Agenda Document Pack - Audit, Performance and Risk Committee - 29/10/2025
Moray Council · 29 October 2025
Back to Audit, Performance and Risk Committee — 29 October 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Audit, Performance and Risk Committee Wednesday, 29 October 2025 Council Chambers NOTICE IS HEREBY GIVEN that a Meeting of the Audit, Performance and Risk Committee, Council Chambers, Council Office, High Street, Elgin, IV30 1BX on Wednesday, 29 October 2025 at 14:00 to consider the business noted below. AGENDA 1. Welcome and Apologies 2. Declaration of Member's Interests 3. Minute of meeting of 19 June 2025 5 - 10 4. Action Log of 19 June 2025 11 - 12 5. Quarter 1 (April to June 2025) Performance Report - Adult Services 13 - 46 6. Quarter 1 (April to June 2025) Performance Report for Children and Families and Justice Social Work 47 - 84 7. Internal Audit Section - Update Report 85 - 92 8. Internal Audit Section Completed Projects Report 93 - 128 9. Update on the Delivery of the Unpaid Carers Strategy 129 - 134 Page 1
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10. External Auditors' Report to those charged with Governance 135 - 206 11. 2024-25 Audited Annual Accounts 207 - 276 12. Public Sector Internal Audit Standards - External Quality Assessment of the Internal Audit Section - Follow Up Review 277 - 298 13. Health and Social Care Moray Strategic Delivery Plan 2025-2028 - Progress Update to 30 September 2025 299 - 338 14. Items for Escalation to MIJB Item(s) which the Committee may wish to consider with the Press and Public excluded 15. CONFIDENTIAL Internal Audit Section Follow Up Review - NHS Grampian • 8 & 9. Information on proposed terms and/or expenditure to be incurred by the Authority; 16. CONFIDENTIAL Internal Audit Follow Up Reviews - Information Communication and Technology • 8 & 9. Information on proposed terms and/or expenditure to be incurred by the Authority; Page 2
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MORAY INTEGRATION JOINT BOARD SEDERUNT Councillor Ben Williams (Chair) Councillor Scott Lawrence (Voting Member) Mr Derick Murray (Voting Member) Mr Sean Coady (Member) Ms Sonya Duncan (Member) Ms Aimee McIntosh (Member) Ms Deborah O'Shea (Member) Ms Judith Proctor (Member) Mr Sandy Riddell (Member) Mr Michael Ritchie (Non-Voting Member) Clerk Name: Caroline O'Connor Clerk Telephone: 07779 999296 Clerk Email: committee.services@moray.gov.uk Page 3
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MINUTE OF MEETING OF THE AUDIT, PERFORMANCE AND RISK COMMITTEE Thursday, 19 June 2025 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Mr Sean Coady, Ms Sonya Duncan, Councillor Scott Lawrence, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Mr Sandy Riddell, Councillor Ben Williams APOLOGIES Ms Deirdre McIntyre IN ATTENDANCE Interim Chief Social Work Officer/Head of Service; Chief Internal Auditor; Iain Macdonald, Deputy Head of Service; Corporate Programme Manager; Angela Pieri, Engagement Lead, Grant Thornton and Caroline O'Connor, Committee Services Officer ALSO IN ATTENDANCE Councillor Tracy Colyer 1. Chair The meeting was chaired by Mr Sandy Riddell. 2. Declaration of Member's Interests The Committee noted there were no declarations of member's interests. 3. Minute of meeting of 27 March 2025 The minute of the meeting of 27 March 2025 was submitted and approved. 4. Action Log of 27 March 2025 Item 3. Page 5
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The Action Log of the meeting of 27 March 2025 was discussed and updated accordingly. 5. Quarter 4 (January - March 2025) Performance Report - Adult Services The meeting had before it a report by the Corporate Programme Manager updating the Committee on performance as at Quarter 4 2025 (January to March). With reference to the pressures outlined in paragraph 5.5 on adult mental health and primary care psychological therapies, Councillor Lawrence firstly asked for a breakdown of areas of pressures and whether issues such as the increasing numbers of adults waiting assessment for Attention Deficit Hyperactivity Disorder (ADHD) were contributing to the increased pressures; and secondly, what effect the Certificate of Equivalence for Specialist Registration (CESR) Fellowship was having to reduce waiting times. In response, the Deputy Head of Service advised currently the main pressure point was self referral into primary care however, as a result of targeted work undertaken over the last 6 months relating to referral routes and more appropriate signposting for people, the average wait time had reduced from 40 weeks to 20 weeks in the last quarter and was confident the adjustments would result in further improvements. He further advised the benefits in relation to CESR Fellowship were wide reaching across the whole system however there were significant benefits being realised within adult services. In response to a question from Councillor Lawrence asking whether long term vacancies were a factor in the staff sickness levels referenced in terms of increased pressure referred to in paragraphs 5.6 and 5.7, the Chief Officer confirmed this was a a contributing factor which management attempt to manage by reviewing processes and providing support within resources. She further advised of ongoing work within the partnership and Council on how to strengthen support for managers to proactively manage absence. In response to a question from Mr Riddell asking when it was anticipated the Mental Health Bed Based Review would be delivered noting the potential implications for Moray, the Deputy Chief advised Priority 6 of the review focusses on Moray and the first meeting of the Working Group relating to that priority was to be held later that day from which a timeline would be prepared on options, likely to take approximately 6 months, which would then be presented to the Moray Integration Joint Board for approval. Following consideration the Committee unanimously agreed to:- (i) note the performance of local indicators for Quarter 4 (January to March 2025) as presented in the Performance Report at Appendix 1; (ii) note the analysis of indicators that have been highlighted and actions being undertaken to address performance that is outside of acceptable target ranges as detailed in Appendix 1; (iii) note the revised format of this report, which will continue to evolve in future reporting periods noting that different service areas may be highlighted within each report, or as requested by the Board; and Page 6
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(iv) note the inclusion of supplementary service information in Appendix 1, which provides additional context and evidence to support the mitigations outlined in relation to the national outcomes. 6. Quarter 4 (January to March 2025) Performance Report for Children and Families and Justice Social Work The meeting had before it a report by the Interim Chief Social Work Officer / Head of Service informing the Committee on Children and Families and Justice Social Work performance as at Quarter 4 (January to March 2025). Mr Murray asked for the reasons for the increase in numbers of Out of Area Placements referenced in Graph 20 of Appendix 1. In response, the Interim Chief Social Work Officer advised all attempts are made to keep families together and wherever possible this is facilitated within Moray however, internal foster care provision was at maximum capacity as a result of significant challenges with the permanence planning process. He further advised a range of measures were being considered including the potential for transitional funding to be agreed by the Council to address the particular issues. Following consideration the Committee unanimously agreed to:- (i) note the performance of local indicators for Quarter 4 as presented in the Performance Report at Appendix 1; and (ii) note the analysis of the local indicators as detailed in Appendix 1. 7. Internal Audit Section - Update Report The meeting had before it a report by the Chief Internal Auditor providing Committee with an update on the work of the Internal Audit Section. Mr Murray, appreciating the reasons provided by the Audit and Risk Manager in relation to his limited assurance opinion on the adequacy of the Board's governance arrangements, sought clarification how close the Board were to achieving reasonable assurance. In response, the Audit and Risk Manager advised his opinion was evidence based in respect of audit reviews undertaken and progression of audit recommendations by services. He confirmed the following years’ opinion would be based on the evidence at that time but stated work was required to ensure a closer working relationship within the NHS on what the Board feed back to NHS Grampian and their auditors to enable a more coordinated approach and allow an overarching view to be taken. In order to provide assurance, the Chief Officer confirmed the senior management team and operational management team were working to ensure there was clarity in terms of the reasons for incomplete audit actions and revised implementation deadlines. She confirmed the team would be working closely with Internal Audit to focus future audits on areas where there and challenges and to ensure recommendations were implementable in terms of both timescale and resource. Following consideration the Committee unanimously agreed to note the audit update. Page 7
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8. Internal Audit Annual Report - 2024-25 The meeting had before it a report by the Chief Internal Auditor providing Committee with details of internal audit work undertaken relative to the Moray Integration Joint Board (MIJB) for the financial year ended 31 March 2025, and the assurances available on which to base the internal audit opinion on the adequacy of the MIJB's systems of internal control. Following consideration the Committee unanimously agreed to note the contents of the annual report given as Appendix 1. 9. Unaudited Annual Accounts The meeting had before it a report by the Chief Financial Officer informing the Committee of the Unaudited Annual Accounts of the Moray Integration Joint Board (MIJB) for the year ended 31 March 2025. In introducing the report, the Chief Financial Officer apologised for an error in paragraph 4.3 noting the figures in the paragraph had been amended to reflect the amended Asylum Seekers Grant of £701,000 which should have been classed as a grant carried forward rather than being included in ear marked reserves and, while the Reserves figure had been updated in the report, the sentence "this increase is primarily due to transfer of reserves from Moray Council to MIJB relating to Asylum Seekers granted during the year" should have been removed from the paragraph. Following consideration the Committee unanimously agreed to:- (i) note the unaudited Annual Accounts and recommend approval to the MIJB to be submitted to the external auditor, noting that all figures remain subject to audit, in Appendix 1; (ii) note the Annual Governance Statement contained within the unaudited Annual Accounts and in Appendix 3; (iii) note the accounting policies applied in the production of the unaudited Annual Accounts, pages 47 to 48 of the accounts; and (iv) approve the updated Local Code of Corporate Governance which supports the Annual Governance Statement, in Appendix 2. 10. Annual Performance Report 2024-25 The meeting had before it a report by the Chief Officer presenting the Committee with the draft Annual Performance Report 2024/25. Following consideration the Committee unanimously agreed to:- (i) note the draft Annual Performance Report 2024/25 at Appendix 1; (ii) note the national indicator 11-19 information will be updated and approved by the Chair and Vice Chair of the Board prior to publication; and Page 8
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(iii) recommend to the Moray Integration Joint Board for approval and publication of the Annual Performance Report 2024/25 by 31 July 2025. 11. Development Sessions in November 2024 for Children Families and Justice Social Work The meeting had before it a report by the Interim Chief Social Work Officer / Head of Service informing Committee of the Development Sessions undertaken by Children and Families and Justice Social Work in November 2024 and the resulting actions to address learning from social work practice. Following consideration the Committee unanimously agreed to:- (i) note the activity and outcomes related to the Development Sessions in 2024; (ii) note the content of the Improvement Plan at Appendix 3; and (iii) agree an update on progress of the Action Plan will be provided to a future Committee meeting. 12. Internal Audit Section Update Report - NHS Grampian Internal Audit Review [Para 6.2.5] The meeting had before it a report by the Chief Internal Auditor providing an update to Committee on the internal audit work completed on NHS Grampian systems and practices. Following consideration the Committee unanimously agreed to note the audit update. 13. Update on Improvement Plan for Adult Social Care Commissioning [Para 6.2.2] The meeting had before it a report by the Interim Chief Social Work Officer / Head of Service updating the Committee of progress on the Improvement Plan for Adult Social Care Commissioning. Following consideration the Committee unanimously agreed:- (i) to note the progress of the Improvement Plan attached at Appendix 1; (ii) to note the progress within this report as at the end of March 2025 regarding the recommendations detailed in the Improvement Plan; and (iii) that future reporting on this work will be submitted to the Moray Integration Joint Board annually, considering that there will be an internal reporting to evidence the implementation of the recommendations detailed within the KPMG Adult Social Care Commissioning review. Page 9
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MEETING OF MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE THURSDAY 19 JUNE 2025 ACTION LOG Item No. Title of Report Action Required Due Date Action By Update for 29 October 2025 1. Q1 Performance Report Information to be provided about the support that is on offer to staff to help improve their wellbeing. 27 June 2024 Sean Coady/ Natalie Jeffrey Due to new template from Scottish Government, new HSCM H&S Delivery Plan and Workforce Delivery Plan now scheduled for later 2025. 2. Q2 Performance Report Chief Officer to issue email update with information relating to the rise in targets detailed in Emergency Admissions graphs in Appendix 1. TBC Chief Officer Targets are being amended. Members will be emailed with background information detailing how targets are calculated. 3. Q3 (Oct-Dec 2024) Performance Paragraph 5.12 – include evidence in future reports of the effectiveness of the initiatives to address staff absence specifically relating to take-up and their impacts. 19 June 2025 Corporate Programme Manager Performance report on today’s agenda. Item 4. Page 11
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Item No. Title of Report Action Required Due Date Action By Update for 29 October 2025 Report – Adult Services 4. Q3 Performance Report for Children and Families and Justice Social Work Chief Officer agreed to discuss with the Chair and Depute Chair of the Board the most suitable approach for Board to recommit to The Promise following transfer of Children’s Services from Council to MIJB. TBC Chief Officer MIJB and Council Development Session titled ‘The Promise 5 Years on and Unpaid Carers’ took place on 24 April 2025. Action closed Page 12
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: QUARTER 1 (APRIL - JUNE 2025) PERFORMANCE REPORT – ADULT SERVICES BY: CORPORATE PROGRAMME MANAGER 1. REASON FOR REPORT 1.1 To update the Committee on performance as at Quarter 1 2025 (April - June). 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and note the performance of local indicators for Quarter 1 (April to June 2025), against revised targets for 2025/26, as presented in the Performance Report at Appendix 1; ii) consider and note the analysis of indicators that have been highlighted and actions being undertaken to address performance that is outside of acceptable target ranges as detailed in section 5; iii) consider and note the commentary in section 6 and graphs for the National and Ministerial Steering Group indicators in Appendix 2; and iv) approve the revised list of local indicators for future quarterly reports included in paragraph 7.3 and the intention to provide deep dives into specific areas of interest through the year. 3. BACKGROUND 3.1 The purpose of this report is to ensure the Moray Integration Joint Board (MIJB) fulfils its ongoing responsibility to ensure effective monitoring and reporting on the delivery of services and on the programme of work as set out in its Strategic Plan. 3.2 Appendix 1 identifies local indicators for the MIJB and the functions delegated by NHS Grampian (NHSG) and Moray Council, enabling broader scrutiny and assurance by the Board. Item 5. Page 13
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4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 Local Indicators are assessed on their performance via a common performance monitoring Red, Amber, and Green (RAG) traffic light rating system. Some of these local indicators sit with acute, although can and do impact our whole system. RAG scoring based on the following criteria: GREEN If Moray is performing better than target. AMBER If Moray is performing worse than target but within agreed tolerance. RED If Moray is performing worse than target by more than agreed tolerance. 4.2 The detailed performance report for quarter 1 is attached in Appendix 1. Summary of Previously Agreed Indicators 4.3 Figure 1 provides a summary and the historical trends in performance within Health and Social Care Moray (HSCM) as demonstrated by the agreed indicators up to the end of quarter 1 of the financial year 2025/26. Where there is no nationally set target the targets for Quarter 1 have been using average of activity for previous calendar year. 4.4 A summary of performance for each of the 6 reporting categories is provided below. One indicator is presenting as green; three are amber and seven are red. EMERGENCY DEPARTMENT - AMBER 4.5 There was a very slight increase in the rate per 1,000 this quarter to 22.1. A slight increase the number presented in the last quarter and slightly above Q1 2024 so performance is largely at target at present. DELAYED DISCHARGES – RED 4.6 The number of delays at the quarter 4 snapshot is at 32, which is down from 40 in quarter 4 and down on the 33 recorded this time last year. The figure fluctuates throughout the period. 4.7 Bed days lost due to delayed discharges decreased to 1,015 this quarter, down from quarter 3 but up from 922 in Q1 2024/25. EMERGENCY ADMISSIONS – GREEN 4.8 The rate of emergency occupied bed days for over 65s has reduced in the last three months to 2,329 this quarter and is continuing to reduce slowly but steadily since the high of 2,749 in quarter 4 2022/23. The emergency admission rate per 1000 population for over 65s has increased this quarter to 179.7 which is just above the revised target. Similarly, the number of people over 65 admitted to hospital in an emergency is also very slightly above the revised target but has maintained the rate of 125.7 in quarter 4 2024/25. HOSPITAL RE-ADMISSIONS - RED Page 14
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4.9 The 7-day re-admissions have increased above target at 4.1%, and the 28-day re- admissions have increased to above target at 9.4%. The target has been revised from 7.9% to 7.4% but the change over the last quarter has been significant. MENTAL HEALTH – RED 4.10 60% of patients were referred within 18 weeks at the end of quarter 1, down from 65% the previous quarter. STAFF MANAGEMENT – RED 4.11 Sickness absence for NHS employed staff has increased to 5.9% for quarter 1 which is lower than 7.0% for the same period last year, but up from quarter 4 absence of 4.9%. Council employed staff sickness has remained high at 8.1% and above the same period last year of 7.5%. Page 15
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Figure 1 – Performance Summary Note: In order to match other national and local data sources indicators are showing the last month in the reporting quarter. Targets have been updated from Q1 2526 using average of activity for previous calendar year. MH and SM are LDP Standard Indicators and targets are set nationally so remain unchanged. Q1 2425 Q2 2425 Q3 2425 Q4 2425 Q1 2526 New Target Previous Target Apr-Jun Jul-Sep Oct-Dec Jan-Mar Apr-Jun (from Q1 2526) (from Q1 2425 or earlier) AE Accident and Emergency AE-01 A&E Attendance rate per 1000 population (All Ages) 21.5 22.6 19.7 22.0 22.1 21.4 21.9 A DD Delayed Discharges DD-01 Number of delayed discharges (including code 9) at census point 33 40 33 40 32 no change 26 R DD-02 Number of bed days occupied by delayed discharges (including code 9) at census point 922 1115 981 1149 1015 no change 850 R EA Emergency Admissions EA-01 Rate of emergency occupied bed days for over 65s per 1000 population 2606 2603 2604 2412 2329 2564 2681 G‚ EA-02 Emergency admission rate per 1000 population for over 65s 178.7 177.7 183.6 177.8 179.7 179.4 187 A EA-03 Number of people over 65 years admitted as an emergency in the previous 12 months per 1000 population 124.2 123.8 127.5 125.7 125.7 125.1 131 A HR Hospital Readmissions HR-01 % Emergency readmissions to hospital within 7 days of discharge 3.6% 4.6% 3.1% 3.9% 4.1% 3.7% 3.7% R HR-02 % Emergency readmissions to hospital within 28 days of discharge 6.9% 8.9% 6.9% 7.4% 9.4% 7.4% 7.9% R MH Mental Health MH-01 % of patients commencing Psychological Therapy Treatment within 18 weeks of referral 70% 60% 44% 65% 60% no change 90% R SM Staff Management SM-01 NHS Sickness Absence (% of hours lost) 7.0% 6.4% 7.0% 4.9% 5.9% no change 4% R SM-02 Council Sickness Absence (% of days lost) 7.5% 7.3% 7.3% 8.2% 8.1% no change 4% R Health and Social Care Moray Performance Report Code Barometer (Indicator) RAG Page 16
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5. AREAS REQUIRING IMPROVEMENT Delayed Discharges - Red Situation 5.1 In April 2025, delayed discharges decreased to 32, below the Q4 2024/25 figure of 40. The average through the quarter was 37 but this remains above the Scottish Government target of 26 for Moray. Bed days occupied by delayed discharges decreased to 1,015 (from 1,149), which is positive and reflects the continued focused effort to scrutinise reasons why people are delayed and to find solutions. There has been a notable increase in persons awaiting care home placement at present however progress with Care at Home transformation, in the establishment of a framework for commissioning personal care and onboarding of other providers, has increased the choice available for people at all options. This is reflected in the number of days occupied decreasing, as well as a decrease in the numbers of people waiting over 90 days for care. 5.2 Community hospitals operated at 99.8% occupancy (Apr-Jun), with an average stay of 81.7 days. Patient acuity remains high, particularly among frail, elderly individuals. The higher acuity has seen an increase in the request for permanent care home placement. 5.3 Unmet need remains high at the end of Q1 with an average of 33 people in hospital and 151 people in the community awaiting care through the period. At the end of June there were 1,205 hours of care not provided, a reduction since the end of the previous quarter and since the same period the previous year. There is a decreasing trend which is a positive sign that the work to increase capacity with the new framework and to strengthen governance around the resource allocation process is increasing choice for people and evidencing prioritisation of available resource. The demand for care continues to exceed available resources and these figures overall reflect ongoing whole-system pressures Mitigation and Impact • Daily multi-disciplinary meetings support real-time collaborative decision- making and system flow. • Surge beds in one community hospital (Seafield) were operational in this quarter easing pressure on acute and community services. • A new home assessment pathway is to be introduced, with funding from Scottish Government, that will aim to return patients home more quickly, allowing for full comprehensive, multi-disciplinary assessment in their own home. There is an expectation to meet the Scottish Government target for delayed discharges, of 26 for Moray, in 12 months. Evaluation of the Page 17
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progress of this initiative with commence in December 2025 and will begin to influence community hospital redesign. • Enhanced scrutiny: All discharges over 90 days are discussed and logged on the Datix system with action plans in place. • The Strategic Care at Home workstream is focused on maximising care delivery within budget. • Innovation and digital solutions: the Digital Health Institute (Growth Deal) is progressing the research of technology-enabled care solutions to support independent living in a trial in Buckie. Outcomes will inform the approach for Technology Enabled Care going forward. • Discharge Without Delay programme, in collaboration with NHS Grampian and Health Intelligence Scotland, is progressing with system wide actions to reduce delays for people medically fit for discharge: Phase One completed, including national self-assessment tool and action planning. • CQS payment changes have enabled provision of sustainable additional care hours. • Resource Allocation meetings have been redesigned for efficiency. • Absence management is in place to stabilise workforce capacity. 5.4 While challenges persist, targeted interventions and strategic programmes are in place to improve flow, reduce delays, and support people to live well at home. Hospital Readmission - Red 5.5 Whilst there has been a slight increase in the 7-day emergency readmission percentage, the increase to 9.4% for the emergency readmission to hospital within 28 days of discharge takes it to its highest level in the past year. 5.6 It should be noted that people do not always present/readmit for the same clinical reasons. In this quarter many readmissions relating to the same reason were respiratory in nature, which was also reflected in staff absences in this quarter also. There were 261 readmissions to Dr Gray’s Hospital in this quarter (28 days) and 9 of these were from community hospitals. 94 were readmitted in the same diagnosis grouping. This is slightly higher than the same time last year and is reflective of the respiratory illnesses experienced in this quarter. Preventative readmission will be a better measure of performance, and the home assessment pathway will begin to measure this as part of their key performance indicators (KPI). Mental Health – Red Situation 5.7 The demand for adult mental health and primary care psychological therapies continues to be high. Secondary care mental health services are meeting the 18-week referral to treatment target for psychological therapies with 100% of people referred starting treatment in September 2025. This is due to a variety of factors but the establishment of groupwork within the service has played a significant part in this. The demand on Primary care psychological therapies is high. 15% of people referred started treatment in September 2025 Referrals are being screened to ensure they meet the criteria for the service and learning from psychological therapies in secondary care mental health services is being Page 18
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incorporated to improve the referral to treatment target. Delayed discharges in relation to Mental Health have improved, but complex cases remain difficult to place. The Medical staffing remains challenging, but an improvement in stability is noted, which will improve performance in primary and secondary care mental health services. Mitigation • Close monitoring of waiting times is place. • Embed some of the learning from provision of secondary care psychological therapies within primary care psychological therapies. • Ward model changes in Ward 4 (e.g., single consultant model) continue to indicate an improvement in patient flow. • Increased stability in medical staffing. Group development and job planning aim to increase throughput and maximise capacity. Staff Management – Red Situation 5.8 Both NHS staff and Council staff sickness absence is above the target of 4%. 5.9 Council employed staff sickness absence was 8.1%, down slightly on the previous quarter but above the 7.5% at the same point in the previous year., whilst NHSG employed staff sickness absence has fluctuated through the year and is now sitting at 5.9%. Common causes of absence remain mental health and musculoskeletal issues, with spikes in respiratory and gastrointestinal illnesses being experienced throughout the year, not limited to winter months as in previous years. Respiratory illness continued to spike into quarter one, and there was a significant amount of planned, elective operations affecting long term sick leave. 5.10 Although Council staff absence rates continue to remain significantly above target around 7-8%, NHSG absence rates have seen a decrease overall in the past 2 years. Robust absence management is in place across the partnership and for NHSG staff there has been a reduction in long term sickness. April 2025 saw 23.5% of all hours lost due to anxiety, stress etc. (long term) and 8.48% short term, whereas February 2024 saw 26% long term and 6.9% short term. This indicates headway has been made into addressing long term sickness caused by mental health reasons, as per HSCM delivery plans. However, MSK injury has seen an increase in long term sickness, from 9.5% in February 2024 to 11.69% in April 2025. HSCM will continue to ensure compliance in manual handling training and to ensure staff are fully rested and prepared for shifts. 5.11 Mitigation • Vaccination campaigns for flu and COVID-19 aim to reduce severity and duration of illness. • There are groups now meeting in both NHSG and Moray Council to monitor, evaluate and discuss strategy regarding absence. • HSCM’s Health and Safety delivery plan has a focus on absence regarding mental health and MSK. Page 19
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• Workstation assessments (DSE) are promoted for desk-based staff, with ergonomic equipment provided as needed. • Wellbeing Initiatives are promoted throughout the organisation and its partners. NHS Grampian actively encourage the We Care website for staff access to health and wellbeing resources. These are often downloaded resources and are shared across HSCM. • Occupational Health Service to provide support for both physical and mental health issues. • Safe Staffing Tools are used daily to support staff, monitor and manage workload, helping to reduce stress related absences in clinical areas. 6. NATIONAL INDICATORS 6.1 The MIJB Annual Performance Report (APR) 2024/25 was agreed on 19 June 2025 (para 8 of the minute refers) with the final version to include the National Performance indicators and the Ministerial Steering Group (MSG) indicators when published in July. 6.2 These indicators were published in July 2025 by Public Health Scotland and are included in the APR published version. Unfortunately, there were issues at a national level with the data that is collated that is out with HSCM’s control, but impacts on the assessment of performance and any trends over time. For both National and MSG indicators there are some data completeness issues. National Indicators 1-9 remained the same as the survey that informs them is only undertaken every two years. For indicators 11-19 there were instructions from Public Health Scotland to use calendar year 2024 as a proxy for 2024/25 due to the national data for 2024/25 being incomplete. 6.3 These issues affect HSCM’s ability to draw out assessment of progress in performance at this stage, but when the data incompleteness issues are addressed, it will be reviewed and commentary provided to this Committee. 6.4 Appendix 2 outlines the performance of the national indicators that were not affected by the data issues: - • MSG 3a Number of A&E Attendances • MSG 4 Number of Delayed Discharge Bed Days • National Indicator 19 – Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) • National Indicator 17 – the proportion of care services graded “good” (4) or better in Care Inspectorate Inspections expressed as a percentage. • National Indicator 18 – the percentage of adults with intensive care needs receiving care at home. 6.5 Overall Moray is maintaining performance levels in these indicators, except for NI17 and NI19. For NI17 was disappointing to see a drop in performance for Moray, this was due to two providers having lower scores than usual. This was addressed and both providers have improved, and a subsequent inspection has been very positive. For NI19 there has been a significant decrease in the number Page 20
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of days people spend in hospital when they are ready to be discharged. This is because of the successful sustained effort during 2024/25 to focus on those patients who had been in hospital for a long time to enable them to be discharged to a suitable place and the continued efforts to focus on getting people home safely. 7. PERFORMANCE FRAMEWORK 7.1 Following the approval of the Strategic Delivery Plan by the Moray Integration Joint Board (MIJB) on 29 May 2025 (para 8 of the draft minute refers), the review of the performance management framework is underway. 7.2 A revised Performance Framework that will set out key performance indicators and governance arrangements is being developed that will: • Ensure robust monitoring and oversight by appropriate groups • Maintain a clear line of sight between activity undertaken and outcomes achieved for people • Support evidence of delivery of the strategic priorities set out in the new plan • Enable evidence-based decision making, • strengthen accountability and continuous improvement 7.3 As part of this exercise the following adjustments are proposed for future reporting on quarterly performance to this committee: Remove from regular reporting Ref Emergency Admissions Comment EA-01 Rate of emergency occupied bed days for over 65s per 1000 population These indicators are more acute focused. These figures will still be collated but will be used to support narrative around delayed discharges. It is intended to do a deep dive on this type of information to show where people are coming from and why, which will inform locality planning. EA-02 Emergency admission rate per 1000 population for over 65s EA-03 Number of people over 65 years admitted as an emergency in the previous 12 months per 1000 population NEW to Include in Quarterly reports Ref Unmet Need Comment UM-01 Unmet Need for care in the community hours & people waiting (at end of quarter) Over time this is intended to demonstrate the impact of various actions being undertaken to increase flow and capacity and reduce waiting times for care. Improving Choice and control over the support people receive Page 21
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SDS- 01,02, 03,04,05 SDS options – numbers of people on each option. % people who received their first option The intention is to monitor the movement through options to demonstrate a shift from option 3 but to also track that people are receiving the option they choose. Support for carers SC-01 SC-02 SC-03 Referrals for support received in quarter. No of carer support plans completed / time taken to complete assessment This will provide information regarding the volume of need and HSCM’s ability to provide the support 7.4 Other areas are being considered and as work progresses with the strategic delivery plan other proposals will be brought forward to this committee for consideration. It is also the intention to undertake deep dives into key aspects of performance to inform the Committee of current status, recognise success and outline future plans to address any issues identified. 8. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Performance management reporting is a legislative requirement under section 42 of the Public Bodies (Joint Working) (Scotland) Act 2014. In addition to publishing an Annual Performance Report, the Moray Integration Scheme requires that the MIJB will “monitor the performance of the delivery of integrated services using the Strategic Plan on an ongoing basis” (para 5.2.2 of the Moray Integration Scheme refers). (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The report is consistent with existing statutory duties and governance arrangements. (c) Financial implications There are no direct financial implications associated with this report. However, performance insights may inform future resource planning and prioritisation aligned with strategic objectives. (d) Risk Implications and Mitigation While there are no immediate risks arising from this report, the long-term impacts of COVID-19 on the health and social care system remain uncertain. The performance framework will continue to be reviewed and adapted to ensure responsiveness to emerging risks and system pressures. Page 22
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There is also a risk that the MIJB may not deliver on the outcomes set out in the Strategic Plan. Where such risks are identified, they will be escalated and presented to the Board for appropriate oversight and action. (e) Staffing Implications While there are no direct staffing implications arising from this report, it is important to acknowledge the ongoing challenges with recruitment and staff absence across health and social care services. These workforce pressures continue to impact the MIJB’s ability to deliver services in line with strategic objectives Recruitment difficulties, particularly in rural and specialist roles, combined with high levels of sickness absence in some areas, pose a significant operational risk. These issues are being monitored closely, are considered within workforce planning, and service redesign efforts. (f) Property There are no property implications directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment (EIA) is not required for this report, as it does not introduce or amend any policy or service that would directly affect individuals with protected characteristics. However, performance data may be used to inform future service improvements that promote equity and inclusion. (h) Climate Change and Biodiversity Impacts There are no direct climate or biodiversity implications arising from this report. However, it is recognised that extreme weather events and rising energy costs may increasingly impact service delivery, particularly in rural areas. These factors will be considered in future strategic planning. (i) Directions No new directions are required as a result of this report. (j) Consultations Senior Management Team, Operational Management Team Health and Social Care, Caroline O’Connor, Committee Services Officer, Moray Council and their comments are incorporated in the report. 9. CONCLUSION 9.1 This report provides the Committee with an overview of the performance of specified Local indicators, outlines actions being undertaken to improve performance in Section 5, and further expanded in Appendix 1. 9.2 In addition, Appendix 2 includes an update on National indicators where trends can be assessed that offers further insight into delivery of our strategic objectives. Section 7 includes proposed amendments to the specified local indicators intended to provide more scrutiny around key focus areas of the Strategic Delivery Plan. Page 23
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9.3 This performance report supports the MIJB’s ongoing commitment to transparency, continuous improvement, and delivery of the strategic outcomes set out in the Moray Strategic Plan. Authors of Report: Jeanette Netherwood, Corporate Programme Manager Background Papers: Available on request Page 24
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Appendix 1 PERFORMANCE REPORT SUPPORTING CHARTS QUARTER 1 2025/26 (1 APRIL 2025 – 30 JUNE 2025) Page 25
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Table of Contents Health and Social Care Moray - 1 - 2022-23 Quarter 1 Performance Report 1. TABLE OF CONTENTS 1. Table of Contents ............................................................................................................................. 1 1. Performance Summary .................................................................................................................... 2 Barometer Overview ........................................................................................................................... 2 2. Delayed Discharge - RED .................................................................................................................. 3 DD-01: Number of delayed discharges (including code 9, Census snapshot, at end of quarter) ....... 3 DD-02: Number of Bed Days Occupied by Delayed Discharges per quarter (inc code 9) per 1000 18+ population ........................................................................................................................................... 4 3. Emergency Admissions - GREEN ...................................................................................................... 5 EA-01: Rate of emergency occupied bed days for over 65s per 1000 population .............................. 5 EA-02: Emergency Admissions rate per 1000 population for over 65s .............................................. 6 EA-03: Number of people over 65 years admitted as an emergency in the previous 12 months per 1000 population .................................................................................................................................. 7 4. Emergency Department – AMBER .................................................................................................. 8 AE-01: ED Attendance rates per 1,000 population (All Ages) ............................................................. 8 5. Hospital Re-admissions - RED .......................................................................................................... 9 HR-01: Percentage of Emergency Re-admissions to hospital within 7 days - Moray Patients ........... 9 HR-02: Percentage of Emergency Re-admissions to hospital within 28 days - Moray Patients ....... 10 6. Mental Health – RED ..................................................................................................................... 11 MH-01: Percentage of patients commencing Psychological Therapy Treatment within 18 weeks of referral ............................................................................................................................................... 11 7. Staff Management - RED ............................................................................................................... 12 SM-01: NHS Sickness Absence % of Hours Lost ................................................................................ 12 SM-02: Council Sickness Absence (% of Calendar Days Lost) ............................................................ 12 Appendix 1: Key and Data Definitions .................................................................................................. 14 RAG Scoring Criteria .......................................................................................................................... 14 Peer Group Definition ....................................................................................................................... 14 Appendix 2: Strategic Priorities............................................................................................................. 15 Appendix 3: National Health and Wellbeing Outcomes ....................................................................... 17 Page 26
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Performance Summary Health and Social Care Moray - 2 - 2022-23 Quarter 1 Performance Report 1. PERFORMANCE SUMMARY BAROMETER OVERVIEW Moray currently has 11 local indicators. Of these 1 is Green, 3 are Amber and 7 are Red. Figure 1 - Performance Summary Note: In order to match other national and local data sources indicators are showing the last month in the reporting quarter. Targets have been updated from Q1 2025/26 using average of activity for previous calendar year. MH and SM are LDP Standard Indicators and targets are set nationally so remain unchanged. Q1 2425 Q2 2425 Q3 2425 Q4 2425 Q1 2526 New Target Previous Target Apr-Jun Jul-Sep Oct-Dec Jan-Mar Apr-Jun (from Q1 2526) (from Q1 2425 or earlier) AE Accident and Emergency AE-01 A&E Attendance rate per 1000 population (All Ages) 21.5 22.6 19.7 22.0 22.1 21.4 21.9 A DD Delayed Discharges DD-01 Number of delayed discharges (including code 9) at census point 33 40 33 40 32 no change 26 R DD-02 Number of bed days occupied by delayed discharges (including code 9) at census point 922 1115 981 1149 1015 no change 850 R EA Emergency Admissions EA-01 Rate of emergency occupied bed days for over 65s per 1000 population 2606 2603 2604 2412 2329 2564 2681 G‚ EA-02 Emergency admission rate per 1000 population for over 65s 178.7 177.7 183.6 177.8 179.7 179.4 187 A EA-03 Number of people over 65 years admitted as an emergency in the previous 12 months per 1000 population 124.2 123.8 127.5 125.7 125.7 125.1 131 A HR Hospital Readmissions HR-01 % Emergency readmissions to hospital within 7 days of discharge 3.6% 4.6% 3.1% 3.9% 4.1% 3.7% 3.7% R HR-02 % Emergency readmissions to hospital within 28 days of discharge 6.9% 8.9% 6.9% 7.4% 9.4% 7.4% 7.9% R MH Mental Health MH-01 % of patients commencing Psychological Therapy Treatment within 18 weeks of referral 70% 60% 44% 65% 60% no change 90% R SM Staff Management SM-01 NHS Sickness Absence (% of hours lost) 7.0% 6.4% 7.0% 4.9% 5.9% no change 4% R SM-02 Council Sickness Absence (% of days lost) 7.5% 7.3% 7.3% 8.2% 8.1% no change 4% R Health and Social Care Moray Performance Report Code Barometer (Indicator) RAG Page 27
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Delayed Discharge - RED Health and Social Care Moray - 3 - 2022-23 Quarter 1 Performance Report 2. DELAYED DISCHARGE - RED Trend Analysis The number of delays at the quarter 1 snapshot is down to 32, which is down from 40 in quarter 4 2024/25 and down on the 33 recorded this time last year. Bed days lost due to delayed discharges decreased to 1,015 this quarter, down from quarter 4 but up from 992 in June 2024. WDD-01: NUMBER OF DELAYED DISCHARGES (INCLUDING CODE 9, CENSUS SNAPSHOT, AT END OF QUARTER) Purpose Reliably achieving timely discharge from hospital is an important indicator of quality and is a marker for person centred, effective, integrated, and harm free care. Strategic Priority 2: HOME FIRST Linked Indicator(s) DD-02 National Health & Wellbeing Outcomes 2, 3, 5, 7 Figure 2 – Delayed Discharges Indicator Trend – stablising Source Public Health Scotland Page 28
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Delayed Discharge - RED Health and Social Care Moray - 4 - 2022-23 Quarter 1 Performance Report DD-02: NUMBER OF BED DAYS OCCUPIED BY DELAYED DISCHARGES PER QUARTER (INC CODE 9) PER 1000 18+ POPULATION Purpose This monitors the number of people delayed in hospital once medically fit for discharge. Longer stays in hospital are associated with increased risk of infection, low mood, and reduced motivation. Strategic Priority 2: HOME FIRST Linked Indicator(s) DD-01 National Health & Wellbeing Outcomes 2, 3, 5, 7 Figure 3 – Delayed Discharge Bed-days Indicator Trend – Stabilising Source Public Health Scotland Page 29
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Emergency Admissions - GREEN Health and Social Care Moray - 5 - 2022-23 Quarter 1 Performance Report 3. EMERGENCY ADMISSIONS - GREEN Trend Analysis The rate of emergency occupied bed days for over 65s has reduced in the last four months to 2,329 this quarter and is still down on the high of 2,749 in quarter 4 2022/23. The emergency admission rate per 1000 population for over 65s has increased this quarter to 179.7 which is now just above the new target of 179.4 but well below the high in quarter 2 2023/24 of 189.9. Similarly, the number of people over 65 admitted to hospital in an emergency also had hit a high of 133.2 in quarter 2 2023/24 and despite an remaining at 125.7 this quarter it is just above the new target of 125.1 for 2025/26. EA-01: RATE OF EMERGENCY OCCUPIED BED DAYS FOR OVER 65S PER 1000 POPULATION Purpose EA-01, EA-02, and EA-03 are all interconnected and provide a narrative when viewed together of whether emergency admissions and bed days are within tolerance and indicate where potential risks could arise. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) EA-02, EA-03 National Health & Wellbeing Outcomes 1, 2, 3, 5 Figure 4 – Emergency Occupied Bed-days (Over 65s) Indicator Trend – Reducing Source Health Intelligence Page 30
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Emergency Admissions - GREEN Health and Social Care Moray - 6 - 2022-23 Quarter 1 Performance Report EA-02: EMERGENCY ADMISSIONS RATE PER 1000 POPULATION FOR OVER 65S Purpose EA-01, EA-02, and EA-03 are all interconnected and provide a story when viewed together of whether emergency admissions and bed days are within tolerance and indicate where potential risks could arise. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) EA-01, EA-03 National Health & Wellbeing Outcomes 1, 2, 3, 5 Figure 5 – Emergency Admissions (Over 65s) Indicator Trend – Steady Source Health Intelligence Page 31
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Emergency Admissions - GREEN Health and Social Care Moray - 7 - 2022-23 Quarter 1 Performance Report EA-03: NUMBER OF PEOPLE OVER 65 YEARS ADMITTED AS AN EMERGENCY IN THE PREVIOUS 12 MONTHS PER 1000 POPULATION Purpose EA-01, EA-02, and EA-03 are all interconnected and provide a story when viewed together of whether emergency admissions and bed days are within tolerance and indicate where potential risks could arise. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) EA-01, EA-02 National Health & Wellbeing Outcomes 1, 2, 3, 5 Figure 6 – Number of Over 65 People Emergency Admissions Indicator Trend – Steady Source Health Intelligence Page 32
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Emergency Department – AMBER Health and Social Care Moray - 8 - 2022-23 Quarter 1 Performance Report 4. EMERGENCY DEPARTMENT – AMBER Trend Analysis There was an increase in the rate per 1,000 this quarter to 22.1. This is a slight increase the numbers presenting in the last 3 quarters but still below March 2024 and the data has been trending down since then despite the small increase in the most recent month. AE-01: ED ATTENDANCE RATES PER 1,000 POPULATION (ALL AGES) Purpose A greater system-wide understanding of how people access emergency care, and why certain choices are made, will allow local health systems to develop intelligence about avoidable attendances at emergency departments and target their responses. Strategic Priority 3: PARTNERS IN CARE Linked Indicator(s) HR-01, HR-02 National Health & Wellbeing Outcomes 1, 2, 3, 5 Figure 7 – ED Attendance Rate Indicator Trend – Steady Source Health Intelligence Page 33
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Hospital Re-admissions - RED Health and Social Care Moray - 9 - 2022-23 Quarter 1 Performance Report 5. HOSPITAL RE-ADMISSIONS - RED Trend Analysis The 7-day re-admissions have increased to just over target to 4.1%, and the 28-day re-admissions have increased further to above target at 9.4%. HR-01: PERCENTAGE OF EMERGENCY RE-ADMISSIONS TO HOSPITAL WITHIN 7 DAYS - MORAY PATIENTS Purpose Re-admissions are often undesirable for patients and have also been shown to be associated with the quality of care provided to patients at several stages along the clinical pathway, including during initial hospital stays, transitional care services and post-discharge support. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) HR-02, AE-01 National Health & Wellbeing Outcome 1, 2, 3, 5 Figure 8 – 7-dayEmergency Readmissions Indicator Trend – Steady Source Health Intelligence Page 34
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Hospital Re-admissions - RED Health and Social Care Moray - 10 - 2022-23 Quarter 1 Performance Report HR-02: PERCENTAGE OF EMERGENCY RE-ADMISSIONS TO HOSPITAL WITHIN 28 DAYS - MORAY PATIENTS Purpose Re-admissions are often undesirable for patients and have also been shown to be associated with the quality of care provided to patients at several stages along the clinical pathway, including during initial hospital stays, transitional care services and post-discharge support. (This measure lags by a month due to the time required for a potential 28 day discharge to occur) Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) HR-01, AE-01 National Health & Wellbeing Outcome 1, 2, 3, 5 Figure 9 – 28-day Emergency Readmissions Indicator Trend – Steady Source Health Intelligence Page 35
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Mental Health – RED Health and Social Care Moray - 11 - 2022-23 Quarter 1 Performance Report 6. MENTAL HEALTH – RED Trend Analysis After an improvement in performance from achieving a low 40% in January 2024 there has been little variation in performance through the rest of 2024 and into 2025 with 60% of patients now being referred within 18 weeks at the end of quarter 1 2025/26. MH-01: PERCENTAGE OF PATIENTS COMMENCING PSYCHOLOGICAL THERAPY TREATMENT WITHIN 18 WEEKS OF REFERRAL Purpose Timely access to healthcare is a key measure of quality and that applies equally in respect of access to mental health services. Strategic Priority 3: PARTNERS IN CARE Linked Indicator(s) National Health & Wellbeing Outcome 1, 2, 3, 5 Figure 10 – Psychological Therapy Treatment within 18 Weeks Indicator Trend – Steady Source Health Intelligence Page 36
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Staff Management - RED Health and Social Care Moray - 12 - 2022-23 Quarter 1 Performance Report 7. STAFF MANAGEMENT - RED Trend Analysis Sickness absence for NHS employed staff has increased to 5.9% at the end of quarter 1 2025/26. Council employed staff sickness has remained high at 8.05%. SM-01: NHS SICKNESS ABSENCE % OF HOURS LOST Purpose Attendance at work of all employees is essential in the interests of the effective and efficient operation of services. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) SM-02 National Health & Wellbeing Outcome 8 Figure 11 – NHS Sickness Absence Indicator Trend – Steadily increasing Source Health Intelligence SM-02: COUNCIL SICKNESS ABSENCE (% OF CALENDAR DAYS LOST) Purpose Attendance at work of all employees is essential in the interests of the effective and efficient operation of services. Strategic Priority 1: BUILDING RESILIENCE Linked Indicator(s) SM-01 National Health & Wellbeing Outcome 1, 2, 3, 5 Page 37
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Staff Management - RED Health and Social Care Moray - 13 - 2022-23 Quarter 1 Performance Report Figure 12 – Moray Council Sickness Absence Indicator Trend – Steady Source Council HR Page 38
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Staff Management - RED Health and Social Care Moray - 14 - 2022-23 Quarter 1 Performance Report APPENDIX 1: KEY AND DATA DEFINITIONS RAG SCORING CRITERIA GREEN If Moray is performing better than target. AMBER If Moray is performing worse than target but within specified tolerance. RED If Moray is performing worse than target but outside of specified tolerance. PEER GROUP DEFINITION Moray is defined as being in Peer Group 2 in the Local Government Benchmarking Framework Family Group 1 Family Group 2 Family Group 3 Family Group 4 East Renfrewshire East Dunbartonshire Aberdeenshire Edinburgh, City of Perth & Kinross Aberdeen City Shetland Islands Orkney Islands Moray Stirling East Lothian Angus Scottish Borders Highland Argyll & Bute Midlothian Falkirk Dumfries & Galloway Fife South Ayrshire West Lothian South Lanarkshire Renfrewshire Clackmannanshire Eilean Siar Dundee City East Ayrshire North Ayrshire North Lanarkshire Inverclyde West Dunbartonshire Glasgow City Page 39
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Staff Management - RED Health and Social Care Moray - 15 - 2022-23 Quarter 1 Performance Report APPENDIX 2: STRATEGIC PRIORITIES Page 40
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Staff Management - RED Health and Social Care Moray - 16 - 2022-23 Quarter 1 Performance Report •EA-01: RATE OF EMERGENCY OCCUPIED BED DAYS FOR OVER 65S PER 1000 POPULATION •EA-02: EMERGENCY ADMISSIONS RATE PER 1000 POPULATION FOR OVER 65S •EA-03: NUMBER OF PEOPLE OVER 65 YEARS ADMITTED AS AN EMERGENCY IN THE PREVIOUS 12 MONTHS PER 1000 POPULATION •HR-01: PERCENTAGE OF EMERGENCY RE-ADMISSIONS TO HOSPITAL WITHIN 28 DAYS -MORAY PATIENTS •HR-02: PERCENTAGE OF EMERGENCY RE-ADMISSIONS TO HOSPITAL WITHIN 7 DAYS -MORAY PATIENTS •SM-01: NHS SICKNESS ABSENCE % OF HOURS LOST •SM-02: COUNCIL SICKNESS ABSENCE (% OF CALENDAR DAYS LOST) BUILDING RESILIENCE •DD-01: NUMBER OF DELAYED DISCHARGES (INCLUDING CODE 9, CENSUS SNAPSHOT, AT END OF QUARTER) •DD-02: NUMBER OF BED DAYS OCCUPIED BY DELAYED DISCHARGES PER QUARTER (INC CODE 9) PER 1000 18+ POPULATION •UN-01: NUMBER OF LONG-TERM HOME CARE HOURS UNMET AT WEEKLY SNAPSHOT •UN-02: NUMBER OF PEOPLE WITH LONG-TERM CARE HOURS UNMET AT WEEKLY SNAPSHOT HOME FIRST •OA-01: NUMBER OF REVIEWS OUTSTANDING AT END OF QUARTER SNAPSHOT •MH-01: PERCENTAGE OF PATIENTS COMMENCING PSYCHOLOGICAL THERAPY TREATMENT WITHIN 18 WEEKS OF REFERRAL •AE-01: A&E ATTENDANCE RATES PER 1000 POPULATION (ALL AGES) PARTNERS IN CARE Page 41
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Staff Management - RED Health and Social Care Moray - 17 - 2022-23 Quarter 1 Performance Report APPENDIX 3: NATIONAL HEALTH AND WELLBEING OUTCOMES 1 - PEOPLE ARE ABLE TO LOOK AFTER AND IMPROVE THEIR OWN HEALTH AND WELLBEING AND LIVE IN GOOD HEALTH FOR LONGER. 2 - PEOPLE, INCLUDING THOSE WITH DISABILITIES OR LONG-TERM CONDITIONS, OR WHO ARE FRAIL; ARE ABLE TO LIVE, AS FAR AS REASONABLY PRACTICABLE, INDEPENDENTLY AT HOME, OR IN A HOMELY SETTING IN THEIR COMMUNITY. 3 - PEOPLE WHO USE HEALTH AND SOCIAL CARE SERVICES HAVE POSITIVE EXPERIENCES OF THOSE SERVICES, AND HAVE THEIR DIGNITY RESPECTED. 4 - HEALTH AND SOCIAL CARE SERVICES ARE CENTRED ON HELPING TO MAINTAIN OR IMPROVE THE QUALITY OF LIFE OF PEOPLE WHO USE THOSE SERVICES. 5 - HEALTH AND SOCIAL CARE SERVICES CONTRIBUTE TO REDUCING HEALTH INEQUALITIES. 6 - PEOPLE WHO PROVIDE UNPAID CARE ARE SUPPORTED TO LOOK AFTER THEIR OWN HEALTH AND WELLBEING, INCLUDING TO REDUCE ANY NEGATIVE IMPACT OF THEIR CARING ROLE ON THEIR OWN HEALTH AND WELLBEING. 7 - PEOPLE USING HEALTH AND SOCIAL CARE SERVICES ARE SAFE FROM HARM. 8 - PEOPLE WHO WORK IN HEALTH AND SOCIAL CARE SERVICES FEEL ENGAGED WITH THE WORK THEY DO AND ARE SUPPORTED TO CONTINUOUSLY IMPROVE THE INFORMATION, SUPPORT, CARE, AND TREATMENT THEY PROVIDE. 9 - RESOURCES ARE USED EFFECTIVELY AND EFFICIENTLY IN THE PROVISION OF HEALTH AND SOCIAL CARE SERVICES. Page 42
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APPENDIX 2 Extract of National Peformance Measures 2024/25 a) MSG Indicator 3a – Number of attendances at A&E The blue line in this graph relates to the figure for Scotland as a whole and the green line relates to Grampian. As you can see the graph lines follow a very similar pattern although the increase in Grampian is more marked from 2022/23 to 2023/24. In Moray this indicator fluctuates throughout the year with some seasonal variations but overall is relatively stable with 26,861 attendances in 2023/24 and a slight reduction to 25,326 in 2024/25. Page 43
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MSG Indicator 4 and national indicator 19 show data in relation to delayed discharges but in slightly different ways The graph on the left is for MSG indicator 4 - the number of delayed discharge bed days. The blue line is Scotland, and the green line is Grampian and again the trend lines are very similar but with a more marked increase in Grampian between 2023/24 and 2024/25. In Moray there has been a slight increase in the number of delayed discharge bed days from 2023/24 figure of 12,119 to 12,737 in 2024/25, but this remains well below the high of 2022/23 of 14,123. The graph below is for national indicator 19 which is the number of days people spend in hospital when they are ready to be discharged (per 1,000 population). In this graph the blue line is the Scottish average, and the red line is Moray. At the end of 2024/25 across Grampian all three health and social care partnership areas were below the Scottish average, with Moray being the only one to show a downwards trajectory. The figures have dropped from 976 in 2023/24 to 865 in 2024/25, the reduction taking place in the last quarter linked to a significant focussed effort to resolve the issues preventing discharge for those with longest stays and a fully staffed internal care at home provision and a slight increase in capacity of the external partner for care at home. National Indicator 19 – Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) Page 44
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The graph below relates to national indicator 17 - the proportion of care services graded ‘good’ (4) or better in Care Inspectorate Inspections expressed as a percentage. Across Grampian all partnerships were well below the Scottish average and Moray figures have shown a decrease of 7.3% from 81.1% to 73.8%. Whilst this looks alarming it is due to the relatively small numbers of inspections occurring and it is the impact of a reduction in score for 2 providers which causes this significant change in our score. A commissioning team member sits in on Care Inspectorate feedback sessions and any grade issues or other issues are reported via social work and taken to the weekly Multi Agency Monitoring Group. An Multi-Disciplinary Team agreement is reached regarding appropriate action and support required. The agreed action is undertaken, and progress is reported to the Collaborative oversight group, along with any recommendations for additional supports or actions, on a weekly basis until resolved, or the matter requires escalation to Senior management team, but we have not experienced that situation to date. NI-18 - the percentage of adults with intensive care needs receiving care at home. Again, unfortunately all three Grampian partnerships are below the Scottish average. Moray is maintaining it’s level in comparison to the Scottish average. National Indicator 17 – the proportion of care services graded ‘good’ (4) or better in Care Inspectorate Inspections expressed as a percentage. National Indicator 18 - the percentage of adults with intensive care needs receiving care at home. Page 45
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: QUARTER 1 (APRIL TO JUNE 2025) PERFORMANCE REPORT FOR CHILDREN AND FAMILIES AND JUSTICE SOCIAL WORK BY: INTERIM CHIEF SOCIAL WORK OFFICER/HEAD OF SERVICE 1. REASON FOR REPORT 1.1 To inform the Committee on Children and Families and Justice Social Work performance as at Quarter 1 (April to June 2025). 2. RECOMMENDATIONS 2.1 It is recommended Committee scrutinises and notes: i) the performance of local indicators for Quarter 1 as presented in the Performance Report at Appendix 1; and ii) the analysis of the local indicators as detailed in Appendix 1. 3. BACKGROUND 3.1 The purpose of this report is to inform Moray Integration Joint Board (MIJB) of the quarterly performance data which provides the analysis of the delivery of Children, Families and Justice Social Work services. 3.2 Appendix 1 identifies local indicators for the MIJB and the functions delegated by NHS Grampian and Moray Council for Children, Families and Justice Social Work services to allow wider scrutiny by the Board. 4. SUMMARY 4.1 Work is underway to develop and agree the refresh of Moray’s key performance indicators to enable recording of local data and measures set against the national performance indicators. 4.2 Appendix 1 provides a summary and the historical trends: • Child Protection activity • Looked after Children Item 6. Page 47
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• Justice and Youth Justice 4.3 Statistics for Child Protection activity are provided against the academic calendar which runs from August to July annually. This is because this data is gathered and analysed by the Children’s Services Partnership and reported to the Child Protection Committee (CPC) through the Child Protection Minimum Data Set. Appendix 1 begins with Child Protection Q3 from page 1 to 11, Financial Q1 data is from page 12 to 38. Any trends or anomalies in this data are considered through the CPC Data Sub-group and reported accordingly. 4.4 Statistics for Looked After Children, Justice and Youth Justice are reported over the financial year which runs from April to March which is the reporting calendar for this data. A summary of performance for each of the reporting categories is provided below. Child Protection activity 4.5 At the end of this Child Protection (CP) Quarter 3, 45 children were registered on the North East Child Protection Register (NECPR). There is no reliable way of comparing data with other areas before this information is officially published nationally. The National data for the reporting year 1 August 2023 to 31 July 2024 was published by Scottish Government on 25 March 2025. Looked After Children 4.6 At the end of Financial (Fin) Quarter 1, the number of looked after children is 165. This includes 4 New Scots (formally Unaccompanied Asylum-Seeking Children (UASC)) and 4 children who are cared for on a part time basis (Short Breaks). 4.7 92.4% (49/53) of children in foster care are cared for by Moray Council foster carers. The Carer Recruitment Campaign continues to focus on recruitment of foster carers and supported lodgings carers. Resultantly, there has been increased capacity to have children and young people cared for by Moray Council foster carers. Thus, reducing the need to purchase external agency care. The Carer Recruitment Campaign is continuing where it is anticipated that the use of in-house carers will increase. 4.8 The target for children living with kinship carers is adjusted annually to the average of comparator authorities which was 28% for 2022/23 (this is a more than target based on the assumption Kinship care is preferable, where it is safe and appropriate, to non-family care). Currently 23% of looked after children in Moray are in approved Kinship care with family members. Moray is currently 5% below this average. Resultantly, work continues to strengthen practice, ensuring children, at the point of allocation, have a holistic extended family map produced, regularly updated, providing clear information on Kinship care options in the event short breaks or alternative care may be necessary in the future. 4.9 22.4% (37/165) of Looked After Children are cared for in residential care. The target for this indicator (this is a less than target based on the assumption foster care and kinship care will be the preferred option when it is safe and appropriate, where possible) is adjusted annually to the average of comparator authorities (17.5% for 2022/23). This figure includes four young people who are Page 48
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cared for on a part-time (short breaks) basis. For illustrative purposes on performance, excluding those who have short breaks (children and young people who are in the care of their families) the figure is 20% (33/165) which is 2.5% higher than the average of comparator authorities. In common with most of the comparator local authorities, Moray is higher than the Scotland national average percentage of 10%. 4.10 88% of brothers and sisters in Foster Care and Kinship Care remain together with at least one sibling. The Maintaining Relationships Project is developing an approach and policy to ensure brothers and sisters can remain together as far as possible and where this is their assessed needs. Due to resource limitations, this is much more difficult to achieve when there is need to accommodate large family groups (3 or more children). 4.11 For New Scots, Moray has not adopted the residential homes model used by other local authorities. Moray’s model comprises of a combination of local authority housing and supported lodgings care and support. As such, the uncertainty regarding the future numbers of New Scots should not have an impact on residential care capacity in Moray. Justice and Youth Justice 4.12 At the end of Financial (Fin) Quarter 1, there were 507 people supported by Justice and Youth Justice Services of whom 46 are “care experienced” young people (CEYP), Youth Justice, 13 and Justice, 33. 4.13 Overall, the number of CEYP in Justice and Youth Justice Social Work has consistently remained below 12% since 2023. A very slight rise of 0.5% from Financial Quarter 4 relates to a reduced number of open cases overall, not an actual rise in the number of CEYP open to the services. 4.14 Most individuals supported by Youth Justice and Justice Social Work are male (86% Justice Social Work, 82% Youth Justice). Gender responsive support is offered to females taking account of research and data indicating women in the justice system are more likely to have experienced trauma and more likely to be a sole carer of a child or family member. 4.15 The Justice Social Work Service submitted 100% of reports to Court by their due date. This includes requests from Moray’s local Court and nationally. Policy, Development and Commissioning 4.16 In line with national direction of travel, Children’s Social Work Service wishes to move towards the inclusion of personal outcomes and impact within its performance reporting to the MIJB. Personal outcomes are those that matter to people receiving services, linking to national indicators; they constitute the impact of supports provided by the Service. 4.17 Following initial scoping and benchmarking, a test of change led by the Policy, Commissioning and Development Team has been agreed to be taken forward. The exercise will use a simple method of gathering the views of the children and families the service works with in relation to progress made towards their personal outcomes. The details of the test of change as well as other Page 49
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developments and commissioning in the Service are on pages 25-35 in Appendix 1. 5. KEY MATTERS RELEVANT TO RECOMMENDATION 5.1 Detailed charts and performance indicator data is attached in Appendix 1. 6. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” This report notes that a review of key performance indicators is currently being developed in respect of the wider service functions that will align with key priority areas across the Children’s Services partnership. (b) Policy and Legal None arising as a direct result of this report. (c) Financial implications None arising as a direct result of this report. (d) Risk Implications and Mitigation None arising as a direct result of this report. (e) Staffing Implications There are no proposed changes to the staffing or reporting relationships. (f) Property None arising as a direct result of this report. (g) Equalities/Socio Economic Impact None arising as a direct result of this report. (h) Climate Change and Biodiversity Impacts None arising as a direct result of this report. (i) Directions None arising as a direct result of this report. (j) Consultations Children, Families and Justice Social Work Senior Management Team. 7. CONCLUSION 7.1 This report provides the MIJB with an overview of the performance of specified local and National indicators. Author of Report: Jim Lyon, Interim Chief Social Work Officer/Head of Service Background Papers: Appendix 1 Page 50
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APPENDIX 1 CHILDREN & FAMILIES AND JUSTICE SOCIAL WORK - QUARTER 1 (APR- JUN 2025) PERFORMANCE REPORT PLEASE NOTE THIS REPORT IS SPLIT INTO TWO SECTIONS. THE FOLLOWING SECTION USES THE ACADEMIC CALENDAR (1 AUG – 31 JULY). THE INFORMATION PRESENTED REPRESENTS CHILD PROTECTION (CP) QUARTER 3 WHICH IS LATEST AVAILABLE DATA (FEB-APR 2025). At the end of the CP Quarter 3, 832 contacts, enquiries and referrals were made to the Access Team for 657 children (as per graph 1). Graph 1: CP Quarter 3 - Referrals received by Access Team The potential referral routes are Social Work, SCRA, Police, Courts, Education, Health, 3rd Sector, community, family and young person. When a referral has been received it can be categorised as: IRD – immediate child protection concerns. Enquiry – information gathering to determine next steps (if any). Assessment of need – team will conduct a child in need assessment. Number of contacts, enquiries and referrals can be more than the number of children, as they can come from a range of sources about the same child. Future reporting shall identify accepted referrals which is the key process for consideration of the need for follow up actions. From the point of referral, our focus is on developing genograms and identifying networks of supportive family members and friends who can contribute to the child or young person’s safety and wellbeing. We are also working in collaboration with colleagues from Children 1st to facilitate Family Group Decision Making meetings. These meetings aim to build a robust support network around the child, helping to maintain safety and, where appropriate and safe, prevent the need for children becoming accommodated into Council care. Pie chart 1: Sources of referral 0 50 100 150 200 250 300 45689 45717 45748 254 288 290 218 210 229 REFERRALS RECEIVED BY ACCESS TEAM Referrals: No. in last month Referrals: No of children Page 51
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2 | P a g e In CP Quarter 3, 37% of referrals were from the Police (299), followed by Education 21% (169), Family and Community 14% (116), Health and Social Work 15% (125), and 13% coming from other professionals (103) (as per pie chart 1). Where the number of referrals is higher than the number of children, this can be attributed to the fact there can be multiple sources of referrals about a child (e.g. Health, Education and Police). This potentially reflects consistent thresholds across the partnership. There has been a 30% increase in referrals from education since CP Quarter 1. The Service Manager is exploring this with the Education Quality Improvement Manager (QIM), to agree actions for clarity on the threshold of need, support to families at the right time from the right service, and to understand the increase in more detail. We continue to work with Education QIMs to support colleagues in schools to ensure families are receiving the right help at the right time, hence not always reaching social work thresholds. Similar conversations are being held with the child protection specialist nurse. Graph 2: IRDs and number of children subject to an IRD Graph 2 shows the quarterly trend in IRDs (between 1 Aug 2024 and 30 April 2025). An interagency referral discussion (IRD) is a co‑ordinated inter-agency exploratory protective process until the point a child protection planning meeting (CPPM) is held, or until a decision is made that such a meeting is not required or alternative action is required. In CP Quarter 3, 57 children were involved in 41 IRDs. For each quarter, the number of children is greater than the number of IRDs as each IRD can consider multiple children within a family. The numbers of IRDs and the number of children involved has decreased slightly since August 2024. 0 10 20 30 40 50 60 70 Q1 24-25 Q2 24-25 Q3 24-25 47 40 41 64 66 57 IRDs and No. of Children No. of IRDs held in Quarter No. of Children involved Page 52
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3 | P a g e Pie chart 2: Main reasons for IRD As per chart above, throughout CP Quarter 3, physical assault remains a consistent reason for an IRD being held (31, 62%), followed by sexual assault (6, 12%), domestic abuse (6, 12%), neglect (3, 6%), child sexual exploitation (1, 2%), mental health (1, 2%), child criminal exploitation (1, 2%). Following the IRDs, seven Initial Child Protection Planning Meetings were convened, and 17 Joint Investigative Interviews were requested. Graph 3: Joint Investigative Interviewing Graph 3 shows the trend across the years 2024/25 for joint investigative interviews and Scottish Child Investigative Interviews. Physical Assault, 31, 62% Sexual Assault, 6, 12% Domestic Abuse, 6, 12% Child Criminal Expl, 1, 2% Child Sexual Expl, 1, 2% Drugs, 1, 2% Mental Health, 1, 2% Neglect , 3, 6% Reasons for IRD Physical Assault Sexual Assault Domestic Abuse Other reason Child Criminal Expl Child Sexual Expl Drugs Mental Health Neglect 13 9 6 13 7 7 13 9 4 7 9 7 11 5 12 8 2 33 3 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 4 4 3 2 3 0 2 2 1 3 1 2 4 3 3 5 0 1 9 5 6 11 4 7 11 8 3 4 8 5 7 2 9 8 2 3 0 2 4 6 8 10 12 14 Aug-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 JII -TRENDS2023-2025 JII: No. of JII by SCIM as decision of IRD JII: No. of JII by 5 day process as decision of IRD JII: No. of children who declined/or did not complete JII JIIs: No. of SCIM JIIs undertaken 2 per. Mov. Avg. (JII: No. of JII by SCIM as decision of IRD) 2 per. Mov. Avg. (JII: No. of children who declined/or did not complete JII) Page 53
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4 | P a g e Graph 4 – JII & SCIM Graph 4 shows the activity of Joint Investigative Interviewing across CP Quarter 3, during which 19 children were recommended for Joint Investigative Interview (JII); 13 Scottish Child Interview Model (SCIM) JIIs were completed, 4 children declined to be interviewed, and 2 young people were spoken with using a “soft approach”. Graph 5: Initial Child Protection Planning Meetings (ICPPM) Graph 5 shows the trend across the last two reporting years (2023 - 2025) for the number of Initial and Pre-birth Child Protection Planning Meetings, and the number of children. The number of children subject to CPPMs is higher than the number of meetings held, due to some meetings considering family groups. At the end of CP Quarter 3 of 2024/2025, seven Initial and Pre-birth CPPMs were held for eleven children, all of whom were placed on the register. 57% were held in timescale of 28 days from the notification of concern. To encourage meaningful family engagement in the development of safety plans, some meetings were rescheduled to enable family participation. This decision acknowledges delays in meeting timelines; however, it reflects our commitment to strengthening family involvement which is a crucial factor in securing safety for children and young people. All these meetings were held only days later than the anticipated date. 100% of Initial and Pre-birth CPPMs had parental attendance as a result. Children and young people are encouraged to attend their CPPMs, where this is possible and in their best interest. There were 3 ICPPMs where 7 children or young person could attend. One young person chose to attend their meeting. However, the 7 9 7 11 5 12 13 2 4 7 9 7 11 5 12 8 2 3 0 0 0 3 1 2 4 3 3 5 0 1 4 8 5 7 2 9 8 2 3 0 5 10 15 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 JIIS Using SCIM JII: No. of children subject to a JII as decision of IRD JII: No. of JII by SCIM as decision of IRD JII: No. of JII by 5 day process as decision of IRD JII: No. of children who declined/or did not complete JII JIIs: No. of SCIM JIIs undertaken 32 41 17 12 22 10 11 16 22 10 7 12 6 7 0 5 10 15 20 25 30 35 40 45 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Aug-Oct Nov-Jan Feb-Apr May-Jul Aug-Oct Nov-Jan Feb-Apr 2023/24 2024/25 NO OF CHILDREN & UNBORN - ICPPMS Number of children subject to Initial and Pre-Birth CPPMs Number of Initial and Pre-Birth CPPMs Page 54
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5 | P a g e young people who did not attend had a range of opportunities to take part in their meeting by having their voice heard. The Reviewing Officer visited 2 young people in their home prior to their meeting; one young person had their views captured by their Moray Rape Crisis support worker and 2 had their views captured by their social worker. Graph 6: Conversions from IRD to ICCPM Graph 6 above shows the trend from 2023 through to 2025 and specifically CP Quarter 3, where the conversion rate from ICPPM to Child Protection Registration was 100%. A small percentage of children discussed in IRDs progress to ICPPMs as the focus must be supporting parents and carers to create safety for their children. This requires periodic review to ensure IRDs are operating effectively as they are resource intensive. There must be clear understanding of the reasons IRDs are being held, for example, large numbers of IRDs resulting in very small numbers of investigations present potential risks in responding to children in greatest need of protection. During CP Quarter 3, there were 20 Review Child Protection Planning Meetings (RCPPM) held for 36 children, where their circumstances were reviewed with their families, lead 25 39 19 14 34 15 17 78 83 94 75 100 100 100 0 20 40 60 80 100 120 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Aug-Oct Nov-Jan Feb-Apr May-Jul Aug-Oct Nov-Jan Feb-Apr 2023/24 2024/25 CONVERSIONS FROM IRD TO ICCPM % IRD to Initial and Pre-Birth CPPMs % Initial and Pre-Birth CPPMs to Registration 832 referrals 41 IRDs 7 ICPPMs The conversion rate from referral to IRD is 4.9% The conversion rate from IRD to ICPPM is 17% Page 55
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6 | P a g e professionals and independent advocates, to assess if the identified risks had been sufficiently reduced to consider removing the child’s name from the register. 13 of the RCPPMs held in this quarter were first reviews, of which, 100% were held within the 6- month timescale. 7 were subsequent reviews and 72% of these were held in timescale. The two not held in timescale were to support family attendance. As above, referrals from education colleagues have increased, prompting reflection to better understand this trend. Collaboration with partner agencies is essential to ensure timely and appropriate support is available. Early support aims to prevent unnecessary escalation to the threshold for social work involvement and ensure referrals are directed to the most suitable sources of support. Graph 7: Child Protection Registration (CPR) Trends The trend is depicted across Graph 7 from 2023 - 2025 and shows in CP Quarter 3, that 26 children were de-registered and eleven new children were registered. This meant at the end of CP Quarter 3, the number of children who were on the (CPR) had decreased by 15 (from 60 to 45). Children and young people can be removed from the CPR for a variety of reasons related to the elimination or reduction of risk. In this quarter, the most prevalent reason was (14) children and young people had Compulsory Supervision Orders in place and the measures attached to the order were protective. For some, this included measures of residence away from parental care. A significant reduction in risk was identified for 11 young people whose protection plans had successfully reduced the risk of significant harm. For these children and young people, ongoing Child in Need planning is in place to sustain progress and ensure that supports are in place to support positive long-term outcomes. 25 34 16 9 22 10 11 50 79 70 66 69 60 45 9 5 25 13 19 19 26 0 10 20 30 40 50 60 70 80 90 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Aug-Oct Nov-Jan Feb-Apr May-Jul Aug-Oct Nov-Jan Feb-Apr 2023/24 2024/25 CHILD PROTECTION REGISTRATION TRENDS Number of Registrations Number on Register Number of De-Registrations Page 56
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7 | P a g e Graph 8: Child Protection Registration Comparator Authority Trends (up to 31 July 2024) Graph 9: Number of Child Protection Registrations Comparator Authority Trends (to 31 July 2024) Chart 10: Number of Child Protection Deregistration Comparator Authority Trends (1 August 2022 to 31 July 2023) Page 57
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8 | P a g e Pie chart 3: Reasons for new child protection registrations in the reporting period Pie chart 3 depicts the reasons that children were added to the CPR in this quarter. The reasons for new registrations often differ from the reasons for having an IRD. This is because, throughout the information-sharing process and child in need assessment, a more comprehensive understanding of the family's needs and a clearer perspective on risk and safety emerges. In Quarter 3, children being impacted by parental mental health was the most prevalent concern (8 children and young people) followed by emotional abuse (4 children and young people) and parental drug use (3 young people). We have experienced a significant rise in recent years for parents struggling with their mental health and with diagnosis on the personality disorder spectrum. The presenting unpredictable behaviour for parent and impact for children has contributed to registration and children moving to the care of family or local authority care. Our partners in adult mental health services have provided development sessions for childcare social workers, to raise awareness of their approaches to support adults with this diagnosis, close partnership working with health and social work colleagues in mental health is key to reducing risk and supporting families holistically. We are working closely with police colleagues due to rising concerns of drug selling and county line activity with some linkage to organised crime. This is having an impact on safety for some children within their families. Page 58
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9 | P a g e Pie chart 4: Child Protection Concerns Pie chart 4 depicts all of the reasons for children being placed on the CPR at the end of CP Quarter 3. Neglect, Child Affected by Parent or Carer Mental Ill Health, Parental Drug Use, Domestic Abuse, and Emotional Abuse are the main child protection concerns noted. *Note there may be more than one concern documented for each child. Graph 11: Family Groups As shown in Graph 12, at the end of CP Quarter 3, there were 11 family groups consisting of one child, six family groups with two children and 7 family groups of three or more children on the child protection register. 10 7 7 7 7 6 13 10 11 0 2 4 6 8 10 12 14 Feb-25 Mar-25 Apr-25 FAMILY GROUPS ON MORAY CPR CPR Family Group: Single child CPR Family Group: 2 CPR Family Group: 3 or more Page 59
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10 | P a g e Graph 12: Previous Registrations At the end of CP Quarter 3, fourteen children on the Child Protection Register had one previous registration, and nine children had two or more. This data highlights a pattern of recurring child protection concerns for some children and families. The core objective of Children and Families and Justice Social Work is to ensure the safety and wellbeing of children through timely, proportionate, and effective support. Repeat registrations indicate that, for a small number of children and families, risks have re-emerged or were not sufficiently reduced following previous support. To address this, the service is committed to: ▪ Strengthening post-registration support to sustain safety and prevent re- escalation. ▪ Improving multi-agency collaboration to ensure families receive the right help at the right time, reducing reliance on statutory support. ▪ Reviewing thresholds and decision-making processes to ensure that registration and de-registration are based on clear, evidence-based criteria ▪ Learning from repeat registrations to identify systemic gaps and improve practice. This analysis informs ongoing service development and quality assurance activity, ensuring that supports are not only protective but also preventative—supporting families to make lasting changes that keep children safe. 0 5 10 15 20 25 30 Q1 Q2 Q3 27 22 1414 15 9 PREVIOUS REGISTRATIONS ON MORAY CPR No. of children with 1 previous registration No. of children with more than 2 previous registration Page 60
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11 | P a g e Graph 13: Time on Moray Child Protection Register Regarding Graph 13, the aim is to support families make changes to safely parent their children within a more focused time frame i.e. 12 months. If risks have not been significantly reduced, then alternative safeguarding measures should be considered. If risk has been sufficiently reduced, and the child is experiencing safe and good enough care, then de-registration should be considered, with the evidence understood and agreed by partners. Children and young people who have been on the CPR for over 1 year are reviewed within the service. Graph 14: Age of children on the Child Protection Register Graph 14 shows the trend for 2024/25 against CP Quarter 3 data. The consistently higher prevalence in the last year, of children aged 5-10 years highlights the need for earlier support and diversion services, ensuring this is provided at the earliest stages of a child’s development. The number of young people aged 16 years has remained static throughout the Quarter. 6 3 15 15 25 1 5 7 17 18 1 5 9 13 17 0 5 10 15 20 25 30 > 2 years 18 mths < 2 years 1 year < 18 mths 6 mths < 1 year <6 months TIME ON THE MORAY CPR Apr-25 Mar-25 Feb-25 0 1 4 4 3 1 0 1 3 20 21 17 18 19 19 19 12 11 25 25 25 26 23 23 26 21 1919 16 20 20 17 15 17 12 10 1 2 3 2 2 2 2 2 2 0 5 10 15 20 25 30 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 AGE OF CHILDREN ON MORAY CPR Unborn 0-4 5 - 10 11 - 15 16+ Page 61
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12 | P a g e THE FOLLOWING SECTIONS REPORT AGAINST THE FINANCIAL QUARTER (APR-JUN 2025) Graph 15: Number of children looked after away from home and at home Graph 15 identifies that at the end of Financial (Fin) Quarter 1, there were 165 children who were looked after by Moray which is an overall reduction from 171 to 165. There was an increase in the number of newly accommodated children in 2024/25 and 2024/25, which is being analysed through the ‘Critical Mass’ work which will support a better understanding of this data and identify mitigating actions. In Quarter 1 the number of newly accommodated children was 5. As such, further investigation of our reporting is required to account for this decrease in the overall number of looked after children given the high number of newly accommodated children. However, it remains positive that there is a potential decreasing trend in the number of looked after children in Moray. Pie chart 5: Care setting categories At the end of Fin Quarter 1, 41% of children were in family settings at home or in kinship care with 59% in other settings such as foster care or residential houses. This has remained a stable figure highlighting many looked after children have been able to remain within their network of family and friends. 172 177 179 175 173 175 177 176 175 180 178 171 171 170 165 155 160 165 170 175 180 185 LAC - AWAY FROM HOME & AT HOME Page 62
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13 | P a g e There has been an ongoing focus on kinship care as an option which has been supported by Family Group Decision Making. With this, Moray has been able to avoid children being cared for out with their familiar network of family and friends. Foster care with Moray carers (49) and kinship care (42) are the highest categories followed by children looked after at home (26). The children’s houses in Moray (11) Cala, Rowan Lea and Land Street, continue to operate at full capacity (14) where three young people are over 18, subject to Continuing Care, and not recorded as looked after children. This is significant as it enables the vast majority of looked after children in Moray to maintain vital connections within their local community, including family, friends, education, and healthcare. A significant majority of young people are in family-based care (124, 75%) rather than residential care (41, 22%). The Carer Recruitment Campaign has seen new foster carers and supported lodgings caregivers approved to support young people remaining in Moray in family-based care settings. There remains the commitment to support young people in family-based care settings. This includes supporting families to identify and promote kinship care options via Family Group Decision Making processes. At the end of June 2025, 88% of brothers and sisters in Foster Care and Kinship Care remain together with at least one sibling. The National Average is 79%. Where brothers and sisters are not together, this is for a variety of reasons including lack of suitable resource, an assessed need to live separately or diverse needs. Maintaining relationships between brothers and sisters remains a priority for the service. At the end of Fin Quarter 1, 21% of our looked after children were cared for on a full-time basis in residential care. If short breaks are included the figure of young people in residential care increases to 23%. As such, Moray is 3.5% above the average indicator when considering full-time care on its own and 5.5% above if short breaks are included. There has been an impact of the increase in newly accommodated young people in in 2024/25 where there has been an associated increase in the use of residential care as foster care is at capacity in Moray. Aside this we will be implementing the revised Continuing Care Procedure. This is aligned with our clear plan to support young people in their transition to adulthood and after care, allowing them to remain in their family, fostering and residential home as non-looked after children up until the age of 21. 'Staying Put' is our default position and future reporting will include the outcomes realised in numbers of looked after children and young people likely reducing to further secure a young person's future care. This provides a stable base from which care experienced young people can move to adulthood and independence. Moray hosts four young people who are New Scots (formerly Unaccompanied Asylum- Seeking Children) via the National Transfer Scheme. These children and young people are assigned to Moray by the Home Office and are then supported by the Throughcare and Aftercare Team. They are counted as looked after children to ensure they receive full support. Initially, these young people are in Supported Lodgings or Supported Accommodation care settings. The team continues to successfully support them to move into their own independent housing once they have been granted asylum. Page 63
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14 | P a g e Moray also hosts a number of other New Scots but they are not all are looked after children due to their age and/or asylum status. The number of new arrivals of New Scots in Fin Quarter 1 was zero which was the same figure for Fin Quarter 4. COSLA and the Home Office cannot yet determine the reason for this reduction and whether it is a short or long-term trend. The resource allocation system in Moray means there are the resources to support New Scots including any future increases in numbers. Graph 16: Moray foster care households At end of Fin Quarter 1 there were 53 children living in foster care, with 49 (92.5%) children living with Moray Council foster carers and 4 (7.5%) living with independent foster carers. This identifies that, despite the challenges in recruiting carers both locally and nationally, Moray has ensured that most children are living with in-house foster carers. Of our 36 fostering households, 80.5% are actively caring for a child. Not all fostering households have children living in their care. At the end of Fin Quarter 1 this comprises seven (19.5%) in total. This is a small number due to family circumstances or matching considerations of their registration approval where foster carers are inactive for a short period of time. The Fostering Team has been broadening the approval range and capacity of Moray foster carers, with additional support and advice, to enable care for a wider group of children and maximise capacity. 35 36 37 37 36 35 36 36 36 27 27 25 25 28 31 31 30 29 0 5 10 15 20 25 30 35 40 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 2023/24 2024/25 2025/26 MORAY - FOSTER CARE HOUSEHOLDS No. of Moray Council Fostering Households No. of Moray Council Foster Carers with 'Active' placements 2 per. Mov. Avg. (No. of Moray Council Fostering Households) Page 64
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15 | P a g e Graph 17: Children who live in foster care Graph 17 identifies that at the end of Fin Quarter 1, there were 49 children cared for by Moray foster carers, which is a decrease from Fin Quarter 1 in 2024 which was 51. However, this includes some quarterly fluctuations where the pattern is relatively stable. The number of approved Moray foster carer households for children has remained stable. Although the carer recruitment campaign is resulting in new fostering households, this is balanced by other foster households ceasing or changing the type of fostering they provide. The challenge in recruiting and retaining foster carers is both a local and national issue. The recruitment campaign is significant in recruiting foster carers accompanied by work to achieve greater retention rates, focused on supporting foster carers with improved supervision, training and finances. The Fostering Team has now introduced a simplified levels system for foster carers. This has reduced the number of levels from four to two and has introduced short term enhanced payments for the most complex care arrangements. This new system has meant that new foster carers will start a higher fee than previously which it is anticipated will support the foster carer recruitment strategy. Young Carers work is reported to other Integration Joint Board Committees which is being reviewed with a view to inclusion in this report. Graph 18: Kinship care settings Kinship care is split into two groups: pre-approved kinship homes awaiting presentation at the Kinship Panel for approval and kinship households already approved 31 29 29 29 29 28 30 28 25 26 26 25 30 27 28 30 32 33 32 32 31 33 31 32 32 32 31 34 31 31 12 9 7 8 8 8 9 9 5 5 5 5 5 6 7 0 10 20 30 40 50 60 70 80 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Kinship Care Settings Kinship: No. of households providing Kinship Placements Kinship: No. of Children in Approved Placements Kinship: No. of Children in Pre-Approved Placements Page 65
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16 | P a g e at Panel. Moray is seeking to increase the numbers of kinship households. This is to ensure more children and young people can remain within their own communities and network of family and friends. It is envisaged that the numbers of kinship households will increase via the use of, for example, Family Group Decision Making processes. We are reviewing our Kinship Policy in line with revised guidance form the Scottish Government. Our basis for this review is to provide Kinship Assistance to children who move to the care of a relative or friend as a decision of a social work led child's plan and to widen our support for Kinship Carers to include those who have caring responsibilities as informal arrangements. The Policy will consider the Eligible Child as primary consideration, which will include the assistance to young people over 16 who are transitioning from child to adulthood. Creating and implementing a Policy that widens our support to Kinship families through the child and young person's childhood to adulthood will provide confidence for potential kinship carers and hopefully lead to an increase in prospective kinship carers feeling able to consider caring for a friend or family members child. Graph 19: Residential care settings Residential care is divided into those in residential care in Moray and those outwith Moray. Children cared for in Moray live in the authority's own children’s houses, Cala and Action for Children’s two houses in Buckie and Elgin. The figure for this category is 11. As above, the children’s houses operate at capacity (14) including three young people in Continuing Care. Out of Area care tends to be specialist residential houses or residential schools. There has been a consistent focus on providing this care in Moray where possible, so children remain close to their families and support network. The figure for this category is 21. Work is underway to reduce the number of young people in Out of Area care which is expensive and does not geographically support young people in maintaining relationship in Moray including health, education, family and friends. We are working with Action for Children and the new transition project. The project will provide targeted support for young people moving on from residential care in Moray or those returning to Moray. This is the early stages of implementation, with a transition worker joining the team around the child or young person. Page 66
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17 | P a g e Residential care settings can be the correct care setting for some children and young people, often due to previous unsuccessful multiple family care arrangements. However, in most cases, a family-based setting is preferrable as it better prepares young people for adulthood as they have a positive model of family life. For those young people in residential care, there is significant preparation via independent living skills to support them in the transition to adulthood. Graph 20: Through Care, After Care and Continuing Care As illustrated in Graph 21, as at 30 June 2025, there were 74 young people receiving care from the Through Care After Care (TCAC) Team including 13 receiving Continuing Care support. It is anticipated that the numbers of young people subject to Continuing Care will increase as this approach becomes more embedded in Moray. This is particularly as there will be a likely increase in the use of Continuing Care for 16- and 17-year-olds and for those in residential care which is supported by a refreshed policy. The team is divided into three sections: • Through Care: Young people receiving support to plan and prepare for independence. • After Care: Young people who have left care and receive support whilst living independently or in a continuing care arrangement. • Continuing Care: Young people who choose to remain in their care arrangement beyond their16th or 18th birthday until they are 21, although it can be in place from 16. These young people cease to be formally looked after by Moray Council but receive the same support and care as when they were, providing a more natural and seamless transition to adulthood. There is a focus on continuing care to ensure young people in different care settings are given the opportunity to remain where they are living potentially until the age of 21. This is a key responsibility for the organisation and partners as corporate parents. The team is responsible for supporting New Scots (formerly Unaccompanied Asylum- Seeking Children) via the National Transfer Scheme. This is an increasing workload for the team, which is dependent, in part, on the numbers of young people arriving in Kent, making future forecasting a significant challenge. 29 35 37 14 19 24 9 11 13 0 5 10 15 20 25 30 35 40 Apr-25 May-25 Jun-25 THROUGH CARE AFTER CARE TCAC: Open as Through Care TCAC: Open as Aftercare TCAC: Open as Continuing Care Page 67
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18 | P a g e The team offers considerable support to young people after they leave care (After Care) up to the age of 26. There is a commitment to offer the same support birth families provide for young people who are transitioning into adulthood. This is a key element of Moray Council’s and Health and Social Care Moray’s responsibilities as Corporate Parents. Other reporting areas being considered are positive destinations: work, education, training, and accommodation, and outcomes for New Scots. Positive Destinations for Looked After Children A new area of reporting is in relation to positive destinations. This relates to school leaving looked after children (S4-S6) moving on to education, employment and training. Graph 20 identifies the trend over the last 5 years which has produced a fluctuating but overall reducing picture. Within the Corporate Parenting Strategic Group there is a focus on positive destinations to consider why the outcomes for looked after children in this area are not improving. It is important to note that the numbers of young people are small where they can be easily identified, tracked and supported. The Throughcare & Aftercare Team have been working with colleague in Education in order to support this group of young people. Graph 20 provides data until 2023/24 where the reporting for 2024/25 is awaited. An update can be provided in future reporting to identify whether there has been an improvement for the outcomes for these young people. Graph 20: Positive Destinations Maintaining Relationships Project The Maintaining Relationships Project has now produced practice Guidance which was agreed by the GIRFEC Leadership Group. This provides a framework for local authority staff and care experienced young people to safely maintain relationships within a flexible and supportive structure. The formal launch is taking place on 28 October at Moray College where there will be a combination of presentations and stalls. Page 68
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19 | P a g e The project will be supported by the Corporate Parenting Strategic Group which is developing tools in order to report on its impact and the outcomes for care experienced young people. These outcome measures being developed will be included in future reporting. As part of this, the Children’s Houses in Moray are currently developing tools to monitor outcomes for young people maintaining relationships. There has been considerable feedback and input from young people to inform this process. A selection of this is as follows: • “Have communication in place about how adults will keep in touch when I move out. It would be good to know how things will be.” • “I like people from the children’s house popping in to see me.” • “The children’s house picks up the phone to me. I go there to visit; I’ve got lots of memories there. I like going because of the people I know there, I like to talk about the past and see what they’ve been up to. It would be good to meet up with them for a burger or, something.” • “I still like having someone there for me. I’ve got a couple of appointments coming up that they’ll come with me.” • “It wasn’t really cooking and cleaning I needed. I needed support to go out and take part in things going on.” Justice Services and Youth Justice. Graph 21: Care experienced young people supported by Justice Services Nationally, care experienced young people (CEYP) are overrepresented in the Scottish Justice Systems. At the end of Fin Quarter 1, 9% (46 of 507) were CEYP (up to age 26) in the Justice System (Youth Justice 13, Justice Social Work 33) as depicted in graph 22. This figure has consistently remained below 12% since 2023 and the very slight rise of 0.5% from Fin Quarter 4 relates to a reduced number of open cases overall, not an actual rise in the number of CEYP open to the services. The aim continues to be to address identified needs and risks to reduce re-offending rates and maximise support, including existing relationships, Research informs that early entry or prolonged exposure to the criminal justice system can draw children into the system rather than rehabilitate and divert from the system, therefore the use of short term interventions are prioritised where possible. Children who are remanded or sentenced to custodial sentences in a secure care facility are included within the numbers above. 450 440 449 443 466 472 478 477 492 490 497 498 488 472 474 37 35 31 34 34 36 40 40 44 46 48 46 39 37 457.58 7.29 6.39 7.23 6.82 7.17 7.8 7.8 8.3 8.6 8.8 8.5 8.7 9.4 8.8 0 100 200 300 400 500 600 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Care Experienced Young People open to Justice Services Open to Justice Team Open to Youth Justice % CEYP open to both MYJ and JS Expon. (Open to Justice Team) Page 69
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20 | P a g e Graph 22: Age of children in Youth Justice The average age of a child receiving Youth Justice services through this quarter is 15 years old which is slightly higher than previous reporting, and at the end of Fin Quarter 1 there are no under 11’s open to the service. This is positive in that the needs of our younger children are being appropriately met by other services. Most of the work continues to be with children aged 11 to 15 years and is undertaken in a multi-agency way, working closely with key partners such as Police Scotland, education services and our local children's houses. Whilst the team works with all schools throughout Moray, it has strong links with Moray Social, Emotion and Behavioural Needs Service (SEBN) where support is offered for social, emotional and behavioural needs. There have been a very small number of young people aged over 18 years in the Youth Justice Service over Fin Q1, where support has been delivered jointly with the Justice Social Work team. Planned transitions and joint working between these teams minimises the impact on the young person. Pie chart 6: Gender of individuals in Youth Justice 0 20 40 60 80 100 0 0 1 1 1 0 0 0 2 1 1 1 0 22 21 21 21 21 21 25 28 26 27 24 22 24 30 16 13 15 10 7 7 8 9 15 18 16 14 11 122 2 1 0 1 0 3 3 3 3 2 2 1 1 40 36 37 32 30 35 36 40 44 50 43 39 37 43 Ages of Young People in Youth Justice YJ: Age Band: 5-10 YJ: Age Band: 11-15 YJ: Age Band: 16-17 YJ: Age Band: 18+ YJ: No. open to Youth Justice YJ Gender: Male, 38 YJ Gender: Female, 7 GENDER OF YOUNG PEOPLE IN YOUTH JUSTICE YJ Gender: Male YJ Gender: Female Page 70
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21 | P a g e Pie chart 7: Gender of individuals in Justice Services At the end of Fin Quarter 1, most individuals supported by Youth Justice were males accounting for 82% of children and young people supported by the service. In Justice Social Work 14% of individuals supported by the service were females, which has increased slightly over the past year. It is recognised women in the justice process are more likely to have experienced trauma and are also more likely to be a sole carer for a child or family member. In line with The Promise, Justice Social Work is committed to keeping women in their local communities where it is safe to do so and provide robust alternatives to custodial sentences. Currently the team offers a gender responsive service which includes a weekly women’s group and a woman only unpaid work group. Support is offered in partnership with other services to promote opportunities for individuals to engage with community resources which will be available beyond their time within the justice service. Work continues to capture the views of individuals to evaluate the impact of this service and shape its development. Recent feedback includes: Justice: Male, 416 Justice: Female , 58 Gender of People in Justice Services Justice: Male Justice: Female Page 71
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22 | P a g e Graph 23: Justice social work reports (JSWR) Justice Social Work reports (JSWR) remain a priority to reduce any delays in sentencing and for Fin Quarter 1 the target of 100% on time has been met. Whilst reports are prepared at the request of any Court for an individual living in Moray, most reports are submitted to Elgin Sheriff Court. Completion of Court reports on time results in appropriate sentencing for individuals which addresses their current assessed risks and needs, and reduces time spent on remand where a community sentence is imposed. It also importantly supports a timely outcome for victims of offences. Pie chart 8: Justice Report Types In addition to a standard JSWR report the Court may request additional assessments such as a Drug Treatment and Testing Order (DTTO) assessment and a Restriction of Liberty Order (ROLO) assessment as shown in pie chart 8. The imposition of a ROLO or DTTO can be a direct alternative to custody so effective assessments for these Orders can offer a robust community-based disposal. At the end of Fin Quarter 1 there were 10 DTTO’s in progress which involves at least two appointments per week for testing and supporting identified needs, and group work in this area is being considered. 130 107 107 138 141 121 95 95 121 119 100 100 100 100 100 0 20 40 60 80 100 120 140 160 Q1 Q2 Q3 Q4 Q1 JUSTICE SOCIAL WORK REPORTS (JSWR) - SUBMITTED ON TIME No. Social Enquiry Reports submitted on Time No. of People % of Reports on time 4, 3% 58, 46% 63, 50% 1, 1% TYPES OF REPORTS JSWR DTTO Assessment JSWR ROLO Assessment JSWR Standard Page 72
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23 | P a g e Graph 24: Structured deferred sentences (SDS) An SDS is a flexible provision with structured social work support for an individual after conviction but prior to sentencing. Successful completion of an SDS reduces the need for a statutory Court Order, in turn reducing the overall length of time an individual is supported by the service. The number of in SDS disposals in Fin Quarter 1 has risen slightly but remain lower than in the previous year likely due to increases in other early intervention measures. Graph 25: Bail supervision Bail supervision is an alternative to remand and the priority for this in Moray is women, young people, those with caring or parental responsibilities and those with issues relating to mental health or addictions. Assessments are undertaken for all people where bail is being opposed by the Procurator Fiscal and are provided on the same day. There is a small reduction in the number of assessments requested in Fin Quarter 1 and a slight decrease in bail supervision orders imposed. There continues to be a significant number of assessments which do not result in bail being opposed and work is being undertaken nationally to understand trends, but data is not yet available to compare. The prison population in Scotland remains high, and bail supervision is one area of work which is hoped will assist in reducing these numbers whilst offering more positive outcomes for individuals within their local communities. There is a plan to use the Outcomes Star as a model for identifying the impact of this work. 0 10 20 30 40 50 Q1 Q2 Q3 Q4 Q1 2024-25 21 8 10 11 16 21 6 10 11 16 STRUCTURED DEFERRED SENTENCES (SDS) No. of Structured Deferred Sentences imposed No. of Individuals with SDS imposed 0 50 100 Q1 Q2 Q3 Q4 Q1 2024-25 2024-25 2024-25 2024-25 2025-26 59 62 50 47 44 14 13 17 12 8 14 12 17 2 8 Bail Supervision No. of requests from Court for Bail Supervision No. of Bail Supervision cases commenced No. of individuals commenced with Bail Supervision Page 73
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24 | P a g e Graph 26: Community Payback Orders with supervision requirement Fin Quarter 1 has seen an increase in the imposition of Community Payback Orders (CPO). Most individuals made subject to a CPO are seen on the day of sentencing, for those where this has not been possible, an appointment with their allocated social worker is made within seven days of an Order being imposed. There has been an improvement in the number of individuals seen within these timescales and additional support offered to staff when completing data to improve accuracy. Where an individual is subject to an Unpaid Work Requirement there is a focus on providing opportunities to develop skills as well as contribute to our local communities. Feedback from this service includes: Diversion from Prosecution Diversion from Prosecution (DfP) allows someone accused of offences to be dealt with outside of the formal justice system. Successful completion of a diversion from prosecution means an individual will not have a conviction for the alleged offence which may impact their current or future employment or education alongside other significant areas of their life. The Justice Social Work team undertakes all assessments of suitability; however, the Youth Justice team aids and supports young people aged 16 and 17. The referral rate varies which is a result of the process of cases being marked by the Procurator Fiscal. There can occasionally be delays in the commencement of these cases where additional agreement is required from the Procurator Fiscal, e.g. an extended period for completion. In comparison to Fin Quarter 4 last year there is a small increase in assessments completed for males and a small decrease in assessments completed for females. Outcomes Star data indicates most individuals feel an improvement in their wellbeing at the end of a DfP. Information contained within exit questionnaires include: 41 53 62 59 69 35 49 55 41 58 Q1 Q2 Q3 Q4 Q1 2024-25 2024-25 2024-25 2024-25 2025-26 CPOS WITH SUPERVISION No. of new CPOs with Sup Req No. seen by Supervisor within 7 days 2 per. Mov. Avg. (No. of new CPOs with Sup Req) Page 74
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25 | P a g e Work is being undertaken to improve the recording and examination of this data and feedback. Finalised updated guidance for DfP is awaited from the Scottish Government, however there are plans from Community Justice Scotland to provide training to all staff which it is anticipated will improve local and national practice. Graph 27: Diversion from prosecution: Female Graph 28: Diversion from prosecution: Male Policy, development, trauma-informed and commissioning. Health and Care (Staffing) (Scotland) Act 2019 Annual report The Health and Care (Staffing) (Scotland) Act 2019, commenced on 1st April 2024, aims to ensure safe and high-quality care by establishing a statutory basis for appropriate staffing levels and training in health and care services. It introduced duties for local authorities and integration authorities when planning and securing certain care services. We must: ▪ have regard to the Act and relevant guidance when we plan or secure particular care services ▪ ensure that we require service providers to have regard to the Act and relevant guidance 1 0 0 4 0 1 2 1 0 0 2 1 2 3 2 3 3 1 1 0 0 4 4 0 1 5 0 2 3 2 1 2 1 0 0 0 2 4 0 0 5 0 0 0 0 0 1 2 3 4 5 6 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Diversion from Prosecution: Female DFP Gender: Female DFP Commencing Gender: Female DFP Completed Gender: Female 2 per. Mov. Avg. (DFP Gender: Female) 12 4 5 8 1 5 6 3 2 1 7 4 1 3 5 7 5 2 4 8 11 4 6 2 8 3 5 1 3 5 2 1 1 2 1 11 4 5 2 5 3 2 0 0 0 0 2 4 6 8 10 12 14 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Diversion from Prosecution: Male DFP Gender: Male DFP Commencing Gender: Male DFP Completed Gender: Male 2 per. Mov. Avg. (DFP Gender: Male) Page 75
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26 | P a g e ▪ make arrangements to monitor service provider compliance ▪ report annually on the steps we have taken and any ongoing risks that may affect our ability to comply with Act. Following internal and external consultation as well as approval from SMT, the first annual report has been published online and shared with the Scottish Government. Trauma-Informed Practice In Moray, as part of the work towards the Scottish Government’s vision of trauma-informed and response workforce within public bodies, mirrored in the Children’s Services Plan 2023-2026, the Trauma Informed Development Officer has been leading on the assessment and improvement of services in terms of the principles of trauma-informed practice. As indicated previously, alongside the delivery of these sessions, the Development Officer has been leading on the establishment of training on trauma-informed practice for staff across Moray Council and the HSCP. This work has now concluded: the Development Officer, in collaboration with the Improvement Service, NHS Education for Scotland (NES) and the National Trauma Transformation Programme (NTTP), has: - developed training to meet Level 1 standard - lead on the incorporation of NES eModules within the CLIVE learning management system - created a process for managers and leaders to engage with the Scottish Trauma Informed Leadership Transformation (STILT) programme. The training outlined in the table below is now available to staff. Course Level 1 (Informed) Level 2 (Skilled) Leadership Development Staff Wellbeing Audience All staff Staff who may engage with people who are having or had experiences of trauma All staff holding leadership and management roles All staff Modules Introduction to trauma- informed principles and practice Understanding the impact of trauma and responding in a trauma- informed way Understanding the impact of trauma and responding in a trauma- informed way Psychological First Aid Trauma in children and young people Protecting the psychological wellbeing of staff and teams for managers and team leaders Staff Wellbeing: taking care of yourself Understanding the of trauma on mental health and evidence- based pathways to recovery Scottish Trauma Informed Leadership Transformation (STILT) webinar Understanding the use of substances to cope with the Page 76
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27 | P a g e impact of trauma The availability of the training has been advertised to staff within the July/August edition of Connect. Queries about the applicability of courses and modules as well as expressions of interest to participate in the STILT programme are to be directed to the Trauma Lead Officer on TraumaInformedPractice@moray.gov.uk. Children’s Social Work Development Plan The Children’s Social Work Development Plan has been steadily progressed in this quarter: - rolling out of training in relation to chronologies, assessments and sexual harmful behaviour - an integrated core assessment has been created and is due to be launched in the next quarter - a number of procedures have been developed and are currently awaiting ratification. For further details, please see the separate report detailing the Children’s Social Work Development Plan and its progression provided to the IJB recently. Newly Qualified Social Workers Conference A group of five local authorities formed the North Partnership to support newly qualified social workers in their final year or at the beginning of their career by facilitating an in-person conference focusing on the theme: ‘How to Survive in Social Work’. The conference, held on 24th April 2025 in Inverness, has been attended by over 100 delegates, indicating the appetite for such events. Following the speech of the keynote speaker, Dr Neil Thompson (author, educator and adviser in social work practice), attendees self-selected 2 of the 5 available workshops. The day, interlaced with opportunities for networking, closed with a speech from Orkney’s CSWO summarising key messages and highlighting the success of the event. Feedback gathered informally on the day and as part of the formal post-event survey indicated that the conference provided practitioners with opportunities to discuss, reflect and learn from each other and fully immerse themselves in the workshops, with precious time out of the office. The delegates appreciated the workshop content and delivery by staff across the local authorities, recognising in-house skills and knowledge. The North Partnership has reflected on the event, considered the helpful feedback from delegates and is keen to keep the momentum of this excellent working partnership. Already, 14 practitioners have expressed an interested in forming a short life working group to discuss next steps, ensuring we meet the needs and wants moving forward in the context of limited resources. This may take the form of establishing online peer support forums and themed online learning sessions providing space for discussion and reflection whilst the evidencing learning and development of newly qualified social workers. It is also hoped that a similar but smaller-scale event can take place in time. Personal outcomes in performance reporting: test of change In line with national direction of travel, Children’s Social Work Service wishes to move towards the inclusion of personal outcomes and impact within its performance reporting to IJB. Personal Page 77
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28 | P a g e outcomes are those that matter to people receiving services; they constitute the impact of supports provided by the Service. A focus on personal outcomes ensures that the provided care and support are appropriate and effective at the time when they are needed. Following initial scoping and benchmarking, a test of change led by the Policy, Commissioning and Development Team has been agreed to be taken forward. The exercise will use a simplified version of the GIRFEC Wellbeing Web to capture the progress of the personal outcomes linked to the SHANARRI indicators alongside space for recording reflections where impact can be detailed. The Web will be filled out with ten families receiving various supports from Children’s Social Work. The Policy, Commissioning and Development Team will guide the lead professionals throughout the exercise and conduct a focus group session upon conclusion to gather their and the participating families’ feedback. The results of the test of change will be shared with IJB in due course. Children and Families and Justice Social Work Commissioning The Commissioning team within Children and Families and Justice Social Work leads on eight key areas of service contracts. The pie chart below indicates the percentage of each area from the total spend for Q1. The individual contracted service areas will be discussed next in turns. Family support services The family support services area, accounting for 11% of the spend, consists of: 1. the independent advocacy service 2. three services for prevention and early intervention to avoid family breakdown and possible out of area care arrangements: 2.1. Families Together 2.2. Functional Family Therapy 2.3. Aberlour Youth Point Moray. Page 78
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29 | P a g e 1. Independent advocacy Moray’s Children’s Right Service, delivered by Quarriers, is available to all young people and their parents, carers and siblings. In this quarter, 186 young people and 164 parents, carers and siblings benefitted from the service. This is similar to previous quarters, as shown on the figure below. Quarriers support children, young people and their parents and carers to have their voice heard in many situations, including during meetings with professionals. The graph on the right shows the number of Social Work, Education or Health-led meetings that Quarriers staff attended alongside the children and adults they advocate for in this quarter. Quarriers are currently operating with a minimal waiting list or pending service list; as at 30th June 2025 there were nine referrals on it. Due to successful recruitment, this issue is hoped to be fully resolved in Q2. In the meanwhile, new referrals are triaged with a view to prioritise service provision for looked after children and children in need of protection. 2. Prevention and early intervention services The three prevention and early intervention services (Aberlour Youth Point, Families Together and Functional Family Therapy) supported a total of 112 children and young people and their families in this quarter. Feedback in relation to the individual service providers is discussed below. Page 79
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30 | P a g e 2.1. Aberlour Youth Point Moray Aberlour Youth Point Moray supports children and young people who struggle to remain positively engaged within their home, school or community and who require a targeted support service. It also provides support to the parents or carers of the children and young people with whom they work. Whist the impact of their work is shown by quotations from children and adults, such as the one above, the progress individuals achieve across the SHANARRI indicators are also recorded. Specifically, people rate themselves across the SHANNARRI indicators during their initial meeting and at regular intervals thereafter. In this quarter, Aberlour worked with 42 young people and four parents. Their progress, which is considered to be the impact of the supports provided, is outlined in the figure below. It indicates that the majority of young people’s wellbeing remained the same or improved in this quarter. 2.2. Families Together This service, provided by Children’s First, delivers a restorative family service in a variety of ways, including a range of one to one and group sessions, family focussed money advice service, practical support (e.g., food parcels and school bank referrals) and the Family Group Decision Making approach. In this quarter, through the financial worker, five families were able to financially gain £5,672.14. Seven families completed their support with Children First during this quarter, the impact of the service is shown in the table below. The table details the starting score as rated by the family initially and is compared to the family’s finishing score. Family Area of work Start score End score +/- Difference 1 Safe 1 4 +3 “I’ve been getting on better with my parent since working with you” Young Person 23/04/2025 “Many thanks for all your hard work in supporting my family, it has been greatly appreciated” Parent, 25/04/25 Page 80
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31 | P a g e Relationships 1 5 +4 Voice 1 4 +3 2 Safe 1 3 +2 Relationships 1 3 +2 Voice 1 3 +2 3 Safe 1 4 +3 Relationships 1 4 +3 Voice 1 3 +2 4 Safe 1 4 +3 Relationships 1 3 +2 Voice 1 4 +3 5 Safe 1 3 +2 Relationships 1 3 +2 Voice 1 3 +2 6 Safe 1 3 +2 Relationships 1 3 +2 Voice 1 3 +2 7 Safe 1 3 +2 Relationships 1 3 +2 Voice 1 3 +2 2.3. Functional Family Therapy Functional Family Therapy is a short term, strengths and family-based therapy programme designed to help families improve communication and relationships with a view to keep them together. Currently, 15 families are supported by this service. The quotation on the left demonstrates the changes one family faced in the service. Two families completed their intervention, the bar chart below shows the outcome measures as rated by the start and end scores by the young people, parents and therapist. The scores are rated on a five-point scale across six key areas, with a score of three recorded as a significant clinical outcome. This quarter the young people’s scores are higher in many areas, which identifies the impact the service has had on them specifically. “Things are more nice, easier to talk to one another than before” Young Person 09/06/2025 Page 81
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32 | P a g e Support for Unpaid Carers This service, delivered by Quarriers, accounting for 4% of the total spend in Q4 and is inclusive of the provision of our statutory requirements under The Carers (Scotland) Act 2016. In Q1, 1219 adult and 209 young carers (the highest this has ever been) benefited from this service with positive feedback, as exemplified by the quote to the right. As of 7 July 2025, the responsibility for the completion of Adult Carer Support Plans and Young Carer Statements changed from Quarriers to Health and Social Care Moray. This allows Quarriers to concentrate solely on the actions of the Unpaid Carers Strategy. Out of area care provision Accounting 55% of the total spend, out of area care is provided to: ✓ 19 young people in residential care (53% of spend) ✓ Seven young people in foster and continuing foster care (2% of spend). This is an increase of three young people compared to 2024/2025 Q4. Local Residential Care Accounting for 14% of the spend, residential care is provided to eight young people by Action for Children across two homes in Moray. This is a static number, as eight beds are commissioned through this contract. Children with a Disability – Residential services The Scotia residential service, accounting for 11% of the spend in this quarter, is delivered by Aberlour Childcare Trust in Alba Place, Elgin. Currently, three young people benefit from this service. Monitoring arrangements indicate that these children are fully supported, maintaining relationships with family and friends, and enjoy a wide range of inclusive community activities. The quote from a parent on the right exemplifies the positive impact of the service and their commitment to maintaining relationships with the wider family and friends. “I feel comfortable talking to you about my caring role” Young Carer, 21/04/2025 “The staff threw a birthday party for my son and invited close family and friends. They went above and beyond, and we had the best time” Parent, 23/06/2025 Page 82
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33 | P a g e Children with a disability- support Commissioned services supporting children and young people with disabilities account for 5% of the total spend and consist of a short break and group activities services. Short Breaks Services This contract provides day care and overnight short breaks for 12 young people. They deliver 15-day care and (on average) 21 overnight sessions per month. This allows a break for the family, the benefits of which is deemed positive, as demonstrated by the quote on the right. Group Activities This is a new service that was co-commissioned with children, young people and their families, which was launched towards the end of the previous reporting period. In this quarter, 40 sessions were delivered, six at Easter, one May Day, 22 after school and eleven at weekends. There were 80 hours of service delivery run at two locations in Moray. The quotation on the left was received from a young person who accessed the service over Easter. This shows how positive the sessions were received. The number of sessions is expected to increase as referrals from other localities are received by the service. Contextual or place-based safeguarding In Moray, similar to other areas in Scotland, an increasing number of young people appear to be at risk of or posing harm in the community. Contextual safeguarding is a novel approach to understanding and responding to children's experiences of significant harm beyond their family and home; it offers a way to understand these risks, engage with children and young people and help to keep them safe. As it was previously reported, initial efforts are focussed on awareness raising and the development of a framework enabling partner agencies to share information about, understand and respond to contextual risk around places or groups of children who may or may not be supported by services on an individual basis. These efforts have continued in this quarter. In addition to this, an intervention was led by the Locality Lead Officer in Buckie, who, as part of the multiagency working group, initiated a community-led discussion to address risks reported by parents concerning a group of S1/S2 pupils. The risks related to illicit vape use, experimentation with alcohol and illicit substances, and the challenging of parental boundaries. This discussion involved, community policing, youth work, third sector organisations (such as AYP and Exchange Counselling), a wellbeing coordinator and the children’s named persons. The discussion focussed on information sharing about available supports and solutions. The outcome of this discussion led to the development of a comprehensive support package aimed at assisting parents, identifying risk areas within the community, and offering direct group- “Lovely to see my daughter so happy when I pick her up, so I know she’s had a nice time” Parent, 22/06/2025 “Can I come back? When is the next session?” Young Person following Easter session Page 83
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34 | P a g e based and individual interventions for the young people involved. Named persons communicated this to the parents and, to capture this positive practice, the Locality Lead Officer will collaborate with the Working Group on 15 July 2025 to create a guidance flowchart to promote consistent practice. Preparing for the Children (Care and Justice) (Scotland) Act 2024 The Children (Care and Justice) (Scotland) Act, designed to create a more child-centred and supportive environment for children within both the care and justice systems in Scotland, received Royal Assent in 2024. Parts of the Act are already active, and work is being undertaken nationally for staged implementation between March 2026 and early 2027. To begin readying the Service for the Act, the Policy Team attained legal advice and thereafter (at the end of 2024) briefed the CSWO the changes it will likely introduce. The CSWO requested a round table discussion with Social Work staff across various levels, to discuss the potential implications with a view to make recommendations. This event was held in May 2025 and led by colleagues from Children and Young People’s Centre for Justice. The interactive event, outlining the key provisions of the Act with management input around potential local implications, was generally positively received by attendees. Through discussion, the attending practitioners generated a range of ideas about actions that can be taken in preparation for the enactment of the Act. These ideas have been written up in a report for the CSWO for consideration. Training and development: AIMS / Safer Futures Feedback from the workforce during the Development Days held in November 2024 indicated a need for methods to assess and respond to cases where sexually harmful behaviours feature. Specific funding was secured in quarter 4 to purchase two days of training and two days of AIMS/ Safer Future awareness raising. AIMS is an assessment framework that evaluates sexual behaviour, non-sexual behaviour, development, environmental/family factors, and self- regulation. Feedback gathered from these sessions has been positive indicating motivation from the workforce to roll out this as an available assessment tool amongst Social Work led assessments of need. Reflecting on the feedback, the Policy Team is - collaborating with the provider and benchmark other local authorities’ approach to embed the framework into existing pathways of support to children and families - considering the securing additional funding to purchase tools specific to the framework. Page 84
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: INTERNAL AUDIT SECTION - UPDATE REPORT BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 This report provides Committee with an update on the work of the Internal Audit Section. 2. RECOMMENDATION 2.1 Committee is asked to consider the contents of the report, seek clarification on any points noted and otherwise note this audit update. 3. BACKGROUND 3.1 Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to prepare and present reports to committee on internal audit’s activity relative to the audit plan and on any other relevant matters. 4. KEY MATTERS RELEVANT TO RECOMMENDATION Audit Plan 2025/26 4.1 The Audit Plan for 2025/26 details an intended review of “Support for Carers”. The broad scope was to examine the processes involved in providing information, advice and support to unpaid carers, including short breaks and respite support. However, I noted that at this Committee on 27 March 2025 (para 7 of the minute refers), a report from the Service Manager Provider Services, titled “Update on the Delivery of the Unpaid Carers Strategy”, was presented to “inform Committee of the progress made towards achieving the objectives outlined in the Unpaid Carers Strategy”. Further to discussions with members and officers, I have decided that to allow sufficient time for the full implementation of the Unpaid Carers Strategy, it would be more beneficial and a better use of audit resources to defer the planned review of “Support for Carers” and include it in a future audit plan. In its place, I intend to undertake an audit Item 7. Page 85
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using a data analysis software package to review non-payroll expenditure. This will focus on assessing compliance with procurement and payment processing regulations. Audit Plan 2026/27 4.2 Preparation has begun to agree on the Audit Plan for 2026/27. Internal Audit’s approach to annual audit planning is risk based, with all areas that may be subject to audit review contained within an ‘audit universe.’ The audit universe is reviewed and updated on an ongoing basis to include all significant activities and systems. 4.3 The consultation process will also provide an opportunity to remind officers of the established timescales for responding to information requests during an audit review, as well as to the recommendations within the audit report. However, Internal Audit recognises the significant workload demands on officers and will always try to accommodate any requests for changes in reporting arrangements. NHS Grampian Internal Audit Reports 4.4 As the Chief Internal Auditor of the Moray Integration Joint Board (MIJB), my role involves providing assurance on the internal controls of systems and practices required by the MIJB to deliver services, regardless of whether they use Council or NHS systems. I can provide members of this Committee with audit reports of reviews undertaken regarding operating practices that use Moray Council owned systems due to my role as the Council’s Auditor. I am pleased to report that I have recently signed an agreement with the Internal Audit Provider of NHS Grampian, which will enable me to report on audit reviews included in their 2025/26 audit plan for NHS Grampian systems and practices to this Committee. 4.5 Internal Audit Staffing The Public Sector Internal Audit Standards (PSIAS), now updated to the Global Internal Audit Standards, require the Chief Internal Auditor to update this Committee on any concerns regarding the level of audit staffing resources within the Internal Audit Section. I have previously raised concerns about whether current staffing levels are sufficient to meet future auditing needs. I am pleased to report the successful appointment of a part-time temporary auditor, which should help meet the increasing demands on the service, although a period of training will be necessary. This temporary post has been primarily funded from the remaining budget following the Council’s decision to reduce the vacant Corporate Investigation Officer position by 0.5 full-time equivalent. The counter fraud responsibilities of that post will be absorbed into the duties of other officers within the Internal Audit section. Despite the overall reduction in staffing resources, this new appointment is expected to strengthen the delivery of the Annual Audit Plan. Follow Up Reviews 4.6 Internal audit reports are regularly presented to members, detailing not only findings but also management's responses to the recommendations with agreed dates of implementation. Internal Audit will also undertake follow up reviews to Page 86
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evidence the effective implementation of these recommendations. Please see detailed the following completed follow up reviews: Data Protection 4.7 A follow up review was undertaken to evidence the implementation of recommendations from an audit that assessed the Council’s compliance with the Data Protection Act 2018. The audit was originally reported to this Committee on 30 March 2023 (para 9 of the minute refers). It included several recommendations for reviewing and updating policies and guidance, as well as introducing further scrutiny and controls over information management arrangements. The Information Management Service advised that a multi-year timescale was required for implementing some of these recommendations due to the lack of staff resources to meet the ongoing volume of work and other information management compliance requirements, which were significantly greater than initially envisaged. However, for two of these recommendations concerning the need to update the Council’s Data Protection Policy and Guidance, as well as to review the guidance documents and forms within the Information Management section of the Interchange, the service agreed to a revised completion date of 31 March 2025. Unfortunately, it was found at the time of this follow-up review that these two recommendations are still to be completed, with the Service providing a revised implementation date of 31 December 2025. 4.8 Effective information governance and data protection arrangements are essential, as failures may lead to breaches of individuals’ personal data. I do not propose to undertake another follow-up review at this stage; however, I will include another audit of compliance with the Data Protection Legislation in a future Audit Annual Plan. The Service has also confirmed its intention to progress with the implementation of the outstanding recommendations set out in the audit report. 4.9 Emergency Planning This follow-up review assessed the implementation of recommendations from an audit of the Council's and Health and Emergency Planning arrangements. The Civil Contingencies Act 2004 places a legal obligation on emergency services and public organisations to assess risks, plan for, and conduct exercises related to emergencies such as floods, adverse weather, pandemics, or other incidents that could significantly impact the community. The follow-up review found that the majority of recommendations have been implemented, although some remain outstanding. The Follow-Up Report reviewing the implementation of the agreed recommendations is provided in Appendix 1. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal Page 87
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The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with published Public Sector Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report (f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 This report provides committee with an update on internal audit work progressed in the latest review period. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: mijb/ap&rc/ Page 88
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APPENDIX 1 Moray Council Internal Audit Section DEPARTMENT: Economy, Environment & Finance SUBJECT: Emergency Planning REPORT REF: 23'021 Follow Up Audit Review Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.1 The Emergency Planning Policy and Procedures should be updated to reflect current operating arrangements and staffing structures. Medium Yes 31/05/2023 (Revised Implementation Date 30/11/2025) Part Implemented – An updated Emergency Planning Policy & Procedures has been prepared in draft, which is now referenced as a General Emergency Plan. The Plan needs to be reviewed by the Corporate Leadership Team before seeking approval from committee. A revised implementation date of 30/11/2025 has been agreed. 5.2 Regular meetings should be held between the Emergency Planning Medium Yes Implemented Implemented– The follow up review has confirmed that regular meetings are held Page 89
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Moray Council Internal Audit Section 2 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Officer and the Business Continuity and Risk Management Officer to ensure ongoing alignment of emergency and business continuity plans. between the Emergency Planning Officer and the Business Continuity and Risk Management Officer. 5.3 Emergency plans should be updated to reflect current risks, working practices and staffing structures of the Council and partner organisations. After updating the emergency plans, testing should be undertaken to evidence their effectiveness and highlight any areas for further improvement. Medium Medium Yes Yes 31/12/2024 (Revised Implementation Date 30/09/2025) Implemented Part Implemented – A review of emergency plans for services noted that all have been updated, except the Health and Social Care Moray - Care for People Plan. This plan still requires further review by senior management before it is finalised. The Service has provided a revised implementation date of 30/09/2025. It was noted that the Emergency Planning Officer is undertaking ongoing testing to evaluate the effectiveness of the emergency plans and identify areas where further improvements are required. Page 90
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Moray Council Internal Audit Section 3 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.4 Further training and documented guidance should be provided to Moray Emergency Response Co- Ordinators (MERC) to support officers in best practices to follow in the event of an emergency incident. Medium Yes 31/12/2023 Implemented– It was noted that further training has been provided to Moray Emergency Response Co-Ordinators (MERC) by the Emergency Planning Officer. In addition, guidance has been developed for officers to assist in the event of an emergency and is available to officers through the MERC Portal within SharePoint. 5.5 Emergency contact details of the Moray Emergency Response Co- Ordinators (MERC) saved within Sharepoint should be restricted to only officers that require access to this information. Medium Yes 31/07/2023 Implemented- Access privileges to the emergency contact details of Moray Emergency Response Co-Ordinators (MERC) held within SharePoint are now restricted to only authorised officers. 5.6 An Annual Report should be provided to elected members detailing the work undertaken and planned within emergency planning. Medium Yes 31/03/2024 (Revised Implementation Outstanding – Discussions with officers noted that an annual report detailing the work undertaken and planned within the Emergency Planning Service is intended and will thereafter Page 91
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Moray Council Internal Audit Section 4 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Date 30/11/2025) be reported to committee. The Service has detailed a revised implementation date of 30/11/2025. 5.7 A review of the hyperlinks contained within emergency planning webpages should be undertaken to ensure they connect to the intended document or website. Medium Yes 30/08/2023 Implemented – The Emergency Planning Service webpage within the Moray Council website has been updated and also includes the correct web links to partner agency websites and key documents. Page 92
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: INTERNAL AUDIT SECTION COMPLETED PROJECTS REPORT BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 To provide an update on audit work completed since the last meeting of the Committee. 2. RECOMMENDATION 2.1 Committee is asked to consider and note this audit update. 3. BACKGROUND 3.1 Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to prepare and present reports to the committee on internal audit’s activity relative to the audit plan and any other relevant matters. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 In line with the approved internal audit plan, the following reviews were completed: Banking and Reconciliation 4.2 An audit has been undertaken into the Council’s banking and reconciliation arrangements. Each year, the Council receives significant funds through its bank accounts. The Council operates three main bank accounts to manage incoming funds, all of which were reviewed as part of this audit. The audit objective was to ensure that effective and systematic processes are in place for the timely and accurate reconciliation of these accounts. This involved a review of operating procedures, verification and testing of completed reconciliations and an assessment of how suspense transactions are administered when income cannot be immediately identified. Overall, the audit found that the Council has effective banking and reconciliation arrangements in place. However, some Item 8. Page 93
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administrative improvements were identified. The findings and recommendations are detailed in the audit report in Appendix 1. Residential Care 4.3 An audit review of residential care was undertaken. The scope of the audit was to examine the processes for making accurate payments at agreed contract rates to third-party providers for the delivery of permanent residential care for older persons. Testing included verifying that all residents entering a residential care home following a care needs assessment had been financially assessed in accordance with Scottish Government Guidance. A check was also carried out to verify the accuracy of the calculation of assessed contributions toward care costs, as well as the administrative arrangements for processing and paying third-party care providers. 4.4 The audit found that processes and information storage systems within the Community Care Finance Service to administer payments to residential care homes are significantly paper-based. The Service should explore opportunities to digitise its current operating arrangements, which could lead to improved efficiency and stronger administrative controls. The audit also identified significant delays in both requesting the necessary financial assessment information and processing it once received from individuals who have entered a care home. These delays affect cash flow and accounting processes, as payments already made need to be recovered from future payments to care homes. The findings and recommendations are detailed in the audit report in Appendix 2. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with published Public Sector Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications and Mitigation Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report Page 94
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(f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 This report provides Committee with a summary of findings arising from audit project completed during the review period. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: Page 95
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Appendix 1 1 Final Internal Audit Report Banking and Reconciliation July 2025 Distribution: Head of Financial Services Finance Manager Assistant Manager – FMS & Banking The Internal Audit Section provides Management with an opinion on the internal control environment and also categories risk ratings for recommendations as high, medium or low (detailed explanation provided in Appendix1). The audit recommendations for this review have been classified as follows Assurance Level Risk Ratings for Recommendations Full Priority 1 0 Priority 2 0 Priority 3 2 Confidentiality and Disclosure Clause This report (“Report”) was prepared by the Internal Audit Section of Moray Council. The matters raised in this Report are only those which came to our attention during our internal audit work. Whilst every care has been taken to ensure that the information provided in this Report is as accurate as possible, the Moray Council Internal Audit Section has only been able to base findings on the information and documentation provided and consequently, no complete guarantee can be given that this Report is necessarily a comprehensive statement of all the weaknesses that exist, or of all the improvements that may be required. This Report was prepared solely for the use and benefit of the Moray Council, Moray Integration Joint Board or the Grampian Valuation Joint Board. Moray Council's Internal Audit Section accepts no responsibility and disclaims all liability to any third party who purports to use or rely for any reason whatsoever on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification. Accordingly, any reliance placed on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification by any third party is entirely at their own risk. Please refer to the Statement of Responsibility in Appendix 2 of this report for further information about responsibilities, limitations and confidentiality. Page 96
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Appendix 1 2 Contents Page Banking and Reconciliation 1. Introduction & Scope 3 2. Key Issues 3-4 Detailed Report 3. Findings/Recommendations 5-8 4. Management Response 6-9 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 97
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Appendix 1 3 1. Introduction and Audit Scope The 2025/2026 annual audit plan provides for a review to be undertaken of the Council's banking and reconciliation arrangements. Bank reconciliation is the process of matching the balances in an organisation's accounting records to the corresponding information on a bank statement. The aim of a bank reconciliation process is to ascertain the differences between the two and make appropriate adjustments to the accounting records to ensure accurate reflection of transactions and balances. The audit scope was to obtain assurance that an effective and systematic methodology is in place to ensure accurate and timely reconciliations are undertaken of the Council's main bank accounts for the receipt of income. This involved a review of the operating procedures, verification and testing of the reconciliations undertaken and the administration of suspense transactions where income has not been immediately identifiable on receipt. The audit has also involved undertaking a review of the Council's banking arrangements. The Council operates three main bank accounts for administering income received and these have been reviewed during the course of the audit. Focus has also been given to the processes for Funds In Transit collections to ensure that all monies received are identified and remain accounted for at all stages between collection and lodgement into the Council's bank accounts. The Council collects a significant and diverse range of income categories, such as Council Tax and Non-Domestic Rates, Housing Rents, Planning Fees, charges for Waste Services, and also encompasses funding of the Council through grant receipts and revenue support. The audit has involved interrogation of the Council's Financial Management System used for accounting and bank reconciliation purposes and the Capita Income Management System used to provide logs and breakdowns of income received by services. The audit was carried out in accordance with Public Sector Internal Audit Standards (PSIAS). 2. Key Issues • The audit confirmed that monthly bank reconciliation exercises are undertaken for all Council bank accounts. However, it was noted that the certification by management of these monthly reconciliations is not retained beyond 28 days within the SharePoint Workflow System. The certification by management of the monthly bank reconciliation exercises should be retained to ensure evidence of an audit trail is Page 98
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Appendix 1 4 maintained of the scrutiny for a core financial control. • Overall, the audit found that within the scope of the review, effective banking and reconciliation arrangements were in place for all income received. It should be noted that significant funds are collected annually through the Council's bank accounts, e.g., in 2024/25, approximately £225 million in Government funding, £196 million in services fees and charges and £51 million in Council Tax. However, at the time of the audit, 18 entries, totalling £40,900 of income, were found to have remained unallocated to accounting codes within the Financial Management System for over one month, the oldest transaction being 2 months old. To ensure accounting records are accurate and reflect current transactions, income received should be allocated to the appropriate financial code at the earliest opportunity. Page 99
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5 Findings/Recommendations - Banking and Reconciliation 2025/26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 Low When income is received, a unique reference is required to identify the source and post it to the correct customer account, and/or accounting code within the Financial Management System's general ledger. However, instances occur where income received into the Council's bank accounts either does not have any source reference, the reference quoted is invalid, or the income represents a miscellaneous receipt, such as a payment received that is not associated with a particular invoice. In these circumstances, an unreconciled item is created within the bank reconciliation process, as the amount will be reflected in the Council's bank account as received but cannot be correspondingly recorded within the Council's financial accounts until a manual identification is made, which allows posting to the correct customer account and / or accounting code. Additionally, identifying breakdowns should be provided by services for Funds In Transit which are accounted for at point of collection, before lodgement into the Council's bank account. The Unallocated income must be identified in a timely manner to allow accurate financial recording within the Council's general ledger. Services should be reminded of the need to provide income detail on a prompt basis. Any receipts not able to be identified within a reasonable timescale should be returned to the bank to progress to a conclusion. Page 100
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6 non-provision of this information also creates an unreconciled item which cannot be recorded within the Council's financial accounts. Overall, from the audit testing undertaken of the bank account reconciliation processes, effective management arrangements were found, where significant funds are identified and reviewed promptly to ensure that monies received are accounted for and allocated correctly to the appropriate accounting code within FMS. However, at the time of the audit, 18 entries, totalling £40,900 of income, were found to have remained unallocated within the FMS for over one month, the oldest transaction being 2 months old. For accurate and timely recording of income in the Council's accounting records, it is important that the source of the monies received is identified at the earliest opportunity. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Manager – FMS & Banking Yes 31/08/2025 All income will be allocated within 1 month of receipt which will allow ample time for identification. Any income remaining Page 101
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7 unidentified after 1 month will be returned to the originating source by the Council's Bank. Page 102
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8 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Low The Council operates three main bank accounts for the administration of income received and these have been reviewed as part of this audit. On a daily basis, reconciling tasks are being undertaken by the Banking Team within the bank reconciliation module of FMS to ensure funds received are appropriately allocated and accounted for. Every month, a full formal reconciliation of each bank account is undertaken and is checked and approved by the Assistant Manager - FMS & Banking, within the SharePoint Workflow system. Audit testing noted that the evidence of authorisation within the SharePoint Workflow system is deleted after 28 days. An improvement to the process is required to ensure that evidence of all bank reconciliation checking and approval by service management is retained for reference purposes. Monthly bank account reconciliations should be signed and dated to retain evidence of the checks and approval undertaken by management of a core financial control. Page 103
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9 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Manager – FMS & Banking Yes 31/08/2025 All bank reconciliations will continue to go through the SharePoint Workflow system. In addition, the approving manager will add their signature and date to the file to preserve the evidence of authorisation when the file moves to the SharePoint records site. Page 104
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10 Appendix 1 AUDIT TERMS OF REFERENCE AND DEFINITIONS 1. Audit Objectives 1.1 The overall audit objective is to provide an objective independent opinion on the adequacy and effectiveness of controls / processes. 1.2 The audit will for each controls / process being considered: • Walkthrough the processes to consider the key controls; • Conduct sample testing of the identified key controls, and • Report on these accordingly 1.3 All audit reviews are carried out in accordance with Public Sector Internal Audit Standards (PSIAS). 2. Definitions for Auditing Opinions and Findings 2.1 In order to assist management in using our reports: The Internal Auditor will categorise audit assurance opinion according to their overall assessment of the risk management system, effectiveness of the controls in place and the level of compliance with these controls and the action being taken to remedy significant findings or weaknesses. Assurance Level System and Testing Conclusion Full The controls tested are being consistently applied Substantial There is evidence that the level of non compliance with some of the controls may put some of the system objectives at risk. Limited The level of non compliance puts the system objectives at risk. None Significant non-compliance with basic controls leaves the system open to error or abuse. 2.2 Risk ratings for each recommendation is based on the following criteria: High Fundamental control weaknesses that require immediate attention by management to action and mitigate significant exposure to risk Medium Less critically important controls absent, not being operated as designed or could be improved Low Lower level controls absent, not being operated as designed or could be improved. Page 105
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11 Appendix 2 STATEMENT OF RESPONSIBILITY The responsibility for designing and maintaining a sound system of internal control to prevent and detect fraud and other irregularities rests with management, with internal audit providing a service to management to support them to achieve this objective. The Internal Audit Section will assess the adequacy and effectiveness of the system of internal control arrangements implemented by management and perform sample testing on those controls in the period under review with a view to providing an opinion on the extent to which risks in this area are managed. The Internal Audit Section will undertake testing with the objective of detecting significant control weaknesses. However, the audit approach alone should not be relied upon to identify all strengths and weaknesses in internal controls nor to find any fraud or irregularity. Even sound systems of internal control can only provide reasonable and not absolute assurance and may not be proof against collusive fraud. The matters raised in this report are only those that came to our attention during the course of the audit review and are not necessarily a comprehensive statement of all the weaknesses that exist or all improvements that might be made. Recommendations for improvements should be assessed by management for their full impact before they are implemented. The performance of the audit review undertaken should not be taken as a substitute for management’s responsibilities for the application of sound management practices. This report must not be disclosed to any third party or reproduced in whole or in part without the written consent of the Moray Council’s Audit and Risk Manager. Page 106
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Appendix 2 1 Final Internal Audit Report Residential Care August 2025 Distribution: Chief Financial Officer (Moray IJB & Dr Grays) Head of Service Interim Finance Manager The Internal Audit Section provides Management with an opinion on the internal control environment and also categories risk ratings for recommendations as high, medium or low (detailed explanation provided in Appendix1). The audit recommendations for this review have been classified as follows Assurance Level Risk Ratings for Recommendations Substantial Priority 1 0 Priority 2 4 Priority 3 3 Confidentiality and Disclosure Clause This report (“Report”) was prepared by the Internal Audit Section of Moray Council. The matters raised in this Report are only those which came to our attention during our internal audit work. Whilst every care has been taken to ensure that the information provided in this Report is as accurate as possible, the Moray Council Internal Audit Section has only been able to base findings on the information and documentation provided and consequently, no complete guarantee can be given that this Report is necessarily a comprehensive statement of all the weaknesses that exist, or of all the improvements that may be required. This Report was prepared solely for the use and benefit of the Moray Council, Moray Integration Joint Board or the Grampian Valuation Joint Board. Moray Council's Internal Audit Section accepts no responsibility and disclaims all liability to any third party who purports to use or rely for any reason whatsoever on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification. Accordingly, any reliance placed on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification by any third party is entirely at their own risk. Please refer to the Statement of Responsibility in Appendix 2 of this report for further information about responsibilities, limitations and confidentiality. Page 107
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Appendix 2 2 Contents Page Residential Care 1. Introduction & Scope 3-4 2. Key Issues 4 Detailed Report 3. Findings/Recommendations 5-18 4. Management Response 6-19 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 108
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Appendix 2 3 1. Introduction and Audit Scope The 2024/25 annual audit plan includes a review of the procedures and administrative arrangements involving third-party suppliers appointed to provide residential care home services. Last year's gross expenditure budget for permanent residential care for older persons was £12.6 million. Monitoring actual expenditure against this budget is undertaken and reported regularly to the Moray Integration Joint Board. At the time of this audit review, an overspend of £1.8 million was noted for 2024/25. The Service has indicated this is due to an increased number of individuals requiring nursing care, which is charged at a higher rate than residential care. A care needs assessment from Health and Social Care Services is required before an individual enters a care home. This assessment determines the type and level of care an individual requires, ensuring the home can provide the necessary support. A financial assessment is then undertaken to evaluate an individual's income, savings and capital to determine how much they can afford to contribute towards their care. The review noted that at the time of the audit, there were 470 supported individuals in permanent residential care. However, these numbers can vary throughout the year. Funding arrangements are in place with 52 individual care home, 14 of which are located within Moray and provide care to 91% of all residents. The National Care Home Contract (NCHC) sets the standard rates for residential and nursing care payable for publicly funded placements in Scotland. For 2024/2025, the standard rate for residential care is £825.94 per week. The standard rate for nursing care is £957.57 per week, which includes the additional costs associated with nursing services, ensuring that residents receive the necessary medical care and support. The amount payable by an individual entering a care home is determined through a financial assessment and a means- tested calculation, which will result in a contribution towards the cost of their care. However, if an individual has capital exceeding £35,000, they are considered a self-funding resident. In such cases, the contract for their care is arranged directly between the individual and the care home. The audit scope was to review the processes for making accurate payments to third-party providers for permanent residential care delivery at agreed contract rates. The audit also involved testing to ensure that all eligible residents are financially assessed in accordance with the Charging for Residential Accommodation Guidance (CRAG) issued by Scottish Government and that assessed contributions towards care costs are appropriately applied. The audit focused on permanent residential care for older persons in the care sector. An audit of social care financial assessments for other care sector groups, non-residential services and temporary residential care has been included as a separate audit project within the 2025/26 Internal Audit Plan. Page 109
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Appendix 2 4 The audit was carried out in accordance with Public Sector Internal Audit Standards (PSIAS). 2. Key Issues • The audit found that the systems used by the Community Care Finance Service to administer the residential care home service are significantly paper-based. Concerns were noted during the review regarding the storage arrangements of resident files, which were further exacerbated by home working arrangements. Consideration should be given to exploring opportunities for digitising processes to improve administrative efficiency and data protection management. • A care needs assessment is required before an individual enters a care home. When a care home is considered the most appropriate care option, a financial assessment is then required to determine how much the individual should contribute towards the cost of their care. Audit testing identified significant delays both in requesting the necessary financial assessment information from individuals and in processing the information once received. However, no concerns were noted regarding the accuracy of the financial assessments undertaken. • When a new resident enters a care home, standard residential or nursing care rates are paid for publicly funded placements. These rates apply until the resident's income, savings and capital are assessed to determine their financial contribution towards the cost of their care. However, it was noted that there is no early identification of individuals who may be "self-funders", A self-funder is someone who pays the full cost of their care, as they declare that their income, savings or assets typically exceed the financial threshold and a financial assessment is not required to be undertaken by Community Care Finance. In such cases, the amounts overpaid are recovered from the care homes. Early identification of self-funders would eliminate this requirement and improve cash flow and the financial accounting processes. Page 110
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5 Findings/Recommendations - Residential Care 2024/25 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 Low Contributions required from individuals towards the cost of their residential care are based on the Charging for Residential Accommodation Guidance (CRAG), issued annually by the Scottish Government. This guidance ensures a nationally consistent approach to the charging criteria for residents in residential care homes. However, the audit review found that the information regarding the financial process for contributing to the cost of residential care, as detailed on the Council's website, is dated 2011 and is not the most current version of information available within the Service. It is understood that Service is developing guidance content which will need to be reflected on both the Moray Council and Health and Social Care Moray websites. Information made available online about residential care and contribution implications should be reviewed and updated to ensure clear guidance is available to members of the public. Page 111
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6 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 30/09/2025 Moray Council and Health and Social Care Moray websites will be updated to reflect CRAG content on an annual basis. Page 112
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7 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Medium A standardised financial assessment form is used to record the information required under Charging for Residential Accommodation Guidance (CRAG) to calculate the contribution a resident must make toward the cost of their residential care. At the time of the audit, the Service was in the process of revising this form. It was noted that the current financial assessment form, along with the supporting information provided in communications with the resident or their representative, is not digitised. The process remains manually intensive in terms of information handling. A modernised approach to engagement is required, offering the potential for administrative savings and improved ease of use for stakeholders. Consideration should be taken to modernise and improve the financial assessment process by digitising the request and submission of assessment information. Page 113
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8 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 31/03/2027 The current Financial Assessment Form has been reviewed and updated to facilitate the easier capture and processing of information. However, the digitisation of the process is linked to the implementation of the replacement of the CareFirst system. Page 114
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9 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 3 Medium As noted in Finding 2, financial assessments and their associated supporting information are not currently available in electronic format. As part of the audit review, access to residents' files was required to test and verify the accuracy of the financial assessments undertaken. However, it was found that there is no organised filing system for identifying the records held and their locations. There is also no dedicated or organised filing space specifically for Community Care Finance. Instead, files are stored securely in a room alongside other social work files in boxes but not in alphabetical order. Files actively being worked on by officers may be located in the Community Care Finance office or at officer's homes due to homeworking practices. However, there is no log maintained of files removed by staff. All files requested for audit sampling were located, either in the storage room, Community Care Finance office, or at officers' homes and were made available to Internal Audit over a period of time. The lack of a system for documenting records held/extracted is not conducive to easy access A filing system should be implemented to ensure that all financial assessments and related records are secure, easily identifiable, and can be located at all times. As detailed in Recommendation 2, further exploration into the digitisation of the information held should be undertaken. Additionally, due to homeworking arrangements and the storage of files at officers homes, a record log detailing the location of these files should also be maintained. All officers should also be reminded of the importance of good data protection arrangements in the storage of information within their own homes. Page 115
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10 or the proper control of supported person's records. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 31/08/2025 An online filing system is to be implemented to eliminate need for manual storage and handling. The Mailroom Service has agreed to scan all backlog records and a new process is in place for scanning new files. Page 116
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11 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 4 Medium A care needs assessment is required before an individual enters a care home. This assessment is usually undertaken by a community care officer or social worker to determine the level of care and support needed. If a care home is considered the most appropriate care option, a financial assessment is then required to determine how much an individual should contribute towards the cost of their care. This assessment considers income, savings and capital to decide whether and how much financial assistance can be provided. The National Care Home Contract (NCHC) standard or nursing rate is paid gross to the care home for a resident until the financial contribution has been determined. Any subsequent overpayment, calculated from the financial assessment, is recovered from future payments made to the care home. The audit undertook a review of the financial assessment process for individuals entering a care home. From a random sample of 20 cases, 8 were identified where there were delays by the Community Care Finance Service, taking The operational demands within the Community Care Finance Service are appreciated. However, as already detailed within this report, the implementation of greater digitisation of processes and storage of information will deliver improved efficiencies. Consideration should also be given to reviewing the roles and responsibilities of officers, which may also highlight where changes in current working practices will deliver improved service performance. In addition, the development of comprehensive performance information to support improved monitoring of service delivery should be undertaken. Page 117
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12 between 5 weeks and 3 months to request information from a resident to be used in the financial assessment to determine an individual's financial contribution towards their care home costs. As care home rates are paid gross to the providers until a resident's financial contribution is determined, this may result in the need to recover significant sums from future payments. It is appreciated that further delays can occur due to the time taken for a resident to provide the information required to undertake a financial assessment. However, it was noted that significant delays were still observed in carrying out financial assessments after the requested information had been received. The audit reviewed a sample of 20 financial assessments and found 7 cases where delays ranging from 4 weeks to 3 months occurred in completing the evaluation. These duties are undertaken by only one officer, and at the time of the audit, 363 referrals for financial assessments had been undertaken in the 11 months of 2024/25. It is also acknowledged that the complexity and level of input required can vary significantly when determining an individual's financial contribution towards their care home costs. Page 118
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13 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 31/03/2027 The digitisation of the financial assessment process will be part of the Carefirst replacement system. In the interim, the financial assessment process has been divided into different administrative roles, and written procedures have been completed. This should help improve the flow of information and reduce timescales for financial assessment completion. Page 119
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14 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 5 Medium A "self-funder" is someone who pays for their care home fees from their own resources. This typically applies when an individual entering a care home has capital in excess of £35,000 (for 2024/25). The self-funder pays their care fees directly to the care home, and the Council is only be liable to pay the free personal care rate as stipulated by the Scottish Government. There is no requirement for a full financial assessment of a self-funder, only a declaration is required as part of the application for the free personal care payment. As detailed in Finding 4, delays were noted within the Community Care Finance Service in undertaking financial assessments to determine the financial contribution required when an individual enters a care home. The audit noted that even for self-funders, payments are being made to care homes at the gross rate. Once the financial assessment is completed and the individual is confirmed as a self-funder, the overpaid expenditure is recovered from the care home. Consideration should be given to refining the assessment processes for individuals entering a care home, to enable the early identification of potential self-funders and ensure that appropriate accounting arrangements are applied from the outset. Page 120
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15 Management Response Responsible Officers Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Head of Service / Interim Finance Manager Yes 30/09/2025 Discussions have been held with Head of Service to ensure Social Workers resume this activity and issue appropriate documentation to enable self-funder identification and processing at the earliest opportunity. Page 121
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16 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 6 Low The scope of this audit included a review to verify the accuracy of the 4 weekly payments made to care homes. It was noted that, as part of the verification process, a paper record is maintained for each resident in each care home, detailing the 4 weekly payments to be made. This record is updated and cross- checked against information in the social work and social care case management system (CareFirst) producing the payment batches, to confirm accuracy. In addition, the paper record is used to calculate any payment adjustments required due to changes in a resident's circumstances. These paper payment records are held individually by the officers responsible for specific care homes. As these officers work from home, the records are not digitised or centrally stored, which limits accessibility for other officers in the event of a query or when further scrutiny is required. The payment records maintained for each resident within a care home should be digitised to improve accessibility and ensure they are readily available to management and other officers within the service. Page 122
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17 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 31/03/2026 System for moving payment records online is underway. A care home is being trialled and there will then be a roll out to the rest of the care homes. Page 123
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18 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 7 Low Payments are made to care home providers on a four-weekly basis and are accompanied by a remittance report that provides a breakdown of the residents at each home. In addition, care homes are contractually required to notify the Social Care Service of any changes in residents' circumstances that may affect ongoing payments. However, it was noted that the Community Care Finance Service also issues a separate payment schedule fortnightly to each care home. The schedule lists the residents and the rates to be paid to each care home. Care homes are expected to confirm the accuracy of this schedule and return the completed form to the Community Care Finance Service. The audit found a low return rate of these forms from care home providers, and non-submissions are not followed up. Discussions with the Service indicated that the requirement for this fortnightly schedule is historical and likely dates back to a previous payment arrangement with care homes. Consideration should be given to whether there is an ongoing need to send the fortnightly estimated payment schedules to all care homes. Page 124
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19 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Interim Finance Manager Yes 31/08/2025 Schedules have been confirmed as a historic practice no longer required given care home contractual requirements and resident details provided to homes on payments made. Practice to be ceased. Page 125
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20 Appendix 1 AUDIT TERMS OF REFERENCE AND DEFINITIONS 1. Audit Objectives 1.1 The overall audit objective is to provide an objective independent opinion on the adequacy and effectiveness of controls / processes. 1.2 The audit will for each controls / process being considered: • Walkthrough the processes to consider the key controls; • Conduct sample testing of the identified key controls, and • Report on these accordingly 1.3 All audit reviews are carried out in accordance with Public Sector Internal Audit Standards (PSIAS). 2. Definitions for Auditing Opinions and Findings 2.1 In order to assist management in using our reports: The Internal Auditor will categorise audit assurance opinion according to their overall assessment of the risk management system, effectiveness of the controls in place and the level of compliance with these controls and the action being taken to remedy significant findings or weaknesses. Assurance Level System and Testing Conclusion Full The controls tested are being consistently applied Substantial There is evidence that the level of non compliance with some of the controls may put some of the system objectives at risk. Limited The level of non compliance puts the system objectives at risk. None Significant non-compliance with basic controls leaves the system open to error or abuse. 2.2 Risk ratings for each recommendation is based on the following criteria: High Fundamental control weaknesses that require immediate attention by management to action and mitigate significant exposure to risk Medium Less critically important controls absent, not being operated as designed or could be improved Low Lower level controls absent, not being operated as designed or could be improved. Page 126
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21 Appendix 2 STATEMENT OF RESPONSIBILITY The responsibility for designing and maintaining a sound system of internal control to prevent and detect fraud and other irregularities rests with management, with internal audit providing a service to management to support them to achieve this objective. The Internal Audit Section will assess the adequacy and effectiveness of the system of internal control arrangements implemented by management and perform sample testing on those controls in the period under review with a view to providing an opinion on the extent to which risks in this area are managed. The Internal Audit Section will undertake testing with the objective of detecting significant control weaknesses. However, the audit approach alone should not be relied upon to identify all strengths and weaknesses in internal controls nor to find any fraud or irregularity. Even sound systems of internal control can only provide reasonable and not absolute assurance and may not be proof against collusive fraud. The matters raised in this report are only those that came to our attention during the course of the audit review and are not necessarily a comprehensive statement of all the weaknesses that exist or all improvements that might be made. Recommendations for improvements should be assessed by management for their full impact before they are implemented. The performance of the audit review undertaken should not be taken as a substitute for management’s responsibilities for the application of sound management practices. This report must not be disclosed to any third party or reproduced in whole or in part without the written consent of the Moray Council’s Audit and Risk Manager. Page 127
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: UPDATE ON THE DELIVERY OF THE UNPAID CARERS STRATEGY BY: SERVICE MANAGER PROVIDER SERVICES 1. REASON FOR REPORT 1.1 This report provides an update to Committee on the progress made in implementing the Moray Carers Strategy, with particular emphasis on key activities and developments over the reporting period. 1.2 The purpose of this report is to inform the Committee of the work undertaken to date in delivering on the objectives outlined within the Strategy and to highlight ongoing actions and outcomes. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) note the progress made to date in delivering the objectives set out in the Carers Strategy; and ii) instruct the Lead Officer for Unpaid Carers to provide quarterly progress reports to this Committee to support ongoing monitoring and scrutiny of the strategy implementation. 3. BACKGROUND 3.1 Unpaid carers are integral to the delivery of health and social care in Moray, providing essential support to individuals who are unable to manage without assistance. It is estimated that around 16,200 individuals in Moray are undertaking some form of unpaid caring role for a partner, family member, friend, or neighbour. 3.2 The local Carers strategy, aligned with the national vision of Valuing, Recognising and Supporting Carers was launched on 1 April 2023. A two-year extension to the Item 9. Page 129
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current strategy was approved by the Moray Integration Joint Board (MIJB) on 19 June 2025 (para 9 of the minute refers). 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 A significant development has been the change in the service delivery model following amendments to the contract specification with Quarriers, the commissioned carers service. Health and Social Care Moray (HSCM) now undertake the full carer assessments for both adult and young carers. This shift has enabled Quarriers to focus on early intervention and prevention, moving beyond the reliance on Adult Carer Support Plans (ACSPs) and Young Carer Statements (YCSs) as the main identifiers of support need and initiators of support itself. As a result, carers have reported improved access to support, with faster response times and a broader range of resources available following initial contact. Carers have reported feeling more valued and supported in line with our strategic outcomes as a result. 4.2 A revised ACSP has been developed, consulted upon, and implemented. Stakeholder engagement included representatives from HSCM, Quarriers, Social Work, and unpaid carers. The new format promotes a strength and assets based approach, facilitating early intervention and self-management through a conversational and empowering framework. Feedback from carers has been overwhelmingly positive with many expressing that their voices are being heard and recognised and feelings of empowerment. 4.3 Work is now underway to redesign the Young Carer Statement. The redesign of the YCS will ensure a more person-centred approach, aligned with the ACSP, with a clear focus on early help, building supportive relationships and recognising strengths and assets. By placing young carers’ voice at the heart of the process, the revised statements will support timely intervention, reduce risks of crisis, and promote wellbeing. To reflect different stages of development, at least two forms will be developed: one for primary-aged young carers, using accessible language, and one for secondary-aged young carers, allowing greater depth and future planning. This will provide a flexible, empowering tool that support young carers’ needs and aspirations. 4.4 Quarriers have introduced new peer support initiatives, including ‘Own Your Hours’ sessions in Buckie and Speyside. Based on participation feedback, these are being replaced by ‘Blether and a Brew’ sessions to be held at different locations across Moray between October 2025 and March 2026. These informal drop-in sessions, led by the Family Wellbeing Workers, provide peer support and core information for carers. The sessions will cover themed topics such as emergency planning and access to short breaks, and will also aim to engage specific carer groups, including male carers and carers supporting someone in residential or nursing care. 4.5 In collaboration with Age Scotland, Quarriers will deliver two Dementia Awareness workshops in Buckie and Forres during October. The Forres session will complement a broader community event focussed on recognising and supporting carers. Building on positive feedback from previous years, the service has Page 130
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scheduled workshops for carers supporting individuals with autism or dementia. Twenty four carers participated in the Autism Reality Experience in September, which simulated what it feels like to live with autism. These sessions enhanced participants’ understanding of how-to better support those they care for in various situations. A Virtual Dementia Tour is planned for later in the year, offering 24 carers the opportunity to experience the challenges faced by individuals living with dementia. Further dementia-related training will include: • Dementia Interpreter Workshop (October): Focussed on improving communication skills and confidence when interacting with people who have dementia • Dementia DIET Session (November): Exploring the impact of food choices, preparation, and presentation on the wellbeing of people with dementia. 4.6 Quarriers will deliver a programme of wellbeing workshops for adult carers between October and March. These sessions will offer carers opportunities to engage in a range of well-being activities within their local communities. The programme will be promoted widely through: • Quarriers’ newsletter and e-news (distributed to both carers and professionals). • Direct outreach to carers most likely to benefit, and • Local advertising ahead of each session. 4.7 Quarriers facilitated a summer programme of activities for young carers in partnership with local providers. A highlight was enabling a small group of young carers to attend the Scottish Young Carers Festival in Dunfermline. The summer programme included: • A visit to the Highland Wildlife Park for very young carers. • Activity days with Wild Things, including a dedicated session for those transitioning to secondary school. • Four outdoor adventure days with Outfit Moray, and • An art workshop designed to help young carers reflect on how their caring role impacts their lives. 4.8 The Service will repeat the successful Hopscotch residential week in November, offering 12 primary-aged young carers the chance to participate in outdoor challenges and enjoy time away from their caring responsibilities in a group setting. In addition, Quarriers will continue working with the Young Carers Strategy Officer to: • Expand opportunities for peer support within schools, and • Develop and deliver skills-based group sessions tailored to young carers’ needs, such as resilience- building and emergency planning. 4.9 The Carers Team are developing a comprehensive suite of training materials to raise awareness of the needs and experiences of both adult and young carers. This will complement the existing TURAS training by providing tailored resources for health and social care professionals, ensuring they are equipped with the knowledge and skills to identify carers early, respond appropriately, and provide support as required. Page 131
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4.10 Quarriers have re-established the Carers Voice Group, with the most recent session held on 17 September 2025. This group provides a vital forum for ensuring that lived experience directly shapes local developments, offering a space for two-way communication between carers and professionals. The group will be influential in wider service improvements, ensuring that carers’ perspectives remain central to the design and delivery of support. 4.11 The Carers Lead remains actively engaged with the national networks to keep abreast of developments in the Care Reform Bill, with a particular focus on the proposed legislation strengthening carers’ rights to a break. The Bill places a greater emphasis on local authorities’ duty to provide meaningful respite, recognising its importance in supporting carers’ health and wellbeing, and ability to sustain their role. In line with this Quarriers are leading on the development of a Short Breaks Bureau supported by the Carers Team and Day Opportunities Team at HSCM. This work will link in with external funding already accessed by Quarriers from Shared Care Scotland and the Time to Live grants. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Carers who are supported to carry out their role in a way that supports their own health and wellbeing and their educational and economic potential, are key to achieving the ambitions of the Moray IJB Strategy Plan, the Corporate Plan and LOIP. The strategy will support HSCM to demonstrate impact on Outcome 6 of the National Health and Wellbeing Outcomes. Involving unpaid carers, the person they care for, and workers from health and social care services work together as partners they increase the chances of better outcomes for all involved, this aligns with Realistic Medicine, putting people at the centre of decision about care and support, alongside the key priorities highlighted through the work of Equal Partners in Care (EPiC). (b) Policy and Legal Having a local carer strategy in place meets the legal obligation on the Moray IJB as prescribed in the Carers (Scotland) Act 2016. It also supports carers right to: • Access a local information and advice service. • Be included in the hospital discharge of the person they are caring for. • Request and Adult Carer Support Plan (if over the age of 18) or a Young Carer Statement (if under aged 18 or younger) • Access Support if they have eligible needs. • Be consulted on services for them and the person they are caring for. (c) Financial implications Page 132
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Annual Carer Act funding is in place to support delivery of the strategy. The actions outlined within the Strategy and Action Plan, including the commissioning of the local information and advice service, require to be delivered within the existing resource envelope and through additional, applied for, funding streams where available. (d) Risk Implications and Mitigation The provisions of the Act are considered to contribute to overall risk management across the responsibilities of the health and social care partnership. Demand for support is likely to increase significantly as more people are identified as carers. A local eligibility criterion is in place to determine whether a carer should receive formal support. (e) Staffing Implications The strategy will be delivered by the workforce in partnership with unpaid carers, the public, third and independent sectors, and the wider community. (f) Property None arising directly from this report. (g) Equalities/Socio Economic Impact Carers are more likely to experience inequality of outcome and more likely to be in poor health than people who do not undertake a caring role. The strategy aims to enhance equality of opportunity for all carers. (h) Climate Change and Biodiversity Impacts None arising directly from this report. (i) Directions No Direction required. (j) Consultations Consultations have taken place with Assistant SDS & Carers Officer, Service Manager Provider Services, Service Manger Quarriers Carer Support Service, Carers Strategy Oversight Group, Operational Management Team (OMT). 6. CONCLUSION 6.1 The paper outlines key updates in the strategy and highlights the ongoing work and developments that will contribute to improved support and recognition for unpaid carers in Moray. Author of Report: Michelle Fleming, Self-Directed Support & Unpaid Carers Team Manager (SDS & Carers Lead Officer) Background Papers: Page 133
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REPORT TO: AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: EXTERNAL AUDITORS’ REPORT TO THOSE CHARGED WITH GOVERNANCE BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To request the Moray Integration Joint Board (MIJB) consider the reports to those charged with governance from the Board’s External Auditor for the year ended 31 March 2025. 2. RECOMMENDATION 2.1 It is recommended that the Board considers and notes the reports from the External Auditor within APPENDICES 1 and 2 and recommends approval to the MIJB. 3. BACKGROUND 3.1 The responsibilities of Audit Scotland as the independent auditor are established by the Local Government (Scotland) Act 1973, the code of Audit Practice (2021), which can be found at Code of Audit Practice and supplementary guidance, and are supported by the auditing profession’s ethical guidance. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The work carried out by Grant Thornton during 2024/25 has produced two reports that are subject to the consideration of those charged with governance. The reports are attached as follows: • Independent Auditors Report to those charged with governance (APPENDIX 1) • The Annual Audit Report 2024/25 (APPENDIX 2) 4.2 The audit opinions expressed were all unqualified and are reported within the ‘independent auditors report’ included within APPENDIX 1. Item 10. Page 135
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4.3 The Annual Audit Report included at APPENDIX 2 provides an Action Plan where recommendations for improvement are made, based on the findings of the review. These recommendations have been discussed with management and corresponding actions have been agreed, together with timescales for completion. 4.4 The Annual Audit Report provides a summary of the significant audit risks identified during planning. The results and conclusions of this work are noted within the report. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The work of the external auditor and the production of these reports for those charged with governance have been completed within the specified timescales agreed. (b) Policy and Legal The Public Bodies (Joint Working ) (Scotland) Act 2014 requires that the Moray Integration Joint Board (MIJB) is subject to the audit and accounts provisions of a body under Section 106 of the Local Government (Scotland) Act 1973. (c) Financial implications There are no direct financial implications arising from this report. (d) Risk Implications and Mitigation The external auditor, Grant Thornton, through the audit process, provides assurance to the Board that the Annual Accounts for 2024/25 give a true and fair view of the financial position. The Annual Audit Report highlights risks identified during the audit process and recommendations for action that have been agreed by management. (e) Staffing Implications None arising directly from this report. (f) Property None arising directly from this report (g) Equalities/Socio Economic Impact None arising directly from this report as there has been no resultant policy change. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy. Page 136
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(i) Directions None arising directly from this report (j) Consultations Consultation has taken place between Grant Thornton and the Chief Financial Officer of the MIJB in preparation of the Annual Audit Report. Any comments received have been considered in writing this report. 6. CONCLUSION 6.1 The External Auditor has issued an unqualified opinion for the 2024/25 Annual Accounts. The Annual Audit Report, Independent Auditors’ Report and the Letter of Representation present the full findings. Author of Report: Deborah O’Shea, Chief Financial Officer Background Papers: with author Ref: Page 137
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APPENDIX 1 Independent auditor’s report to the members of Moray Integration Joint Board and the Accounts Commission Reporting on the audit of the financial statements Opinion on financial statements We certify that we have audited the financial statements in the annual accounts of Moray Integration Joint Board for the year ended 31 March 2025 under Part VII of the Local Government (Scotland) Act 1973. The financial statements comprise the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, Balance Sheet and notes to the financial statements, including material accounting policy information. The financial reporting framework that has been applied in their preparation is applicable law and UK adopted international accounting standards, as interpreted and adapted by the Code of Practice on Local Authority Accounting in the United Kingdom 2024/25 (the 2024/25 Code). In our opinion the accompanying financial statements: • give a true and fair view of the state of affairs of the Board as at 31 March 2025 and of its income and expenditure for the year then ended; • have been properly prepared in accordance with UK adopted international accounting standards, as interpreted and adapted by the 2024/25 Code; and • have been prepared in accordance with the requirements of the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003. Basis for opinion We conducted our audit in accordance with applicable law and International Standards on Auditing (UK) (ISAs (UK)), as required by the Code of Audit Practice approved by the Accounts Commission for Scotland. Our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We were appointed by the Accounts Commission on 18 May 2022. Our period of appointment is five years, covering 2022/23 to 2026/27. We are independent of the Board in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance Page 138
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APPENDIX 1 with these requirements. Non-audit services prohibited by the Ethical Standard were not provided to the Board. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Conclusions relating to going concern basis of accounting We have concluded that the use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Board’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from when the financial statements are authorised for issue. These conclusions are not intended to, nor do they, provide assurance on the Board’s current or future financial sustainability. However, we report on the Board’s arrangements for financial sustainability in a separate Annual Audit Report available from the Audit Scotland website. Risks of material misstatement We report in our Annual Audit Report the most significant assessed risks of material misstatement that we identified and our judgements thereon. Responsibilities of the Chief Financial Officer and Moray Integration Joint Board for the financial statements As explained more fully in the Statement of Responsibilities, the Chief Financial Officer is responsible for the preparation of financial statements that give a true and fair view in accordance with the financial reporting framework, and for such internal control as the Chief Financial Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Chief Financial Officer is responsible for assessing the Board’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless there is an intention to discontinue the Board’s operations. The Moray Integration Joint Board is responsible for overseeing the financial reporting process. Page 139
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APPENDIX 1 Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities outlined above to detect material misstatements in respect of irregularities, including fraud. Procedures include: • using our understanding of the local government sector to identify that the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003 are significant in the context of the Board; • inquiring of the Chief Financial Officer as to other laws or regulations that may be expected to have a fundamental effect on the operations of the Board; • inquiring of the Chief Financial Officer concerning the Board’s policies and procedures regarding compliance with the applicable legal and regulatory framework; • discussions among our audit team on the susceptibility of the financial statements to material misstatement, including how fraud might occur; and • considering whether the audit team collectively has the appropriate competence and capabilities to identify or recognise non-compliance with laws and regulations. The extent to which our procedures are capable of detecting irregularities, including fraud, is affected by the inherent difficulty in detecting irregularities, the effectiveness of the Board’s controls, and the nature, timing and extent of the audit procedures performed. Page 140
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APPENDIX 1 Irregularities that result from fraud are inherently more difficult to detect than irregularities that result from error as fraud may involve collusion, intentional omissions, misrepresentations, or the override of internal control. The capability of the audit to detect fraud and other irregularities depends on factors such as the skilfulness of the perpetrator, the frequency and extent of manipulation, the degree of collusion involved, the relative size of individual amounts manipulated, and the seniority of those individuals involved. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report. Reporting on other requirements Opinion prescribed by the Accounts Commission on the audited parts of the Remuneration Report We have audited the parts of the Remuneration Report described as audited. In our opinion, the audited parts of the Remuneration Report have been properly prepared in accordance with The Local Authority Accounts (Scotland) Regulations 2014. Other information The Chief Financial Officer is responsible for the other information in the annual accounts. The other information comprises the Management Commentary, Annual Governance Statement, Statement of Responsibilities and the unaudited part of the Remuneration Report. Our responsibility is to read all the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon except on the Management Commentary and Annual Governance Statement to the extent Page 141
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APPENDIX 1 explicitly stated in the following opinions prescribed by the Accounts Commission. Opinions prescribed by the Accounts Commission on the Management Commentary and Annual Governance Statement In our opinion, based on the work undertaken in the course of the audit: • the information given in the Management Commentary for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with statutory guidance issued under the Local Government in Scotland Act 2003; and • the information given in the Annual Governance Statement for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with the Delivering Good Governance in Local Government: Framework (2016). Matters on which we are required to report by exception We are required by the Accounts Commission to report to you if, in our opinion: • adequate accounting records have not been kept; or • the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or • we have not received all the information and explanations we require for our audit. We have nothing to report in respect of these matters. Conclusions on wider scope responsibilities In addition to our responsibilities for the annual accounts, our conclusions on the wider scope responsibilities specified in the Code of Audit Practice, including those in respect of Best Value, are set out in our Annual Audit Report. Use of our report This report is made solely to the parties to whom it is addressed in accordance with Part VII of the Local Government (Scotland) Act 1973 and for no other purpose. In accordance with paragraph 108 of the Code of Audit Practice, we do Page 142
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APPENDIX 1 not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Angela Pieri, (for and on behalf of Grant Thornton UK LLP), 120 Bothwell Street, Glasgow, G2 7JS Date: Page 143
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Moray Integration Joint Board Annual Audit Report Financial year ending 31 March 2025 17 October 2025 Prepared for those Charged with Governance and the Controller of Audit Page 144
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow GUIDANCE NOTES: Table of contents does not update automatically • Please delete or factor in any instruction slides at the start of the deck before pagination • Please populate the page numbers manually before distributing Table of contents 2 01 Headlines 03 02 Introduction 06 03 Audit of the annual report and accounts 09 04 Wider scope and best value conclusions 22 Appendices A Audit adjustments 47 B Action plan and recommendations – wider scope 49 C Follow up of prior year audit recommendations 51 D Audit fees, ethics and independence 58 E Client Service Review 60 F Communication of audit matters 61 Tip – Select View/Outline View, Right click and select "Collapse" and copy slide titles then paste into your table of conents Don’t forget to change the footer The contents of this report relate only to the matters which have come to our attention, which we believe need to be reported to you as part of our external audit process. It is not a comprehensive record of all the relevant matters, which may be subject to change, and in particular we cannot be held responsible to you for reporting all of the risks which may affect the Council or all weaknesses in your internal controls. This report has been prepared solely for your benefit and Audit Scotland (under the Audit Scotland Code of Audit Practice 2021). We do not accept any responsibility for any loss occasioned to any third part acting, or refraining from acting on the basis of the content of this report, as this report was not prepared for, nor intended for, any other purpose.Page 145
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Headlines01 Page 146
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|© 2025 Grant Thornton UK LLP
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Financial statements
Under International Standards of Audit (UK) (ISAs) and Audit Scotland’s Code of
Audit Practice ('the Code'), we are required to report whether, in our opinion:
• the IJB’s financial statements give a true and fair view of the state of affairs of
the IJB as at 31 March 2025 and of the income and expenditure of the
organisation for the year then ended;
• the IJB’s financial statements have been properly prepared in accordance with
UK adopted international accounting standards, as interpreted and adapted
by the 2024/25 Code;
• the IJB’s financial statements have been prepared in accordance with the
requirements of the Local Government (Scotland) Act 1973, The Local Authority
Accounts (Scotland) Regulations 2014, and the Local Government in Scotland
Act 2003; and
• the audited part of the Remuneration Report has been properly prepared in
accordance with The Local Authority Accounts (Scotland) Regulations 2014.
We are required to report whether the information given in the Management
Commentary is consistent with the financial statements and has been prepared
in accordance with statutory guidance issued under the Local Government in
Scotland Act 2003.
We are also required to report on whether the information given in the Annual
Governance Statement is consistent with the financial statements and prepared
in accordance with the Delivering Good Governance in Local government:
Framework (2016).
We have concluded that the Remuneration Report has been prepared in
accordance with requirements.
We have concluded the work on the Governance Statement has been prepared in
accordance with the relevant guidance.
We have concluded that the other information to be published alongside the
financial statements is consistent with our knowledge of the IJB.
Draft financial statements
The draft financial statements were presented for audit by the deadline of 30
June 2025, with the IJB authorising their financial statements on 24 June 2025.
We have been supported by Moray IJB’s officers during the audit process with
effective working relationships and commitment to the audit process.
We have completed our audit work and subject to the satisfactory completion of
outstanding items outlined at page 6, we anticipate issuing an unmodified
opinion on 30 October 2025.
The working papers presented for audit were a good quality, and any
supplementary working papers, sample requests and queries were responded to
effectively.
4
This table summarises the key findings and other matters arising from the external audit of Moray Integration Joint Board (IJB) and the preparation of the
financial statements for the year ended 31 March 2025 for those charged with governance (the Board) and the Controller of Audit.
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Headlines (2) Financial statements Wider scope and best value arrangements Our audit work was substantially completed during September 2025. Our findings are summarised on pages 8 to 17. We have identified no adjustments or unadjusted misstatements to the primary financial during the course of the audit. Further detail is set out within Appendix 1 including minor disclosure adjustments. We have not identified any financial statements recommendations for management as a result of our audit work on the financial statements, and there were no recommendations for follow up from the previous audit. We would like to take this opportunity to record our appreciation for the assistance provided by the Chief Financial Officer and other staff in completing the external audit. Under the Audit Scotland Code of Audit Practice (‘the Code’), the scope of public audit extends beyond the audit of the financial statements. The Code requires auditors to consider the IJB’s arrangements in respect of financial management, financial sustainability, vision leadership and governance and use of resources to improve outcomes. In our External Audit Plan for the year ended 31 March 2025, we documented our assessment of the wider scope risks and planned audit work. At the planning stage, we identified one risk in respect of financial sustainability. We outline our work undertaken in response to the arrangements in place and the risks identified and conclude on the effectiveness and appropriateness of the arrangements in place based on the work carried out. There remains a significant risk in respect of financial sustainability given the significant financial challenges the IJB faces over the longer term. Further details of the work undertaken are outlined on pages 23 to 45. We have raised two recommendations for management as a result of our audit work on wider scope. These are set out in Appendix B. We have followed up the twelve recommendations raised in our previous audit. Six out of twelve recommendations have been cleared with one in progress and five still open. The clearance of the remaining recommendations will be followed up in 2025/26. This is the fourth year in succession that Internal Audit have provided a limited assurance opinion, indicating there are weaknesses in the framework of governance, risk management and control. A number of the recommendations made by internal audit span multiple years and the IJB must ensure that audit recommendations are actioned in a timely manner. Due to the level of follow up work and the amount of work required for wider scope, as indicated in our Audit Plan we have levied £2,500 additional audit fee as noted on page 59. Integration Joint Board’s have a statutory duty to have arrangements to secure Best Value. The IJB have arrangements in place to meet the Best Value obligations, however these could be strengthened by completing an assessment of the arrangements against the Best Value assurance framework, with the outcome being reported to the Audit, Performance and Risk Committee at the end of each financial year. 5 Page 148
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Headlines (3) Status of Audit Work Our work is substantially complete, and at this stage there are no matters of which we are aware that would require modification of our audit opinion. subject to the finalisation of the following outstanding matters : • finalisation of review of disclosures and accounting policies within the financial statements and annual report In addition, the usual closing processes at the final stages of the audit process will need to be performed as listed below: • receipt of management representation letter • review of the final set of financial statements • receipt of final signed financial statements • final sign off by the engagement lead • receipt of management’s updated going concern and post balance sheet events assessment at the date of sign off. We would like to take this opportunity to record our appreciation for the assistance provided by the finance team. 6 Page 149
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Introduction02 Page 150
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Introduction Scope of our audit work Our work has been undertaken in accordance with International Standards of Auditing (ISAs) (UK) and the Code. This report is addressed to the IJB and the Controller of Audit and will be published on Audit Scotland's website www.audit-scotland.gov.uk in due course. This report is a summary of our findings from our external audit work for the financial year at Moray IJB. The scope of our audit was set out in our External Audit Plan dated 27 March 2025. The core elements of our audit work in 2024/25 have been: • An audit of the IJB’s annual report and accounts for the financial year ended 31 March 2025 [findings reported within this report]; • Consideration of the wider dimensions that frame the scope of public audit as set out in Audit Scotland’s Code of Audit Practice 2021 (‘the Code’) [within this report]; • Any other work requested by Audit Scotland. Responsibilities The IJB has primary responsibility for ensuring the proper financial stewardship of public funds. This includes preparing annual accounts in accordance with proper accounting practices. The IJB is also responsible for compliance with legislation, and establishing arrangements over governance, propriety and regularity that enable it to successfully deliver its objectives. Our responsibilities as independent auditors, appointed by the Accounts Commission, are set out in the Local Government in Scotland Act 1973, the Code and supplementary guidance, and International Standards on Auditing in the UK. The recommendations or risks identified in this report are only those that have come to our attention during our normal audit work and may not be all that exist. Communication in this report of matters arising from the audit or of risks or weaknesses does not absolve officers from their responsibility to address the issues raised and to maintain an adequate system of control. Adding value through our audit work We aim to add value to the IJB throughout our audit work. We do this through using our wider public sector knowledge and we invited IJB officers to our annual local government accounting workshop. Through our expertise, we provide constructive, forward-looking recommendations where we identify areas for improvement and encourage good practice around financial management and financial sustainability, risk management and performance monitoring. In so doing, we aim to help the IJB promote improved standards of governance, better management and decision making, and more effective use of resources. 8 Page 151
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Audit of the annual report and accounts 03 Page 152
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Audit of the annual report and accounts Approach to the audit of financial statements Key audit matters and significant risks The following significant risks have been identified: • Management override of controls (significant risk). No key audit matters have been identified. Internal control environment In accordance with ISA requirements, we have developed an understanding of the IJB’s control environment. Our audit is not controls based and we have not placed reliance on controls operating effectively as our audit is substantive in nature. In accordance with ISAs, over those areas of significant risk of material misstatement we consider the design of controls in place. However, we do not place reliance on the design of controls when undertaking our substantive testing. We identified no material weaknesses or areas of concern from this work which would have caused us to alter the planned approach as documented in our plan. Recap of our audit approach and key changes in our audit strategy We have not identified any changes in our approach since our Audit Plan was presented to the Audit, Performance and Risk Committee on 27 March 2025. The risks identified remain the same. 10 Key audit matters Scoping Materiality Page 153
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Our application of materiality We apply the concept of materiality both in planning and performing the audit, and in evaluating the effect of identified misstatements on the audit and of uncorrected misstatements, if any, on the financial statements and in forming the opinion in the auditor’s report. The concept of materiality is fundamental to the preparation of the financial statements and the audit process and applies not only to the monetary misstatements but also to disclosure requirements and adherence to acceptable accounting practice and applicable law. Our audit approach was set out in our audit plan. • We reviewed and updated our assessment of materiality from planning based upon your 2024/25 draft financial statements and concluded that materiality is £5.278 million (PY £4.056 million), which equates to approximately 2.5% (PY 2%) of 2024/25 gross expenditure. • Performance materiality was set at £3.943 million (PY £3.042 million) representing 75% of our calculated materiality (PY 75%). • We report to Officers (Management) any difference identified over £0.263 million representing 5% of our calculated materiality (PY £0.203 million). • Due to the public interest in senior officer remuneration disclosures, we apply specific audit procedures to this work and set a lower materiality level for this area of £25,000 (PY £25,000). We design our procedures to detect errors in specific accounts at a lower level of precision which we have determined to be applicable for senior officer remuneration disclosures. We evaluate errors in the remuneration report for both quantitative and qualitative factors against this lower level of materiality. We will apply heightened auditor focus on the completeness and clarity of disclosures in this area and will request amendments to be made if any errors exceed the threshold we have set or would alter the bandings reported for any individual. There is a change in materiality values since our final audit plan was communicated to you on 27 March 2025 as final gross expenditure for 2024/25 was used as the basis of the calculation. The percentage chosen for higher materiality, performance materiality and triviality remains unchanged. 11 Page 154
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Detecting irregularities, including fraud Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, to detect material misstatements in respect of irregularities, including fraud. Owing to the inherent limitations of an audit, there is an unavoidable risk that material misstatements in the financial statements may not be detected, even though the audit is properly planned and performed in accordance with the ISAs (UK). The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below: • We obtained an understanding of the legal and regulatory frameworks that are applicable to Moray IJB and determined that the most significant which are directly relevant to specific assertions in the financial statements are those related to the reporting frameworks; International Financial Reporting Standards and the 2024/25 Local Government Accounting Code of Practice. • We enquired of Senior Officers and the Chair of the Audit, Performance and Risk Committee, concerning the IJB’s policies and procedures relating to the identification, evaluation and compliance with laws and regulations; the detection and response to the risks of fraud; and the establishment of internal controls to mitigate risks related to fraud or non-compliance with laws and regulations. • We enquired of Senior Officers and the Chair of the Audit, Performance and Risk Committee, whether they were aware of any instances of non-compliance with laws and regulations or whether they had any knowledge of actual, suspected or alleged fraud. • We assessed the susceptibility of the IJB’s financial statements to material misstatement, including how fraud might occur, by evaluating officers incentives and opportunities for manipulation of the financial statements. This included the evaluation of the risk of management override of controls. We determined that the principal risks were in relation to journal entries that altered the IJB’s financial performance for the year and potential management bias in determining accounting estimates. Our audit procedures are documented within our response to the significant risk of management override of controls below. These audit procedures were designed to provide reasonable assurance that the financial statements were free from fraud or error. However, detecting irregularities that result from fraud is inherently more difficult than detecting those that result from error, as those irregularities that result from fraud may involve collusion, deliberate concealment, forgery or intentional misrepresentations. Also, the further removed non-compliance with laws and regulations is from events and transactions reflected in the financial statements, the less likely we would become aware of it. The team communications in respect of potential non-compliance with relevant laws and regulations, included the potential for fraud in in certain account balances and significant accounting estimates. In assessing the potential risks of material misstatement, we obtained an understanding of: − Moray IJB’s operations, including the nature of its operating revenue and expenditure and its services and of its objectives and strategies to understand the classes of transactions, account balances, expected financial statement disclosures and business risks that may result in risks of material misstatement. − The IJB’s control environment, including the policies and procedures implemented by the organisation to ensure compliance with the requirements of the financial reporting framework. 12 Page 155
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Overview of audit risks The table below summarises the key audit matters, significant and other risks discussed in more detail on the subsequent pages. Significant risks are defined by ISAs (UK) as an identified risk of material misstatement for which the assessment of inherent risk is close to the upper end of the spectrum due to the degree to which risk factors affect the combination of the likelihood of a misstatement occurring and the magnitude of the potential misstatement if that misstatement occurs. A significant risk can be a significant risk due to error or due to fraud. For the purposes of the ISAs (UK), the auditor is concerned with fraud or suspected fraud that causes a material misstatement in the financial statements. Two types of intentional misstatements are relevant to the auditor – misstatements resulting from fraudulent financial reporting and misstatements resulting from misappropriation of assets. As part of our consideration of risks relating to fraudulent financial reporting, we consider the potential for override of controls or other inappropriate influence over the financial reporting process, such as efforts by management to manage income and expenditure in order to influence the IJB’s year-end performance. 13 Risk title Risk level Change in risk since audit plan Fraud risk Key audit matter Level of judgment or estimation uncertainty Testing approach Status of work to date Management override of controls Significant ✓ Low Substantive Green ↑ Assessed risk increased since Audit Plan Assessed risk consistent with Audit Plan ↓ Assessed risk decreased since Audit Plan Not considered likely to result in material adjustment or change to disclosures within the financial statements Potential to result in material adjustment or significant change to disclosures within the financial statements Likely to result in material adjustment or significant change to disclosures within the financial statements. Page 156
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters Responding to significant financial statement risks Significant risks are defined by ISAs (UK) as risks that, in the judgement of the auditor, require special audit consideration. In identifying risks, audit teams consider the nature of the risk, the potential magnitude of misstatement, and its likelihood. Significant risks are those risks that have a higher risk of material misstatement. This section provides commentary on the significant audit risks communicated in the External Audit Plan. Key audit matters Key audit matters are those matters that, in our professional judgement, were of most significance in our audit of the IJB’s financial statements of the current year and include the most significant assessed risks of material misstatement (whether or not due to fraud) that we identified. These matters include those that had the greatest effect on: • the overall audit strategy; • the allocation of resources in the audit; and • directing the efforts of the engagement team. These matters were addressed in the context of our audit of the financial statements as a whole, and in forming our opinion thereon, and we do not provide a separate opinion on these matters. There were no key audit matters identified. Other risks Other risks are, in the auditor's judgement, those where the risk of material misstatement is lower than that for a significant risk, but they are nonetheless an area of focus for our audit. There were no other risks identified as part of our procedures. 14 Description Audit reponse Disclosures Key observations KAM Page 157
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters (2) 15 Significant risks identified in our Audit Plan Commentary Management override of controls Under ISA (UK) 240 there is a non- rebuttable presumed risk that the risk of management override of controls is present in all entities. Our risk focuses on the areas of the financial statements where there is potential for management to use their judgement to influence the financial statements alongside the potential to override the entity’s internal controls, related to individual transactions. We have therefore identified management override of controls as a significant risk of material misstatement. This relates to the elements involving consolidation, after the information is extracted from partner ledgers, to produce the financial statements for Moray IJB. We have considered the design of controls in place over key accounting estimates and judgements through performance of walkthrough procedures and planning inquiries with management. In doing this work, we have concluded there are no significant estimates and judgements within the Annual Report and Accounts. This is appropriately disclosed within the IJB’s accounting policies and in line with our understanding of an IJB organisation. Across our public sector clients, we look to understand and test the control environment over journals including target testing journals on a risk assessment basis to ensure no management override of control that could result in fraud or material error. Therefore, we have: • documented our understanding of and evaluated the design effectiveness of management’s key controls over journals within Moray Council and NHS Grampian; • considered our journals testing within the NHS and the Council (as the external auditor of both organisations); • understood how the IJB accounts were produced and whether there is an opportunity or incentive for management to override controls to show an improved IJB financial performance through financial reporting; • gained an understanding of the critical judgements applied by management in the preparation of the financial statements and considered their reasonableness; • gained an understanding of the key accounting estimates made by management and • evaluated the rationale for any changes in accounting policies, estimates or significant unusual transactions Conclusion Through our audit procedures performed, we found that there was no evidence of management override of controls. We have placed reliance upon the journals work completed on the Moray Council and NHS Grampian audits where recommendations were made on each around the journal authorisation process. As the IJB’s financial statements are prepared by merging the relevant transactions from Moray Council and NHS Grampian, we have agreed the figures to underlying joint ledger reports to confirm accuracy and completeness. We did not identify indication of fraud or inappropriate management bias that could result in a material misstatement.Page 158
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters (3) 16 Significant risks identified in our Audit Plan Commentary The revenue cycle includes fraudulent transactions As set out in ISA (UK) 240 (Revised May 2021), there is a rebuttable presumed risk that revenue may be misstated due to the improper recognition of revenue. This presumption can be rebutted if the auditor concludes that there is no risk of material misstatement due to fraud relating to revenue recognition. (rebutted) Auditing standards require us to consider the risk of fraud in revenue. This is considered a presumed risk in all entities. Having considered the risk factors set out in ISA 240 and the nature of the revenue streams at Moray IJB, we have determined that the risk of fraud arising from revenue recognition can be rebutted as there is deemed to be little incentive to manipulate revenue recognition and opportunities to manipulate revenue recognition are deemed to be limited. As part of our work on material transactions and balances, we have agreed revenue balances to assurance letters provided confirming the balances at NHS and Council level as well as an assessment of the income recognition accounting policies and relevant disclosures. Conclusion Our work has not identified any issues to raise in relation to revenue recognition. Risk of fraud in expenditure As set out in practice note 10 (Revised 2022) ‘The Audit of Public sector Financial Statements’, issued by the Public Audit Forum, which applies to all public sector entities, we consider there to be an inherent risk of fraud in expenditure recognition. (rebutted) Having considered the risk factors set out in PN10 and the nature of the expenditure streams at Moray IJB, we have determined that the risk of fraud arising from expenditure recognition can be rebutted as opportunities to manipulate expenditure recognition are deemed to be limited. As part of our work on expenditure, we have agreed revenue balances to assurance letters provided confirming the balances at NHS and Council level. We have also reviewed expenditure recognition accounting policies and relevant disclosures. Conclusion Our work has not identified any issues to raise in relation to expenditure recognition. Page 159
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Financial statements – key judgements and estimates 17 As required in the IJB’s accounting policies, officers outline critical judgements in applying accounting policies and in addition, assumptions about the future and other sources of estimation uncertainty. In particular, where estimates and judgements are identified, these should be quantified. This section provides commentary on key estimates and judgments in line with the enhanced requirements for auditors. Significant judgement or estimate Summary of management’s approach Audit Comments Assessment None The note within the IJB accounting policies (Note 2 Critical Judgements and Estimation Uncertainty) confirms there are no judgements or estimates within the IJB accounts. We have confirmed there are no significant estimate or judgements within the IJB annual reports and accounts. Not Applicable Page 160
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other key elements of the financial statements 18 There were other key areas of focus during our audit. Whilst not considered a significant risk, these are areas of focus either in accordance with the Audit Scotland Code of Audit Practice (2021) or ISAs or due to their complexity or importance to the user of the accounts: Issue Commentary Matters in relation to fraud and irregularity It is the IJB’s responsibility to establish arrangements to prevent and detect fraud and other irregularity. As auditors, we obtain reasonable assurance that the financial statements as a whole are free from material misstatement, whether due to fraud or error. We obtain annual representation from officers and those charged with governance regarding the IJB’s assessment of fraud risk, including internal controls, and any known or suspected fraud or misstatement. We have also made inquires of internal audit around internal control, fraud risk and any known or suspected frauds in year. We have not been made aware of any incidents in the period and no issues in relation to these areas have been identified during the course of our audit procedures that are outside of the usual expected investigations. Accounting practices We have evaluated the appropriateness of Moray IJB’s accounting policies, accounting estimates and financial statement disclosures. We have identified disclosure adjustments required to the financial statements which have been detailed in Appendix 1. Matters in relation to related parties We are not aware of any other related parties or related party transactions which have not been disclosed. The principal related parties are Moray Council and NHS Grampian. Matters in relation to laws and regulations You have not made us aware of any significant incidences of non-compliance with relevant laws and regulations and we have not identified any incidences from our audit work. We have not identified any cases of money laundering or fraud at the IJB. Other information We are required to give an opinion on whether the other information published together with the audited financial statements (including the Annual Report), is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. Minor amendments have been made to the Annual Report and we are satisfied that there are no material inconsistencies to report. As these are minor, they do not warrant separate reporting. Page 161
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other key elements of the financial statements (2) 19 Issue Commentary Governance statement We are required to report on whether the information given in the Annual Governance Statement is consistent with the financial statements and prepared in accordance with the Delivering Good Governance in Local government: Framework (2016). No inconsistencies have been identified; we plan to issue an unmodified opinion in this respect. Minor amendments were processed in the Statement, and these have been noted within Appendix A. Matters on which we report by exception We are required by the Accounts Commission to report to you if, in our opinion: adequate accounting records have not been kept; or the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or we have not received all the information and explanations we require for our audit or there has been a failure to achieve a prescribed financial objective. We have nothing to report in respect of these matters. Written representations A letter of representation has been requested from the Integration Joint Board as required by auditing standards. We have not requested any specific representations in this letter. Going Concern In performing our work on going concern, we have had reference to Statement of Recommended Practice – Practice Note 10: Audit of financial statements of public sector bodies in the United Kingdom (Revised 2022). The Financial Reporting Council recognises that for particular sectors, it may be necessary to clarify how auditing standards are applied to an entity in a manner that is relevant and provides useful information to the users of financial statements in that sector. Practice Note 10 provides that clarification for audits of public sector bodies. Practice Note 10 states that if the financial reporting framework provides for the adoption of the going concern basis of accounting on the basis of the anticipated continuation of the provision of a service in the future, the auditor applies the continued provision of service approach set out in Practice Note 10. The financial reporting framework adopted by the Integration Joint Board meets this criteria, and so we have applied the continued provision of service approach. In accordance with Audit Scotland guidance: Going concern in the public sector, we have therefore considered management’s (senior officer’s) assessment of the appropriateness of the going concern basis of accounting and conclude that: a material uncertainty related to going concern has not been identified management’s (senior officer’s) use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Page 162
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other responsibilities under the Code (1) 20 Issue Commentary WGA return For local government audits, we are required to complete Whole of Government Accounts (WGA) work and provide an assurance statement on the WGA return as mandated by National Audit Office. The IJB will fall under its parents return (Moray Council).We will complete the relevant specified procedures and prepare and submit a partial assurance statement once we have completed all our work on Moray Council’s financial statements, and when the final guidance is received. Health board consolidation For health boards, we are required to under the Code of Audit Practice to examine and report on the consolidation schedules. The IJB expenditure for NHS Grampian was included within the health board consolidation process and this was submitted as part of our work on NHS Grampian’s financial statements. Other returns to Audit Scotland In accordance with the Audit Scotland Planning Guidance, as appointed auditors we have prepared and submitted Fraud Returns and Current Issues Returns to Audit Scotland, sector annual reports, shared intelligence on health and social care, sector meetings and Technical Guidance Notes. There is nothing we need to bring to your attention in this respect. Page 163
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other findings – information technology Assessment - Significant deficiencies identified in IT controls relevant to the audit of the financial statements. - Non-significant deficiencies identified in IT controls relevant to the audit of the financial statements / significant deficiencies identified with sufficient mitigation of risk. - IT controls relevant to the audit of financials statements judged to be effective at the level of testing in scope. - Not in scope for testing 21 This section provides an overview of results from our assessment of Information Technology (IT) environment and controls which included identifying risks from the use of IT related to business process controls relevant to the financial audit. This includes an overall IT General Control (ITGC) rating per IT system and details of the ratings assigned to individual control areas. IT application Level of assessment performed Overall ITGC rating ITGC control area rating – security management ITGC control area rating – technology acquisition, development and maintenance ITGC control area rating – technology infrastructure Related significant risks / other risks Advance Business Solutions e5 system – Moray Council’s general ledger ITGC assessment (design and implementation effectiveness only) Green Green Green Green All significant risk areas eFinancials – NHS Grampian’s general ledger ITGC assessment (design and implementation effectiveness only) Green Green Green Green All significant risk areas Page 164
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Wider scope and best value conclusions 04 Page 165
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope conclusions This section of our report documents our conclusions from audit work on the wider scope areas set out in the Code. We take a risk-based audit approach to wider scope work. Within our audit plan we identified one significant risk in respect of financial sustainability. Wider scope area Our risk considerations and focus Significant risk identified - final stage Wider scope conclusion Financial Management The arrangements in place at the IJB to ensure sound financial management, accountability and the arrangements to prevent and detect fraud, error and other irregularities No The IJB did not approve the 2024/25 before the start of the financial year, with the final budget not approved until 30 May 2024. Due to costs pressures and the non-delivery of all required savings during 2024/25, both partner organisations required to provide additional funding contributions to enable the IJB to achieve financial balance. An improvement recommendation on year-end reporting of savings has been made at Appendix C. There is regular reporting of the financial position throughout the financial year. The IJB approved the 2025/26 budget in March 2025, before the start of the financial year and in line with required timescales. Financial Sustainability The projected financial position of the IJB in the medium to longer term and the relevance and appropriateness of assumptions applied to financial plans that will allow the council to effectively deliver services in the future Yes The 2025/26 budget is based on an unprecedented level of savings being delivered during the year. The quarter monitoring reports indicate the IJB will not deliver all required savings, which may result in partner organisations providing additional funding should savings not be achieved. Partners have provisions in their accounts for the risk of the IJB not achieving break even. The IJB has relied on the use of earmarked reserves to balance the 2025/26 budget. This is not sustainable for future years as reserves balances will diminish. The IJB are projecting an £18.2 million funding gap to 2029/30 and must ensure that transformation is the key driver for addressing identified budget gaps over the longer term. Use of Resources to Improve Outcomes The effectiveness of the IJB’s governance arrangements and the arrangements in place to deliver the vision, strategy and priorities set by the council No The IJB have governance arrangements in place that are appropriate and operate effectively. The results of both Moray Council and NHS Grampian internal audit activity is now reported to the Audit, Performance and Risk Committee. For the fourth year in succession, Internal Audit have provided a limited assurance audit opinion, which indicates there are weaknesses in the framework of governance, risk management and control. The IJB should have definitive plans in place to avoid further limited assurance opinions and four years of limited assurance opinions requires timely, secured and sustained action. Vision, Leadership and Governance How the IJB demonstrates economy, efficiency and effectiveness through its use of financial and other resources No The IJB have approved the new Strategic Delivery Plan which identifies the programme of transformational and improvement work required to meet the IJBs strategic objectives. The IJB have appropriate performance monitoring and reporting arrangements in place however the format of the Performance Report and content within should be reviewed to ensure the correct level of detail is included in year end reporting. The IJB’s performance is showing a general trend of improvement against the national indicators, however a number of local indicators are below target. No risks identified Other risks identified. Significant risk identified. 23 Page 166
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management 24 Wider scope area Wider scope audit response and findings Conclusion Financial management No risk identified Financial Management Arrangements The IJB’s financial performance is reported to the Board as an integral part of the budget monitoring process. Budget monitoring reports are submitted to the IJB Board throughout the year and senior management and members receive regular and accurate financial information on the IJB’s financial position. All in-year financial information is reported on a timely basis and there are several supporting appendices to the monitoring reports. The outturn to date and projected year-end outturn position, alongside revisions to the budget are clearly stated in these reports. Where assumptions are determined unrealistic or changes significantly from budget, this is captured, and actions will be identified to resolve any adverse variances. Members are provided with the opportunity to review, challenge and scrutinise the financial performance. The finance team have access to real time information through the finance ledger systems within Moray Council and NHS Grampian to provide accurate financial monitoring reports. The IJB commission services from Moray Council and NHS Grampian. The management of services within each of these organisations continue to be governed by the existing Standing Financial Instructions, Schedule of Reserved Decisions, Operational Scheme of Delegation within the partner organisations. The Financial Regulations were subject to review during 2025 and approved by the IJB Board on 29 May 2025. Finance Team Individuals involved in the preparation and reporting of financial information are qualified and experienced and held finance positions at the organisation for a number of years. Given the nature of the IJB and how it operates, the finance team is relatively small, and if staff shortages or sickness arise, the organisation could face capacity issues. Our review of financial monitoring reports during the year did not identify any significant issues. We have not identified any issues regarding the skills and capability of finance staff within the organisation. Given the size of the organisation, should staff shortages arise, the finance team may face capacity issues. We are satisfied that the IJB have appropriate financial monitoring arrangements in place. Page 167
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (1) 25 Wider scope area Wider scope audit response and findings Conclusion Financial management (continued) Financial Performance The IJB has a responsibility under the Public Bodies (Joint Working) (Scotland) Act 2014 to set a budget before 31 March each year. For 2024/25, the IJB presented a “working budget” to the 28 March 2024 Board Meeting. The initial budget was in deficit of £3.764 million. Following this, the IJB presented its final budget for 2024/25 to the 30 May 2024 Board Meeting. The final Revenue Budget for 2024/25 totalled £200.641 million which included £14.665 million set aside services. The funding provided totalled £190.998 million and built into the 2024/25 funding assumptions was expected savings of £8.297 million. The IJB predicted an overall budget deficit of £1.346 million, with the intention to fund the deficit from earmarked reserves. Throughout 2024/25, there were several adjustments to the final 2024/25 Revenue Budget. All budget revisions were reported to the IJB with detailed reasoning of the changes made. The final revised budget position for 2023/24 was £211.765 million. The table below shows the IJB’s outturn position for the year. The IJB had total expenditure of £210.315 million against a final budget of £211.765 million, resulting in an underspend against budget of £1.450 million. This position was following both partner bodies providing an additional funding contribution to the IJB. Moray Council provided £2.061 million whilst NHS Grampian provided £2.196 million. Note: Strategic Funds relate to additional Scottish Government funding for Integrated Joint Boards. For Moray IJB, this generally relates to additional funding received via NHS Grampian and Moray Council. The IJB required additional funding contributions from both partners in order to achieve the year-end outturn position. 2024/25 Financial Outturn Revised Budget (£m) Actual (£m) Core Services 181.235 £188.656 Strategic Funds & Other Resources 14.891 6.020 Set Aside 15.639 15.639 Total 211.765 210.315 Page 168
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (2) 26 Wider scope area Wider scope audit response and findings Conclusion Financial management (continued) Financial Performance (continued) The main overspends within core services were as follows: • Learning Disabilities - The service was overspent by £2.27 million due to the additional purchase of care for people with complex needs. • Older People Services and Physical & Sensory Disability – The overspend of £2.26 million primarily related to overspends for home care and permanent care due to the increase in clients receiving nursing care rather than residential care. • Primary Care Prescribing - The primary care prescribing budget reported an overspend of £3.19 million, mainly due to by the impact of short supply causing an increase in costs. Financial Performance - Savings To balance the 2024/25 budget, the IJB intended to make savings of £8.297 million in 2024/25, with progress on the savings plan reported as part of the budget monitoring reports presented to the IJB Board. Each saving is broken down by project and continues to be reported on a RAG basis. There is no indication in either the budget or budget monitoring report whether savings are expected to be recurring in nature. Adding this context into both documents would provide a clear indication as to whether savings are expected to be one off savings or whether the benefit will continue in future years. See recommendation 1. Throughout the year, the IJB made it clear they would not achieve all planned savings and where savings were not fully achieved, it was expected that partner authorities would need to provide additional funding to meet any in year deficits. The budget and monitoring report should make it clear that savings are either recurring or non-recurring in nature. Page 169
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (3) 27 Wider scope area Wider scope audit response and findings Conclusion Financial management (continued) Financial Performance – Savings (continued) The year-end outturn report, presented to the IJB Board on 19 June 2025, provides an overview on the savings delivered during 2024/25: Of the £4.633 million of savings delivered in year, the IJB expect £3.398 million to be recurring in nature, with the remaining £1.235 million being non-recurring savings. As outlined previously, this additional context should be added to both the in-year monitoring report and year-end outturn report. We noted that whilst the year-end outturn report provides the final high-level savings position, it does not include the appendix presented as part of the in-year monitoring reports detailing the final delivery position. It would be good practice to provide this same level of detail as part of the year-end outturn report which allows a comparison across the full financial year. See recommendation 1. During 2024/25, the IJB have implemented a Budget Saving Oversight Group. The Chief Officer chairs the group, and membership is the senior management team plus project management officers to support to the process. Monthly meetings are held to review progress on the savings programmes, with the focus on the high risk/high value savings. The IJB did not deliver all planned savings in 2024/25 and required additional funding from partners to meet the in-year funding deficit. Reporting of savings could be improved by providing a detailed breakdown of savings delivered during the year as part of the year-end outturn report. Actual (£m) Savings delivered 2.302 Savings delivered through reduction in overspends 2.331 Savings not delivered 3.664 Page 170
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability 28 Potential significant risk identified in audit plan (narrative from Audit Plan) Response to potential significant risk (planned work in Audit Plan) Conclusion on potential significant risk The draft Revenue Budget for 2024/25 was £200.641 million, which included £14.665 million set aside services, representing Moray’s share of the Large Hospital Services. The total funding provided from the partner authorities and Scottish Government was £191.088 million, resulting in a budget gap of £9.553 million. To manage the funding deficit, the IJB identified efficiency savings totalling £8.297 million, resulting in a projected budget deficit of £1.346 million. The Quarter 2 revenue monitoring report presented to the Board in November 2024 identified that the IJB are projecting a total overspend of £5.580 million for 2024/25. If this deficit cannot be reduced by year end, partner authorities will require to provide additional funding contributions to manage the overspend. The IJB has a Medium-Term Financial Framework 2023/24 - 2027/28 which has not been subject to update since the 2023/24 budget was agreed and is now considered to be out of date. The funding deficit identified in the MTFF shows a budget gap of approximately £26 million from 2025/26 - 2027/28. The IJB is preparing an updated Medium Term Financial Framework which will presented to the Board in March 2025, alongside the 2025/26 budget. Our audit work included: • understanding the future financial forecasts and plans for the IJB for 2025/26 and beyond, including key assumptions used, scenario planning, sensitivity analysis, risk analysis and the extent of any budget pressures any impact upon reserves • considered the actions the IJB is taking to address identified funding gaps and associated savings plans. • followed up the prior year recommendations in respect of the financial sustainability risk highlighted last year. The 2025/26 Revenue Budget is predicated on delivering savings of £9.467 million. The IJB have also budgeted to use earmarked reserves to fund a projected budgeted deficit of £1.000 million in 2025/26. The IJB are forecasting a budget deficit of £4.685 million for financial year 2025/26. It is unlikely that the IJB will deliver all required savings in 2024/25 and if possible, they should look for alternative options to help achieve a balanced budget. The updated Medium Term Financial Framework (MTFF) confirms that financial pressures for 2025/26 and beyond are significant, with the total funding gap for the period currently projected to be £18.2 million. The IJB will need to identify and deliver significant savings and transformation to reduce funding gaps and continue to deliver key services and IJB priorities. The continued reliance on reserves is not sustainable and although it helps achieve a balanced budget in 2025/26, the IJB will not have sufficient available earmarked reserves to draw upon in order to meet the 2026/27 funding deficit. The risk below was included in the Annual Audit Plan. The narrative is the wording from the Audit Plan and identifies the work we would undertake in response to the risk identified. Pages 29 to 33 details the work undertaken in response to the assessed risk and we have outlined our overall conclusion below. Page 171
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (1) 29 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability Significant risk: There is a risk that transformation and savings plans to address financial pressures for medium to longer term are not sufficient to address future funding gaps and increasing deficits. Short Term Financial Planning – Budget Setting 2025/26 Moray IJB’s main source of funding comes from the contributions received from the two partner authorities. The IJB undertakes an annual budget process which forms part of the wider medium term strategy process. This includes discussions taking place between management, Moray Council and NHS Grampian regarding funding requirements. As outlined, IJB did not present a balanced budget for 2024/25 before the end of March. As a result, we recommended in our previous audit that the IJB should ensure it presents its final budget, with all agreed savings, before the start of the financial year. The 2025/26 budget and savings plan was approved by the IJB Board on 27 March 2025, in line with required timescales. The final revenue Budget for 2025/26 is £213.843 million which included £15.638 million for set aside services. The funding provided totalled £212.843 million and built into the 2025/26 funding assumptions is projected savings of £9.469 million. The IJB expect £8.279 million of these savings to be recurring in nature. Overall, the IJB predicted an overall budget deficit of £1.000 million, with the intention to fund the deficit from earmarked reserves. The IJB agreed the 25/26 budget in line with required timescales. The IJB are intending to utilise £1.000 million of earmarked reserves balances to manage the budget deficit in 2025/26. 2025/26 Budget 2025/26 (£m) Total Budget 213.843 Total Funding (203.376) Savings Identified (9.467) Budget Deficit (1.000) Page 172
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (2) 30 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Short Term Financial Planning – Budget Setting 2025/26 (continued) The level of savings the IJB require to produce in year is unprecedented. As outlined, the IJB did not deliver all planned savings for 2024/25 and were the full £9.467 million of savings not fully achieved during 2025/26, it is expected that partner authorities will need to provide additional funding to meet any in year deficits. The IJB will need to closely monitor savings delivery during 2025/26 via the Budget Savings Oversight Group. The savings plan for 2025/26 is made up of several wide-ranging savings proposals including reduction in locum use, reviewing care packages provided to patients, efficiencies in prescribing and reductions in overtime. 2025/26 Revenue Budget Monitoring The IJB presented Quarter 1 revenue monitoring report to the September 2025 Board Meeting. The report provides an update on the IJB’s performance against the 2025/26 budget and shows detailed forecast projections for the remainder of 2025/26. The budget position at the end of June 2025 is an overspend to date on the Core Services budget of £1.425 million, and an overspend on the Strategic Funds budget of £0.592 million. Looking ahead, the IJB are forecasting a budget deficit of £4.685 million (2.2% of the IJB budget) for financial year 2025/26. The progress towards the IJB’s savings plans is included as part of the monitoring report and is reported on a RAG basis. At the end of June 2025, the IJB were predicting: - Expect to achieve £6.871 million of savings (rated green) - £2.598 million of savings are at risk of not being achieved (rated amber or red). The monitoring reports indicate that it is likely the IJB will overspend in 2025/26 and as such, the IJB must ensure there is close liaison with partner bodies so that they understand the financial implications the projected overspend will have on their own budgets. The IJB share the financial position with the partners on a regular basis, as part of partners meetings held every six weeks. The IJB will require to deliver a significant level of savings in order to manage the funding gap in 2025/26. It is unlikely that the IJB will deliver all required savings in 2025/26 and if possible, they should look for alternative options to help achieve a balanced budget The IJB must ensure there is close liaison with partner bodies so that they understand the financial implications the projected overspend will have on their own budgets. Page 173
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (3) 31 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Medium Term Financial Strategy The updated Medium Term Financial Framework (MTFF) 2025/26 - 2029/30 was approved at the IJB Board meeting on 27 March 2025. The financial pressures for 2025/26 and beyond are significant, with the total funding gap for the period currently projected to be £18.2 million. The summary position (in the table above) highlights that the IJB will need to closely monitor the financial constraints within which it is operating. Future funding assumes a level of savings will be achieved each year, together with transformational redesign that the IJB know they need to make in order to provide affordable sustainable services within the resources available. The MTFF assumes that the existing financial pressures will be addressed through savings alongside the need to transform the way services are provided across the system. Risks such as potential reduction in future funding, pay negotiations, rising inflation, cost of living crises and supply chain pressures are embedded within the MTFF however, given the economic uncertainty of these factors, this could result in a growth of the cumulative funding gap. To achieve financial sustainability and reduce reliance on useable reserves to bridge funding gaps, the IJB will need to identify and deliver significant savings and transformation to reduce funding gaps and continue to deliver key services and IJB priorities. There is a risk that where savings and transformation plans are not delivered, in the short to medium term this could provide financial sustainability challenges for the IJB. 2025/26 £m 2026/27 £m 2027/28 £m 2028/29 £m 2029/30 £m Estimated Budget Requirement 204.375 212.158 215.950 220.268 224.715 Total Funding (203.375) (207.390) (211.525) (215.784) (220.170) Use of earmarked reserves (1.000) Budget Surplus/ (Deficit) - (4.768) (4.425) (4.484) (4.545) Page 174
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (4) 32 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Reserves Reserves are a key performance indicator of monitoring the financial health of a body. At 31 March 2025, the IJB held £1.450 million of reserves which were fully earmarked. During 2024/25, the IJB utilised £0.536 million of reserves. The IJB has budgeted to utilise £1.000 million of general earmarked reserves in 2025/26 to achieve a balanced budget. This will reduce general earmarked reserves to £0.450 million by 31 March 2025. The use of reserves to balance the budget should not be relied upon, as this is finite and not a way to create financial sustainability for the IJB. As mentioned above, the IJB will need to prioritise and focus on transformation to ensure that reserves are used for their intended purpose to and not to meet budget gaps. At the 31 March 2025, the IJB general reserves balance is nil, which means any future overspends will need to be fully met by the partner authorities. The table below outlines the movement in reserves during 2024/25: In our previous audit, we recommended that the IJB continue to monitor the percentage level of adequate reserves as funding gaps continue to grow and that the IJB should look to transformation in future years to ensure reserves do not dip to an unsustainable level. This recommendation remains valid as the IJB have budgeted to use earmarked reserves to balanced the 2025/26 budget, which will not be sustainable in future years. The continued reliance on reserves is not sustainable and although it helps achieve a balanced budget in 2025/26, the IJB will not have sufficient available earmarked reserves to draw upon in order to meet the 2026/27 funding deficit. There is no general reserve balance, and the level of reserves is at an unsustainable level. General Reserves £m PCIP & Action 15 £m Other Earmarked £m Total £m As at 31 March 2024 - 33 1.953 1.986 Transferred Out - (33) (0.503) (0.536) Balance at 31 March 2025 - - 1.450 1.450 Page 175
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (5) 33 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Transformation Plans The cumulative funding gap position in the next four years is significant and outlines serious concerns over the future financial sustainability of the IJB where additional funding is not provided or where the IJB does not operate within its funding allocation. This creates a risk, as Moray IJB will have to balance ensuring that it maintains financial sustainability with ensuring that it continues its service delivery to meet its priorities. To reduce the current funding gap, a major transformation programme will need to be undertaken. The IJB has recognised the fact that it will require transformational redesign to reduce future funding gaps and reshape the organisation to ensure efficient service delivery. Substantial transformation is required to bring about financial sustainability. The size and scale of transformation required to deliver the savings and efficiencies required to close the projected funding gap is unprecedented. It is important that IJB members have oversight of the transformation programme to ensure the savings and efficiencies required to reduce future funding gaps can be delivered. Audit Scotland - Review of Integration Joint Boards In March 2025, Audit Scotland published Integration Joint Boards: Finance Bulletin 2023/24 which provided an independent analysis over the finances of Integration Joint Boards for financial year 2023/24. Key findings from the report included: • The majority of IJBs reported a deficit on the cost of providing services requiring unplanned use of reserves and additional contributions from partner bodies. • Total reserves held by IJBs have reduced by 40 per cent in 2023/24. Contingency reserves have almost halved, limiting IJBs ability to address future deficits. • The majority of the total planned savings were achieved, but a substantial proportion were achieved on a one-off basis Several items raised in the Audit Scotland report are consistent with the issues that Moray IJB are facing and there is an understanding that shape of service delivery will have to change in order to deliver services in a more sustainable manner. To ensure financial sustainability for the medium to longer term, the IJB will need to ensure that it is able to deliver increased income and efficiency initiatives to reduce costs and deliver financial benefits. The IJB will need to upscale the pace and delivery of transformation to achieve and mitigate the risk of becoming financially unsustainable. Moray IJB are facing several of the issues raised in the Audit Scotland report and are reviewing how they can provide services in a more sustainable manner. Page 176
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance 34 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance No risk identified Leadership and Committee Effectiveness Moray IJB hold a committee-based structure which has delegated functions to several committees who subsequently become responsible for the administration of services. There are currently three different committees, namely the Board, the Audit, Performance and Risk Committee and the Clinical and Care Governance Committee. The Audit, Performance and Risk Committee undertakes the role of Those Charged with Governance (TCWG) and looks to consider reports and obtain assurance through internal and external audit reports concerning the IJB’s functions. The Committee also obtains assurance over performance monitoring and receive reports on the performance of and trends within the IJB’s services in terms of service standards and performance information. Monitoring of action plan progress and service performance in key areas is reported to ensure a process of continuous improvement. This allows the IJB the opportunity to evaluate on strengths and weaknesses and draw any themes arising from results of self evaluations. It also enables the implementation of any necessary action plans to support continuous improvement in priority areas and ensure it is demonstrating compliance against the CIPFA Code of Principles for Delivering Good Governance (revised 2016). In our previous audit, we recommended that the IJB and Moray Council need to secure permanent positions for the Chief Officer and Chief Social Worker at the Council, to provide certainty over the future direction of the IJB. The IJB appointed a Chief Officer on an interim basis in July 2024, with the appointment being made permanent in November 2024. The Chief Social Worker at the Council left in May 2024, with a replacement Chief Social Worker appointed on an interim basis in the same month. To date, no permanent appointment has been made, and the post continues to be filled on an interim basis. A recruitment process is underway to find a permanent replacement. The previous audit recommendation remains valid until a permanent appointment has been made. Our review of attendance of members at Committee meetings has not flagged any issues. We are satisfied that the governance arrangements are appropriate and operate effectively. We conclude that the Audit, Performance and Risk Committee effectively challenge and scrutinize reports presented and ensure effective decision making. The Council are actively recruiting a permanent Chief Social Worker. Page 177
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (1) 35 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Governance Statement The Governance Statement details the composition and governance structure of Moray IJB and how that supports the achievement of the organisation’s priority themes. From review of the Statement, we are satisfied that it reflects the key findings from audit, scrutiny and inspection, including details of the limited assurance Internal Audit opinion issued for 2024/25 (see Internal Audit section for further detail). Risk Management The IJB maintains a strategic risk register which sets out the inherent risks being faced by the IJB, together with a current assessment on the level of the risks and mitigating actions being taken to reduce the impact of the risks. As part of the risk monitoring framework, the Strategic Risk Register was subject to review during 2024/25 and was co-developed with Board members during a development session in October 2024. The updated Strategic Risk register was formally approved by the Board in May 2025. The risk register is reviewed monthly by the Senior Management Team, updated and presented biannually to the Audit, Performance and Risk Committee, and annually to the Moray IJB Board for oversight. Any emerging or increasing risks are presented as required outside of the agreed reporting cycle. Changes made to the risk register since it was last presented to the Committee are easily identifiable and are highlighted to members. Risk scores are weighted, based on assessment according to their likelihood and corresponding impact as set out in the Risk Appetite Statement. The most recent risk register presented to the Board included one “very high” risk identified by the IJB as follows: • The MIJB must operate within the resources allocated to it by the partner bodies and it is good financial practice to set a balanced budget at the start of each financial year. There is a risk that Financial pressures being experienced by the funding partners will directly impact the MIJB’s strategic planning of services and its decision-making. This risk and the mitigating actions the IJB are implementing in response are in in line with our findings reported in the financial sustainability section of this report. The Strategic Risk Register has been updated during 2024/25 and we are satisfied that the key risks have been identified and that the pace of improvement is appropriate to the risks and challenges facing Moray IJB. The IJB has in place a wide range of policies and procedures designed to ensure compliance with laws and regulations, including for example financial regulations and standing orders. Our review of these policies have found the policies to be relevant and promoted within the organisation. Page 178
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (2) 36 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Internal Controls The IJB has in place a range of policies and procedures designed to ensure compliance with laws and regulations, including for example financial regulations and standing orders. The date of approval and adoption by the Board for the Standing Orders was May 2022. The Financial Regulations were updated in May 2025 and approved by the Board. The IJB does not have its own separate code of conduct, whistleblowing or fraud policies and follows those set out by the partner organisations. Internal Audit Internal audit activity is undertaken by the Audit and Risk Manager of Moray Council, who was appointed as the Chief Internal Auditor of Moray IJB in 2022, for a period of two years to 31 March 2024. This was extended by a further two years following approval at the May 2024 Board meeting. Internal audit undertook the following reviews during the financial year: • An audit of the administrative arrangements for fostering and kinship care payments. • A review of the IJB’s governance arrangements to prevent fraud and corruption. • An audit of the systems and procedures supporting the delivery of services to individuals receiving adult care services who are classified as out of area (OOA). • A review of residential care to examine the processes for making accurate payments at agreed contract rates to third-party providers for the delivery of permanent residential care. • Follow-up audits of Self-Directed Support and Moray Integrated Community Stores As a result of the reviews, Internal Audit identified several audit recommendations. This resulted in an overall assurance opinion for the 2024/25 financial year of limited assurance. The IJB has in place a wide range of policies and procedures designed to ensure compliance with laws and regulations, including for example financial regulations and standing orders. Our review of these policies have found the policies to be relevant and promoted within the organisation. The IJB have an effective internal audit function in place to assist with assurance over governance framework, risk and internal controls. Page 179
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (3) 37 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Internal Audit (continued) The internal audit opinion notes that “the Service has made progress by introducing improved governance arrangements, notably through regular reporting on the implementation of audit recommendations at Senior Management and Practice Governance Board meetings. However, significant findings have emerged from the audits undertaken, and follow-up reviews have identified recommendations that remain outstanding and require revised implementation dates. Furthermore, advancing the development of a single case recording system within the Service continues to be a matter of significant importance. After careful consideration, it is my opinion that I can only provide limited assurance that the Moray Integration Joint Board has adequate systems of governance and internal control.” This is the fourth year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. We have previously reported that the IJB should ensure audit recommendation dates are realistic and monitored for implementation and it is clear that the IJB must aim to implement internal audit recommendations at a faster pace to move away from limited assurance opinions. Our recommendation remains valid As outlined, as part of their review of process at the IJB, internal audit make recommendations for management in order to improve controls. The IJB have introduced an internal audit recommendations tracker, however this is not presented to each Audit, Performance and Risk Committee meeting. In our previous audit, we recommended that the tracker of internal audit recommendations is reviewed periodically and reported to each Audit, Performance and Risk Committee meeting. During 2024/25, the IJB have agreed that internal audit recommendations will be reviewed at Operational Management Team (OMT) meetings, with monthly escalations to Senior Management Team (SMT) meetings on an exception basis. If SMT deem any issues require escalation, a report would then be compiled for reporting to the Audit, Performance and Risk Committee. This is the fourth year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. The IJB should have definitive plans in place to avoid further limited assurance opinions. The recommendations made by internal audit span multiple years and the IJB must ensure that audit recommendations are actioned in a timely manner. Our prior year recommendation raised remains valid. Page 180
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (4) 38 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Internal Audit (continued) We had also reported previously that the IJB should create a mechanism to monitor progress against external audit recommendations. The IJB presented a report to the IJB on 27 March 2025 detailing progress made with external audit recommendations, and progress updates will continue to be reported on a regular basis. The Audit, Performance and Risk Committee received quarterly audit and inspection reports from internal audit which outlined the work undertaken in each quarter alongside any follow up audits and the results of the audits. This provides Audit, Performance and Risk Committee members the opportunity to gain assurance that internal controls are operating as expected. We had previously reported that the IJB should look to strengthen the reporting of NHS Grampian’s internal audit results. In prior years, the reporting had been heavily weighted towards activity at Moray Council, with limited updates on the results of internal audit activity at the health board. An agreement has now been reached with the management of NHS Grampian and their Internal Audit Provider to allow the Chief Internal Auditor to confidentially report NHS Grampian's internal audit reviews of systems and practices of interest to the IJB to the Audit, Performance, and Risk Committee. This improves the level of oversight members have and provides a complete picture of both organisations. Joint inspection of adult support and protection: review of progress in the Moray partnership The Care Inspectorate published a report in October 2024 detailing the results of a progress review carried out by the Care Inspectorate, Healthcare Improvement Scotland and His Majesty’s Inspectorate of Constabulary in Scotland, following a previous joint inspection of adult support and protection conducted in 2022. The results of both Moray Council and NHS Grampian internal audit activity is now reported to the Audit, Performance and Risk Committee. Improvements were noted by the Care Inspectorate in relation to the delivery of adult support and protection. Page 181
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (5) 39 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Joint inspection of adult support and protection: review of progress in the Moray partnership (continued) The progress review concluded that the Moray partnership’s efforts to implement seven priority areas for improvement were timely, rigorous and effective. Inspectors found that key processes for adult support and protection that required improvement were now demonstrably sound and effective. This improved the safety, health, and wellbeing outcomes for adults at risk of harm. Some improvement areas were identified by the Care Inspectorate, notably the provision of risk assessments for all adults at risk of harm who require them, and the quality of recording adult support and protection matters in health records. In November 2024, the IJB approved the Adult Support and Protection (ASP) Improvement Action Plan following the inspection. A progress report outlining the progress made towards each of the planned actions is presented at each sitting of the Adult Protection Committee. The IJB have agreed that any reporting to the Board will be by exception. Joint Strategic Needs Assessment All integration authorities are required to oversee the production of Joint Strategic Needs Assessments (JSNA) to analyse the needs of local populations and to inform and guide the commissioning of health, wellbeing and social care services within their area. The revised JSNA for adults was approved by the Moray IJB on 26 September 2024. The findings from the JSNA were considered when preparing the new Strategic Delivery Plan. Page 182
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources 40 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes No risk identified Strategic Planning The IJB have a Strategic Plan covering 2022-2032. The Strategic Plan identifies the IJB’s strategic themes: • Building Resilience - Taking greater responsibility for health and wellbeing • Home First - Being supported at home or in a homely setting as far as possible • Partners in Care - Making choices and taking control over decisions affecting care and support Underpinning these themes are several objectives which detail how the IJB will achieve each objective. To support the delivery of the Strategic Plan, the IJB approved the Strategic Delivery Plan 2025 – 2028 at the IJB Board meeting on 27 March 2025. The Strategic Delivery Plan sets out the programme of transformational and improvement work underway to enable the IJB to meet its strategic priorities. The Strategic Plan itself is also supported by the IJB's Workforce Plan, Medium Term Financial Strategy and Commissioning and Procurement Plan. The Strategic Delivery Plan reflects the key actions being driven by the IJB over the next three years. It is a live document, meaning the IJB can be responsive to new or emerging priorities. The Strategic Delivery Plan provides high level information about each action, and links to strategic objectives and strategic themes. This includes a key summary and the priority tasks that will be undertaken. A lead action owner is identified alongside a timescale for completion. Progress of the Strategic Delivery Plan is monitored by the Senior Management Team (SMT) and the Strategic Planning and Commissioning Group (SPCG), with a summary report to the Board every six months. A high- level summary of performance against the outcomes of the Strategic Delivery Plan is also reported to the Audit, Performance and Risk (APR) Committee on a quarterly basis. The IJB have approved the new Strategic Delivery Plan which identifies the set of actions the IJB will complete in order to deliver its strategic objectives. There are clear links between the Strategic Plan and Strategic Delivery Plan with a clear set of actions laid out in the Strategic Delivery Plan Page 183
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (1) 41 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting A performance report is published annually which outlines the IJB’s annual performance against the strategic priorities of the Health and Social Care Partnership and evidencing some of the key achievements and challenges faced by the IJB. Furthermore, the report provides details on the IJB’s performance in relation to the Scottish Government’s core suite of national integration indicators which allows comparisons to be made over time and against Scotland as a whole. We have previously reported that management should review the format of the Performance Report and content to ensure it is succinct, focuses on the IJB’s performance and outcomes, and supports the user of the financial statements to understand the IJB’s purpose and achievements in year. This has not been actioned during 2024/25 and remains an open action for implementation. The IJB have confirmed that the Performance Management Framework will be reviewed in 2025/26 following the approval of the Strategic Delivery Plan. Our review of the 24/25 performance report highlights that out of the 19 national indicators reported: • nine were showing as green (IJB performance has improved from last year), • four indicators were showing as amber (performance is similar to last year) • five were showing as red (performance is worse than previous year. There was one indicator that data is not available for reporting. The red indicators in the performance report, where the IJB’s performance worsened during 2024/25 are detailed on the following page. The performance report notes that national indicators 1-9 only report performance information every two years and therefore the comparisons being made relate to 2023/24 performance, not 2024/25 performance for these nine indicators. We have obtained assurance that appropriate performance monitoring and reporting arrangements are in place at the IJB, and where indicators are worsening, the IJB then agree upon actions that need to be taken to improve performance. The IJB’s performance is showing a general trend of improvement against the national indicators. Page 184
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (2) 42 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting (continued) Source: 2024/25 Annual Performance Report Note: National Indicators 1-9 are based on the HACE survey which is undertaken every two years. 2024/25 figures remain the same as reported in 2023/24 Annual Performance Report. Moray faces the challenge of an increasing older population with a decline in working age population, staff recruitment challenges and lack of available accommodation against a backdrop of significant financial challenge. Adult social care is widely publicised as being under pressure in all local government authorities, so this issue is not specific to Moray IJB. The IJB will need to ensure that it is able to continue to deliver safe and effective adult services considering the challenging financial background faced alongside a growing aging demographic. This will require wider transformation of the IJB which is outlined within the Financial Sustainability section of this report. National Indicator (Moray IJB reporting as red) 2023/24 2024/25 Scotland Avg. (24/25) 2. Percentage of adults supported at home who agree that they are supported to live as independently as possible 72% 72% 72% 3. Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided 59% 59% 60% 8. Percentage of carers who feel supported to continue in their caring 28% 28% 31% 9. Percentage of adults supported at home who agree they felt safe 70% 70% 73% 17. Inspectorate inspections 81.1% 73.8% 81.9% Page 185
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (3) 43 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting (continued) The IJB have an agreed set of local performance indicators, with updates reported each quarter to the Audit, Performance and Risk Committee. Performance is reported in a RAG status, with five of the eleven indicators within agreed tolerance levels The table below shows the performance of each indicator as at March 2025: The IJB’s performance against its local indicators is mixed, with six indicators below agreed target levels. Target 2024/25 RAG A&E attendance rate per 1000 population all ages 21.9 22.0 Number of Delayed Discharges (including code 9) at census point 26 40 Number of bed days occupied by delayed discharges (incl. code 9) at census point 850 1149 Rate of emergency occupied bed days for over 65s per 1000 population 2681 2412 Emergency admission rate per 1000 population for over 65’s 187 177.8 Number of people over 65 years admitted as an emergency in the previous 12 months per 1000 population 131 125.7 % Emergency readmissions to hospital within 7 days of discharge 3.7% 3.9% % Emergency readmissions to hospital within 28 days of discharge 7.9% 7.4% % of patients commencing Psychological Therapy Treatment within 18 weeks of referral 90% 65% NHS Sickness Absence (% of hours lost) 4% 4.9% Council Sickness Absence (% of calendar days lost) 4% 8.2% Page 186
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (4) 44 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting (continued) The performance monitoring reports taken to the Audit, Performance Risk Committee clearly indicate the planned actions to address each indicator assessed as below target. The reports identify mitigations the IJB have agreed to achieve improvement in each indicator, and these are monitored via the reporting to the Committee. Performance Framework Development Following the approval of the Strategic Delivery Plan, a review of the performance management framework is underway. The IJB have appointed a Senior Performance Officer as part of the review process. The IJB intend to develop a refreshed set of performance indicators as part of the review. Reporting arrangements are also being developed to ensure there is more clarity between activity and outcomes and to support the delivery of the strategic priorities set out in the Strategic Delivery Plan plan The IJB are carrying out a review of the Performance Framework with updates planned to be in place by the end of 2025. Page 187
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Best value conclusions 45 Under the Code of Audit Practice, the audit of Best Value in Integration Joint Boards is fully integrated within the annual audit work performed by appointed auditors and their teams. As part of our integrated wider-scope annual audit work, we as appointed auditors use a risk-based approach to assess and report whether the IJB has made proper arrangements for securing Best Value and how the body demonstrates that it is meeting Best Value responsibilities. The principles of best value are embedded within the wider scope work we perform, and the judgements made within the wider scope work allow us to make an assessment over Best Value. Conclusion Integration Joint Board’s have a statutory duty to have arrangements to secure Best Value. To achieve this, Integration Joint Boards should have effective processes for scrutinising performance, monitoring progress towards the strategic objectives and holding partners to account. The IJB have arrangements in place to secure Best Value, as demonstrated in the Annual Governance Statement. We consider these arrangements as part of our regular wider scope work and have provided our conclusions. We have noted that the IJB have no mechanism for formally reviewing and reporting on the arrangements to secure best value. We recommend that the IJB should undertake a formal review of the Best Value assurance framework and complete an assessment of the arrangements to secure Best Value. The outcome of the assessment should be reported to the Audit, Performance and Risk Committee at the end of each financial year, with reference made to this assessment in the Annual Governance Statement. See recommendation raised at Appendix B. Page 188
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Appendices 46 Page 189
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow A. Audit adjustments Impact of adjusted misstatements During the course of the audit, there were no adjusted non-trivial misstatements which were made that require reporting within our Annual Audit Report. Impact of unadjusted misstatements During the course of the audit, there were no unadjusted non-trivial misstatements which were made that require reporting within our Annual Audit Report. Impact of unadjusted misstatements in the prior year There was no unadjusted misstatement identified in the prior year audit. 47 We are required to report all non-trivial misstatements to those charged with governance, whether or not the accounts have been adjusted by management. Page 190
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow A. Audit adjustments (2) Misclassification and disclosure changes The table below provides details of substantive misclassification and disclosure changes identified during the audit which have been made in the final set of financial statements. This list of misclassification and disclosure changes reflects presentational adjustments to the financial statements which have no impact on the Council’s reported financial position. 48 Disclosure Auditor recommendations Adjusted? General There were minor changes noted to grammar and to correct spelling and other consistency issues. The health board has corrected these in the final version of the financial statements. Such changes are are expected and do not warrant detailed explanation. Yes Other Information We identified changes were required to the Moray Integration Joint Board members disclosure to accurately reflect membership during 2024/25. Yes Management Commentary We identified that detail should be added into the Management Commentary to explain the underspend in Strategic Funds and Other Resources budget. Yes Governance Statement We identified that additional disclosure should be added to confirm the processes in place to monitor the implementation of audit recommendations. Yes Remuneration Report We identified that all references to Interim Chief Officer should be removed as the position was made permanent in November 2024. We identified a difference of £2k in the lump sum calculation for the Chief Officer. The accounts were amended to include the correct figure. Yes Note 4 - Expenditure and Income Analysis by Nature We identified that the audit fee disclosure should be amended to state the final agreed audit fee. Yes Page 191
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Action plan and recommendations – wider scope and best value 49 We have set our below, based on our audit work undertaken in 2024/25, the key recommendations arising from our wider scope and best value audit work: Recommendation Agreed management response 1. Financial Management – Reporting of savings The budget and financial reports presented to the Board and Audit, Risk and Performance Committee do not detail whether savings are expected to be recurring in nature. Adding this context into both documents would provide a clear indication as to whether savings are expected to be one off savings or whether the benefit will continue in future years. The IJB prepare a year-end outturn which includes the final high-level savings position. However, this report does not include the appendix presented as part of the in-year monitoring reports detailing the final delivery position. It would be good practice to provide this same level of detail as part of the year-end outturn report which allows a comparison across the full financial year. Recommendation: The IJB should indicate whether savings are expected to be recurring or non- recurring in nature. The IJB should prepare a report showing a breakdown of savings delivered on a project basis as part of the year-end outturn report. Summary has previously been shown at year end but detailed workings always available and this recommendation can easily be implemented along with recurring and non-recurring savings for the next report due. Action Owner: Chief Finance Officer Timescale for implementation: 30 June 2026 Page 192
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Action plan and recommendations – wider scope and best value (2) 50 Recommendation Agreed management response 2. Assessment over the arrangements to secure Best Value We have noted that the IJB have no mechanism for formally reviewing and reporting on the arrangements to secure best value. Recommendation: The IJB should undertake a formal review of the Best Value assurance framework and complete an assessment of the arrangements to secure best value. The outcome of the assessment should be reported to the Audit, Performance and Risk Committee. The IJB will complete a self assessment for best value assurance for the end of the financial year. Action Owner: Chief Finance Officer Timescale for implementation: 31 March 2026 Page 193
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations 51 We identified the following issues in our prior year wider scope work, which resulted in twelve recommendations being reported in our 2023/24 Audit Findings Report. We have performed additional work in year to obtain assurance whether the recommendations have been closed and resolved in the current year or whether the issue still exists and the recommendation remains open and/or in progress. Six out of twelve recommendations have been cleared with one in progress and five still open. Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed Revenue Budget Setting The IJB is required to set its budget before the end of March. Whilst the IJB set a working budget on 28 March 2024 it did not formally approve the 2024/25 revenue budget until 30 May 2024. Recommendation: The IJB should ensure it presents its final budget, with all agreed savings, before the start of the financial year Work has been ongoing throughout 2024/25 to produce a balanced budget for 2025/26 which was presented to the Moray IJB Board on 27 March 2025 The IJB presented the 2025/26 budget to the Board on 27 March 2025, in advance of the start of the financial year and in line with required timescales. [Red] Recommendation is open [Amber] Recommendation is in progress [ Green] Recommendation is closed Page 194
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (2) 52 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Financial Sustainability – Reserves The IJB intend to utilise £1.346 million of earmarked reserves to bridge the budget deficit in 2024/25. There is a risk that continued reliance on reserves to bridge funding gaps will create financial sustainability issues for the IJB. Recommendation: The IJB will need to continue to monitor the percentage level of adequate reserves as funding gaps continue to grow and the IJB looks to transformation in future years to ensure reserves do not dip to an unsustainable level. Consideration has been given to the level of reserves in the IJB and the savings achieved are not able to provide a level of general reserves for 2025/26. For 2025/26 budget the IJB again intends to utilise £1 million of ear marked reserves to bridge the budget deficit. The latest Audit Scotland publication makes reference to the fact a significant number of IJBs are using reserves and not just unique to Moray. The 2025/26 budget has been agreed, with the IJB intending to use £1.000 million of earmarked reserves balances. The IJB have a limited amount of reserves balances (£1.450 million as at end of 2024/25) and continued use of reserves balances to manage the funding gap is not sustainable. The IJB should aim to bridge funding gaps through transformation and identifying alternative ways to deliver services. Recommendation remains valid. Revised Target Date: 31 March 2026 Closed Medium-Term Financial Strategy The Medium-Term Financial Strategy was last updated in March 2023 and is considered out of date. If the plan is not updated on a regular basis, there is a risk that the IJB are unaware of the potential funding implications over the medium term. Recommendation: The IJB should re-evaluate the financial outlook over the medium term and update the Medium-Term Financial Strategy to identify the total funding gap over the medium term. The updates to the Medium-Term Financial Framework (MTFF) were delayed, however the MTFF has now been refreshed and was presented at the Moray IJB Committee meeting on 27 March 2025. The MTFF has been updated and provides detail on the financial pressures for 2025/26 and beyond. The funding gap to 2029/30 is estimated to be £18.2 million. Page 195
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (3) 53 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed Reporting of NHS Grampian Internal Audit Activity Internal audit reporting is heavily based on activities within Moray Council. Moray IJB should look to strengthen the reporting of NHS Grampian’s internal audit results within the IJB to provide oversight to members and to provide a complete picture of both organisations. Recommendation: To ensure oversight of NHS Grampian internal audit reports, reporting to the Audit, Performance and Risk Committee needs to be strengthened. Implemented – An agreement has now been reached with the management of NHS Grampian and their Internal Audit Provider to allow the Chief Internal Auditor to confidentially report NHS Grampian's internal audit reviews of systems and practices of interest to the MIJB to the Audit, Performance, and Risk Committee NHS Grampian Internal Audit report which are relevant to the IJB are now reported in private to the Audit, Performance and Risk Committee. This ensures IJB members have oversight of the reporting of NHS Grampian internal audit activity. In progress Senior Management Team Following the retirement of the previous Chief Officer, the current Chief Officer has been appointed on an interim basis. Furthermore, the Chief Social Worker at the Council is also appointed on an interim basis. Recommendation: The IJB and Council need to secure permanent positions for the both posts to provide certainty over the future direction of the IJB. Following an open recruitment process a permanent Chief Officer was appointed in November 2024, the role being offered and accepted by the person undertaking the role as an interim. Given this, they were able to start in the permanent role immediately. A process will now be undertaken to recruit to the permanent CSWO role. The IJB have recruited a permanent Chief Officer who has been in role since November 2024 and had previously been appointed on an interim basis. To date, no permanent appointment has been made to the CSWO role meaning this recommendation is in progress. Recommendation is in-progress. Revised Target Date: 31 March 2026 Page 196
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (4) 54 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Internal Audit Limited Assurance Opinion This is the third year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. Recommendation: The IJB should have definitive plans in place to avoid further limited assurance opinions. Progress has been made, however there are still concerns with the recommendations being implemented following audits, progress on CareFirst and realisation of the savings, resulting in the Internal Audit Manager providing another limited assurance opinion in 2024/25. This is the fourth year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. The IJB still require to put definitive plans in place to avoid further limited assurance opinions. Recommendation remains valid. Revised Target Date: 31 March 2026 Closed Internal Audit Recommendations As part of their reviews, internal audit make recommendations for management to action. Whilst the IJB have introduced a recommendations tracker, this is not presented to each Audit Committee meeting. Recommendation: The IJB should ensure that the tracker of internal audit recommendations is reviewed periodically and reported to each Audit, Risk & Performance Committee meeting. Tracker has been completed and ownership agreed at OMT meetings, with monthly escalations to SMT on an exception basis. Then if SMT deem it should be escalated to APR a report will be compiled. The IJB have introduced an internal audit recommendations tracker, however this is not presented to each Audit, Performance and Risk Committee meeting. During 2024/25, the IJB have agreed that internal audit recommendations will be reviewed at Operational Management Team (OMT) meetings, with monthly escalations to Senior Management Team (SMT) meetings on an exception basis. If SMT deem any issues require escalation, a report would then be compiled for reporting to the Audit, Performance and Risk Committee. This approach is deemed to be reasonable and recommendation can be closed. Page 197
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (5) 55 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Performance Report - Recommendation: Management should review the format of the Performance Report and content to ensure it is succinct, focuses on the IJB’s performance and outcomes, and supports the user of the financial statements to understand the IJB’s purpose and achievements in year. Due to continuation of limited staffing resources this has not been able to be achieved in this financial year. The performance will be reviewed for 2025/26 following the approval of the Strategic Delivery Plan which was presented to the Moray IJB Committee on 27 March 2025 There has been no updates to the format of the Performance Report in 2024/25. Recommendation remains valid. Revised Target Date: 31 March 2026 Closed Financial Sustainability – Reserves – Recommendation: The IJB will need to continue to monitor the percentage level of adequate reserves as funding gaps continue to grow and the IJB looks to transformation in future years to ensure reserves do not dip to an unsustainable level. There have been no general reserves maintained in the IJB and the level of earmarked reserves has decreased as they have been used during the year. This recommendation has been superseded by a further recommendation on reserves balances and is now closed. Page 198
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (6) 56 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Financial Sustainability - Transformation - Recommendation: A depth of pace will need to be undertaken on the transformation programme to ensure the IJB can bridge the significant funding gap in a short space of time, to ensure that not only efficiencies can be delivered but that financial sustainability can be achieved. To ensure financial sustainability for the medium to longer term, the IJB will need to ensure that it is able to deliver increased productivity and efficiency initiatives to reduce costs and deliver financial benefits. The IJB will need to upscale the pace and delivery of transformation to achieve and mitigate the risk of becoming financially unsustainable. Savings plan in place for 2024/25 covered two financial years and the savings plan in place for 2025/26 will again be over more than one financial year. Transformation plans are also part of the savings plan for future years. The IJB understand the need for transformational change however the 2025/26 budget monitoring outlines that the IJB is projecting to overspend by £4.685 million. The recommendation remains relevant as the IJB need to continue to look for alternative means of service delivery which will increase productivity and the efficiency of the service. Recommendation remains valid. Revised Target Date: 31 March 2026 Closed Best Value – External Audit Action Log - Recommendation: Moray IJB should create a mechanism to monitor progress against external audit recommendations and the report should be brought to the relevant Committee on a regular basis to ensure scrutiny and challenge by members. Included in the papers for IJB on 27 March 2025 and will be scrutinised on a regular basis thereafter The IJB presented a report to the Audit, Performance & Risk Committee meeting in March 2025 which provided a progress update on external audit recommendations. This will be a standard agenda item going forward. Page 199
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Follow up of prior year recommendations (7) 57 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Vision, Leadership and Governance – Internal Audit – Recommendation: Moray IJB should ensure audit recommendation dates are realistic when set and are monitored for implementation. Where dates are moved or not met, a thorough understanding and follow up of these should be sought and explanations provided. A mechanism should be implemented to follow up on officers should missing recommendation deadlines becomes regular. Tracker has been completed and ownership agreed at OMT meetings, with monthly escalations to SMT on an exception basis. Then if SMT deem it should be escalated to APR a report will be compiled. The Internal Audit Annual Report confirmed that the follow-up audits undertaken during 2024/25 found a number of recommendations where revised timescales for the implementation of recommendations were required. The need to revisit audit reviews to evidence the implementation of recommendations has resulted in an additional workload commitment for the Internal Audit Section. The implementation of recommendations is a key determinant in assessing the adequacy and effectiveness of the internal control system. If recommendations are not implemented in a timely manner, then weaknesses in control and governance frameworks will remain. The lack of response to previous recommendations is one of the reasons for the limited audit assurance opinion issued by Internal Audit. Whilst we recognise the IJB have agreed an approach to monitoring existing recommendations, focus must be given to implementing these recommendations. Recommendation remains valid. Revised Target Date: 31 March 2026 Page 200
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow D. Audit fees, ethics and independence 58 Independence and ethics We confirm that there are no significant facts or matters that impact on our independence as auditors that we are required or wish to draw to your attention and consider that an objective reasonable and informed third party would take the same view. We have complied with the Financial Reporting Council's Ethical Standard and confirm that we, as a firm, and each covered person, are independent and are able to express an objective opinion on the financial statements. We confirm that we have implemented policies and procedures to meet the requirement of the Financial Reporting Board’s Ethical Standard. Ethical Standards and ISA (UK) 260 require us to give you timely disclosure of all significant matters that may bear upon the integrity, objectivity, and independence of the firm or covered persons (including its partners, senior managers, managers and network firms). In this context, there are no independence matters that we would like to report to you. As part of our assessment of our independence we note the following matters: Matter Conclusion Relationship with Grant Thornton We are not aware of any relationships between Grant Thornton and Moray IJB that may reasonably be thought to bear on our integrity, independence and objectivity Relationships and investments held by individuals We have not identified any potential issues in respect of personal relationships with the Entity or investments in the organisation held by individuals Employment of Grant Thornton staff We are not aware of any former Grant Thornton partners or staff being employed, or holding discussions in respect of employment, by the IJB as a director or in a senior management role covering financial, accounting or control related areas. Business relationships We have not identified any business relationships between Grant Thornton and Moray IJB. Contingent fees in relation to non-audit services No contingent fee arrangements are in place, note that there are no non-audit services provided. Gifts and hospitality We have not identified any gifts or hospitality provided to, or received from, a member of the organisation's board, senior management or staff. Page 201
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow D. Audit fees, ethics and independence (2) 59 Fees and non-audit services The tables below set out the total fees for audit and other services charged from the beginning of the financial year to the current date, as well as the threats to our independence and safeguards have been applied to mitigate these threats. None of the below services were provided on a contingent fee basis. For the purposes of our audit we have made enquiries of all Grant Thornton teams within the Grant Thornton International Limited network member firms providing services to Moray IJB. The table summarises all non-audit services which were identified. The final audit fee includes additional audit fee of £2,500 which has been agreed with the Chief Finance Officer. The planned audit fee included an additional fee for significant additional work that is required in the wider scope analysis than would usually be expected. This included a more detailed section on financial sustainability appreciating the significance of savings and budget pressures in 2024/25 and beyond. The Annual Audit Report will be considered by the Audit, Performance and Risk Committee on 24 October 2025 including agreement of audit fees. External audit fee Fees for other non-audit services Service Planned Fees Final Fees External Auditor Remuneration - Baseline £36,450 £36,450 External Auditor Remuneration - Additional audit fee £2,500 £2,500 Pooled Costs £920 £920 Contribution to Performance Audit and Best Value £7,000 £7,000 Sectoral cap adjustment (£10,370) (£10,370) 2024/25 Audit Fee £36,500 £36,500 Service Fees £ We confirm that for 2024/25 we did not receive any fees for non-audit services Nil The fees reconcile to the financial statements (round £’000 in the financial statements): • Fees per financial statements £37,000 • Total fees as above £36,500 The final audit fee with the additional fees is £36,500. The total fee is £2,500 higher than the Audit Scotland indicative fee set. Page 202
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow E. Client Service Review 60 Client service We take our client service seriously and continuously seek your feedback on our external audit service. Should you feel our service falls short of expected standards please contact Joanne Brown, Head of Public Sector Assurance Scotland in the first instance who oversees our portfolio of Audit Scotland work (joanne.e.brown@uk.gt.com). Alternatively, should you wish to raise your concerns further please contact Mark Stocks, Partner, 8 Finsbury Circus, London, EC2M 7EA. If you feedback relates to audit quality and we have not successfully resolved your concerns, your concerns should be reported to John Gilchrist, Audit Scotland Quality and Appointments in accordance with the Audit Scotland audit quality complaints process. Transparency Grant Thornton publishes an annual Transparency Report, which sets our details of the action we have taken over the past year to improve audit quality as well as the results of internal and external quality inspections. For more details see Transparency report 2024 (grantthornton.co.uk). Page 203
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Our communication plan Audit Plan Annual Report (ISA 260 Report) Respective responsibilities of auditor and management/those charged with governance Overview of the planned scope and timing of the audit, including planning assessment of audit risks and wider scope risks Confirmation of independence and objectivity A statement that we have complied with relevant ethical requirements regarding independence. Relationships and other matters which might be thought to bear on independence. Details of non-audit work performed by Grant Thornton UK LLP and network firms, together with fees charged. Details of safeguards applied to threats to independence Significant matters in relation to going concern Views about the qualitative aspects of Moray IJB’s accounting and financial reporting practices, including accounting policies, accounting estimates and financial statement disclosures Significant findings from the audit Significant matters and issues arising during the audit and written representations that have been sought Significant difficulties encountered during the audit Significant deficiencies in internal control identified during the audit Significant matters arising in connection with related parties Identification or suspicion of fraud involving management and/or which results in material misstatement of the financial statements Non-compliance with laws and regulations F. Communication of audit matters 61 RECOMMENDED CONTENT – entities OTHER THAN PIEs Guidance note The requirements here are relevant to entities that are not PIEs. For PIEs, delete the slide. Red text may not be applicable and should be either deleted or amended as appropriate. Page 204
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© 2025 Grant Thornton. All rights reserved. ‘Grant Thornton’ refers to the brand under which the Grant Thornton member firms provide assurance, tax and advisory services to their clients and/or refers to one or more member firms, as the context requires. Grant Thornton International Ltd (GTIL) and the member firms are not a worldwide partnership. GTIL and each member firm is a separate legal entity. Services are delivered by the member firms. GTIL does not provide services to clients. GTIL and its member firms are not agents of, and do not obligate, one another and are not liable for one another’s acts or omissions. GUIDANCE NOTES: Please ensure every presentation has a back page with disclaimer Page 205
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REPORT TO: AUDIT, PERFORMANCE & RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: 2024/25 AUDITED ANNUAL ACCOUNTS BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To submit to Committee the Audited Annual Accounts for the year then ended 31 March 2025. 2. RECOMMENDATION 2.1 It is recommended that Committee consider and scrutinise the Audited Annual Accounts for the financial year 2024/25 and the letter of Representation and recommend approval to the Moray Integration Joint Board. 3. BACKGROUND 3.1 The Unaudited Annual Accounts for 2024/25 were submitted to the meeting of the Audit, Performance and Risk Committee on 19 June 2025 prior to submission to the Moray Integration Joint Board (MIJB) and external audit (paragraph 11 of the Minute refers). 3.2 The Annual Accounts have been prepared in accordance with International Financial Reporting Standards and the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014 and the Local Government in Scotland Act 2003. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The audit undertaken by the Board’s External Auditors, Grant Thornton is now complete. The External Auditors have expressed unqualified opinions in respect of the financial statements, the remuneration report, the management commentary and the annual governance statement. The Independent Auditor’s Report to the Members of the MIJB and the Accounts Commission is included Item 11. Page 207
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within the audited Annual Accounts and can be found on page 56. The audited Annual Accounts are attached at Appendix 1. 4.2 Attached at Appendix 2, is the letter of representation to the External Auditors from the members of the MIJB, for approval by Committee to be signed following this meeting. 4.3 The audit process highlighted changes to be made to the accounts which in the main were presentational and in parallel with expectation following external audit inspection. 4.3 The Auditor’s Annual Audit Report to the MIJB and the Accounts Commission is the subject of a separate report to this meeting. The report sets out the responsibilities of Grant Thornton as the independent auditor and presents a summary of the findings arising from the 2024/25 audit. The report confirms there are no unadjusted misstatements in the annual accounts to report to those charged with governance. 4.4 The Audited Annual Accounts are presented to this meeting for consideration and approval. Thereafter, the Chief Officer, Chief Financial Officer and the Chair of the Board will sign the accounts prior to submission to Grant Thornton prior to publication. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The Audited Annual Accounts have been completed within the statutory timescales and are being presented for consideration and sign off. (b) Policy and Legal The Public Bodies (Joint Working) (Scotland) Act 2014 requires that the MIJB is subject to the audit and accounts provisions of a body under Section 106 of the Local Government (Scotland) Act 1973. (c) Financial implications The adjustments and revisions made to the Annual Accounts following the external audit had no financial impact on the MIJB. (d) Risk Implications and Mitigation There are no risk issues arising directly from this report. The work undertaken by Audit Scotland provides assurance to the Board that the Annual Accounts for 2024/25 give a true and fair view in accordance with applicable law and the 2024/25 Code of the state of affairs of the MIJB as at 31 March. (e) Staffing Implications None arising directly from this report. (f) Property Page 208
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None arising directly from this report. (g) Equalities/Socio Economic Impact None arising directly from this report as there is no resultant change in policy. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy. (i) Directions None arising directly from this report (j) Consultations In preparation of the Annual Accounts, consultations have taken place between finance staff of both Moray Council and NHS Grampian who are in agreement within their areas of responsibility. The Chief Officer has been consulted and comments have been considered. 6. CONCLUSION 6.1 Following a completed external audit process and an unqualified opinion being received. The Audited Annual Accounts are presented here for scrutiny and to recommend the MIJB approve and formally sign off. Author of Report: Deborah O’Shea, Chief Financial Officer Background Papers: With author Ref: Page 209
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 Page 210
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 If you need information from the Moray Council in a different language or format, such as Braille, audio tape or large print, please contact: ياروم سلجم لبق نم تامولعم لىإ ةجاح ي ف متنك اذإ نوكتو ةغلب وأ ويدوأ ةناوطسأ ،يا ربلا لثم فلتخم لكش لىعوأ ةفلتخم نوكت نأ مط ب لاصّتلإا ءاجّرلاف ةظيلغ فورح لامعتساب ةعوب Jei pageidaujate tarnybos Moray tarybos teikiamą informaciją gauti kitokiu formatu, pvz., Brailio raštu, garso įrašu ar stambiu šriftu, kreipkitės: Jeśli potrzebują Państwo informacji od Rady Okręgu Moray w innym formacie, takim jak alfabet Braille'a, kasety audio lub druk dużą czcionką, prosimy o kontakt: Se necessitar de receber informações por parte do Concelho de Moray num formato diferente, como Braille, cassete áudio ou letras grandes, contacte: Ja Jums vajadzīga informācija no Marejas domes (Moray Council) citā valodā vai formātā, piemēram, Braila rakstā, audio lentā vai lielā drukā, sazinieties ar: ای نابز رگید یسک ےس لسنوک ےروم وک پآرگاتروص راکرد تامولعم ںیم لاثم ںوہ ˝ ،فورح ےڑب ای پیٹ ویڈآ ،ےلیربںیئامرف ہطبار رک امرف ینابرہم وت: Chief Finance Officer to the Moray Integration Joint Board, High Street, Elgin, IV30 1BX accountancy.support@moray.gov.uk Page 211
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 Table of Contents MORAY INTEGRATION JOINT BOARD MEMBERS 2024/25 .............................................. 1 MANAGEMENT COMMENTARY .......................................................................................... 2 STATEMENT OF RESPONSIBILITIES ............................................................................... 27 REMUNERATION REPORT ............................................................................................... 29 ANNUAL GOVERNANCE STATEMENT ............................................................................. 33 COMPREHENSIVE INCOME AND EXPENDITURE STATEMENT ..................................... 44 MOVEMENT IN RESERVES STATEMENT ........................................................................ 45 BALANCE SHEET .............................................................................................................. 46 NOTES TO THE FINANCIAL STATEMENTS ..................................................................... 47 Note 1 Significant Accounting Policies ............................................................................. 47 Note 2 Critical Judgements and Estimation Uncertainty .................................................. 48 Note 3 Events after the Reporting Period ........................................................................ 49 Note 4 Expenditure and Income Analysis by Nature ........................................................ 49 Note 5 Taxation and Non-Specific Grant Income ............................................................. 50 Note 6 Debtors ................................................................................................................ 50 Note 7 Usable Reserve: General Fund ............................................................................ 51 Note 8 Agency Income and Expenditure .......................................................................... 52 Note 9 Related Party Transactions .................................................................................. 53 Note 10 VAT .................................................................................................................... 55 Note 11 Accounting Standards That Have Been Issued but Have Yet To Be Adopted .... 55 INDEPENDENT AUDITORS REPORT…………………………………………………………...56 Page 212
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 1 MORAY INTEGRATION JOINT BOARD MEMBERS 2024/25 Voting Members Dennis Robertson (Chair) Grampian Health Board Tracy Colyer (Chair) Moray Council (Resigned 26/09/2024) Elaine Kirby (Chair) Moray Council (21/11/2024 to 31/07/2025) Bridget Mustard (Vice-Chair) Moray Council (Joined 1/08/2025) Sandy Riddell Grampian Health Board Derick Murray Grampian Health Board Alex Stephen Grampian Health Board (Joined 1/7/2024) Cllr. Peter Bloomfield Moray Council Cllr. Scott Lawrence Moray Council Cllr Ben Williams Moray Council Non-Voting Members Simon Bokor-Ingram Chief Officer (left 31/5/2024) Judith Proctor Chief Officer (Joined 15/7/2024) Jim Lyon Interim Chief Social Work Officer (Joined 3/6/2024) Tracey Stephen Chief Social Work Officer (left 17/6/2024) Jane Ewen Lead Nurse Professor Duff Bruce Non Primary Medical Service Lead Dr Robert Lockhart GP Lead Dr Malcolm Simmons GP Lead (left 31/3/2025) Janette Topp Third Sector Stakeholder (19/4/2024 – 11/2/2025) Sheila Brumby Service User Rep. (Joined 19/4/2024) Ivan Augustus Carer Representative Kevin Todd Moray Council Staff Representative Elizabeth Robinson Public Health Representative Deirdre McIntyre Grampian Health Board Staff Partnership Page 213
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 2 MORAY INTEGRATION JOINT BOARD MEMBERS 2024/25 Continued Co-opted Members Sean Coady Head of Service and Deputy Chief Officer Deborah O’Shea Chief Finance Officer Adam Coldwells Interim Chief Executive Grampian Health Board Roddy Burns Chief Executive, Moray Council (retired 31/5/2024) John Mundell Interim Chief Executive, Moray Council (2/4/2024 – 14/3/2025) Karen Greaves Chief Executive, Moray Council (Joined 17/3/2025) Sonya Duncan Interim Corporate Manager . MANAGEMENT COMMENTARY The Role and Remit of the Moray Integration Joint Board The Public Bodies (Joint Working) (Scotland) Act 2014 required that Moray Council and Grampian Health Board prepared an Integration Scheme for the area of the local authority detailing the governance arrangements for the integration of health and social care services. This legislation resulted in the establishment of the Moray Integration Joint Board (MIJB) that became operational from 1 April 2016. Moray Council and Grampian Health Board, as the parties to the Integration Scheme, each nominate voting members to the MIJB, currently, four elected members from Moray Council and four Grampian Health Board members. Under the Public Bodies (Joint Working) (Scotland) Act 2014, a range of health and social care functions have been delegated from Moray Council and Grampian Health Board to the MIJB who has assumed responsibility for the planning and operational oversight of delivery of integrated services. MIJB also has a role to play in the strategic planning of unscheduled acute hospital based services provided by Grampian Health Board as part of the ‘set aside’ arrangements. Hosted services also form part of the MIJB budget. There are a number of services which are hosted by one of the three IJB’s within Grampian Health Board area on behalf of all the IJBs. Responsibilities include the planning and operational oversight of delivery of services managed by one IJB on a day to day basis. MIJB has responsibility for hosting services relating to Primary Care Contracts and the Grampian Medical Emergency Department (GMED) Primary Care Out of Hours service. Page 214
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 3 MANAGEMENT COMMENTARY (continued) Key Purpose and Strategy Following review and consultation, the refreshed Strategic Plan (2022-2032) is a continuation of the 2019 Strategic Plan. The current plan emphasises the strength of integration and in addition to our two main Partners – Moray Council and Grampian Health Board - the MIJB recognises the importance of the Third and Independent Sectors and Unpaid Carers, in facilitating the successful operation of the partnership of Health & Social Care Moray. As with all health and social care systems Moray is facing increasing demand for services at the same time as resources – both funding and workforce availability - are under pressure. These challenges will intensify in the coming years as our population ages and more people with increasing complex needs require support to meet their health and care needs. The MIJB sets the direction and strategic intent through the development and implementation of the Strategic Plan and seeks assurance on the management and delivery of services through Board level performance reporting which ensures an appropriate level of scrutiny and challenge. The Strategic Plan identifies priority areas to support strategic direction and vision. STRATEGIC PLAN KEY THEMES MANAGEMENT COMMENTARY (continued) BUILDING RESILIENCE – Taking greater responsibility for our health and wellbeing HOME FIRST – Being supported at home or in a homely setting as far as possible PARTNERS IN CARE – Supporting citizens to make choices and take control of their care and support WE ARE PARTNERS IN CARE OUR VISION: “We come together as equal and valued partners in care to achieve the best health and wellbeing possible for everyone in Moray throughout their lives.” OUR VALUES: Dignity and respect; person-led; care and compassion; safe, effective and responsive OUTCOMES: Lives are healthier – People live more independently – Experiences of services are positive – Quality of life is maintained/improved – Health inequalities are reduced – Carers are supported – People are safe – The workforce continually improves – Resources are used effectively and efficiently Page 215
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 4 The Plan purposefully places an emphasis on prevention and early intervention activities and seeks to prioritise these activities as a long term goal, actively pursuing good health and wellbeing for the population, with increased investment in this area of work. It highlights the Home First approach and the rationale for this is to assist people in understanding that “hospital is not always the best place for people”, a statement frequently used and in particular if you are frail and elderly can be counter intuitive to a successful recovery. Initiatives to transform services in response to high levels of demand continue. The Moray Strategic Plan was refreshed in 2022 and along with the associated delivery plan, which was updated in May 2025, highlights key priorities for transformation. Population Moray is a largely rural area covering a land mass of 2,238 sq. km. It has a long coastline on the Moray Firth with harbours, fishing villages and world-class beaches. From the 2022 census, the area’s population is 93,4001, which is an increase of 0.1% since 2011. The population growth in Moray is slowing and it is projected that the population in Moray will start to decline by 2030. This trend is forecast to continue. The main centre of population is Elgin, which is home to more than one quarter of the people living in Moray. Other towns of population between 4,000 and 10,000 are Forres, Buckie, Lossiemouth and Keith. The table below sets out projected population growth based on the 2022 baseline, which has not changed from the 2018 publication. Across Scotland there is a projected reduction in those in the 0-15 age group, limited change in the working age population, but significant growth in adults of pensionable age. By comparison it is projected that Moray will have a greater decrease in children, a marked decrease in those of a working age, but a significantly higher change in those of a pensionable age2. MANAGEMENT COMMENTARY (continued) 1 Scotland's Census 2022 - Rounded population estimates - data | Scotland's Census 2 Population Projections for Scottish Areas 2018-based - National Records of Scotland (NRS) -22.2% -9.0% 30.8% -10.5% -0.2% 23.2% -30.0% -20.0% -10.0% 0.0% 10.0% 20.0% 30.0% 40.0% Children (0-15) Working Age Pensionable age and overProjected change (%) Age Group Projected percentage change in population (2018- 2043) by age Moray Scotland Page 216
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 5 Performance Reporting Performance is reported quarterly to the Audit, Performance and Risk Committee of the MIJB. In addition to the quarterly reporting, there is a requirement under the Public Sector (Joint Working) (Scotland) Act 2014 for the MIJB to produce and publish an Annual Performance Report setting out an assessment of performance in planning and carrying out the delegated functions for which they are responsible. The Annual Performance Report is due to be published by 31 July this year and will be published on the Health & Social Care Moray website, once approved by the MIJB. One of the major aims of integration and a key measurable target for MIJB is to reduce the number of Moray residents that are ready to be sent home from hospital but have been delayed in this process. This is referred to as a ‘delayed discharge’. Delayed discharge can occur due to many reasons but quite often involves the onward provision of social care which can be complex in nature and/or finite in its availability. Figures 1 and 2, below, notes Moray’s performance over a six-year period showing the number of delayed discharge bed days occupied varying significantly and with minimal seasonal pattern up to March 2025. Delayed discharges reduced during the COVID pandemic and the lock down periods, as people stayed in their own homes as per advice at the time and there was more availability of family members to support care needs. Notably, delayed discharges began to rise in Moray and across the country in March 2022 and work commenced across the three partnerships in Grampian to address the issue. Results in this activity can be seen from March 2023 onwards. However, winter 2023 saw delayed discharges increasing, in Moray and across the country and continues at an increased level. Figure 1 MANAGEMENT COMMENTARY (continued) Page 217
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 6 Figure 2 There continues to be a focus on ensuring people are getting home quickly and can maintain their independence. In figures 3 and 4, below, the rate of emergency occupied bed days for over 65 years of age per 1000 population has increased since 2021/22 with a slow decrease since March 2023. With an ageing population the number of people delayed at any one time could increase again unless viable, sustainable alternative community provision is developed. Presentations to hospital from an older population have more acuity and complexity, exacerbating the issue of delays. The Scottish Government have now set targets for delayed discharges per 100,000 and for Moray the target is 26. This presents a challenge, but efforts continue to review and streamline processes and improve flow across the system. The importance of integration across the system is key to making progress, and over the year teams have enhanced communication and decision making as a Moray system. There has been further redesign of pathways and dedicated resource assigned to supporting critical decision making in social care. This has all supported the steady progress that is evident from the national comparisons of Moray’s performance. 0 200 400 600 800 1000 1200 1400 1600 Jun Sep Dec Mar Number of bed days occupied by delayed discharges 18+ at census date 2020/21 2021/22 2022/23 2023/24 2024/25 Page 218
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 7 MANAGEMENT COMMENTARY (continued) Figure 3 The figures for 2019/20 and 2020/21 have been restated as these figures are subject to change as more patients are discharged from hospital and when there is a annual mid year population estimate. The figures now included are accurate and in line with reports elsewhere. Figure 4 1500 1700 1900 2100 2300 2500 2700 2900 Jun Sep Dec Mar Rate of Emergency Occupied Bed Days for over 65s per 1000 population 2020/21 2021/22 2022/23 2023/24 2024/25 Page 219
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 8 MANAGEMENT COMMENTARY (continued) Moray Integration Joint Board (MIJB) The MIJB has scrutinised and directed the delivery of services in line with the Integration Scheme and Strategic Plan while recognising that the cost base has to change as the level of available budget in real terms is reducing. Both funding partners (Moray Council and NHS Grampian) have significant savings to achieve, and against this backdrop the MIJB directed a series of workshops during the year to support officers in their work. The focus has continued to be on achieving the highest quality and safety possible within a diminished budget, while being most efficient, and achieving the best possible outcomes for our residents. The Strategic Plan aspires to increasing spend on preventative work, “upstream” to tackle issues earlier, preventing crises where possible and reducing demand. However, a key challenge going forwards will be to continue that focus at a time when budgets are under so much pressure and people are presenting with increasingly complex needs. Performance The MIJB, its committees and the Health and Social Care Partnership Senior Management Team receive regular assurance reports and updates on how the Strategic Plan commitments are being progressed through work streams and individual service plans, as well as detailed financial and performance updates. The strategic risk register was reviewed by the Moray Integration Joint Board and Senior Management Team. It was approved in May 2025 and will form part of a robust risk monitoring framework in order to identify, assess and prioritise risks related to the delivery of services, particularly any which are likely to affect the delivery of the Strategic Plan. The inherent risks being faced by the MIJB, together with a current assessment on the level of the risks and mitigating actions being taken to reduce the impact of the risks, is reported to biannually to the Audit Performance and Risk Committee for oversight and assurance. Management teams and the Care and Clinical Governance Group review and respond to any reports produced by Audit Scotland, Healthcare Improvement Scotland, the Care Inspectorate, and the Mental Welfare Commission for Scotland. Quarterly performance reports are produced for Health and Social Care Moray (HSCM) management to review performance and to determine actions required to address areas for concern or to highlight areas showing improvement. This information is further scrutinised by the Senior Management team and then reported to the MIJB’s Audit, Performance and Risk Committee. There are many initiatives and ongoing projects being undertaken by HSCM that are seeking to reduce the delays in hospitals and to meet unmet needs. For example, ensuring the provision of care at home is maximised within available budget is a key aspect of the Strategic Care at Home workstream. Page 220
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 9 MANAGEMENT COMMENTARY (continued) Research into the type of equipment, benefits and impacts is being undertaken by the Digital Health Institute as part of the Growth Deal which will inform our Technology Enabled Care and Digital strategy which will provide other options for supporting people to live independently in their own homes. The collaborative initiative Discharge Without Delays being undertaken by partners across NHS Grampian, is aiming to reduce delays currently experienced by people who are medically fit to return home and is being facilitated by Health Intelligence Scotland. Whole system outcomes have been determined which will be incorporated into the revised performance report to this committee for 2025/26. The integration of Children & families and Justice services into Health & Social Care Moray under the direction of the MIJB is not yet reflected in the Board’s Strategic Plan. Work in ongoing to ensure appropriate governance of performance reporting so that it can be included in future MIJB Annual Performance Reports. Strategy and Plans The MIJB is required to review its Strategic Plan every three years as per the legislation. The Strategic Plan 2022-2032 places an emphasis on prevention and early intervention with the aim of building resilience for individuals and communities. The Plan identified key aims of the MIJB and directed HSCM to work closely with communities and key partners to reform the system of health and social care in Moray. It was also recognised that progress has been made against the three strategic themes and the review of the Plan focused on what already has been achieved the long-term strategic objectives make room for adapting to challenges and developments in health and social care over the coming years. The current Strategic Plan sets out the 3 key themes and the objectives; • Building Resilience – supporting people to take greater responsibility for their health and wellbeing. • Home First – supporting people at home or in a homely setting as far as possible. • Partners in Care – supporting citizens to make choices and take control of their care and support. Page 221
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 10 MANAGEMENT COMMENTARY (continued) Staff Wellbeing Health & Social Care Moray’s Health Improvement Team has achieved the Paths for All Walk at Work Award for its innovative efforts to promote physical activity in the workplace and encourage colleagues to boost their health and wellbeing through daily walking. Morgan McKay, Health Walk Coordinator, led the team in developing initiatives to get colleagues moving more. She carried out a travel survey to identify how staff travel to and from work and used the data to develop a plan to increase workplace activity. The team mapped convenient walking routes from two key work locations in Elgin – the Moray Council Annexe and Dr Gray's Hospital – offering both 30-minute and 15- minute options. To encourage staff to keep walking no matter the weather, Morgan arranged for umbrellas to be available for borrowing and designated areas for drying wet outdoor gear. Staff engagement was further boosted through participation in the Paths for All step count challenge, a twice-yearly walking initiative that connects Scottish workplaces in friendly competition. The Walk Moray project supports a network of trained volunteers to deliver a variety of weekly low-level, accessible and friendly health walks in communities across Moray which are a great way to increase your activity levels. Promoting Health and Wellbeing Health & Social Care Moray (HSCM) teamed up with community partners to highlight the importance of eating well and staying hydrated during Nutrition and Hydration Week. The national campaign aims to highlight how proper food and drink intake plays a vital role in overall health, particularly for people in care settings such as hospitals and care homes. Malnutrition and dehydration are often overlooked but can have serious consequences, leading to hospital admissions, longer hospital stays, delayed recovery, and a decline in overall wellbeing. HSCM is tackling this issue head-on with an exciting lineup of activities designed to educate, engage, and inspire action by colleagues and the wider public. Throughout the week, HSCM’s Health Improvement Team has been helping local partners host a variety of activities including information stands; launch of new food and drink initiatives; daily themed food days; poster displays; themed drinks trollies; and tea parties. Page 222
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 11 MANAGEMENT COMMENTARY (continued) Service Delivery/Business as Usual HSCM continues to invest in the delivery of high-quality services through commissioning activity across mental health, advocacy, and primary care. Following a competitive procurement process, Scottish mental health charity SAMH (Scottish Action for Mental Health) has been awarded contracts to deliver adult mental health community support services in Moray until 2029. SAMH will provide two key services: an intensive recovery service for individuals with higher-level mental health needs, and a new community support service, which includes delivery of the Distress Brief Intervention (DBI) programme. The intensive recovery service will continue to support people receiving care from hospital or community mental health teams, offering enhanced, community-based outreach to promote recovery and independent living. The new community support service will provide short-term, practical assistance to help individuals access appropriate support and tackle factors affecting their mental wellbeing. DBI will offer a rapid response to individuals in emotional distress, particularly those presenting to emergency or crisis services. As part of ongoing efforts to support people to have their voices heard, HSCM has commissioned VoiceAbility as its new independent advocacy service provider. Launched in October 2024, this free and confidential service is available to adults accessing social care services in Moray, including those with mental health conditions, learning disabilities, autism, dementia, physical and sensory disabilities, as well as unpaid carers. VoiceAbility's trained advocates support individuals to understand their rights, express their views, and take an active role in decisions affecting their health and wellbeing. A new contract has also been awarded to secure the future of GP services in Aberlour Medical Practice, with Speyside Medical Group appointed as the new provider from April 2025. The experienced partnership of eight GPs currently operates Grantown-on-Spey and Glenlivet Medical Practices and will bring its expertise to serve the 3,000 patients in Aberlour. The practice had been under interim management by HSCM and NHS Grampian since February 2024, following the withdrawal of the previous sole GP contractor. Page 223
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 12 MANAGEMENT COMMENTARY (continued) The aim of a Community Appointment Day (CAD) is to create the right conditions to allow clinicians to support people with their condition and beyond, lean into the local community services, embed personalised care and focus on prevention. With the intention of addressing increasing waiting lists by trialling a new model of care, NHS Grampian delivered their first CAD in Moray for MSK Physiotherapy and Podiatry patients. This was a new way of working, moving away from treatment led health and delivering services differently by strengthening local partnerships, particularly with communities, to enhance both patient and practitioner experience. There were 210 patients on the waiting list who were all invited, with 162 opted to attend and 120 attending on the day. Patients were linked their own online Personal Health Passport, which was completed by them as they moved around the zones. Patients received a one-to-one consultation with the appropriate clinician and were encouraged to have meaningful conversations about what matters most to them. The CAD followed Realistic medicine principles, focusing on personalised and values-based care. The voice of lived experience was heard throughout the planning process by involving the local Versus Arthritis Chronic Pain Group who offered valuable feedback and guidance. 19 community groups and partner services were in attendance to provide information about the support available within the local community. Bringing health and community organisations together under one roof, allowed people’s health and wellbeing to be viewed in full totality. Preliminary Feedback was largely positive, indicating that patients felt the day had been ‘enlightening’, benefited greatly from having services available in one place and found out about what is available in communities. Page 224
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 13 MANAGEMENT COMMENTARY (continued) Longer Term Changes to Strategies and Plans Moray Community Justice Partnership The Moray Community Justice Partnership has formally launched its new improvement plan, which will bring together local agencies and communities to strengthen efforts to make Moray a safer place to live and work. The five-year plan focuses on rehabilitation and public safety. It builds on existing work to reduce reoffending and minimise the number of victims by offering individuals who have offended support to make positive life changes. The local priorities for improving justice outcomes were identified through engagement with community justice stakeholders and residents, and a strategic assessment of Moray's strengths and needs. By 2029, the Moray Community Justice Partnership aims to: • Strengthen engagement with communities to reduce stigma, increase understanding and support for community justice, and embed lived experience within its work; • Improve access to support for individuals leaving prison to aid reintegration; • Expand access to employability skills and employment opportunities for those with convictions; • Enhance support for individuals in police custody; • Develop more community-based restorative justice options. Significant progress in reducing drug and alcohol-related harms and improving lives across communities has been achieved through the work of the Moray Alcohol and Drug Partnership (ADP). Moray ADP has made notable progress in implementing the national Medication Assisted Treatment (MAT) standards, which are a key part of Scotland’s response to the ongoing drug related deaths crisis. The standards provide a framework ensuring treatment is safe, person-centred and effective. Improved referral pathways, delivered through a third sector direct access service, have reduced waiting times for people and enabled faster access to support. Feedback from lived experience groups has shaped pathways into and through Page 225
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 14 MANAGEMENT COMMENTARY (continued) services to better reflect the realities of people’s lives, leading to improved outcomes, while frontline staff have benefitted from continued training on rights awareness, trauma informed practice and crisis response. Strategic Delivery Plan A revised Strategic Delivery Plan for 2025 to 2028 was approved in draft by MIJB in March 2025 and final version in May 2025. This plan incorporates the developments required to enhance our ability to meet predicted future demands for services, whilst undertaking reviews of existing models of care to ensure that the services provided are sustainable and fit for purpose. There are also projects to implement more efficient ways of working, to aid in meeting the financial challenge that is impacting on all public sector organisations. A robust governance framework will be essential to ensure that projects can be delivered within available resources and have a clear focus on outcomes Joint Inspection Moray's multi-agency Public Protection Partnership has evidenced substantial improvement in supporting and protecting adults at risk of harm The positive impact achieved by local authority, health and police colleagues in their work to keep people safe, has been acknowledged with publication in October 2024 of the Joint Inspection of Adult Support and Protection in Moray. The progress review by the Care Inspectorate and its scrutiny partners was a follow-up to a joint inspection carried out in 2022. On their return, inspectors found significant progress had been achieved across all seven priority areas identified for improvement. Mental Health Strategic Delivery Plan The Moray Mental Health and Wellbeing Delivery Plan 2024-2026 was approved by the MIJB in September 2024 and was updated in May 2025, which underpins the work required to progress the Moray Mental Health and Wellbeing Strategy 2016- 2026. Scotland is currently facing a growing mental health crisis, with challenges including rising demand for services, increased complexity of cases, and persistent inequalities in access and support. While there is a focus on developing and expanding services, significant workforce challenges, and funding shortfalls continue to hinder progress. Many of these challenges are amplified in Moray due to the rural nature of many of our communities, difficulties in the recruitment and retention of staff, and access to specialist tertiary services. Page 226
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 15 MANAGEMENT COMMENTARY (continued) The Moray Adult Mental Health and Wellbeing Strategic group aim to ensure that the collective voice of lived and living experience influences the way that we design services and responses to address the challenges facing individuals and families affected by mental health in Moray. The group work closely with Moray Wellbeing Hub, Making Recovery Real Partnership and tsiMoray to achieve this; for example, the involvement of lived experience in service development, commissioning, implementation and evaluation of the recently commissioned SAMH projects. The alignment of Children’s Services and Adults Services mental health strategic planning and delivery is essential. Within Moray there is currently a Children’s Mental Health and Wellbeing Partnership and there is the Moray Mental Health and Wellbeing Strategic Group. There is a degree of cross representation between both groups to ensure shared planning however, there remains the medium term vision for there to be a single strategic group for children and adult mental health services in Moray. Financial Review and Performance Financial performance forms part of the regular reporting cycle to the MIJB. Throughout the year the Board, through the reports it receives, is asked to consider the financial position at a given point and any management action deemed as necessary to ensure delivery of services within the designated financial framework. From the first quarter in the financial year, the Board was presented with financial information that included a forecast position to the end of the year. In November 2024 the Board received a financial report which forecast an expected overspend to the end of the financial year of £5.58m. This forecast remained consistent throughout the remainder of the year and in January 2025, MIJB were forecasting an overspend to the end of the year of £5.51m, the MIJB actually out turned at £4.26m overspent. Both partners in line with the Integration Scheme, put in additional funding to cover this overspend, so with the use of ear marked reserves totalling £0.536m, this leaves a balance of £1.45m in ear marked reserves to be carried forward into 2025/26. In May 2024, the MIJB agreed a savings plan of £8.297m, with a mixture of recurring savings and recurring reductions in spend. At the end of the financial year, this had been achieved in part, with recurring savings of £2.302m and £2.331m reduction in overspend. Given the uncertainties associated with funding and the emerging overspend position at the early stage of the financial year, it was necessary to update the Board regularly on the emerging financial position. This was done formally through MIJB meetings and informally through development sessions. Page 227
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 16 MANAGEMENT COMMENTARY (continued) Service Area Budget £000’s Actual £000’s Variance (Over)/ under spend £000’s Note Community Hospitals & Services 7,701 8,329 (628) Community Nursing104,360 5,979 6,166 (187) Learning Disabilities 17,702 19,975 (2,273) 1 Mental Health 12,140 12,055 85 Addictions 1,907 1,763 144 Adult Protection & Health Improvement 249 273 (24) Care Services Provided In-House 24,743 22,754 1,989 2 Older People Services & Physical & Sensory Disability 24,775 27,034 (2,259) 3 Intermediate Care & OT 1,771 1,972 (201) Care Services Provided by External Contractors 1,836 1,817 19 Other Community Services 10,383 10,280 103 Administration & Management 3,333 3,152 181 Other Operational Services 1,377 1,535 (158) Primary Care Prescribing 18,748 21,937 (3,189) 4 Primary Care Services 21,427 21,331 96 Hosted Services 5,713 5,665 48 Out of Area Placements 720 1,971 (1,251) 5 Improvement Grants 1,207 1,021 186 Children’s & Justice Services 19,524 19,626 (102) Total Core Services 181,235 188,656 (7,421) Strategic Funds & Other Resources 14,891 6,020 8,871 6 TOTALS (before set aside) 196,126 194,676 1,450 Set Aside 15,639 15,639 - TOTAL 211,765 210,315 1,450 The table above summarises the financial performance of the MIJB by comparing budget against actual performance for the year. Page 228
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 17 MANAGEMENT COMMENTARY (continued) Significant variances against the budget were notably: Note 1 Learning Disabilities (LD) – The LD service is overspent by £2,272,694 at the year-end. The overspend is essentially due to the purchase of care for people with complex needs which resulted in an overspend of £2,806,801 and client transport of £13,781. This is offset by more income received than expected of £524,800 (income due from another authority and Change Fund funds from NHS) and other small underspends of £18,619 which primarily relate to property costs. There was a minor underspend of £4,469 in other Learning Disabilities clinical services. This budget has been under pressure for a number of years due to demographic pressures, transitions from Children’s services and people living longer and getting frailer whilst staying at home. The biggest overspends was for services provided to individuals in their own homes to support their daily living needs which enables people to stay living at home or in a homely setting for as long as possible and day care which provides activities during the day in the community. Note 2 Care Services Provided In-House – This budget is underspent by £1,988,757 at the end of the year. This relates to underspend in staffing across all the services in this budget totalling £2,291,755 and other minor underspends of £8,275 which is being reduced by overspends relating to transport costs £97,970; insurance costs £29,047, utility costs £62,430 and less income than expected £121,826. Unfilled vacancies have been the main reason for the underspend throughout the year, and the issue of recruitment has been an ongoing problem. Note 3 Older People Services and Physical & Sensory Disability - This budget is overspent by £2,259,056 at the end of the year. This primarily relates to overspends for home care in the area teams £539,818, permanent care £1,766,157 due to the increase in the number of clients receiving nursing care rather than residential care and respite care £105,776 this is being reduced by an underspend for day care £152,695. The variances within this overall budget heading reflect the shift in the balance of care to enable people to remain in their homes for longer. The ageing population requiring more complex care and local demographics also contributes to this overspend as well as the correlation between the recruitment and retention of the internal home care service provision. Note 4 Primary Care Prescribing - The primary care prescribing budget is reporting an over spend of £3,189,386 for the twelve months to 31 March 2025. The overall average price has remained relatively consistent and includes cost reduction savings identified by Pharmacy implemented countered by the impact of short supply causing an increase in costs. This is spread across a range of products and is ongoing. This overall volume increase at 3.5% is less than previously anticipated. Note 5 Out of Area Placements – This budget is overspent by £1,250,899 at the year end. This is due to the continuing number of high cost individual specialised NHS placements. Page 229
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 18 MANAGEMENT COMMENTARY (continued) Note 6 Strategic Funds and Other Resources – This budget is underspent by £8,871,064 as it relates to savings achieved during the year, any unallocated funding and reserves balances. MIJB’s financial performance is presented in the comprehensive income and expenditure statement (CIES), which can be seen on page 44. At 31 March 2025 there were ear marked reserves of £1.45m available to the MIJB, compared to £1.986m at 31 March 2024. These remaining reserves of £1.45m are for various purposes as described below: Earmarked Reserves Amount £000’s GP Premises 39 National Drugs MAT 250 OOH Winter Pressure funding 172 Moray Cervical screening 35 Moray hospital at home 5 Moray Psychological 315 MHO Funding 138 Adult protection funding for CA 18 Adult Disability payment 45 National Trauma Training services 62 Moray School Nurse 32 Moray Winter Fund HCSW & MDT 182 LD Annual Health Checks 69 Community Planning partnership 2 Moray District Nurses 56 OOH Dev Fellowship scheme 30 Total Earmarked 1,450 General Reserves 0 TOTAL Earmarked & General 1,450 Page 230
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 19 MANAGEMENT COMMENTARY (continued) GP Premises – balance of funding for improvement grants including the making of premises improvement grants to GP contractors. The continued digitalisation of paper GP records. Modifications for the purposes of improving ventilation and increase to the space available in NHS owned or leased premises for primary care multi- disciplinary teams. National Drugs Medication Assisted Treatment (MAT) for embedding and implementation of the standards will he be overseen by the MAT implementation support team (MIST). National Drugs Mission Moray – balance of funding for range of activities including: drug deaths, taskforce funding, priorities of national mission, residential rehabilitation, whole family approach, outreach, bear fatal overdose pathways and lived and living experience. Out of Hours Winter Pressure funding – balance of funding to sustain GO out of hours and to support resilience to explore operational solutions. Moray Cervical Screening – balance of funding for smear test catch up campaign. Moray Hospital at home – development of Hospital at Home provides Acute hospital level care delivered by healthcare professionals, in a home context for a condition that would otherwise require acute hospital inpatient care. Moray Psychological – funding streams for mental health, psychological wellbeing, facilities, post diagnostic support and psychological therapies. Mental Health Officer (MHO) funding – funding to support additional mental health officer capacity. Adult protection funding for care at home– balance of funding to build capacity in care at home community based services. Adult Disability payment – funding to assist with the implementation of the adult disability payments. National Trauma Training services – training for dealing with people affected by trauma and adversity. Moray School nurse – funding to support NHS Grampian to retain school nurse posts. Moray Winter Fund Health Care Social Workers (HCSW) – additional funding for further HCSW in both the IJB and Emergency department. Moray Winter fund Multi Disciplinary Team – additional funding for service pressures includes Discharge to Assess, Home First Frailty team and volunteer development. Page 231
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 20 MANAGEMENT COMMENTARY (continued) Learning Disability Annual Health Checks – to implement the annual health checks. Community Planning Partnership – funding towards community planning partnership. Moray District Nurses – allocation to support recruitment and training of District Nurses Out of Hours (OOH) Development Fellowship Scheme – scheme to keep GPs within clinical practice, increase GP’s confidence and competence in OOHs work. All reserves are expected to be utilised for their intended purpose during 2025/26. Set Aside – Excluded from the financial performance table above on page 16 but included within the Comprehensive Income & Expenditure Account is £15.639m for Set Aside services. Set Aside is an amount representing resource consumption for large hospital services that are managed on a day to day basis by the NHS Grampian. MIJB has a responsibility for the strategic planning of these services in partnership with the Acute Sector. Set Aside services include: • Accident and emergency services at Aberdeen Royal Infirmary and Dr Gray’s inpatient and outpatient departments; • Inpatient hospital services relating to general medicine, geriatric medicine, rehabilitation medicine, respiratory medicine, learning disabilities, old age psychiatry and general psychiatry; and • Palliative care services provided at Roxburgh House Aberdeen and The Oaks Elgin. The budget allocated to Moray is designed to represent the consumption of these services by the Moray population. The figures for 2024/25 have been derived by uplifting 2019/20 figures by baseline funding uplift in 2020/21 (3.00%), 2021/22 (3.36%) ,2022/23 (6.70%), and 2023/24 (5.35%) and 2024/25 (6.64%): 2024/25 2023/24 2022/23 2021/22 2020/21 Budget 15.639m 14.665m 13.92m 13.04m 12.62m Page 232
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 21 MANAGEMENT COMMENTARY (continued) Risks, Uncertainties and Future Developments The MIJB Chief Officer has a responsibility to maintain a risk strategy and risk reporting framework. Risks inherent within the MIJB are monitored, managed and reported at Audit, Performance and Risk Committee. In addition, a risk action log is monitored and managed by the Senior Management Team. The key strategic risks of the MIJB classed as ‘High’ and ‘Very High’ are presented below, the risk number relates to the MIJB internal risk numbering: VERY HIGH Risk 2 - The MIJB must operate within the resources allocated to it by the partner bodies and it is good financial practice to set a balanced budget at the start of each financial year. There is a risk that financial pressures being experienced by the funding partners will directly impact the MIJB’s strategic planning of services and its decision-making. Managing the risk – current controls in place – 1. Medium Term Financial Framework (MTFF) approved by MIJB on 27 March 2025. 2. Additional resource to support services a Programme Management Office agreed until September 2025. 3. Tri-partite partnership performance meetings with partner CEOs, Finance Directors and Chair/Vice Chair of MIJB. 4. Operational financial monitoring undertaken by Chief Finance Officer (CFO), Heads of Service (HOS) and Budget Managers. 5. Budget Savings Oversight Group chaired by Chief Officer, attended by HOS, CFO and Service Managers as appropriate. 6. Review of MIJB Strategic Delivery Plan ensuring all projects are aligned with savings plans. Assurances: Quarterly Budget monitoring reporting to APR and MIJB. Financial Reporting through MIJB, NHS Grampian and Moray Council. The Project Management Office will support the Financial Recovery Savings presented as part of the budget setting for 2025/26. Financial Development Sessions with MIJB members. Internal Audit quarterly reporting to APR. External Audits presented to MIJB/ Committees as appropriate. Six weekly Tri-partite partnership performance meetings with partner CEOs, Finance Directors and regular meetings with the Chair/Vice Chair of MIJB. Page 233
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 22 MANAGEMENT COMMENTARY (continued) HIGH Risk 3 - There is a risk that the MIJB’s workforce strategy is not delivered impacting the quality of paid and unpaid Health & Social Care. Managing the risk – Current controls in place 1. Management structure currently under review. 2. Moray Council are aware of the housing issues and are conducting an assessment of needs, including people working in the Health and Care sector. 3. Staff wellbeing is a key focus and there are many initiatives across both parent organisations offering information, support and access to activities. 4. Collaborative approaches with educational institutions e.g. intakes and programmes for future workforce development. 5. Professional Development and retention programmes; Incentives have been secured to attract additional NHS dentists and dental practices to Moray. The Scottish Dental Access Initiative includes Moray, with grants of £50,000 and above available to allow dental practices to be established or extended– provided there is a seven-year commitment to providing NHS treatment. A recruitment and retention bonus is also being offered to eligible new dentists in Moray 6. GP sustainability Group and Primary Care Vison for the Future Groups now progressing across Grampian. 7. iMatter reports are used to develop actions plans for teams. Assurances: Operational oversight by Moray Workforce Forum. The HSCM Response Group continues to focus on leadership around emerging issues and resolving them, including staffing. Risk 5 - There is a risk that the MIJB does not comply with the necessary legislative and regulatory requirements in which it operates. Managing the risk – Current controls in place: 1. NHS Grampian Resilience Standards Action Plan approved (3 year). New standards are being drafted by Scottish Government, and these are expected in 2025 and will replace the current standards. 2. Continuous emergency preparedness awareness with partners under GLRP – including exercises and debriefs. 3. Learning from Inspection Reports, Adverse Events, Complaints – action plans and performance measures monitored by OMT with oversight by SMT. 4. HSCM Civil Contingencies group review specific risks and action plans to mitigate, developing plans and testing arrangements in partnership with NHSG and Council. 5. Annual review of internal resilience and emergency processes with Senior Managers on Call. Page 234
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 23 MANAGEMENT COMMENTARY (continued) HIGH (continued) Assurances: Quarterly reporting to Clinical and Care Governance and Audit, Performance and Risk Committees. Annual Performance Report – published September 2024. Chief Social Work Officers Report. Internal and External Audits. Senior Management Meetings fortnightly. Joint meeting of MIJB Chief Officer with two Partner Body Chief Executives. Annual report on MIJB activity developed and reported to Moray Council and NHSG Risk 6 - There is a risk that the MIJB’s strategic aspirations are not transformative and as a result, we are unable to deliver outcomes for people in a sustainable way. Managing the risk – Current controls in place: 1. Clinical and Care Governance (CCG) Committee. Clinical Risk Management and Practice Governance group has oversight of their respective professional standards and links into Clinical and Care Governance Group, which escalates to CCG Committee as necessary. 2. High and Very High operational health service risks are reviewed by HSCM Clinical Risk Management (CRM) Group and also NHS Grampian CRM Group. 3. Annual Performance Reports. 4. Internal and External Audit. 5. Internal/External Inspection reports are scrutinised by appropriate operational groups and by exception to SLT for subsequent reporting to CCG or APR Committee as appropriate. 6. Care Home Collaborative Support Group meets to oversee and manage risks in care homes. 7. Children and Adult Protection services report to their respective committees. Governance Structure and Process (Senior Leadership Team meetings, Operational Team Meetings, Daily Huddles). Assurances: Audit, Performance and Risk and Clinical and Care Governance Sub-Committees oversight and scrutiny. The Clinical and Care Governance Framework was refreshed and presented to CCG Committee in November 2023 Page 235
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 24 MANAGEMENT COMMENTARY (continued) HIGH (continued) Risk 7 - There is a risk that the MIJB is unable to exert influence on services delegated but hosted within another organisation. Managing the risk – Current controls in place: 1. Chief Officer regularly meets with Chief Officers of Aberdeen City Health and Social Care Partnership and Aberdeenshire Health and Social Care Partnership. 2. Significant changes to service delivery are discussed across all three HSCP’s. 3. Agreement that proposals regard significant service changes are presented to all three MIJB’s for approval. 4. Internal Audit of MIJB Hosted Services. Assurances: These largely come from the systems, process and procedures put in place by NHS Grampian, which are still being operated, along with any new processes which are put in place by the lead MIJB. North East System Wide Transformation Group (Officers only) led by the 4 pan- Grampian chief executives. The aim of the group is to develop real top-level leadership to drive forward the change agenda, especially relating to the delegated hospital-based services. Both the CEO group and the Chairs & Vice Chairs group meet quarterly. The meetings are evenly staggered between groups, giving some six weeks between them, allowing progressive work / iterative work to be timely between the forums. The Portfolio approach and wider system approach demonstrates closer joint working across the three Health and Social Care Partnerships and the Acute Sector. Development Aims for 2025/26 Discharge without Delay & Frailty at the Front Door Health and Social Care Moray is taking part, supported by the MIJB, in the National Collaborative to support Discharge without Delay. This approach supports us in undertaking mapping and self-assessment work and understanding where the application of best practice and learning from other areas can help us improve locally and get people home from an acute setting as quickly and safely as possible. By taking part in this collaborative, we aim to reduce further the number of people delayed in our system and to ensure we apply optimum practice across acute and community setting to do so. Page 236
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 25 MANAGEMENT COMMENTARY (continued) Realignment of Organisational Structures Since its inception the MIJB has sought to ensure the most effective and efficient structures are in place to support the delivery of its strategic aims and overall strategic plan. Over the course of 2025/26 a review of the HSCM organisational structure will take place that will support these aims and ensure that both HSCM and the MIJB have the right resources in place, and the right operational structure to enact our plans, deliver the best outcomes for people and operate sustainably within the current challenging financial conditions. Our organisational structure supports how we deliver our ambitions in our communities and directly with people and is a key enabler in driving progress against our priorities. Strengthening Integration and Oversight of Children, Families and Justice within our system Children, Families and Justice Services were delegated formally to the MIJB in 2023/24 under the integration scheme and there is now reporting of these services within the Clinical and Care Governance structures in place. Moray Council and Councillors retain statutory responsibilities for outcomes for Children and also remain Corporate Parents in respect of those Children and Young People who are cared for or accommodated out with their families. MIJB is committed to ensuring robust reporting across the system that ensures all partners can fulfil their statutory obligations while focussing on improving outcomes for our young people. A review of current reporting arrangements will take place to reduce any duplication in reporting whilst strengthening oversight of performance and delivery. Strengthening Performance Oversight The MIJB approved its Strategic Delivery Plan at its meeting in May 2025, and this now provides a clear line of sight from Strategic Plan to the impact of the programmes, services and initiatives in place to deliver it. Over the course of this year, we aim to further strengthen this line of sight, aligned to the Board’s Risk Appetite Statement, to ensure that our programmes of work are effective in achieving their objectives and represent value for money. Page 237
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 26 MANAGEMENT COMMENTARY (continued) In addition, we will seek to: • Maintain our focus on early intervention and prevention, reducing demand and supporting the resilience of people and communities. We’ll undertake learning from the successful Community Appointment Day which took place in Elgin as a possible model to support this; • Continue to develop how we care for our staff well-being, with staff our most valuable asset; • Provide leadership and participation as key partners in the NHS Grampian led Strategic Change Programme and ensure we explore effective joint working; • Focus our budget setting efforts in the context of the Medium Term Financial Strategy and longer term sustainability. ………………………… ……………………… ……………………… Dennis Robertson Judith Proctor Deborah O’Shea Chair of Moray IJB Chief Officer Chief Financial Officer Page 238
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 27 STATEMENT OF RESPONSIBILITIES Responsibilities of the MIJB • To make arrangements for the proper administration of its financial affairs and to secure that one of its officers has the responsibility for the administration of those affairs. In Moray Integration Joint Board, that officer is the Chief Financial Officer; • To manage its affairs to achieve best value in the use of its resources and safeguard its assets; • Ensure the Annual Accounts are prepared in accordance with legislation (The Local Authority Accounts (Scotland) Regulations 2014) and so far as is compatible with that legislation, in accordance with proper accounting practices (section 12 of the Local Government in Scotland Act 2003); and • To approve the Annual Accounts. Signed on behalf of the Moray Integration Joint Board Dennis Robertson Chair of Moray IJB Page 239
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 28 STATEMENT OF RESPONSIBILITIES (continued) Responsibilities of the Chief Financial Officer The Chief Financial Officer is responsible for the preparation of the Moray Integration Joint Board’s statement of accounts in accordance with proper practices as set out in the CIPFA/LASAAC Code of Practice on Local Authority Accounting in the United Kingdom (the Code) 2024/25. In preparing the Annual Accounts the Chief Financial Officer has: • Selected suitable accounting policies and applied them consistently; • Made judgements and estimates that were reasonable and prudent; • Complied with legislation; and • Complied with the local authority code (in so far as it is compatible with legislation). The Chief Financial Officer has also: • Kept proper accounting records that were up to date; and • Taken reasonable steps for the prevention and detection of fraud and other irregularities. I certify that the financial statements give a true and fair view of the financial position of the Moray Integration Joint Board as at 31 March 2025 and the transactions for the year then ended. Deborah O’Shea FCCA Chief Financial Officer Page 240
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 29 REMUNERATION REPORT Introduction This Remuneration Report is provided in accordance with the Local Authority Accounts (Scotland) Regulations 2014 (SSI2014/200) as part of the MIJB annual accounts. This report discloses information relating to the remuneration and pension benefits of specified MIJB members. All information disclosed in the tables is subject to external audit. Other sections within the Remuneration Report will be reviewed for consistency with the financial statements. Moray Integration Joint Board The voting members of MIJB are appointed through nomination by Moray Council and Grampian Health Board. There is provision within the Order to identify a suitably experienced proxy or deputy member for both the voting and non-voting membership to ensure that business is not disrupted by lack of attendance by any individual. MIJB Chair and Vice-Chair Nomination of the MIJB Chair and Vice-Chair post holders alternates every 18 months between a Councillor and a Health Board non-executive member. The MIJB does not provide any additional remuneration to the Chair, Vice-Chair or any other board members relating to their role on the MIJB. The MIJB does not reimburse the relevant partner organisations for any voting member costs borne by the partner. The MIJB does not have responsibilities in either the current or in future years for funding any pension entitlements of voting MIJB members. Therefore, no pension rights disclosures are provided for the Chair or Vice-Chair. Taxable Expenses 2023/24 Name Position Held Nomination By Taxable Expenses 2024/25 £ £ - Dennis Robertson Vice-Chair 01/04/24 – 26/09/24; 01/04/2025 to date Chair 27/09/24 to 31/03/25 Grampian Health Board - - Cllr Tracy Colyer Chair 01/04/24 – 26/09/24 Moray Council - - Cllr Elaine Kirby Vice-Chair 21/11/24 – 31/03/25 Chair 1/04/25 to date Moray Council - Page 241
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 30 REMUNERATION REPORT (continued) Officers of the MIJB The MIJB does not directly employ any staff in its own right; however specific post- holding officers are non-voting members of the Board. Chief Officer Under section 10 of the Public Bodies (Joint Working) (Scotland) Act 2014 a Chief Officer for the integration joint board has to be appointed and the employing partner has to formally second the officer to the Board. The employment contract for the Chief Officer will adhere to the legislative and regulatory framework of the employing partner organisation. The remuneration terms of the Chief Officer‘s employment are approved by the Board. Other Officers No other staff are appointed by the MIJB under a similar legal regime. Other non- voting board members who meet the criteria for disclosure are included in the disclosures below. Total 2023/24 Senior Employees Salary, Fees & Allowances Total 2024/25 £ £ £ 122,460 Simon Bokor-Ingram Chief Officer (1/04/24- 31/05/24) 20,268 20,268 - Judith Proctor (from 25/07/24) 95,673 95,673 83,476 Deborah O’Shea Chief Financial Officer 90,729 90,729 In respect of officers’ pension benefits, the statutory liability for any future contributions to be made rests with the relevant employing partner organisation. On this basis there is no pensions liability reflected on the MIJB balance sheet for the Chief Officer or any other officers. The MIJB however has a responsibility for funding the employer contributions for the current year in respect of the officer time spent on fulfilling the responsibilities of their role on the MIJB. The following table shows the MIJB’s funding during the year to support the officers’ pension benefits. The table also shows the total value of accrued pension benefits which may include benefits earned in other employment positions and from each officer’s own contributions. Page 242
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 31 REMUNERATION REPORT (continued) NOTE: no bonuses, expenses allowances, compensation for loss of office or any taxable benefits were made in 2024/25 In Year Pension Contributions Accrued Pension Benefits Year to 31/03/24 Year to 31/03/25 As at 31/03/2025 Difference from 31/03/2024 £ £ £ 000’s £ 000’s Simon Bokor- Ingram, Chief Officer (*) 24,346 4,378 Pension 40 (6) Lump Sum 101 (22) Judith Proctor, Chief Officer - 21,526 Pension 36 9 Lump Sum 99 19 Deborah O’Shea Chief Financial Officer 7,179 20,339 Pension 9 (19) Lump Sum 31 - (*) Simon Bokor-Ingram figures included in the table above, relate to the full year and employment after Chief Officer, as figures are unable to be apportioned. Page 243
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 32 REMUNERATION REPORT (continued) Disclosure by Pay bands As required by the regulations, the following table shows the number of persons whose remuneration for the year was £50,000 or above, in bands of £5,000. Number of Employees in Band 2023/24 Remuneration Band Number of Employees in Band 2024/25 1 £80,000 - £84,999 - - £85,000 - £89,999 1 1 £120,000 - £124,999 - £130,000 - £134,999 1 Exit Packages There were no exit packages agreed by the MIJB during 2024/25 financial year, or in the preceding year. ……………………….. ……………………… Dennis Robertson Judith Proctor Chair of Moray IJB Chief Officer Page 244
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 33 ANNUAL GOVERNANCE STATEMENT The Annual Governance Statement describes the Moray Integration Joint Board’s (MIJB) governance arrangements and reports on the effectiveness of the MIJB’s system of internal control. Scope of Responsibility The MIJB is responsible for ensuring that its business is conducted in accordance with the law and appropriate standards, and that public money is safeguarded and used efficiently and effectively in pursuit of best value. In discharging its responsibilities, the MIJB has established arrangements for its governance which includes the system of internal control. This system is intended to manage risk and support the achievement of the MIJB’s policies, aims and objectives. The system provides reasonable but not absolute assurance of effectiveness. The MIJB places reliance of the systems of internal control of NHS Grampian systems and Moray Council, which supports organisational compliance of policies and procedures in addition to those of the MIJB. Assurances are required on the effectiveness of the governance arrangements of all three organisations, meaning a significant failure in one of the three Partners may require to be disclosed in the annual accounts of all three Partners. The Governance Framework The CIPFA/SOLACE framework for ‘Delivering Good Governance in Local Government’ last updated in 2016 remains current and provides a structured approach in defining seven principles that underpin effective governance arrangements. Whilst the framework is written specifically for Local Government, the principles apply equally to integration authorities, and while the MIJB continues to evolve as an entity in its own right. It continues to draw on the governance assurances of NHS Grampian and Moray Council as its principal funding partners. Given the scope of responsibility within the MIJB and the complexities surrounding the assurance arrangements, a Local Code of Corporate Governance was developed and the MIJB assesses the effectiveness of its governance arrangements against the principles set out in the document. The Code outlines the seven governance principles from the CIPFA/SOLACE guidance (as referenced below) and provides the sources of assurance for assessing compliance relative to the MIJB, Moray Council and NHS Grampian. These assurances include referencing the governance arrangements of NHS Grampian and Moray Council which are summarised annually and published in their respective Annual Governance Statements which form part of the annual accounts of each organisation. The respective governance statements can be found on the individual organisations websites: Moray Council: Annual Accounts - Moray Council and NHS Grampian: https://www.nhsgrampian.org/about-us/annual- accounts/. Page 245
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 34 ANNUAL GOVERNANCE STATEMENT (continued) Key Governance Arrangements All of the scheduled Audit Performance and Risk and Clinical Care Governance Committee meetings were held as timetabled during 2024/25. Health and Social Care Moray (HSCM) established an emergency response group that has been operational since the end of March 2020, this has now transformed into a Daily Response meeting. Representation on the response groups of the Partner organisations is provided by HSCM staff, ensuring the necessary links and flow of information to ensure a co-ordinated response on a pan Grampian basis and locally within Moray. There continues to be governance standards and collaborative working across the whole system, both across the NHS Portfolios and Grampian wide system. The use of a Grampian Operation Performance Escalation System (GOPES) was established to enable senior leaders to have oversight of where pressures were located in the system and to direct responses accordingly. This development has also strengthened the identification of key metric thresholds to inform the levels for escalation. Evaluation of the Effectiveness of Governance Governance Principle 1 – Behaving with integrity, demonstrating strong commitment to ethical values and respecting the rule of law Assessment of Effectiveness • The activities of the MIJB are governed by a Board comprising both voting and non-voting members, drawn from a diverse range of backgrounds to ensure broad representation. The Board meets bi-monthly and is supported by regular development sessions that allow for in depth exploration of key strategic and operational issues. Governance is further strengthened through the work of two committees: the Audit, Performance and Risk Committee, and a Clinical and Care Governance Committee, each with clearly defined remits to support effective governance and assurance. The MIJB operates in accordance with Standing Orders, which set out the rules governing the proceedings of the Board and its Committees. These include the Scheme of Administration which defines the structure and remit of the Board’s committees, ensuring clarity and consistency in governance arrangements. • To uphold high standards of ethical conduct, the MIJB has appointed a Standards Officer. This role supports compliance with the Ethical Standards in Public Life etc. (Scotland) Act 2000, which requires members of devolved public bodies to comply with Codes of Conduct approved by Scottish Ministers. The Standards Officer also ensures alignment with guidance issued by the Standards Commission for Scotland, reinforcing the Board’s commitment to integrity, accountability, and ethical governance. Page 246
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 35 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 2 – Ensuring openness and comprehensive stakeholder engagement Assessment of Effectiveness • MIJB’s Standing Orders provide for public and press access to meetings and reports, supporting transparency and accountability. In response to positive feedback and to enhance accessibility, hybrid meetings continued throughout 2024/25. A dedicated website was developed for Health and Social Care Moray and is continuously monitored for improvement, and about to transition to a new platform to further improve the accessibility and quality of information. Agendas, reports and minutes for all committees can be accessed via Moray Council website, alongside links to all relevant strategies of the MIJB. • Both the voting and non-voting membership arrangements of the MIJB are in line with the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014. There are eight voting members, four are elected members appointed by Moray Council and four are non-executive members of NHS Grampian Board. The non-voting membership comprises six professional members and five stakeholder members representing: staff, third sector bodies carrying out activities in relation to health and social care, service users and unpaid carers, and six additional non-voting members which include the Chief Executives of Moray Council and NHS Grampian in an Ex-officio capacity. The broad membership of the MIJB ensures valued input and engagement from a wide range of stakeholders. • The Community Empowerment (Scotland) Act 2015 places a statutory duty on MIJB and its Community Planning Partners to engage with communities on the planning and delivery of services and securing local outcomes. The MIJB has an approved Communications and Engagement Strategy which recognises and promotes the active and meaningful engagement with all stakeholders. Governance Principle 3 – Defining outcomes in terms of sustainable economic, social and environmental benefits Assessment of Effectiveness • The MIJB Strategic Plan 2022-2032 building on the foundations of the 2019 plan, sets out long-term strategic objectives that are flexible and responsive to emerging challenges and developments in health. To support the delivery of these objectives a 3 year delivery plan was approved by MIJB in May 2025, underpinned by a medium-term financial framework. • The strategic plan is supported by a comprehensive suite of documents, including a performance framework, workforce plan, and a communications, engagement and participation plan. These documents are currently under review, with a focus on enabling service transformation within existing financial constraints. • These documents collectively provide a structured approach to defining and achieving outcomes, with a clear focus on medium term priorities. The outcomes are directly aligned with the delivery of health and social care services and are aimed at driving measurable improvements for the population of Moray. Page 247
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 36 ANNUAL GOVERNANCE STATEMENT (continued) • In support of environmental sustainability, a climate change duties report is compiled and submitted annually on behalf of the MIJB, demonstrating the Board’s commitment to meeting its statutory environmental responsibilities Governance Principle 4 – Determining the interventions necessary to optimise the achievement of intended outcomes Assessment of Effectiveness • The MIJB’s decision making processes are designed to ensure that Board members receive clear, objective and comprehensive analysis of available options. Each proposal outlines how intended outcomes will be achieved, supported by detailed assessments of associated risks and opportunities. • Board papers reflect the broad range of strategic and operational matters under consideration. These include regular updates from the Chief Officer on current developments, as well as agenda items covering both opportunities and challenges, particularly those arising from reconfiguration and transformation of services. • The MIJB recognises the importance of sound financial governance and has adopted the Financial Management Code promoted by CIPFA as a guiding framework for effective financial administration. A Medium-Term Financial Strategy, approved in March 2025, supports this approach and will be reviewed regularly to ensure alignment with the Strategic Plan, Delivery Plan and the integration of delegated children’s services. Governance Principle 5 – Developing the entity’s capacity, including the capability of its leadership and the individuals within it Assessment of Effectiveness • The Senior Management Team (SMT) and Officers and have developed a programme of Development sessions with Board members with a focus on the challenging financial position and exploring opportunities for service transformation. Officers present a range of proposals aimed at delivering the MIJB’s strategic objectives whilst also contributing to the necessary financial savings for the upcoming year. • The MIJB continues to prioritise leadership development and collaborative working through the regular development sessions with Officers. These sessions provide valuable opportunities for shared learning, strategic dialogue, and constructive challenge, helping to strengthen leadership capabilities and organisational resilience. Page 248
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 37 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 6 – Managing risk and performance through robust internal control and strong public financial management Assessment of Effectiveness • As part of a robust risk monitoring framework the Strategic Risk Register was co-developed with Board members during a dedicated development session in October 2024 and was formally approved by the Board in May 2025. This updated register will be reviewed monthly by the Senior Management Team and updated and presented biannually to Audit, Performance and Risk Committee, and annually to MIJB. A related action log was created for monitoring purposes and is owned and monitored by the Senior Management Team. The committee agreed in October that the register would be presented biannually with the caveat that any emerging or increasing risks would be presented as required. • The Performance Management Framework has currently under review. Performance reporting falls within the scope of the Audit, Performance and Risk Committee and reporting is quarterly. This now includes reporting by the delegated Children’s & Families Services. • The internal control system is closely aligned with those of MIJB’s Partner organisations, reflecting their operational responsibility for service delivery under direction of the MIJB. The Audit, Performance and Risk committee through its consideration of reports monitors the effectiveness of internal control procedures. The MIJB Chief Internal Auditor undertakes an annual review of the adequacy of internal controls and the opinion is included within this statement. • The MIJB benefits from the oversight of an independent S95 Officer, who is a member of the Board. This Officer provides expert advice on all financial matters and ensure timely preparation and reporting of budget estimates, monitoring reports and annual accounts. • Governance arrangements have been developed and maintained to comply with the core functions of various good framework guidelines including Code of Practice on Managing the Risk of Fraud and Corruption, Public Sector Internal Audit Standards (incorporating the principles of the Role of the Head of Internal Audit), Audit Committees: Practical Guidance for Local Authorities and Police. These frameworks support the MIJB’s commitment to strong financial stewardship and effective internal control. Page 249
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 38 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 7 – Implementing good practices in transparency, reporting and audit to deliver effective accountability Assessment of Effectiveness • MIJB business is conducted through an approved cycle of Board meetings. To promote openness and accessibility, recordings of Board meetings are made available to the public. In addition, agendas, reports and minutes are published and accessible for the public to inspect. There is a standardised reporting format in place to ensure consistency, clarify and transparency in decision making processes. • The MIJB demonstrates its commitment to accountability through publication of both its Annual Accounts and Annual Performance Report. Following formal approval by the Board. • The Chief Internal Auditor reports independently to the Audit, Performance and Risk committee with direct access to the Chief Officer, Chief Financial Officer and Chair of the Audit, Performance and Risk committee on any matter of concern. Throughout 2024/25, the Chief Internal Auditor has continued to provide regular reports to the Committee, supporting effective oversight of internal accounts and assurance processes. Review of Adequacy and Effectiveness The MIJB has a responsibility for conducting, at least annually, a review of the effectiveness of the governance arrangements, including the system of internal control. The review is informed by the work of the Senior Management Team (which has responsibility for the development and maintenance of the internal control framework environment), the work of the Internal Auditors and the Chief Internal Auditor’s annual report and the reports from the External Auditor and other review agencies and inspectorates. Internal Audit Opinion Moray Council’s Internal Audit Section delivers the Internal Audit Service for the Moray Integration Joint Board (MIJB), and the Council’s Audit and Risk Manager holds the Chief Internal Auditor appointment to the MIJB until the 31st of March 2026. The Council’s Internal Audit Section has adopted the Public Sector Internal Audit Standards (PSIAS), which requires the Chief Internal Auditor to deliver an annual internal audit opinion and report, which has also been used to inform this governance statement. The Chief Internal Auditor’s evaluation of the adequacy and effectiveness of the MIJB framework of governance, risk management and internal control includes consideration of the findings from the audit work undertaken by the Chief Internal Auditor in his role as the Audit and Risk Manager for the Moray Council. Assurance is also sought from the Internal Audit Service Provider for NHS Grampian of the governance processes adopted by that organisation. This includes the Chief Internal Auditor now being provided with internal audit reports by the Internal Audit Service Provider for NHS Grampian of interest to the MIJB. In addition, reports issued by other Page 250
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 39 ANNUAL GOVERNANCE STATEMENT (continued) external review agencies are considered in the opinion provided by the Chief Internal Auditor. Internal Audit operates independently within the organisation, with no management- imposed limitations on the scope of audit work performed. In accordance with PSIAS, the Chief Internal Auditor prepares a risk-based Audit Plan for the MIJB, considering the internal audit arrangements of both Moray Council and NHS Grampian functions. The Annual Audit Plan for 2024/25 agreed to the following audits to be undertaken: • Out of Area Placements- A review of the systems and procedures of people receiving adult social care services who are out of the Moray area. • Residential Care- A review to assess the adequacy of procedures and administrative arrangements for third-party suppliers that provide care home services. The audit also included testing to verify the accuracy of financial assessments and the charging of residential care for both respite and permanent care residents. • Fostering and Kinship- An audit to review fostering and kinship payments of fees and allowances, ensuring they comply with agreed policies and procedures. The audit review of out of area placements identified significant concerns regarding the progress in determining the ordinary residence status of individuals receiving adult social care services, contractual arrangements with care providers, and budgetary control arrangements. A review of residential care highlighted the need for improved administrative processes and the potential for further digitalisation. The fostering and kinship payments audit was found to be well managed within the scope of the review, though some administrative control improvements were noted. In addition to the projects outlined in the Audit Plan, governance arrangements were reviewed to prevent fraud and corruption. The audit found that further improvements are needed to enhance the effectiveness of counter fraud measures. Internal Audit has also undertaken follow-up reviews to evidence the implementation of recommendations from previously issued audit reports. The follow-up audits undertaken of Self-Directed Support and the Moray Integrated Community Store found several recommendations where revised timescales for implementing recommendations were required. A previous review of social care information governance noted a need for a single case recording system. The Service is seeking a replacement for the current arrangements for recording social care information, but there is a need for this to be progressed in a timely manner. Implementation of recommendations is a key element in determining the adequacy and effectiveness of governance and internal control systems. If recommendations are not implemented in a timely manner, then weaknesses in control and governance frameworks will remain. Page 251
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 40 ANNUAL GOVERNANCE STATEMENT (continued) The Chief Internal Auditor, after considering the results of the work carried out by Internal Audit, together with other sources of assurance, has provided limited assurance that the Moray Integration Joint Board had adequate systems of governance and internal control for the year ended 31 March 2025. There is now a process in place within both the Senior Management Team (SMT) and Operational Management Teams (OMT) that tracks all audit actions. SMT has a regular discussion on these and a focus on those that are due completion or open and overdue. There is ongoing discussion with the Internal Audit Team in relation to the planned audits and in relation to agreeing audit actions to ensure improved accuracy of agreeing feasible closure dates. Supporting all of this is an action plan overseen by SMT. Prior Year Governance Issues The Annual Governance Statement for 2023/24 highlighted a number of areas for development in looking to secure continuous improvement. An assessment of progress is provided below: Area for Improvement Identified in 2023/24 Action Undertaken / Progress Made in 2024/25 GP visioning programme to deliver resilience and sustainability. Financial Sustainability with best value and outcomes. Progress within the agreed priority workstreams has been made across the year and there have been regular updates to the IJB on the programme. A Visioning refresh event was held in March 2025 and further work to strengthen the programme deliverables will be taken forward from that into the next financial year. The Chief Officer has put in place a Budget Savings Oversight Group (BSOG) which supports oversight of the delivery of the savings programme on a monthly basis. A Programme Management Office (PMO) has been established to support this work and our senior responsible officers for each savings programme. In addition, regular tri- partite meetings between the Chief Officer, Chief Finance Officer and the Director and Head of Finance in NHS Grampian and Moray Council take place to ensure shared visibility on financial matters for all partners. Page 252
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 41 Area for Improvement Identified in 2023/24 Action Undertaken / Progress Made in 2024/25 Assurance and reporting for Children’s Social Work and Justice Services. Improvement in compliance with audit recommendations. Assurance and reporting for CF&J continues to take place in both the IJB and its committees and within Moray Council Structures. Resource has now been secured to support a review of this across 2025/26 to ensure robust and proportionate reporting that is cognisant of the statutory roles of partner organisations. Improvements continue to be made in this area with a process now in place to review audit actions in both the Operational Management Team (OMT) and within the Chief Officer’s Senior Management Team (SMT). This provides visibility on the delivery of actions within agreed timescales and on those actions that remain open and overdue so that a focus can be put upon those and ensure their closure. Improvement on progress has been evidenced; however, this area of improvement requires further development and will be included for developments in 2025/26. Further Developments Following consideration of the review of adequacy and effectiveness, the following action plan has been established to ensure continual improvement of the MIJB’s governance arrangements and progress against the implementation of these issues will be assessed as part of the next annual review. Areas of focus for 2025/26 1. Developing further our approaches to frailty and Discharge without Delay. 2. Realigning our organisational structure to ensure effective delivery of strategy and transformation. 3. Integration of Children’s Social Work and Justice Services governance and oversight within the IJB. 4. Further strengthen performance oversight of the Board’s key strategies and priorities. 5 Continue to improve on the progress for compliance with audit recommendations. ANNUAL GOVERNANCE STATEMENT (continued) Page 253
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 42 ANNUAL GOVERNANCE STATEMENT (continued) Key Governance challenges going forward will involve: • Providing capacity to meet statutory obligations and ambitions to transform services, whilst managing expectations, increasing complexity and rising demand for services and the wider societal economic challenges now presented that also potentially drive demand. • As a Board, difficult decisions will be required in balancing how we meet the needs of our community whilst operating within the available resource envelope, this will be supported by our approach to risk as set out in our risk appetite statement. • Continuing to address our work force challenges in respect of recruitment and retention and where persistent vacancies will necessitate the need for redesign of roles and/or services. • Continuing to work closely with NHS Grampian, Moray Council and Moray Community Planning Partnership to build on existing relationships and establishing collaborative leadership, and to maximise the opportunities from an expanded health and social care remit within the revised Portfolio approach, including Dr Grays hospital, and how the IJB contributes to the wider community planning agenda in Moray and the North East. • Continuing to implement the recommendations of internal and external audit, including learning from national reviews. • Continuing work with teams to provide assurance to MIJB as we develop the governance structures for Children’s Social Work and Criminal Justice Services that support decision making on how best to tackle poverty and inequalities. • There have been no significant events up to the authorised for issue date. Page 254
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 43 ANNUAL GOVERNANCE STATEMENT (continued) Statement In our respective roles as Chair and Chief Officer of the MIJB, we are committed to ensuring good governance and recognise the contribution it makes to securing delivery of service outcomes in an effective and efficient manner. This annual governance statement summarises the MIJB’s current governance arrangements and affirms our commitment to ensuring they are regularly reviewed, developed and fit for purpose. Whilst recognising that improvements are required, as detailed earlier in the statement, it is our opinion that a reasonable level of assurance can be placed upon the adequacy and effectiveness of the MIJB’s governance arrangements. The ongoing challenge will be to meet all operational demands and pressures as we continue to operate within the legacy of the Covid 19 pandemic and global financial pressures, both of which have impacted at a socioeconomic level on our region and the community. Pressure on financial settlements is increasing for all partners, and we will continue to engage with them, the Scottish Government and the wider community to agree plans and outcomes that are both sustainable and achievable within this context. Taking that forward will be challenging as we aim to fulfil the nine Health and Wellbeing national health and well-being outcomes, and the strategic priorities identified and detailed in our Strategic Plan. Good governance remains an essential focus in delivering services in a way that both meets the needs of communities and discharges statutory best value responsibilities. These were arrangements in place for 2024/25 and up to the date of authorised for issue. ………………………… ……………………… Dennis Robertson Judith Proctor Chair of Moray IJB Chief Officer Page 255
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 44 COMPREHENSIVE INCOME AND EXPENDITURE STATEMENT This statement shows the cost of providing services for the year ended 31 March 2025 according to generally accepted accounting practices. 2023/24 2024/25 Net Expenditure Net Expenditure £ 000 £ 000 7,942 Community Hospitals 8,329 5,702 Community Nursing 6,166 18,366 Learning Disabilities 19,975 11,506 Mental Health 12,055 1,726 Addictions 1,763 213 Adult Protection & Health Improvement 273 23,044 Care Services Provided In-House 22,754 25,191 Older People & Physical & Sensory Disability Services 27,034 1,881 Intermediate Care and Occupational Therapy 1,972 1,808 Care Services Provided by External Providers 1,817 10,012 Other Community Services 10,280 2,828 Administration & Management 3,152 1,299 Other Operational services 1,535 21,339 Primary Care Prescribing 21,937 19,939 Primary Care Services 21,331 5,936 Hosted Services 5,665 1,777 Out of Area Placements 1,971 949 Improvement Grants 1,021 19,762 Children & Justice Services 19,626 6,898 Strategic Funds & Other Resources 6,020 14,665 Set Aside 15,639 202,783 Cost of Services 210,315 (200,086) Taxation and Non-Specific Grant Income (note 5) (209,779) 2,697 Deficit on provision of Services 536 2,697 Total Comprehensive Income and Expenditure 536 There are no statutory or presentational adjustments which reflect the MIJB’s application of the funding received from partners. The movement in the General Fund balance is therefore solely due to the transactions shown in the Comprehensive Income and Expenditure Statement. Consequently, an Expenditure and Funding Analysis is not provided in these annual accounts. Children & Justice Services were integrated into the MIJB from 2023/24, with the first year being the shadow year meaning all financial responsibilities remained with the Council but from 2024/25 the MIJB has full control over the finances. Page 256
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 45 MOVEMENT IN RESERVES STATEMENT This statement shows the movement in the year on the Moray Integration Joint Boards (MIJB) reserves. The movements which arise due to statutory adjustments which affect the General Fund balance are separately identified from the movements due to accounting practices. Additional detail included within note 7 on page 51. Movement of Reserves During 2024/25 General Fund Balance £000 Opening Balance at 1 April 2024 (1,986) Total Comprehensive Income and Expenditure 536 (Increase) in 2024/25 536 Closing Balance at 31 March 2025 (1,450) Movement of Reserves During 2023/24 General Fund Balance £000 Opening Balance at 1 April 2023 (4,683) Total Comprehensive Income and Expenditure 2,697 Decrease in 2023/24 2,697 Closing Balance at 31 March 2024 (1,986) Page 257
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 46 BALANCE SHEET The Balance Sheet shows the value of the Moray Integration Joint Board’s (MIJB) assets and liabilities as at the balance sheet date. The net assets of the MIJB (assets less liabilities) are matched by the reserves held by the MIJB. 31 March 2024 £000 Notes 31 March 2025 £000 1,986 Short Term Debtors 6 1,450 Current Assets - Short Term Creditors - Current Liabilities - Provisions - Long Term Liabilities 1,986 Net Assets 1,450 1,986 Usable Reserve General Fund 7 1,450 1,986 Total Reserves 1,450 The unaudited annual accounts were issued on 19 June 2025 and the audited annual accounts were authorised for issue on 30 October 2025. The Annual Accounts present a true and fair view of the financial position of the MIJB as at 31 March 2025 and its income and expenditure for the year then ended. Deborah O’Shea FCCA Chief Financial Officer Page 258
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 47 NOTES TO THE FINANCIAL STATEMENTS Note 1 Significant Accounting Policies General Principles The Financial Statements summarise the Moray Integration Joint Board’s (MIJB) transactions for the 2024/25 financial year and its position at the year-end of 31 March 2025. The MIJB was established under the requirements of the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Act 2014 and is a Section 106 body as defined in the Local Government (Scotland) Act 1973. The Financial Statements are therefore prepared in compliance with the Code of Practice on Local Authority Accounting in the United Kingdom 2024/25, supported by International Financial Reporting Standards (IFRS), unless legislation or statutory guidance requires different treatment. The accounts are prepared on a going concern basis, which assumes that the MIJB will continue in operational existence for the foreseeable future. The historical cost convention has been adopted. Accruals of Income and Expenditure Activity is accounted for in the year that it takes place, not simply when settlement in cash occurs. In particular: • Expenditure is recognised when goods or services are received, and their benefits are used by the MIJB. • Income is recognised when the MIJB has a right to the income, for instance by meeting any terms and conditions required to earn the income, and receipt of the income is probable. • Where income and expenditure have been recognised but settlement in cash has not taken place, a debtor or creditor is recorded in the Balance Sheet. • Where debts may not be received, the balance of debtors is written down. Funding The MIJB is primarily funded through funding contributions from the statutory funding partners, Moray Council and Grampian Health Board. Expenditure is incurred as the MIJB commissions’ specified health and social care services from the funding partners for the benefit of service recipients in Moray area. Cash and Cash Equivalents The MIJB does not operate a bank account or hold cash. Transactions are settled on behalf of the MIJB by the funding partners. Consequently, the MIJB does not present a ‘Cash and Cash Equivalent’ figure on the balance sheet. The funding balance due to or from each funding partner as at 31 March is represented as a debtor or creditor on the MIJB’s Balance Sheet. Page 259
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 48 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 1 Significant Accounting Policies (continued) Employee Benefits The MIJB does not directly employ staff. Staff are formally employed by the funding partners who retain the liability for pension benefits payable in the future. The MIJB therefore does not present a Pensions Liability on its Balance Sheet. The MIJB has a legal responsibility to appoint a Chief Officer. More details on the arrangements are provided in the Remuneration Report. The charges from the employing partner are treated as employee costs. Where material the Chief Officer’s absence entitlement as at 31 March is accrued, for example in relation to annual leave earned but not yet taken. Charges from funding partners for other staff are treated as administration costs. Reserves The MIJB’s reserves are classified as either Usable or Unusable Reserves. The MIJB’s only Usable Reserve is the General Fund. The balance of the General Fund as at 31 March shows the extent of resources which the MIJB can use in later years to support service provision. Indemnity Insurance The MIJB has indemnity insurance for costs relating primarily to potential claim liabilities regarding Board members. Grampian Health Board and Moray Council have responsibility for claims in respect of the services that they are statutorily responsible for and that they provide. Unlike NHS Boards, the MIJB does not have any ‘shared risk’ exposure from participation in the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS). The MIJB participation in the CNORIS scheme is therefore analogous to normal insurance arrangements. Note 2 Critical Judgements and Estimation Uncertainty In applying the accounting policies, the MIJB has had to make certain judgements about complex transactions or those involving uncertainty about future events. There are no material critical judgements or estimation uncertainty. Page 260
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 49 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 3 Events after the Reporting Period The unaudited accounts were issued by Deborah O’Shea, Chief Financial Officer on 19 June 2025 and the audited accounts were authorised for issue on 30 October 2025. Events taking place after this date are not reflected in the financial statements or notes. Note 4 Expenditure and Income Analysis by Nature 2023/24 2024/25 £000 £000 95,500 Services commissioned from Moray Council 98,217 107,247 Services commissioned from Grampian Health Board 112,061 36 Auditor Fee: External Audit Work 37 202,783 Total Expenditure 210,315 (200,086) Partners Funding Contributions and Non- Specific Grant Income (209,779) 2,697 Deficit on the Provision of Services 536 Page 261
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 50 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 5 Taxation and Non-Specific Grant Income 2023/24 2024/25 £000 £000 84,615 Funding Contribution from Moray Council 88,441 115,471 Funding Contribution from Grampian Health Board 121,338 200,086 Taxation and Non-specific Grant Income 209,779 The funding contribution from Grampian Health Board shown above includes £15.639m in respect of ‘set aside’ resources relating to acute hospital and other resources. These are provided by Grampian Health Board who retains responsibility for managing the costs of providing the services. The MIJB however has responsibility for the consumption of, and level of demand placed on, these resources. Note 6 Debtors 31 March 2024 31 March 2025 £000 £000 1,723 Grampian Health Board 1,187 263 Moray Council 263 1,986 Debtors 1,450 Amounts owed by the funding partners are stated on a net basis. Creditor balances relating to expenditure obligations incurred by the funding partners but not yet settled in cash terms are offset against the funds they are holding on behalf of the MIJB. Page 262
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 51 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 7 Usable Reserve: General Fund The MIJB holds a balance on the General Fund for two main purposes: • To earmark, or build up, funds which are to be used for specific purposes in the future, such as known or predicted future expenditure needs. This supports strategic financial management. • To provide a contingency fund to cushion the impact of unexpected events or emergencies. This is regarded as a key part of the MIJB’s risk management framework. The table below shows the movements on the General Fund balance: Earmarked Reserves General Reserves PCIP & Action 15 Other Earmarked Total £000 £000 £000 £000 Balance at 1 April 2023 - 937 3,746 4,683 Transfers (out) 2023/24 - (904) (1,793) (2,697) Balance at 31 March 2024 - 33 1,953 1,986 Transfer (out) 2024/25 - (33) (503) (536) Balance at 31 March 2025 - - 1,450 1,450 Primary Care Improvement Fund (PCIP) - The purpose of this fund is to ring fence funding received from the Scottish Government as part of its Primary Care Transformation Plan; this includes Action 15 funding as part of this plan. Other earmarked reserves are noted in detail on pages 18 to 20. Page 263
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 52 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 8 Agency Income and Expenditure On behalf of all IJB’s within Grampian Health Board, the MIJB acts as the lead manager for Grampian Medical Emergency Department (GMED) and Primary Care Contracts. It commissions services on behalf of the other IJBs and reclaims the costs involved. The payments that are made on behalf of the other IJBs, and the consequential reimbursement, are not included in the Comprehensive Income and Expenditure Statement (CIES) since the MIJB is not acting as principal in these transactions. The amount of expenditure and income relating to the agency arrangement is shown below: 2023/24 2024/25 £000 £000 10,615 Expenditure on Agency Services 10,680 (10,615) Reimbursement for Agency Services (10,680) - Net Agency Expenditure excluded from the CIES - Page 264
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 53 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 9 Related Party Transactions The MIJB has related party relationships with Grampian Health Board and Moray Council. In particular the nature of the partnership means that the MIJB may influence, and be influenced by, its partners. The following transactions and balances included in the MIJB’s accounts are presented to provide additional information on the relationships. Transactions with Grampian Health Board 2023/24 2024/25 £000 £000 (115,471) Funding Contributions received from the NHS Board (121,338) 107,064 Expenditure on Services Provided by the NHS Board 111,864 183 Key Management Personnel: Non-Voting Board Members 197 (8,224) Net Transactions with Grampian Health Board (9,227) Key Management Personnel: The Chief Officer and Chief Financial Officer are non- voting Board members and are both employed by Grampian Health Board and recharged to the MIJB. Details of the remuneration of both officers are provided in the Remuneration Report. The Chief Officer is a joint appointment made by Moray Council and Grampian Health Board and is jointly accountable to the Chief Executives of both organisations, as such this post is jointly funded. The Chief Financial Officer, whilst a Board appointment, does not share this arrangement of funding. Balances with Grampian Health Board 31 March 2024 31 March 2025 £000 £000 1,723 Debtor balances: Amounts due from Grampian Health Board 1,187 1,723 Net Balance due from Grampian Health Board 1,187 Page 265
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 54 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 9 Related Party Transactions (continued) Transactions with Moray Council 2023/24 2024/25 £000 £000 (84,615) Funding Contributions received from the Council (88,441) 95,455 Expenditure on Services Provided by the Council 98,179 81 Key Management Personnel: Non-Voting Board Members 75 10,921 Net Transactions with Moray Council 9,813 Balances with Moray Council 31 March 2024 31 March 2025 £000 £000 263 Debtor balances: Amounts due from Moray Council 263 263 Net Balance due from Moray Council 263 Page 266
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 55 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 10 VAT The MIJB is not registered for VAT and as such VAT is settled or recovered by the partners. The VAT treatment of expenditure in the MIJB accounts depends on which of the partners is providing the services as each of these partners are treated differently for VAT purposes. VAT payable is included as an expense only to the extent that it is not recoverable from His Majesty’s Revenue and Customs. VAT receivable is excluded from income. Note 11 Accounting Standards That Have Been Issued but Have Yet To Be Adopted The Code requires the MIJB to identify any accounting standards that have been issued but have yet to be adopted and could have material impact on the accounts. This applies to the adoption of the following new or amended standards within the 2024/25 Code: • IAS 21 The Effects of Changes in Foreign Exchange Rate (Lack of Exchangeability) issued in August 2023; • IFRS 17 Insurance Contracts issued in May 2017; and • Changes to the measurement of non-investment assets within the 2025 to 2026 Code include adaptations and interpretations of IAS16 Property, Plant and Equipment, and IAS 38 Intangible Assets. The Code requires implementation from 1 April 2025 and there is, therefore, no impact on the 2024/25 financial statements. The above amendments are not anticipated to have a material impact on the information provided in the financial statements. Page 267
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 56 INDEPENDENT AUDITOR’S REPORT Independent auditor’s report to the members of Moray Integration Joint Board and the Accounts Commission Reporting on the audit of the financial statements Opinion on financial statements We certify that we have audited the financial statements in the annual accounts of Moray Integration Joint Board for the year ended 31 March 2025 under Part VII of the Local Government (Scotland) Act 1973. The financial statements comprise the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, Balance Sheet and notes to the financial statements, including material accounting policy information. The financial reporting framework that has been applied in their preparation is applicable law and UK adopted international accounting standards, as interpreted and adapted by the Code of Practice on Local Authority Accounting in the United Kingdom 2024/25 (the 2024/25 Code). In our opinion the accompanying financial statements: • give a true and fair view of the state of affairs of the Board as at 31 March 2025 and of its income and expenditure for the year then ended; • have been properly prepared in accordance with UK adopted international accounting standards, as interpreted and adapted by the 2024/25 Code; and • have been prepared in accordance with the requirements of the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003. Basis for opinion We conducted our audit in accordance with applicable law and International Standards on Auditing (UK) (ISAs (UK)), as required by the Code of Audit Practice approved by the Accounts Commission for Scotland. Our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We were appointed by the Accounts Commission on 18 May 2022. Our period of appointment is five years, covering 2022/23 to 2026/27. We are independent of the Board in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. Non-audit services prohibited by the Ethical Standard were not provided to the Board. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Page 268
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 57 INDEPENDENT AUDITOR’S REPORT (Continued) Conclusions relating to going concern basis of accounting We have concluded that the use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Board’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from when the financial statements are authorised for issue. These conclusions are not intended to, nor do they, provide assurance on the Board’s current or future financial sustainability. However, we report on the Board’s arrangements for financial sustainability in a separate Annual Audit Report available from the Audit Scotland website. Risks of material misstatement We report in our Annual Audit Report the most significant assessed risks of material misstatement that we identified and our judgements thereon. Responsibilities of the Chief Financial Officer and Moray Integration Joint Board for the financial statements As explained more fully in the Statement of Responsibilities, the Chief Financial Officer is responsible for the preparation of financial statements that give a true and fair view in accordance with the financial reporting framework, and for such internal control as the Chief Financial Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Chief Financial Officer is responsible for assessing the Board’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless there is an intention to discontinue the Board’s operations. The Moray Integration Joint Board is responsible for overseeing the financial reporting process. Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement Page 269
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 58 INDEPENDENT AUDITOR’S REPORT (Continued) when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities outlined above to detect material misstatements in respect of irregularities, including fraud. Procedures include: • using our understanding of the local government sector to identify that the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003 are significant in the context of the Board; • inquiring of the Chief Financial Officer as to other laws or regulations that may be expected to have a fundamental effect on the operations of the Board; • inquiring of the Chief Financial Officer concerning the Board’s policies and procedures regarding compliance with the applicable legal and regulatory framework; • discussions among our audit team on the susceptibility of the financial statements to material misstatement, including how fraud might occur; and • considering whether the audit team collectively has the appropriate competence and capabilities to identify or recognise non-compliance with laws and regulations. The extent to which our procedures are capable of detecting irregularities, including fraud, is affected by the inherent difficulty in detecting irregularities, the effectiveness of the Board’s controls, and the nature, timing and extent of the audit procedures performed. Irregularities that result from fraud are inherently more difficult to detect than irregularities that result from error as fraud may involve collusion, intentional omissions, misrepresentations, or the override of internal control. The capability of the audit to detect fraud and other irregularities depends on factors such as the skilfulness of the perpetrator, the frequency and extent of manipulation, the degree of collusion involved, the relative size of individual amounts manipulated, and the seniority of those individuals involved. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report. Page 270
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 59 INDEPENDENT AUDITOR’S REPORT (Continued) Reporting on other requirements Opinion prescribed by the Accounts Commission on the audited parts of the Remuneration Report We have audited the parts of the Remuneration Report described as audited. In our opinion, the audited parts of the Remuneration Report have been properly prepared in accordance with The Local Authority Accounts (Scotland) Regulations 2014. Other information The Chief Financial Officer is responsible for the other information in the annual accounts. The other information comprises the Management Commentary, Annual Governance Statement, Statement of Responsibilities and the unaudited part of the Remuneration Report. Our responsibility is to read all the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon except on the Management Commentary and Annual Governance Statement to the extent explicitly stated in the following opinions prescribed by the Accounts Commission. Opinions prescribed by the Accounts Commission on the Management Commentary and Annual Governance Statement In our opinion, based on the work undertaken in the course of the audit: • the information given in the Management Commentary for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with statutory guidance issued under the Local Government in Scotland Act 2003; and • the information given in the Annual Governance Statement for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with the Delivering Good Governance in Local Government: Framework (2016). Page 271
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2024/25 60 INDEPENDENT AUDITOR’S REPORT (Continued) Matters on which we are required to report by exception We are required by the Accounts Commission to report to you if, in our opinion: • adequate accounting records have not been kept; or • the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or • we have not received all the information and explanations we require for our audit. We have nothing to report in respect of these matters. Conclusions on wider scope responsibilities In addition to our responsibilities for the annual accounts, our conclusions on the wider scope responsibilities specified in the Code of Audit Practice, including those in respect of Best Value, are set out in our Annual Audit Report. Use of our report This report is made solely to the parties to whom it is addressed in accordance with Part VII of the Local Government (Scotland) Act 1973 and for no other purpose. In accordance with paragraph 108 of the Code of Audit Practice, we do not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Angela Pieri, (for and on behalf of Grant Thornton UK LLP), 120 Bothwell Street, Glasgow, G2 7JS Date: Page 272
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APPENDIX 2
Health & Social Care Moray
Judith Proctor
Chief Officer
Health & Social Care Moray
Moray Council HQ
High Street
ELGIN IV30 1BX
01343 563552
hscmchiefofficer@moray.gov.uk
www.hscmoray.co.uk
Grant Thornton UK LLP
120 Bothwell Street
Glasgow
G2 7JS
Moray Integration Joint Board
Financial Statements for the year ended 31 March 2025
This representation letter is provided in connection with the audit of the financial statements of Moray
Integration Joint Board (the “IJB”) for the year ended 31 March 2025 for the purpose of expressing an
opinion as to whether the IJB’s financial statements are presented fairly, in all material respects in
accordance with International Financial Reporting Standards, and the CIPFA/LASAAC Code of Practice
on Local Authority Accounting in the United Kingdom 2024/25 and applicable law.
We confirm that to the best of our knowledge and belief having made such inquiries as we considered
necessary for the purpose of appropriately informing ourselves:
Financial Statements
i. We have fulfilled our responsibilities for the preparation of the IJB’s financial statements in
accordance with International Financial Reporting Standards and the CIPFA/LASAAC Code of
Practice on Local Authority Accounting in the United Kingdom 2024/25 ("the Code"); in particular
the financial statements are fairly presented in accordance therewith.
ii. We have complied with the requirements of all statutory directions affecting the IJB and these
matters have been appropriately reflected and disclosed in the financial statements.
iii. The IJB has complied with all aspects of contractual agreements that could have a material effect
on the financial statements in the event of non-compliance. There has been no non-compliance
with requirements of any regulatory authorities that could have a material effect on the financial
statements in the event of non-compliance.
iv. We acknowledge our responsibility for the design, implementation and maintenance of internal
control to prevent and detect fraud.
v. We are satisfied that the methods, the data and the significant assumptions used by us in making
accounting estimates and their related disclosures are appropriate to achieve recognition,
measurement or disclosure that is reasonable in accordance with the Code and adequately
disclosed in the financial statements. In this context we confirm there are no significant
assumptions and accounting estimates.
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vi. Except as disclosed in the financial statements: a. there are no unrecorded liabilities, actual or contingent b. none of the assets of the IJB has been assigned, pledged or mortgaged c. there are no material prior year charges or credits, nor exceptional or non-recurring items requiring separate disclosure. vii. Related party relationships and transactions have been appropriately accounted for and disclosed in accordance with the requirements of International Financial Reporting Standards and the Code. viii. We have considered the disclosures changes schedules included in your Auditor’s Annual Report. The financial statements have been amended for these disclosure changes and they financial statements are free of material misstatements, including omissions. ix. All events subsequent to the date of the financial statements and for which International Financial Reporting Standards and the Code require adjustment or disclosure have been adjusted or disclosed. x. Actual or possible litigation and claims have been accounted for and disclosed in accordance with the requirements of International Financial Reporting Standards. xi. We have no plans or intentions that may materially alter the carrying value or classification of assets and liabilities reflected in the financial statements. xii. We have updated our going concern assessment. We continue to believe that the IJB financial statements should be prepared on a going concern basis and have not identified any material uncertainties related to going concern on the grounds that : a. the nature of the IJB means that, notwithstanding any intention to cease its operations in their current form, it will continue to be appropriate to adopt the going concern basis of accounting because, in such an event, services it performs can be expected to continue to be delivered by related public authorities and preparing the financial statements on a going concern basis will still provide a faithful representation of the items in the financial statements b. the financial reporting framework permits the entry to prepare its financial statements on the basis of the presumption set out under a) above; and c. the IJB system of internal control has not identified any events or conditions relevant to going concern. We believe that no further disclosures relating to the IJB’s ability to continue as a going concern need to be made in the financial statements. xiii. The IJB has complied with all aspects of ring-fenced grants that could have a material effect on the IJB’s financial statements in the event of non-compliance. Information Provided xiv. We have provided you with: a. access to all information of which we are aware that is relevant to the preparation of the IJB’s financial statements such as records, documentation and other matters; b. additional information that you have requested from us for the purpose of your audit; and c. access to persons within the Council and NHS via remote and in person arrangements from whom you determined it necessary to obtain audit evidence. Page 275
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xv. We have communicated to you all deficiencies in internal control of which management is aware. xvi. All transactions have been recorded in the accounting records and are reflected in the financial statements. xvii. We have disclosed to you the results of our assessment of the risk that the financial statements may be materially misstated as a result of fraud. xviii. We have disclosed to you all information in relation to fraud or suspected fraud that we are aware of and that affects the IJB and involves: a. management; b. employees who have significant roles in internal control; or c. others where the fraud could have a material effect on the financial statements. xix. We have disclosed to you all information in relation to allegations of fraud, or suspected fraud, affecting the financial statements communicated by employees, former employees, analysts, regulators or others. xx. We have disclosed to you all known instances of non-compliance or suspected non-compliance with laws and regulations whose effects should be considered when preparing financial statements. xxi. We have disclosed to you the identity of the IJB’s related parties and all the related party relationships and transactions of which we are aware. xxii. We have disclosed to you all known actual or possible litigation and claims whose effects should be considered when preparing the financial statements. Annual Governance Statement xxiii. We are satisfied that the Annual Governance Statement (AGS) fairly reflects the IJB’s risk assurance and governance framework and we confirm that we are not aware of any significant risks that are not disclosed within the AGS. Management Summary xxiv. The disclosures within the Management Summary fairly reflect our understanding of the IJB’s financial and operating performance over the period covered by the IJB’s financial statements. Approval The approval of this letter of representation was minuted by the IJB Board at its meeting on 30 October 2025. Yours faithfully Name: Judith Proctor Position: Chief Officer Date: Signed on behalf of the Moray Integration Joint Board Page 276
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 29 OCTOBER 2025 SUBJECT: PUBLIC SECTOR INTERNAL AUDIT STANDARDS - EXTERNAL QUALITY ASSESSMENT OF THE INTERNAL AUDIT SECTION- FOLLOW UP REVIEW BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 The purpose of this report is to provide an update on the implementation of recommendations detailed within the external quality assessment undertaken on the Council’s Internal Audit Section. 2. RECOMMENDATION 2.1 Committee is asked to consider the contents of the report, seek clarification on any points noted and otherwise note the report. 3. BACKGROUND 3.1 The Local Authority Accounts (Scotland) Regulations 2014 paragraph 7 requires that ‘a local authority must operate a professional and objective internal auditing service in accordance with recognised standards and practices in relation to internal auditing’. 3.2 The recognised standards adopted by all Scottish councils are the Public Sector Internal Audit Standards (PSIAS) developed by standard setters, including the Chartered Institute of Public Finance and Accountancy and the Chartered Institute of Internal Auditors. The standards include a requirement for an External Quality Assessment (EQA) of internal audit once every five years and for the findings to be considered at a meeting of a Council committee. An EQA of the Council’s Internal Audit Section was completed last year by the Chief Internal Auditor of Perth and Kinross Council. The findings were reported to this Committee on 26 September 2024 (paragraph 10 of the minute refers). This report provides an update on the implementation of recommendations contained within this EQA report. Item 12. Page 277
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4. KEY MATTERS RELEVANT TO RECOMMENDATION Public Sector Internal Audit Standards- External Quality Assessment of the Internal Audit Section- Follow Up Review Audit Plan 2025/26 4.1 Through the Scottish Local Authorities Chief Internal Auditors’ Group, in which the Council participates, it was agreed that the EQA requirement could be met through a peer review process. This required each Council’s chief internal auditor to lead a review of another Council’s internal audit service and receive a review in return. Perth and Kinross Council was selected to undertake the assessment of the Moray Council’s Internal Audit Section. 4.2 An assessment took place in March 2024, during which the Chief Internal Auditor of Perth and Kinross Council reviewed the operating arrangements within Moray against the PSIAS. The overall conclusion of the external assessment is that Moray Council’s Internal Audit Section fully conforms with the PSIAS. This represents the highest level of conformance and should reassure members and senior management about the effectiveness of the Internal Audit Section’s operating arrangements. However, the report included several recommendations, highlighting the need to reinforce Internal Audit’s role as an independent appraisal function for the Council and its partner organisations, as well as concerns regarding the availability of staffing resources. 4.3 A follow-up review has been undertaken by the Senior Auditor to evidence the implementation of the recommendations. The Follow-Up Report is included in Appendix 1. It is pleasing to confirm that the majority of the recommendations have been implemented. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with published Public Sector Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. Page 278
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(e) Staffing Implications No implications directly arising from this report (f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 Committee is asked to consider and note the progress made in implementing the recommendations detailed in the External Quality Assessment Report of the Internal Audit Section. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: mijb/ap&rc/ Page 279
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Appendix 1 XXX 2020 Page 1 EXTERNAL QUALITY ASSESSMENT 2 OF MORAY COUNCIL’S INTERNAL AUDIT SERVICE Report Recipients: J Mundell, Interim Chief Executive D Whitworth, Depute Chief Executive (Education, Communities & Organisational Development) A McEachan, Head of Governance, Strategy & Performance D Lewis, Chief Audit Executive (Audit and Risk Manager) Councillor G Leadbitter, Chair of Audit & Scrutiny Committee Page 280
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EXECUTIVE SUMMARY 2 1. INTRODUCTION 1.1 The mandatory Public Sector Internal Audit Standards (PSIAS), published initially in April 2013 and updated most recently in March 2017, apply to all internal audit service providers in the UK public sector, whether in-house, provided via a shared service arrangement or outsourced. To supplement the PSIAS and provide specific guidance surrounding its application within a local government setting, the Chartered Institute of Public Finance and Accountancy (CIPFA) compiled a Local Government Application Note, which was last updated in 2019. 1.2 The objectives of the PSIAS are to define the nature of internal auditing within the UK public sector; set basic principles for carrying out internal audit; establish a framework for providing internal audit services, which add value to the organisation, leading to improved organisational processes and operations; establish the basis for the evaluation of internal audit performance and drive improvement planning. 1.3 The PSIAS require the Chief Audit Executive (the Audit and Risk Manager in Moray Council) to develop and maintain a quality assurance and improvement programme (QAIP) that covers all aspects of the internal audit activity. The QAIP must include both periodic internal self-assessments and five-yearly external assessments, carried out by a qualified, independent assessor from outwith the organisation, and enable evaluation of the internal audit activity’s (Internal Audit in Perth & Kinross Council) conformance with the PSIAS, including the Mission of Internal Audit, Definition of Internal Auditing and Code of Ethics. In addition, the QAIP should also assess the efficiency and effectiveness of the internal audit activity and identify opportunities for improvement. 1.4 To assist its members to meet the five-yearly external assessment requirement, the Scottish Local Authorities Chief Internal Auditors’ Group (SLACIAG) established a collaborative system of formal peer reviews. This approach not only assists with ensuring that independent assessors, and their teams, have appropriate knowledge and experience of the local government internal audit environment but also removes the financial burden from councils, associated with procuring these services externally. The allocation of assessors / assessment teams to councils participating in the peer review process was undertaken autonomously, ensuring that, amongst other governing principles, local authorities with perceived / known conflicts of interest could not review one another. At the outset, assessors were required to formally declare any interests so that these could be appropriately addressed during the allocation process. Perth & Kinross Council was selected to carry out the external assessment in Moray Council. 1.5 To support the peer review process, SLACIAG developed a comprehensive External Quality Assessment (EQA) framework, including an EQA Checklist for Assessing Conformance with the PSIAS and the Local Government Application Note (EQA Checklist) and a key Stakeholder Questionnaire proforma. The external assessment of Moray Council’s Internal Audit Service has been carried out by Perth & Kinross Council’s Internal Audit service utilising this framework. 1.6 This report provides a high level summary of requirements for each standard per the PSIAS and CIPFA Local Government Application Note and sets out the findings, conclusions and recommendations from the external assessment, which involved discussions with key members of staff, including the Chief Audit Executive, review of the most recent self-assessment carried out utilising the EQA Checklist and consideration of other relevant supporting documentation / information (Evidence Pack) including working paper files and completed stakeholder questionnaires. A comprehensive list of supporting documentation / information and completed stakeholder questionnaires considered as part of the assessment can be found at appendices B and C respectively. Page 281
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3 2. OVERALL CONCLUSION 2.1 The overall conclusion of the external assessment is that Moray Council’s Internal Audit Service fully conforms with the PSIAS. However, it should be noted that Standard ref No. 1100.2 Independence & Objectivity have been assessed as generally conforms and steps should be taken to address the associated areas for improvement. A full summary of assessment, per assessment area, can be found at Appendix A. A summary of totals is as follows: Fully Conforms Generally Conforms Partially Conforms Does Not Conform TOTALS 13 1 0 0 2.2 The main areas for improvement highlighted in the report are as follows: • Enhancing the organisational independence of the Chief Audit Executive by including the role of the post within the Scheme of Delegation • Ensuring clarity over areas where the Chief Audit Executive has functional responsibility 2.3 Full details of the assessment recommendations and management responses can be found in the Action Plan at Appendix D. Page 282
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4 3. SECTION A – MISSION OF INTERNAL AUDIT AND CORE PRINCIPLES The PSIAS state that the Mission of Internal Audit articulates what internal audit aspires to accomplish within an organisation, which is ‘to enhance and protect organisational value by providing risk-based and objective assurance, advice and insight’. Taken as a whole, the Core Principles for the Professional Practice of Internal Auditing, as set out in the PSIAS, articulate internal audit effectiveness. For an internal audit function to be considered effective, all Core Principles should be present and operating effectively. Failure to achieve any of the Core Principles would imply that an internal audit activity was not as effective as it could be in achieving the Mission of Internal Audit. 3.1 Evidence obtained from assessing conformance with other standards in the PSIAS has been used, along with specific consideration surrounding the achievement of the Core Principles, to conclude that the Internal Audit Service at Moray Council fully conforms with accomplishing the Mission of Internal Audit as detailed above. 4. SECTION B – DEFINITION OF INTERNAL AUDITING The PSIAS state that internal auditing is an independent, objective assurance and consulting activity designed to add value and improve an organisation’s operations. It helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control and governance processes. 4.1 Evidence obtained from assessing conformance with other standards in the PSIAS has been used to conclude that the Internal Audit Service at Moray Council fully conforms with the definition of Internal Auditing as detailed above. The main reasons for this assessment include the Internal Audit Charter and engagement with stakeholders. 5. SECTION C – CODE OF ETHICS The PSIAS state that the purpose of the Institute of Internal Auditor’s Code of Ethics is to promote an ethical culture in the profession of internal auditing. A code of ethics is necessary and appropriate for the profession of internal auditing, founded as it is on the trust placed in its objective assurance about risk management, control and governance. Internal auditors in UK public sector organisations must conform to the Code of Ethics as set out in the PSIAS. If individual internal auditors have membership of another professional body then he or she must also comply with the relevant requirements of that organisation. 5.1 Evidence obtained from assessing conformance with other standards in the PSIAS, in particular the Attribute Standards 1000 – Purpose Authority and Responsibility, 1100 – Independence and Objectivity, 1200 – Proficiency and Due Professional Care and Professional Standards 2000 – Managing the Internal Audit Activity and 2300 – Performing the Engagement, has been used to conclude that Moray Council’s Internal Audit Service fully conforms with the requirement to comply with the Code of Ethics. Page 283
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5 6. SECTION D – ATTRIBUTE STANDARDS Attribute Standards apply to organisations and individual internal auditors providing the internal audit services in a local authority. 6.1 1000 - Purpose, Authority, and Responsibility The PSIAS state that the purpose, authority and responsibility of the internal audit activity must be formally defined in an Internal Audit Charter, consistent with the Mission of Internal Audit and the mandatory elements of the International Professional Practices Framework. The chief audit executive must periodically review the internal audit charter and present it to senior management and the board for approval. The internal audit charter must also: • define the terms ‘board’ and ‘senior management’ for the purposes of internal audit activity; • cover the arrangements for appropriate resourcing; • define the role of internal audit in any fraud-related work; and • describe safeguards to limit impairments of independence or objectivity if internal audit or the chief audit executive undertakes non-audit activities. 6.1.1 Moray Council’s Internal Audit Charter is periodically reviewed with the most recent review taking place in 2022. The Internal Audit Charter was approved by the Audit & Scrutiny Committee on 23 November 2022. 6.1.2 Having considered the findings above, it has been concluded that the Internal Audit Service at Moray Council fully conforms with Standard 1000 on Purpose, Authority and Responsibility. 6.2 1100 - Independence and Objectivity The internal audit activity must be independent and internal auditors must be objective in performing their work. Various aspects of independence and objectivity are covered in this standard as well as 1200, including reporting functional lines of the CAE, the relationship between the CAE and the board and any impairment to individual internal auditors’ objectivity or independence. Reporting and management arrangements must be put in place that preserve the CAE’s independence and objectivity, in particular with regard to the principle that the CAE must be independent of the audited activities. 6.2.1 The Chief Audit Executive reports functionally to the Audit & Scrutiny Committee and administratively to the Head of Governance, Strategy & Performance, who is a member of the Council’s Corporate Management Team. The Chief Audit Executive has direct and unrestricted access to the Chief Executive and the Chair of the Audit & Scrutiny Committee and this has been confirmed through Stakeholder engagement. These reporting / access arrangements are defined within the job description of the Chief Audit Executive but not specifically within the Internal Audit Charter. The Audit Charter does contain reference to arrangements for safeguards to limit impairment of independence or objectivity on behalf of the audit team. 6.2.2 In support of organisational independence, the Chief Audit Executive attends the Audit & Scrutiny Committee meetings to present all internal audit reports (including, for example, the Internal Audit Charter, Annual Report, Internal Audit Plan and reports / executive summaries from the planned audits) to Elected Members. The reports are all submitted in the Chief Audit Executive’s name. 6.2.3 The Chief Audit Executive has functional and operational responsibility for non-audit activities, namely supporting business continuity and risk management arrangements within services. This function is operationally kept separate from the delivery of internal audit. but this, and the potential for impairment to the Chief Audit Executive’s Page 284
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6 independence and objectivity, is not clearly communicated to stakeholders through the Audit Charter. 6.2.4 All staff within the Internal Audit service are required to complete a declaration form, that includes the requirement to raise any issues or concerns where a conflict of interest may arise on an annual basis. 6.2.5 There is scope for improving clarity regarding reporting lines by explicitly stating reporting lines within the Audit Charter 6.2.6 Furthermore, there is scope to consider the Chief Audit Executive’s delegated authority within the Scheme of Delegation. 6.2.7 Where the Chief Audit Executive has roles and responsibility in addition to Internal Audit, this should be clearly communicated to the Audit & Scrutiny Committee and Senior Officers. The Audit Charter should be updated in this regard to ensure that there are clear arrangements for ensuring the independence and objectivity of the Internal Audit function. 6.2.8 Moray Council’s Internal Audit Service generally conforms with Standard 1100 on Independence and Objectivity. 6.3 1200 - Proficiency and Due Professional Care The CAE must be professionally qualified, suitably experienced and responsible, in accordance with the organisation’s human resources processes, for recruiting appropriate staff. He or she is responsible for ensuring that up-to-date job descriptions exist, reflecting roles and responsibilities, and that person specifications define the required qualifications, competencies, skills, experience and personal attributes. The CAE should periodically assess individual auditors’ skills and competencies against those set out in the relevant job descriptions and person specifications. Any training or development needs identified should be included in an appropriate ongoing development programme that is recorded and regularly reviewed and monitored. In addition, all internal auditors have a personal responsibility to undertake a programme of continuing professional development (CPD) to maintain and develop their competence. This may be fulfilled through requirements set by professional bodies or through the organisation’s own appraisal and development programme. Auditors should maintain a record of such professional training and development activities. The internal audit activity should be appropriately resourced to meet its objectives. It should have appropriate numbers of staff in terms of grades, qualifications, personal attributes and experience or have access to appropriate resources in order to meet its objectives and to comply with these standards. The PSIAS states that the CAE must obtain competent advice and assistance if the activity is unable to perform all or part of an engagement. 6.3.1 The Chief Audit Executive holds a relevant professional qualification and is suitably experienced, with over 30 years internal audit experience within local government. The Chief Audit Executive is a member of SLACIAG and regularly attends and contributes to meetings. In relation to the two SLACIAG Sub-groups, the Computer Audit Sub- Group (CASG) and the Scottish Local Authorities Investigators Group (SLAIG), Moray Council’s Internal Audit team is represented on both. Page 285
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7 6.3.2 To support the Chief Audit Executive in Moray Council’s Internal Audit service there is one Senior Auditor, who is also suitably qualified and experienced. There are a total of 3.8 FTE members of staff in the Internal Audit service, including the Chief Audit Executive and Senior Auditor. The Internal Audit Service delivers internal audit services to Moray Council, Moray Integration Joint Board, the Grampian Valuation Board and Moray Growth Deal. Whilst there are no specialist computer auditors or fraud investigators, the Chief Audit Executive is a member of the Computer Audit Sub Group and the team contains officers who are experienced in fraud and corruption investigations. 6.3.3 All Internal Audit team members participate in Moray Council’s corporate Employee Review and Development process. 6.3.4 The Internal Audit Service is represented on a number of corporate groups, including the Information Assurance Group and the Leadership Forums, and may be asked to advise other Council groups on specific issues connected with the control environment. 6.3.5 The Chief Audit Executive, Senior Auditor and one auditor have specific CPD requirements to adhere to, with the remaining team member currently undertaking professional training with the Institute of Internal Auditors. Training records are held. 6.3.6 Engagement with key stakeholders, as part of the validation of the self assessment process has confirmed that the Chief Audit Executive demonstrates sufficient knowledge and experience and that all members of the Internal Audit Service exercise due professional care. 6.3.7 Consideration should be given to the size of the Internal Audit team in order to ensure that the Internal Audit Service meet its objectives for all organisations that it provides internal audit services to (as detailed in 6.3.2). 6.3.8 Moray Council’s Internal Audit Service fully conforms with standard 1200 on Proficiency and Due Professional Care. 6.4 1300 - Quality Assurance and Improvement Programme The PSIAS state that the Chief Audit Executive must develop and maintain a quality assurance and improvement programme (QAIP) that covers all aspects of the internal audit activity. The QAIP must include both periodic internal self-assessments and five-yearly external assessments, carried out by a qualified, independent assessor from outside the organisation, and enable evaluation of the internal audit activity’s conformance with the PSIAS, including the Definition of Internal Auditing and Code of Ethics. In addition, the QAIP should also assess the efficiency and effectiveness of the internal audit activity and identify opportunities for improvement. The public sector requirement in the PSIAS states that results of the QAIP and progress against any improvement plans must be reported in the annual report. 6.4.1 Internal audit reports are reviewed by the Chief Audit Executive prior to issue and working papers are reviewed by either the Chief Audit Executive or Senior Internal Auditor. Where the assignment is carried out by the Senior Internal Auditor, the Chief Audit Executive will review the working paper file. 6.4.2 Client feedback is actively pursued by the Internal Audit Service for assignments carried out within Moray Council. Page 286
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8 6.4.3 Performance measures are in place to monitor the performance of the Internal Audit service. These include the audit plan delivery and the budget surrounding the plan. The performance against these measures is reported to Audit & Scrutiny Committee as part of the Annual Audit Report and Opinion. 6.4.4 The EQA Checklist has been used for a formal self-assessment of compliance with the PSIAS. The Quality Assurance Improvement Plan was provided to the Audit & Scrutiny Committee, with ongoing compliance being reported in subsequent years. 6.4.5 Moray Council’s Internal Audit Service fully conforms with Standard 1300 on Quality Assurance and Improvement Programme. 7. SECTION E – PERFORMANCE STANDARDS Performance Standards describe the nature of the internal audit services being provided and provide criteria against which the performance of an internal audit function can be measured. 7.1 2000 - Managing the Internal Audit Activity The chief audit executive must effectively manage the internal audit activity to ensure it adds value to the organisation. The internal audit activity is effectively managed when it achieves the purpose and responsibility included in the internal audit charter, it conforms with the PSIAS, its individual members conform with the Code of Ethics and the PSIAS and it considers trends and emerging issues that could impact the organisation. The internal audit activity adds value to the organisation and its stakeholders when it considers strategies, objectives and risks; strives to offer ways to enhance governance, risk management, and control processes; and objectively provides relevant assurance. 7.1.1 An annual Internal Audit Plan is compiled by the Chief Audit Executive outlining the planned programme of work to be undertaken. A review is undertaken of the Audit Universe, taking account of internal audit risk assessment and historic internal audit activity over a 5 year period. Consideration is given to the Corporate Risk Register (compiled by Heads of Services supported by the Business Continuity and Risk Management Officer), as well as corporate transformation and improvement plans. The Corporate Management Team, Heads of Services, Council Leader and the Chair of the Audit and Scrutiny Committee are also consulted and asked if there are any projects they want to be included in the Annual Audit Plan. Contact is made with the External Auditor to detail the projects contained within the Audit Plan. 7.1.2 The draft Internal Audit Plan is presented to the Audit & Scrutiny Committee for formal approval. 7.1.3 Progress towards completion of the Internal Audit Plan, and the individual audits contained within it are reported to each Audit & Scrutiny Committee, which routinely take place five times a year. 7.1.4 Managers are asked to complete a feedback questionnaire from the reviews undertaken, which is assessed to determine whether any improvements are needed to the audit process. 7.1.5 Moray Council’s Internal Audit Service fully conforms with Standard 2000 on Managing the Internal Audit Activity. Page 287
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9 7.2 2100 - Nature of Work The internal audit activity must evaluate and contribute to the improvement of the organisation’s governance, risk management, and control processes using a systematic, disciplined, and risk-based approach. Internal audit credibility and value are enhanced when auditors are proactive and their evaluations offer new insights and consider future impact. More specifically, the internal audit activity must assess and make appropriate recommendations to improve the organisation’s governance processes, evaluate the effectiveness and contribute to the improvement of risk management processes and assist the organisation in maintaining effective controls by evaluating their efficiency and effectiveness and promoting continuous improvement. 7.2.1 The Chief Audit Executive includes an appropriate balance of work within the Plan to evaluate and contribute to the improvement of the Council’s governance, risk management and control processes. Findings re coverage of governance, risk management and control processes. 7.2.3 Moray Council’s Internal Audit Service fully conforms with Standard 2100 on Nature of Work. 7.3 2200 - Engagement Planning Internal auditors must develop and document a plan for each engagement, including the engagement’s objectives, scope, timing and resource allocations. The plan must consider the organisation’s strategies, objectives and risks relevant to the engagement. The CIPFA Local Government Application note states that for each engagement, a brief should be prepared, discussed and agreed with relevant managers. The brief should establish the objectives, scope and timing for the assignment and its resource and reporting requirements. Audit work should be undertaken using a risk-based audit approach. 7.3.1 The Audit Plan includes a brief summary of the scope for each audit, which is developed more fully prior to the commencement of the audit. The audit programme is compiled by the auditor and is reviewed by the Chief Audit Executive or Senior Auditor to ensure that the programme is consistent with, and will provide sufficient evidence for arriving at an opinion on, the agreed scope. 7.3.2 Moray Council’s Internal Audit Service fully conforms with Standard 2200 on Engagement Planning. 7.4 2300 - Performing the Engagement Internal auditors must identify, analyse, evaluate and document sufficient information to achieve the engagement’s objectives. At each stage of the audit, auditors should consider what specific work needs to be conducted and evidence needs to be gathered to achieve the engagement objectives and support an independent and objective audit opinion. Systems should be in place to ensure that auditors obtain and record, within the working papers, sufficient evidence to support their conclusions, professional judgements and recommendations. Working papers should always be sufficiently complete and detailed to enable an experienced internal auditor with no previous connection with the audit to ascertain what work was performed, re-perform it if necessary and support the conclusions reached. The CAE should also specify how long all audit documentation should be retained, whether held on paper or electronically. All audit work should be subject to an appropriate internal quality review process. Internal auditors must be alert to the possibility of intentional wrongdoing, errors and omissions, poor value for money, failure to comply with management policy and conflicts Page 288
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10 of interest when performing their individual audits. They must also have sufficient knowledge to identify indicators that fraud or corruption may have been committed. 7.4.1 The Internal Audit Manual details the procedures for use within Moray Council’s Audit Service. The Manual is supported by the Pentana system, which is an audit automation tool supporting the service’s management and control workflow. 7.4.2 All audit files are stored electronically within Pentana. 7.4.3 Evidence for file and report reviews, which are undertaken by the Chief Audit Executive or the Senior Auditor, is retained within Pentana. 7.4.5 Records management arrangements are appropriate and consider GDPR. 7.4.6 Moray Council’s Internal Audit Service fully conforms with Standard 2300 on Performing the Engagement. 7.5 2400 - Communicating Results The basic aims of every internal audit report should be to: • give an opinion on the risk and controls of the area under review, building up to the annual opinion on the overall adequacy and effectiveness of the organisation’s framework of governance, risk management and control; • prompt management to implement the agreed actions for change leading to improvement in the control environment and performance; and • provide a formal record of points arising from the audit and, where appropriate, of agreements reached with management, together with appropriate timescales. Each report should include the scope and purpose of the audit to help the reader to understand the extent, or limitations, of the assurance(s) provided by the report. During the course of the audit, key issues should be brought to the attention of the relevant manager to enable them to take corrective action and to avoid surprises at the closure stage. Before issuing the final report, the internal auditor should normally discuss the contents with the appropriate levels of management to confirm the factual accuracy, to seek comments and to confirm the agreed management actions. A draft report is useful for this purpose. Recommendations should be prioritised according to risk. The recommendations and the resultant management action plans should be agreed prior to the issue of the final report. Any areas of disagreement between the internal auditor and management that cannot be resolved by discussion should be recorded in the action plan and the residual risk highlighted. Those weaknesses giving rise to significant risks that are not agreed should be brought to the attention of a more senior level of management and the board. As set out in the PSIAS, the CAE must deliver an annual internal audit opinion and report that can be used by the organisation to inform its annual governance statement. This must include the annual internal audit opinion concluding on the overall adequacy and effectiveness of the organisation’s governance, risk and control framework, a summary of the audit work from which the opinion is derived (including reliance placed on work by other assurance bodies); and a statement of conformance with the PSIAS and the results of the internal audit QAIP. 7.5.1 Draft reports are prepared for each audit assignment by the lead auditor and reviewed by the Chief Audit Executive or Senior Auditor. This includes assessing the strength of controls in place within the audited area. 7.5.2 Once factual accuracy has been confirmed with the service being audited, the action plan is completed, with any issues being addressed with the relevant Head of Service before the report is passed for presentation to the Audit & Scrutiny Committee. Page 289
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11 7.5.3 The work of the Internal Audit service for the year is considered, summarised and forms part of the overall opinion that is provided annually by the Chief Audit Executive. 7.5.4 Engagement with stakeholders during the validation of the EQA confirms that this process is understood, respected and valued by the organisation. 7.5.5 Moray Council’s Internal Audit Service fully conforms with Standard 2400 on Communicating Results. 7.6 2500 - Monitoring Progress The PSIAS place responsibility for monitoring progress with the CAE to ensure that management actions have been effectively implemented or, if not, that senior management have accepted the risk of not taking action. The CAE must, therefore, implement a follow-up process for ensuring the effective implementation of audit results or ensuring senior management are aware of the consequences of not implementing an action point and are prepared to accept the risk of such consequences occurring. The results of this process should be communicated to the board. The CAE should develop escalation procedures for cases where agreed actions have not been effectively implemented by the date agreed. These procedures should ensure that the risks of not taking action have been understood and accepted at a sufficiently senior management level. The effective involvement of the board in the follow-up process is critical to ensuring that it works. The CAE should consider revising the internal audit opinion in light of findings from the follow-up process. The findings of follow-up reviews should inform the planning of future audit work. 7.6.1 The audit follow-up review process is documented within the Internal Audit Manual. Follow-up audits take place following the last date of implementation for all recommendations. A control record is maintained to monitor when audits are due for follow up. Follow-up audits are reviewed by the CAE or Senior Auditor, following which they are now reported to Audit & Scrutiny Committee. 7.6.3 Moray Council’s Internal Audit Service fully conforms with Standard 2500 on Monitoring Progress. 7.7 2600 - Communicating the Acceptance of Risks When the chief audit executive concludes that management has accepted a level of risk that may be unacceptable to the organisation, they must discuss the matter with senior management. If the chief audit executive determines that the matter has not been resolved, they must communicate the matter to the board. It is not the responsibility of the chief audit executive to resolve the risk. 7.7.1 All audits on systems and practices are reported to the Board including Management responses to recommendations. Where a recommendation is made which is not accepted by management, which has been found to be rare, the Chief Audit Executive presents a report to Audit & Scrutiny Committee where a ‘no’ response has been entered against a recommendation, the CAE and elected members would have the opportunity to challenge this response from Management. 7.7.2 The organisational structure allows for direct communication between the Chief Audit Executive and the Chief Executive and the Chair of the Audit & Scrutiny Committee. 7.7.3 The full scope of internal audit responsibilities are covered in the annual report / opinion i.e. governance, risk management and control. 7.7.4 Moray Council’s Internal Audit Service fully conforms to the Standard on Communicating the Acceptance of Risk. Page 290
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12 Jackie Clark Chief Internal Auditor Perth & Kinross Council August 2024 Page 291
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13 APPENDIX A – SUMMARY OF ASSESSMENT REF PAGE No. ASSESSMENT AREA Fully Conforms Generally Conforms Partially Conforms Does Not Conform Section A Mission of Internal Audit and Core Principles Section B Definition of Internal Auditing Section C Code of Ethics Section D ATTRIBUTE STANDARDS 1000 Purpose, Authority and Responsibility 1100 Independence and Objectivity 1200 Proficiency and Due Professional Care 1300 Quality Assurance and Improvement Programme Section E PERFORMANCE STANDARDS 2000 Managing the internal Audit Activity 2100 Nature of Work 2200 Engagement Planning 2300 Performing the Engagement 2400 Communicating Results Page 292
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14 2500 Monitoring Progress 2600 Communicating the Acceptance of Risks TOTALS 13 1 0 0 Page 293
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15 APPENDIX B – EVIDENCE PACK • Completed self-assessment against the Public Sector Internal Audit Standards • Internal Audit Charter • Internal Audit Manual • Pentana system outputs • Organisational charts, Job descriptions • Links to relevant Committee reports • Relevant communication Page 294
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16 APPENDIX C – STAKEHOLDERS Stakeholder interviews were held with the following key members of staff and Elected Members: • D Lewis, Audit & Risk Manager (Chief Audit Executive) • T Laing, Senior Internal Auditor • J Lovie, Internal Auditor • R Burns, Chief Executive (former) • A McEachan, Head of Governance, Strategy & Performance • Councillor G Leadbitter, Chair of Audit & Scrutiny Committee Page 295
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17 APPENDIX D – ACTION PLAN ACTION PLAN – INTERML AUDIT FOLLOW UP REVIEW – JUNE 2025 No. Report Para Recommendation Management Response Responsible Officer / Agreed Completion Date 1 6.2.5 There is scope for improving clarity regarding reporting lines by explicitly stating reporting lines within the Audit Charter The Audit Charter will be updated to provide greater clarification regarding the rights of access for Internal Audit Section officers to documentation and to seek explanations from any officer regarding any issues in completing their duties Audit and Risk Manager / Agreed 30 November 2024 Follow Up Review Status Comment Implemented The Internal Audit Charter has been updated to include further reference to the administrative and functional reporting requirements of the Audit & Risk Manager (Chief Audit Executive (CAE)). In addition, greater clarity has also been included regarding the Audit and Risk Manager’s “rights of access” to members and senior management. The Audit and Scrutiny Committee approved the updated Audit Charter on 20 November 2024 (paragraph 10 of the minutes refers). No. Report Para Recommendation Management Response Responsible Officer / Agreed Completion Date 2 6.2.6 Furthermore, there is scope to consider the Chief Audit Executive’s delegated authority within the Scheme of Delegation The Scheme of Delegation will be updated to include the responsibility for the Audit and Risk Manager to act as the Head of Governance, Strategy and Page 296
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18 Chief Audit Executive for the delivery of internal audit services. Performance / Agreed 31 January 2025 Follow Up Review Status Comment Implemented The Scheme of Delegation has been updated to include reference to the requirement for the Audit and Risk Manager’s responsibility to deliver the internal audit service in accordance with the Public Sector Internal Audit Standards. The updated Scheme of Delegation was approved by full Council on 25 June 2025. No. Report Para Recommendation Management Response Responsible Officer / Agreed Completion Date 3 6.2.7 Where the Chief Audit Executive has roles and responsibility in addition to Internal Audit, this should be clearly communicated to the Audit & Scrutiny Committee and Senior Officers. The Audit Charter should be updated in this regard to ensure that there are clear arrangements for ensuring the independence and objectivity of the Int The updated Audit Charter was approved by the Audit and Scrutiny Committee on 20 November 2024 (paragraph 10 of the minutes refers).ernal Audit function. As detailed in the ‘management response’ to recommendation 1, the Audit Charter will also be updated to detail the separate roles of the Audit and Risk Manager within the Council. Audit and Risk Manager / Agreed 30 November 2024 Follow Up Review Status Comment Implemented The Internal Audit Charter has been updated to include reference of the requirement that any duties of the Audit and Risk Manager that fall outside internal auditing must not impact the requirement for independence or objectivity. Page 297
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19 No. Report Para Recommendation Management Response Responsible Officer / Agreed Completion Date 4 6.3.7 Consideration should be given to the size of the Internal Audit team in order to ensure that the Internal Audit Service meet its objectives for all organisations that it provides internal audit services to (as detailed in 6.3.2) Concerns regarding the current staffing resources of the Internal Audit Service to meet the auditing and also counter fraud requirements of the Council and partner organisations have already been highlighted to senior management and members. However, this issue will be raised again for consideration with senior management. Audit and Risk Manager / Agreed 30 September 2024 Follow Up Review Status Comment Part- Implemented In accordance with the Public Sector Internal Auditing Standards (PSIAS), the Audit and Risk Manager must ensure that internal audit resources are appropriate and sufficient. Where the Audit and Risk Manager believes that the level of resources will adversely impact the provision of the annual internal audit opinion, this must be brought to the attention of the Audit and Scrutiny Committee. Concerns were raised by the Audit and Risk Manager within the Annual Internal Audit Report to the Audit and Scrutiny Committee on 24 June 2025 (paragraph 6 of the minutes refers) regarding the level of staff resources. However, the recent appointment of a part-time temporary auditor should assist in meeting the increasing demands on the Service. . Critical Significant Routine Page 298
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT AND PERFORMANCE COMMITTEE ON 29 OCTOBER 2025 SUBJECT: HEALTH AND SOCIAL CARE MORAY STRATEGIC DELIVERY PLAN 2025-2028 – PROGRESS UPDATE TO 30 SEPTEMBER 2025 BY: CORPORATE PROGRAMME MANAGER 1. REASON FOR REPORT 1.1 To provide the Committee with an update on progress on delivery of the to scrutinise the progress to September 2025 of the implementation of the Strategic Delivery Plan (SDP). 2. RECOMMENDATION 2.1 It is recommended that the Committee:- i) consider and note the progress to September 2025 of the Strategic Delivery Plan (2025-2028) attached at Appendix 1; ii) note the areas that are progressing well and those where adjustments to timescales are required as outlined in 4.3 to 4.10; and iii) approve amendment to the outcome identified in 4.11 3. BACKGROUND 3.1 The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty on Integrated Authorities to develop a Strategic Plan for delegated functions under their direction. As reported to the Board on 24 November 2022 (paragraph 13 of the minute refers), the revised strategic plan ‘Partners in Care 2022-2032’ was approved to allow for the Strategic Delivery Plan (SDP) to be developed. 3.2 The Strategic Delivery Plan 2025 to 2028 was agreed by the Board on 29 May 2025 (para 8 of the minute refers) and set out how the Strategy will be delivered, highlighting the key improvements and transformational change which will be required. 4. KEY MATTERS RELEVANT TO RECOMMENDATION Item 13. Page 299
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4.1 The progress updates for the projects in the SDP are set out in Appendix 1. Of the 66 actions, 55 are on schedule (or not due to have started), four are behind, three are overdue and four have completed. Completed 4.2 2.2.1 – 2.2.2 Primary Care Improvement Plan – actions specified are completed but will continually be subject to ongoing review through the project board. Other completed actions are the contribution to the development of the Moray wide poverty Strategy Action plan (1.2.1) and definition of requirements for older people supported accommodation (5.4.2) has been incorporated into the Local Housing Strategy. Progress delayed or overdue 4.3 Locality Plans – changes in staffing following retirals has meant progress is slower than anticipated, it is now underway however there is a need to extend the due date to December 2025. 4.4 Good progress with development of the SDS framework on Scotland Excel Self Directed Support (SDS) (3.2.1) but a delay has occurred regarding the mechanism to publish the framework to ensure it remains a live advert. Consideration of options to ascertain the most appropriate solution is underway. The timeline needs to be slightly extended by a month to January 2026. In relation to the self- evaluation against the national SDS framework (3.2.2) progress has been delayed due to lack of a lead, which has now been resolved through the funding for Internal Audit Team to support this. 4.5 The strategic review and redesign of care at home service 5.2.1 has progressed with the development of the commissioning framework that is enabling more providers to participate in the provision of care. There is work to be completed regarding data sharing governance, and this is being progressed with support from Council Information Governance team. 4.6 The review and redesign of Adults Day Care services is underway but progressed has been hampered by competing priorities and lack of project support. This is also impacting on delivery of budget savings, although alternative savings have been identified for implementation this financial year. A project officer has now been appointed, and this project will be a priority to progress, however the timeline requires to move from March to December 2026 to allow time for appropriate engagement with stakeholders. 4.7 Progress on the Children Service Plan is reported to Girfec Leadership Group on a quarterly basis, and some highlights are incorporated into this update. In relation to Family Support (action 2.5.6) wider children services collaboration is required to deliver on the whole system change and family support centre and spoke models. The Head of Service, Children’s, Families and Justice services is considering and will bring forward proposal in due course. 4.8 The rollout of the engagement plan for the GMED redesign was delayed due to limited operational capacity and the complexity of the review process. Page 300
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Engagement will complete in January 2026 with the revised service model presented to MIJB in March 2026. 4.9 Work has commenced on the revised communications strategy (E3.1) to ensure the document reflects statutory principles, including “Planning with People,” and aligns with relevant HSCP communications and engagement guidance. Revised date for draft document completion is from September to December 2025. 4.10 The annual report Annexe A was completed via NHSG and the HSCM workforce plan is underway but was delayed whilst waiting for Scottish Government response to Annexe A, to be able to proceed. This has now been received and the information from the KPMG report for NHSG will also be incorporated in our plan, which will be completed in March 2026. Amendment to outcome proposed 4.11 In relation to reducing reoffending, following feedback from MIJB regarding responsibility for housing it is proposed to replace the previously agreed “Less homelessness applications are made by people released from prison” with “More people are supported by throughcare services upon release from prison”. This is within the Scottish Government Community Justice Outcomes – Improvement Planning (CJOIP) and is more aligned with the health and social care Moray’s services and activities. Further Development 4.12 Working is progressing on the performance framework and the governance framework to support oversight of the project progression, evidencing impact and improvement in outcomes for people. Whilst progress has been made it is not yet completed so the revised framework will now be presented to this Committee in February 2026. As part of this framework, we aim to adopt exception reporting through strengthening establishment of clear milestones and SMART objectives. 4.13 Given the ongoing budgetary pressures, the Senior Management Team (SMT) will be scrutinising progress with SDP and the budget savings projects to ensure that the focus is on financial sustainability. The need to prioritise resource allocation to key savings projects may impact on progress on some other SDP actions over the next 6 months however any necessary amendments in timescales will be managed and reported in the next update. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The SDP underpins the named plans and supports achieving better outcomes for citizens in Moray. (b) Policy and Legal Page 301
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The implementation and publication of the delivery plan ensures the MIJB complies with legal requirements. Delivery of aspects of the plan will require review of policies and procedures and these will be taken forward through the necessary governance processes to ensure compliance with statutory requirements. (c) Financial implications Pivotal to the effective delivery on the actions in the SDP are the financial resources available to MIJB. To assist with the planning process, a Medium-Term Financial Framework supports the delivery of the strategic plan to aid decision making. This is scrutinised regularly by Senior Management and reported quarterly to MIJB. The Budget Savings Oversight Group regularly monitors the progress of projects regarding delivery of budget savings to ensure anticipated savings are achieved. (d) Risk Implications and Mitigation Risks to achieving the deliverables in the plan will be highlighted through the Strategic Risk Register and monitored by this Committee. The immediate risk to successfully delivering the Plan could be defined as Intensification – trying to do more with the same (e.g. financial resources, workforce availability). To mitigate against this, the MIJB at their meeting on 29 June 2023 (para 10 of the minute refers) agreed the 3-year transformation priorities and improvement projects; to offer a clear focus for Health and Social Care Moray (HSCM) staff and these priorities are incorporated in the SDP. Each service/team will have or will develop service plans that encompass their responsibilities contained in the SDP. This supports good governance, risk and issue escalation if required. (e) Staffing Implications With any changes in ways and models of working, there may be implications for staff in how they go about their work and how supported they are within a pressured and changing environment. Staff side, Unions and Human Resources will be working alongside SMT in delivering change, observing the associated policy and procedures of the Council and NHS Grampian (NHSG). The SDP will be delivered using existing staffing. That said, as a saving target has been agreed though vacancy management, the MIJB must be cognisant of the health and wellbeing of the workforce as they continue to deliver and transform in a resource constraint environment. (f) Property The Moray Infrastructure Board offers oversight and scrutiny to service delivery, linking into the assets management arrangements for NHSG and Moray Council. Service specific infrastructure and property issues will be detailed in service plans and risks raised through the Infrastructure Board and Strategic Risk register is appropriate. (g) Equalities/Socio Economic Impact Page 302
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An Equality Impact Assessment (including assessment against Fairer Scotland Duty) was undertaken in line with statutory obligations. This has been reviewed and there were no changes identified. The EIA was included as part of the submission for the Strategy Plan agreed by MIJB at their meeting on 29 November 2022 (para 14 of minute refers) and are available publicly on HSCM website. As projects progress, they will undertake Integrated Impact Assessments that will be reported and published, as necessary. (h) Climate Change and Biodiversity Impacts There are no direct impacts arising from the recommendations of this report. Climate change impacts are considered and incorporated into project documentation and business plans as HSCM work towards reducing carbon footprint and delivering on net zero emissions targets. (i) Directions No direction requires to be issued to Moray Council or NHSG as a result of this report. (j) Consultations Consultations have been undertaken with Senior Management Team and Caroline O’Connor, Committee Services Officer, Moray Council, and comments have been incorporated in this report. 6. CONCLUSION 6.1 This update on progress of the SDP outlines what is being achieved against approved priorities, within the capacity and resources currently available. It provides assurance of actions being undertaken to deliver objectives and that progress is regularly monitored. The work progressing on the performance framework will strengthen the links to the Annual Performance Report, where the impacts and outcomes for the people of Moray will be evidenced. Author of Report: Jeanette Netherwood, Corporate Programme Manager Background Papers: 20250327 HSCM Strategic Delivery Plan 2025-28 and Appendix 1 20250130 North East Route Map for Strategic Change Report and Appendix 20230928 Strategic Delivery Plan 2023-26 and Appendix 20230629 Strategic Transformation Plan Report 20221124 Strategic Plan 2022-2032 Report and Appendix Page 303
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APPENDIX 1 1 Health and Social Care Moray Strategic Delivery Plan 2025-28 Report Type: Actions Report Generated on: 17 October 2025 Action Status Cancelled Overdue; Neglected Unassigned; Check Progress Not Started; In Progress; Assigned Completed Strategic Delivery Plan 2025-2028 1. Building Resilience 1. We focus on prevention and tackling inequality; 1.1 Early Intervention and Prevention Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat1.1.1 LD Health Checks - Annual Health Checks for people 16+ with a Learning Disability. LD Service Manager All people aged 16+ with a learning disability receive an annual health check. 30-Apr-2026 Since the launch of the health check rollout in Moray, including the initial pilot phase, a total of 220 health checks have been offered, with 157 completed to date. Home visits have been provided for individuals unable to attend GP surgeries, ensuring equitable access to the service. Referrals generated through these health checks have supported timely access to appropriate services, contributing to improved health outcomes. Ongoing monitoring of outcomes and individual feedback continues to inform and shape future development. 50% Page 304
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APPENDIX 1 2 STRADPLAN 25-28 Cat1.1.2 Social Prescribing - Deliver the Social Prescribing model to all Moray localities by March 2026. Health Improveme nt (HI) Team Leader Reduction in targeted service waiting lists by delivering the Social Prescribing model to all Moray localities by March 2026. 30-Apr-2026 SP model ongoing in Forres and Lossiemouth, which is currently under review including patient feedback, an aspect previously missing from evaluation. Maryhill Practice are interested in implementing a SP model and the team have presented further information to the staff. Aim to deliver a pilot at Maryhill with current resource and the learning taken from this will inform upscale of SP across Moray. 15% Strategic Delivery Plan 2025-2028 1. Building Resilience 1. We focus on prevention and tackling inequality; 1.2 Poverty Strategy Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat1.2.1 Contribute to development of Moray wide poverty Strategy and Action Plan Locality Manager (West) By working with partners, we will raise awareness and work to reduce the impact of poverty on people's health and wellbeing in Moray. 30-Sep-2025 Initial milestone completed with input to the action plan from a Health and Social Care perspective. Further milestones to be defined for monitoring. 100% STRADPLAN 25-28 Cat1.2.2 Raising awareness of the Impact of Poverty on health HI Team Leader We will increase the number of frontline staff trained and confident in speaking about poverty and referring on for appropriate support. 30-Sep-2026 Making every Opportunity Count (MeOC) Target is 2 awareness sessions delivered per quarter. Awareness sessions refreshed and updated to include Realistic Medicine principles which offer practical approaches to enable staff to have conversations. Q1 – 3 sessions, 24 attended Qualitative data is collected to evaluate frontline staff confidence. Relaunch of the Fairer Moray Forum planned for Nov 25 25% Page 305
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APPENDIX 1 3 Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.1 Supporting Unpaid Carers Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat2.1.1 Implement actions outlined in the Unpaid Carers delivery plan Unpaid Carers Strategy Group By Implementing the actions outlined in the Unpaid Carers delivery plan we achieve increased awareness of unpaid carers with professionals across health and social care and within the community. 31-Mar-2026 This work is planned, sessions taking place in Q3 25/26 with Social Work staff in C&F to discuss young carers, where to signpost and to raise awareness of the unpaid carer training on TURAS for staff to access. The project with Elgin Health Centre commenced with evaluation and learning from that will influence how we role this out to wider GP practices expected during Q3 25/26. 20% HSCM STRADPLAN Cat2.1.2 Produce and plan implementation of the Unpaid Carers Strategy for 2027-2030 Unpaid Carers Strategy Group By Implementing the actions outlined in the Unpaid Carers Strategy we will achieve increased number of unpaid carers feel supported in their caring role. 31-Mar-2027 Following the extension of the Carers Strategy as approved at MIJB taking it to March 2028, a revised implementation plan is being developed and will be taken to the Carers Strategy Oversight Group in September 2025 for approval. 5% Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.2 Primary Care Sustainability Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat2.2.1 Provide support and guidance to PCIP works-streams and GP practices through transformation and delivery of the key theme changes Primary Care Development Manager GP Clinical Lead Deliver on the 2018 contract memorandum of understanding within allocated budget 31-Jul-2025 At month 3 of financial year 25/26 we are within budget. We continue to monitor Moray PCIP via our financial plan. We will be undertaking an in-depth review at month 6 and this will ascertain the anticipated year-end and will be the decider for any risks/mitigation that we need to undertake for the remainder of the financial year. Moray PCIP Board meets monthly with PCIP work stream to discuss performance, spend, risk & mitigation, key actions required, and any escalations required. 100% Page 306
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APPENDIX 1 4 Moray PCIP Board provides guidance on an as and when required basis to all work stream leads and to GP Practices for all work streams. Moray PCIP Board provides the GP Practices with a quarterly newsletter providing updates on PCIP progress. NHSG Project provide updates on GP Vision progress. STRADPLAN 25-28 Cat2.2.2 Provide support and guidance to GP practice to safeguard sustainability Primary Care Development Manager GP Clinical Lead Increased access to support for GP Practices if they encounter any sustainability concerns 30-Sep-2025 Moray provides support and guidance to GP Practices on an as and a when required basis. In the last quarter in depth support and guidance was provided to two Moray GP Practices and this support continues. 100% STRADPLAN 25-28 Cat2.2.3 Support the delivery of the 2018 GMS contract and Memorandum of Understanding (MOU) for PCIP Primary Care Development Manager GP Clinical Lead Moray PCIP Plan for 2025-26 is delivered successfully 31-Mar-2026 Vision Programme progressing towards aims and objectives of 2018 contract and MoU and implementation of the improvement plan. Moray PCIP plan for 2025-26 incorporates all work- stream service plans as well as financial plan – this has been completed for 2025/26 50% STRADPLAN 25-28 Cat2.2.4 Develop and support opportunities for flexibility in the contract Primary Care Development Manager GP Clinical Lead Consideration of local flexibilities and included within the GP vision programme 31-Mar-2026 Moray PCIP plan for 2025- 26 incorporates all work- stream service plans as well as financial plan – this has been completed for 2025/26 Moray PCIP Board meets monthly with PCIP work stream to discuss and develop and support opportunities Continue to explore opportunities and flexibilities in line with the work being progressed with the GP Vision Program 50% Page 307
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APPENDIX 1 5 Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.3 Mental Health Services Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat2.3.1 Mental Health - Early intervention, prevention, and self-management Mental Health (MH) Services Manager / HI Team Leaders / MH Strategic Lead We aim to move towards a preventative, population health model which promotes and sustains good mental health and wellbeing. The community feels they have social connections, stronger resilience, worthwhile community assets and do not feel isolated. People on distress feel happier with the responses they have received - both from services and the wider community. 31-Mar-2026 New SAMH Commissioned Services are now operational and fully staffed. The Distress Brief Intervention Service have provided support for 108 individuals, and the Intensive Recovery and Community Support Service have provided support for 85 individuals in the 1st Quarter 2025. Social Prescribing, Realistic Medicine, and Community Appointment days are being developed/scaled up across Moray on a Locality basis facilitated by the Health Improvement Team. The principles of Getting it Right for Everyone (GIRFE) are being embedded in this work. Mental health and wellbeing practitioners are embedded in GP practices across Moray to offer support and signposting. In the previous financial year 2,726 appointments were offered with approximately 90% being from GP Practices. The Moray Wellbeing Hub work with Moray residents to ensure the voice of those with lived experience is collected, listened to, and fed back through governance structures to inform service delivery. This information feedback into the Mental Health Strategic Group. Digital Health and Care innovation Centre Living Lab 5 – mental wellbeing - is developing and testing innovative solutions to tackle poor mental health and low wellbeing. The aim is to enhance access to essential service, promote wellbeing and reduce loneliness. The main piece of work to date has been the incorporation of a mental health and wellbeing portal on the Moray Community Connections site which will enable the public and staff to access information of local and national support services. Staff in core mental health services have received trauma informed training. 65% Page 308
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APPENDIX 1 6 HSCM STRADPLAN Cat2.3.2 Mental Health Quality Standard 1: Access Mental Health (MH) Services Manager / HI Team Leaders / MH Strategic Lead People in Moray have equitable and non- discriminatory access to effective and relevant support for their mental health, within appropriate timescales. Increased number of people able to access the person- centred support they require within a reasonable timescale. 31-Mar-2026 Work has been undertaken to improve pathways for access to psychological therapies in primary and secondary care services. The inclusion of primary care psychological therapies team lead at the secondary care psychological therapies referral meetings has ensured that people are picked up for assessment and treatment by the most appropriate team via a step up/step down pathway without the need for them to go back through their GP. Secondary care mental health services are meeting the 18-week referral to treatment target for psychological therapies with 100% of people referred starting treatment in September 2025. This is due to a variety of factors but the establishment of groups within the service has played a significant part in this. Primary care psychological therapies are struggling to meet the demand with only 15% of people starting treatment in September 2025. Referrals are being screened to ensure they meet the criteria for the service, but further work is needed to address the lengthy waiting lists. 60% Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.4 Promoting third sector and community services to enable people to manage their own physical, social, and mental well-being Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat2.4.1 Build the infrastructure and capacity in the community to support people to self-manage. All Service managers / Commissioni ng Team Increased third sector representation in all appropriate service redesign or contract reviews. 31-Mar-2026 Commissioning activity involves third sector and lived experience representatives via PINs, service reviews, monitoring, contract meetings, strategy groups, and forums. The Commissioning Team’s work is underpinned by engagement and collaboration with third sector providers. This is all embedded in the Commissioning Procedure. 30% Page 309
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APPENDIX 1 7 HSCM STRADPLAN Cat2.4.2 Increase resilience, sustainability, and growth of our own groups and third and community led groups across Moray Community Wellbeing Developmen t Team Increased number of resilient community led groups and partnerships supporting mental and physical wellbeing, prevention, and enablement in Moray. 30-Jun-2026 • All current 18 Be Active Life Long (BALL) groups continue to be supported to be self-managed and resilient. Continue to work with the BALL forum, which is still in its infancy with the aim of eventually being an umbrella support for BALL Committee members. • 4 Seated Exercise and Tea (SET) groups continue to be supported, with 3 now fully established and 1 new group developed on track to become sustainable. • 10 local community groups continue to receive light touch support when needed. • 5 sessions run in partnership with Wild things with over 50 participants. • Continue to work in collaboration with Dance North – have delivered 2 open exercise sessions for the wider community reach in the last quarter. • Working in collaboration with the Health Improvement Team- to deliver MEOC workshops to each of our 18 BALL group members, with 3 delivered in the last quarter. • Processed and triaged c.500 enquiries from across HSCM services and the wider community for information, signposting, and places on our existing groups. 75% Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.5 Children Service plan 2023-2026 Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat2.5.1 Delivery of the 6 improvement priorities - 1 Head of Service / Chief Social Work Officer (CWSO) Improved outcomes for looked after and care experienced young people 31-Mar-2026 Corporate Parent self-evaluation toolkit to quality assure information system has been introduced in Secondary Schools. Health assessments of looked after children coming into care have 81% completion within four, weeks against a target of 100% Recruitment campaigns for Foster Carers have been stepped up. Currently 36 fostering households with 18 40% Page 310
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APPENDIX 1 8 enquiries leading to 5 progressing to assessment in Qtr 1 & 2 New framework and support guidance around maintaining relationships of care experienced children and young people has been completed with launch date October 2025 HSCM STRADPLAN Cat2.5.2 Delivery of the 6 improvement priorities - 2 Head of Service / Chief Social Work Officer (CWSO) Tackling child poverty 31-Mar-2026 Cost of school day guidance was issued to all schools in June 2025 and is available on Moray Council website. Housing initiatives to avoid homelessness have successfully prevented 3 families with disabilities being made homeless. 57 Parental Employability referrals received to September – an increase of 50% in referral rate compared to previous year. 118 new referrals for young people (16+) with 98 positive outcomes. Additional funding of £54k secured to provide breakfast clubs for children. 30% HSCM STRADPLAN Cat2.5.3 Delivery of the 6 improvement priorities - 3 Head of Service / Chief Social Work Officer (CWSO) Supporting children and families who experience challenges due to disability/neurodiversity 31-Mar-2026 Significant engagement with parents and carers through a survey received 781 responses. 10 themes were identified and considered by Education, Children’s, and Leisure Committee of Moray Council in September 2025. Regular meetings are being established with parent support group to take improvement proposals forward. 50% HSCM STRADPLAN Cat2.5.4 Delivery of the 6 improvement priorities - 4 Head of Service / Chief Social Work Officer (CWSO) Keeping children safe 31-Mar-2026 Learning reviewer training completed and individual reviews underway, outcomes of which will underpin the learning culture. Advocacy report services in place and actively supporting children experiencing child protection process ensuring the child’s voice is heard. Online safety programme delivered in Schools and with parents and professionals covering consent, gender equality, and health relationships aiming to raise awareness and keep children and young people safe when online. 80% HSCM STRADPLAN Cat2.5.5 Delivery of the 6 improvement priorities - 5 Head of Service / Chief Social Work Officer (CWSO) Improving emotional and mental wellbeing 31-Mar-2026 Moray wide parent focused support service has been established to support parents/carers to understand and support their children’s mental health and wellbeing needs. Of parents accessing the service 87% have reported an increase in their confidence and skills to support their children’s mental health. 60% Page 311
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APPENDIX 1 9 Procurement completed for a new community mental health service for children from 5 years upward, with SAMH the successful provider. HSCM STRADPLAN Cat2.5.6 Delivery of the 6 improvement priorities - 6 Head of Service / Chief Social Work Officer (CWSO) Strengthening family support 31-Mar-2026 Family support ranging from prevention to intensive family support has increased, with 22 groups running every week (compared to 10 groups last year). In last two quarters 13 new volunteers have been trained to support delivery. Commissioned services have been embedded to support families with intensive support requirements – currently supporting 53 families. Evaluation of the outcomes of this work will be undertaken as part of the wider family support offer. At this stage it is felt that more capacity is required to deliver a whole system change and family support centre and spoke model. 25% Strategic Delivery Plan 2025-2028 1. Building Resilience 2. We nurture and are part of communities that care for each other; 2.6 Provision of a Sustainable Locality Model Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat2.6.1 Establish Locality plans for all areas Locality Managers Locality plans will be refreshed and have action plans that capture the work being undertaken and planned across HSCM specific to the Locality, alongside any other specific work being undertaken in that Locality. 30-Sep-2025 Locality Plans in process of being refreshed. Action plans being developed for the next 3 years in line with and pulling from the HSCM Strategy and Strategic Delivery Plan once completed. Specifics to each locality not covered in the Strategic Delivery Plan, but in line with our strategic direction, will be added to the Action Plan 25% HSCM STRADPLAN Cat2.6.2 Communities involved in monitoring effectiveness of local service delivery Locality Managers HSCM Teams working across Moray will ensure that the people using our services, their families and unpaid carers are central to services and involved in line with 30-Sep-2026 GIRFE being rolled out to teams (See GIRFE Section) Home First is being progressed and encompasses a lot of the work being done across and impacting on localities. 20% Page 312
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APPENDIX 1 10 GIRFE Principles and that there is consultation and involvement opportunities for the wider community around new, changing or evolving services and opportunities. PCIP work feeding into Localities via GP Practice Community Conversations and information days being planned with first one being run in Burghead 30th Oct 2025. HSCM STRADPLAN Cat2.6.3 Multi-Disciplinary Teams will be embedded in all localities Locality Managers To develop a comprehensive framework for mapping, aligning and optimising MDTs across Moray with a focus on community teams. This work will support HSCM principles and priorities and align with key strategic drivers: Home First Improvement Programme, the HSCM Strategic Plan ‘Partners in Care’ and the GIRFE approach. 30-Jun-2026 MDT Mapping has begun, and data is being collated. A variety of MDT meetings are being attended and key members consulted with. (Also monitoring MDT work currently being done in DGH/Community Hospitals to align). 10% Strategic Delivery Plan 2025-2028 2. Home First 3. We work together to give you the right care in the right place at the right time; 3.1 Discharge without Delay (DwD) Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat3.1.1 Discharge to Assess (D2A)/HomeFirst NHS OT Lead Avoidance of unnecessary admissions: - Reduction in unnecessary admissions from Emergency Department, AMAU and CDU Increase number (and percentage) of people re- abled through D2A/START process within 12-week target 31-Dec-2025 D2A team and START will be working collaboratively under the enhanced D2A (home assessment) pathway which will be in place October 2025. This is one of the 4 DWD work streams which have national and local meetings that we are participating in. Phase one of DWD is complete. 10% HSCM STRADPLAN Cat3.1.2 Community Hospital and Step Down Rehabilitation Units Professional lead OT / Team Manager To be” status designed, and action plan developed and approved 31-Dec-2026 Locally, this project will commence under home assessment pathway October 2025. This is part of the national DWD work stream. National and local meetings are ongoing. 10% Page 313
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APPENDIX 1 11 (Independe nt Living) Changes identified in plan are implemented Avoidance of unnecessary admissions: - Reduction in unnecessary admissions from Emergency Department, AMAU and CDU The average Community hospital stays in Q1 was 81 days. Days spent in hospital is closely monitored as part of the delayed discharge focus and this average should reduce. Occupancy for quarter one remained at 99.8% HSCM STRADPLAN Cat3.1.3 Frailty at Front Door Claire Power (DGH) Increased number of pathways completed and communicated Increased number of assessments for support (inc care) undertaken in the home 31-Mar-2026 Redesign at the front door of Dr Grays is ongoing with the successful bid that will see enhanced pathways to create a discharge lounge and AHP in the emergency department. First review expected December 2025. DGH lead on this DWD work stream. Presently 23% of our delays are in acute. 8/35. This changes frequently. 10% HSCM STRADPLAN Cat3.1.4 Planned Date of Discharge (PDD) process and Integrated Discharge Teams Lead Nurse Increase in % (and number) of compliant PDD (target to be defined) 31-Dec-2026 Phase two of Discharge without Delay has commenced. Compliance at present is DGH 77%, Seafield 41%, Stephen 100% and Turner 93%. Dr Gray’s has successfully bid for additional staffing for the discharge pathway. Home assessment pathway will influence Moray’s outcomes, bearing in mind DWD is a national programme. 10% Strategic Delivery Plan 2025-2028 2. Home First 3. We work together to give you the right care in the right place at the right time; 3.2 Promotion of Self Directed Support (SDS) Options Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat3.2.1 Develop SDS Framework for options 1, 2 & 3 providers SDS Officer / Procuremen t Officer MC, Provider Services Manager Increased choice and control for individuals through SDS Options, driven by individual preference opposed to market availability. Social work processes and assessment align with the principles of SDS 31-Dec-2025 The specification for the framework has been developed, and a PIN was published on PCS. Meetings were held with interested providers week 23/06/2025 with representatives of HSCM. Commissioning lead is now consulting with procurement and SXL to establish the most efficient way to publish the framework to ensure it remains a live advert enabling new providers to be onboarded timeously. Progress is delayed whilst assessment undertaken to ascertain the most appropriate route for this. 20% Page 314
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APPENDIX 1 12 HSCM STRADPLAN Cat3.2.2 Self-evaluation against national SDS framework of standards to inform future requirements to improve performance and delivery SDS Steering Group Conduct self-evaluation Identify areas of improvement Develop robust implementation plan to improve practise and peoples lived experience of accessing SDS. Internal process will align with the national vision for SDS. Social work process and assessment and commissioning activity will align with the principles of SDS. 31-Aug-2025 Work on this has been delayed due to the need to establish the lead person to take this forward. The SDS Standards Steering Group has agreed that it would be beneficial for this to be led by our internal audit team. It has been confirmed 01/10/25 that funding has been agreed to support internal audit and conversation will take place in due course to move this piece of work forward. 20% HSCM STRADPLAN Cat3.2.3 Continue promotion of independent support and advise for SDS options SDS Steering Group Individuals will have access to independent support and advice enabling them to make informed decisions around the four options of SDS. Individuals will have access to independent SDS Advocacy to support with accessing SDS. 31-Mar-2028 The work to promote the use of the Support in the Right Direction (SiRD) projects in Moray continues. The SDS team, in support of the SiRD project with Cornerstone are starting to host monthly drop-in sessions through a mixture of online and in person sessions to support those in receipt of an SDS Option 1 (DP), to discuss the mechanics of those interested in utilising an option 1. The independent support advisor from the SIRD project will also be in attendance to discuss all SS Options available, and sessions could be developed for those moving forward following evaluation of the session to be held on 6th November 2025. 10% Strategic Delivery Plan 2025-2028 2. Home First 4. We help build communities where people are safe; 4.1 Managing frailty in the community Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat4.1.1 Identification and assessment of frailty within primary care over 65s GP Strategic Lead / Increased opportunities for collaborative working between general practice and 30-Jun-2027 Collaborative work progressing with Dr Gray’s. Home assessment pathway virtual wards will assist identification of our most vulnerable cohort. 5% Page 315
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APPENDIX 1 13 Moray Frailty Lead secondary care teams, proactively managing frailty in the community. Strategic Delivery Plan 2025-2028 2. Home First 4. We help build communities where people are safe; 4.2 Public Protection Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat4.2.1 Preventing Suicide and Self Harm Deliver the Moray Suicide Prevention Action Plan 2025-28 Working in partnership so that People: - in distress experience timely, compassionate and trauma informed responses. - who have self-harmed receive effective treatment and aftercare - are prevented from future suicide attempts and/or self-harm HSCM Mental Health Strategic Group Moray Suicide Prevention Group (SP1) More people in our communities have a clear understanding of suicide, risk factors, and its prevention (SP2) People experiencing suicidal crisis are kept safe and their situations do not further escalate (SP3) More people are supported through Distress Brief Interventions 31-Mar-2028 SP1 - There has been a wide range of information/capacity building events for young people, community groups, and staff groups. Of note are events in two Moray secondary schools, armed forces bases, larger local employers, and highland games events. SP2 - Additional Moray staff have been trained to deliver ASIST (Applied Suicide Intervention Skills Training) courses. One course has been delivered with two more courses to follow within the current financial year. The Moray Suicide Prevention Group is currently establishing a local multiagency review model for suicide deaths, drawing from the existing approach by the Moray ADP Drug Related Death and Learning process. Suicide death reviews are currently completed on a Grampian basis by SAMH and Police. A learning report prepared by the Grampian Suicide Prevention Group provides a snapshot of 38 deaths by suicide in the North East between Jun-Dec 2024. Cases were reviewed to determine what contact had taken place with support services prior to death. The learning from this has been fed back into discussions within the Moray Suicide Prevention Group. Following the information sessions arranged by Public Health Scotland, Moray has agreed to implement the QES system for recording suicides. This will allow the capture and analysis of data from multiple agency 60% Page 316
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APPENDIX 1 14 sources, contributing towards the development of a multiagency suicide review model. The Moray Suicide Prevention group are currently finalising a suicide cluster response protocol for Moray. This will identify the development of any trends and prompt a proactive prevention response SP3 - The recently commissioned SAMH Services are now operational and fully staffed. The Distress Brief Intervention Service have provided support for 108 individuals, and the Intensive Recovery and Community Support Service have provided support for 85 individuals in the 1st Quarter 2025. HSCM STRADPLAN Cat4.2.2 Reducing drug and alcohol related harm Deliver the Moray Alcohol & Drug Partnership Strategic Delivery Plan 2025-28 Working in partnership so that People: - who take harmful drugs are offered evidence-based harm reduction and advice - can access the services they need to support their recovery. - remain in treatment for as long as they need to. Moray Integrated Drug and Alcohol Service (MIDAS) Moray Alcohol & Drug Partnership (ADP1) More people receive overdose awareness advice and provision of take-home naloxone (ADP2) People wait no more than three weeks for specialist drug and alcohol treatment (ADP3) More people have access to Residential Rehabilitation placements (ADP4) Fewer people disengage from specialist drug and alcohol treatment 31-Mar-2028 ADP1 -Harm reduction outreach has remained consistent, with daily huddles, assertive follow-up to non-fatal overdoses, and third sector involvement ensuring supplies, training and advice remain accessible. • In Q1 2025/26, 45 naloxone supplies were recorded. This is higher than the low figure of 5 supplies distributed in Q4 2024/25 but remains lower than past averages. (Data for Q2 2024/26 is not yet available). • A review of the dip in supplies distributed in Q4 2024/25 has been completed, with the Arrows service building move identified as a temporary contributing factor. Moray’s second recovery community engagement event took place in Lossiemouth on 30 Aug to incorporate national overdose awareness day and included a recovery walk in memory of people who have lost their lives to substance use. ADP2 -Moray’s integrated pathway, with single-point access, same-day prescribing where appropriate, and improved service co-location, continues to ensure accessible and timely support. • In Q1 2025/26, 97.4% of people started treatment within three weeks of referral. • In Q2 2025/26, this remained high at 96.8%. 15% Page 317
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APPENDIX 1 15 • Both figures are above the national target of 90%. ADP3 -- The ADP actively attends and participates in national networks and thematic groups on residential rehabilitation, ensuring local practice aligns with national priorities and learning. These actions are strengthening consistency of referral processes, provider engagement, and aftercare arrangements. • A clear local residential rehabilitation pathway is now fully established. The pathway has been co- produced with people with lived and living experience and promoted widely across Moray. • A Residential Rehabilitation Link Worker has now been onboarded by our third sector provider service (Arrows) to provide tailored support before, during, and after placements. • Good working relationships with rehab providers have been maintained, and Moray continues to use the new Scotland Excel framework to support placement access. • Local area allocation of residential rehab funding is fully used with further placements secured through the Scottish Government’s additional placement fund. • In Q1 and Q2 2025/26, 9 people completed residential rehabilitation. This is an increase on annual total of 8 for 2024/25 ADP4 - Unplanned discharges continue to highlight the challenges for services to sustain engagement. Real- time monitoring systems remain in place, with assertive follow-up, welfare checks, and lived/living experience outreach supporting people to re-engage after leaving treatment. Multi-agency partners continue to review discharge trends, and escalation processes have been agreed to ensure risks are identified and addressed promptly. • In Q1 2025/26, 120 unplanned discharges were recorded, a small reduction from 126 in Q4 2024/25. • Data for Q2 2025/26 is not yet available. • A joint review recently conducted by MIDAS and Arrows identified system challenges for discharge recording, where the discharge data currently Page 318
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APPENDIX 1 16 includes examples of service re-allocation within our integrated system. Training on the Drug and Alcohol Information System (DAISy) has now been implemented for teams to enable more consistent and accurate recording. It is anticipated that this will result in more accurate discharge data to monitor going forward. HSCM STRADPLAN Cat4.2.3 Protecting Children and Young People Deliver the Moray Children’s Services Plan 2023-26 Priority - Keeping Children & Young People Safe Working in partnership so that children and young people: - are safer because risks have been identified early and responded to effectively. - lives improve with high quality planning and support - experience sustained loving and nurturing relationships to keep them safe from further harm. Moray Children & Families Social Work and Community Child Health Services Moray Child Protection Committee (CPC1) More children and young people are supported to develop healthy relationships with peers, online and in the community (CPC2) More children and young people are protected from harm because of improved home circumstances (CPC3) Children who have experienced or witnessed abuse are supported through recovery and do not experience further trauma. 31-Mar-2026 CPC1 - More children and young people are supported to develop healthy relationships with peers, online and in the community Advice, information, and training is provided across a range of professional, community and school engagement events covering online safety, sexual extortion and sharing nude images as part of the CPCs online safety campaign. •Staff across the partnership have received ‘manosphere’ training from Moray CPC and Moray’s VAWG partnership on influences of harmful misogynistic content online •Parent/carer workshops continue to be offered on various online safety topics. A new session on the manosphere has been developed for parents with the first workshop delivered during the school summer holidays. All secondary schools in Moray have signed up to the Equally Safe at School programme. This intervention works with the whole school community to address gender-based violence, which includes staff training, policy development, and student-led action groups. •Moray Rape Crisis continue to deliver the Sexual Violence Prevention programme across schools and youth settings, for young people aged 11 to 25 in Moray. •The Mentors in Violence Prevention programme is also being implemented in all secondary schools. CPC2 - More children and young people are protected from harm because of improved home circumstances Baseline measurements are in the process of being established to understand the vulnerability factors recorded when children’s names are placed on the child protection register, and the definition for improved 60% Page 319
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APPENDIX 1 17 circumstances that are recorded when children’s names are removed. There is potential that this learning will inform joint development activity with adult mental health and substance use services, based on the prevalence of child protection activity with parent/carer mental health and substance use recorded as a factor. Work to embed the Graded Care Profile 2, a strengths- based assessment of care, continues with training delivery for the children’s services workforce. Evaluation of the tool’s uptake and application in practice is in the early stages. A review of local multiagency training on understanding neglect is also underway, to align it with new national training materials on this subject. Activity to support wider practice improvement continues in line with national guidance with the following workstreams underway: •Development of an interagency assessment protocol to provide practitioners with a defined list of resources and the accompanying criteria for use • Introducing a Contextual Safeguarding approach for young people at risk of harm from outside the home/in the community. •Development of a toolkit to assist practitioners in gathering and understanding the voice of the child CPC3 -Children who have experienced or witnessed abuse are supported through recovery and do not experience further trauma. The Scottish Child Interview Model, a new trauma informed approach for joint investigative interviews, is fully embedded in Moray with most interviews now conducted by the SCIM team. 2025/26 Bairns’ Hoose Development Funding has been awarded to Moray to establish a local Bairns’ Hoose Partnership and conduct a self-evaluation against the national Bairns’ Hoose Standards. Through process mapping and engagement activities with children, families and practitioners, the evaluation will inform long term plans to develop a joined up holistic model of therapeutic recovery support for children in Moray who Page 320
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APPENDIX 1 18 have experienced or witnessed abuse. The funding includes additional resource for key services including 1.5FTE Quarriers Children’s Rights Workers (now in post) and 1FTE Senior Social Worker (recruitment underway). Additional staff resource has also been secured through test of change funding to align with Grampian wide Bairns’ Hoose activity to develop co- ordinated healthcare support and enhance specialist speech and language provision. The development of a Journey Audit Tool has been completed and agreed by Moray Adult Protection Committee and HSCM SW Practice Governance Board. Audits are being undertaken by ASP lead officer with view to widen auditors to include multi-agency practitioners in future. HSCM STRADPLAN Cat4.2.4 Protecting Adults at risk of harm Deliver the Moray Adult Support and Protection Self Evaluation Improvement Action Plan 2024- 2026 Moray Adult Social Work Services Moray Adult Protection Committee (ASP1) More Adults are protected from harm due to a reduction of risk (ASP2) Adults at risk of harm report feeling safer because of their adult support and protection plan (ASP3) Adults at risk of harm experience improvement to their health, wellbeing and overall quality of life 31-Mar-2026 ASP1- Awareness raising and practice development activity continues across the partnership, aligned with Grampian Adult Support & Protection improvement activity. •A Grampian wide webinar took place in September supporting trauma informed approaches for adults who are ‘out of sight’ and hard to reach. •A multi-agency short life working group on self-neglect and hoarding has been established for Moray, to raise awareness of the subject area and to develop clear practitioner guidance, training, and practice tools. In partnership with the Care Inspectorate, Moray ASP have completed a self-evaluation exercise against Quality Indicator 5.7 from the Quality Improvement Framework: ‘’Effective support and early intervention for adults with escalating risks for whom a straightforward application of the three-point criteria is difficult to apply’’. •As part of this workstream the Partnership showcased Moray’s Interagency Vulnerable Adults process (MIVA). MIVA is a proactive and collaborative workstream where adults who are of concern in the community and are experiencing perceived escalating risks can be discussed within a multi-agency forum. •The evaluation identified several strengths in local systems and practice, highlighting the good work undertaken by the MIVA workstream. 60% Page 321
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APPENDIX 1 19 •Areas for improvement have also been highlighted; these actions will be incorporated into the existing ASP improvement plan for the partnership. •In addition to the Adult Protection Committee, the self- evaluation findings will be presented to Moray Public Protection Chief Officers Group, NHS Grampian Public Protection Committee and HSCM SW Practice Governance Board. ASP2- Improvement activity relating to Adult Support and Protection Planning continues across the partnership: •Grampian ASP Case Conference Standards have now been completed following consultation, and approval from Moray Adult Protection Committee. To support dissemination and embedding of the Standards an information/awareness session will take place within Forums across the Partnership. •A full review of Moray ASP Operational Guidance for local authority (lead agency) is underway, including consultation with front line practitioners •Work is underway with advocacy services to develop a “Statement of views” document to enhance participation in adult protection processes ASP3 -The development of a Journey Audit Tool has been completed and agreed by Moray Adult Protection Committee and HSCM SW Practice Governance Board. Audits are being undertaken by ASP lead officer with view to widen auditors to include multi-agency practitioners in future. HSCM STRADPLAN Cat4.2.5 Reduce reoffending Deliver the Moray Community Justice Outcome Improvement Plan 2024-27 Working in partnership so that: - People can access the services they need to support desistance - People have access to suitable support following release from a prison sentence Moray Justice Social Work Service Moray Community Justice Partnership (CJP1) More people successfully complete their community payback or drug testing and treatment orders (CJP2) More people are supported by throughcare services upon release from prison (CJP3) More people are referred onto support services by custody centres 31-Mar-2027 CJP1 More people successfully complete their community payback or drug testing and treatment orders The partnership is delivering a broad range of services and programmes to support desistance, address individual needs, and promote successful completion of community sentences. • Groupwork delivery for Moving Forward to Change (MF2C) programme has been introduced, using a 2:1 model where required. 25% Page 322
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APPENDIX 1 20 - People in police custody receive support to address their needs • Preparation activity for the Caledonian System included staff training, completion of strategic case profiling, and awareness raising with partners and community members. • Work is underway with the Learning Disabilities Social Work Team to understand and address the specific needs of individuals with learning disabilities within the justice cohort. A review of Unpaid Work has been completed, resulting in a new leaflet and improved guidance. Processes have been updated through an Operations Manual, staff training delivered, and monthly practice sessions established. Community inputs and stalls have taken place to raise awareness. Following initial evaluation, a pilot project between justice social work and Crossreach Counselling has been extended. With the aim of providing additional supports to enable adherence to Community Payback Orders (CPOs), priority is given to women and care- experienced young people supported by Justice Social Work. Evaluation of the project will also continue. CJP2- Feedback was received through HMP Inverness that joint in-reach visits from Arrows (alcohol and drug service), and MIDAS (Moray Integrated Drug and Alcohol Service) were desired, this is now in place. Moray has strengthened collaborative approaches to ensure continuity of health and social care for individuals released from custody. Activity has included participation in structures such as the HMP Inverness Liberation Planning meetings, Grampian Case Management Board, local prison liberation subgroups, and the Health & Prisons Group with HMP Highland, ensuring that health and social care needs, including mental health and guardianships, are considered in planning for the new establishment. A Moray services event was recently held in HMP Inverness, those with a Moray postcode were invited to learn about services who can support them on liberation. Moray Pathways provided a presentation on their employability work, including the Swap project. Page 323
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APPENDIX 1 21 NHS Grampian Health Improvement provided a presentation on their work and how to access via drop ins and the Health Point. They were joined following this by the NHS Grampian Oral Health team, DWP and Moray Wellbeing Hub in providing stalls in the afternoon. The Community Justice Partnership stall also collected on the day feedback from those who attended, which will be combined with feedback from stallholders to inform future in-reach activity and events An event for community members and partners was hosted to publicise the new Upside Voluntary Throughcare Service available for those leaving prison on a short-term sentence (4 years or less) without license conditions. This will sit alongside, and compliment, the Justice Services Voluntary Throughcare work. Press release - Moray welcomes national service to support people leaving prison - Moray Protects CJP3 - Moray does not currently have a local police custody project. Instead, we are monitoring and learning from the work being undertaken in Aberdeen City, alongside Aberdeenshire. This approach was agreed with Police Scotland colleagues, as all three areas share the Grampian policing area, allowing any successful initiatives to be implemented consistently across the region. • The partnership is collaborating with Police Scotland to explore the development of a Police Scotland local arrest referral offer. This work is at an early stage. • A collaborative approach and strong links with the custody nurses in Elgin Custody Suite has improved information-sharing and referral opportunities into wider support services, particularly around substance use and mental health. A key area of development within Youth Justice is to create a strategic approach for those under 18, with alignment to forthcoming changes under the Care and Justice Act. This work is supported through the creation of a weekly plan, which helps to provide consistency and structure in how young people’s needs are identified and addressed. Page 324
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APPENDIX 1 22 HSCM STRADPLAN Cat4.2.6 Eradicating Violence against Women & Girls (VAWG) Deliver the Moray Violence against Women and Girls Partnership Delivery Plan 2025-28 Working in partnership so that: - People in Moray are equally safe and respected - Survivors of VAWG have access to trauma-informed recovery, support, and justice. - Children affected by domestic abuse are supported to stay safe and remain in the care of their non-offending parent - Perpetrators are held to account and supported to change their behaviour Moray Children & Families and Justice Social Work Community Child Health Services Moray Violence against Women & Girls Partnership (VAWG 1) More people in our communities understand the causes and consequences of VAWG (VAWG 2) Women and children report feeling safer as a result of the specialist support they have received. (VAWG 3) Fewer children and young people are placed in care due to domestic abuse (VAWG 4) More people successfully complete specialist perpetrator interventions 31-Mar-2028 VAWG 1 -Through Delivering Equally Safe Funding, the Moray VAWG Partnership continues to deliver a wide range of awareness raising and workforce development activity. • In September, Moray hosted ‘Closing the Gap’ conference exploring the current legal, political, social & technological barriers to ending violence against women & girls. Over 100 attendees heard inputs from key speaker and survivors voice to better understand how the Scottish legal system could better support the survivors of VAWG, how gender equality is under attack worldwide, and how technology is reinvigorating misogyny • For this year’s 16 Days of Activism against Gender- Based Violence, Moray VAWG Partnership will host our second Reclaim the Night March on 25 Nov, and welcome Susie Heywood, public health specialist and suicide-prevention expert, on 28 Nov to talk about her work on challenging harmful gender stereotypes in the early-years. VAWG 2 - Moray faces significant gaps in Violence Against Women and Girls (VAWG) provision, most notably the absence of Independent Domestic Abuse Advocacy (IDAA) for victims at highest risk of harm. Partnership coordination is also under-resourced, and demand for specialist VAWG services continues to grow with waiting lists in operation. • At the request of Moray Chief Officers Group for Public Protection, Moray VAWG Partnership produced a Position Statement on Violence Against Women and Girls Funding, setting out the funding pressures facing local specialist services and providing national context for these challenges to inform future planning. • A coordinated partnership approach to strategic planning and commissioning will be essential to address chronic underfunding, strengthen local leadership, and ensure victims receive the support they need. A new Moray Multi-Agency Risk Assessment Conference (MARAC) steering group has been established, to review 10% Page 325
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APPENDIX 1 23 and improve the multiagency assessment and support for victims where high-risk Domestic Abuse is identified. • Two senior staff in social work are now trained to chair MARACs building local capacity and supporting the existing Police chair provision for the Northeast. • Seven places have been funded for partnership staff to complete MARAC rep training. • Delivery of wider workforce development is underway with new introductory sessions for frontline staff on the Domestic Abuse, Stalking and Honour Based Violence Risk Identification Checklist (DASH-RIC), Multi-Agency Risk Assessment Conference (MARAC), and Disclosure Scheme for Domestic Abuse Scotland (DSDAS). VAWG 3- Local implementation of the Safe & Together practice model is well underway in Moray, with a programme of accredited workforce training delivered across multiagency frontline practitioners and supervisors. Evaluation of impact, including file audit, is to be completed and will inform next steps. Baseline measurements are to be confirmed to understand the proportion of children placed on the child protection register due to concerns relating to domestic abuse, and those living in care both at home and away from home due to domestic abuse. The implementation of Safe & Together involves practice, system and culture change that may not be reflected in this data over a short term. VAWG 4 - The Justice Social Work Service are now able to offer the Caledonian System, an integrated approach to addressing domestic abuse in Scotland. This programme combines a court-ordered behaviour change initiative for men with support services for women and children. A new staff member has recently been appointed to the support work post which assists with women's work in the programme. Page 326
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APPENDIX 1 24 Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.1 Redesigning models of care Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat5.1.1 Community Hospital Redesign Head of Service Develop rehab and reablement capacity to improve flow through the system and maximise the services community hospitals provide. Minimise time people spend in hospital and do more reablement in people’s homes. 31-Dec-2027 After a temporary delay due to a change in personnel, the redesign discussions have commenced once more. An options appraisal is being completed, bearing in mind Discharge without Delay and home assessment programmes are underway. Once the Home assessment pathway is properly commenced by December 2025, the evaluation of the pathway success will shape the future model, in collaboration with Discharge Lounge and front door activity at Dr Gray’s 5% STRADPLAN 25-28 Cat5.1.2 GMED - redesign Service Manager - GMED Developing a sustainable workforce to provide a responsive service to the public to ensure people are seen by the right people at the right time in the right location. Delivery of high quality, person-centred sustainable urgent and unscheduled primary care services to the Grampian population by ensuring that the service has safe workforce levels 31-Dec-2026 The rollout of the engagement plan has been delayed due to limited operational capacity across the service during the spring and summer months, compounded by the complexity of the review process. As a result, the deadline for presenting the service model to the Integration Joint Boards (IJBs) will be rescheduled to early 2026. To support progress, additional capacity has now been identified within HSCM. 20% Page 327
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APPENDIX 1 25 Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.2 Strategic Review and redesign of care at home service. Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat5.2.1 Strategic Review and redesign of care at home service Service Manager - Provider Services Provide person centred outcomes-based care service with greater choice and control by September 2028. Strengthen the community and individual asset led approach to increase options for support and early intervention by September 2028. Creation of the ability to provide efficient, safe, and effective service. Provide a quality service across all providers that achieves a Care Inspectorate rating of 4 and above. 30-Nov-2025 Redesign culminated in report going to the IJB. Initial milestone - New Framework put in place using SXL for all Option 3 provision and Community Asset Framework can be used for Option 2 where required. This is action is progressing well with some new provider onboarding which enables better choice for people requiring services. There is some development work required to enable the appropriate sharing of information and data sharing protocols are being worked through at present. In addition, levels of unmet need for care is showing signs of reduction. The steering group will be defining further milestones for reporting progress and collation of evidence to support achievement of outcomes for people. 80% Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.3 Adults Day Services Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN Cat5.3.1 Review and Redesign of Adults Day Care services Service Manager - Provider Services A full redesign and modernisation of Adult day services where individuals are able to access sustainable day support, which is person centred and meets their 31-Mar-2026 This project has not progressed as intended, in part due to lack of project management. The project officer appointed retired in April and their replacement does not start until December 2025. Work has progressed in service on identification of needs and current provision, both internally provided 20% Page 328
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APPENDIX 1 26 agreed outcomes and aspiration. Where appropriate day service will be provided within their own local communities, and where this is not possible the review of the transportation policy will provide clarity of what support will be available. and externally provided. The establishment of an SDS framework under Scotland Excel and some initial block contracts for some providers is reducing our off contract spend and providing additional assurance that available places are being effectively used. Work on the review of transport policy has progressed and a draft produced but further work is required to establish the potential implications for people and for budgets for the options identified before a decision can be made. A decision on transport will impact on the day services costs so the two elements need to proceed alongside each other. The project timescale will need to extend to December 2026 to enable appropriate engagement with stakeholders. Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.4 Suitable Housing - Strategic Oversight of accommodation requirements Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat5.4.1 Learning Disability long term sustainable accommodation Service Manager - LD / Locality Manager Elgin Reduction in the out of area placements and associated costs Increase in the number of people with learning disabilities establishing tenancies 31-Mar-2026 Some individuals have recently returned from Out of Area placements. Due to significant delays in the progression of the Woodview 2 project, these individuals have transitioned into standalone tenancies, supported by outreach services provided through the Woodview team. While this transition has successfully reduced the total number of Out of Area placements, there has not yet been a corresponding reduction in costs. This is due to the standalone support packages currently in place being similar in cost to the original placements. However, it is anticipated that costs will decrease over time as the individuals settle into their new routines and associated challenging behaviours diminish. Phase 1 of the Western Village project has successfully enabled some adults with Learning Disabilities to secure supported tenancies. Phase 2 is progressing well and will provide supported tenancies for a further thirteen adults with Learning Disabilities. This includes some 40% Page 329
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APPENDIX 1 27 individuals currently placed out of area. The project has an expected completion date of April 2026. The Learning Disabilities Integrated Service Manager continues to maintain strong collaborative links with housing services to ensure the needs of adults with Learning Disabilities are fully considered in strategic planning. The Community Learning Disability Team continues to maintain an up-to-date register of anticipated accommodation needs. This includes young people transitioning into adult services who are projected to require care and accommodation. This supports effective planning and enables the strategic use of housing and care options that provide cost efficiencies and economies of scale. STRADPLAN 25-28 Cat5.4.2 Older People - provision of sustainable supported accommodation Local Housing Strategy Steering Group Requirement defined for incorporating into the Local Housing Strategy 31-Aug-2025 Older people requirements have been defined and incorporated in the Local Housing Strategy 100% STRADPLAN 25-28 Cat5.4.3 Mental health - provision of sustainable, appropriate supported accommodation Local Housing Strategy Steering Group Plan for provision of supported accommodation 30-Sep-2026 Commissioning are progressing a piece of work in relation to Mental Health needs analysis which will be presented to the next strategic mental health group on 5 November 10% Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.5 GIRFE Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-18 Cat5.5.1 Embed the GIRFE toolkit and principles into the planning and delivery of services. GIRFE Lead Officer GIRFE principles embedded in service delivery 31-Mar-2026 Presentation on the toolkit for operational management team completed and signposting to further information and supports. Training to wider teams ongoing. Social Prescribing, Realistic Medicine, and Community Appointment days are being developed/scaled up across Moray on a Locality basis facilitated by the Health Improvement Team. The principles of Getting it Right for Everyone (GIRFE) are being embedded in this work. 60% Page 330
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APPENDIX 1 28 Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.6 Support for long term conditions Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat5.6.1 Heart of Moray - Making it easier to improve our health and wellbeing. - Diabetes Lead Dietician Improvement in health of participants in the programme. Increased number of participants accessing the services 30-Sep-2026 DHI Lab 2 - Long-Term Conditions Co-Management (NHS) are focusing on those living with type 2 diabetes and high BMI. Heart of Moray launched in February 2025 in partnership with Moray Leisure as a supportive self-management programme focused on physical activity and healthy weight. It is open to those living with or at risk of one or more controlled long-term conditions and who require support to engage in physical activity. Data is being collated to assess the effectiveness of the initiative which will inform the next steps. 50% STRADPLAN 25-28 Cat5.6.2 Consolidation of palliative cancer services Chief Nurse Sustainable model of care in place Support available to those who need it. 31-Mar-2026 Details of existing provision being collated to provide evidence for potential options for the service model review. The new lead operational nurse will be taking this forward 10% STRADPLAN 25-28 Cat5.6.3 Establishment of a Moray Dementia Strategy and Moray Dementia Pathway in line with Grampian and National dementia delivery plans. Mental Health Services Manager Moray Dementia pathway in place. 31-Mar-2026 Engagement with this is being discussed at a Grampian level. There is a requirement to set up a Moray Group as a subgroup of the Grampian Dementia Strategy group. 10% STRADPLAN 25-28 Cat5.6.4 Embed promotion of technology enabled care (TEC) options within assessment process to increase use and impact of TEC, supporting self-management (i.e. to support management of longer-term conditions) Digital Lead Increase in use of TEC to support people to live independently. 31-Mar-2026 On target to complete transfer of Analogue to Digital community alarms by end of October. HSCM have been awarded Gold level One Digital Telecare Implementation Award from Digital Telecare for Scottish Local Government. The Smart Housing Smart Communities initiative is underway in Buckie, in partnership with Digital Health Institute and Archangel to evaluate AI-powered ambient monitoring and predictive care technologies to enhance telecare delivery. This project will inform the direction of TEC provision in Moray. 20% Page 331
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APPENDIX 1 29 Strategic Delivery Plan 2025-2028 3. Partners in Care 5. We are an ambitious and effective partnership; 5.7 Moray Growth Deal Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon STRADPLAN 25-28 Cat5.7.1 Partnership working to support the research and development initiatives led by DHI (Research and development of the 5 Living Lab research and design projects) DHI / Digital Health Lead Reduced dependency on HSCM Services through: * Increased access to community services * Development of a community occupational health pathway * Development of a Personal Data Store and the Community Connections Moray digital platform * Increased access to SMART housing and remote monitoring within the community 31-Mar-2026 All elements of the workstreams have progressed. Living Lab 1 - Supported Self-Management and Living Lab 2 - Long-Term Conditions Co-Management (NHS) are focusing on those living with type 2 diabetes and high BMI. Heart of Moray launched in February 2025 in partnership with Moray Leisure as a supportive self- management programme focused on physical activity and healthy weight. It is open to those living with or at risk of one or more controlled long-term conditions and who require support to engage in physical activity. Data is being collated to assess the effectiveness of the initiative which will inform the next steps. Living Lab 3 – Care in Place – development of the Personal Data store has progressed with a lot of background digital architecture and data sharing protocols being established. There is work underway being led by the Digital office and the work in Moray is being fed into this National project. Moray Community Connections is an online tool to assist people and those who support them the ability to find local services and supports available in the community, as well mechanisms for referrals to appropriate HSCM services, such as District Nurses and Occupational Therapy. A business case to ensure this tool remains updated and is sustainable is being prepared. Living Lab 4 – Smart Housing/Communities, the RCE team, in partnership with Health and Social Care Moray, is exploring innovative uses of digital systems, creating an opportunity to enhance safety and independence at home through smart technology. Updated in 18.4 Living Lab 5 - Mental Well-Being, is developing and testing innovative solutions to tackle poor mental health and low well-being. 80% Page 332
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APPENDIX 1 30 Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E1 Digital Health and Care Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE1.1 Develop Strategy for Technology Enabled Care - Implementation of the Analogue to Digital plan for community alarms Project Board A2D / DHI / Team manager (OT) First phase of transfer completed by December 2025 31-Dec-2025 Plan on target and due to complete before end of October 2025 which is the revised date for the switch over. 95% HSCM STRADPLAN CatE1.2 Develop Strategy for Technology Enabled Care - Developing and implementing a strategic approach and framework for TEC support, based on evidence, to provide sustainable options through collaboration with DHI Project Board A2D / DHI / Team manager (OT) Model of support is in place and shared widely 31-Mar-2026 Learning from the Rural Centre of Excellence (RCE) Digital health and care innovation and living lab 4 will inform the development of the strategic approach for Moray. A test of change is underway along with benchmarking with other partnerships to consider and evaluate options. On target to produce a strategic framework by end of March. 30% HSCM STRADPLAN CatE1.3 New Social Work and Social Care Information Management System Head of Service/ CSWO Implement a new system that will be the single source of truth about people receiving services, which is fit for future development and will underpin efficient and effective working. 31-Mar-2027 Evaluation of options and procurement process is progressing, and it is hoped a preferred supplier will be identified by the end of October. Both the Council and MIJB recognise the requirement for a new system and discussions regarding funding options are ongoing but will be resolved to enable a contract to be progressed. All potential suppliers have advised that implementation will be able to be completed by 31/3/27, if sufficiently skilled staff resource is identified for key roles. The project Board has recognised this and provided assurance that this project will be a key priority for HSCM. 15% HSCM STRADPLAN CatE1.4 Incorporating new technologies Digital Lead Increased capacity for other essential tasks through the implementation of artificial intelligence in various functions. 31-Dec-2026 Trials of “co-pilot” are underway with a view to identifying more efficient and effective ways of working to release capacity. One aspect is the ability to take notes and record actions from low level meetings which releases admin time. A programme of trials will be developed to take this forward so learning can be shared and decisions made regarding adoption across services. 10% Page 333
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APPENDIX 1 31 Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E2 Strategic Commissioning Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE2.1 In collaboration with stakeholders, develop a Strategic Commissioning Strategy and Market position statement that underpins the MIJB Strategic Plan SMT / Strategic Planning and Commissioni ng Group Strategic Framework and governance approved and implemented 31-Dec-2025 In progress. First milestone is establishment of governance framework. Proposed structure for governance oversight of SDP discussed at SMT and draft TOR and attendees being collated. Progress updated on SDP actions collated and being reported to Audit performance and risk committee in October 2025. Work on the commissioning strategy has commenced but timescale is into next year for completion. 75% Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E3 Communications Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE3.1 Develop and embed a strategy to inform and engage with all stakeholders and to include management of expectations Corporate Manager / SMT Communications Strategy approved and implemented. 30-Sep-2025 In development, but the report is not yet complete due to current workload pressures. Work is ongoing to ensure the document reflects statutory principles, including ‘Planning with People,’ and aligns with relevant HSCP communications and engagement guidance. Revised date for draft document completion is end of December 2025 30% Page 334
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APPENDIX 1 32 Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E4 Workforce Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE4.1 Ensuring we have a Workforce that is agile and motivated to meet the challenges presented and that is sustainable and safe with a focus on staff wellbeing. SMT Annual Report (via NHSG) Workforce plan implemented Improved retention rates Succession Planning embedded 31-Dec-2025 Annexe A for NHSG workforce annual plan was completed. The workforce plan is underway and will be completed by March 2026, but we needed to understand the KPMG priorities and had been waiting for SG response to annexe a which we now have. We will need to 'rightsize' the workforce - right person in the right post. Our delivery plan remains in place until it is superseded by the new workforce plan which will be accompanied by a delivery plan. 30% HSCM STRADPLAN CatE4.2 Our volunteers provide a vital and valuable contribution to the levels of support that can be provided to our communities. This is an area we need to grow in order to meet needs appropriately. SMT Increased number of people living well in their own homes. Reduction in those feeling socially isolated Increase in number of volunteers and volunteer roles to support work being done in clinical settings 31-Dec-2025 Social volunteers supporting 58 people in their own home. Volunteer responders supporting 36 people in the community. Waiting list for social volunteers and community responders is currently 94 and 88, respectively. 77 NHS volunteers providing around 500 hours per month. 10% Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E5 Infrastructure Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE5.1 Working with partners, review of occupancy and use of premises to seek opportunities for rationalisation or collaboration Moray Infrastructu re Group Accommodation assessed as suitable for service delivery 30-Apr-2027 Work on going daily/weekly/monthly discussions with partners 20% Page 335
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APPENDIX 1 33 with partners, to secure sustainable and efficient use of buildings and premises establish the Infrastructure plan for HSCM Moray. Development of opportunities is occurring via discussions with partners in particular to review/rationalise premises. This will continue to develop over the next 5-10years HSCM STRADPLAN CatE5.2 Establish the Infrastructure plan for HSCM Moray. Moray Infrastructu re Group Infrastructure plan developed and adopted 31-Dec-2027 First draft has been completed and being discussed at HSCM SMT in October 2025. 50% Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E6 Performance and Quality Assurance & Improvement Frameworks Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE6.1 Develop Performance framework to further support informed decision making Deputy Head of Service / Corporate Programme Manager Performance framework updated and implemented 31-Dec-2026 Draft performance framework completed and circulated for consultation. Revised local indicators to APR committee in October for consideration Working progressing on aligning indicators to the appropriate governance group and assigning to individuals as the source of truth. 30% HSCM STRADPLAN CatE6.2 Embed Quality Assurance Framework Deputy Head of Service / Corporate Programme Manager Quality Assurance Framework embedded 31-Dec-2026 The new Social Work Assessment audit process and tool have been developed and implemented in June. The finding of the first audit will be presented at Practice Governance meeting at the end of October. 20% Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E7 Governance Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE7.1 With partners develop good governance protocols based on up-to-date policies that support SMT Policy and protocol are updated and implemented 31-Mar-2026 Revised governance framework for SDP monitoring and development has been considered by SMT, and draft TOR are being compiled. 40% Page 336
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APPENDIX 1 34 delivery of efficient, effective, and quality services. Policy register has been reviewed by HofS and prioritised. Work is progressing on the transport policy review. HSCM STRADPLAN CatE7.2 Implementation of learning from audits and inspections SMT Positive inspection and audit reports received 31-Mar-2027 Mechanism for corporate monitoring of progress on delivery of learning and actions from audits and inspections has been implemented, and SMT will receive quarterly assurance updates to ensure actions are addressed in a timely manner and any delays are escalated. 10% Strategic Delivery Plan 2025-2028 4. Strategic Leadership, Planning and Performance E8 Finance Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN CatE8.1 Develop and monitor the Financial Recovery Plan that will enable the delivery of the Strategic Plan objectives whilst maintaining Financial Sustainability. Chief Finance Officer Budget savings plan approved and delivered Medium term financial plan approved by MIJB 31-Mar-2026 Budget Savings oversight group continues to monitor progress with savings projects and taking action, as necessary. Increased focus on grip and control monitoring is being implemented with SMT leading deep dives into budget alongside peer reviews. Sustainability and Transformation workshop to take place on 27 October to inform alignment of strategic and financial requirements for future years. MIJB development workshop scheduled for December. 40% Strategic Delivery Plan 2025-2028 5. Overall plan progress 2025-28 Action Code Action Title Lead Desired Outcome Due Date Latest Status Update Progress Status Icon HSCM STRADPLAN 25-28 HSCM Strategic Delivery Plan 2025-2028 SMT 31-Mar-2028 Health and Social Care Moray Strategic Delivery Plan 2025-2028 14% Page 337
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