communities and CWB. March 2025 (Annual) Deliver improvements to support the Energy Efficient Scotland programme and encourage homeowners to do the same Continue to improve the energy efficiency of the Council’s housing stock contributing towards national climate change ambitions The Housing Investment Programme will continue to incorporate sustainable changes to the Council’s housing stock, working towards increasing the number of properties that meet the relevant energy efficiency standards for social housing. March 2025 (Annual) Continue to implement energy efficiency measures across council and partner facilities including investment in renewable energy solutions and low/ zero-carbon heating Deliver a range of projects as part of the Community Energy Efficiency Fund programme. March 2025 (Annual) Reduce embodied carbon from construction (new builds and refurbishment) Continue to maximise external funding to support owners and private rented properties improve their property Work with partners, including Home Energy Scotland, to provide advice and support to owners and private landlords on funding opportunities available to them. March 2025 (Annual) Implement and administer the Energy Company Obligation (ECO) scheme within South Lanarkshire. March 2025 Repurpose neglected town centre assets to encourage footfall and spend in the local economy and create thriving places where people can access goods and services on foot or via public transport. Take the “20-minute neighbourhood” concept into account when planning capital schemes. Include “20-minute neighbourhoods” within the scoring criteria when assessing bids for UK, Scottish Government and Council funded capital schemes October 2025 (Annual) Apply the principles of Community Wealth Building to spatial planning decision including the preparation of Local Development Plan 3 and Ensure LDP3 supports the principles of Local Living and community wealth building. 44
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We will: High Level Actions Steps we will take to deliver this action Timescales the assessment of planning applications. Approval of proposed Plan followed by consultation and examination Adoption of Plan October 2025 December 2027 Look to ensure that Council-led physical regeneration schemes have input from other anchor institutions and key partners and enable sharing and participation form the community and voluntary sectors. Engage with public, private, and voluntary sector partners to marry - up aspirations and pool funding to add value and deliver one-stop service provision Ensure cross sector- partners are aware of planned projects and opportunities for collaboration October 2025 (Annual) 45
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Finance We will: High Level Actions Steps we will take to deliver this action Timescales Building on the relationship we already have with local Credit Unions; we will work locally with the credit unions and other community partners to explore ways to encourage use of the savings and affordable credit facilities which they offer. Develop working relationships with CUs and community partners to promote savings and affordable credit Explore options and opportunities to support the work of the Credit Unions. (TBC) March 2025 Promote the NHS credit union and other local credit unions through the anchor communications plan. Through media and procurement interventions, we will encourage our staff to spend locally, in our communities to allow them to grow. We will look to encourage Council employees who live locally to spend locally. Publicity campaign(s) to explain the benefits of local spend for local SMEs and communities. March 2025 Continue our Participatory Budgeting process to deliver locally targeted spend. Continue the PB approach embedded in practices over recent years. Continue PB across Council Services to ensure local spend decisions are made by local people. Ongoing Look at ways of attracting and promoting investment opportunities in our area to regional and national institutions. Progress South Lanarkshire City Deal projects as part of the Glasgow City Region City Deal programme which facilitates economic growth in the South Lanarkshire and City Region area. The Council will continue to support the City Region programme financially as well as progressing and managing a number of South Lanarkshire capital projects. March 2025 (Annual) 46
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Building the generative economy We will: High Level Actions Steps we will take to deliver this action Timescales Continue to develop how business grants can help grow communities Offer targeted support to South Lanarkshire businesses, enabling them to create and safeguard jobs, increase turnover and profit Develop sector specific programmes (tourism, food and drink, social enterprises, green economy, construction, manufacturing etc) March 2025 (Annual) Signpost businesses to other sources of help and advice March 2025 (Annual) Promote investment opportunities to regional and national institutions to market South Lanarkshire as a place to visit and do business Develop a marketing/investment strategy, including a promotional programme with targeted/seasonal events and promotions around key employment sectors. Improve web presence/ online material March 2025 (Annual) Ensure planning and other statutory advice is up-to- date and accessible March 2025 (Annual) Deliver the Social Enterprise Strategy and Action Plan Deliver the objectives outlined in the social enterprise strategy 2023- 27 Deliver actions under the key priorities of Stimulating Social Enterprise, Developing Stronger Organisations and Realising Market Opportunity. March 2025 47
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive Subject: Context for Community Wealth Building: Data Digest 1. Purpose of Report 1.1. The purpose of the report is to:- present data on the social and economic situation in South Lanarkshire as context for Community Wealth Building. 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- (1) that the contents of the report be noted. 3. Background 3.1. To set the scene for the work of the Community Wealth Building Commission, a “data digest” was compiled and presented to the first Commission on 31 August 2021. The digest covered a range of demographic, social and economic indicators and grew out of a joint CPP session on tackling inequalities. 3.2. The Commission agreed that it would be helpful for regular updates on key statistics would to be brought forward to assist debate and provide essential context for the work of the Commission. An updated data digest has been presented annually to the Commission. 3.3. The data digest been refreshed for 2024 and is attached as appendix 1 to this report. 3.4. The data digest covers a range of topics, including: general population claimant unemployment and universal credit claimants child poverty welfare service statistics economic performance including GVA, business start-ups and failures, and businesses per population health impact of Covid on the labour market A range of public health indicators including road accident casualties, crime statistics and hospital admissions data. 4. Employee Implications 4.1. There are no direct employee implications. 5 49
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5. Financial Implications 5.1. There are no direct financial implications. 6. Climate Change, Sustainability and Environmental Implications 6.1. There are no climate change implications as a result of this report. 7. Other Implications 7.1. None. 8. Equality Impact Assessment and Consultation Arrangements 8.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and therefore no impact assessment is required. Paul Manning Chief Executive 2 August 2024 Link(s) to Council Values/Priorities/Outcomes • Accountable, efficient, effective and transparent Previous References • CWB Commission 12 December 2023 – Context for Community Wealth Building: Data Digest List of Background Papers • None Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Tom Little, Head of Communications and Strategy Ext: 4904 (Tel: 01698.454904) E-mail: Tom.Little@southlanarkshire.gov.uk 50
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Appendix 1 – data digest Community Wealth Building Commission Data Digest September 2024 51
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General Population - 2022 Indicator North Lanarkshire % of Total Population South Lanarkshire % of Total Population Total Population 340,930 100.0% 327,430 100.0% Male Population 165,738 48.6% 158,312 48.3% Female Population 175,192 51.4% 169,118 51.7% Adult Population (Aged 16 and over) 280,851 82.4% 272,156 83.1% Working Age population (Aged 16 to 64) 219,482 64.4% 205,490 62.8% Population aged 65 and over 61,369 18.0% 66,666 20.4% Source: NRS Mid-Year Estimates 2022 Claimant Unemployment July 2022 July 2023 July 2024 Council Numbers Rate Numbers Rate Numbers Rate North Lanarkshire 7,850 3.6% 7,585 3.5% 7,835 3.6% South Lanarkshire 6,645 3.3% 6,355 3.1% 6,490 3.2% Scotland 113,155 3.2% 111,930 3.2% 116,855 3.3% Source: NOMIS (July 2024 provisional figures) People on Universal Credit July 2022 July 2023 July 2024 Council Numbers Rate Numbers Rate Numbers Rate North Lanarkshire 33,373 15.2% 35,541 16.2% 41,399 18.9% South Lanarkshire 27,599 13.4% 29,480 14.3% 33,709 16.4% Scotland 457,956 13.2% 491,053 14.2% 561,568 16.2% Source: DWP Stat-Xplore (July 2024 provisional figures, rates based on 2022 MYE working age) Child Poverty after housing costs - 2022/2023 Council Numbers Rate North Lanarkshire 18,264 26.9% South Lanarkshire 14,641 23.6% Scotland 247,144 24.5% Source: The End Child Poverty Coalition 52
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Scottish Welfare Fund – Quarter January to March Indicator North Lanarkshire South Lanarkshire 2022 2023 2024 2022 2023 2024 Number of applications for the Scottish Welfare Fund 7,520 7,455 6,135 5,090 4,575 4,165 Number of applications for the Community Care Grant 1,570 1,705 1,750 1,660 1,580 1,335 Number of Community Care Grants awarded 830 1,160 1,030 1,060 1,175 555 Number of applications for the Crisis Grant 5,945 5,750 5,165 3,430 2,995 2,830 Number of Crisis Grant awarded 3,120 3,930 3,410 2,065 1,870 1,665 Source: Scottish Government Welfare Statistics Council Tax Reduction - June Indicator North Lanarkshire South Lanarkshire 2022 2023 2024 2022 2023 2024 Council Tax Reduction recipients 34,530 34,850 35,130 30,760 30,820 31,180 Council Tax Reduction weekly income forgone (£000’s) 474.6 503.1 511.8 423.7 449.7 458.2 Source: Scottish Government Council Tax Reduction in Scotland Discretionary Housing Payments (DHP) – April to March Indicator North Lanarkshire South Lanarkshire 21/22 22/23 23/24 21/22 22/23 23/24 DHP awards 10,370 10,270 10,335 7,760 7,890 8,065 DHP average value £597 £599 £638 £575 £591 £617 Source: Scottish Government Welfare Statistics 53
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Annual Welfare Services Statistics Indicator South Lanarkshire March 2022 March 2023 March 2024 Number of automatic awards for free school meals 5,335 families 5,343 families 5,201 families Number of clothing grants 12,906 12,672 14,097 Tenants in receipt of Universal Credit 8,679 9,465 10,451 Tenants on Universal Credit who were in arrears 5,432 5,820 5,938 Source: South Lanarkshire Council Economic Performance Indicator North Lanarkshire South Lanarkshire Gross Value Added (GVA) - 2022 £9,208m £7,463m Gross Value Added per hour worked – 2022 £40.70 £36.20 Business expenditure in R&D per head - 2020 £206 £87.07 Number of active businesses - 2022 8,635 9,575 Enterprise rate per 10,000 working-age population - 2023 345.1 438.5 New business start-ups - 2022 1,140 1,175 Business start-ups birth rate per 10,000 16-64 population – 2022 51.9 57.2 % of Scottish business start-ups – 2022 6.04% 6.23% Business deaths – 2022 1,115 1,100 Business start-ups death rate per 10,000 16-64 population - 2022 50.8 53.5 % of all business failures in Scotland - 2022 5.68% 5.60% Businesses surviving after three years in of those established in 2019 and still in business in 2022 54.1% 56.3% Growth sector enterprise 2023 2,195 3,200 Source: Office for National Statistics 54
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Health Indicator North Lanarkshire South Lanarkshire Scotland Adult Disability Payment - processed applications authorised - to 30 April 2024 58% 58% 57% Number of residents economically inactive due to long-term sickness - year to June 2023 27,100 13,700 258,500 Rate of residents economically inactive due to long-term sickness - year to June 2023 42.3% 32.4% 32.7% Number of Incapacity-based benefits (per 1,000 16-64 population) – August2023 65.8 54.8 52.7 Healthy Life Expectancy for those born in the 2019 to 2021 period for Females 56.7 years 62.7 years 61.1 years Healthy Life Expectancy for those born in the 2019 to 2021 period for Males 54.3 years 60.2 years 60.4 years Source: Social Security Scotland; NOMIS; National Records of Scotland Selected Information from ScotPHO profiles at Council Area level More detail can be found on the Scottish Public Health Observatory website Indicator North Lanarkshire South Lanarkshire Scotland Active travel to work - 2020 10.06% 10.34% 16.93% Adults rating neighbourhood as a very good place to live - 2020 42.3% 59.6% 59.1% Alcohol-related hospital admissions per 100,000 population - 2021/2022 790.18 683.81 611.05 Annual participation (in education, training or employment) measure for 16 - 19 year olds – 2023 92.84% 95.02% 94.27% Asthma patient hospitalisations per 100,000 population - 2019/20 to 2021/22; 3-year aggregates 101.76 80.67 68.44 Babies exclusively breastfed at 6-8 weeks - 2019/20 to 2021/22; 3-year aggregates 16.88% 22.31% 31.88% Bowel screening uptake - 2020 to 2022; 3-year aggregates 61.48% 64.74% 66.23% Breast screening uptake - 2010 to 2012; 3-year aggregates 68.26% 70.85% 72.48% Cancer registrations per 100,000 population - 2019 to 2021; 3-year aggregates 628.41 625.71 630.34 Child dental health in primary 1 - 2022/2023 School year 72.54% 75.59% 73.80% Child dental health in primary 7 - 2022/2023 School year 72.34% 75.77% 75.17% Child healthy weight in primary 1 - 2019/2020 73.61% 76.50% 76.34% Children looked after by local authority - 2021 July snapshot - Crude rate per 1,000 children aged 0-17 years 10.51 12.03 12.93 Children referred to the Children's Reporter for offences -2021/2022 - 5.52 5.46 4.97 55
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Indicator North Lanarkshire South Lanarkshire Scotland Crude rate per 1,000 children aged 8-15 years Chronic obstructive pulmonary disease (COPD) patient hospitalisations per 100,000 population - 2019/20 to 2021/22; 3-year aggregates 322.78 243.94 207.45 Coronary heart disease (CHD) patient hospitalisations per 100,000 population - 2019/20 to 2021/22; 3-year aggregates 388.83 361.43 341.63 Deaths all ages per 100,000 population - 2019 to 2021; 3-year aggregates 1382.12 1270.62 1180.65 Deaths from suicide per 100,000 population - 2017 to 2021; 5-year aggregates 15.96 13.25 14.13 Deaths, aged 15-44 years per 100,000 population - 2019 to 2021; 3-year aggregates 149.77 139.24 117.14 Domestic abuse - 2021/2022 - Crude rate per 1,000 population 139.84 118.40 118.26 Drug crimes recorded - 2021/2022 - Crude rate per 1,000 population 67.55 55.42 50.59 Drug-related deaths, males - per 100,000 population - 2017 to 2021; 5- year aggregates 33.55 34.67 33.15 Drug-related deaths, females - per 100,000 population - 2017 to 2021; 5- year aggregates 13.90 13.77 13.12 Drug-related hospital admissions - per 100,000 population – 2019/20 to 2021/22; 3-year aggregates 254.62 204.90 228.36 Early deaths from cancer, aged <75 years - per 100,000 population - 2019 to 2021; 3-year aggregates 168.87 153.69 149.58 Early deaths from coronary heart disease (CHD), aged <75 years - per 100,000 population - 2019 to 2021; 3- year aggregates 64.61 53.36 52.59 Emergency patient hospitalisations per 100,000 - 2019 to 2021; 3-year aggregates 9327.28 8013.66 7236.08 Healthy birth weight - 2020/21 to 2022/23; 3-year aggregates 84.58% 85.14% 84.57% Immunisation uptake at 24 months - 6 in 1 - 2020 to 2022; 3-year aggregates 97.00% 97.59% 96.98% Immunisation uptake at 24 months – MMR - 2020 to 2022; 3-year aggregates 95.15% 95.81% 94.39% Life expectancy, females – 2020-2022 78.69 years 80.12 years 80.72 years Life expectancy, males - 2020-2022 74.50 years 75.56 years 76.54 years Multiple emergency hospital admissions, aged >65 years - per 100,000 - 2019 to 2021; 3-year aggregates 6458.11 5592.38 5000.91 People aged 65+ with high levels of care needs who are cared for at home - 2022/2023 44.49% 45.75% 36.70% People living in 15% most 'access deprived' areas - 2019 8.79% 13.36% 14.99% Population income deprived – 2019 14.91% 12.70% 11.98% 56
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Indicator North Lanarkshire South Lanarkshire Scotland Population prescribed drugs for anxiety/depression/psychosis - 2021/22 22.35% 21.92% 20.14% Population within 500 metres of a derelict site – 2022 68.47% 18.80% 26.64% Psychiatric patient hospitalisations per 100,000 - 2019/20 to 2021/22; 3-year aggregates 195.49 192.71 230.66 Road traffic accident casualties - per 100,000 - 2019 to 2021; 3-year aggregates 43.12 46.06 54.70 School leavers in positive destinations - 2022/23 school year 94.73% 96.88% 95.87% School leavers with 1 or more qualification at SCQF Level 4 - 2022/23 school year 56.25% 60.66% 57.93% School leavers with 1 or more qualification at SCQF Level 6 – 2022/23 school year 43.51% 42.12% 41.48% Single adult dwellings – 2022 40.21% 38.34% 38.45% Smoking attributable deaths per 100,000 - 2020 to 2021; 2-year aggregates 327.95 280.38 270.02 Smoking during pregnancy - 2019/20 to 2021/22; 3-year aggregates 15.32% 11.35% 12.92% Smoking prevalence, aged 16-34 years - 2019 survey year 19.2% 15.5% 18.6% Teenage pregnancies - 2019 to 2021; 3- year aggregates- Crude rate per 1,000 females aged 15-19 29.08 25.13 24.95 Violent crime – 2020/21 - Crude rate per 10,000 15.77 15.9 16.41 Working age adults with low or no educational qualifications – 2019 16.20% 13.10% 11.64% Working age population employment deprived – 2019 11.3% 9.7% 9.3% Source: Scottish Public Health Observatory 57
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive Subject: Community Wish List Update 1. Purpose of Report 1.1. The purpose of the report is to: - [purpose] provide an update on the establishment and development of the Community Wish List [1purpose] 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s): - [recs] (1) that progress made on the implementation of the Community Wish List be noted; (2) that it be noted that South Lanarkshire will continue to use its own software platform to process local wishes while assessment continues of a new City Region platform, as outlined in section 6; and (3) that it be noted that the continuing local system will be maintained by the council’s Community Engagement Team, as outlined in section 7. 3. Background 3.1. Community Wish Lists have been established across the Public Sector where communities are enabled to put forward requests for specific needs or benefits that can then be supported by suppliers delivering contracts. 3.2. In July 2022, the Commission received an update that noted that all eight local authorities in the Glasgow City Region had agreed in 2022 to work together to develop a regional web-based Community Wish List interface, which would have a shared backroom and individual landing pages. It was hoped that this would allow South Lanarkshire and the other member authorities to have control over their own process and the content of their web page. 3.3. At the time, South Lanarkshire Council identified investment funding which supported a fixed term 0.5 FTE officer post in the Community Engagement Team to work with communities to promote understanding and awareness of the Community Wish List. That funding and post moved the Wish List forward in South Lanarkshire despite a delay in establishing the regional platform. 3.4. There was a great deal of preparatory work with communities in South Lanarkshire to introduce the new concept prior to the interface going live. The postholder commenced in June 2022 and focused on establishing an in-house platform, promoting the service and supporting groups to identify their wishes. The South Lanarkshire Wish List launched in July 2023. 6 59
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4. Current Progress 4.1. The Community Wish List has been ‘trading’ for 12 months. At the end of July is had 189 open wishes, 69 wishes answered worth a value of £51,000. 4.2. The most recent wishes completed include:- Community Organisation Wish Supplier Fernhill Soccer School Kits, trophies, medals, equipment AM Phillip Trucktech Ltd. Hamilton Churches Drop In Food Items and supplies McConechy’s Tyres Blantyre Nursery Waste removal for nursery improvements to inside space and gardens Jettison Professional Waste Management Strathaven Junior Parkrun Waterproof clipboards, storage boxes, pole bags, storage bags, access to a printer Share Alike (another community group) Menshed £500 towards upgrade to accessible toilets and a new kitchen MacClay Civil Engineering Burnhill Highbacks Youth environment group Free shredding of personal information for the community Paper Shredding Services • Doorstep crime awareness • Youth engagement with community Reach Lanarkshire Autism Sensory education items such as floor puzzles and sand RM Resources Kilbryde Hospice train staff and volunteers to act as ‘biographers’, offering patients the chance to record their life story onto a digital device for their families to keep. Forte Engineering Ltd donated £800 to allow four people to be trained as ‘biographers’. 5 Current Delivery Model 5.1. The delivery of the programme to date requires contact with both communities and suppliers to continually develop the wishes, find offers and to find matches. Team members in procurement liaise with suppliers to assist them to choose from the Wish List and then refer the supplier to the Community Engagement Team to support the match to take place. 5.2. The consistent messaging and pro-active promotion of the wish list through both teams’ networks has contributed to its quick growth and the pace of successful matches. 5.3. The Community Wish List has been fully integrated into the SLC Community Benefits menu. The refreshed Community Benefits menu sets out a range of opportunities for suppliers to engage with the Community Wish List, with hyperlinks from the menu taking bidders directly to the wish list webpage. This is promoted and monitored by the Procurement team. 60
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6 Regional Platform 6.1 As noted at 3.2 above, the council has been engaged in the Glasgow City Region project to develop a shared Community Wish List platform for the region. After some delays, the platform has now been developed and full testing is underway. 6.2 As South Lanarkshire Council has already developed its own in-house platform, we will assess the pros and cons of using the regional platform against those offered by our current systems and processes. 6.3. Development of the regional platform will continue to be monitored and we will continue to engage with the City Region on its implementation. In the meantime, we will continue to use the Council’s own platform. 7. Reshaping the local Community Wish List service 7.1. Funding for the council’s Wish List officer has previously been extended but is scheduled to end on 10 November 2024. In the absence of further funding, a change will be required to the council’s approach to delivering the service. 7.2. The Wish List would move from a developmental phase into a maintenance phase, with tasks incorporated into the regular work undertaken by the Community Engagement Team. 7.3. We will continue to use our in-house platform, maintain a manual reporting system, and monitor the use of the Wish List system. This will allow the council to understand and consider the impact of these changes on the numbers of wishes being submitted and those being fulfilled. 8. Employee Implications 8.1. The Wish List Development Officer is a 0.5 FTE temporary contract that will end on 10 November 2024. 9. Financial Implications 9.1. The funding for the temporary post has ended and, therefore. there will be no further costs when the contract ends. 10. Climate Change, Sustainability and Environmental Implications 10.1. There are no climate change, sustainability or environmental implications as a result of this report. 11. Other Implications 11.1. There are no other implications. 12. Equality Impact Assessment and Consultation Arrangements 12.1. There are no Equality Impact Assessment or consultation implications associated with this report. Paul Manning Chief Executive 23 August 2024 Link(s) to Council Values/Priorities/Outcomes 61
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Values Focused on people and their needs Working with and respecting others Accountable, effective, efficient and transparent Ambitious, self-aware and improving Fair, open and sustainable Priorities We will work to put people first and reduce inequality We will work towards a sustainable future in sustainable places We will work to recover, progress, and improve Outcomes Good quality, suitable and sustainable places to live Thriving business, fair jobs and vibrant town centres Caring, connected, sustainable communities People live the healthiest lives possible 62
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Previous References None List of Background Papers None Contact for Further Information If you would like to inspect the background papers or want further information, please contact: - Jen Kerr, Community Engagement Manager Email: Jennifer.Kerr1@southlanarkshire.gov.uk 63
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive, South Lanarkshire Council Subject: Marmot Place for South Lanarkshire Briefing 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] Inform Community Wealth Building Commission members of the Marmot approach to place and establish a rational for a South Lanarkshire application for support to have a local Marmot Place 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- (1) endorse that that South Lanarkshire Council, in partnership with NHS Lanarkshire, are seeking to host and submit an application to particate in the Scottish Marmot Place Pilot on behalf of the CPP; and (2) note that the Hamilton Locality is the Marmot Place area within which we will apply to the Marmot place model. 3. Background 3.1. Marmot Places is an evidence based, place approach where partners collaborate to reduce inequalities in a defined ‘place’. The ‘place’ could be a town, a neighbourhood, or a whole authority. 3.2. Public Health Scotland (PHS) and 3 local areas in Scotland have an opportunity to collaborate with the University College London Institute of Health Equity (IHE), led by Professor Sir Michael Marmot. A leading global health institute, the IHE has worked with more than 45 local authorities, the NHS, businesses and the community and voluntary sector to improve health and reduce inequalities. 3.3. A Marmot Place recognises that health and health inequalities are mostly shaped by the conditions in which people are born, grow, live, work and age. It takes action to improve health and reduce health inequalities and can demonstrate success in Marmot Towns in reducing health inequalities. 3.4. Based on 8 principles, Marmot Places develop and deliver interventions and policies to improve health equity, embed health equity approaches in local systems and take a long-term, whole-system approach to improving health equity. 3.5. A whole systems approach to health recognises that our health is shaped by many things: 40% social and economic factors, 30% health behaviours, 20% health services, 10% physical environment.1 No one service or agency controls all of 1 Adapted from the Kings Fund (A Vision For Population Health | The King's Fund (kingsfund.org.uk) 7 65
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these factors and indeed some of them are beyond control of public services, but many are not. 4. The 8 Marmot Place Principles 4.1. The Marmot Place Principles evolved from an evidence-base of social determinants of health, which can influence health equity in positive and negative ways. A Marmot place work across all of the 8 principles: - 1. Early Years: Give Every Child the Best Start in Life 2. Education: Enable all children, young people and adults to maximise their capabilities and control their lives 3. Work: Create fair employment and good work for all 4. Living standards: Ensure a healthy standard of living for all 5. Places: Create and develop healthy and sustainable places and communities 6. Ill health prevention: Strengthen the role and impact of ill health prevention 7. Discrimination: Tackle discrimination, racism and their outcomes 8. Just transition: Pursue environmental sustainability and health equity together 5 Community Planning Partnership (CPP) Whole Systems Approach 5.1. At meeting on 14 September 2022, the CPP agreed to develop a project concept for a whole systems approach to place that would be tested in an area. 5.2. Community Planning Partnerships have duties under the Community Empowerment Act (Scotland) 2015 to produce 'locality plans' at a more local level for areas experiencing particular disadvantage. All partners must take account of these plans in carrying out their functions and must contribute appropriate resources to improve the priority outcomes. CPPs must furthermore support community bodies to participate in all parts of the process, in the development, design and delivery of plans and in review, revision and reporting of progress. We currently meet these duties through neighbourhood planning work, but we believe implementing whole systems place approach would greatly improve the impact of locality planning. 5.3. The project would follow a whole systems model that, therefore, seeks to understand the contribution of all partners and sectors, including community partners, local residents, patients, clients, service beneficiaries. 5.4. The whole systems project would examine the key priorities of the CPP’s Community Plan to do address inequalities which is outline in figure 1. The key priorities and ambitions of the Community plan align closely to the Marmot Principles. Figure 1: - 6 Key Priorities 1- Our children and young people Thrive 2- Putting Learning at the centre 3- Thriving Businesses and fair jobs 4- Good quality, suitable housing for everyone 5- Caring, connected Communities 2023 Priorities 66
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5.5. The CPP whole systems project will attempt to identify inequalities in a place and shift the conditions that are holding that problem in place. 5.6. Much like the Marmot approach, and the Shaping Places for wellbeing model, the partnership views a ‘whole system’ as a set of interconnected parts, where each part is dependent on the other, like an ecosystem. In a place approach, systems can include policies, routines, relationships, resources, power structures, values, and beliefs. Systems are complex and dynamic, therefore difficult to change. 5.7. We would work to implement the tools and learning from our participation in the Shaping Places for Wellbeing project which advocates collaboration, evidence and a place approach to health improvement to address the social and economic factors of inequality that affect health. Rutherglen was a project town and we will incorporate the Place and Wellbeing Assessment process and the Place and Wellbeing Outcomes Wheel into any approaches we develop. 5.8. The CPP Outcomes Leads Group have been reviewing profiling data for the Hamilton area across a range of variables which have been aligned to the Community Plan priorities. This has been used to identify the Burnbank area of Hamilton for the application of a partnership approach to whole systems working. The SIMD 2020 shows that in relation to health deprivation in South Lanarkshire, Burnbank South is the most deprived and is ranked as the 45th most health deprived area in Scotland. The area also ranks the highest in South Lanarkshire for income deprivation; and is the 64th most income deprived area in Scotland. In South Lanarkshire, it is also ranked second for employment deprivation, and 9th for Crime deprivation. 5.9. NHS Lanarkshire’s Public Health Consultant is currently assisting partners to compile and assess heath inequality data for Burnbank. This work is in progress. 5.10 The project would also explore taking a Community Wealth Building/ wellbeing economy approach to place planning in the area as part of a place governance framework. It will explore and pilot practical ideas to building, retaining, monitoring, and growing local wealth in the area. The Community Wealth Building Commission Strategy would be a key document in the strategic evaluation for the area and support the Child Poverty Action Plan in its family employment initiatives. 6. Place Planning for Economic and Social Impact 6.1. SLC’s Planning Service is presently preparing its next Local Development Plan (LDP) which will represent the spatial strategy of the area. Among other things the Plan must take account of the Community Plan and will consider the health needs of the population. The plan will incorporate a place-based approach to deliver change and development in a particular place including supporting improved health outcomes and reducing health inequalities. 6.2. LDPs can help create healthier places and support active lifestyles by providing opportunities for play and open space and supporting active travel. The Marmot Place approach would contribute to the preparation of LDP3 by helping to understand the reasons for health inequalities in an area and develop a spatial response where appropriate. 5 of the Marmot Place principles described above have direct links to several policy topics that will be addressed in the LDP i.e. work, living standards, places, ill health prevention and just transition. 67
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6.3. Hamilton is a town centre undergoing a Master Planning exercise. It has strong assets and a definable place quality. This is evident though the strong civic presence, business base, historical architecture, and investment to date. These provide the foundations for Hamilton to reassert its role as a strong and vibrant town centre, that will be re-designed to have a positive impact on the economic, social, and physical wellbeing of its residents and the surrounding communities. 6.4. Recognition of the change in retail requirements in the town allows focus on other key aspects of the town centre including leisure and cultural offering, services, and town centre living. The town has been steadily expanding over recent years and has an ever-increasing population base which can support a multifunctional town centre. As one of Lanarkshire’s largest towns, Hamilton is well placed to provide a variety of functions to a large catchment area. 6.5. The masterplan is detailed and complex bringing together a range of solutions which balance the ambitions of the community with the challenging commercial environment. It will be a15+ year project but the impact on the health and wellbeing can be considered at the planning stage and in early developments. 7. Marmot Place Scottish Programme 7.1. The Marmot place programme will operate in Scotland as a 2-year partnership between IHE, Public Health Scotland and 3 Scottish Local Authorities to foster a whole system collaboration (health & social care services, national and local government, private sector, Third Sector, civic society, communities, academia) around a place with health equity at its core. 7.2. The process in 3 Local Authorities will take just under 2 years and the place- based work will have 4 main components: - 1. Analysis of data Working with local data analysts and national and local data to provide data packs identifying inequalities in health and the social determinants of health with focus on particular groups and places Production of data and relevant advocacy for stakeholders within the place including, across local government and the community planning partnerships, healthcare, social care and public services, business and the economic sector, the community and voluntary sector, communities Prioritisation of specific issues, places, and population groups 2. Understanding enablers and barriers to action Working with stakeholders across the ‘health equity' system within the place to assess opportunities and barriers to action Workshops with various stakeholders on specific areas, identified as priorities There will be a focus on commissioning and resource allocations within the place Working with the health equity system to identify ways forward for a long -lasting health equity system 3. Development of recommendations for action Based on stages 1 and 2 IHE will work with key stakeholders to develop recommendations to support better health and well being Following development of recommendations, an implementation plan will be proposed 68
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4. Work with other places and the national system in Scotland Based on the work within places, places will be asked to share their experiences and learning with other places and with the national system in Scotland IHE will support places to do this with briefings and relevant analyses. 8. Considerations 8.1 The Marmot Place approach incorporates the evidence-based approach to inequality that we currently use in Neighbourhood Planning processes and are going to improve through implementing the Shaping Places to Wellbeing model learning. This will widen the scope of evidence we draw on and it will improve our joint analysis skills. 8.2. The Marmot Place Principles mirror the key priorities and aims of South Lanarkshire’s CPP Community Plan, and both can incorporate the Shaping Places for Wellbeing approaches. We are committed to working within this model. 8.3. Stage 2 of the Marmot Place Programme is the unique difference in the Marmot approach that we wish to learn. It recognises the inbuilt and unconscious resistance within a system to maintain its status quo and can provide evidence and experience as tools to change the factors that are holding problems in place. 8.4. Stage 2 focuses on resource allocation and works to identify a case for ‘disproportionate universalism’ which means, to redirect resources from universal services into effective prevention and support for inequalities. This is also referred to as integrated or joint resourcing in other policy areas and would be the key aim of any place project the CPP enters into. 8.5. IHE offers a wealth of research and experience in other Marmot Towns to learn from and apply in South Lanarkshire. 8.6. We could consider a Marmot Place at any level. We could apply the work to all of South Lanarkshire, to one town, to a locality or a neighbourhood. Given the geographic size and variation of density across south Lanarkshire, we would suggest that a locality boundary would be the highest level to look a whole system of place in a detailed way. 8.7. If Hamilton locality were considered, it would be possible to expand CPP project concept from current to include other Hamilton locality Neighbourhood Plans and the town centre master planning exercise. 8.9 Key Dates for Applications:- Expressions of Interest 23 September 2024 Shortlist notifications 3 October 2024 Shortlisted meetings 15-20 October 2024 Three areas announced 4 November 2024 8.10 Criteria for Applications:- 1. Leadership and stakeholders’ willingness to prioritise action on health, wellbeing and reducing health inequity over the next two years 2. Evidence that participation in this programme will enhance existing work already being progressed locally through the CPP or other local leadership forum 3. Inclusion of the place complements the contexts of the other two places and as such will help generate learning useful more broadly across Scotland 69
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9. Employee Implications 9.1. There are employee implications associated with this report for all resources working with the geographic area of a Marmot Place. 9.2. All resources within the Marmot Place are part of a system and would be expected to be open to participating in the programme, examining their current resources and staff and be open to considering adapting these resources to support any proposed changes. 10. Financial Implications 10.1. At this stage, there are no financial implications 10.2 However, there are likely to be financial implications associated with participating in a Marmot Place as it aims to provide an evidence base for investment in inequality through a disinvestment in universal services. Without a commitment to review resourcing arrangements against a new evidence base and the Marmot Principles, the project would not realise the changes it seeks. 10.3. Any implications would be considered, negotiated, and agreed within phase 3 of the project. Any recommendations would have a strong evidence base and seek approvals as required. 11. Climate Change, Sustainability and Environmental Implications 11.1 It is expected there would be positive environmental impacts to a Marmot Place. It is one of the 8 principles to address in the programme. 12. Other Implications 12.1. There are risks associated with this report because success depends on factors in a whole system that are out with the control of the council. Our ability to facilitate collaboration and be systems leaders mitigates this risk. 12.2 The Marmot principles, which aim to reduce inequality and improve health outcomes for all, would have to be embedded across all of the core functions of the Council and its partners”. The approach would be transformative but would need to be integral to how the Council and its partners works. This has practical operational considerations for all. 12. Equality Impact Assessment and Consultation Arrangements 12.1. If approved, this report would introduce a new policy approach and review and change existing policy, function or strategy and at this point EIAs would be required. Paul Manning Chief Executive South Lanarkshire Council 28 August 2024 Links to Council Objectives/Values/Ambitions • Accountable, efficient and effective 70
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List of Background Papers Collaborating to reduce inequality Marmot Places (PDF) Contact for Further Information If you would like further information, please contact:- Professor Soumen Sengupta, Director, Health and Social Care. South Lanarkshire University Health and Social Care Partnership Email: soumen.sengupta@southlanarkshire.gov.uk Prof S. Josephine Pravinkumar, Director of Public Health & Health Policy, NHS Lanarkshire Email: josephine.pravinkumar@lanarkshire.scot.nhs.uk Jen Kerr, Community Engagement Manager, South Lanarkshire Council Email: Jennifer.Kerr1@southlanarkshire.gov.uk Aileen Murray, Community Planning Advisor, South Lanarkshire Council Email: aileen.murray@southlanarkshire.gov.uk 71
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Collaborating to reduce inequalities Marmot Places Scotland Scotland’s challenge •People in Scotland die younger than in any other country in western Europe. People in our poorest areas die a decade before their neighbours in the wealthiest areas.1 •Both life expectancy and health inequalities are getting worse. Scotland needs collective action to change course. 1 •National action – like the smoking ban or minimum unit pricing for alcohol – needs to be combined with local action to improve the nation's health. Opportunity for collaboration •Public Health Scotland (PHS) and three local areas in Scotland have an opportunity to collaborate with the University College London Institute of Health Equity (IHE), led by Professor Sir Michael Marmot. A leading global health institute, the IHE has worked with more than 45 local authorities, the NHS, businesses and the community and voluntary sector to improve health and reduce inequalities. •This collaboration will address Scotland’s challenges and share insight and expertise to apply learning from Marmot Places in Scotland. This work will be done collaboratively, supporting work that is already underway at a local level. •We invite leaders at a local, regional and national level with a passion for improving health and tackling health inequality to help shape the approach we take. Delivering change •Since 2013, Coventry has been a Marmot City. It has seen: Improved life expectancy by 6 months. Positive changes in health outcomes. Improvements in school readiness at age 5. Reduction in number of areas rated in England’s poorest neighbourhoods. Enhanced life satisfaction. Reductions in crime in priority locations.Employment gains. 1 https://publichealthscotland.scot/our-areas-of-work/public-health-approach-to-prevention/scotlands- public-health-challenges/ 7 73
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For more information on Sir Michael Marmot, Marmot Cities and the IHE, visit www.instituteofhealthequity.org Email: phs.chiefexecutive@phs.scot to get in touch. 1517 6/2024 © Public Health Scotland 2024 Becoming a Marmot Place •A Marmot Place recognises that health and health inequalities are mostly shaped by the conditions in which people are born, grow, live, work and age. It takes action to improve health and reduce health inequalities. 'Marmot Eight' principles •Based on eight principles, Marmot Places develop and deliver interventions and policies to improve health equity, embed health equity approaches in local systems and take a long-term, whole-system approach to improving health equity. Discrimination •Tackle discrimination, racism and their outcomes. Work •Create fair employment and good work for all. Education •Enable all children, young people and adults to maximise their capabilities and control their lives. Early years •Give every child the best start in life. Just transition •Pursue environmental sustainability and health equality together. Ill health prevention •Strengthen the role and impact of ill health prevention. Places •Create and develop healthy and sustainable places and communities. Living standards •Ensure a healthy standard of living for all. Sir Michael Marmot is a leader in improving population health. He has been Professor of Epidemiology and Public Health at University College London (UCL) since 1985. He currently serves as the Director of the UCL Institute of Health Equity. For nearly 50 years, Sir Michael has led research groups dedicated to understanding and addressing health inequalities. His influential work includes the groundbreaking ̒ Fair Society, Healthy Lives ̓ (known as 'The Marmot Review'), published in 2010. Sir Michael played a pivotal role as the chair of the Commission on Social Determinants of Health (CSDH), established by the World Health Organization (WHO) in 2005. In 2008, he authored the report ̒ Closing the Gap in a Generation ̓ for the CSDH.1 About Sir Michael Marmot PHS is an NHS board with a mission to improve health and tackle health inequality, working both nationally and in support of local partners. About PHS 1 www.who.int/publications/i/item/WHO-IER-CSDH-08.174
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Prof S. Josephine Pravinkumar, Director of Public Health and Health Policy Subject: Director of Public Health Annual Report 2023 1. Purpose of Report The purpose of this paper is to: provide an overview of the NHSL Director of Public Health Annual Report for 2023 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- (1) note the key themes covered in the report including, NHS Lanarkshire’s progress as an anchor organisation; progress on the public health priorities which featured in the 2021/2022 report; and a summary of the health of the Lanarkshire population. 3 Background 3.1. The Director of Public Health Annual report for 2023 focuses on the theme of NHS Lanarkshire as an anchor organisation and outlines the progress that has been made by NHS Lanarkshire in developing this priority area of work. The report is attached at Appendix 1. 3.2 Anchor organisations are typically large local employers that can have a strong and positive influence on the health and wellbeing of their local communities. Organisations can make a difference to health and well-being outcomes and reduce inequalities by their work across five anchor pillars: Being an exemplar anchor; Employer; Procurement; Environment and assets; and Service design and delivery. 3.3 NHS Lanarkshire has developed a 3-year strategic anchor plan which outlines actions it will take to support community wealth building and a more inequalities focused approach to service delivery. 3.4 Opportunities to work with other local and regional anchors on common goals to support community wealth building are evolving through working in partnership. The priorities for action are laid out in the report with examples of work NHS Lanarkshire and partners are taking forward under our anchor ambitions. 3.5 The annual report also includes a reflection on the key Public Health priorities which featured in the previous annual report 2021/22, viewed through a What we said and What happened lens. 8 75
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3.6 Some of the areas of progress noted since the last report include: - NHS Lanarkshire cost of living plan whereby the actions have been incorporated into the NHS Lanarkshire anchor plan in order to ensure a streamlined approach all oral health improvement programmes and the National Dental Inspection Programme have been remobilised. NHS dental activity has continued to increase progress in the area of long-term conditions in 2023 in NHS Lanarkshire has included completion of a Test of Change (pilot) with regards to support for patients attending the respiratory laboratory to quit smoking, which has now been successfully incorporated into usual practice 3.7 The Health of the Population section of the report provides an overview of key demographics for Lanarkshire, drawing from the 2022 census. 3.8 The estimated population of Lanarkshire from Census 2022 figures is 668,200, a 2.6% increase from 2011 Census with South Lanarkshire estimated population 327,000 (4.3% increase from 2011 Census). 3.9 The latest projections available are based on estimates for 2018 and show the population of Lanarkshire as a whole is expected to rise about 0.5% between 2021 and 2032 and fall slightly between 2023 and 2042, making the expected overall change from 2021 to 2042 an increase of 0.2%. 3.10 The projected age structure of Lanarkshire’s population between 2021 and 2042 indicates an increase of the over 75 years’ age group which will equate to 64% of the overall population. 3.11 The lower life expectancy and higher premature deaths in Lanarkshire compared to Scotland, and the inequalities across Lanarkshire, necessitates whole systems working as a key priority, applying multidisciplinary, interagency, and collaborative approaches to prevention, early intervention, and ongoing care. 3.12 The DPH Annual Report 2023 also provides a brief update on health protection work, dental public health, and screening services. 4. Next Steps 4.1. Feedback on the DPH annual report 2023 format and content is welcomed in order to inform future annual reports. List of Background Papers NHS Lanarkshire Director of Public Health Annual Report 2023 2 August 2024 Contact for Further Information If you would like further information, please contact: Prof S. Josephine Pravinkumar, Director of Public Health and Health Policy, NHS Lanarkshire Tel: 01698 752952 E-mail: josephine.pravinkumar@lanarkshire.scot.nhs.uk 76
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2 Acknowledgements I am grateful to the staff within the Directorate of Public Health for all their work over the year. I am also grateful for their continued commitment, and the commitment of NHS Lanarkshire and staff in other organisations, to public health in Lanarkshire. I would like to thank all the contributors to this report within the Directorate of Public Health, the Health Improvement Department and colleagues across NHS Lanarkshire, North Lanarkshire Council and South Lanarkshire Council. Finally, I would like to extend my thanks to all organisations who work with NHS Lanarkshire to protect, maintain and improve the health of the public. This includes North Lanarkshire Council, South Lanarkshire Council, North Lanarkshire University Health and Social Care Partnership and South Lanarkshire University Health and Social Care Partnership. You can contact us by emailing publichealthannualreport@lanarkshire.scot.nhs.uk. The Directorate of Public Health NHS Lanarkshire Headquarters Kirklands Fallside Road Bothwell G71 8BB Telephone: 01698 752952 www.nhslanarkshire.scot.nhs.uk © Lanarkshire NHS Board Published March 2024 We encourage the use by others of information and data contained in this publication. Brief extracts may be reproduced provided the source is fully acknowledged. Proposals for reproduction of large extracts should be sent to the address above. ISBN 978-0-905453-46-0 Cover image: Represents the role of an Anchor organisation, with the five dimensions from chapter 3, on a background featuring the ‘wave’ from NHS Lanarkshire’s logo. 78
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3 Contents Foreword 4 Reflections on the 2021/22 Annual Report 5 1. Health of the People of Lanarkshire 8 1.1 Population Profile and Key Health Measures 8 2. Health Protection 17 2.1 Health Protection Team Update 17 2.2 Lanarkshire’s Hepatitis C (HCV) Elimination Project 20 3. Anchor Themes 26 3.1 NHS Lanarkshire as an Anchor Organisation 26 3.2 Widening Access and Employability Opportunities 28 3.3 Monklands Replacement Project and Community Benefits 31 3.4 Service Design and Delivery 33 3.5 Environment, Sustainability and Assets 35 3.6 Being an Exemplar Anchor 37 3.7 Community Wealth Building 39 4. Healthcare Public Health 44 4.1 Strategic Prevention in Healthcare: Opportunities and Challenges in Lanarkshire 44 4.2 Population Screening 47 4.3 Scottish Dental Needs Assessment Report on Older Adults: Challenges and Recommendations 51 Statistical Appendix 54 79
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4 Foreword It is my pleasure and a privilege to present my second Director of Public Health annual report. It is a huge honour to serve the population of Lanarkshire and I'm very grateful to my team, the colleagues in NHS Lanarkshire, the health and social care partnerships and all our key stakeholders for their support and excellent whole system working that we are all committed to. This year I have focused the report on the theme of Anchor organisations. Anchor organisations are typically large local employers that can have a strong and positive influence on the health and well-being of their local communities. Organisations who are able to do this can make a difference to health and well-being outcomes and reduce inequalities by their work across the five pillars. Organisations can embed this thinking and be an exemplar employer, adopt good procurement practices, design services to suit vulnerable populations better, and also through managing their assets. NHS Lanarkshire and its partner organisations are very committed to the anchors in the local communities we serve. I have also included the usual valuable chapters on the health of the population and our health protection work, dental public health and screening services. Lanarkshire’s population is expected to slightly increase, however there is a change to population age structure; we have an ‘aging population’. Over the next 20 years we expect an increase in people aged over 75 and fewer people aged under 30 years. However, life expectancy in Scotland and Lanarkshire has started to decrease in recent years and there is huge variation between areas. Those living in the most deprived areas have fewer years of life than those living in the least deprived. In Lanarkshire, for men this difference is 11.3 years and for women 8.5 years. Over 40% of all deaths in 2022 were caused by cancer (25.8% of all deaths), coronary heart disease (11.5%), and stroke (5.9%). These are key issues that we would like to continue to tackle. In addition, respiratory diseases accounted for 10% of deaths and dementia and Alzheimer’s accounted for 9.6% of deaths in Lanarkshire in 2022. I am very grateful to the editorial team for being with me throughout this journey and for helping to collate this report. I’m indebted to all for their excellent efforts. I hope you find the report helpful and would be very keen to hear any feedback and also suggestions for themes for future reports. I have included a new section in this year’s report to give a brief update on some of the key population health priorities that we highlighted last year. Prof S. Josephine Pravinkumar, Director of Public Health & Health Policy Email: josephine.pravinkumar@lanarkshire.scot.nhs.uk 80
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Director of Public Health Annual Report 2023 NHS Lanarkshire 5 Reflections on the 2021/22 Annual Report This is a new chapter to report on work undertaken over the last 12 months on key Public Health projects. Cost of Living What we said • The cost of living crisis is likely to lead to adverse health impacts, widen existing health inequalities and increase demand on health and social care services. • A NHS Lanarkshire cost of living action plan has been developed to mitigate the impact of the crisis on patients, carers and staff. • This plan builds on the collaborative work already established through the Child Poverty action plans. What Happened • The cost of living plan actions have been incorporated into the NHS Lanarkshire anchor plan in order to ensure a streamlined approach. • Work is underway to develop a transport strategy for NHS Lanarkshire including the offer of online appointments where appropriate, in order to reduce unnecessary travel costs. • The Health Improvement Team are leading a programme of work to embed raising the issue of financial wellbeing into patient assessments. This also includes asking staff who are on sick leave about their financial wellbeing via occupational health assessments. • A Frequently Asked Questions resource has been developed for staff and managers to raise awareness of resources and supports available. • A communications plan has been taken forward with key messages for staff and patients and a dedicated email address has been provided for staff to feedback experiences and ideas. • Staff roadshows in hospitals have included benefit/debt advice and staff health initiatives within localities have also addressed cost of living issues. Children and Young People What we said • Inequalities across a number of areas, including health, have been exacerbated for children, young people and their families following the pandemic. • Child poverty remains. • Child death review activity is an important tool to learn from and potentially prevent the unnecessary deaths of children and young people. • Health outcomes for care experienced children and young people remain poorer and addressing gaps in access and support is a key priority. 81
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Director of Public Health Annual Report 2023 NHS Lanarkshire 6 NHS Lanarkshire, alongside key partners, are working together to tackle these issues through The Children and Young People’s Health Plan and the local Child Poverty Action Plans for North Lanarkshire and South Lanarkshire among others. What happened • The Children and Young People’s Health Plan for 2021-23 Annual Report details activity over the 2023 period. It shows progress and achievements have been made in many areas, however, there is some way to go in improving outcomes for children and young people experiencing the effects of the COVID-19 pandemic. Impact of COVID-19 pandemic across the Four Harms in relation to dentistry What we said • The four harms are related: harms to health impact on society and the economy, just as the societal and economic effects impact on physical and mental health and wellbeing. • The COVID-19 pandemic has had a sustained impact on the delivery of dental services, which are only recovering gradually. • The disruption of oral health improvement programmes had primarily impacted on more socially disadvantaged groups, further widening health inequalities What happened • All oral health improvement programmes and the National Dental Inspection Programme have been remobilised. • NHS dental activity has continued to increase. The new dental payment reform has been implemented since 1 November 2023 and will both preserve the position of NHS dentistry and safeguard levels of access. • Three local general dental practitioners have recently completed their training to become dentists with enhanced skills in domiciliary care. Health Promoting Health Service (HPHS) What we said • Identifying the needs of each hospital site required a collaborative approach looking at the available evidence of need. • The Holistic Needs Assessment (HNA) is a tool used to open up discussions with an individual that seeks to understand the issues they have. The HNA identifies the wider determinants of health and signposts to the support needed to help alleviate/ameliorate issues allowing individuals to support themselves. • A partnership approach to undertaking an HNA as early as possible in the patient journey helps facilitate Discharge without Delay. What happened • The HNA is being used within teams where a Test of Change (pilot) has been carried out when a Health Improvement Senior (HIS) is not available. However, due to 82
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Director of Public Health Annual Report 2023 NHS Lanarkshire 7 staffing capacity, patients are normally referred to the HIS to undertake the assessment. • Funding is in place to support one HIS per hospital site till the end of March 2025. One HIS has been recruited to deliver the Staff Health and Wellbeing agenda in North Lanarkshire University Health and Social Care Partnership with the contract ending in August 2025. These posts help support a holistic needs approach to care across the organisation. • The work with the Scottish Ambulance Service (SAS) Pathways Hub has been extended to all three hospital sites. The Holistic Needs Assessment is completed by SAS staff and sent to HPHS when an individual is conveyed to hospital. The appropriate HIS will visit the individual whilst in hospital to complete the HNA process. Long Term Conditions What we said • At least one in four people in Lanarkshire report having a minimum of two or more long term medical conditions. • Mental health conditions, cardiovascular disease, and cancers represent significant long term problems for Lanarkshire residents. • Compared to the rest of Scotland, these conditions are more prevalent in Lanarkshire. What happened • Progress in the area of long term conditions in 2023 in NHS Lanarkshire has included completion of a Test of Change (pilot) with regards to support for patients attending the respiratory laboratory to quit smoking, which has now been successfully incorporated into usual practice. • In addition, a Lanarkshire Pathways Framework was produced by the Long Term Conditions workstream. This resource will help support work on person-centred healthcare journeys for people with long term conditions. Prof S. Josephine Pravinkumar, Director of Public Health & Health Policy Email: josephine.pravinkumar@lanarkshire.scot.nhs.uk 83
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 8 1. Health of the People of Lanarkshire 1.1 Population Profile and Key Health Measures Background This section describes the population of NHS Lanarkshire, and how it is projected to change over the next 20 years. The number of births and deaths registered in 2022, and data on life expectancy are reported. Mortality information for specific diseases is presented. Data on cancer registrations is also described. Detailed information on each area is included in the relevant section of the Statistical Appendix, which readers are referred to. This chapter also includes the latest Scottish Health Survey results for Lanarkshire. Census 2022 Initial Outputs (1) The first outputs from the Census in 2022 were published on 14 September 2023. This first release included population estimates by age and sex at Scotland and Local Authority level, as described in Table 1.1.1 below. The census release reports that estimates were individually rounded to the nearest hundred and therefore the sum of estimates may not exactly equal the total. North Lanarkshire estimated population: 341,000 (1.0% increase from 2011 Census). South Lanarkshire estimated population: 327,200 (4.3% increase on the 2011 Census). Adding the above estimates, the population of Lanarkshire is estimated to be 668,200. This is a 2.6% increase from the 2011 Census added Local Authority estimates of 651,557. Table 1.1.1: Estimated population structure of North Lanarkshire, South Lanarkshire and Scotland, Census 2022 Females Males 0–14 15–64 65 years and over North Lanarkshire 51.4% 48.6% 16.5% 65.6% 17.9% South Lanarkshire 51.6% 48.4% 15.8% 64.0% 20.3% Scotland 51.4% 48.6% 15.3% 64.6% 20.1% Data source: National Records of Scotland(1) Population projections (2) The latest projections of Lanarkshire’s future population are based on estimates for 2018, and show that the population is expected to rise about 0.5% between 2021 and 2032. The population is expected to fall slightly between 2032 and 2042, making the expected overall change from 2021 to 2042 an increase of 0.2%. The projected change in the age structure of Lanarkshire’s population between 2021 and 2042 is shown in Figure 1.1.1. Key components in the changing Lanarkshire population are as follows: • There is a projected increase of 64.2% in the population aged 75 and over between 2021 and 2042. This would result in 34,494 more people in this age group. 84
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 9 • The largest fall in population will be in the under 30 year olds, with a projected decrease of 10.7% between 2021 and 2042. There is estimated to be 24,026 less people aged under 30 in the next twenty years, likely to be contributed by fewer births. Figure 1.1.1: Projected percentage change in the age structure of Lanarkshire's population, 2021-2042 Data source: National Records of Scotland(2) More details on population estimates and projections for Lanarkshire are provided in tables A2 and A3 in the Statistical Appendix. Births (2) There were 6,309 live births registered among NHS Lanarkshire residents in 2022, a slight decrease from 2021 of 1.5%. The number of stillbirths increased slightly from 24 in 2021 to 28 in 2022. The overall live birth rate per 1,000 women aged 15-44 was 52.2 for Lanarkshire, higher than the Scottish rate of 45.5. Over the three-year period 2020-2022, 99.6% of all babies born alive in Lanarkshire survived their first year. There was an average of 23 deaths per year, excluding stillborn babies. These deaths were similar to the level in Lanarkshire for the period 2019-2021. The infant death rate (deaths during the first year of life) in Lanarkshire was 3.7 per 1,000 live births – slightly higher than the Scottish rate of 3.5 per 1,000 live births. Due to the small numbers involved, death figures among children aged one year or younger fluctuate from year to year. Further information on births is shown in tables A4 and A5 in the Statistical Appendix. Life expectancy Life expectancy figures from National Records of Scotland (NRS)(2) are provisional for 2020- 2022. There is a decrease in life expectancy at birth in Lanarkshire between the time period 2010-2012 and 2020-2022. This decrease is 1.8 years for males (from 77.0 to 75.2 years) and 1.6 years for females (from 81.0 to 79.4 years). Over the same time period, 85
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 10 Scotland life expectancy had stabilised, but has now started to decrease. UK life expectancy reported by Office for National Statistics(3) had been slowly increasing, and has now started to decrease. NRS figures(2) describe that females in Lanarkshire live on average 4.2 years longer than males. This gap between male and female life expectancy is similar to that for Scotland (4.2 years)(2) and the UK as a whole (4.0 years)(3). Life expectancy is below national levels; males in Lanarkshire live on average 1.3 years less and females 1.4 years less than in Scotland overall.(2) Compared to the UK as a whole, life expectancy in Lanarkshire is lower by 3.3 years in males and 3.2 years in females. (2,3) Within Lanarkshire, life expectancy in South Lanarkshire is higher than in North Lanarkshire; in the South males live 1.5 years longer and females 1.3 years longer on average than those in the North (see Figure 1.1.2).(2) Figure 1.1.2: Trends over time in life expectancy at birth in North Lanarkshire, South Lanarkshire and Scotland by sex F: Females; M: Males; North: North Lanarkshire; Scot: Scotland; South: South Lanarkshire Data Source: National Records of Scotland(2) Life expectancy in Lanarkshire also varies by Scottish Index of Multiple Deprivation (SIMD) quintile (ranking of area-level deprivation), as shown in data from 2017-2021.(4) Males living in the most deprived areas of Lanarkshire live on average 11.3 years less than males living in the least deprived areas; for females, life expectancy is 8.5 years less in the most deprived areas compared to the least deprived areas.(4) Further information on life expectancy is shown in table A12 of the Statistical Appendix. 70 72 74 76 78 80 82 2016-2018 2017-2019 2018-2020 2019-2021 2020-2022 Life Expectancy at Birth (in Years) Year North M North F South M South F Scot M Scot F 86
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 11 Deaths (2) There were 7,694 deaths registered in Lanarkshire in 2022, a decrease of 438 (5.4%) from 2021. Standardised mortality ratios (SMRs) were calculated for deaths in Lanarkshire, using Scotland as the standard population. SMRs show whether the number of deaths are higher or lower in Lanarkshire than would be expected based on Scotland’s mortality rates. Overall SMRs in Lanarkshire remain above the Scottish average for both sexes, both for mortality in those aged under 75 years and mortality in those aged 75 years and over. There is wide variation in SMRs between the different localities in Lanarkshire. From one locality with an SMR 20.4% below the Scottish rate for females aged less than 75 years, to another locality with an SMR 51.3% above the Scottish rate for females aged less than 75 years. Since 2012, the combined proportion of all deaths due to cancer, coronary heart disease (CHD) and stroke has accounted for less than 50% of all deaths and, in 2022, the proportion was 43.1%. Deaths from cancer decreased slightly this year from previous recent years, whilst for CHD they increased slightly and for stroke they remained relatively stable compared to previous years. In 2022, the ‘big killer’ diseases accounted for 3,316 deaths: individually cancer, CHD and stroke were responsible for 25.8%, 11.5% and 5.9% of all deaths in Lanarkshire, respectively. Respiratory disease was also a significant cause of mortality in 2022, accounting for 10.0% of all deaths in Lanarkshire. Another major cause of death in 2022 was dementia and Alzheimer’s, accounting for 9.6% of deaths. More detailed information on mortality is provided in the tables and charts in A6–A11 of the Statistical Appendix. 87
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 12 Figure 1.1.3: Population Infographic (4-7) 88
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 13 Cancer Registrations in Lanarkshire, 2021 (8) Number of cancer registrations is a measure of the number of cancers diagnosed in a given year. Cancer registration is a dynamic process therefore the figures presented here may differ from previously published information. The infographic below outlines key points derived from the detailed data in tables A13-A15 of the Statistical Appendix. Figure 1.1.4: Cancer infographic (8) 89
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 14 Scottish Health Survey The Scottish Health Survey 2022 was published in December 2023.(9) A sample of households across Scotland were interviewed and data at Health Board level has been presented for 2018, 2019, 2021 and 2022 surveys combined.(9) The results from 2020 were excluded since these were experimental statistics.(10) The following infographic describes key results for Lanarkshire from this data, based on between 1002 and 1755 survey responses (varied depending on the question).(10) Figure 1.1.5: Scottish Health Survey infographic (10) 90
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 15 Key Points • The estimated population of Lanarkshire from Census 2022 figures is 668,200, a 2.6% increase from 2011 Census. • The latest projections of Lanarkshire’s future population, based on estimates for 2018, show that the age structure of the population is expected to change between 2021 and 2042, with an increase in people aged 75 and over and fall in number of people aged under 30. • There has been a decrease in life expectancy in Lanarkshire over the last 10 years. • Life expectancy is lower in Lanarkshire than in Scotland overall and life expectancy is lower in North Lanarkshire than South Lanarkshire • There were 7,694 deaths registered in Lanarkshire in 2022, a decrease of 5.4% from 2021. • Overall standardised mortality ratios (SMRs) in Lanarkshire remain above the Scottish average for both sexes, both for those under 75 years and those 75 years and over. There is a wide variation in SMRs between the different localities in Lanarkshire. • In 2022, the ‘big killer’ diseases accounted for 43.1% of all deaths – cancer (25.8% of all deaths), coronary heart disease (11.5%), and stroke (5.9%). In addition, respiratory diseases accounted for 10% of deaths and dementia and Alzheimer’s accounted for 9.6% of deaths. • The highest number of cancer registrations in 2021 related to Trachea, Bronchus and Lung Cancer, Female Breast Cancer, Large Bowel Cancer and Prostate Cancer. • The Scottish Health Survey Lanarkshire data describe that over 1 in 3 people experience a limiting long-term illness and nearly 1 in 4 people experience mental health symptoms. Priorities for Action • Responding to the expected shift in population structure over the next 20 years, with fewer younger people and more older people, requires investment and preparation. • The lower life expectancy and higher premature deaths in Lanarkshire compared to Scotland, and inequalities in these figures across Lanarkshire, necessitates whole systems working, applying multidisciplinary, interagency, and collaborative approaches to prevention, early intervention and ongoing care. An example of an initiative being undertaken through the Respiratory Speciality Improvement Group, is the ongoing work to develop a Respiratory Prevention Plan, which thereafter could be used as a blueprint for other long term conditions. • An update to the Lanarkshire Long Term Conditions analysis is planned for 2024 and this will be valuable for the continued monitoring and assessment of the burden of disease in Lanarkshire. References (1) National Records of Scotland (NRS). Scotland's Census 2022 - Rounded population estimates – data. Scotland’s Census. Website. https://www.scotlandscensus.gov.uk/2022-results/scotland-s-census- 2022-rounded-population-estimates/ [Published 14 September 2023; accessed 23 January 2024]. (2) The statistics in this section were obtained from local analysis of data supplied by NRS or directly from NRS published online at https://www.nrscotland.gov.uk [Accessed 23 January 2024]. 91
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Director of Public Health Annual Report 2023 NHS Lanarkshire 1. Health of the People of Lanarkshire 16 (3) Office for National Statistics. National life tables – life expectancy in the UK: 2020 to 2022. Office for National Statistics. Website. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/b ulletins/nationallifetablesunitedkingdom/2020to2022 [Published 11 January 2024; accessed 24 January 2024]. (4) Public Health Scotland. ScotPHO Online Profiles Tool. Public Health Scotland. Website. https://scotland.shinyapps.io/ScotPHO_profiles_tool/ [Accessed 9 February 2024]. (5) National Records of Scotland. Vital Events Reference Tables 2022. National Records of Scotland. Website. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital- events/general-publications/vital-events-reference-tables/2022 [Last updated 20 July 2023; accessed 21 December 2023]. (6) National Records of Scotland. Mid-2021 Population Estimates Scotland. National Records of Scotland. Website. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by- theme/population/population-estimates/mid-year-population-estimates/mid-2021 [Accessed 21 December 2023]. (7) National Records of Scotland. Population Projections for Scottish Areas (2018-based). National Records of Scotland. Website. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics- by-theme/population/population-projections/sub-national-population-projections/2018-based [Accessed 21 December 2023]. (8) Tables A13-A15 of the NHS Lanarkshire Annual Report of the Director of Public Health 2023. (9) Scottish Government. The Scottish Health Survey 2022 – volume 1: main report. Edinburgh: Scottish Government; December 2023. https://www.gov.scot/publications/scottish-health-survey-2022-volume- 1-main-report/documents [Accessed 15 December 2023]. (10) Scottish Government. Scottish Health Survey dashboard. Scottish Government. Website. https://scotland.shinyapps.io/sg-scottish-health-survey/ [Last updated February 2024; accessed 9 February 2024]. Karen Lorenzetti, Principal Public Health Information Analyst Email: karen.lorenzetti@lanarkshire.scot.nhs.uk Lisa Maria Neil, Public Health Information Analyst Email: lisamaria.neil@lanarkshire.scot.nhs.uk Emma Baird, Locum Consultant in Public Health Medicine Email: emma.baird@lanarkshire.scot.nhs.uk 92
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 17 2. Health Protection 2.1 Health Protection Team Update Background The Health Protection team are responsible for protecting individuals, groups and populations from infectious disease and non-infectious public health threats in the environment. During the winter of 2022/2023 there was a national increase in cases of group A Streptococcal infection and outbreaks of Scarlet fever in nurseries and schools. The team worked with colleagues in local education authorities to respond to these outbreaks and ensure staff and parents had the appropriate information. The winter also saw high levels of influenza activity across the community and a number of cases requiring admission to hospital. The summer brought the normal seasonal increase in cases of a range of gastrointestinal illness including Shiga toxin producing Escherichia coli (STEC), Salmonella and Cryptosporidium and cases of more exotic infections in residents returning from travel overseas including Salmonella typhi and paratyphi. Over the last year the Health Protection Team have supported the health of the population of Lanarkshire through a range of activities with two examples given below. Care Homes Within Care Homes across North and South Lanarkshire there are 4360 resident places. Care Homes came through challenging times over the COVID-19 pandemic years and are now looking to restore some routine and ‘business as usual’ approach to their services and to have a more settled environment for the lives of the residents in their care. The NHSL Health Protection Team work closely in collaboration with Care Home staff to help facilitate this. The team offers support and advice to Care Homes in line with local and national infection prevention and control guidance. Following the available guidance enables Care Homes to promote a protective, proactive environment for residents and staff. NHSL Health Protection Team have aligned Care Home Health Protection Nurses to localities. In addition, there is a Nurse Consultant Lead to provide overall co-ordination. With this specialist aligned support the Health Protection Team can ensure both one to one and locality input including visits to care homes to provide advice pertinent to their individual, person centred needs. During any outbreak situation a care home may have, the Health Protection Team will liaise daily with the care home staff to offer ongoing appropriate assessment and advice to minimise potential further spread of any infection. An outbreak is where two or more residents or staff have the same symptoms or diagnosis within the same time frame. This number of two is regardless of the size or population numbers of the Care Home. The Health Protection Team will advise use of the Care Home Infection Prevention and Control Manual (CH IPCM)(1) to adopt evidence based practice. 93
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 18 During the COVID-19 pandemic there were frequent changes in national guidance for care homes to follow as more was learned about the new emerging virus. Guidance is now more stable and established. To assist and support care home staff in accessing the correct and most up to date guidance as part of preparing for winter 2023-2024 the Health Protection Nurse Team compiled a ‘one stop’ aide memoire to be used which contains a selection of links, guidance and information in one document. The aide memoire aims to help staff deliver effective care and have more time to do so, by providing faster access to information. This was sent to each care home manager at the start of winter 2023. The feedback from care homes has been positive with reports that the aide memoire is proving to be a useful tool to support quick access to guidance and information. Immunisation programme Over the last year there has been a significant amount of work taken forward by Public Health and partners to improve our immunisation coverage across the health board. We have set up an Immunisation Inclusivity Short Life Working Group which meets regularly and includes many different disciplines involved in immunisation, with representatives from across Lanarkshire. This group is working towards improving inclusivity for all immunisation programmes within Lanarkshire, with a particular focus at present on childhood immunisations. Measles elimination action plan There is ongoing widespread concern around the increase in measles cases throughout Europe and some parts of the UK. This resulted in the World Health Organisation (WHO) Europe branch calling for all countries to ensure there is sustained high measles, mumps, rubella (MMR) vaccination coverage, and for those who have previously missed doses of MMR vaccine to be offered vaccination, in order to prevent a resurgence of measles(2). In response to this, we are developing an up to date measles elimination action plan. This focuses on developing strategies within 3 main domains – before school entry, during school age and targeted groups (including groups within the population that may have lower vaccination uptake than the general population for various reasons). We have been in discussions with various stakeholders to gather qualitative information on potential barriers to vaccination and reasons for lower uptake within some populations. We are also looking at MMR vaccination rates by geographical area in Lanarkshire within the pre-school and school age populations which has helped identify areas with a disproportionately low uptake rate. This will help us develop effective targeted interventions for specific populations or areas in order to ensure that access to vaccination across the whole of Lanarkshire is as equitable as possible. Maximising MMR vaccination coverage in our health board will help give the population the best protection possible against measles. Tertiary education institutions It is also important that students entering tertiary education institutions are up to date with their vaccinations to help protect them against serious, vaccine preventable diseases. 94
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 19 We have been working with the tertiary education institutions across Lanarkshire to encourage students to check that they are up to date with their MMR, Meningitis (MenACWY) and human papillomavirus (HPV) vaccines. If students have missed these during the routine childhood immunisation programme, or they are new entrants to Scotland and have not previously received any of these vaccines, we provide an opportunity to catch up with these vaccinations via an easily accessible on- campus vaccination catch up clinic. So far, we have successfully carried out one catch up clinic within South Lanarkshire College and have also linked many students into the generic vaccination service which runs across Lanarkshire. We are working with other tertiary institutions within Lanarkshire to implement similar catch up clinics in the new year. Key points • The Health Protection Team are supporting care homes in the post COVID-19 pandemic era, in particular through advising on infection prevention and control guidance. • A significant amount work has been undertaken to improve our immunisation coverage across the health board through a range of initiatives. Priorities for Action • Continue to provide expert advice and input to care homes across Lanarkshire. • Maximise uptake of immunisations across Lanarkshire and ensuring programmes are as equitable as possible. References (1) NHS National Services Scotland. National Infection Prevention and Control Manual: Care Home Infection Prevention and Control Manual (CH IPCM) [Internet]. 2023. Available from: https://www.nipcm.scot.nhs.uk/care-home-infection-prevention-and-control-manual-ch-ipcm/ (2) Chief Medical Officer for Scotland. Averting the Resurgence of Measles in Scotland 2023 [Internet]. Scottish Government; 2023 Aug. Available from: https://www.publications.scot.nhs.uk/publication/7931 Caroline Thomson, Health Protection Nurse Consultant Email: caroline.thomson2@lanarkshire.scot.nhs.uk Sophie El-Nahas, Clinical Fellow Email: Sophie.El-Nahas@lanarkshire.scot.nhs.uk Alison Smith-Palmer, Deputy Director of Public Health Email: Alison.Smith-Palmer@lanarkshire.scot.nhs.uk 95
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 20 2.2 Lanarkshire’s Hepatitis C (HCV) Elimination Project April 2023 to March 2025 The initial phase of Lanarkshire’s 2 year HCV Elimination Project, including how using a broader model of community liver health/screening to deliver HCV awareness and testing has revealed a grave picture of liver health and health related behaviour in the Lanarkshire adult population. Background: Liver Disease – A Public Health Emergency in Scotland The British Liver Trust’s (BLT) report titled ‘Liver Disease: A Public Health Emergency in Scotland’ was discussed by members of the Scottish Parliament on 14 June 2023(1). The Cross-Party debate addressed the liver disease crisis in Scotland and highlighted Lanarkshire to be amongst the poorest in Scotland in terms of liver disease mortality and early detection. For nearly two decades NHS Boards across Scotland have contributed to the challenge of Scotland’s poor liver health and specifically hepatitis C (Hep C) related liver disease, via the delivery of the Scottish Government’s Hep C Action Plan (‘the Action Plan’). ‘Scotland’s Hepatitis C Action Plan: Achievements of the First Decade and Proposals for a Scottish Government Strategy (2019) for the Elimination of both Infection and Disease’(2) highlights achievements of the first decade of ‘the Action Plan’ and stresses the importance of the introduction of direct acting antivirals in 2014. These achievements for Scotland include: a decline in hepatitis C related decompensated cirrhosis (liver failure); a reduction in new presentation of hepatitis C related hepatocellular carcinoma; and a decline in hepatitis C related deaths. The final phase of the Hep C Action Plan has now moved to delivering Hep C elimination in Scotland(3), with a national target of 5000 Hep C treatment initiations required across Scotland by March 2025. From April 2023 to March 2025, NHS Lanarkshire requires a tripling of previous yearly HCV treatment initiations targets to meet their elimination target of 511 Hep C treatment initiations. Furthermore, the requirement to triple HCV treatment initiations number in Lanarkshire came with no additional resource, and so required a re-think on how the challenge would be met within the existing funding envelope and service provision. NHS Lanarkshire Hep C Elimination Project The Lanarkshire Blood Borne Virus (BBV) Network leads on all aspects of BBV related work in Lanarkshire and, in response to this HCV elimination challenge, developed the Lanarkshire Hep C Elimination Project (‘the project’). Pivotal to the development of the project was a review of all BBV testing across Lanarkshire; the who, where, when and what (types of tests), review of current evidence related to HCV elimination practice in Scotland and UK wide, and a re-allocation of available resources and negotiation of service involvement. The first six months of the project has resulted in an increase in HCV treatment initiations by 130% compared to the previous year, which is extremely positive. Whilst the core aim of the project is progressing well, the 10 locality ‘Love Your Liver Events’ held during the 96
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 21 summer of 2023 have highlighted a grave picture of liver health and lifestyle behaviours in the adult population in Lanarkshire. The Lanarkshire BBV Network HCV Elimination Project focused on the development of 4 key work-streams. Work-stream 1: BBV Testing Finding and testing individuals who have been at risk of acquiring HCV is pivotal to achieving HCV treatment initiation targets and delivering HCV elimination in Lanarkshire and Scotland. A development session took place in November 2022 involving all Lanarkshire services who delivered BBV testing in the community. The three key outcomes from this session included: a. Establishing lead roles for each service within key settings to support better coordination and more efficient use of resources. b. Establishing a dedicated BBV Testing Team led by the Lanarkshire Harm Reduction Team and supported by Positive Support (BBV Network, Third Sector Service). BBV testing has been extended to Criminal Justice, Police Custody Suites, Pharmacy (Harm Reduction Team Pharmacy Development Worker), Mental Health Services, with continued work with all statutory and commissioned drug and alcohol services in Lanarkshire. c. 2024 will focus on business as usual, with an additional focus on HMP Shotts and opportunities for joint work with HMP Addiewell, as well as community Criminal Justice Services. Work-stream 2: New HCV Pathway A short life working group was established to review and develop a new HCV Pathway. The new streamlined pathway, with simplified criteria from testing to treatment, has been a significant factor in the 130% increase in HCV treatment initiations in the first six months of the project, compared with initiation numbers last year. Building relationships and developing new ways of working with staff across statutory and third sector drug and alcohol services, as well as the partnership between the Lanarkshire Harm Reduction Team and BBV Specialist Nurses have been pivotal to the increase in HCV treatment initiations. Work-stream 3: Implementing Public Health Scotland’s RECAST project The RECAST project will facilitate the reengagement and treatment of people with chronic HCV infection. Led by Public Health Scotland (PHS) and in partnership with NHS Boards, PHS has led an audit of the national HCV data held by PHS and supported the identification of individuals with chronic HCV infection. The CHI number was provided to enable follow- up. NHS Lanarkshire took part in the pilot exercise along with two other NHS Boards prior to the roll out across Scotland. This initial phase has identified approximately 500 individuals in Lanarkshire who will be followed up in Phase 2 of the project. A short life working group has been established to support the next phase of contacting and re-engaging with individuals. 97
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 22 Work-stream 4: Love Your Liver Community Events (Summer 2023) NHS Lanarkshire, in partnership with the British Liver Trust (BLT), held ten ‘Love Your Liver’ roadshow events across North and South Lanarkshire between June and August 2023. The roadshow offered a unique chance for individuals to prioritise their liver health by receiving free liver health checks and gaining valuable information about various types of liver disease. Visitors to the unit had the opportunity to undergo a free fibro-scan, a non- invasive liver scan, and a swab test for hepatitis C if identified as being at high risk. These health checks are crucial as liver diseases, including hepatitis C, can often develop silently and lead to severe complications if left undetected. Nine in 10 cases of liver disease are preventable with the main causes being alcohol, obesity and viral hepatitis, including hepatitis C. Partnership The British Liver Trust approach to partnership working with statutory and third sector services, and their community engagement model (drop in, accommodated via a large trailer with 3 clinical rooms) has been used in England to support Hep C Elimination, raise awareness of liver health, including hepatitis C. The Lanarkshire BBV Network chose this partnership approach and model of good practice to support their wider community engagement work. The Lanarkshire Love Your Liver events were delivered by staff and volunteers from the British Liver Trust, NHS Lanarkshire’s BBV Network Support Team; Harm Reduction Team; Gastro/Liver Service based at University Hospital Hairmyres (UHH); BBV Network Third Sector commissioned services including Positive Support and Landed Peer Education Project: Phase 1: Planning • Appraisal, analysis and re-allocation of resources and leadership roles • Funding for Gastro/Liver Service to support additional referrals and to deliver the fibro-scanning during community events • Development of referral pathway directly into Gastro/Liver Service in UHH. • Limited advertising preceded each event via the British Liver Trust website and twitter account to facilitate opportunistic drop-in access. Phase 2: Delivery • 847 people attended 10 events delivered across Lanarkshire localities from June 2023 to August 2023. Venues included: Cumbernauld: Antonine Shopping Centre Airdrie: Morrisons Coatbridge: Main Street Cambuslang: Morrisons East Kilbride: Morrisons Hamilton: Morrisons Lanark: Morrisons Bellshill: Morrisons Motherwell: Shopping Centre Wishaw: Caledonian Retail Park 98
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 23 Key Points Health Survey • 847 attendees - 627 (74% of attendees) completed the survey Liver Health • 431/627 (68%) received a fibro-scan • Overall, 52 of the 431 (12.1%) participants fibro-scanned in Lanarkshire had an E median of 8.0+, indicating a follow-up with primary care is recommended. • Of those, 16/52 had a fibro-scan score indicative of advanced damage. • 29/52 referred to Gastro/Liver Service UHH • 6/29 on the Hepatocellular Carcinoma (HCC) surveillance pathway HCV • Low HCV awareness • 170/611 identified HCV risk • When looking at only the under 50 yrs surveyed, this fraction increases to half (83 out of 165). • 162 HCV point of care test (POCT) • 9 POCT had positive (antibody) POCT • 3 individuals Dry Blood Spot Testing /3 positives Health Behaviours Diet • The majority of men and women under 40 yrs old who were surveyed had a takeaway twice or more per week (41 out of 75). • 2 in 5 people in Lanarkshire said they had processed foods three or more times per week, indicating a potential significant current and future impact on liver health across the population. • Men and women under 39 yrs represented the largest consumers of processed foods (men = 73.3%, women = 70.5%). • The majority of those surveyed admitted to snacking on crisps, chocolate, cake or biscuits between meals or in the evening (63.7%). • Over three quarters of women aged 40 to 59 yrs (76.5%) snacked between meals and in the evening Weight Of the 579 people whose BMI was calculated: • more than 70% were overweight or obese. • less than a third of women and less than a quarter of men had a healthy BMI. • 85.8% of participants had a diet categorised as caution or high risk for Non-Alcoholic Fatty Liver Disease (NAFLD) (n=611). • A third of participants were high risk 99
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 24 Alcohol All 614 individuals who participated in the alcohol section of the survey were sorted into groups, based on whether or not they drank more than 14 units of alcohol per week. • When split by sex (332 women, 282 men), men were more than twice as likely to drink more than 14 units per week (women = 20.2%, men = 42.2%). • 67 women (19.8% of all women surveyed) drank more than 14 units of alcohol a week with an average of 29.9 units; more than double recommended maximum levels. • 119 men (41.3% of all men surveyed) drank more than 14 units of alcohol per week, their average was 35.7 units per week. • Further analysis of this data is in process. Reports will be shared with relevant stakeholders and partners of NHS Lanarkshire to shape ongoing work in this area. Referral to local services Information on local services was also provided to individuals who took part in the liver health check and to many individuals who stopped to chat to staff outside the BLT trailer. Information on a range of health issues was provided, as was information on and links to financial and welfare support services. Referrals were also made to local statutory and third sector alcohol and drug services. Priorities for Action • At a time when we are expected to ‘do more with less’, strong strategic decision making, and utilising and re-focusing people, resources and expertise is key. • We will continue with our focus on BBV testing in high risk settings, as well as continuing to promote the new Hep C pathway across local services. • Phase 2 (2024) of the RECAST project will be pivotal to enabling NHS Lanarkshire to achieve Hep C Elimination by March 2025. • The British Liver Trust model of community roadshow events provides clear evidence for more community health outreach work and has shown the benefit of community health checks as part of early detection and prevention. • The findings from the Lanarkshire Love Your Liver events reflect the poor liver health status of the Lanarkshire population, as highlighted in the British Liver Trust and Scottish Governments cross party debate in June 2023(1). These events also demonstrate the significant role that community outreach/health checks can play in engaging with local communities and supporting early detection and prevention. References (1) British Liver Trust. Scottish ministers unite to address alarming liver disease crisis as deaths surge by almost 20% in two years [Internet]. 2023.Available from https://britishlivertrust.org.uk/scottish- ministers-unite-to-address-alarming-liver-disease-crisis-as-deaths-surge-by-almost-20-in-two-years/ (2) Coalition for Global Hepatitis Elimination. Scotland’s Hepatitis C Action Plan: Achievements of the First Decade and Proposals for a Scottish Government Strategy (2019) for the Elimination of both 100
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Director of Public Health Annual Report 2023 NHS Lanarkshire 2. Health Protection 25 Infection and Disease [Internet]. 2019. Available from https://www.globalhep.org/tools- resources/action-plans/scotlands-hepatitis-c-action-plan-achievements-first-decade-and (3) Scottish Government. Sexual health and blood borne virus action plan: 2023 to 2026 [Internet]. 2023. Available from https://www.gov.scot/publications/sexual-health-blood-borne-virus-action-plan-2023- 2026/pages/2/ Trish Tougher, BBV Network Manager Email: Trish.tougher@lanarkshire.scot.nhs.uk Acknowledgements British Liver Trust • Emma Bowering, Engagement and Events Manager, British Liver Trust • Jonathan Worsfield, Project Delivery Manager, British Liver Trust NHS Lanarkshire • Callum Buchanan, Information Analyst, Public Health Directorate • Aileen Divers, Sister, Gastro/Liver Service, University Hospital Hairmyres (UHH) • Dr Nick Kennedy, Consultant Infectious Diseases/BBV Network Lead Clinician • Chris Kimber, BBV Network Development Officer • Dr John Logan, Consultant Public Health Medicine (CPHM)/BBV Executive Lead • Maureen Woods, BBV Testing Lead, Harm Reduction Team Third Sector • Jaki Brown, Team Leader, Positive Support • Lauren Kelly, Support Worker, Positive Support • Laura McLean, Development Officer, Landed Peer Education Project • Eddie Wilkie, Support Worker, Positive Support 101
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 26 3. Anchor Themes 3.1 NHS Lanarkshire as an Anchor Organisation What is an Anchor Organisation?(1) Anchor organisations are typically large local employers with a strong local presence in an area like the NHS, local authorities, colleges and large local businesses. Figure 3.1.1: Anchor organisation Anchor organisations can have a sizeable positive influence on the health and wealth of communities as they employ large numbers of local people, spend substantial amounts of money, own and manage local land and buildings. Taking positive actions in these areas is known as community wealth building which is a new approach to local economic development which aims to mitigate inequalities. Community wealth building aims to direct financial resources back into the local economy and ensures local people are able to have control over, and benefit from, the opportunities these investments can bring. Anchor organisations also often deliver crucial services intrinsic to health and wellbeing and are rooted in the local community offering stability and support to communities, hence the term “anchor”. In addition, smaller local organisations, often in disadvantaged areas, can be community anchors through their ability to build trusted relationships with local people, offer local employment and community led activities, and connect their residents to opportunities that will support their health and wellbeing. How Can Anchor Organisations Make a Difference? The Health Foundation(1) identified five dimensions where anchors can have a positive influence. Taking intentional actions across these areas can affect social, economic and 102
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 27 environmental change, contribute to positive health and wellbeing outcomes, and mitigate the impact of inequalities. Being an exemplar anchor – organisations can embed ‘anchors thinking’ across their culture, planning and actions, and work with other anchors to systematically share good practice and deliver enhanced positive impacts for their people and places. Employer – organisational policies on recruitment, pay and conditions, career progression and health can support inclusion goals and lower paid workers and help organisations to recruit and retain staff and fully tap the talents of their workforce. Procurement – organisations can adopt practices for buying goods and services which support local businesses and job opportunities, recirculate wealth and bring community benefits as well as improve supply chain resilience, responsiveness and relationships. Environment and assets – organisations can act to respond to the climate emergency, reduce energy, waste and pollution, use their assets for the benefits of communities and create better built and natural environments to support place making. Service design and delivery – public sector and community anchors can deliver their services in ways designed to help those facing poverty and disadvantage. Key Points • NHS Lanarkshire has a long history of operating as an anchor organisation with a strong inclusive culture and many positive examples of working in partnership across these five areas. • NHS Lanarkshire is committed to working with other anchors through more intentionally targeting opportunities and services to those who are most vulnerable and through shaping employability, procurement and asset strategies to be more inequalities focused. • This ambition fits with national policy direction as the Scottish Government Health Inequalities: Place and Wellbeing Programme(2) now includes an anchors workstream and all Health Boards are required to have a 3-year strategic anchor plan in place. Priorities for Action • In the following chapters we describe examples of work NHS Lanarkshire and partners are taking forward under our anchor ambitions. References (1) Reed S, Göpfert A, Wood S, Allwood D, Warbuton W. Building healthier communities: the role of the NHS as an anchor institution. The Health Foundation [Internet]. 2019. Available from: https://www.health.org.uk/publications/reports/building-healthier-communities-role-of-nhs-as-anchor- institution (2) Scottish Government. Health Inequalities: Place and Wellbeing Programme [Internet]. Available from: https://www.gov.scot/groups/health-inequalities-place-and-wellbeing-programme Elspeth Russell, Consultant in Public Health Email: elspeth.russell@lanarkshire.scot.nhs.uk 103
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 28 3.2 Widening Access and Employability Opportunities Background NHS Lanarkshire recognises, as an anchor organisation and exemplar employer, the reciprocal link between health and work, and by widening access and employability, we enhance social mobility and life chances of our local communities. The right career with fair pay and conditions, improves people’s overall physical and mental health, supports quality of life and creates a positive and virtuous cycle leading to a reduction in health inequalities. Workforce NHS Lanarkshire is committed to putting in place a healthcare workforce which is representative of the communities we serve, with particular focus on widening access for those who are underrepresented within our existing workforce, from lower socioeconomic and deprived areas, or from minority backgrounds. Historically, individuals taking up work experience, apprenticeships and volunteering opportunities within NHS Lanarkshire have typically come from more advantaged communities. Widening access to these opportunities through inclusive recruitment practices and targeting to key populations, such as those affected by child poverty, is beneficial to both the individuals and the organisation as a whole as results in a wider and more diverse talent pool for staff recruitment. Figure 3.2.1: Impact of NHS Lanarkshire’s Demonstrator programme, 2022–2023 104
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 29 Employability Programmes NHS Demonstrator Project The first Demonstrator Project was introduced under the Best Start, Bright Futures: Tackling child poverty delivery plan 2022–2026(1) focussing on those over 25 years old and unemployed. The project aims to increase participant’s confidence, learn new skills and develop skills for employment. Working in Partnership with both Local Employability Partnerships, NHS Lanarkshire has supported 26 individuals into paid placements, 17 (65%) of which achieved a positive outcome. Clinical Employability Programme In support of the No One Left Behind: Delivery Plan(2) NHS Lanarkshire has worked in partnership with New College Lanarkshire to support approximately 80 unemployed individuals annually into health care support worker roles. David Forbes-Nixon (DFN) Project SEARCH Project SEARCH is based on the most successful transition to work programme in the world and has been has recognised by the Scottish Government as a model of good practice within the national learning disability strategy The keys to life: Improving quality of life for people with learning disabilities(3). This project is aimed at young people with additional support needs, it is in its 13th year at University Hospital Wishaw and 11th Year at University Hospital Monklands and Hairmyres. To date, 160 young people have come through the NHS Lanarkshire programme, with approximately 70% going on to a positive destination in terms of employment or further study. Community outreach NHS Lanarkshire Employability team have been proactively engaging with partners with the aim of attracting and supporting individuals into health and social care careers. This has included attending events and client information sessions with partners such as Department for Work and Pensions, Prince’s Trust, and Remploy. In addition, the team have engaged with care experienced individuals and the armed forces talent programme Key Points • The employability projects delivered by NHS Lanarkshire are making an impact on people’s lives by getting them back into the workplace. • Targeting employment opportunities to key priority groups will contribute to the overall ambition of reducing inequalities. Priorities for Action • Provide paid placements and work experience for individuals facing barriers to employment or those facing poverty. • Provide outreach activities to our local community to promote NHS Lanarkshire as an exemplar employer. 105
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 30 References (1) Scottish Government. Best Start, Bright Futures: Tackling child poverty delivery plan 2022–2026 [Internet]. 2022. Available from: https://www.gov.scot/publications/best-start-bright-futures-tackling- child-poverty-delivery-plan-2022-26 (2) Scottish Government. No One Left Behind: Delivery Plan [Internet]. 2020. Available from: https://www.gov.scot/publications/no-one-left-behind-delivery-plan (3) Scottish Government. The keys to life - Improving Quality of Life for People with Learning Disabilities Plan [Internet]. 2013. Available from: https://www.gov.scot/publications/keys-life-improving-quality-life- people-learning-disabilities Lorraine Scott, HR Business Partner Email: lorraine.scott2@lanarkshire.scot.nhs.uk 106
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 31 3.3 Monklands Replacement Project and Community Benefits Background The Monklands Replacement Project (MRP) will deliver NHS Lanarkshire’s vision for a new acute hospital to replace the existing University Hospital Monklands as set out in NHS Lanarkshire’s strategic framework. The new hospital will be delivered on a new site at Wester Moffat Farm, east Airdrie and is being designed to support delivery of a new model of care that moves the focus of care away from long inpatient stays to one where day case, day treatment, outpatient and community care is the norm. Community Benefit All public sector contracting authorities are required to include community benefit requirements for all regulated procurements where the estimated value of the contract is equal to or greater than £4 million. The value of the MRP is significantly greater than that threshold therefore delivery of community benefits was a core part of the procurement strategy. The MRP has an established community benefit group which developed the community benefits plan and set the following key objectives: 1. To encourage the local community to be involved in the project by supporting local community initiatives. 2. To ensure community benefits are directed towards positive outcomes for disadvantaged and vulnerable groups that reflect what the community needs and contribute to reducing inequalities. 3. To facilitate opportunities for sustainable employment through the provision of skills, education and training programmes; apprenticeships; and new graduate job opportunities that are targeted to vulnerable groups including those who are unemployed or experiencing in-work poverty. 4. To promote economic growth through the involvement of small and medium-sized enterprises, Third Sector and Supported Businesses by facilitating awareness of the project, promoting contract and supply chain opportunities and related Community Wealth Building opportunities, while also ensuring these organisations are as ready to tender for opportunities as they can be. 5. To promote health & wellbeing through the inclusion of environmental and other initiatives that contribute to sustainable health & wellbeing outcomes. 6. To inform community benefits for future NHS Lanarkshire projects through measuring and reporting on community benefit targets and outcomes that highlight best practice, whilst seeking continual improvement and innovation. The Community Benefit requirements have been identified across five key themes as shown, below. Figure 3.3.1: Community Benefit Themes 107
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 32 Key Points There is an opportunity for NHS Lanarkshire to harness wider opportunities through delivery of community benefits. Some of these opportunities include: • Promoting NHS Lanarkshire’s role as an inclusive anchor organisation offering more targeted employment opportunities for local people, increasing procurement spend within the community, and being a role model for environmental sustainability through the hospital build process and ongoing policies and practices. • Supporting Community Wealth Building through working with the local authorities and the local business base to identify opportunities to generate and keep money in the local economy. • Positively contribute to the current Public Health Scotland priorities. Priorities for Action • Develop the delivery plan. • Develop the supporting communication plan. • Establish the progress monitoring tool and reporting arrangements. Kathryn Henderson, MRP Senior Project Manager Email: kathryn.henderson2@lanarkshire.scot.nhs.uk 108
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 33 3.4 Service Design and Delivery Background As part of our anchor approach, services should be designed and delivered in a way that support disadvantaged communities, working with partners and the community to help reduce inequalities and tackle poverty. Some examples of work within this area have included progressing a comprehensive cost of living action plan and ensuring that integrated Equality Impact Assessments (EQIA) are carried out and acted upon by our services. Cost of Living A range of initiatives this year have focussed on what we can do to enhance NHS Lanarkshire’s service delivery to support those at risk of, or experiencing, poverty within our communities and our own workforce. Tackling poverty is not the remit of specialist teams or any single organisation. Everyone can contribute to the collective effort to reduce poverty and this has been the message that we have been conveying this year, alongside our partners. • An FAQ for managers on how to support staff who may be struggling with money worries has been developed. • An FAQ for services on how to support patients who may be struggling with money worries has been developed. • Working with partners, free period products have been made available in some of our sites. • Workforce development sessions have taken place across services and teams with support to embed routine enquiry of finances. • Support, in the form of a Welfare Rights Officer, from Money Matters Advice Service has been commissioned. • A comprehensive communications plan has been developed and delivered. • We have continued to work with partners to prioritise action on child poverty. Equality Impact Assessments It is widely documented that the COVID-19 pandemic has further exacerbated inequalities across our communities. The importance of embedding health inequalities across NHS Lanarkshire as part of COVID-19 Recovery has never more been at the forefront of policy making with the aim of ensuring equity of access for all Lanarkshire residents. Identifying inequalities and addressing these through service design and delivery, will enable services to be developed that focus on the needs of those who are most vulnerable. To ensure an inequalities focussed approach and compliance with the Equality Act 2010, NHS Lanarkshire undertakes a robust programme of integrated EQIAs across all work streams. There has been extensive work undertaken to ensure the assessment process complies with the Equality Act 2010, integrates the Children’s Rights Wellbeing Assessment and also pays (due regard) to reducing inequalities of outcome caused by socio-economic disadvantage. 109
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 34 Key points • NHS Lanarkshire has been taking forward a range of initiatives to mitigate the impact of the cost of living crisis on patients and staff. • The development of the new NHS Lanarkshire healthcare strategy has provided an opportunity to embed an inequalities approach through the use of integrated EQIAs across all workstreams. Priorities for Action • Supporting patients and staff with cost of living issues through a variety of actions, including addressing child poverty, is a key component of our anchor plan. • Continue to ensure that integrated EQIA’s are carried out and our services are designed to reach and support our most disadvantaged communities. Ann McLaughlin, Senior Health Improvement Manager (South Lanarkshire HSCP) Email: ann.mclaughlin2@lanarkshire.scot.nhs.uk 110
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 35 3.5 Environment, Sustainability and Assets Background Environmental sustainability is one of the pillars of the NHS as an anchor organisation and gives the opportunity to do environmentally sustainable work that has local impact on people’s health and inequalities as well as positively contributing to climate change. Our Natural Health Service provides benefits to physical, mental and social health(1-3) and can help to reduce inequalities in health through access to quality greenspace(3). There is a significant evidence base for the range of individual and wider social health and wellbeing benefits that can be achieved through outdoor activity and contact with nature. These benefits include: improved physical and mental health; therapeutic and restorative qualities enhancing recovery; reduced social isolation and greater community cohesion. There is overwhelming evidence to show that being physically active; including walking, has been shown to reduce a range of illnesses, reduce stress levels helping to reduce blood pressure and reduce feelings of depression and stress(4). Lanarkshire Green Health Partnership (LGHP) The Lanarkshire Green Health Partnership (LGHP), is integrated with weight management services and is partly funded via NHS Charities Together. The LGHP works to connect people with nature and maximise health inducing green assets. The partnership was formed, in 2018, as part of the national work ‘Our Natural Health Service’ and supports health sectors to embrace green health. It complements the NHS, to support the breadth of health and social care activity and see nature-based health programmes used as part of health improvement and encourage health behaviour change. As a partnership we recognise the importance of an integrated approach and developing opportunities and pathways to ensure individuals within our communities have access to engage in activities. The LGHP have taken approaches to help support specific areas of work and link to the outcomes of the partnership. Lanarkshire is rich in green spaces, including the NHS estate and the aim of the partnership is to coordinate and promote the use of all green spaces for health benefits and provide supportive green health programmes. Key priorities for 2023–2026 will be: • Deliver an integrated model of leadership for LGHP • Get Walking Lanarkshire • Clydesdale Community Initiative – Therapeutic Garden Projects • Voluntary Action South Lanarkshire/Voluntary Action North Lanarkshire – Green Health and Wellbeing Volunteer development. 111
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 36 Key Points • There is a broad range of partnership activity being delivered within Lanarkshire communities supporting adults, children and families to connect with nature and the positive impact on physical, mental and social health and wellbeing, especially for our most vulnerable groups. • The contribution that these programmes make to the prevention agenda and tackling health inequality through targeted intervention and the offer of free local, health enhancing greenspace. Priorities for Action – LGHP • Raise awareness and share the benefits of engaging with green health and promote engagement with activity. • Support and build partnerships to inspire projects that help people connect to nature and be active outdoors. • Empower health & social care and third sector staff to be confident to connect people to green health opportunities as appropriate. • Seek and secure funding to enable contribution and continuation of evidence based practice. Priorities for Action – wider Environment, Sustainability and Assets anchor actions • Enhance active travel and transport opportunities and ensure developments meet the needs of groups most affected by inequalities. • Further develop community use of facilities and outdoor estates with a strong focus on engaging those most affected by inequalities. References (1) World Health Organization. Urban green spaces and health [Internet]. 2016. Available from: https://www.who.int/europe/publications/i/item/WHO-EURO-2016-3352-43111-60341 (2) Department for Environment, Food & Rural Affairs. Social Science Research Fellowship on the natural environment and human health - BE0109 [Internet]. 2017. Available from: https://randd.defra.gov.uk/ProjectDetails?ProjectId=19511 (3) Staatsen B, van der Vliet N, Kruize H, et al. INHERIT Exploring triple-win solutions for living, moving and consuming that encourage behavioural change, protect the environment, promote health and health equity. Chapter 4 Living – green space [Internet]. 2017. Available from: https://inherit.eu/baseline-review (4) NHS. Benefits of exercise [Internet]. 2021. Available from: https://www.nhs.uk/live- well/exercise/exercise-health-benefits Ann McLaughlin, Senior Health Improvement Manager (South Lanarkshire HSCP) Email: ann.mclaughlin2@lanarkshire.scot.nhs.uk Marie McKeown, Lanarkshire Weight Management Service Team Lead & Green Health Partnership Manager. Email: marie.mckeown@lanarkshire.scot.nhs.uk 112
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 37 3.6 Being an Exemplar Anchor Background Being an exemplar anchor is about how organisations recognise the potential of their anchor role and intentionally embed anchor principles in their culture and values, corporate priorities, the day to day running of their services, and in how they work with, and learn from, other anchors. This involves reflecting on current practice and taking forward opportunities to further develop areas of good practice or to develop different ways of doing things that will benefit the local community. Development of NHS Lanarkshire Strategic Anchor Plan NHS Lanarkshire started their journey to more intentionally consider their role as an anchor back in 2021 as they began to recover from the pandemic and recognised the need to build back better with a stronger focus on inequalities. Seminars were held with senior leaders to gain their support for this agenda and from this initial work a strategic commitment was made to embedding anchor ways of working into the new NHS Lanarkshire Healthcare Strategy which is due to be published in 2024. To inform the development of the anchor plan, NHS Lanarkshire used a national anchor assessment framework(1) to assess their baseline position as an anchor and to identify priority actions across the five anchor dimensions. The actions that have been prioritised focus on further developing areas of good practice identified from the anchor baseline assessment or more intentionally applying an inequalities anchor lens to existing programmes of work. The actions aim to positively influence wider determinants of health through taking a public health prevention approach. The anchor action plan sets out milestones to be achieved annually for the next three years and high level performance measures have been proposed for each action. Working with Other Anchors NHS Lanarkshire are working closely with both local authorities, third sector organisations, and other local partners to align the anchor ambitions with partnership strategic priorities including Community Wealth Building, Child Poverty plans and Community Planning Partnerships. NHS Lanarkshire are also participating in regional, national and UK anchor networks in order to learn from others and identify opportunities for collaboration. 113
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 38 Key points • NHS Lanarkshire has developed a 3-year strategic anchor plan which outlines actions it will take to support community wealth building and a more inequalities focused approach to service delivery. • Opportunities to work with other anchors on common goals to support community wealth building are evolving through working in partnership. Priorities for action • Delivery of the strategic anchor plan requires leadership, ownership and support from across all services within NHS Lanarkshire. • Communications to raise awareness of the anchor concept is a key priority for this programme of work. • Maximising NHS Lanarkshire’s role as an anchor will require investing time to build on the local partnerships already in place with other anchor organisations to develop shared goals and to learn from each other. • In November 2023, the Scottish Government issued a set of metrics for measuring baseline activity in relation to anchor activity. These will be incorporated into programme governance for 2024/25. Reference (1) Les Newby Associates, Wordfern Ltd. Harnessing the power of anchor institutions: a progressive framework for Scottish organisations. Public Health Scotland; 2023 Jun. Elspeth Russell, Consultant in Public Health Email: elspeth.russell@lanarkshire.scot.nhs.uk 114
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 39 3.7 Community Wealth Building Background Community Wealth Building (CWB) is a practical approach to local economic development that supports the delivery of a wellbeing economy. The approach is based around five pillars: • Inclusive Ownership • Workforce • Spending • Land and Property • Finance CWB seeks to redirect wealth back into local and regional economies and place more control over economic benefits in the hands of local people and businesses. CWB has a key focus on the role of anchor organisations and how they can use their economic levers to better support their local and regional economies. From a policy perspective, CWB forms part of the Scotland’s National Strategy for Economic Transformation(1) and the National Planning Framework 4(2). Building on the development of the approach across Scotland, the Scottish Government has committed to take forward a Community Wealth Building Bill in this Parliament, to enable more local communities and people to own, have a stake in, access and benefit from the wealth their economy generates. The Bill seeks to cement and augment the role public sector anchors play in supporting local economic development and advancing a wellbeing economy, legislating for them to consider their economic footprint within a wider place system. Figure 3.7.1: Community Wealth Building Adapted with permission from Economic Development Association Scotland and Scottish Government 115
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 40 The North Lanarkshire approach The Commitment There is commitment across the North Lanarkshire Community Planning Partners to develop a shared approach to CWB that that can be applied across a number of policies, strategies and services for the benefit of local people, businesses and communities. This commitment will be realised through delivery of the following aims: • Developing a common understanding of CWB. • Understanding the breadth of work that contributes to CWB and identify further opportunities to enhance this. • Developing a CWB statement to be embedded across several policy and strategy development areas. • Ensuring that decision-making and practice is developed through a CWB ‘lens’. Developing the Approach A North Lanarkshire Partnership Working Group is in place with representatives from North Lanarkshire Council, NHS Lanarkshire, Voluntary Action North Lanarkshire, Police Scotland, and Scottish Fire and Rescue Service to drive forward the approach. An initial mapping document has been produced highlighting the many activities already happening which align to CWB across North Lanarkshire. The Partnership hosted a stakeholder session in August 2023. This included a presentation from the Scottish Government, an update on the North Lanarkshire Approach and five workshops around each pillar exploring: what is working well; gaps; what could we do more of; what assets are in place; and, any partnership/collaborative opportunities. The feedback from the event has been collated and circulated. An engagement plan is in place to consult and gather views from a wide range of internal and external stakeholders including Community Boards, elected representatives, businesses and young people. The consultation exercise will conclude by the end of February 2024. The findings of the consultation exercise, along with a review of best practise across Scotland, will form the basis for the development of the final statement and associated action plans and monitoring frameworks. Key Points • Commitment is in place from the North Lanarkshire Community Planning Partners to develop a shared approach. • The adopted approach will be embedded across several policy and strategy development areas. • The approach will ensure that decision-making and practice is developed through a CWB ‘lens’. 116
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 41 Priorities for Action • Continued consultation and engagement on the approach. • Adoption of the approach by the North Lanarkshire Strategic Leadership Board and partners by late summer 2024. References (1) Scottish Government. Scotland's National Strategy for Economic Transformation [Internet]. 2022. Available from: https://www.gov.scot/publications/scotlands-national-strategy-economic- transformation (2) Scottish Government. National Planning Framework 4 [Internet]. 2023. Available from: https://www.gov.scot/publications/national-planning-framework-4 Yvonne Weir, Enterprise Manager, North Lanarkshire Council Email: weiry@northlan.gov.uk Leanne Pollock, Community Partnership Manager, North Lanarkshire Council Email: pollockle@northlan.gov.uk The South Lanarkshire approach The Commitment The challenges of the last few years – the COVID-19 pandemic, soaring cost of living, and the war in Ukraine – have underlined the importance of local services rooted in local places and communities. It was therefore imperative to develop new ways of working which not only support the communities served by statutory services but also to contribute to making our services and our places stronger, more resilient and more sustainable. In March 2021, South Lanarkshire Council launched its Community Wealth Building Strategy(1). The strategy set out an aspiration to work in a new way for the people of South Lanarkshire, to use the power and influence of the council and other organisations to support communities and the South Lanarkshire economy. 117
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 42 Developing the approach From the start of the strategy development process, there was a strong recognition that CWB should be built into all areas of the Council’s business. There was a need to ensure that CWB became part of a new culture and way of working and to do this required the change in thinking to be led from the top. To facilitate this senior level support, a Community Wealth Building Commission was established which has cross-party political support within the council and engages senior officers from South Lanarkshire’s anchor organisations. These include NHS Lanarkshire, University of the West of Scotland, Voluntary Action South Lanarkshire (VASLan) and the business sector. By working together collaboratively across the five pillars of CWB, anchor organisations can multiply their effectiveness and deliver far-reaching transformational change. Turning strategic aspirations into action on the ground is the job of the CWB Progress Group. This multi-agency group is chaired by VASLan and aims to take the practical steps necessary to deliver the actions underpinning the CWB strategy. With the right structures in place and the key stakeholders involved from the start, results of our work are beginning to emerge across the five pillars of CWB. This strategic, whole- systems approach is beginning to bear fruit in what is a long-term aspiration to change our way of working for the benefit of the South Lanarkshire economy. Progress to date includes: • Analysis of the council’s procurement spend; • Changes to QuickQuote process to enable more local bids; • A range of engagement events with local businesses to improve engagement with procurement processes; • Development of Community Wishlists; • Community benefits arising from council capital projects; • Development of a Social Enterprise strategy and action plan; and, • Development of a South Lanarkshire Community Wealth Building Charter. Key points • South Lanarkshire Council and the South Lanarkshire Community Planning Partners are committed to improving the lives and prospects of everyone in South Lanarkshire through maximising opportunities for community wealth building. • A Community Wealth Building Commission has been established to provide strategic leadership and support for this commitment and a CWB strategy has been developed along with a draft charter. • There has been good progress made through proactive work on procurement practices and community benefit programmes. Priorities for action • Work together to strengthen the collective role of key anchor organisations who deliver services across the area, in order to bring wealth into the area and generate real change across South Lanarkshire. 118
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Director of Public Health Annual Report 2023 NHS Lanarkshire 3. Anchor Themes 43 • Develop opportunities to share expertise and learning between local anchor organisations. • Develop joint CWB indicators of progress and monitor these over time. Reference (1) South Lanarkshire Council. Community Wealth Building Strategy 2021 [Internet]. 2021. Available from: https://www.southlanarkshire.gov.uk/downloads/file/14909/community_wealth_building_strategy_2021 Tom Little, Head of Communications and Strategy, South Lanarkshire Council Email: tom.little@southlanarkshire.gov.uk 119
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 44 4. Healthcare Public Health 4.1 Strategic Prevention in Healthcare: Opportunities and Challenges in Lanarkshire Background Improvements in life expectancy have stalled in Scotland and is reducing in the most deprived areas (Figure 4.1.1, more discussion regarding life expectancy can be found in chapter 1.1 and appendix A12). Those living in the most deprived areas experience approximately 25 years fewer healthy years of life than the least deprived(1). Preventative healthcare in Lanarkshire, aligned with national healthcare directives, represents a pivotal shift in managing health and wellness that can reverse this trend. This strategic focus underscores the potential to transform the landscape of healthcare delivery and outcomes. Figure 4.1.1: Scotland all-cause mortality rate in men 0 – 64 years Source: Glasgow Centre for Population Health Opportunities for Lanarkshire Emphasising primary prevention through legislation, regulation, lifestyle support, vaccinations, and screening reduce chronic diseases, cardiovascular diseases, cancers, and diabetes(2) through service provision and advocacy, ensuring prevention is embedded into all areas of public sector service provision. Embracing targeted universalism, Lanarkshire can target resources whereby communities who uptake services least are supported and empowered to access those services in a focused manner(3): 120
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 45 • Secondary prevention efforts, including routine screenings for diseases like cancer and hypertension, facilitate early detection and treatment, improving patient outcomes. • Tertiary prevention, managing existing conditions, can significantly reduce complications and improve quality of life. Preventative strategies can be cost-effective, reducing later need for expensive treatments and hospitalisations. Proactive health measures encourage community participation and awareness, fostering a culture of health and wellness. Figure 4.1.2: Lanarkshire mortality rate* in under 75s in the lowest and highest SIMD quintiles and overall Challenges to implementing a prevention mindset can be mitigated: Upfront dedicated proportionate spend on areas clearly defined as prevention can alleviate pressure against prioritising prevention in an environment with limited resources and an imperative to focus on deliver in the acute sector. Preventative healthcare must address inequalities to tackle disparities in mortality and life expectancy (see Figure 4.1.2 & chapter 1.1, Figure 1.1.2). The Inverse Care Law suggests that those most in need of medical care often receive the least(3). Structural change and investment in that change is required to successfully integrate preventative strategies requiring substantial effort, training, in that restructuring. Infrastructure to support individuals and patients to participate in prevention to ensure patient compliance and the effectiveness of interventions, can be built through a new vision of Primary Care reaching out and supporting personal change. Lanarkshire’s strategic leaning towards a preventative approach in healthcare presents significant opportunities to enhance health outcomes, reduce long-term costs, and further engage communities in their health and wellbeing. However, this approach also faces 121
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 46 challenges, including resource allocation, addressing health inequalities, implementation complexities, variable effectiveness, and the prevailing focus on immediate treatment. Effective integration of preventative measures requires careful planning, community involvement, and a commitment to addressing these challenges head-on. Key Points • Allocating funds specifically for prevention can reduce pressure in resource-limited settings. • Prioritising prevention is key in delivering acceptable acute sector services. • Effective preventative healthcare must tackle existing health inequalities. • Structural changes and investments are vital for integrating preventative strategies. • Preventative strategy integration demands considerable effort and training. • Developing infrastructure is crucial for patient participation in prevention. • A new Primary Care vision can support personal change and ensure intervention effectiveness. Priorities for Action • Develop and promote in our own and partner organisations a prevention mindset at a strategic, tactical, and operational level. • Restrict a proportion of budget for well-defined prevention infrastructure development. • Develop a proportionate universalism framework of delivery to tackle inequalities. • Develop anchor collaboration and infrastructure to support successful adoption of prevention by patients and communities. References (1) Walsh D, McCartney G. Changing Mortality Rates in Scotland and the UK - An Updated Summary. Glasgow Centre for Population Health; (2023). (cited 15/12/23). Available from: https://www.gcph.co.uk/publications/1083_changing_mortality_rates_in_scotland_and_the_uk_an_up dated_summary. (2) Buck D, Baylis A, Dougall D, Robertson R. A vision for population health: Towards a healthier future. [London]: The King’s Fund; 2018. Available from: https://www.kingsfund.org.uk/publications/vision- population-health. (3) Tudor Hart J. The Inverse Care Law. Lancet. 1971; 297: 405–412. Dr Paul Nelson, Consultant in Public Health Email: paul.nelson@lanarkshire.scot.nhs.uk (or paul.nelson3@phs.scot) 122
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 47 4.2 Population Screening Background NHS Lanarkshire provides all of the national population screening programmes available in Scotland. Table 4.2.1 shows the number of people in the target population, as well as uptake for each programme and a brief summary of our achievements against Healthcare Improvement Scotland standards Uptake Uptake rates for some screening programmes are improving (e.g. breast and bowel cancer screening) and others have levelled off (e.g. cervical cancer screening) over the last year. Uptake remains high in pregnancy and new-born screening programmes. Inequalities Activity to raise awareness of the benefits of screening and address the barriers to screening participation are being coordinated through an updated 3-year Screening Inequalities Action Plan. This includes allocation of the Scottish Government Cancer Screening Inequalities Fund to support a number of new areas of work, the continuation of an outreach approach to engage with people experiencing homelessness, community development work in areas of deprivation to encourage and support increased uptake of the cancer screening programmes and targeted messaging to support informed choice. All of the work to improve uptake in screening will now feature under the larger Detect Cancer Early programme of work across NHS Lanarkshire which aims to improve cancer outcomes through prevention, earlier detection and treatment. The national equity in screening strategy and action plan was published in the summer of 2023. Our local action plan will support the achievement of identified outcomes. National Cervical Exclusion Audit Following an incident in the national Scottish Cervical Screening Programme, an audit of patient records of those who have been excluded from the programme is being carried out to review the appropriateness of any exclusion applied. It has been identified that 13,199 records will require to be audited by NHS Lanarkshire. This National Cervical Exclusion Audit commenced within NHS Lanarkshire in April 2023 should take around 12 months to complete. The audit is progressing well and is on track to complete late spring of 2024. The audit has required close partnership working with primary and secondary care in Lanarkshire to ensure evidence is uploaded, reviewed and clinical management of patients, where appropriate, is in place. 123
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 48 Table 4.2.1: Summary of Screening Programmes in Lanarkshire Target population Denominator and time frame Standard Uptake Outcomes(1) Bowel screening All males and females aged 50 to 74 years 195,306(1) men and women May 2020 – Apr 2022 Nationally agreed KPIs, including the target uptake of 60.0%. 63.6 % All persons. Uptake varies across SIMD quintiles from 53.4% in SIMD 1 (most deprived) to 70.7%% in SIMD 5 (least deprived). 61.4% male 65.7% female Meets uptake standard for both sexes. Standards for pre assessment and colonoscopy waiting times continue to be a challenge following the introduction of the new bowel screening test called qFIT in 2017. Breast Cancer Screening Females 50-70 years 91,142(2) women Apr 2019 - Mar 2022 Nationally agreed standards including minimum uptake of 70.0%. 72.5% Uptake varies across SIMD quintiles from 63.7 % in SIMD 1 (most deprived) to 81.4 %in SIMD 5 (least deprived). Meets all standards except time to issue results and time to assessment from first adequate screen. Across Apr 2020 - Mar 2021, 136 invasive cancers were detected in women following breast screening: 31 were detected at the first screen (women aged 50-52) and 105 were detected at subsequent screens in women 53-70 years old. Cervical screening All women aged 25-64 years 176,872 women Data from Apr 2021- Mar 2022 Nationally agreed standards including the target uptake of 80.0% in each Scottish Index of Multiple Deprivation (SIMD) quintile. 71.1%(3) 25-49 year olds 70.2 % 50-64 year olds 72.5% Uptake varies across SIMD quintiles from 63.7% in SIMD 1 (most deprived) to 79.0% in SIMD 5 (least deprived). Meets all standards apart from uptake and laboratory turnaround times for cytology. Sample to routine colposcopy referral are proving challenging to meet while NHS Lanarkshire deliver the National Cervical Exclusion Audit. Universal Newborn Hearing Screening (UNHS) All newborn babies born to Lanarkshire residents or moving into Lanarkshire under the age of 12 weeks 6253 Apr 2022 – Mar 2023 98.0% of babies should have completed the hearing screen by 10 weeks. 99.8% of all newborn babies born to Lanarkshire residents, or moving into Lanarkshire under the age of 12 weeks in 22/23, have completed their hearing screening by 10 week 6 babies with moderate to severe permanent hearing loss were detected through screening. 124
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 49 Newborn Bloodspot Screening All newborn babies born to Lanarkshire residents and babies with no bloodspot result moving into Lanarkshire before age 12 months 6156(4) Apr 2022 – Mar 2023 99.5% of infants who have undergone screening tests have a screening result available or are recalled for repeat testing by 20 days of age. 99.86% (standard ≥99.5%) of all babies born to Lanarkshire residents 2022/2023 have undergone bloodspot screening 11 babies were identified with four of the 9 conditions screened in the newborn blood spot programme. A further 29 babies were identified as carriers for Cystic Fibrosis or Haemoglobinopathies (including Sickle Cell Disease) Diabetic Eye Screening Patients with diabetes aged 12 years and over 44383 Nationally agreed Key Performance Indicators (KPIs), including minimum uptake of 80.0% uptake. 85.4% of those invited for screening attended for at least one screening test Currently unavailable as KPI data calculations are being validated AAA Screening Men aged 65 years 4184(5) men aged 65 who became eligible in year ending 31 March 2022 (based on provisional data) Nationally agreed KPIs, including minimum uptake of ≥75.0% uptake. 78.0% for those invited for screening. Uptake varies across SIMD quintiles from 72.1% in SIMD 1 (most deprived) to 76.6 % in SIMD 5 (least deprived). Highest is for SIMD 4(88.0%) 10 large aneurysms detected and referred for assessment by a Vascular Specialist for consideration of appropriateness for intervention. Key Points • Screening can help prevent conditions (including cancers) developing as well as detecting conditions and cancers at an early stage, when treatment is more likely to be successful. Maximising uptake across the population, and targeting areas where uptake is lowest, will improve outcomes for those individuals and at a population level. • Where members of the population make an informed choice not to participate in population screening programmes, awareness of the signs and symptoms of conditions, including cancer, is important, to improve outcomes and detect conditions earlier. • Barriers to accessing services exist for screening tests and any required diagnostic testing or interventions. Identifying and addressing these barriers continues to be a focus within the work of the screening programmes 125
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 50 Priorities for Action • Continue work on the recovery of the Diabetic Eye Screening Programme; although, noting that significant progress has been made in addressing the backlog. • Continue efforts to encourage engagement with, and participation in, population screening programmes in the most disadvantaged populations. • Completion of the National Cervical Exclusion Audit across Lanarkshire to ensure all who have been excluded from cervical screening were excluded appropriately. References (1) Public Health Scotland. Scottish Bowel Screening Programme Statistics - For the period of invitations from May 2020 to April 2022 [Internet]. 2023. Available from: https://publichealthscotland.scot/publications/scottish-bowel-screening-programme-statistics/scottish- bowel-screening-programme-statistics-for-the-period-of-invitations-from-may-2020-to-april-2022/ (2) Public Health Scotland. Scottish breast screening programme statistics - Annual update to 31 March 2022 [Internet]. 2023. Available from: https://publichealthscotland.scot/publications/scottish-breast- screening-programme-statistics/scottish-breast-screening-programme-statistics-annual-update-to-31- march-2022/ (3) Public Health Scotland. Scottish cervical screening programme statistics - Annual update to 31 March 2022 [Internet]. 2023. Available from: https://publichealthscotland.scot/publications/scottish-cervical- screening-programme-statistics/scottish-cervical-screening-programme-statistics-annual-update-to- 31-march-2022/#:~:text=For%20the%20financial%20year%202021 (4) NHS National Services Scotland. Scottish Newborn Screening Laboratory. Data Report 2022/23. 2023 (5) Public Health Scotland. Scottish Abdominal Aortic Aneurysm (AAA) screening programme statistics - Year ending 31 March 2022 [Internet]. 2023. Available from: https://publichealthscotland.scot/publications/scottish-abdominal-aortic-aneurysm-aaa-screening- programme-statistics/scottish-abdominal-aortic-aneurysm-aaa-screening-programme-statistics-year- ending-31-march-2022/#:~:text=The%20total%20number%20of%20initial Dr Cathy Johnman, Consultant in Public Health Email: cathy.johnman@lanarkshire.scot.nhs.uk Celia Briffa-Watt, Consultant in Public Health Email: celia.watt@lanarkshire.scot.nhs.uk Morag Nicholson, Public Health Screening Programme Manager Email: morag.nicholson@lanarkshire.scot.nhs.uk 126
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 51 4.3 Scottish Dental Needs Assessment Report on Older Adults: Challenges and Recommendations Background The Scottish Dental Needs Assessment Programme (SDNAP) was tasked by the National Dental Advisory Committee to conduct a needs assessment of oral health and dental services for older adults. Given the demographic shift towards an increasingly aged population in Scotland(1), the needs assessment investigated the challenges and barriers associated with providing dental care for individuals entering their later years, often having received complex dental treatments in the past. The COVID-19 pandemic significantly affected the older population, increasing isolation and loneliness(2). The fieldwork for the SDNAP Report on Older Adults was conducted before the pandemic and serves as a crucial baseline for understanding the evolving challenges. Health Inequalities and Increasing Complexity of Care Despite the expectation of good health and well-being in later life, social determinants of health contribute to inequalities among older adults(3). Issues such as dependency, access to nutritious food, suitable accommodation, and timely healthcare interventions emerge as critical factors influencing oral health. Qualitative interviews conducted with general dental practitioners, hospital dental consultants and public dental service specialists and dental officers revealed the growing challenges in managing older adults, citing factors like increased medical complexity and changes in oral disease patterns. The need for specialised care, especially for patients with multiple comorbidities, was evident. Stakeholders recognised an overlap between challenging dental treatment and patient modifying factors. The Role of Prevention All stakeholders unanimously acknowledged the importance of prevention in maintaining oral health for older adults. Dentists called for a comprehensive, transparent, and fairly remunerated system that prioritises prevention across the life course. Patients valued preventative advice, highlighting the need for wider preventative education. The report acknowledges the challenges posed by an aging population, including multiple comorbidities and polypharmacy, underscoring the integral role of oral health in overall well-being(4). Training and Workforce Requirements Stakeholders also recognised the increasing complexity of care for older adults and the need for additional training opportunities. Dentists reported gaps in knowledge regarding the management of patients with two or more chronic conditions where each condition may influence the care of the other condition. The evolving demands on services, compounded by staff losses and shortages, underscored the importance of skill mix and utilising competencies effectively. 127
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 52 Government Initiatives The Scottish Government has demonstrated a commitment to addressing the unique needs of older adults through various initiatives. The National Performance Framework, aligned with the United Nations 2030 Agenda for Sustainable Development Goals, emphasises healthy aging and equitable access to health and care services(5). Frameworks like A Fairer Scotland for Older People(6), and the Oral Health Improvement Plan(7) provide a strategic approach to tackle health inequalities and evolving oral health challenges. Key Points • Dental care for older adults faces challenges due to complex medical histories, changing disease patterns, and increased patient expectations. • Prevention is unanimously recognised as pivotal in maintaining oral health. Dentists advocate for a comprehensive prevention-focused approach across all age groups. Priorities for Action • Policy Alignment: Ensure ongoing alignment of national policies with the evolving needs of older adults. • Oral Health Improvement Programme Adaptation: Regularly review and adapt national oral health improvement programmes like Caring for Smiles to meet changing demographic needs. • Education and Training: Prioritise education and training opportunities for the dental workforce to address the increasing complexity of care and patient expectations. • System Review: Conduct a thorough review of the relationship between Public Dental Service, Hospital specialist dental service, special care dentistry, and General Dental Service to bridge the gap in service provision. References (1) Scottish Government. A Scotland for the future: opportunities and challenges of Scotland's changing population [Internet]. 2021 [cited 2023 Dec]. Available from: https://www.gov.scot/publications/scotland-future-opportunities-challenges-scotlands-changing- population/ (2) Age UK. Age UK research lays bare the drastic impact of the pandemic on our older population’s health and morale [Internet]. 2020 [cited 2023 Dec 11]. Available from: https://www.ageuk.org.uk/latest-press/articles/2020/10/age-uk--research-into-the-effects-of-the- pandemic-on-the-older-populations-health/ (3) Age UK. Later Life in the United Kingdom 2019 [Internet]. 2019. [cited 2023 Dec 12]. Available from: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and- publications/later_life_uk_factsheet.pdf (4) Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet. 2012 Jul;380(9836): 37-43. (5) United Nations. Transforming our world: the 2030 Agenda for Sustainable Development [Internet]. 2015. [cited 2023 Dec 13]. Available from: https://www.unep.org/resources/report/transforming-our- world-2030-agenda-sustainable-development (6) Scottish Government. A Fairer Scotland for Older People: framework for action [Internet]. 2019. [cited 2023 Dec 15]. Available from: https://www.gov.scot/publications/fairer-scotland-older-people- framework-action/ 128
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Director of Public Health Annual Report 2023 NHS Lanarkshire 4. Healthcare Public Health 53 (7) Scottish Government. Oral health improvement plan [Internet]. 2018. [cited 2023 Dec 15]. Available from: https://www.gov.scot/publications/oral-health-improvement-plan/ Praveena Symeonoglou, Public Health Researcher/Programme Manager – Health Protection in Dentistry, based in NHS Lanarkshire Email: praveena.symeonoglou@lanarkshire.scot.nhs.uk 129
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Director of Public Health Annual Report 2023 NHS Lanarkshire Statistical Appendix 54 Statistical Appendix List of tables A1 Sociodemographic summary: by locality/HSCP A2 Estimated population: by age group and locality/HSCP A3 Projected population: by age group and sex A4 Births: by year A5 Births, perinatal deaths, neonatal deaths and infant deaths: by HSCP A6 Deaths from all causes: by sex, age group and year A7 Deaths from all causes: by sex, age group and locality/HSCP A8 Deaths from malignant neoplasms: by sex, age group and year A9 Deaths from coronary heart disease: by sex, age group and year A10 Deaths from cerebrovascular disease: by sex, age group and year A11 Deaths from respiratory disease: by sex, age group and year A12 Expectation of life: by age and sex; trend by sex A13 Cancer registrations: by sex, age group and year A14 Cancer registrations: by year and site; standardised ratios by sex, age group and site A15 Cancer registrations: by locality/HSCP and site A16 Notifiable diseases – clinically notified cases: by year A17 Dental registrations and participation. Dental health of children: by Lanarkshire A18 Primary and booster immunisation uptake rates: by locality/HSCP General notes • Lanarkshire has two Health and Social Care Partnerships (HSCPs) – North Lanarkshire and South Lanarkshire. The HSCPs cover the same geographical areas as North Lanarkshire Council and South Lanarkshire Council. There are ten localities within the HSCPs – six in North Lanarkshire (Airdrie, Coatbridge, North, Bellshill, Motherwell and Wishaw) and four in South Lanarkshire (Cambuslang/Rutherglen, East Kilbride, Clydesdale and Hamilton) – see map on page 2. On 1 April 2014, changes to NHS board boundaries resulted in NHS Lanarkshire becoming coterminous with the HSCPs and local authorities. The tables in the Statistical Appendix indicate whether information relates to the old or new NHS Lanarkshire boundary, the exception being where all data relate to April 2014 onwards. On 1 April 2019, changes to the Lanarkshire and Greater Glasgow and Clyde boundary at Cardowan by Stepps resulted in the following postcodes now being part of North Lanarkshire and NHS Lanarkshire - G33 6GZ, G33 6GX, G33 6GS, G33 6GY, G33 6GW, G33 6GT, G33 6GU, G33 6NS. • Populations shown and used in rates calculations are, for NHS Lanarkshire, the HSCPs and Scotland, mid-year estimates produced by National Records of Scotland (NRS). Locality populations are from NRS small area population estimates at data zone level. Health Intelligence Team Email: karen.lorenzetti@lanarkshire.scot.nhs.uk 130
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Elspeth Russell, Consultant in Public Health Subject: NHS Lanarkshire Anchor Metrics Performance 1. Purpose of Report The purpose of this paper is to:- provide an update on NHS Lanarkshire’s 2022/23 performance against the Scottish Government suite of anchor metrics. 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s): (1) note the progress made by NHS Lanarkshire as an anchor organisation 3 Background 3.1. In line with the Health Board Annual Delivery Plan requirements, NHS Lanarkshire (NHSL) submitted a 3-year strategic anchor plan to the Scottish Government at the end of October 2023. This is detailed at Appendix 1 in the report. 3.2 As part of the Annual Delivery Plan guidance for 2023/24, the Scottish Government asked boards to develop a baseline in relation to three of the anchor pillars: workforce/employer; local procurement; and, use or disposal of and assets for the benefit of the community. This is detailed in Appendix 2 and 3 in the report. 3.3 A set of anchor baseline metrics were issued to Boards in November 2023 and the reporting period for the baseline is 2022/23. The aim of the baseline is to support NHS Boards measure progress on anchor activity to help inform strategic plans as well as provide an overview of the current position of NHS Scotland as an anchor organisation. 3.4 The metrics were developed through engagement with stakeholders and testing within three Boards (NHS Ayrshire and Arran, NHS Forth Valley and NHS Lothian). There are caveats and limitations to some of the measures, due to completeness and availability of appropriate data. These caveats are described in full in the Delivery Plan guidance: Additional guidance on establishing a baseline to inform Anchor Strategic Plans (Nov 2023). Further supplementary guidance was also issued in January 2024. 3.5 The Scottish Government recognises that had the metrics been issued earlier they could have been used to inform the development of Board’s anchor plans however the process of establishing metrics took longer than anticipated due to the lack of appropriate data to measure complex outcomes. 9 131
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3.6 It is intended that Boards will be asked to report their progress against these metrics on an annual basis however the metrics will be reviewed after the 2022/23 submission, taking on board any feedback and comments from stakeholders. 3.7 A national anchor reporting dashboard has been established to support access to the data required for some of the workforce metrics. Boards are not required to report on W19 Distribution of applicants and their success rate by protected characteristics and SIMD as this data will not be made available on the dashboard for the reporting period 2022/23. 4.0 NHS Lanarkshire baseline metrics 4.1 Appendix 4 outlines NHSL’s baseline position against the anchor metrics. 4.2 Overall, the national anchor metrics broadly align to the actions in the local anchor plan and NHSL is able to positively report against many of the metrics set. 4.3 Against the workforce metrics, NHSL offers a range of employability programmes, supportive employee policies and has a good relationship with the Local Employability Partnerships (LEPs), enhanced by the expansion of the Career Academy initiative to South Lanarkshire. 4.4 Some of the workforce metrics related to accreditations which NHSL don’t have however we do have policies for these areas and will look to promote these policies to employees and through job packs. With regards Equally Safe we await feedback from the two pilot Boards who are exploring accreditation. 4.5 We are unable to adequately report on the workforce protected characteristics metrics as this data has not been fully completed by our employees or potential applicants. Work will be undertaken through the Anchor communication plan to promote the importance of staff completing this information on our workforce systems. 4.6 A positive national development of note is that going forward the NHS workforce systems will be collecting data on whether applicants/employees are care experienced; have caring responsibilities; and, information on their socio-economic background (defined by occupational category of main household earner when applicant aged 14). 4.7 In terms of targeting of employability programmes we have focused on child poverty initially but will look to target other groups going forward through working with our employability partners. 4.8 For the procurement and land and asset metrics, NHSL procurement processes support local employment opportunities and the Monklands Community Benefits Plan is a good example of using a capital build project to advance our anchor ambitions. 4.9 We are slightly below our Procurement Strategy target of 10% for local spend and Procurement have limited capacity to do more proactive work to support increasing local spend however we will continue to seek opportunities for more local spend through working with partners and learning from other areas. 4.10 We have a broad range of positive examples of where NHSL assets are being used by community groups including gardening projects and community led cafes within acute sites and third sector hospice services. There are also a broad range of services which have a regular or ad hoc presence within the public spaces of the acute sites 132
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and most of these are services targeted to those experiencing poverty or inequality such as Home Energy Scotland, Tackling Poverty teams and carer’s organisations. 5. Financial Implications 5.1 The strategic anchor plan covers a broad range of actions with responsibility across different Directorates and partnerships. Where additional resource is required this will be raised through the respective management structures and escalated to the Anchor Steering Group and NHS Lanarkshire Corporate Management Team as required. 6. Risk Assessment/Management Implications 6.1 The strategic anchor plan has risks and controls identified for each action. 6.2 The strategic anchor plan and metrics have been developed against a backdrop of considerable system pressures and financial constraints and as such actions may need to be reviewed if there are changes to capacity to deliver or areas of work which require to be paused. 7. Equality Impact Assessment and Consultation Arrangements 7.1. EQIAs have been completed on the strategies and plans that contribute to the overarching anchor plan e.g. NHSL Employability Strategy, NHSL Cost of Living Action Plan, Monklands Replacement Project Community Benefits Plan. 7.2 An overarching EQIA has also been developed for the Strategic 3-year anchor plan. 7.3 This is the first year of the national anchor metrics and Scottish Government are inviting feedback on the metrics to inform the requirements for future years. 8. Next Steps 8.1. Going forward, the national anchor metrics will be aligned to the relevant action areas in the anchor strategic plan and leads will be asked to consider their measure of progress for years 2 and 3 of the plan. 8.2 The NHSL anchor actions and metrics will contribute to the South Lanarkshire Community Wealth Building Action Plan. List of Background Papers NHS Lanarkshire Strategic Anchor Plan 2023 to 2026 Delivery Plan guidance: Additional guidance on establishing a baseline to inform Anchor Strategic Plans (Nov 2023). Supplementary guidance on establishing a baseline to inform Anchor Strategic Plans (Jan 2024). 2 August 2024 Contact for Further Information If you would like further information, please contact: Elspeth Russell, Consultant in Public Health, NHS Lanarkshire Tel: 07825657964 E-mail: elspeth.russell@lanarkshire.scot.nhs.uk 133
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1 Appendix 1 NHS Lanarkshire 3-year Strategic Anchor Plan Oct 2023-Oct 2026 Introduction 9 135
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2 NHS Lanarkshire has a long history of operating as an anchor organisation with a strong inclusive culture and many positive examples of working in partnership on programmes which have focused on wider determinants of health including action on poverty, employability, green health, and staff health and wellbeing. NHS Lanarkshire is committed to further enhancing its role as an anchor through more intentionally targeting opportunities and services to those who are most vulnerable and through shaping employability, procurement and asset strategies to be more inequalities focused. A strategic commitment has been made to the anchor approach across NHSL with anchor principles embedded into NHS Lanarkshire Healthcare Strategy Our Health Together and reflected in the corporate objectives. Methodology NHS Lanarkshire have used the Scottish Anchor Assessment Framework to assess their baseline position and from this process priority actions have been agreed for the 3-year strategic plan. The plan outlines 20 actions to be taken across the system and will require support across all Directorates as well as wider partners. The actions that have been prioritised focus on further developing areas of good practice identified from the anchor baseline assessment or more intentionally applying an inequalities anchor lens to existing programmes of work. The actions aim to positively influence wider determinants of health through taking a public health prevention approach. NHS Lanarkshire are working closely with both local authorities, third sector organisations, and other local partners to align the anchor ambitions with local Community Wealth Building strategies. NHS Lanarkshire are also key partners in the Local Employability Partnerships, Tackling Poverty Groups, Child Poverty Groups and Community Planning Partnerships. A Child Poverty lens has been applied throughout the NHS Lanarkshire anchor plan, particularly for the Employer and Service Delivery and Redesign actions. The Child Poverty priority family types are key target groups for the actions both with our work with patients and the community and in terms of how we recruit, retain, develop and support staff. Our Local Child Poverty Action plans align with our strategic anchor priorities. All actions within the plan will contribute to Community Wealth Building, either directly or indirectly. The Becoming an Exemplar anchor section of the action plan outlines how we already work and will continue to prioritise work, with our community planning partners to progress joint actions around Community Wealth Building. Monitoring and governance arrangements 136
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3 The anchor action plan sets out milestones to be achieved annually for the next three years and high level performance measures have been proposed for each action. The activities outlined in the baseline assessment which are not reflected in the Strategic Anchor plan will continue to be delivered and reported through their respective governance structures and the full baseline assessment will be reviewed and updated annually and reported as part of the overall anchor programme governance. The Scottish Government are currently consulting on an appropriate set of metrics for measuring baseline activity in relation to anchor activity. Once available these nationally agreed metrics will also be incorporated into programme governance and will be used to inform future areas for action. An NHS Lanarkshire Anchor Steering Group has been established, chaired by the Director of Public Health, to oversee implementation and monitoring of this programme of work. This group will report on progress bi-annually to the Population Health & Primary and Community Services Governance Committee of NHS Lanarkshire Board. It is important to note that the anchor work programme is relatively new both nationally and locally, and opportunities to work with other anchors on common goals to support community wealth building are evolving. As this work programme develops it is anticipated actions and milestones may need to be reviewed and amended as new opportunities for anchor activity are identified. Contacts For further information, please contact: Elspeth Russell, Consultant in Public Health elspeth.russell@lanarkshire.scot.nhs.uk Alana McGlynn, Health Improvement Programme Manager alana.mcglynn@lanarkshire.scot.nhs.uk 137
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4 NHS Lanarkshire Anchor Action Plan (2023-2026) Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure Employer 1 Workforce data Review and analyse workforce data from an inequalities perspective and ensure data is used to inform actions to address gaps in recruitment, retention and staff development with a particular focus on lower paid staff and disadvantaged groups. (1.1) Review existing workforce datasets alongside local demographics to inform actions that address gaps in recruitment, retention and staff development. Review existing workforce datasets alongside local demographics to and inform actions that address gaps in recruitment, retention and staff development. Review existing workforce datasets alongside local demographics to consider how we can better target groups affected by wider inequalities (e.g. child poverty and staff who are carers). Jonathan Pender Availability of data. Work with national colleagues to address gaps in routinely available data Workforce Equality Monitoring Report and Gender Equal Pay Analysis, in NHS Lanarkshire Equalities Progress Report 2021-23. 2 Employability Prioritise employability through targeted recruitment, and apprenticeships to groups most affected by inequalities. (1.2, 1.3) Through the Care Academy: build on work to date to identify target groups for employability programmes and apprenticeships; identify innovative strategies to reach and recruit candidates from two target groups and test wrap Identify innovative strategies to reach and recruit candidates from a further two target groups and ensure appropriate support is available once in role. Work with managers to raise Identify innovative strategies to reach and recruit candidates from a further two target groups and ensure appropriate support is available once in role. Work with managers to raise awareness of employability programmes and Lorraine Scott Capacity and continued resourcing of employability team. Additional resources have been successfully sought from a variety of sources to date. Good relationships have been built nationally and with Local Employability Partnerships. Measure(s) of progress will be developed as a part of the Employability Strategy - targets for number in the strategy for year one only 23/24 138
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5 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure around support for participants. Work with managers to raise awareness of employability programmes and identify suitable roles for placements. Monitor the equality characteristics of those taking part in employability programmes. awareness of employability programmes and identify suitable roles for placements Monitor the equality characteristics of those taking part in employability programmes. identify suitable roles for placements Monitor the equality characteristics of those taking part in employability programmes. Initiate local apprenticeships through MRP early construction phase. 3 Pensions and credit union Promote the benefits of the NHS pension scheme and credit union to lower paid and low uptake groups. (1.7) Continue with auto-enrolment process. Promote the NHS credit union and benefit of the pension through the anchor communications plan. Continue with auto-enrolment process. Review NHS pension opt out data to identify low uptake groups and develop communications to low update groups with communications re benefits of saving. Continue with auto- enrolment process. Further implement communication actions to promote benefits of savings including the NHS Pension scheme. Brian Houston Jackie McColl Cost of living crisis may impact on pension affordability. Continue to promote financial supports to staff as part of the cost of living plan. Reach of communication campaigns. Number of pension opt outs. Monitor this over time by grade and other characteristics. 139
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6 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure 4 Training, development and progression Provide a range of opportunities for lower pay bands and groups most affected by inequalities. (1.9) Identify target groups within NMAHP and map career pathways currently available for identified groups. Clearly aligned learning opportunities provided that support national and regulatory developed career pathways – e.g. NES Estates and Facilities and Administration and Clerical Staff. Monitor participation levels and report on progress. Develop a targeted action plan to address gaps as part of the organisational learning plan. Actively promote progression opportunities using innovative ways to reach target groups. Margot Russell Kirsty Cole National work programme in discussion which may impact on local work for NMAHP. Promote learning and development opportunities for NMAHP HCSW. Organisational Learning Plan and Strategy reporting. NMAHP - Reporting on uptake of programmes such as MA / HNC / HNC endorsed and open university programmes. Case studies of good practice. Procurement 5 Working with local suppliers Engage and enable local suppliers (including local SMEs, social enterprises and supported businesses) Suppliers will be signposted to Supplier Development Programme and Procurement Journey Supplier Guide. Suppliers will be signposted to Supplier Development Programme and procurement Journey Supplier Guide. Suppliers will be signposted to Supplier Development Programme and Procurement Journey Supplier Guide. Euan Erskine Capacity and resource to further develop opportunities for local procurement and roll out learning from Opportunities for further investment and linking with other anchors will be explored through the Steering Group. Increase in % of local suppliers quoting for tenders For all unregulated procurements (<£50k) at least half the suppliers 140
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7 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure on contract opportunities and identify and address local supply gaps. (2.2, 2.3 and 2.4) Procurement team will attend Meet the Buyer events and highlight procurement opportunities to local known businesses. Contracts will be split into lots where possible to support SME access to opportunities. In line with policy at least half of the suppliers invited to quote for unregulated procurements will be local suppliers. This will support identification of local supply gaps. Procurement team and MRP team will attend Meet the Buyer events and highlight procurement opportunities to local known businesses. Contracts will be split into lots where possible to support SME access to opportunities. In line with policy at least half of the suppliers invited to quote for unregulated procurements will be local suppliers. This will support identification of local supply gaps. Consider learning from the national Procurement test Procurement team and MRP team will attend Meet the Buyer events and highlight procurement opportunities to local known businesses. Contracts will be split into lots where possible to support SME access to opportunities. In line with policy at least half of the suppliers invited to quote for unregulated procurements will be local suppliers. This will support identification of local supply gaps. Explore feasibility to embed recommendations Lesley Aitken Euan Erskine Euan Erskine Euan Erskine national Procurement test site. invited to quote will be locally based. Identification of local supply gaps reported through the Procurement annual report. 141
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8 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure site which aims to explore opportunities and barriers to local procurement. from the national test where resource and capacity allows. 6 Community benefits Apply community benefit goals and scoring widely in competitively tendered contracts. (2.5) Continue to ensure suite of questions covering community benefits, fair work and sustainability in place for all regulated procurements (i.e. £50k +) and signpost all contractors to the National Community Benefits Gateway. Identify examples of good practice for use of scored value criteria in unregulated contracts. Targeted approach to use of social value scored criteria in unregulated procurements (<£50k) in order to ensure this is not a barrier for SMEs and signpost all contractors to the National Community Benefits Gateway. Raise awareness of social value in procurement to all NHS services as part of the anchor communications plan in order to spread good practice. Targeted approach to use of social value scored criteria in unregulated procurements (<£50k) in order to ensure this is not a barrier for SMEs and signpost all contractors to the National Community Benefits Gateway. Raise awareness of social value in procurement to all NHS services as part of the anchor communications plan. Euan Erskine Jackie McColl Lesley Aitken Capacity of procurement team to support development work in this area Learning from Scottish Government test site work will help to identify new ways of working. Procurement management system Provalido will report on community benefits and social value. Good practice examples shared as part of communications plan. 142
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9 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure Community benefits plan developed for MRP with indicative delivery programme. Delivery of MRP community benefits plan. Delivery of MRP community benefits plan. MRP community benefit tracker and annual report. Environment, sustainability and assets 7 Transport Enhance active travel and transport opportunities and ensure developments meet the needs of groups most affected by inequalities. (3.6) Continue to develop active travel in line emerging evidence and the findings of the travel survey. Further enhance shower facilities and bike storage across the estate. Promote Cycle to work scheme, e- Bike lending and bike repair stations. Undertake an EQIA of emerging transport and active travel initiatives. Work with local authority partners to maximise sustainable travel options and active travel links. Development of Car share scheme. Ensure the needs of groups most affected by inequalities are reflected in travel and transport strategies and initiatives being developed. Jacqui McGeough Craig Brown Graham Johnstone Lesley Robertson Availability of funding. Capacity to deliver. Supporting infrastructure may be out with the control of NHSL. Work/project plan reported and monitored through the Sustainability and Environment Group. Evidence of active travel developments and promotion. Completion of EQIA and development of EQIA action plan. 8 Natural environment Develop good quality greenspace that supports health and wellbeing, community and therapeutic programmes. Continue to develop opportunities for community and therapeutic programmes that utilise greenspace in our sites with a focus on groups Aim to expand community and therapeutic programmes (resource dependent). Therapeutic programmes in place as business as usual. Grounds team engaged with biodiversity Kerri Todd Mary Ann Kane Availability of funding to embed programmes and capacity of existing teams to support. Explore alternative funding streams. Work with other anchors to access expertise on biodiversity e.g. Number of therapeutic programmes in place. Case studies. 143
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10 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure (3.8) most affected by inequalities. Engagement and development of grounds staff in greenspace initiative. MRP outdoor space being designed with health and wellbeing of patients and staff in mind. Biodiversity lead identified within the Board. MRP outdoor space being designed with health and wellbeing of patients and staff in mind. embedded as business as usual. MRP outdoor space being designed with health and wellbeing of patients and staff in mind. Lesley Aitken Lack of local expertise in biodiversity. local authorities and Universities. Lead for biodiversity identified. 9 Use of assets Further develop community use of facilities and outdoor estates with a strong focus on engaging those most affected by inequalities. (3.9) Further develop webpage on public facing site to promote asset transfer and communicate opportunities. Continue to ensure community involvement in the development of the MRP and the regeneration plans for the existing UHM site Build on learning and work with partners to explore how we can support organisations to submit asset transfer requests. Continue to ensure community involvement in the development of the MRP and the regeneration plans for the existing UHM site Build on learning and work with partners to explore how we can support organisations to submit asset transfer requests. Continue to ensure community involvement in the development of the MRP and the regeneration plans for the existing UHM site with a focus on engaging Scott Anderson Lesley Aitken Supporting organisations with the asset transfer process is resource intensive. Engage with Development Trusts Association Scotland’s Community Ownership Support Service to provide advice and support with asset transfer applications. Number of completed asset transfers and queries Evidence of community involvement in MRP and the plans for the regeneration of the existing UHM site. Advice hubs established in a phased approach across three sites, 144
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11 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure with a focus on engaging those most affected by inequalities. Scope different models for the provision of information and community support services hubs within the acute hospital sites. with a focus on engaging those most affected by inequalities. Embed learning in local model of provision. those most affected by inequalities. Embed learning in local model of provision. Kerri Todd Health Promoting Health Service posts are fixed term to March 2025. Opportunities will be explored to work with third sector partners on a volunteer led model of delivery. engagement data, and evaluation. Establishment of an information and support hub model across hospital sites. SERVICE DESIGN AND DELIVERY 10 Public Health intelligence Development of a Lanarkshire public health intelligence repository. (4.1) Work with partners to build a Lanarkshire public health intelligence repository using routinely published data sets. Test use of the intelligence repository across three priority areas. Evaluate use of the repository and draw on the findings to further develop the repository in line with needs of stakeholders including addressing any user training needs. Josephine Pravinkumar Ensure the repository adds value to work being developed elsewhere. Capacity for maintenance and development of the repository. Community Planning Partners and Public Health Scotland are engaged in the repository design and development to ensure it is needs-led and shared ownership. Public health intelligence repository developed 11 Integrated EQIA Reviewing existing service delivery and designing new services to reach and benefit diverse and Evaluate work done to date around integrated EQIA and develop recommendation s and good practice. Take forward the findings of the evaluation. Take forward the findings of the evaluation. Kerri Todd Hina Sheikh The Health Inequalities lead post is fixed term to January 2024. Key service areas have been early adopters of taking an inequalities focused approach and lessons will Evaluation of integrated EQIA support completed and recommendations made for future practice. 145
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12 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure disadvantaged communities. (4.2) EQIA monitoring and governance process established by Equality Team. be drawn from this work. The development of the Public Health repository will support services to access data without support over the longer term. EQIA monitoring and governance process in place. 12 Financial wellbeing Increase awareness of, and access to, financial and related supports and advice that are available locally for our patients, carers and staff. (4.2) Drawing on evidence from the cost of living health impact assessment work with targeted teams to embed routine enquiry of financial inclusion. Take forward a range of communications and other interventions to support patients, staff and carers with their financial wellbeing. Evaluate impact from year 1 and spread learning using a quality improvement approach. Take forward a range of communications and other interventions to support patients, staff and carers with their financial wellbeing. Evaluate impact from year 1 and 2 and further spread learning using a quality improvement approach. Take forward a range of communications and other interventions to support patients, staff and carers with their financial wellbeing. Kerri Todd Capacity of services to engage in training and changes to practice. Data may not be able to be easily extracted to provide evidence of routine enquiry across some services. Innovative approaches to staff learning will be adopted. Learning from areas where routine enquiry for financial wellbeing is embedded will be drawn upon. Number of services raising the issue of financial wellbeing with patients. Number of referrals to Financial Inclusion services. Evidence of reach of communications plan. 13 Social prescribing Map all social prescribing programmes, Maximise opportunities to work together, Maximise opportunities to work together, Kerri Todd Variety of funding sources of programmes Having an overview of all resources and Mapping completed. 146
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13 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure Maximise social prescribing programmes available and ensure a consistent approach. (4.2) tools and data collection. Develop social prescribing network. reduce duplication and utilise digital support where appropriate. reduce duplication and utilise digital support where appropriate. and lack of long term security. how they complement each other will support best use of resources. Network created. 14 Period poverty Promote access to free period products. (4.2) Promote access to free period products available in the community through the Anchor communications plan. In partnership with local authorities, review uptake of free period products available in the community and target communications to areas of low uptake. Review uptake of free period products available in the community and target communications to areas of low uptake. Kerri Todd Lack of data to identify areas of low uptake. Low public awareness of availability. Working with partners to improve data collection and target communications. Uptake of free period products. 15 Business and community support Support to local business and communities' success through the provision of expertise and innovation. (4.4) Healthy Working Lives and Health Improvement will further develop opportunities to provide expertise and support to community groups and employers (through SALUS and other workplace connections). Further expand opportunities to develop the Healthy Working Lives programme in line with needs identified with a focus on SMEs, employers with lower paid staff and disadvantaged communities. Scope feasibility of incorporating the development of a staff volunteering policy into the NHSL Volunteering Strategy. Further development of MRP local business mentoring programme. Colin Maxwell Kerri Todd Elspeth Russell Kathryn Henderson Future funding for Healthy Working Lives Consider all opportunities to engage with local employers as part of health improvement programme delivery alongside local authorities. Healthy Working Lives team are around national discussions re budget. Uptake of Healthy Working Lives and Health Improvement input to businesses and communities. MRP business mentoring established. 147
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14 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure Local business mentoring programme established by MRP team. 16 Community Benefits Gateway Promote and further develop opportunities for use of the NSS Community Benefits Gateway locally. (4.4) Promotion of Community Benefits Gateway (CBG) to local third sector organisations. Scope opportunities with local authorities and third sector interfaces to link CBG and community wishlists. Promotion of Community Benefits Gateway (CBG) to local suppliers through NHS Procurement processes. Develop a process to better integrate the CBG with community wishlists. Further develop CBG in line with feedback from partners. Kerri Todd CBG is managed through NSS so limited opportunity to modify. Employer participation in CBG is voluntary. Engage in national CBG group in order to influence future development. Maximise opportunities within large procurement contracts to promote the CBG e.g. through Monklands Replacement Programme. Number of community asks added to CBG and number of suppliers matched and the number of benefits delivered. 17 Links with Education Build links with local schools, colleges and universities with a particular focus on groups most affected by inequalities. (1.1, 4.5) Establishment of pan Lanarkshire Care Academy Steering Group. Ensure the needs of groups most affected by inequalities are reflected in the Care Academy workplan. Ensure the needs of groups most affected by inequalities are reflected in the Care Academy workplan MRP will continue engagement with schools through Future Fridays programme and Ensure the needs of groups most affected by inequalities are reflected in the Care Academy workplan MRP will continue engagement with schools through Future Fridays programme and Morag Dendy Lorraine Scott Margot Russell Lesley Aitken Staff Capacity Capacity to support the Care Academy will be considered as part of the Steering Group. Measures of success will be established by the Care Academy Steering Group. 148
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15 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure MRP will continue engagement with schools through Future Fridays programme and use learning from the summer school to plan more initiatives, with a particular focus on target groups. use learning from the summer school to plan more initiatives- with a particular focus on target groups. use learning from the summer school to plan more initiatives- with a particular focus on target groups. Being an exemplar anchor 18 Inclusive anchor thinking Develop a communications plan to support embedding the anchor principles in values, behaviours and cultures. (5.3) Identify the key themes to be included in the anchor communications plan with a focus in year one on promotion of cost of living messaging for patients, carers and staff. Link with Scottish Government and local anchors to maximise opportunities for sharing anchor assets and case studies. Develop and implement the anchor communications plan in line with themes identified, linking with other anchors where appropriate to maximise reach of messaging. Develop and implement the anchor communications plan in line with themes identified, linking with other anchors where appropriate to maximise reach of messaging. Jackie McColl Kerri Todd Elspeth Russell Development of national anchor assets may not meet local timeframes. Messaging may not reach those most disadvantaged. Develop own communications based on learning from other Health Boards and anchors. Undertake EQIA on the communication plan as it is developed. Communications Plan developed Evidence of reach of messaging. Case studies of embedding anchor in practice 149
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16 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure 19 Finance and resources Investment in anchor activity and programmes which support community led positive impacts on health and wider determinants. (5.4) Continue to prioritise and develop commissioning frameworks with third sector interfaces and other anchors as part of strategic healthcare planning. Review existing and future resources and capacity required to deliver strategic anchor plan. This will include embedding anchor practice in staff objectives and working with other anchors and the NHSL Funding and Development Officer to lever external funding or pool resources Continue to prioritise and develop commissioning frameworks with third sector interfaces and other anchors as part of strategic healthcare planning. Review existing and future resources and capacity required to deliver strategic anchor plan. This will include embedding anchor practice in staff objectives and working with other anchors and the NHSL Funding and Development Officer to lever external funding or pool resources Continue to prioritise and develop commissioning frameworks with third sector interfaces and other anchors as part of strategic healthcare planning. Review existing and future resources and capacity required to deliver strategic anchor plan. This will include embedding anchor practice in staff objectives and working with other anchors and the NHSL Funding and Development Officer to lever external funding or pool resources to support delivery. Craig Cunningham Morag Dendy Colin Lauder Anchor Steering Group and Corporate Management team NHS financial sustainability. NHS financial sustainability Work with third sector and community partners to demonstrate impact of investment on failure demand to support case for shifting investment towards prevention. Build anchor actions into corporate objectives and service delivery. Evidence of impact of third sector commissioning frameworks. Evidence of anchor related actions in corporate and team objectives and investment in anchor activity and programmes. 150
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17 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure to support delivery. to support delivery. 20 Anchor collaboration Proactively work in partnership with local anchors and national partners to maximise anchor influence. (5.6) Participate in national Workforce task and finish anchor groups. Contribute to community wealth building strategies and approaches across North and South Lanarkshire. Contribute to wider partnership groups including Child Poverty Groups, Local Employability Partnerships and Community Planning Partnerships. Continue to link with and share best practice across regional and national anchor networks. Contribute to community wealth building strategies and approaches across North and South Lanarkshire. Contribute to wider partnership groups including Child Poverty Groups, Local Employability Partnerships and Community Planning Partnerships. Development of a partnership community wealth building pledge for North Lanarkshire and community wealth building charter for South Lanarkshire. Continue to link with and share Contribute to community wealth building strategies and approaches across North and South Lanarkshire Contribute to wider partnership groups including Child Poverty Groups, Local Employability Partnerships and Community Planning Partnerships. Continue to link with and share best practice across regional and national anchor networks. Lorraine Scott Elspeth Russell Kerri Todd Proposed community wealth building (CWB) legislation may change how we are required to work with partners and report on CWB actions. Close working with local partners on CWB and receive updates through national groups. Outcomes from task and finish groups. Learning from network shared with action leads. Evidence of participation in anchor networks and wider partnerships. Delivery of the performance measures set out in the Local Child Poverty Action Reports. 151
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18 Deliverable (baseline ref.) Year 1 milestone Year 2 milestone Year 3 milestone Lead(s) Risk and Issues Controls Progress measure best practice across regional and national anchor networks. 152
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Appendix 2 Delivery Plan Guidance Supplementary guidance on establishing a baseline to inform Anchor Strategic Plans January 2023 9 153
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Official 2 Contents Introduction ......................................................................................................................................... 3 1. Supplementary guidance on Workforce data ..................................................................... 4 1.1 Availability of data ................................................................................................................ 4 1.2 Format of data ....................................................................................................................... 4 1.3 Note on Young Person’s Guarantee (W8) ........................................................................ 4 2. Supplementary guidance on Procurement data ................................................................ 4 3. Contact .......................................................................................................................................... 5 154
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Official 3 Introduction As part of the NHS Scotland Delivery Plan Guidance, issued in February 2023, the Scottish Government asked NHS Boards to develop the following: ‘a clear baseline in relation to workforce; local procurement; and use or disposal of land and assets for the benefit of the community1’. Guidance was issued to NHS Board Anchor Leads in November 2023 to support NHS Boards measure progress on their anchor activity and included a template for their baseline to be submitted by Friday 29 March 2024. This communication includes supplementary guidance which should be used alongside the original guidance issued in November 2023. 1 See Section 6.5 of the NHS Scotland Delivery Plan Guidance. 155
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Official 4 1. Supplementary guidance on Workforce data 1.1 Availability of data (W17-18) NHS Board users will be able to access reporting on their workforce to provide the data for metrics W17 - W18 via Anchors reporting on Turas Data Intelligence. A Turas Account is needed to be able to do this and a registration form is available on the link provided. The data should be available in late February, based on workforce data on 31 December 2023. If users have any questions about accessing the Turas data, they should contact the team at Datagroup@nes.nhs.scot.uk. We recognise that the data on the Anchors reporting dashboard may be incomplete due to a range of factors, including rates of disclosure of characteristics and the availability of SIMD data for individuals who are not resident in Scotland. Please submit the data for W17 and W18 as a separate report alongside the completed template that was issued with the guidance in November 2023. 1.2 Availability of data (W19) Please note that data for this metric will not be available on the Anchors reporting dashboard this reporting year. NHS Boards are therefore not required to report on this metric when they submit their baseline. 1.3 Note on Young Person’s Guarantee (W8) We understand that NHS Boards do not work to achieve formal accreditation with the Young Person’s Guarantee, and instead are able to pledge their support. If you have pledged your support for the Young Person’s Guarantee, please answer yes to W8 – “Are you accredited with the Young Person’s Guarantee?”. 2. Supplementary guidance on Procurement data 2.1 Note on spend with third sector bodies (P6) We are aware that not all NHS Boards currently report this information as part of their procurement annual reports, and that there is no standard report for spend with third sector bodies in Spikes Cavell/DXC. Data for spend with registered charities should therefore be reported for this metric, which is available from Spikes Cavell/DXC. We understand that this information will not fully represent total spend with third sector bodies. 156
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Official 5 3. Contact If you have any comments or questions, please contact PAWSecretariat@gov.scot. Úna Bartley Team Leader, Place and Wellbeing Programme Return dates Baseline for Anchor Strategic Plans 2023/24 Friday 29 March 2024 157
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Appendix 3 Delivery Plan Guidance Additional guidance on establishing a baseline to inform Anchor Strategic Plans November 2023 9 159
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Official 2 Contents Introduction .............................................................................................................. 3 1. Background ........................................................................................................ 4 2. Reporting ............................................................................................................ 5 3. Future reporting ................................................................................................. 5 Annex A – Baseline of anchor activity ................................................................... 6 Annex B – Data sources and additional notes .................................................... 11 Annex C – Engagement ......................................................................................... 13 160
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Official 3 Introduction As part of the NHS Scotland Delivery Plan Guidance, issued in February 2023, the Scottish Government asked NHS Boards to develop the following: ‘a clear baseline in relation to workforce; local procurement; and use or disposal of land and assets for the benefit of the community1’. The aim of the baseline is to support NHS Boards measure progress on their anchor activity to inform their Anchor Strategic Plans, as well as to provide an overview of the current position of NHS Scotland as an anchor institution. This communication includes a template (Annex A) that NHS Boards should use to establish their baseline and which should be submitted to the Scottish Government by Friday 29 March 2024. Further information on how the metrics were developed is outlined below along with a note on some caveats and limitations in relation to the proposed metrics and data sources. 1 See Section 6.5 of the NHS Scotland Delivery Plan Guidance. 161
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Official 4 1. Background 1.1 Process to develop appropriate metrics Scottish Government Health and Social Care Analysts, in collaboration with NHS Boards, have developed a set of metrics to support NHS Boards establish a baseline to measure their impact at a local level as anchor institutions. The process of developing a set of metrics involved extensive engagement with stakeholders to explore and review existing data sources and metrics. Other existing frameworks, such as the UCL Partners Anchors measurement framework, were also reviewed. Three Boards – NHS Ayrshire and Arran, NHS Forth Valley, and NHS Lothian – tested the final set of metrics to identify any practical issues in reporting. Feedback received through this engagement process was fundamental in ensuring that the final set of metrics are feasible, manageable, and proportionate for NHS Boards to report on. The metrics were signed off by the Place and Wellbeing Programme Board on 12 October 2023. 1.2 Caveats and limitations While we are confident that the proposed metrics are robust and feasible measures to support NHS Boards baseline their impact as anchor institutions, there are a number of caveats that should be acknowledged. Some of the metrics are relatively blunt measures for the complex and nuanced outcomes around reducing health inequalities at a local level. However, as such outcomes are challenging to measure with the existing data, the proposed metrics should provide the most robust measurement possible with the available data. For the land and assets strand, identifying appropriate metrics proved particularly challenging due to the lack of meaningful data as well as the complexity of outcomes. We have therefore included two qualitative questions to elicit a narrative on community use and barriers, which we recognise will not lend themselves to year-on-year comparison. However, they will provide some of the nuance needed to understand the current position around use and disposal of land and assets. There are some issues around data incompleteness for the agreed metrics, in particular for the self-reported workforce equalities data. Incompleteness of self-reported staff equalities data is an analytical issue across all employers and sectors, and while this limits conclusions and interpretation, such data still provide valuable insights and are used widely in analysis and policy development. For workforce, we have asked about Scottish Index of Multiple Deprivation (SIMD) to capture deprivation data relating to the proportion of staff, applicants, and leavers, which will provide amongst other things useful insights into the workforce geographical spread. However, as SIMD is primarily a measure of area-based deprivation we recognise there are limitations to the conclusions that can be drawn using SIMD, particularly in remote and rural areas. 162
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Official 5 It should also be noted that in a number of instances, we are asking NHS Boards to report on data that they report elsewhere. This is to signal that these data should be included and monitored as part of their Anchor Strategic Plans. 2. Reporting All NHS Boards are asked to establish a baseline for their anchor activity using the template in Annex A. The template should be completed and submitted to PAWSecretariat@gov.scot by Friday 29 March 2024. To avoid additional burden on NHS Boards, the metrics draw on existing data. Data sources and additional notes to help complete the template are set out in Annex B. The baseline reporting period for the metrics will be the financial year 2022/2023. If you have any comments or questions regarding the completion of the template in Annex A, please contact PAWSecretariat@gov.scot. 3. Future reporting The main aim of asking each NHS Board to establish a baseline is to support them measure progress on their anchor activity which should in turn inform future iterations of their Anchor Strategic Plans. We recognise that if the metrics had been included with the guidance issued in June 2023, NHS Boards could have baselined their current activity to inform their Anchor Strategic Plan for 2023/24. However, the process of establishing appropriate metrics took significantly longer than anticipated due to the lack of appropriate data to measure complex outcomes. Our intention is to ask NHS Boards to measure their progress against their baseline on an annual basis, and we will issue further guidance in 2024 on submitting data for the reporting year 2023/24. It should be noted that we have agreed to review the metrics set out in Annex A once we have received the baselines, taking on board any feedback and comments from NHS Boards and other stakeholders. Finally, we would like to recognise the significant input of the many individuals from the groups listed in Annex C who contributed to the process of identifying and agreeing the final set of metrics. Úna Bartley Team Leader, Place and Wellbeing Programme Return dates Baseline for Anchor Strategic Plans 2023/24 Friday 29 March 2024 163
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Official 6 Annex A – Baseline of anchor activity Reporting year: 2022/2023 NHS Board: Workforce Code Metric Response W1 How many employability programmes were underway within your Board in the reporting year? (Please refer to guidance note) W2 How many people have you engaged through employability programmes in the reporting year? W3 Are you accredited as a Real Living Wage employer? Yes/No If no, are you working towards being a Real Living Wage employer? W4 Are you accredited as Carer Positive? Yes/No W5 Are you accredited as Disability Confident? Yes/No W6 Are you accredited as Equally Safe at Work? Yes/No W7 Are you accredited as Menopause Friendly? Yes/No W8 Are you accredited with the Young Person’s Guarantee? Yes/No W10 Are you accredited with the Defence Employer Recognition Scheme? Yes/No W11 Do you publish a race pay gap? Yes/No W12 Do you publish a disability pay gap? Yes/No W13 Do you have a clear strategy for engaging with Local Employability Partnerships (LEPs) within your Board area? Yes/No W14 Does your Board have an identified LEP rep who attends regularly and contributes to the development, implementation and continuous improvement of the LEP Investment Plan? Please provide name and title for the rep(s) within your Board. Yes/No Name and title: 164
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Official 7 Code Metric Response W15 Please state if you are actively targeting one or more of the following groups, either through recruitment, employability programmes or progression schemes, or through working with partners e.g. LEP, college, university. (Please tick all groups that you are actively targeting). (Please refer to guidance note) ☐ Care experienced ☐ Carers ☐ Black and Minority Ethnic groups ☐ People living in the 20% most deprived areas ☐ Disabled people ☐ Gypsy Travellers ☐ Dependent on alcohol and drugs ☐ Homeless people ☐ Recently left prison ☐ Refugees and asylum seekers Priority family groups at risk of child poverty, please state which: ☐ lone parents ☐ young mothers (under 25 years old) ☐ minority ethnic families ☐ large families (with three or more children) ☐ families with a baby (under one) ☐ families with a disabled adult or child Other (please state): W16 Do you have plans to systematically collect data on any of these groups? Yes/No If yes, which groups: 165
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Official 8 Code Metric Response W17 What is the distribution of your workforce by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) W18 What is the distribution of your workforce leavers by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) W19 What is the distribution of applicants and their success rate by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) Procurement Code Metric (Please refer to guidance notes for each question below) Response P1 What is your total spend on local businesses in the reporting year? P2 What percentage of your overall spend is on local businesses in the reporting year? P3 What is your total spend with SMEs in the reporting year? P4 What percentage of your overall spend is with SMEs in the reporting year? P5 What is your total spend on contracts with supported business in the reporting year? P6 What is your total spend with third sector bodies in the reporting year? P7 Please list all community benefits delivered through procurement during the reporting year. P8 What percentage of your newly awarded contracts are with suppliers that are Real Living Wage Accredited or committed to pay the Real Living Wage, for the reporting period? 166
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Official 9 Land and Assets Code Metric Response LA1 How many asset transfer requests have you received to date? (Please refer to guidance note) LA2 How many asset transfers have been awarded to date? (Please refer to guidance note) LA3 Do you have a process in place for embedding anchor procurement activities in new developments? For example, working with local suppliers. Yes/No LA4 Do you have a process in place for embedding anchor employment and activities in new developments? For example, providing local employment opportunities (including apprenticeships) through direct or indirect employment through suppliers. Yes/No LA5 Do you have a process in place for embedding anchor sustainability activities in a) new developments (e.g. energy supply through renewable sources and utilising opportunities for energy generation where surplus energy can be used by target populations) b) existing sites (e.g. green space, café, bookable multipurpose spaces)? (Please refer to guidance note) a) Yes/No b) Yes/No LA6 Does your strategy for new building and estates development include provision for community use a) now (e.g. green space, café, bookable multipurpose spaces) b) in the future (e.g. disposal or redevelopment, suitability for conversion to housing, education)? (Please refer to guidance note) a) Yes/No b) Yes/No LA7 Do you have a process in place for engaging with the local community in planning the design and use of new developments? Yes/No LA8 Does engagement with the community on new developments include any of your Yes/No 167
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Official 10 Code Metric Response Board’s target populations and/or target organisations? LA9 Do you engage with other anchor partners in planning new developments (e.g. local authority, college, university)? (Please refer to guidance note) Yes/No LA10 Do you have a policy or strategy in place for local community use of existing land and buildings? Yes/No LA11 Do you have a process for local community to engage with the organisation to request use of existing sites? Yes/No LA12 Does engagement with the community on existing sites include any of your Board’s target populations and/or target organisations? Yes/No LA13 Do you have a mechanism in place for community and partners to be notified of assets that are surplus/ could be transferred? Yes/No LA14 Please list the current use of land and assets by community groups and activity type (including retail space). LA15 Please list the known key barriers to use/disposal of land and assets by community groups. 168
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Official 11 Annex B – Data sources and additional notes Workforce metrics Key data sources: Staff Governance Monitoring; NES TURAS. Additional notes on Workforce metrics • W1: Definition of Employability: Employability covers a range of activity to help participants gain skills, confidence and experience supporting them to progress towards and access employment opportunities, and to sustain and progress in work. • W15: When we ask about the following groups – dependent on alcohol and drugs, homeless people, recently left prison – we are referring to a people with lived experience of addiction, homelessness and the criminal justice system. When we ask about ‘Priority family groups at risk of child poverty’ we are referring to those identified within the Government’s Best start, Bright Futures: tackling child poverty delivery plan. We recognise the challenge in identifying these groups as they are quite specific, however we are seeking this information to understand where NHS employment could help to mitigate against child poverty, which we know can lead to health inequalities. • W17 – W18: NHS Education Scotland will provide the data via Turas Data Intelligence by March 2024. When available, we will write to Anchor Leads with instructions on how to access the data. • W19: NHS Education Scotland will provide the data via Turas Data Intelligence by March 2024, providing data sharing agreement is reached with sufficient time to undertake analysis and quality assurance. If available, we will write to Anchor Leads with instructions on how to access the data. Procurement metrics Key data source: Procurement Annual Report Annex A. Additional notes on Procurement metrics • P1 – P2: o ‘Local’ is defined using the invoice address as registered on Spike Cavell/DXC. o For territorial NHS Boards, local spend is classified as expenditure with suppliers whose postcodes within DXC Spend Analytics are located within the local authority areas covered by the territorial Health Board. o For national NHS Boards, local spend is classified as expenditure with suppliers whose postcodes within DXC Spend Analytics are located within Scotland. • P3 – P4: ‘Small and medium enterprises’ (SMEs) means businesses with no more than 250 employees. 169
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Official 12 • P4: We are aware this is not reported as part of procurement annual reports. This should be calculated by dividing the total spend with SMEs in reporting year (metric P3) by your total overall procurement spend in the reporting year. • P5: ‘Supported business’ means an organisation whose main aim is the social and professional integration of disabled or disadvantaged persons and where at least 30% of the employees of the organisation are disabled or disadvantaged persons. • P7: Community benefits are defined as relating to training and recruitment or availability of sub-contracting opportunities; or which is otherwise intended to improve the economic, social or environmental wellbeing of the contracting authority’s area in a way additional to the main purpose of the contract in which the requirement is included. Land and Assets metrics Key data source: Asset Transfer Request annual report. Additional notes on Land and Assets metrics • LA1 – LA2: This should be counted from the earliest available data on asset transfers up to and including the reporting year 2022/23. • LA5, LA6 and LA9: We have provided examples of the types of activities that may feature as part of Anchors Land and Assets work however, these are not exhaustive. 170
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Official 13 Annex C – Engagement To develop the metrics to support NHS Boards establish a baseline, we engaged with representatives from the following groups and organisations: • Anchors Delivery Group • Anchors Workforce Strategic Group • Land and Assets Task and Finish group • National Services Scotland • NHS Ayrshire and Arran • NHS Forth Valley • NHS Lothian • NHS Education for Scotland • NHS Procurement Services Senior Management Team • Procurement Task and Finish group • Public Health Scotland • Scottish Property Advisory Group • Scottish Government NHS Workforce Policy • Scottish Government Procurement Policy and Analysis • Scottish Government Wellbeing Economy Analysis • Supplier Development Programme • UCL Partners (Health Foundation). 171
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1 Appendix 4 Baseline of anchor activity – 19th March 2024 Reporting year: 2022/2023 NHS Board: Lanarkshire Workforce Code Metric Response W1 How many employability programmes were underway within your Board in the reporting year? (Please refer to guidance note) Project Search NHS Demonstrator Programme Clinical Employability Programme Graduate Apprenticeship Programme – upskilling existing staff Modern Apprenticeships including upskilling current staff W2 How many people have you engaged through employability programmes in the reporting year? 187 W3 Are you accredited as a Real Living Wage employer? Yes W4 Are you accredited as Carer Positive? No NHSL has the following policies: New Parent Support policy Parental leave policy Special leave policy Flexible working pattern policy Maternity policy Shared maternity and adoption leave policy Actions are being taken forward to make Employee 9 173
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2 Code Metric Response support policies more accessible through a dedicated Human Resources (HR) webpage and this will be promoted to staff and to new recruits through inclusion in job pack information. W5 Are you accredited as Disability Confident? Yes W6 Are you accredited as Equally Safe at Work? No NHSL has a Gender Based Violence Policy in place and we await the findings from the pilot board sites who are progressing Equally Safe at Work accreditation. Actions are being taken forward to make Employee support policies more accessible through a dedicated Human Resources (HR) webpage and this will be promoted to staff and to new recruits through inclusion in job pack information. W7 Are you accredited as Menopause Friendly? No NHSL has a Menopause at work Policy. Actions are being taken forward to make Employee support policies more accessible through a dedicated Human Resources (HR) webpage and this will be promoted to staff and to new recruits through inclusion in job pack information. W8 Are you accredited with the Young Person’s Guarantee? Yes W10 Are you accredited with the Defence Employer Recognition Scheme? Yes W11 Do you publish a race pay gap? No 174
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3 Code Metric Response Staff completion of this information on eESS is low. A new HR webpage will include a guide for staff on how to update their equality information on eESS. This guide will also be promoted as part of the anchor communications plan. W12 Do you publish a disability pay gap? No Staff completion of this information on eESS is low. The new HR webpage will include a guide for staff on how to update their equality information on eESS. This guide will also be promoted as part of the anchor communications plan. W13 Do you have a clear strategy for engaging with Local Employability Partnerships (LEPs) within your Board area? Yes We have a commitment for both employability and health promotion staff attending the LEP meetings and fully participating in any activities. Both LEP’s in North and South Lan work slightly differently. The LEPs have provided a mechanism to build relationships and identify employability opportunities within health and social care. W14 Does your Board have an identified LEP rep who attends regularly and contributes to the development, implementation and continuous improvement of the LEP Yes Name and title: 175
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4 Code Metric Response Investment Plan? Please provide name and title for the rep(s) within your Board. Lorraine Scott HR Business Partner Christine Reid – Health Improvement Team Leader Jane Paton – Health Improvement Team Leader 176
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5 W15 Please state if you are actively targeting one or more of the following groups, either through recruitment, employability programmes or progression schemes, or through working with partners e.g. LEP, college, university. (Please tick all groups that you are actively targeting). (Please refer to guidance note) ☒ Care experienced ☐ Carers ☐ Black and Minority Ethnic groups ☐ People living in the 20% most deprived areas ☒ Disabled people ☐ Gypsy Travellers ☐ Dependent on alcohol and drugs ☐ Homeless people ☐ Recently left prison ☐ Refugees and asylum seekers Priority family groups at risk of child poverty, please state which: ☒ lone parents ☒ young mothers (under 25 years old) ☒ minority ethnic families ☒ large families (with three or more children) ☒ families with a baby (under one) ☒ families with a disabled adult or child Other (please state): Targeting of employability programmes has focused on child poverty groups in year one of the anchor plan. The anchor plan includes targeting employability to a further two additional priority groups each year. 177
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6 Code Metric Response W16 Do you have plans to systematically collect data on any of these groups? In part. We are able to collect data on the protected characteristics and SIMD of those taking part in employability programmes where this information is completed on Jobtrain. We have been able to elicit further information from successful applicants when they join the organisation if they choose to disclose this e.g. those who have been care experienced, however this data is not captured routinely. From April 2024, equality and diversity information captured on jobtrain and eESS will be updated to include whether applicants/employees are care experienced; have caring responsibilities; and, information on socio- economic background (defined by occupational category of main household earner when applicant aged 14). W17 What is the distribution of your workforce by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) Please see spreadsheet embedded below for data tables with NHS Lanarkshire Employee and Leavers Data from TDI Anchors Reporting Dashboard: NHS Lanarkshire Employee and Leavers W18 What is the distribution of your workforce leavers by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) Please see spreadsheet embedded below for data tables with NHS Lanarkshire Employee and Leavers Data from TDI 178
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7 Code Metric Response Anchors Reporting Dashboard: NHS Lanarkshire Employee and Leaver W19 What is the distribution of applicants and their success rate by protected characteristics and SIMD in the reporting year? (Please refer to guidance note) Not required for 2022-23 baseline report. Procurement Code Metric (Please refer to guidance notes for each question below) Response P1 What is your total spend on local businesses in the reporting year? £27,719,055.18 P2 What percentage of your overall spend is on local businesses in the reporting year? 9% P3 What is your total spend with SMEs in the reporting year? £95,781,422.32 P4 What percentage of your overall spend is with SMEs in the reporting year? 31% P5 What is your total spend on contracts with supported business in the reporting year? £76,332.54 P6 What is your total spend with third sector bodies in the reporting year? £13,309,432.29 P7 Please list all community benefits delivered through procurement during the reporting year. 4 full-time jobs created; 2 student placements provided P8 What percentage of your newly awarded contracts are with suppliers that are Real Living Wage Accredited or committed to pay the Real Living Wage, for the reporting period? 56%. This is based on the new contracts (n=30) awarded during 2022/23 where the supplier is RLW accredited and/or committed to pay the RLW as part of that contract. This does not mean other contractors do not pay RLW but this information is not available. 179
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8 Land and Assets Code Metric Response LA1 How many asset transfer requests have you received to date? (Please refer to guidance note) 2 LA2 How many asset transfers have been awarded to date? (Please refer to guidance note) 0 One organisation was unable to meet the constitutional requirements for the Community Empowerment legislation requirements. The other was in process during the time period of this return and has since been awarded. LA3 Do you have a process in place for embedding anchor procurement activities in new developments? For example, working with local suppliers. Yes – included as part of the procurement tender documentation and scoring process and in the Procurement strategy 2023-26. LA4 Do you have a process in place for embedding anchor employment and activities in new developments? For example, providing local employment opportunities (including apprenticeships) through direct or indirect employment through suppliers. Yes – included as part of the procurement tender documentation and scoring process. A good example is the development of a Community benefits plan for the new University Hospital Monklands. LA5 Do you have a process in place for embedding anchor sustainability activities in a) new developments (e.g. energy supply through renewable sources and utilising opportunities for energy generation where surplus energy can be used by target populations) b) existing sites (e.g. green space, café, bookable multipurpose spaces)? (Please refer to guidance note) a) This is currently a work in progress as part of our new University Hospital Monklands development. This is also required as part of the NHS Scotland Achieving Excellence Design Evaluation Toolkit (AEDET) guidance. We are also exploring opportunities for renewables through our Sustainability and Climate Change Strategy 2022- 2026. b) No, local informal processes exist depending on the site and the activity. LA6 Does your strategy for new building and estates development include provision for community use a) now (e.g. green space, café, bookable multipurpose spaces) a) No, there is not a specific strategy however any new developments would reflect the NHS Scotland Achieving Excellence Design Evaluation Toolkit (AEDET) guidance. 180
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9 Code Metric Response b) in the future (e.g. disposal or redevelopment, suitability for conversion to housing, education)? (Please refer to guidance note) b) No, there is not a specific strategy but we would work with our local authority partners in considering potential future use of any sites being disposed of. LA7 Do you have a process in place for engaging with the local community in planning the design and use of new developments? Yes, we would engage local community in line with the national community engagement standards. The Health Improvement teams are linked into community planning partnership groups at a local level (e.g. community boards and neighbourhood groups, local voluntary organisation networks) and will support community engagement appropriately depending on the focus of the new development. Examples include Monklands Replacement Project and the new CAMHS unit at Udston hospital. LA8 Does engagement with the community on new developments include any of your Board’s target populations and/or target organisations? Yes, target groups would be identified in line with the proposed use for the development. For example, the CAMHS development at Udston Hospital had engagement with children, young people and their families. LA9 Do you engage with other anchor partners in planning new developments (e.g. local authority, college, university)? (Please refer to guidance note) Yes, there is routine engagement with local authorities. LA10 Do you have a policy or strategy in place for local community use of existing land and buildings? No Whilst we have many positive examples of community groups making use of NHSL assets, we do not have a policy for supporting local community use of land and buildings. This process is managed separately by each site. LA11 Do you have a process for local community to engage with the Yes As per LA 10 above this is managed separately by each site. 181
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10 Code Metric Response organisation to request use of existing sites? LA12 Does engagement with the community on existing sites include any of your Board’s target populations and/or target organisations? Yes As per list in LA14 there are a range of community organisations who use the acute sites and many of these services are targeted to those experiencing poverty or other inequalities. LA13 Do you have a mechanism in place for community and partners to be notified of assets that are surplus/ could be transferred? No There is no formal process at present and communities and partners will hear through local networks and groups. There is now an Asset Transfer section on NHS Lanarkshire website and there is potential to include information on sites due to be disposed of as a future development of this section. LA14 Please list the current use of land and assets by community groups and activity type (including retail space). 8 Community Gardening projects facilitated by Clydesdale community Initiative delivered across the following sites: Kirklands; Coathill Hospital; Airbles Road Centre (council land but community input and NHS patients); University Hospital Wishaw (King George V park - council land but community input and NHS patients); Udston Hospital; Ladyholme Hospital; University Hospital Hairmyres; and, Kello Hospital. Royal Voluntary Service Tea bar – University Hospital Monklands Coffee Bar – University Hospital Hairmyres Café Bar – University Hospital Wishaw Radio Law – University Hospital Wishaw Kirktonhome Nursery (private) – University Hospital Wishaw Kirriemuir Nursery (private) – University Hospital Hairmyres Kilbryde Hospice – University Hospital Hairmyres 182
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11 Code Metric Response Haven Hospice – University Hospital Wishaw Maggie’s Centre – University Hospital Monklands. Dentist – Rutherglen Health Centre A number of community pharmacies lease premises. These are as follows: Lloyds Pharmacy – Woodstock GP Coatbridge Dispensary Ltd – Coatbridge Health Centre Deans Chemist Ltd – Newmains Health Centre Crawfords Chemists – Shotts Health Centre In addition, there are a range of community services, third sector providers and social enterprises which have utilised the public spaces within the three acute sites including: cancer charities; carer’s organisations; Lanarkshire food and health partnership; the Tackling Poverty team; and, Home Energy Scotland. A full list of services by site is provided in the attached. Community groups mapping.docx LA15 Please list the known key barriers to use/disposal of land and assets by community groups. Community Empowerment Legislation can be restrictive. Examples noted as follows - Local groups having to organise and register as a charity to pursue Community Asset Transfer (CAT). - Application withdrawn from an unincorporated charity as they did not meet requirements of the legislation due to the work involved to meet the legislative requirements. 183
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12 Code Metric Response Time and resource - In the spirit of the legislation, public bodies have to support groups through the process. Groups have limited knowledge or experience of process. Requirement to secure the best obtainable terms in property transactions. Usually measured in the receipt to the Board. Groups that have engaged on CAT expect that they can secure ownership for less than market value. There is scope to transfer at a discount to market value. However, out with the legislative framework, there is a requirement to achieve market value, with no discount. In some instances, for groups looking to secure property at a discounted figure, there isn’t a clear alternative route to dispose of the property to them. 184
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Report Agenda Item Report to: Community Wealth Building Commission Date of Meeting: 10 September 2024 Report by: Chief Executive, South Lanarkshire Council Subject: Forward Programme for Future Meetings 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] advise members of the forward programme for the meetings of the Community Wealth Building Commission invite members to suggest topics for inclusion in the Commission’s forward programme [1purpose] 2. Recommendation(s) 2.1. The Commission is asked to approve the following recommendation(s):- [recs] (1) that the report and the outline forward programme for the meetings of the Commission, attached as an appendix to the report, be noted. [1recs] 3. Background 3.1. Members of the Commission have expressed an interest in bringing forward items to future meetings which would explore each of the 5 pillars in detail and allow constructive discussion on how collectively to progress the CWB agenda in South Lanarkshire. 3.2. To assist in shaping the future deliberations of the Commission, an outline forward programme is attached as an appendix to the report. Members are invited to consider the programme and suggest topics that they would like to see addressed at future meetings. 4. Employee Implications 4.1. There are no employee implications. 5. Financial Implications 5.1. There are no financial implications. 6. Climate Change, Sustainability and Environmental Implications 6.1. There are no climate change, sustainability or environmental implications in terms of the information contained within this report. 7. Other Implications 7.1. There are no risk implications in terms of the information contained within this report. 10 185
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8. Equality Impact Assessment and Consultation Arrangements 8.1. The report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and, therefore, no impact assessment is required. 8.2. There was no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Chief Executive South Lanarkshire Council 23 August 2024 Link(s) to Council Values/Priorities/Outcomes Accountable, effective, efficient and transparent Previous References None List of Background Papers None Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Tom Little, Head of Communications and Strategy Ext: 4904 (Tel: 01698.454904) E-mail: Tom.Little@southlanarkshire.gov.uk 186
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APPENDIX – CWB COMMISSION OUTLINE FORWARD PROGRAMME Meeting Date Item Responsibility 3 December 2024 Q2 Progress Report Forward Programme for Future Meetings Risk Register Community Fight Back Carluke Development Trust Involvement - ONECAN Neil Tom Craig Tom Future Meetings SLC land and property link to renewable energy? (requested by Cllr Robb at December 2023 meeting) Employability and the Employment Pillar Asset Transfer Planning for Place and CWB Community Benefits within Contracts UN Sustainable Development Goals Supplier Development Programme Business Gateway Country Parks Shaping Places for Wellbeing Update on local data sets SLC SLC SLC SLC SLC VASLan or Cmty Planning Iain Iain Iain Gillian Jen 187
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