Agenda reports pack
Argyll and Bute Council · 28 May 2025
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 28 May 2025 and its agenda
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21 May 2025 NOTICE OF MEETING A meeting of the ARGYLL AND BUTE HSCP INTEGRATION JOINT BOARD (IJB) will be held ON A HYBRID BASIS IN THE STUDIO THEATRE, CORRAN HALLS, OBAN AND BY MICROSOFT TEAMS on WEDNESDAY, 28 MAY 2025 at 1:00 PM, which you are requested to attend. BUSINESS 1. APOLOGIES FOR ABSENCE 2. DECLARATIONS OF INTEREST (IF ANY) 3. MINUTES (Pages 3 - 8) Argyll and Bute HSCP Integration Joint Board held on 26 March 2025 4. MINUTES OF COMMITTEES (a) Argyll and Bute HSCP Clinical and Care Governance Committee held on 1 May 2025 (Pages 9 - 12) (b) Special Argyll and Bute HSCP Finance and Policy Committee held on 19 May 2025 (Pages 13 - 16) 5. CHIEF OFFICER'S REPORT (Pages 17 - 26) Report by Chief Officer 6. FINANCE Reports by Head of Finance (a) Social Work / Social Care Financial Recovery (Pages 27 - 32) 7. Q4 WORKFORCE REPORT (2024/25) (Pages 33 - 56) Report by Deputy Director of People 8. ARGYLL AND BUTE HSCP EQUALITIES MAINSTREAMING PROGRESS REPORT 2021-2025 AND EQUALITIES OUTCOMES 2025-2029 (Pages 57 - 90) Report by Associate Director of Public Health 9. JOINT STRATEGIC PLAN 2022 - 2025 YEAR THREE PROGRESS REPORT (Pages 91 - 140) Report by Interim Head of Strategic Planning, Performance and Technology 10. DIRECTION LOG (Pages 141 - 142) Report by Interim Head of Strategic Planning, Performance and Technology Public Document Pack
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11. DATE OF NEXT MEETING Wednesday 17 September 2025 Argyll and Bute HSCP Integration Joint Board (IJB) Contact: Hazel MacInnes, Senior Committee Officer Tel:01546 604269
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MINUTES of MEETING of ARGYLL AND BUTE HSCP INTEGRATION JOINT BOARD (IJB) held ON A HYBRID BASIS IN THE COUNCIL CHAMBER, KILMORY, LOCHGILPHEAD AND BY MICROSOFT TEAMS on WEDNESDAY, 26 MARCH 2025 Present: Councillor Dougie McFadzean, Argyll and Bute Council (Chair) Councillor Kieron Green, Argyll and Bute Council Councillor Ross Moreland, Argyll and Bute Council Councillor Gary Mulvaney, Argyll and Bute Council Graham Bell, NHS Highland Non-Executive Board Member (Vice Chair) Emily Austin, NHS Highland Non-Executive Board Member Karen Leach, NHS Highland Non-Executive Board Member Janice Preston, NHS Highland Non-Executive Board Member Evan Beswick, Chief Officer, Argyll and Bute HSCP Fiona Broderick, Staffside Lead, Argyll and Bute HSCP (Health) Jan Chapple, on behalf of Linda Currie, Associate Director AHP, NHS Highland David Gibson, Chief Social Worker/Head of Children and Families and Justice, Argyll and Bute HSCP James Gow, Head of Finance, Argyll and Bute HSCP Rebecca Helliwell, Depute Medical Director, Argyll and Bute HSCP Elizabeth Higgins, Associate Nurse Director, NHS Highland Julie Hodges, Independent Sector Representative Kenny Mathieson, Public Representative Angus MacTaggart, GP Representative, Argyll and Bute HSCP Alison McGrory, Associate Director of Public Health, Argyll and Bute HSCP Kirstie Reid, Carers Representative, NHS Highland Takki Sulaiman, Chief Executive, Argyll and Bute Third Sector Interface Fiona Thomson, Lead Pharmacist, NHS Highland Tracey White, Carers Representative, NHS Highland Attending: Gareth Adkins, Director of People and Culture, NHS Highland Caroline Cherry, Head of Adult Services, Argyll and Bute HSCP Charlotte Craig, Interim Head of Strategic Planning, Performance and Technology, Argyll and Bute HSCP Nikki Gillespie, Interim Head of Service – Mental Health, Disability and Dementia Services, Argyll and Bute HSCP Douglas Hendry, IJB Standards Officer/Executive Director, Argyll and Bute Council Hazel MacInnes, Senior Committee Officer, Argyll and Bute Council Pippa Milne, Chief Executive, Argyll and Bute Council Prior to the commencement of Business, the Chair advised that this was Caroline Cherry’s last meeting of the Integration Joint Board as she would be leaving her role as Head of Adult Services on 1 June 2025. The Chair, on behalf of the Board, thanked Caroline for her hard work and support and wished her well for the future. Caroline thanked the Chair, the Board and all staff within the HSCP for their support during her time as Head of Adult Services. Page 3 Agenda Item 3
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1. APOLOGIES FOR ABSENCE Apologies for absence were received from Linda Currie and Duncan Scott. 2. DECLARATIONS OF INTEREST There were no declarations of interest intimated. 3. MINUTES The Minutes of the meeting of the Argyll and Bute Integration Joint Board held on 29 January 2025 were approved as a correct record. 4. MINUTES OF COMMITTEES (a) Argyll and Bute HSCP Clinical and Care Governance Committee held on 6 February 2025 The Minutes of the meeting of the Argyll and Bute HSCP Clinical and Care Governance Committee held on 6 February 2025 were noted. (b) Argyll and Bute HSCP Audit and Risk Committee held on 18 February 2025 The Minutes of the meeting of the Argyll and Bute HSCP Audit and Risk Committee held on 18 February 2025 were noted. (c) Argyll and Bute HSCP Finance and Policy Committee held on 25 February 2025 The Minutes of the meeting of the Argyll and Bute HSCP Finance and Policy Committee held on 25 February 2025 were noted. (d) Argyll and Bute HSCP Strategic Planning Group held on 13 March 2025 The Minutes of the meeting of the Argyll and Bute HSCP Strategic Planning Group held on 13 March 2025 were noted. (e) Argyll and Bute HSCP Finance and Policy Committee held on 18 March 2025 The Minutes of the meeting of the Argyll and Bute HSCP Finance and Policy Committee held on 18 March 2025 were noted. 5. CHIEF OFFICER'S REPORT The Board gave consideration to a report from the Chief Officer providing an update on activity across the Health and Social Care Partnership since the last report to the Board in January 2025. Decision The Integration Joint Board noted the report from the Chief Officer. (Reference: Report by Chief Officer dated 26 March 2025, submitted) Page 4
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6. TRANSITION OF THE CHAIR AND VICE CHAIR OF THE INTEGRATION JOINT BOARD The Board gave consideration to a report advising that the current Chair, Dougie McFadzean would complete his tenure on 31 March 2025 and the current Vice Chair and NHS Nominated Chair, Graham Bell would take up the office of Chair for the two year period from 1 April 2025 to 31 March 2027; with Council nominee Dougie McFadzean taking up the position of Vice Chair from 1 April 2025 to 31 March 2027. Decision The Integration Joint Board noted the transition to a new Chair and Vice Chair of the Integration Joint Board in accordance with the Integration Scheme and the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014. (Reference: Report by Interim Head of Strategic Planning, Performance and Technology dated 26 March 2025, submitted) 7. REVIEW OF THE INTEGRATION SCHEME 2025 The Board gave consideration to a report advising of the requirement to review the Health and Social Care Integration Scheme (the Scheme) and the proposed steps to achieve this. Decision The Integration Joint Board noted – 1. the requirement for a review of the current Integration Scheme to be carried out by 23rd March 2026; 2. the proposed steps in respect of carrying out the review, including the formation of a working group; and 3. that further updates in respect of the review would be prepared for future meetings of Argyll and Bute Council, IJB and NHS Highland Board. (Reference: Report by IJB Standards Officer dated 26 March 2025, submitted) 8. STANDARD REVIEW OF THE COMMITTEE TERMS OF REFERENCE The Board gave consideration to a report recommending changes to the Committee Terms of Reference by the Committees and Strategic Planning Group to ensure that they remained fit for purpose. Decision The Integration Joint Board approved the updated Committee Terms of Reference as recommended by the Committees and Strategic Planning Group. (Reference: Report by Interim Head of Strategic Planning, Performance and Technology dated 26 March 2025, submitted) Page 5
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9. FINANCE (a) Audited Annual Accounts 2023/24 & External Audit Report The Board gave consideration to a report presenting the Audited Annual Accounts, Audit Report and Letter of Representation which had been considered and endorsed by the Audit & Risk Committee at its meeting on 18 February 2025. Decision The Integration Joint Board – 1. noted that Mazars had completed their audit of the Annual Accounts and for 2023-24 and issued a draft unqualified Independent Auditor’s Report; 2. noted the Annual Audit Report prepared by Mazars and management responses to their recommendations; 3. noted that the IJB was reporting an underspend of £2.9m carried forward in general reserves; 4. approved the Letter of Representation and the Audited Accounts for signature and publication; and 5. noted that the accounts were prepared on a going concern basis. (Reference: Report by Head of Finance dated 26 March 2025, submitted) (b) Management Accounts - 11 Months to 28 February 2025 The Board gave consideration to a report providing a summary of the financial position of the Health and Social Care Partnership as at the end of month 11 and forecast to the year end. Decision The Integration Joint Board – 1. noted that the HSCP had overspent its budget by £2.2m; 2. noted an overspend of £2.3m was forecast; 3. noted Argyll & Bute Council had confirmed the HSCP could access £3.05m in pension saving resource they hold on behalf of the IJB; 4. noted reserves would be utilised to cover the remaining deficit and new projects funded from this source are on hold; and 5. noted savings of £5.1m had been delivered, 77% of target. (Reference: Report by Head of Finance dated 26 March 2025, submitted) Takki Sulaiman joined the meeting at this point. Page 6
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(c) Argyll and Bute HSCP Budget 2025/26 The Board gave consideration to a report which sought approval for the HSCP operational budget for 2025/26. Decision The Integration Joint Board – 1. noted the budget gap before savings and use of non-recurring resources was £12.8m; 2. approved the HSCP expenditure budget for 2025/26 totalling £398.1m incorporating a savings plan totalling £5.6m and allocation of £3m in non- recurring resourcing; 3. noted the HSCP continues to face severe financial challenge and further savings were required as part of a financial recovery plan; 4. noted the HSCP had not been able to identify 3% in NHS savings and therefore expects to be required to implement further savings or it would require additional resource from NHS Highland. The gap was £4.2m as an opening position; 5. noted the HSCP had worked with both partners throughout the development of the budget; and 6. requested the management team urgently develop plans to move the HSCP into a more sustainable operating model. (Reference: Report by Head of Finance dated 26 March 2025, submitted) 10. Q3 WORKFORCE REPORT 2024/25 The Board gave consideration to a report presenting the workforce data of the HSCP as at 31st December 2024 and providing the current demographic position, highlighting trends and advising of changes and progress made, as well as actions taken to address areas of concern. Decision The Integration Joint Board noted the content of the report. (Reference: Report by Deputy Director of People dated 26 March 2025, submitted) Janice Preston left the meeting during the consideration of the following item of Business. 11. ARGYLL AND BUTE HSCP PERFORMANCE REPORT FQ3 2024/25 (OCTOBER TO DECEMBER) The Board gave consideration to a report detailing performance of the HSCP for Financial Quarter (FQ) 3 2024/25 (October – December 2024). Page 7
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Decision The Integration Joint Board – 1. acknowledged performance for FQ3 2024/25 (October - December); 2. acknowledged the performance update on the National Health & Wellbeing Outcomes and Ministerial Steering Group Integration Indicators (Appendix 1); and 3. noted Delayed Discharge Sitrep as of 06 January 2025 (Appendix 2). (Reference: Report by Interim Head of Strategic Planning, Performance and Technology dated 26 March 2025, submitted) Councillor Gary Mulvaney, Councillor Ross Moreland and Kenny Mathieson left the meeting during the consideration of the following item of Business. 12. UPDATE - RENEWAL OF THE JOINT STRATEGIC PLAN The Board gave consideration to a report providing an update on the progress of the renewed Joint Strategic Plan. Decision The Integration Joint Board noted the updated timeline for the renewal of the Joint Strategic Plan. (Reference: Report by Interim Head of Strategic Planning, Performance and Technology dated 26 March 2025, submitted) 13. DATE OF NEXT MEETING The date of the next meeting was noted as Wednesday 28 May 2025. Page 8
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MINUTES of MEETING of ARGYLL AND BUTE HSCP CLINICAL AND CARE GOVERNANCE COMMITTEE held BY MICROSOFT TEAMS on THURSDAY, 1 MAY 2025 Present: Graham Bell (Chair) Karen Leach Rebecca Helliwell Elizabeth Higgins Kevin McIntosh Councillor Dougie McFadzean Councillor Ross Moreland Attending: Jan Chapple, on behalf of Associate Director of AHP Charlotte Craig, Interim Head of Strategic Planning, Performance and Technology Leah Smith, Clinical Governance Manager (Interim) Fiona Thomson, Associate Director of Pharmacy Hazel MacInnes, Senior Committee Officer 1. WELCOME AND APOLOGIES The Chair welcomed everyone to the meeting. Apologies for absence were intimated on behalf of David Gibson, Fiona Broderick, Alison McGrory, Nicola Gillespie, and Caroline Cherry. 2. MINUTES (a) Minute of the previous meeting of the Clinical and Care Governance Committee, held on 6 February 2025 The Minute of the meeting of the Clinical and Care Governance Committee held on 6 February 2025 were approved as a correct record. 3. ACTION LOG Having Given consideration to the Action Log, the Committee agreed – Action 1 (Hospital at Home Report) – The Interim Head of Planning, Performance and Technology provided a brief update and proposed that this be a focus for the Integration Joint Board Development Session in May with a further report on outcomes to be provided to a future meeting of the Committee. It was agreed that this item would be kept on the Action Log for the next meeting. Action 2 (Overlap of inspections spreadsheet) – The Committee noted that there was no update available at this time. It was agreed that this item would be kept on the Action Log and an update provided for the next meeting. Action 3 (Sexual Health Provision Update) – The Deputy Medical Director provided a brief update and it was agreed that this item could now be removed from the Action Log. Action 4 (HIS Oban Police Custody) - The Deputy Medical Director provided a brief update and it was agreed that this item could now be removed from the Action Log. Page 9 Agenda Item 4a
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Action 5 (Issues with 2c practices) - The Deputy Medical Director provided a brief update and it was agreed that a further update be provided to the next meeting. It was agreed that this item would remain on the Action Log for the August meeting and would be removed thereafter. 4. HEALTH AND SOCIAL CARE PARTNERSHIP - PERFORMANCE REPORT - FQ3 2024/25 (OCT - DEC) The Committee gave consideration to a report which detailed the performance for FQ3 2024/25 (October to December) highlighting key performance trends across the 84 Key Performance Indicators. The report also included performance updates from Heads of Service and Service Leads across the twelve service areas; the latest performance against the National Health and Wellbeing Outcome Indicators and the latest national update on Delayed Discharges. Decision The Committee – 1. Acknowledged performance for FQ3 2025/25 (October – December). 2. Acknowledged performance update on the National Health & Wellbeing Outcomes and Ministerial Steering Group Integration Indicators (Appendix 1). 3. Noted Delayed Discharge Sitrep as of 6 January 2025 (Appendix 2). 4. Noted supporting Service Feedback and Risk commentary from Heads of Service and Service Leads (Appendix 3). (Reference: Report by Head of Strategic Planning, Performance and Technology dated 1 May 2025, submitted) 5. DASHBOARD REPORT The Committee gave consideration to the dashboard report, which provided information on stage 2 complaints over the last 13 months; adverse events over the last 13 months; the number of inpatient falls over the last 13 months; the number of tissue viability incidents over the last 13 months; the number of violence and aggression incidents over the last 13 months and the number of medication errors over the last 13 months. Decision The Clinical and Care Governance Committee considered and noted the information contained within the dashboard report. (Reference: Report by Clinical and Care Governance Manager dated 1 May 2025, submitted) 6. CLINICAL DEEP DIVE 1 The Committee agreed to remove this item from the agenda. Page 10
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7. DATE OF NEXT MEETING The date of the next meeting was noted as Thursday 14 August 2025. Page 11
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MINUTES of MEETING of ARGYLL AND BUTE HSCP FINANCE AND POLICY COMMITTEE held BY MICROSOFT TEAMS on MONDAY, 19 MAY 2025 Present: Councillor Dougie McFadzean (Chair) Graham Bell Councillor Gary Mulvaney Fiona Thomson Karen Leach Kenny Mathieson Tracey Whyte Attending: Evan Beswick, Chief Officer, Argyll and Bute HSCP Fiona Broderick, Staffside Lead, Argyll and Bute HSCP (Health) Charlotte Craig, Interim Head of Service Strategic Planning, Performance and Technology, Argyll and Bute HSCP Linda Currie, Associate Director AHP, NHS Highland David Gibson, Chief Social Worker/Head of Children and Families and Justice, Argyll and Bute HSCP Nicola Gillespie, Interim Head of Adult Services (Mental Health, Disabilities, ASP & Dementia Services), Argyll and Bute HSCP James Gow, Head of Finance, Argyll and Bute HSCP Councillor Kieron Green, Argyll and Bute Council Elizabeth Higgins, Associate Nurse Director, NHS Highland Julie Hodges, Independent Sector Representative Alison McGrory, Associate Director of Public Health, Argyll and Bute HSCP Councillor Ross Moreland, Argyll and Bute Council Kirstie Reid, Carers Representative, NHS Highland Angela Tillery, Principal Accountant, Argyll and Bute Council Donald Watt, Interim Head of Adult Services (Acute and Community Care), Argyll and Bute HSCP Katie McKenzie, Committee Services Officer, Argyll and Bute Council 1. APOLOGIES FOR ABSENCE There were no apologies for absence. 2. DECLARATIONS OF INTEREST There were no declarations of interest. 3. SOCIAL WORK / SOCIAL CARE FINANCIAL RECOVERY The Committee gave consideration to a report outlining proposed Financial Recovery actions to address the budget shortfall. Decision The Finance and Policy Committee – 1. endorsed the recovery actions outlined in the report; Page 13 Agenda Item 4b
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2. noted that the report sits alongside other work on the delivery of approved savings and development of further options; and 3. agreed to refer the Recovery Plan to the Integration Joint Board. (Reference: Report by Head of Finance dated 19 May 2025, submitted) 4. OLDER ADULT SERVICES EFFICIENCY - CEILING OF CARE The Committee gave consideration to a report outlining a proposed approach to implementing a ceiling of care within Adult Services – Care at Home. Decision The Finance and Policy Committee – 1. considered and endorsed the content of the report; 2. noted that it was proposed that no further Care at Home packages would be authorised above the ceiling of care without Chief Officer approval; and 3. noted that existing packages above this level would be reviewed systematically and the provision offered / commissioned by the HSCP was anticipated to reduce accordingly; 4. noted that an EQIA for the proposal was attached as an appendix; 5. agreed that a community consultation exercise would be undertaken in order to produce a more robust EQIA; and 6. agreed to refer this paper to a future meeting of the Integration Joint Board for final approval. (Reference: Report by Head of Finance and Head of Adult Services dated 19 May 2025, submitted) 5. INTEGRATION JOINT BOARDS - FINANCE BULLETIN 2023/24 The Committee gave consideration to a report detailing Audit Scotland’s recently published annual analysis of Integration Joint Board accounts for the year ended 31 March 2024. Decision The Finance and Policy Committee – 1. noted the content of the report published by Audit Scotland; 2. noted the severe financial and operational challenges that continue to face Health and Social Care; and 3. noted that the Argyll and Bute HSCP was in a relatively favourable financial position at the end of the 2023/24 year. Page 14
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(Reference: Report by Head of Finance dated 19 May 2025, submitted) 6. CARE HOMES STRATEGIC DEVELOPMENT - STAGE 1 OUTPUT The Committee gave consideration to a report providing an overview of the main findings of stage 1 of the Care Homes Strategic Assessment. Decision The Finance and Policy Committee – 1. noted the Care Homes Strategic Assessment stage 1 report; 2. noted that the report clearly demonstrated a mismatch between current care home capacity and provision and current and future anticipated demand; and 3. noted that the HSCP was progressing to Stage 2 in partnership with Hub North. (Reference: Report by Head of Finance and Head of Adult Services dated 19 May 2025, submitted) 7. DATE OF NEXT MEETING The Finance and Policy Committee noted the date of the next meeting as Tuesday 24 June 2025. Page 15
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1 Integration Joint Board Date of Meeting: 28 May 2025 Title of Report: Chief Officer Report Presented by: Evan Beswick, Chief Officer The Integration Joint Board is asked to: • Note the following report from the Chief Officer Introduction I would like to thank you for taking the time to read my Chief Officer Report for May 2025. As per usual I have highlighted some of the good work that staff are carrying out on a daily basis across the HSCP to help the people of Argyll and Bute. I will outline this later in my report however firstly I wanted to start by detailing some of the major challenges that we are facing as an organisation. As I have previously described, one of the most pressing challenges is our current financial situation and we are not alone in this as it is a situation faced by many HSCPs across the country. We are having to operate within a budget that is continuing to reduce in real terms while we are facing increasing demands on our health and social care services. Our social work/social care services are under particular financial pressure and you will see today that the team within the HSCP is working hard and making difficult choices to manage this. In the papers for the IJB meeting this month there are proposals for a financial ‘recovery plan’ for these services. At the same time, however, we are looking forward to the future of these services. They are such an important part of our health and social care system but demographic, workforce and financial changes mean it is becoming more difficult to deliver them. We are therefore looking into how we can make them more efficient while still delivering a high standard of care for the people who use them. It’s important that we understand and communicate the impact of the changes we are making to social care, which will involve targeting resources at the most vulnerable, focussing on people’s individual circumstances (i.e. what they can do, rather than what they can’t), and ensuring our processes for assessment and commissioning are as good as they can be. Our local teams are also looking at how we can help individuals utilise other support mechanisms that may be available to them such as carers centres, maximising any benefits that may be available and Page 17 Agenda Item 5
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2 working with families to provide them with guidance and support in relation to caring for their relatives. We need to be transparent that the changes we are making will impact the way people experience our care and the amount of it some people are able to access. We must always ensure that we deliver on our statutory obligations. I was able to see some of this work in action when I visited Bute last month. It was a privilege to join staff and service users in the Learning Disabilities day centre, where I learned about some of the ways in which the centre supports individuals and their families to live their lives independently. I heard from the staff about their commitment to changing traditional and institutional approaches to care, which focus on service dependence, to models which support and bolster individual autonomy and assets. This is matched with a rigorous approach to ensuring management efficiencies and standard processes. I also met with community teams based in the Victoria Hospital Annexe and heard about the holistic approach to care, and the clear ambition to work across professional and organisational boundaries to provide the best care within the resources we have available. Our new strategic plan, now under development, will draw upon the best of these examples. We also need to think differently about how we organise ourselves as an HSCP and one potential area that we are engaged with partners in is discussion around a ‘Single Authority Model’ (SAM) of integration, which might involve much closer public sector working in areas such as Argyll and Bute. NHS Highland have been working alongside Argyll and Bute Council as well as Orkney and the Western Isles to explore innovative options for the public sector. This includes considering different options for the scope of a SAM, taking into account ‘parameters’ that will be set by the Scottish Government in relation to what must be retained in terms of NHS identity, governance and accountability. I will continue to keep you updated on this issue as we move forward. I also wanted to highlight that there have been a significant number of changes within our Senior Leadership Team recently due to staff moving on or retiring and while it is heartening to see colleagues develop and build their career path further, it does lead to SLT having a number of interim posts at the moment. I am working closely with the team to recruit to more permanent positions to provide SLT with a more stable structure moving forward. On 30 April I was delighted to hold our first stakeholder briefing session with elected members to discuss the challenges facing the HSCP and also outline some of the good work being implemented by our staff. I would like to thank those individuals who attended on the day and the many others, who were unable to attend, but who did contact me separately with their own queries. These briefing sessions will be arranged on a regular basis. I was also really pleased that the Bairns Hoose in Argyll and Bute opened on 6 May 2025 with the first child interview taking place the following week. This is an exemplary environment for children involved in the child protection system to both be interviewed and to receive support in their recovery from trauma. The opening was supported by staff from the core partners of Police, Social Work, Health and Education. We were also delighted to host a visit from Jenni Minto MSP, the Minister for Public Health and Women’s Health, along with the Chief Midwifery Officer for Scotland, Page 18
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3 Justine Craig, and Jaki Lambert, the Director of the Royal College of Midwives in Scotland. It was a privilege to showcase our community midwifery unit in Dunoon and our fantastic staff and highlight the exceptional continuity of care provided. Moving on to the body of my report I would firstly like to highlight the COVID-19 spring vaccination programme which is taking place at the moment and I would urge everyone offered a vaccine to come forward, get vaccinated and stay protected. This year’s vaccination programme is focused on protecting those most vulnerable to COVID-19 including older adults in care homes, people aged 75 and over, and those with a weakened immune system. I was delighted to see that a number of staff from Argyll and Bute were recognised for the work they are doing within their local communities by winning an NHS Highland VIP Award. More details are available further down my report and my congratulations go to each of them for this well-deserved acknowledgment of their work. I have also included details of grants from NHS Highland’s Screening Inequalities Fund that were awarded to various third sector organisations across Argyll and Bute. These grants are to help improve access and uptake of the various national screening programmes and will especially target groups who are less likely to take part in screening. Information on the various third sector organisations and the excellent work they are carrying out are included in the body of my report. Another really excellent piece of work is the bespoke training course developed by the University of the Highlands and Islands for Care Homes in Argyll and Bute. This course, which was specifically designed for use in care settings, gives an initial qualification to members of staff with limited or no prior experience of planning and delivering training. This course demonstrates real collaborative working to address the issue of remote and rural access to training and aiming to ensure equity for all. As per usual I have also included in the National Updates section information on some of the recent announcements from the Scottish Government and there are also web links where you can find out more details of these announcements. Finally, I would like to thank Fiona Duff who was our interim Head of Primary Care and who retired at the beginning of April. Primary Care is absolutely pivotal if we are to achieve any of our aims around supporting the health, wellbeing and aspirations of our population and Fiona brought her decades of experience to this end and I’m extremely grateful to her for doing that. She has made a huge contribution in her relatively short time in post in Argyll and Bute and I wish her well for her retirement. Thank you once again for taking the time to read my report and please feel free to contact me if you have any comments or suggestions for inclusion in future reports. HSCP Updates Elected Member Briefing Sessions We held an online briefing session for elected members (both councillors and MSPs were invited) on Wednesday 30 April where myself, and a number of my Senior Page 19
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4 Officers, discussed some of the key issues facing the HSCP over the coming year. Central among these was our current financial situation where it has been more challenging than ever before to develop and present a budget and to operate within resources that are reducing in real terms with increasing demands for health and care services. In our invitation to elected members we included a stakeholder briefing which provided information on the HSCP and how we deliver our services across Argyll and Bute. It also outlined more details on our challenges, the changes that we are making as an organisation and our current priorities. We are planning to hold further briefing sessions and issue further stakeholder briefings on a regular basis throughout the year. Ministerial Visit to Community Midwifery Unit in Dunoon On Friday 16 May 2025 we were delighted to host a visit from Jenni Minto MSP, the Minister for Public Health and Women’s Health, along with the Chief Midwifery Officer for Scotland, Justine Craig, and Jaki Lambert, the Director of the Royal College of Midwives in Scotland. It was a privilege to showcase our community midwifery unit in Dunoon and our fantastic staff and highlight the exceptional continuity of care provided throughout Argyll and Bute. During the visit we were joined by several local mothers, and their babies, who shared their experiences and emphasised the support they received. Blarbuie Woodland Walk Appeal The HSCP has been seeking community support to maintain a key local asset - the Blarbuie Woodland Walk in Lochgilphead. While this site does not fall under HSCP services, we understand its significance to local walkers. Throughout the years, the site has been managed and developed by local groups and organisations; however, their departure has led to challenges in maintenance. To uphold public safety, the HSCP is responsible for mitigating risks and ultimately dismantling any unsafe structures on the site. After reaching out to the local community we had a small number of individual members of the public express an interest and we will be holding a meeting with them in the near future to discuss whether it would be feasible for them to assist us in taking over the management of the woodland. COVID-19 Spring Vaccination Programme We would urge everyone offered a COVID-19 vaccine to come forward, get vaccinated and stay protected - because COVID-19 hasn’t disappeared. This year’s spring vaccination programme is focused on protecting those most vulnerable to COVID-19. This includes older adults in care homes, people aged 75 and over, and those with a weakened immune system, as they are at greater risk of illness from COVID-19. Page 20
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5 If you’re invited for your vaccination, it’s because experts know that your age or health condition mean you’re at higher risk of becoming seriously ill from COVID-19. You get your strongest protection from the vaccine in the first three months after getting it. Over time, this protection gradually fades so, even if you had your winter vaccination, it’s important to get another dose this spring to reinforce your immunity and help keep you safe. The spring vaccination programme runs from 31 March until 30 June 2025. If you’re eligible, you will be invited by letter, email or text message, depending on your selected communication preference. You can reschedule your appointment using the online portal or via the National Vaccination Helpline (0800 030 8013). More information is available at www.nhsinform.scot/covid19vaccine NHS Highland VIP Awards I would like to congratulate a number of staff members from Argyll and Bute who recently received an NHS Highland VIP Award for the work they are doing within their own communities. The most recent winners (April 2025) are as follows: Care and Compassion Category Caterina Orr, Healthcare Support Worker, Cowal Community Hospital Dignity and Respect Category Martina McNair, Patients’ Travel Payments Officer, Kilmory Castle Openness, Honesty and Responsibility Category Linda Gray, Practice Manager, Kilcreggan Health Centre The NHS Highland VIP (Values in Practice) Awards are a way to recognise, thank and celebrate the contributions of individuals and teams across NHS Highland. Public Sector Equality Duty The Equality and Human Rights Commission (EHRC) have been undertaking a programme of Public Sector Equality Duty (PSED) improvement work with Integration Joint Boards since 2022. As part of this work they recently carried out PSED compliance monitoring for Argyll and Bute in relation to a range of key information required by The Equality Act 2010. I am delighted to report that we have been formally informed by the EHRC that all the key information they require for the HSCP is available. The public sector equality duty (PSED) is a legal requirement for public authorities and organisations carrying out public functions. The purpose of the PSED is to make sure that public authorities and organisations carrying out public functions think about how they can improve society and promote equality in every aspect of their day-to-day business. Page 21
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6 Strategic Plan Our public, and indeed our staff, require us to plan for the future for health and social care services in Argyll and Bute. Accordingly, we are underway with the development of our next Strategic Plan for the HSCP. Our aim with this plan is to shift part of our focus away from delivering the same services we have always done, towards what we are doing to maximise the health outcomes and independence of people across Argyll and Bute. As part of the development of the Plan we will be engaging with the people who use our services, our staff, local communities and local stakeholders. New Heartstart Training Supervisor Jason Zuccarini has been appointed as the new Heartstart Training Supervisor for NHS Greater Glasgow and Clyde and his responsibilities include working closely in partnership with the HSCP. Under Jason’s leadership, the programme aims to broaden its outreach, ensuring that more children and adults acquire essential skills for managing life-threatening emergencies. Jason is dedicated to volunteers, co-ordinators, community members and local businesses and is actively working alongside a committed team of volunteers to enhance the programme's reach throughout Argyll and Bute. Within Argyll and Bute we really value this programme and recognise the immense value of teaching life support skills. It has been a successful training initiative for over 27 years, thanks to the dedication and commitment of past and present Heartstart Supervisors and volunteer/Coordinators involved in delivering the courses. We would also like to express our gratitude to all the volunteers for their commitment and hard work. Heartstart is a programme designed to educate young people and adults on how to respond in life-threatening situations. The two-hour training session equips participants with essential skills, including recognising cardiac arrest, performing Cardiopulmonary Resuscitation (CPR), and using an Automated External Defibrillator (AED). The training also covers basic emergency life support techniques, such as identifying heart attacks and dealing with choking incidents in adults, children and infants. Service Updates Screening Inequalities Grant Funding Lives are cut short by health inequalities resulting in people in some communities living shorter lives. Accessing screening programmes reduces deaths but research shows people living in the most deprived communities are least likely to take part in screening. To improve access and uptake and act against inequalities we have awarded a number of local third sector organisations with a grant from NHS Highland’s Screening Inequalities Fund. These partners will work within our local communities to reduce barriers and increase participation in screening programmes. This will Page 22
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7 empower community members to access screening. The projects awarded a grant are as follows: Jean’s Bothy hosted a community wellbeing festival with a focus on prevention of poor health and the importance of screening. Argyll Wellbeing Hub are raising awareness of screening by providing a monthly “Health and Wellbeing Day” and by holding a screening information session on a different topic following their Monday Wellbeing Walk. Oban’s Community Trust Rockfield Centre is aiming to use arts-based community engagement to increase knowledge of health screening programmes and their purpose with centre users. MECOPP (Minority Ethnic Carers of People Project) aim to produce screening information that is culturally appropriate to the Gypsy/Traveller Community and to cascade this through their networks and social media platforms. Kintyre Link Club is planning to deliver a community health project aimed at increasing awareness and participation in national screening programmes among under-served groups within the Kintyre area. International Day of the Midwife Monday 5 May 2025 was International Day of the Midwife and this year’s theme, Critical in Every Crisis, focused on the importance of good and safe midwifery care for women and babies through some of life’s most significant, and sometimes challenging, moments. We highlighted on our social media channels some of the amazing work that our midwives are carrying out across Argyll and Bute and we would like to thank them for the essential work they provide in our local communities on a daily basis. International Nurses Day International Nurses Day is observed every year on 12 May, the anniversary of Florence Nightingale’s birth. The day is organised by the International Council of Nurses and serves to highlight the importance of nurses in the health and social care system, celebrating their dedication and hard work. We would like to thank all the nurses working across the HSCP for their dedication and the fantastic work they do every day for the people who use our services. Bairns Hoose Opening in Helensburgh Bairns’ Hoose is Scotland’s child-centred, trauma-informed approach to supporting children who have experienced abuse or harm. Inspired by the Icelandic Barnahus model (meaning “children’s house”), it aims to provide a safe, supportive, and integrated environment where children can receive justice, care, and recovery services under one roof. Page 23
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8 The Bairns Hoose in Argyll and Bute was opened on 6th May 2025 with the first child interview taking place the following week. There is now an exemplary environment for children involved in the child protection system to both be interviewed and to receive support in their recovery from trauma. The opening was supported by staff from the core partners of Police, Social Work, Health and Education. The crucial role by the Scottish Government in funding this development requires to be recognised. Grant funding has been received to support further Bairns Hoose developments over the next year. Focus will be on consolidating investigative practice, developing the recovery model and exploring how the service is further evolved to meet the needs of children. It is intended that West Dunbartonshire Council will also make use of our facilities in Helensburgh. National Updates NHS Pay Deal Agreed Nurses, midwives and other healthcare staff across Scotland have voted to accept an 8% pay increase, over two years, that will ensure they continue to be the best paid in the UK. The deal, which benefits almost 170,000 NHS Agenda for Change staff – including nurses, midwives, paramedics, allied health professionals, porters and others – guarantees the pay increase will be one percentage point above inflation over same period. Further information is available here. Progress in Clearing Longest Waits More than 105,500 appointments and procedures were delivered by health boards last year through an additional £30 million of targeted investment – exceeding a pledge to carry out 64,000 appointments by the end of March 2025. The funding was targeted at the longest waits and, as seen in latest published data, there have been reductions in waiting lists across a number of specialities. Further information is available here. Additional Funding for National Treatment Centre Highland Funding of £2.6 million will allow National Treatment Centre (NTC) Highland to deliver thousands of additional orthopaedic and ophthalmic operations every year. The additional investment – allocated from £200 million contained in the Budget to tackle waiting times, delayed discharge and improve hospital flow across the country – will support the recruitment of new nurses, anaesthetists and healthcare support workers. This is expected to allow the centre to carry out around 8,418 procedures in the coming year – a 67% increase on the 5,054 commissioned by the Scottish Page 24
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9 Government last year. The increase in capacity will deliver procedures for patients in NHS Highland, NHS Grampian, NHS Tayside and NHS Shetland. Further information is available here. Strengthening Scotland’s NHS Health Secretary Neil Gray has set out how the Scottish Government plans to improve access to treatment, reduce waiting times and shift the balance of care from hospitals to primary care through the publication of the Operational Improvement Plan. Through the additional £200 million investment contained in the Budget to reduce waiting times and improve flow through hospital, we will create 150,000 extra appointments and procedures using greater use of regional and national working. Further information is available here. News Care Home Course The University of the Highlands and Islands (UHI) attended a Colleges Scotland Parliamentary Reception in the Scottish Parliament on 29 April 2025 where they showcased the bespoke training course they developed for Care Homes in Argyll and Bute called 'Planning & Delivering Training'. The course, which was specifically designed for use in care settings, gives an initial qualification to those with limited or no prior experience of planning and delivering training. A number of care home staff are currently undertaking the course and four of them attended the Parliamentary Reception to share their learning experience. This course demonstrates real collaborative working to address the issue of remote and rural access to training and aiming to ensure equity for all. I would also like to highlight the amazing input from the UHI Team in working with Mary-Anne Douglas (Lead Nurse, Care Homes) and Julie Hodges (Scottish Care) particularly Margaret Eccles from UHI who has done a sensational job in supporting our students. The funding for the course was provided and supported by the Care Home Collaborative Group and a place was offered to every care home in Argyll and Bute. Staffing Updates Interim Head of Primary Care I would like to thank Fiona Duff who recently retired as Interim Head of Primary Care for the HSCP. Primary Care is absolutely pivotal if we are to achieve any of our aims around supporting the health, wellbeing and aspirations of our population. Realising that potential requires sustained respect, constructive dialogue and the creation of space for innovation between, in particular, our managed services and independent partners. Fiona brought her decades of experience to this end, and Page 25
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10 I’m extremely grateful to her for doing that and she has made a huge contribution in her relatively short time in post. I wish her well in her retirement. Recruitment processes have been taking place for a permanent Head of Primary Care. In the meantime, I will be a point of contact for Primary Care issues, working closely alongside Rebecca Helliwell, our Depute Medical Director. Page 26
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1 Integration Joint Board Date of Meeting: 28 May 2025 Title of Report: Social Work / Social Care Financial Recovery Presented by: James Gow, Head of Finance The Integration Joint Board is asked to: • Endorse the recovery actions outlined in this report. • Note this report sits alongside other work on the delivery of approved savings and development of further options. • Request integrated impact assessments and that appropriate community engagement is carried out in respect of relevant proposals. 1. EXECUTIVE SUMMARY 1.1 The Social Work budget as approved by the IJB in March 2025 had a balance of savings still to be identified. This is a shortfall from the start of the year totalling £500k. The purpose of this report is outline a specific recovery plan to address this. The actions outlined in this paper are in the context of: • This gap is in addition to £1.5m of financial savings planned for 2025/26. • There is a larger gap in 2026/27 due to £3m of non-recurring funding no longer being available. This requires to be addressed urgently and it is intended that there is some overlap between short term recovery actions and the longer term requirement to reduce costs substantially. • There are strategic pieces of work underway which include consideration of dis-investment in some existing services. 1.2 The Finance & Policy Committee requested from officers a paper in March 2025 which outlined potential options for managing down the deficit. Work is on-going in respect of these with a view to formal decisions being made during the course of the current year. This report was also considered by the Finance & Policy at its meeting on 19 May 2025 (all board members were invited to attend this meeting), it was agreed that the HSCP would commence consultation on its proposals where appropriate. 1.2 The drivers of the financial challenge are described in more detail in other reports, in summary these are: • Real terms reduction in funding over a number of years. • Increasing demand for services due to the ageing demographic. • On-going shortages of staff resulting in increased dependency upon agency staffing. The Health and Social Care sector is in a difficult position due to the financial challenge and lack of a national strategic vision for the sector at present. Most IJBs have significant forecast deficits and depleted reserves, a recent report prepared by the Chief Officers Group confirms this and has been communicated Page 27 Agenda Item 6a
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2 to Government Ministers to again highlight the scale of the problem. IJB’s are also featuring in Health Board financial forecasts as a cost pressure and financial risk, contributing to Board overspending. Audit Scotland have repeatedly reported that the sector is not operating on a financially sustainable basis. As general reserves reduce, service reduction is now required and is driven by real terms reductions in budgets in the face of increasing demand. This process is being taken forward by IJBs individually. Similarly the NHS element of the budget is not in balance and discussions are on-going with NHS Highland in respect of the approach to this, the scale of that gap is £4.2m and a plan to address this element of the budget gap has been formally requested. 2. Recommendations 2.1 The Integration Joint Board is recommended to: • Endorse the recovery actions outlined in this report. • Note this report sits alongside other work on the delivery of approved savings and development of further options. • Request integrated impact assessments and that appropriate community engagement is carried out in respect of relevant proposals. 3. DETAIL OF REPORT 3.1 The HSCP is required to seek approval for a financial recovery plan designed to convert the outstanding savings target into tangible and measurable actions. Approval of this report provides service management with authority to progress these as timeously as possible. These actions are on top of an already approved and challenging savings programme. Further savings cannot be delivered without some reductions in service and capacity within the HSCP. Almost all social care services are provided to individuals with protected characteristics (children, older people, people with disability). Therefore it is also not possible to reduce services without having a disproportionate adverse impact on these groups (and those experiencing financial exclusion / poverty not covered by the legislation in the same way). The table below summarises the proposals, estimated values and highlights those proposals that require further stakeholder engagement and integrated impact assessments: Saving Saving £’000 Recurring Description Engagement & EQIA Additional Fostering Income 100 TBC Income from other LAs for fostering service. May be a recurring saving. Operational – Impact Assessment not required Direct Payment Recovery 50 No One-off income from review of DP balances where clients have not been able to spend on their assessed care needs. Operational – Impact Assessment not required SLT Vacancy Savings 25 No Non-recurring vacancy saving from gaps in SLT. Operational – Impact Assessment not required Remove vacant Handyperson Post - KCC 31 TBC May require some additional support with room changeovers to be provided from other locations. Operational – Impact Assessment not required Return 2 voids Lorn Campbell 5 10 Vacant flats and Lorn Campbell Court to be Operational – Impact Assessment not required Page 28
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3 Court handed back to the landlord as the HSCP has being covering the cost of the voids for some months. A review of the service is on- going. Day Service Review 50 TBC Nature of saving to be confirmed, review is currently underway and due to report shortly. The saving will either be from a reduced service offer based on the evidence provided in the review or from increased charging. Detail will be provided upon completion of the review. Consultation is being carried out as part of the review process. Depending upon the recommendations further engagement and consultation may be required. An Integrated Impact Assessment will be prepared as part of the review documentation. Transport services 25 118 Commence negotiations to scale back community transport provision. This would be a change in approach by the HSCP to cease / reduce funding community transport for social care services. Notice will be provided timeously. Although this is a non- statutory service, the HSCP will commence a consultation process to inform an Impact Assessment before taking steps to reduce / end community transport services. Ceiling of Care 80 TBC The HSCP is developing a proposal to place a ceiling upon the number of hours of care normally offered by the care at home service. A consultation and engagement process will commence in June to inform an Integrated Impact Assessment to inform the proposal and decision-making process. Agency Care @ Home - Oban 90 TBC Four posts have been removed from efficiency wok relating to homecare packages saving up to £7k per week inc. accommodation and travel. Some of this saving is required to contribute to other savings targets. Operational – Impact Assessment not required Internal Care Home Efficiency 44 TBC Review expensive provision and aim to either reduce costs or increase charges / review shift patterns and agency staffing. Operational – Impact Assessment not required Total 500 Additionally the following will remain in place: • All vacancies to be approved by vacancy monitoring group prior to advert. • Presumption against new spend or development. • Moratorium on new agency staffing and renewals signed by Head of Service and Chief Officer. Page 29
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4 • All contracts and grants to be reviewed on a systematic basis, particularly where arrangements have been put in place in one area and are not A&B wide. The HSCP will be taking greater account of available resources when committing to new care provision. This will be a challenging change for teams not used to working in this way and will in turn have an impact on those who require support. Some service budgets are fully committed to support packages already in place. There is little or no budget to action new assessments. Without sufficient budget, support will only be available in exceptional circumstances. Further consideration and review will also be required of the level of support given to those already assessed and in receipt of support. Messaging and communication to staff and stakeholders is a critical part of the financial recovery process. A shift in culture is required to help reduce spending and re-set expectations. The HSCP will need to identify further ways of reducing cost during the course of 2025. It is unlikely that this can be achieved without identifying a way forward to dis-invest in some services, reduce internal costs and staffing costs as well as reducing external contracts. Detailed consultation and engagement work will commence upon approval of the approach to financial recovery in 2025/26 outlined in this report. It is anticipated that Integrated Impact Assessments and final proposal will be provided to assist formal approval at the next meeting of the IJB. 4. RELEVANT DATA AND INDICATORS 4.1 The data presented in this report is largely derived from financial data held in the systems of Argyll & Bute Council and performance data held on Care First and the Integrated Performance Management Framework. 5 CONTRIBUTION TO STRATEGIC PRIORITIES 5.1 The HSCP is required to operate within the resources made available to it by both partners. 6. GOVERNANCE IMPLICATIONS 6.1 Financial Impact – the above savings or alternatives require to be actioned to enable the HSCP to balance its Social Work / Social Care budget in 2025/26. This is a legal requirement. 6.2 Staff Governance – implications will require to be considered in detail if any of the options outlined are progressed. Professional HR input is a gap within the HSCP management team at present. 6.3 Clinical Governance – implications will require to be considered in detail if any of the options outlined are progressed. 7. PROFESSIONAL ADVISORY 7.1 Professional leadership are involved throughout discussions on financial management. Further professional and legal advice will be required through the Integrated Impact Assessment and implementation phase of some aspects of the recovery plan. Page 30
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5 8. EQUALITY & DIVERSITY IMPLICATIONS 8.1 There will be adverse impacts on individuals covered by equality legislation associated with the contents of this report. Integrated Impact Assessments will be provided prior to implementation of policy or service changes. 9. GENERAL DATA PROTECTION PRINCIPLES COMPLIANCE 9.1 None. 10. RISK ASSESSMENT 10.1 This report is intended to address the immediate financial sustainability risk associated with the HSCP budget. There are health and care risks associated with savings options. There are also risks associated with legal challenge in respect of service changes, the HSCP will continue to liaise with its legal advisors in this respect to mitigate these risks as far as is reasonable and proportionate. 11. PUBLIC & USER INVOLVEMENT & ENGAGEMENT 11.1 The HSCP will be required to engage effectively with communities in respect of changes to services and the financial challenge it currently faces, a communications plan is under development. 12. CONCLUSIONS 12.1 This report seeks to outline a recovery plan to address the Social Work / Social Care element of the HSCP budget shortfall in 2025/26. Implementing these will assist with the budget gap in 2026/27. 12.2 None of the options are easy to implement and all have associated risk and detriment to the service. However, failure to implement changes that are likely to be effective in reducing spend will likely result in the failure of the HSCP to operate on a financially sustainable basis (Social Work / Social Care services). 13. DIRECTIONS Directions required to Council, NHS Board or both. Directions to: tick No Directions required √ Argyll & Bute Council NHS Highland Health Board Argyll & Bute Council and NHS Highland Health Board 14. PREVIOUS REVIEW OF THE REPORT Meeting Title of report Date Output (if relevant) SLT Savings Options – Social Work / Social Care 5/2/2025 and 7/2/25 Concerns raised and amendments made to draft SLT Social Work Recovery Plan 16/4/25 and 30/4/25 final Supported and some Page 31
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6 version amendments made Council ELT Social Work Recovery Plan 22/4/25 Endorsed Finance & Policy Committee Social Work Recovery Plan 19/5/25 Further work on Consultation and Impact Assessments requested. Report amended. AUTHOR NAME: James Gow, Head of Finance EMAIL: james.gow@argyll-bute.gov.uk Page 32
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Integration Joint Board Agenda item: Date of Meeting: May 2025 Title of Report: Q4 Workforce Report (2024/25) Presented by: Gaye Boyd, Deputy Director of People The Integrated Joint Board is asked to: • Note the content of the report. 1. EXECUTIVE SUMMARY This workforce report details the workforce data of the HSCP as at 31st March 2025 and provides the current demographic position, highlighting trends and advising of changes and progress made, as well as actions taken to address areas of concern. 2. RECOMMENDATIONS To note and discuss the workforce data contained within the report. 3. DETAIL OF REPORT The attached information is provided in relevant sections with observations and actions advised and provides data on the following: • Headcount and WTE • Workforce Profile • Time to Fill (recruitment) • Vacancies • Sickness Absence • Employee Relations • Redeployment • Mandatory Training • Appraisals Page 33 Agenda Item 7
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4. RELEVANT DATA AND INDICATORS - Both employers reporting a slight increase in workforce at end of Q4 - Both employers reporting 50% of workforce are over 50 - Within the HSCP, Council posts take an average of 79 days to fill while the NHS average is 116.1 days in March. Both employers reporting an increase in time to fill since last report in December. (69 – Council. 113.6 – NHS) - Sickness absence in NHS has decreased further to 5.08%. For Council workforce the days lost per WTE per month has shown a slight increase, 1.74 in December 2024 to 2.35 in March 2025. - No data was available for Q4 from Council on Disciplinaries due to an system error. 1 grievance was closed during this period. NHS Employee Relations cases at end of March 2025: 1 new Bullying & Harassment cases with 12 remaining active; no new Conduct cases with 4 remaining active and 1 new Grievances and 9 remaining active. - Statutory and Mandatory Training completion rate for NHS staff at 31st March is 70.5% overall for eLearning modules. The compliance rates continue to improve however is short of the target of 95%. Reporting issues remain in place for Council data with Q3 data available however compliance rate remains low - The NHS appraisal completion rate has increased slightly since the last quarter report to 27.2%. Argyll & Bute Council have moved away from PDP/appraisals to a less formalised quality conversation approach. It was agreed that an Annual survey would be conducted to measure the success and impact of the quality conversation. The next survey is currently being run, with a closing date of 13 May 2025. 5. CONTRIBUTION TO STRATEGIC PRIORITIES The information within this report contributes to the strategic priorities by informing decision making at all levels aligned to the delivery plan objectives, supporting best value and evidencing performance and progress. 6. GOVERNANCE IMPLICATIONS 6.1 Financial Impact A reduction in sickness absence will reduce costs and can evidence a direct saving. 6.2 Staff Governance The workforce report is part of the suite of staff governance reports which evidence contribution to the Staff Governance Standard; Well Informed, Appropriately Trained and Developed, Involved in Decisions, Treated Fairly and Consistently and Continuously 7. PROFESSIONAL ADVISORY None 2 Page 34
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8. EQUALITY & DIVERSITY IMPLICATIONS E&D data is contained within the report. 9. GENERAL DATA PROTECTION PRINCIPLES COMPLIANCE No personal or sensitive information is contained within the report 10. RISK ASSESSMENT Workforce associated risks are contained within the risk register 11. PUBLIC & USER INVOLVEMENT & ENGAGEMENT No public or user involvement to report within this current report 12. CONCLUSIONS It is recommended that the Integration Joint Board: • Note the content of this quarterly workforce report. 13. DIRECTIONS Directions required to Council, NHS Board or both. Directions to: tick No Directions required X Argyll & Bute Council NHS Highland Health Board Argyll & Bute Council and NHS Highland Health Board 14. PREVIOUS REVIEW OF THE REPORT NIL REPORT AUTHOR AND CONTACT Officers that contributed information to the report are: Jo McDill, HR&OD Officer, Argyll and Bute Council hr-hscp@argyll-bute.gov.uk Iain MacDiarmid, Workforce Planning Manager, NHS Highland, nhsh.workforceplanning@nhs.scot 3 Page 35
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WORKFORCE REPORT Argyll & Bute IJB May 2025 Page 37
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CONTENT •Introduction •Headcount and WTE •Workforce Profile •Vacancies •Sickness Absence •Employee Relations •Redeployment •Mandatory Training •Appraisals 20XX 2 Page 38
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INTRODUCTION The Workforce Report considers the workforce position as of 31st March 2025, providing high level information for A&B HSCP. Some sections may represent an alternative timeline and will be highlighted. The report has been developed in partnership and aims to shows the current position, trends and highlights where there have been changes and progress from previous periods as well as actions that are being taken to address some of the areas of concern. The Workforce Systems Teams proactively assesses data quality based on agreed data quality principles that are part of the data quality framework and addresses data quality issues at source to ensure that our workforce data is of high quality, reliable, and valuable to NHS Highland, and its stakeholders. Work continues on developing integrated (NHS and Council) data sets where possible. NHS Workforce dashboards are available at Operational levels as well as Job Families and continue to be developed. Council Health of the Organisation (HOO) reports are distributed to each service lead on a quarterly basis and Absence summaries are distributed monthly. 20XX 3 Page 39
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HEADCOUNT AND WTE NHS Key points: 0.55% increase of workforce in the last 12months March 2025 in post figure of 1,646 (headcount) of Substantive Staff is an increase of 7 (0.43%) in the last 3 months 96.6% of contracts are permanent and this has been a consistent position since December 2022 4 Council HeadcountNHS Council Key points: Increase in total employed by 5 in last 3 months Increase in casual staff by 53 95% of contracts are permanent Page 40
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NHS WORKFORCE PROFILE SAMPLE FOOTER TEXT 5 Key points (NHS): • 842 employees (51.2% of the workforce) are over 50, 310 (18.9%) over 60 years, 70 (4.3%) over 65 • 39 (2.4%) employees are under 25 • 1397 (84.9%) employees are female • 852 (51.7%) employees are part time • 55 (3.4%) contracts are fixed term • Monthly Turnover (1.4%) is 0.9% higher than December’s figure and is higher than the Board figure of 0.82%. • Retirement continues to be the main reason (53.8%) for leaving. Page 41
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COUNCIL WORKFORCE PROFILE SAMPLE FOOTER TEXT 6 Key points: • 50% of the workforce remain over 50 years old with 4% over 65 years • 83% of the workforce is female. • 44% of the workforce are part time • 5% of the workforce are temporary (37) • Voluntary Turnover rate has reduced again from 4% to 3% • No temporary employees leaving prior to end of contract • Modern apprenticeship retention remains higher than the council wide figure at 82% vs 70% Page 42
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TIME TO FILL Time to fill presents a count of days between post added to the recruitment system and the start date of the candidate. The fill period is therefore reliant on timely and accurate data input. Within the HSCP, Council posts take an average of 79 days to fill while the NHS average is 116.1 days in March compared to 113.6 for December. Time to fill has been reducing for board posts. Scotland wide benchmarking is also being sought and will be used for comparison when available. Council time to fill has increased slightly during Q4, from 69 days in the last Quarter to 79 days this quarter. There has been a slight increase in the numbers of vacancies advertised from 61 in Q3 to 65 during Q4. At the end of March 2025, there were only 7 positions that remained unfilled. Both recruitment systems have the capability of reporting at each stage of the recruitment process and Recruitment Metrics is being finalised for future reporting. This will assist in identifying the source of delays. 7 Council NHS Status Posts at 31/03/2025 Conditional 47 Generic/Cohort 2 Interview 26 Live Advert 37 Redeployment 2 Shortlisting 9 Shortlisting Complete 6 Unconditional 31 Total 160 Average time to Fill (days) 116.1 Page 43
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HSCP CURRENT VACANCIES 8 NHS Vacancies (Jobtrain) 31/03/2025 Council Vacancies This slide provides a detailed breakdown of the vacant posts. Information relating to re- advertising and posts vacant for a long period of time is being further developed and will be provided when available. Division Number of Vacancies A&B Children Families & Justice 9 Administrative Services 1 Allied Health Professions 2 Nursing and Midwifery 6 A&B MH LD & Addiction Services 17 Administrative Services 2 Allied Health Professions 3 Nursing and Midwifery 12 A&B Older Adults & Hospital Services 109 Administrative Services 12 Allied Health Professions 24 Healthcare Sciences 2 Medical and Dental 5 Nursing and Midwifery 51 Other Therapeutic 1 Personal and Social Care 1 Support Services 13 A&B Primary Care 15 Administrative Services 7 Dental Support 1 Medical and Dental 3 Nursing and Midwifery 2 Other Therapeutic 2 Argyll & Bute Central 10 Administrative Services 3 Allied Health Professions 1 Nursing and Midwifery 0 Personal and Social Care 2 Support Services 4 Total 160 This table has a total of 75 posts during Q4 – which includes all internal/Ring Fenced as well as Casual posts, hence the difference of 10 from the previous slide. Page 44
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NHS SICKNESS ABSENCE 9 The graph presents absence rates across Argyll & Bute Divisions. The table presents the average absence rates of the HSCP in comparison with NHS Highland as a whole and the NHS Scotland national average per month. A&B HSCP has, in the main, a consistently lower absence rate than the board wide and National averages. * We await NHS Scotland average rates for March 2025. 4.00 4.50 5.00 5.50 6.00 6.50 7.00 7.50 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 A&B HSCP 5.27 5.21 5.29 6.01 5.14 4.99 5.75 5.72 6.30 5.73 6.02 5.21 5.08 NHS Highland 6.16 5.94 5.92 6.00 5.99 5.58 5.79 6.07 5.97 6.41 6.94 5.72 5.77 NHS Scotland Average 6.07 6.19 6.39 6.22 6.67 6.04 6.01 6.53 6.16 7.07 7.01 5.87 % Absence Rate A&B HSCP NHS Highland NHS Scotland Average Page 45
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NHS SICKNESS ABSENCE REASONS 10 Top 20 Absence reasons presented for the 12 months to March 2025. Absences with an unknown cause/not specified remaining high (24.5%). Managers continue to be asked to ensure that an appropriate reason is recorded and continuously updated. System solutions and prompts are also being investigated. For committee purposes absence reason is reported at HSCP level. Heads of Services receive their own divisional information. The top 3 reasons for absence are: • cold, cough, flu • gastro-intestinal • Anxiety/ stress /depression /other Top 20 Absence Reasons % for 12 months to March 2025 24.50% 19.36% 13.27% 6.64% 6.05% 4.33% 4.03% 3.85% 3.37% 2.57% 2.27% 1.69% 1.58% 1.25% 1.14% 0.81% 0.70% 0.40% 0.40% 0.40% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% % of Total Absences Page 46
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COUNCIL SICKNESS ABSENCE SAMPLE FOOTER TEXT 11 The costs for sickness absences for FQ4 are shown below. Overall, the HSCP has spent above the Council average during this quarter with 7.8% compared to 5.2% (and last quarter it was 6.4% compared to 4.4%) The days lost per FTE per month has shown a slight increase, 1.74 in December 2024 to 2.35 in March 2025. Page 47
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COUNCIL SICKNESS REASONS & RTWD 12 Absence Reasons ‘Mental Health’ reasons have remained as the top reason in the short-term and long-term absence categories for FQ4. Managers have access to the Council’s Wellbeing team for assistance in following the Supporting Attendances procedures. Return to Work Discussion (RTWD) The RTW Discussions remain an extremely important part of the absence management process, and there is a commitment for them to take place within 3 days of an employee’s return to work after a period of absence. Page 48
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From 1st April 2024 cases include early resolution where known. In February 2025, 1 new Bullying and Harassment was raised in Aryll & Bute and 12 remained active. 0 2 4 6 8 10 12 14 16 18 Feb-24 Mar- 24 Apr-24 May- 24 Jun-24 Jul-24 Aug- 24 Sep-24Oct-24 Nov- 24 Dec-24 Jan-25 Feb-25 A&B 17 17 17 17 15 13 13 13 15 15 12 11 12 Bullying and Harassment February 24 - February 25 (active cases at end of month) 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 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 A&B 0 0 0 0 1 1 0 1 4 0 0 0 1 Bullying and Harassment February 24 - February 25 (new cases open per month) Page 49
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From 1st April 2024 cases include early resolution where known. In February 2025, 0 new conduct cases were opened and 4 cases remained active in Argyll & Bute 0 1 2 3 4 5 6 7 Feb-24 Mar- 24 Apr-24 May- 24 Jun-24 Jul-24 Aug-24Sep-24Oct-24Nov-24Dec-24 Jan-25 Feb-25 A&B 1 1 2 2 2 2 6 5 3 3 4 4 4 Conduct February 24 - February 25 (active cases at end of month) 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Feb-24 Mar- 24 Apr-24 May- 24 Jun-24 Jul-24 Aug-24Sep-24Oct-24Nov-24Dec-24 Jan-25 Feb-25 A&B 0 0 1 0 0 0 4 0 0 0 1 0 0 Conduct February 24 - February 25 (new cases open per month) Page 50
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From 1st April 2024 cases include early resolution where known. In February 2025, 1 new grievance case was opened in A&B with 11 cases active in the same month 0 2 4 6 8 10 12 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 A&B 7 7 6 8 8 7 6 6 5 9 11 11 11 Grievance February 24 - February 25 (active cases at end of month) 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Feb-24 Mar-24Apr-24 May- 24 Jun-24 Jul-24 Aug-24Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 A&B 2 0 0 2 1 0 0 0 0 4 2 0 1 Grievance February 24 - February 25 (new cases open per month) Page 51
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EMPLOYEE RELATIONS 16 HSCP Council Grievance cases continue to remain relatively low; with one concluded during Q4. With regards to Council Disciplinaries, the statistics for Q4 are unavailable due to a systems issue. Page 52
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REDEPLOYMENT 17 All NHS Highland Band/Grade Reason TotalJob Family Band 1 Band 2 Band 3 Band 4 Band 5 Band 6 Band 7 Other Org Change Capability/ Attendance End of FTC Pay Protection Other Admin Services 1 0 3 2 3 3 0 0 3 0 3 6 0 12 Allied Health Services 0 0 2 1 0 1 0 0 0 1 1 2 0 4 Dental Support 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Healthcare Sciences 0 1 1 0 1 0 0 0 1 0 0 1 1 3 Medical and Dental 0 0 0 0 0 0 0 1 0 1 0 0 0 1 Nursing and Midwifery 0 0 12 0 3 2 3 0 1 1 7 10 0 20 Other therapeutic 0 1 0 0 1 0 0 0 0 0 1 1 0 2 Personal and Social Care 0 0 1 1 1 0 0 0 2 0 0 1 0 3 Support Services 3 10 0 4 0 1 0 0 8 1 0 9 0 18 Total 4 12 19 8 9 7 3 1 15 4 12 31 1 63 As of the 31st March 2025 there were 31 employees within Argyll & Bute on the redeployment register. All NHS vacancies at any stage prior to appointment are considered for redeployment as they arise. Page 53
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MANDATORY TRAINING - NHS In March 2025, the Mandatory Training completion rate is 70.5% overall for eLearning modules, an increase since December 2024 when 68.2% was reported. Over the course of the year there has been focused attention on statutory mandatory training resulting in incremental improvement across all statutory mandatory training course. The launch of a new Violence & Aggression course in July 2024 for all job families caused a dip in the figures but completion numbers are now improving. There remains low levels of compliance in Staying Safe Online eLearning, but it is improving. 18 30% 40% 50% 60% 70% 80% 90% 100% 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 Trajectory (% Completed) Equality and Diversity Fire Safety Hand Hygiene Information Governance Moving and Handling Module A Public Protection Staying Safe Online Violence and Aggression Why Infection Prevention Matters Target Page 54
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Unfortunately, due to continued issues with the Council IT systems, there are only training statistics available for Q3. The tables show both mandatory and non mandatory training courses completed during the previous quarter. LEON continues to notify employees when their training is due and sends reminders to the employee and line manager. The reporting for this is still being refined, but it is expected to improve the overall compliance rates in the next few quarters. 19 MANDATORY TRAINING (COUNCIL) Page 55
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APPRAISALS NHS - the table shows the appraisal completion percentage, recorded on the Turas Appraisal system for NHS employees as of 31/03/2025. The chart represents the overall appraisal completion percentage over the last 13 months recorded on the Turas Appraisal system for NHS employees. Improvement of appraisal rates and quality is a Board priority, and this will be an area of focus for the year ahead. Training for reviewees is available on the Turas Learn system Council - The Council moved away from PDP/appraisals to a less formalised quality conversation approach. It was agreed that an Annual survey would be conducted to measure the success and impact of the quality conversation. The next survey is currently being run, with a closing date of 13 May 2025. Quality conversations – My Council Works Results will be shared in due course. 20 0% 5% 10% 15% 20% 25% 30% Mar-24 Mar-25 Page 56
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1 Meeting name: Integration Joint Board Date of Meeting: 28 May 2025 Title of Report: Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Presented by: Alison McGrory The IJB/Committee/Group is asked to: ▪ Note the content of the report, including progress towards the 2021-2025 Equalities Outcomes, for publication by June to meet the legal requirement ▪ Discuss/agree the proposed new Equalities Outcomes for 2025-2029, for publication by June to meet the legal requirement ▪ Note the requirement for an HSCP process to assess the impact of service changes and decision on children’s rights, as per the UNCRC legislation. These are known as Child Rights and Wellbeing Impact Assessments (CRWIA) ▪ Approve in principle the move to Argyll and Bute Council Integrated Impact Assessment (IIA) tool, in order for the HSCP to remain aligned to Argyll and Bute Council processes. 1. EXECUTIVE SUMMARY The report sets out Argyll and Bute Integration Joint Board’s (IJB) continued commitment to advancing equality through the implementation of its statutory duties under the Equality Act 2010 and Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012. It focuses on progress made in delivering the IJB’s 2021–2025 Equality Outcomes, which are designed to help meet the requirements of the General Equality Duty. The 2021-2025 Equality Outcomes are: 1. People from identified groups, such as those with protected characteristics, will have improved access to the resources needed to support their health and wellbeing. 2. People from identified groups, such as those with protected characteristics, will be empowered to have an influence on how services are delivered, including when changes are made to services. 3. People from identified groups, such as those with protected characteristics, will have improved experiences of services Page 57 Agenda Item 8
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2 The report provides an overview of the progress against each outcome, with a wide range of supporting activities and interventions as examples. It builds upon the interim progress report published in 2023 and highlights significant achievements in outcomes 1 and 2. While progress on outcome 3 has been challenging, work is ongoing and this outcome will be carried forward into 2025- 2029 with a renewed focus and clearer delivery plan. The report also outlines the IJB’s new Equality Outcomes for 2025–2029. The outcomes were developed by reviewing the 2021-2025 outcomes and aligning them with the strategies of NHS Highland and Argyll & Bute Council. An online survey was conducted to test the clarity and relevance of the four new outcomes. Feedback highlighted the need for clearer language and more inclusive, practical actions, leading to revisions in the final outcomes 2025-2029 as follows: 1. Work Towards Fairer Health and Social Care for Everyone 2. Involve People and Communities in Shaping Services 3. Build Services That Feel Safe, Inclusive and Respectful 4. Work Together to Reduce Inequality Health inequalities are avoidable, unfair differences in health between groups, such as those defined by protected characteristics, socioeconomic status, or geography. The HSCP is committed to addressing these disparities by ensuring equal access, experience, and outcomes for all residents of Argyll and Bute, helping everyone lead healthier lives. By mainstreaming equalities, the IJB continues to promote equality, tackle inequalities, and ensure that services meet the needs of all people in Argyll and Bute. 2. INTRODUCTION The report outlines Argyll and Bute Integration Joint Board’s (IJB) responsibilities and progress in meeting the requirements of the Equality Act 2010 and the Equality Act (Specific Duties) (Scotland) Regulations 2012 through its 2021–2025 Equality Outcomes. It also introduces the IJB’s proposed Equality Outcomes for 2025–2029. 3. DETAIL OF REPORT The report outlines Argyll and Bute Integration Joint Board’s (IJB) responsibilities and progress in meeting the requirements of the Equality Act 2010 and the Equality Act (Specific Duties) (Scotland) Regulations 2012 through its 2021–2025 Equality Outcomes. It also introduces the IJB’s proposed Equality Outcomes for 2025–2029. Legal Context The Equality Act 2010 consolidates over 116 pieces of legislation and protects individuals from discrimination based on nine protected characteristics. Public bodies, including the IJB, are legally required to meet the requirements of the General Equality Duty: 1. Eliminate discrimination, harassment, victimisation and any other conduct which is prohibited under this Act. Page 58
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3 2. Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not. 3. Foster good relations between people who share a protected characteristic and those who do not by tackling prejudice and promoting understanding. The Specific Duties (Scotland) Regulations 2012 require the IJB to report on mainstreaming equality, publish and report on equality outcomes, review policies and practices, and ensure accessible equality information. As the IJB does not employ staff directly, workforce-related data (e.g., gender pay gap) is published by NHS Highland and Argyll and Bute Council. Equality Outcomes 2021–2025: Progress Overview In 2021, the IJB updated its equality outcomes for 2021 to 2025, building on the previous ones: 1. People from identified groups, such as those with protected characteristics, will have improved access to the resources needed to support their health and wellbeing. 2. People from identified groups, such as those with protected characteristics, will be empowered to have an influence on how services are delivered, including when changes are made to services. 3. People from identified groups, such as those with protected characteristics, will have improved experiences of services. Progress towards Outcome 1 includes a wide range of initiatives, such as the Child Poverty Action Plan, Planet Youth, Secondary Health Drama Programme, Community Link Worker Programme, and Living Well Grants. These have improved access to essential resources, particularly for families, young people, and under-represented communities. Under Outcome 2, the IJB has strengthened community engagement, ensuring that individuals, including those from protected groups, help shape services. Examples include strategic consultation on the Joint Strategic Plan, development of the Island Strategy, input into the UNCRC implementation, and collaborative efforts with the Alcohol and Drug Partnership and Women’s Health initiatives. While work on Outcome 3 has been challenging, the IJB has implemented equality and diversity training, Equality Impact Assessments, and strategic planning tools to improve service experiences. This outcome will be carried forward into 2025-2029 with a renewed focus and clearer delivery plan. Lessons learned from the current reporting cycle include the need for more robust monitoring and reporting systems to strengthen accountability and better reflect a fuller range of equalities work across the HSCP. Alongside this, to work to raise staff awareness of the new outcomes and how their roles can help embed them across the organisation. Also, the need for more accessible, inclusive and engaging report formats – easy read, youth, and plain English – to support clearer communication and fairer access to information for everyone. New Equality Outcomes 2025–2029 To comply with the four-year cycle required under the Specific Duties, the IJB will Page 59
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4 introduce updated outcomes for 2025–2029. The outcomes were developed by reviewing the 2021-2025 outcomes and aligning them with the strategies of NHS Highland and Argyll & Bute Council. An online survey was conducted to test the clarity and relevance of the four new outcomes. Feedback, received from 116 valid responses, highlighted the need for clearer language and more inclusive, practical actions, leading to revisions in the final outcomes 2025-2029 as follows: 1. Work Towards Fairer Health and Social Care for Everyone: We want to improve access to care for everyone, especially people who face extra barriers or have worse health outcomes than others. 2. Involve People and Communities in Shaping Services: We want to work alongside people—especially those often left out of decision-making—to help shape local services. 3. Build Services That Feel Safe, Inclusive and Respectful: We want everyone—patients and staff—to feel welcome, respected and supported in our services. 4. Work Together to Reduce Inequality: We will work with others to tackle the wider issues that affect people’s health, inclusion and access to services. 4. RELEVANT DATA AND INDICATORS Not applicable. 5. CONTRIBUTION TO STRATEGIC PRIORITIES The Joint Strategic Plan 2022–2025 acknowledges the significant impact of inequalities on health and wellbeing and outlines the commitment to embedding equality throughout the delivery of its objectives during this period. 6. GOVERNANCE IMPLICATIONS Guidance: Please ensure that you have followed the appropriate governance structure taking consideration of the following areas prior to submitting your paper. 6.1 Financial Impact None identified. 6.2 Staff Governance/Culture Promoting equality and diversity is essential to fostering an inclusive workplace culture and delivering equitable services. This should remain a core element for all staff, actively supported by the HSCP and made accessible through the employing organisations, NHS Highland and Argyll and Bute Council. 6.3 Clinical & Care Governance None identified. 7. PROFESSIONAL ADVISORY Not applicable. Page 60
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5 8. EQUALITY & DIVERSITY IMPLICATIONS Guidance: This section seeks to ensure you have considered implications for equalities the items below meet specific duties in consideration of this over and above general considerations. Please ensure that you have considered the requirement for EQSEIA and fully completed if required. Committee support on recommendation for IJB decision making should be in place if pertinent. a. Fairer Scotland Duty b. Islands Act c. Children and Young People d. Climate Change This report demonstrates the IJB’s compliance with the Equality Act 2010 and the Specific Duties (Scotland) Regulations 2012. Its publication on the NHS Highland website supports transparency and enables monitoring by external bodies such as the Scottish Human Rights Commission. The report highlights the wide-ranging efforts undertaken by the HSCP to promote equality and diversity across its services and functions. The needs of people with protected characteristics—as well as those from remote, rural, and island communities, and other under-served groups—remain a top priority. This is demonstrated through actions such as the delivery of equality and diversity training, the consistent use of Equality Impact Assessments (EQIAs), the integration of inclusive principles within key strategies and plans, and the publication of equality outcomes. In line with national guidance, the 2025-2029 outcomes also incorporate commitments under the UNCRC and net zero obligations, to uphold children’s rights and to ensure climate action is fair—recognising that groups with protected characteristics are often more vulnerable to environmental change. An EQSEIA on the Equality Outcomes is not required, as the outcomes themselves are designed to advance equality. 9. GENERAL DATA PROTECTION PRINCIPLES COMPLIANCE No impact identified. 10. RISK ASSESSMENT Not applicable. 11. PUBLIC & USER INVOLVEMENT & ENGAGEMENT The new Equality Outcomes for 2025–2029 were shaped by policy frameworks, the equality priorities of both NHS Highland and Argyll and Bute Council, and public engagement. A short public online survey in April to gather feedback on the draft outcomes received 116 valid responses (from people living or working Page 61
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6 in the area). 89% of these respondents reported one or more protected characteristics (excluding sex and marriage). Based on the feedback, the outcomes and actions were revised to be easier to understand, grounded in real-life action, more accessible and inclusive, and more thoughtfully aligned. While this engagement provided valuable insights, the limited timescale was identified as a key learning point, along with a need for future targeted engagement with under-represented groups. This will be addressed in the monitoring and review plan for the current outcomes, ensuring more robust engagement ahead of the next cycle of refreshed Equality Outcomes in 2029. 12. RECOMMENDATIONS • That the IJB note the Argyll and Bute HSCP Equalities Mainstreaming report, including progress towards the 2021-2025 Equalities Outcomes, for publication by June to meet the legal requirement. • Discuss/agree the proposed new Equality Outcomes for 2025-2029, for publication by June to meet the legal requirement. • Note the requirement for an HSCP process to assess the impact of service changes and decision on children’s rights, as per the UNCRC legislation. These are known as Child Rights and Wellbeing Impact Assessments (CRWIA). • Approve in principle the move to Argyll and Bute Council Integrated Impact Assessment (IIA) tool, in order for the HSCP to remain aligned to Argyll and Bute Council processes. 13. DIRECTIONS Directions required to Council, NHS Board or both. Directions to: tick No Directions required x Argyll & Bute Council NHS Highland Health Board Argyll & Bute Council and NHS Highland Health Board REPORT AUTHOR AND CONTACT Author Name: Helen Moffat Email: helen.moffat4@nhs.scot This paper has previously been reviewed in draft format at: Meeting Reviewed (tick) Date Finance & Policy Committee e.g. Audit & Risk Committee Clinical & Care Governance Committee Page 62
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7 Strategic Planning Group Argyll & Bute Council NHS Highland Board Community Planning Partnership Other SLT 30.04.2025 Page 63
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 2 Contents 3 4 6 6 6 7 8 8 9 9 10 10 11 12 12 13 13 13 14 14 15 16 16 16 17 17 17 18 18 19 19 21 21 21 21 22 23 23 INTRODUCTION ................................................................................................................................................. LEGAL CONTEXT ............................................................................................................................................... PROGRESS WITH 2021-2025 EQUALITIES OUTCOMES .................................................................. 1. Outcome 1: People from identified groups, such as those with protected characteristics, will have improved access to the resources needed to support their health and wellbeing ........................................................................................................................................ 1.1. Child Poverty Action Plan ................................................................................................................. 1.2. Planet Youth .......................................................................................................................................... 1.3. Secondary Health Drama Programme ......................................................................................... 1.4. School Support Services .................................................................................................................. 1.5. Adult Population Screening Programmes .................................................................................. 1.6. Community Link Workers ................................................................................................................. 1.7. Living Well Grants ............................................................................................................................... 1.8. Money Counts Training ..................................................................................................................... 1.9. Mental Health and Suicide Prevention Training ........................................................................ 2. Outcome 2: People from identified groups, such as those with protected characteristics, will be empowered to have an influence on how services are delivered, including when changes are made to services ..................................................................................... 2.1. Argyll and Bute Joint Strategic Plan (2022-2025) Engagement ......................................... 2.2. Coll Health and Social Care Needs Assessment ..................................................................... 2.3. Island Strategy ..................................................................................................................................... 2.4. Child Poverty Action Plan ................................................................................................................ 2.5. United Nations Convention on the Rights of the Child .......................................................... 2.6. Alcohol and Drug Partnership Engagement ............................................................................. 2.7. Women’s Health ................................................................................................................................. 3. Outcome 3: People from identified groups, such as those with protected characteristics, will have improved experiences of services ......................................................... 3.1. Staff Training ........................................................................................................................................ 3.2. Equality Impact Assessments ......................................................................................................... 3.3. Joint Strategic Plan ............................................................................................................................ 3.4. Routine Feedback Mechanisms .................................................................................................... 3.5. Medication Assisted Treatment (MAT) Standards .................................................................... NEW EQUALITIES OUTCOMES FOR 2025-2029 ................................................................................ Developing the Outcomes ......................................................................................................................... Engaging the Public ...................................................................................................................................... What We Learned .......................................................................................................................................... How We Responded ..................................................................................................................................... Outcome 1: Work Towards Fairer Health and Social Care for Everyone .................................... Outcome 2. Involve People and Communities in Shaping Services ............................................ Outcome 3. Build Services That Feel Safe, Inclusive and Respectful ......................................... Outcome 4. Work Together to Reduce Inequality ............................................................................... Learning and Future Considerations ....................................................................................................... Next Steps ........................................................................................................................................................ Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 2 Page 66
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 3 Introduction The Argyll and Bute Health and Social Care Partnership (HSCP) brings together health and social care services and was formed in April 2016 by NHS Highland and Argyll and Bute Council. The HSCP is managed by the Integration Joint Board (IJB), which is responsible for improving health and wellbeing for people in Argyll and Bute and delivering services to the local population. The IJB is committed to integrating equality into all aspects of its work, in line with the Equality Act 2010 (Specific Duties) (Scotland) Regulations 20121. “Mainstreaming equality” means making sure that all HSCP functions consider equality, ensuring everyone in Argyll and Bute has equal opportunities, regardless of their background. It is a long-term commitment that ensures that equality and diversity is part of cultural change and organisation development and behaviour. Health inequalities are the systematic, avoidable, and unfair differences in health between groups, including those defined by protected characteristics, socioeconomic status, disadvantage, or geography. These disparities prevent everyone from achieving the highest possible standard of physical and mental health. The HSCP is committed to tackling these inequalities, ensuring equal access, experience, and outcomes for all residents of Argyll and Bute, so everyone can lead healthier lives. The Equalities Outcomes set the HSCP’s equality goals for a four-year period. Progress is reported every four years, with an interim update every two years. In 2021, the HSCP updated its equalities outcomes for 2021-2025. An interim progress report was published in 2023, and this report outlines the progress made since then. It also sets out the new equalities outcomes for 2025-2029, with an interim report planned for 2027 to track progress. 1 The Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 3 Page 67
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 4 LEGAL CONTEXT 2 Equality Act 2010 The Equality Act (2010)² combines over 116 separate laws into one single act, providing a legal framework to protect individual rights and promote equality for all. It also introduced the Public Sector Equality Duty, which includes both a general equality duty and specific duties. The ‘General Equality Duty’, part of the Equality Act (2010), requires public authorities to consider equality and good relations in their daily business. For Argyll and Bute IJB, this means the legal obligation to pay due regard to the need to; Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act. Advance equality of opportunity between people who share a relevant protected characteristic and those who do not Foster good relations between people who share a protected characteristic and those who do not. The Equality Act (2010) protects people from discrimination based on nine protected characteristics: age, race, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation. The three aims of the general equality duty applies to all protected characteristics, except marriage and civil partnership, which only relates to the first aim. ✓ ✓ ✓ Page 68
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 5 The Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 lists the specific duties which are required to help public bodies meet the general equalities duty. For the IJB, these duties include: As the IJB does not employ staff directly, employee and gender pay gap information is published by the employing organisations—NHS Highland and Argyll & Bute Council—in their respective equality mainstreaming reports. • NHS Highland Equality Outcomes and Mainstreaming Report 2021-2025 • Equality and Diversity | Argyll and Bute Council (due to be published shortly). Report progress on mainstreaming the equality duty Publish equality outcomes and report progress Assess and review policies and practices Consider award criteria and conditions in relation to public procurement Publish equality information in a manner which is accessible. 1. 2. 3. 4. 5. Page 69
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 6 1. 2. 3. PROGRESS WITH 2021-2025 EQUALITIES OUTCOMES In 2021, the HSCP updated its equality outcomes for 2021 to 2025, building on the previous ones: Examples include: 1.1. Child Poverty Action Plan The Child Poverty Action Plan is one key initiative, which has introduced several programmes aimed at alleviating child poverty in Argyll and Bute. A graphic version of the plan was co-produced with children and young people to make it more accessible, directingindividuals to support services related to income, benefits, and the cost of living. People from identified groups, such as those with protected characteristics, will have improved access to the resources needed to support their health and wellbeing. People from identified groups, such as those with protected characteristics, will be empowered to have an influence on how services are delivered, including when changes are made to services. People from identified groups, such as those with protected characteristics, will have improved experiences of services. The following section highlights the progress made so far, with examples provided. However, this is not a complete list of all the work done to advance equality in these areas. Through our review, we have learned valuable lessons that will guide our approach for 2025-2029. This includes improving how we monitor and report progress across the organisation, especially in areas where progress has been slower than anticipated. 1. Outcome 1: People from identified groups, such as those with protected characteristics, will have improved access to the resources needed to support their health and wellbeing. The HSCP has focused on improving access to health and wellbeing resources for children, young people and families, as well as for adults, including those with protected characteristics. Together, these initiatives have made significant progress in improving access to essential health and wellbeing resources for individuals in Argyll and Bute. Page 70
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 7 Notable initiatives under this plan include the Flexible Food and Fuel Fund, which supported 3,218 cases between January 2021 and January 2025, helping low-income families with a total client gain of nearly £4.8 million. The Family Nurse Partnership Programme, launched in April 2024, has supported young mothers (aged 21 and under) from pregnancy through to their child’s second birthday, providing guidance and connecting them to other services. The School Clothing Banks initiative has helped 72 families in South Kintyre in 2023- 2024, with plans to expand. The Free Period Products initiative, launched in 2023-2024, provides free period products at over 250 locations across Argyll and Bute, and awareness of the scheme increased by 65% from 2022 to 2023. 1.2. Planet Youth Another significant initiative is Planet Youth, a national pilot in Scotland aimed at reducing risk-taking behaviours among young people and strengthening protective factors. From March 2022 to March 2025, the initiative has focused on five secondary schools in Argyll and Bute, with plans to expand to all ten secondary schools in 2025-2026. The Planet Youth team conducts a survey every 2 years with S3 and S4 students to gather data on risk and protective factors influencing their behaviour, which helps inform local action plans. For example, the surveys have highlighted a rise in vaping among students over the past three years, prompting the HSCP to collaborate with the Behavioural Change Team at Aberdeen University to develop a comic addressing the harms of vaping aimed at young people. This resource will complement the Secondary Health Drama Programme. Page 71
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 8 1.3. Secondary Health Drama Programme The HSCP funded school-based health drama programme has been running since 2017, delivered by Raenbow Productions. The programme, called ‘You Are Not Alone’, uses interactive drama, comedy, and music to explore social issues like peer pressure, social media, stigma, stereotypes, safe relationships, and the sharing of sexually explicit images. The programme has been delivered to S2 pupils across nine secondary schools in the region, with positive feedback. In 2024, double sessions were provided for both S2 and S3 pupils, in response to feedback to target S2 pupils specifically, since many S3 pupils had already encountered some of the issues addressed. The programme is effective in raising awareness of available support services, introducing pupils to professionals during the sessions, and encouraging young people to seek help when needed. 1.4. School Support Services A review of School Support Services has taken place, which included an online survey for young people in secondary schools and semi-structured interviews with teachers. Representation from schools and services also helped shape the development of the service specification. The School Support Services work closely with secondary schools to provide evidence-based alcohol and drug education, linking students to specialist services, such as school counselling. They work in partnership to ensure young people can access the support tailored to their specific needs, at the right time. The service also provides a listening service and offers advice on alcohol and drug use, using GIRFEC (Getting It Right For Every Child) assessment tools to connect young people with appropriate services. Page 72
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 9 1.5. Adult Population Screening Programmes Several initiatives, supported by Scottish Government funding, have been undertaken to address inequalities in the Adult Population Screening Programmes. In 2021, an initiative identified a need for better training for those assisting under-screened groups. In response, the HSCP, in partnership with NHS Highland, developed a TURAS training module in 2024 to help improve training for these professionals. Additional interventions include a Screening Brief Intervention introduced during smoking cession appointments between May 2022 and March 2024 to raise awareness about screening services. As well as awareness sessions in 2023 to encourage screening uptake among partner organisations supporting under-served groups, such as those with poor mental health. For 2024-25, local grants have been awarded to organisations like Argyll Wellbeing Hub, MECOPP (for Gypsy/Traveller communities), and Jean’s Bothy (for people with poor mental health) to further support under-screened populations in accessing screening. 1.6. Community Link Workers The Community Link Worker (CLW) Programme has been another key achievement in supporting individuals with social issues affecting health and wellbeing, such as debt, relationships, employment, housing, and loneliness. Between 2021 and 2024, NHS Highland commissioned “We Are With You” to provide the service to 12 GP practices, including across Argyll and Bute, focusing on areas with higher socioeconomic deprivation. The most common reasons for referral included mental health and wellbeing, loneliness and isolation, and financial advice. Positive outcomes were reported, with 90% of individuals who exited the service demonstrating improved wellbeing (of 58% of individuals exiting). A new CLW contract has been commissioned with “With You” for 2024–2028, with an expanded remote and rural service. Page 73
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 10 1.7. Living Well Grants The Living Well Strategy (2019-2024) promotes self-management for people in Argyll and Bute with long-term conditions or those at risk of developing them. Since 2021, Living Well Grants have been awarded to third sector organisations to support community projects aligned with the strategy’s goals. In 2024-2025, £23,000 is allocated to projects aimed at improving health and wellbeing in rural island communities, with a focus on connecting people to the right support, supporting self- management, and raising awareness of available community resources. 1.8. Money Counts Training The Money Counts Training initiative has helped individuals build confidence around discussing financial issues. It offers basic awareness sessions and promotes the use of the Worrying about Money referral leaflet, available in multiple languages, to guide people facing financial difficulties, and their support workers, to access local services. From 2023-2024 to 2024-2025, 53 participants took part in the training in Argyll and Bute, which helped increase their knowledge and confidence in discussing financial issues and signposting individuals to appropriate services. Page 74
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 11 1.9. Mental Health and Suicide Prevention Training Finally, Mental Health and Suicide Prevention Training aims to enhance knowledge around these areas through a variety of courses. These courses help people living or working in the area to provide brief interventions and signpost individuals to appropriate support services. Courses have been targeted at people who are more likely to encounter individuals experiencing poor mental health or suicidal thoughts. Between September 2024 and March 2025, 221 people have attended training courses in Applied Suicide Intervention Skills Training (ASIST), Scotland’s Mental Health First Aid, First Aid for Youth Mental Health, and the Ask, Tell workshops. Page 75
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 12 2.Outcome 2: People from identified groups, such as those with protected characteristics, will be empowered to have an influence on how services are delivered, including when changes are made to services. The HSCP is committed to empowering individuals, including those from protected groups, to influence how services are planned and delivered. This helps ensure decisions reflect the real experiences and needs of local communities. To support this, the HSCP prioritises meaningful engagement to make services more responsive and inclusive. Staff and services follow a clear and consistent approach set out in the Engagement Framework, which is aligned to the Scottish Government’s Planning With People guidance. As part of this process, services also complete an annual engagement tracker, to record planned and required engagement activity, helping to ensure that communities continue to be involved in shaping services. Examples include: 2.1. Argyll and Bute Joint Strategic Plan (2022-2025) Engagement The Argyll and Bute Joint Strategic Plan (JSP) (2022-2025) strives to ensure that people in the area will lead longer, healthier, and more independent lives. A central focus of the JSP, under the strategic priority of “Choice and Control and Innovation” is ensuring that all decisions are made in consultation with the people of Argyll and Bute, with a strong emphasis on delivering positive outcomes for those with protected characteristics. In 2022-2023, the HSCP engaged with the local community on how well the JSP was meeting its priorities and commissioning intentions after the first year of implementation. The engagement process included a series of community drop-in events, an online survey, and an online virtual event (although the latter had no participants). Additionally, the Chief Officer published an Online Vlog. These events helped identify what’s working well, the challenges and barriers to accessing services, and potential areas for improvement. Page 76
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 13 2.2. Coll Health and Social Care Needs Assessment The HSCP has also worked to include local communities in decision-making. The Coll Health and Social Care Needs Assessment (HNA) helped shape a redefined model of service delivery that addresses the needs of remote and island communities, including those with protected characteristics. The establishment of the Coll Collaborative Working Group in 2022 brought together local community representatives and partners to assess needs and formulate an action plan. The Coll Community Survey in 2022 was a key part of this process, enabling the community to voice its specific concerns and needs regarding health and social care provision. The HNA findings have been used to create an action plan to improve access to services. 2.3. Island Strategy Community engagement has been a central component in the development of the Island Strategy (expected in 2025). In 2024, engagement on the draft strategy involved soliciting feedback from island residents, including those with protected characteristics, about their specific needs for access. This was through an online web page containing the draft document, asset maps, appendices, and a survey. A webinar was also held, and people were encouraged to submit additional feedback via email. This engagement process was designed to empower island residents to have a voice in shaping the strategy and to ensure their needs are considered in the final version. 2.4. Child Poverty Action Plan Addressing child poverty has been another key focus, with consultations and co- production to involve children and young people on key issues like children’s rights and child poverty in 2024-2025. Feedback from children and young people was collected on the child-friendly ‘Plan on a Page’ and other potential initiatives, helping to identify what is working and where gaps exist, and ensure the involvement of children, young people and families in shaping future action. Additionally, the “Taking Action on Rural Poverty” project, running from September 2023 to August 2026. Led by the Poverty Alliance and funded by the Robertson Trust, it collaborates with the Argyll and Bute Child Poverty Action Group to explore new ways of addressing rural poverty in Scotland. The project includes a Lived Experience Panel, whose input is helping shape local solutions to poverty, ensuring those affected have a direct role in influencing services. Page 77
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 14 2.6. Alcohol and Drug Partnership Engagement The Alcohol and Drug Partnership (ADP) has also made strides in empowering communities to shape services through a series of engagements in 2023. A review of School Support Services was conducted through an online survey with 226 responses from secondary school students, alongside nine semi-structured interviews with teachers (plus one email response). This input helped shape the development of the service specification. 2.5. United Nations Convention on the Rights of the Child The HSCP has worked to ensure that children’s rights are embedded in all aspects of service planning and decision making, and services better reflect their needs. The United Nations Convention on the Rights of the Child (UNCRC), which became an Act in Scotland in 2024, guides this work. In 2024-2025, the HSCP contributed to the development and application of a UNCRC tracking tool, to identify and address gaps in children’s rights. It has also integrated these considerations into Equality Impact Assessment (EQIA) and Child Rights and Wellbeing Impact Assessment (CRWIA) processes. Furthermore, it is implementing Argyll & Bute Council’s Integrated Impact Assessment (IIA) Tool, which brings together EQIAs and CRWIAs to support a more systematic and consistent assessment to identify the potential impacts of proposed decisions – such as policies, programmes, and services – on children and protected characteristic groups, ensuring they are engaged and their views are taken into account. In addition, in 2024-2025, the HSCP created a graphic plan to inform new parents, single parents and early years professionals about children’s rights and the resources available to them. All schools in Argyll and Bute are also participating in the Rights Respecting Schools Programme in 2025, which educates children and young people about their rights and promotes respect for the rights of others. Page 78
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 15 2.7. Women’s Health The HSCP is also focused on women’s health, recognising the importance of giving women, including those from protected groups, a voice in shaping health and social care services locally. The findings from two surveys in 2023—the Public Women’s Health Survey and the Staff Women’s Health Survey—were used to inform a Women’s Health Action Plan aimed at addressing the barriers in accessing health services. A total of 249 responses provided valuable feedback on areas like sexual health, maternity, menopause, and gynaecology. These findings will directly shape improvements in services, ensuring that women’s voices are heard and their needs are acted upon. As part of the ADP Strategy Refresh, 23 stakeholder interviews were conducted between August and November 2024. Input from people with lived experience was gathered through recovery cafés, conferences, and third sector partners. This engagement ensured that people directly affected by substance use had a voice in shaping services and influencing change. In 2024–2025, a Health Needs Assessment was carried out to gather views on substance use and service needs across Argyll and Bute. An online survey with seven questions was shared through HSCP and Alcohol and Drug Partnership (ADP) networks, with 98 responses received. The same questions were used in nine focus groups involving 94 people with lived experience, including a group of secondary school pupils with lived experience of substance use in the home. These discussions helped identify community concerns and priorities. Page 79
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 16 3. Outcome 3: People from identified groups, such as those with protected characteristics, will have improved experiences of services The review acknowledges that it can be challenging to evidence progress towards this outcome, although there are ongoing efforts to improve the experiences of people accessing services. Key efforts include staff training, Equality Impact Assessments and the Joint Strategic Plan. Although specific intervention to progress this outcome have been challenging, steps have been taken and examples are given below. To ensure meaningful progress, this outcome .will be carried forward into 2025-2029 with a more focused plan for delivery. 3.1. Staff Training Improving staff knowledge and skills through training is a key way the HSCP supports better experiences of services for all. Equality and Diversity Training supports inclusive services and workplace culture. Health Inequalities Training enables staff to recognise how their roles may impact health inequalities and equips them to help tackle inequalities. Public Health Training raises awareness of key issues such as mental health, substance use, and suicide prevention, helping staff provide informed support. Together, these training initiatives contribute to more equitable and positive service experiences. 3.2. Equality Impact Assessments The HSCP has a legal responsibility under the Equality Act 2010 to consider equality in its public functions. One way to ensure this is through Equality Impact Assessments (EQIA), which assess how proposed changes - such as new or revised policies, strategies, procedures, or services - may affect different groups, especially those with protected characteristics. EQIAs identify potential negative impacts on specific groups before decisions are made. This helps to ensure decision-making processes are fair and no group is disadvantaged or excluded. They also help mitigate negative impacts and build upon positive impacts. All completed HSCP EQIAs are published on the NHS Highland website to demonstrate how equality is considered in our planning and decision- making. Page 80
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 17 3.4. Routine Feedback Mechanisms In 2024-2025, the HSCP reviewed existing feedback mechanisms to assess how well they capture the experiences of people, including from protected characteristic groups. This review identified that current mechanisms are not fully inclusive or representative, particularly of older adults, disabled people, and people from ethnic minority backgrounds. In response, the HSCP has developed a plan for more inclusive and representative service feedback. This includes a mixed-method approach that gathers both data and lived experience. While implementation has been delayed due to challenges with new IT systems, work on a broader complaints and feedback mechanism is actively progressing. 3.5. Medication Assisted Treatment (MAT) Standards The Medication Assisted Treatment (MAT) Standards, introduced in 2021 by the Drug Deaths Taskforce, aim to improve the treatment experience for individuals with drug- related issues. MAT combines medication with psychological and social support, offering a holistic approach to care. These standards ensure that MAT is safe, effective, accessible, and person-centered, providing individuals with the support they need. The HSCP is working to ensure that services in the Argyll and Bute area meet these standards. The standards focus on improving access to MAT, helping people stay in treatment, empowering them to make informed choices, and ensuring strong leadership and accountability in their implementation. By viewing individuals as more than their drug use, the standards help reduce inequalities and improve the overall experience for people accessing these services. 3.3. Joint Strategic Plan The HSCP also works to ensure that people from identified groups, including those with protected characteristics, have improved experiences of services through service improvement, strategic planning and transformation. The Argyll and Bute HSCP Joint Strategic Plan 2019-2025 aspires that people in the area lead longer, healthier, independent lives. This includes a focus on improving experiences by 1) ensuring that everyone who is part of providing support is trauma informed, and 2) promoting an inequalities sensitive approach, targeting resources where they will have the most impact. Transformation and service redesign are key elements of the Joint Strategic Plan, with annual updates on progress to ensure continuous improvement in services for all groups. Page 81
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 18 NEW EQUALITIES OUTCOMES FOR 2025-2029 These outcomes aim to reduce disadvantage and foster inclusion across all aspects of health and social care, particularly for individuals and communities with one or more protected characteristics (age, sex, race, disability, religion or belief, gender reassignment, sexual orientation, pregnancy or maternity, and marriage or civil partnership). In line with national guidance, the outcomes also incorporate our commitments under the UNCRC and net zero obligations. These highlight our responsibilities to uphold children’s rights and to ensure climate action is fair—recognising that groups with protected characteristics are often more vulnerable to environmental change. The outcomes were shaped not only by policy frameworks but by lived experience, captured through public engagement and local feedback. Following this, the review of progress against the 2021-2025 outcomes highlighted a need to carry forward Outcome 3: “People from identified groups, such as those with protected characteristics, will have improved experiences of services.” While this request came after the main engagement phase had closed, we have also reflected on how this intent is captured in the revised outcomes. Rather than presenting this as a standalone outcome, we have embedded its core purpose ensuring inclusive and equitable service experiences—across all four new outcomes. This includes a strong emphasis on improving access, promoting respectful and inclusive service delivery, and ensuring meaningful participation from people who are often underrepresented in decision- making. This approach also responds to feedback from our public survey, which highlighted that some previous wording—such as “identified groups”—felt distancing or reinforced a sense of “us and them.” By embedding the needs of people with protected characteristics throughout all outcomes and using more inclusive language, we hope to avoid unintentionally creating division while maintaining a clear focus on our legal and moral responsibilities. Developing the Outcomes We started by reviewing the 2021–2025 Equality Outcomes and comparing them with NHS Highland and Argyll & Bute Council’s strategies. From this, four outcomes were drafted to balance continuity with ambition. While these were aligned with strategic aims, they were initially written in a policy- heavy style. Before finalising them, we tested their clarity and relevance with the public particularly those outside professional or clinical roles. As part of our duties under the Equality Act 2010, Argyll and Bute Health and Social Care Partnership (HSCP) has developed new Equality Outcomes for 2025–2029 Page 82
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 19 Although protected characteristics are not individually listed in the outcome titles, they remain central to the delivery and monitoring of our work. We will continue to meet our duties under the Equality Act 2010 by embedding equality considerations across services and assessing their impact through Equality Impact Assessments (EQIAs), Child Rights and Wellbeing Impact Assessments (CRWIAs), and inclusive engagement. Engaging the Public A short public survey was launched in April 2025 to gather feedback on the draft outcomes. It received 157 responses, 116 of which were valid (from people living or working in Argyll & Bute). Notably, 89% of valid respondents reported one or more protected characteristics (excluding sex and marriage). Who responded? What We Learned Clarity was a key issue. While 66% found the outcomes clear or very clear, 43% described them as unclear, very unclear or neutral. Within the 43% who found the outcomes neutral or unclear, we noted the following patterns: This suggested that language used in the original draft didn’t always resonate— particularly with older men, those outside the sector, and some religious or disabled respondents. 43 respondents reported a disability 90 were aged 50 or over 13 identified as LGB+ 3 identified as transgender 4 were from an ethnic minority background 2 were pregnant or had recently given birth These numbers are broadly consistent with local demographics but highlight a need for future targeted engagement with underrepresented groups. ✓ ✓ ✓ ✓ ✓ ✓ Calls for plain English and practical, real-world language Frustration with aspirational statements lacking clear action Strong demand for joined-up, respectful services—especially in rural areas A mix of views on protected characteristics—some felt excluded or confused A desire for fairness and support without a sense of division 78% were over 50 63% were male 37% had a disability 47% held a religious belief 80% did not work in health or social care ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ “Sometimes equality talk just makes me feel like I don’t belong anymore.” Themes from open-text responses included: Page 83
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 20 How We Responded Based on what we heard through the survey, we revised the outcomes and actions to be Equality Outcomes and Actions (2025–2029) Outcome 1: Work Towards Fairer Health and Social Care for Everyone We want to improve access to care for everyone, especially people who face extra barriers or have worse health outcomes than others. What we’ll do: Easier to understand, using plain English and avoiding policy jargon Grounded in real-life action, with practical, achievable steps rather than abstract ambitions More accessible and inclusive, removing language that might create an “us and them” dynamic More thoughtfully aligned with our duties under the UNCRC and our commitment to a fair transition to net zero Rather than listing protected characteristics directly in the outcome statements, we chose to reflect their importance through the actions—such as improving accessible communication, involving children and young people, and considering the needs of disabled people or those affected by rural isolation. This approach recognises that many people do not realise they have a protected characteristic and avoids reinforcing a sense that equality work is “for other people.” Importantly, we also recognised that improving clarity isn’t about “over-simplifying” but about opening up the conversation— so that more people see themselves reflected in this work, and so that fairness is understood as something that benefits whole communities, not just specific groups. ✓ ✓ ✓ ✓ Provide health and care information in clear, accessible formats that meet different needs (e.g. large print, translations), especially when materials are updated. Use data that includes protected characteristics to check whether our services are reaching everyone fairly and to spot areas for improvement. Identify what might be stopping people from accessing services—such as transport, appointment systems, digital exclusion, or lack of face-to-face options—and take practical steps to reduce those barriers where possible. Carry out Equality Impact Assessments (EQIAs) and Child Rights and Wellbeing Impact Assessments (CRWIAs) when making service changes, so we understand how different groups might be affected. ✓ ✓ ✓ ✓ “Just say what you mean in plain English. If I don’t understand it, I’ll ignore it.” Page 84
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 21 Outcome 2. Involve People and Communities in Shaping Services We want to work alongside people— especially those often left out of decision- making—to help shape local services. What we’ll do: Ask about protected characteristics (where relevant) to help us understand who we’re reaching—and who we’re not. Involve children and young people in decisions that affect them, in line with our UNCRC duties. Be open about what we’ve heard and show how this has shaped decisions, for example using ‘You Said, We Did’ updates. Use engagement methods that are accessible and consider the environment, including options that reduce the need for travel. ✓ ✓ ✓ ✓ Outcome 3. Build Services That Feel Safe, Inclusive and Respectful We want everyone—patients and staff—to feel welcome, respected and supported in our services. What we’ll do: Review how our services and spaces work to make sure they feel inclusive and meet different needs. Provide training to support staff in treating everyone with fairness, kindness and respect. Support staff wellbeing and promote a workplace culture that values inclusion, dignity and safety. Reduce our environmental impact in ways that are fair and accessible—for example, using energy more efficiently without creating barriers for service users. ✓ ✓ ✓ ✓ Use a mix of feedback methods— such as surveys, focus groups, and interviews—so that people can share their views in ways that suit them. “Equality should bring people together, not split us up.” “We need to stop making it ‘us and them’.” ✓ Page 85
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029Page 22 Outcome 4. Work Together to Reduce Inequality We will work with others to tackle the wider issues that affect people’s health, inclusion and access to services. What we’ll do: Use Argyll & Bute Council’s Integrated Impact Assessment (IIA) tool to complete Equality Impact Assessments (EQIAs) and Child Rights and Wellbeing Impact Assessments (CRWIAs), helping us understand and address the impact of decisions on different groups. Partner with Argyll & Bute Council and local community and third sector organisations to design more joined-up, inclusive services. Include people with protected characteristics in planning for climate change, recognising they are often most affected by environmental risks. Support fairer local economies by promoting local jobs, community-led services and inclusive employment. ✓ ✓ ✓ ✓ “It all feels a bit vague and corporate.” “I didn’t realise I had a protected characteristic until I filled out this survey.” “Sometimes equality talk just makes me feel like I don’t belong anymore.” Page 86
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Argyll and Bute HSCP Equalities Mainstreaming Progress Report 2021-2025 and Equalities Outcomes 2025-2029 Page 23 Learning and Future Considerations Next Steps Finally, the survey responses surfaced some sensitive and complex issues around sex, gender reassignment, and perceptions of fairness. While sex and gender reassignment—both protected characteristics under the Equality Act 2010—are not explicitly referenced in the wording of the outcomes, they remain a core consideration in how we implement and monitor our work. We are committed to creating inclusive services that uphold legal duties and human rights, and to navigating this space with care, clarity, and respect for the diverse views and lived experiences within our communities. We also acknowledge that this is an evolving area and will remain responsive to forthcoming guidance from the Equality and Human Rights Commission (EHRC). This work has taught us that language matters—not just for clarity, but for inclusion and trust. Many people didn’t realise they had a protected characteristic and felt equality work was for “others.” A next step will be to improve awareness of how the Equality Act applies to everyone and why these outcomes matter. We plan to develop simple, engaging communications to support this. We also acknowledge the need for continued engagement with underrepresented groups—such as ethnic minorities, pregnant women, and trans people—whose small numbers in this survey still offered valuable insights. Future efforts will explore more tailored engagement methods. By continuing to listen and adapt, we aim to build a fairer, more inclusive health and social care system for everyone in Argyll and Bute. Share the new outcomes across staff and communities Develop materials to explain protected characteristics and their importance Monitor delivery through routine feedback and impact assessments ✓ ✓ ✓ Page 87
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May NC25-00131 Raigmore Hospital, Inverness If you need this document in a different format, such as large print or easy read, please get in touch with us to discuss your requirements at: nhsh.abhealthimprovement@nhs.scot Page 88
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Live and Work in Argyll & Bute Work in Argyll & Bute Live in Argyll & Bute RESPONDENT DEMOGRAPHICS Respondents - living or working in Argyll & Bute 116 Number of respondents who have 1 or more protected characteristic PROTECTED CHARACTERISTICS 1+ NONE 89% 11% Aged 50+ LGB+ Transgender 37% 78% 11% 3% PROTECTED CHARACTERISTICS OF RESPONDENTS If you need this document in a different format please get in touch at: NHSH.ABHEALTHIMPROVEMENT@NHS.SCOT EQUALITY OUTCOMES SURVEY RESULTS Ethnic Minority Pregnant/Recently Gave Birth 3% 2% Have a Disability Found the draft outcomes clear or very clear 66% "I didn’t even realise I had a protected characteristic until I filled in this survey." Male Have a Disability Have a Religious Belief 78% 63% 37% 47% THOSE WHO DID NOT FIND THE OUTCOMES CLEAR Do not work in Health or Social Care 80% Aged 50+ Page 89
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1 Integration Joint Board Date of Meeting: 28 May 2025 Title of Report: Joint Strategic Plan 2022 – 2025 Year Three Progress Report Presented by: Charlotte Craig, Interim Head of Strategic Planning, Performance and Technology The Board is asked to: ▪ Note the JSP Progress report for Year 3: 2024 - 2025 ▪ Discuss what will be taken forward as priorities into 2025-2026 and for the future five year JSP 1. EXECUTIVE SUMMARY As noted in the previous update in March 2025 to the Integration Joint Board, The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty on Integration Joint Boards to develop a Joint Strategic Plan (JSP) for integrated functions and budgets that they control, reviewing the plan at least every three years. The JSP is a high level strategy which sets out the vision, strategic objectives and priorities. The JSP is linked with the Joint Strategic Commissioning Strategy (JSCP) which sets out priorities for commissioning and market messages for providers. The development of the JSP and JSCP is overseen by the Strategic Planning Group (SPG). The JSP is monitored on an annual basis. Service areas are asked for a progress report against each stated priority for that area. They are also asked for a RAG status and whether the priority should be carried forward to the following year which is scrutinised by the Strategic Planning Group. The progress reports will support the development of the future JSP for 2025 – 2030 as well as identifying what interim priorities will be focused on in 2025-2026. The IJB have agreed to the first draft of the next five year plan being presented to the IJB in September 2025. The IJB also agreed, in March 2025, that the reporting of the annual priorities (year 3) would allow the IJB to review and extend the plan with a focus on outstanding priorities until the new plan is in place. This approach would aim to provide the Integration Joint Board with a greater level of assurance that the final plan has considered the transformational requirement and taken cognisance of both operational and strategic risk. We are also cognisant of our requirement to look outward in respect of our wider partnership including stakeholder communities, be Page 91 Agenda Item 9
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2 explicit in our commissioning intentions and how we develop this to address our strategic risks and support sustainable service provision. 2. RECOMMENDATIONS The Integration Joint Board is asked to note the year 3 progress report and discuss the priorities which will be taken into the current and future years, what is no longer pertinent in the current climate and what moves into transformation or operational priorities. 3. DETAIL OF REPORT To allow a review of the strategic direction of the HSCP for the next five years, IJB was asked to support a short extension to the current plan based on the review of the year three priorities in May 2025. It was agreed that delivery of the first draft of the renewed strategy in September 2025 would be presented to the IJB for consultation approval. The progress report for the final year of the current plan (2022-2025) is now being presented at Appendix 1. All service areas are asked on an annual basis for progress against agreed priorities and whether these priorities will continue onto the next financial year. As can be seen from the report there is an extremely large amount of work that is being undertaken in all service areas within the HSCP. Many priorities are identified as being carried over into the next year. Some of the service areas have their own strategies and operational plans and governance of these plans. Other service areas may not have such structures, however this will be reviewed in the new plan. The IJB are asked to review this report with a view to discussing these service priorities within the larger, whole system approach to the wider strategic priorities and strategic direction of the organisation within the current financial climate. It is important that the new strategic plan and its priorities are realistic, align with staffing and financial resources and enable honest and transparent engagement with the communities we serve. This will take some additional time to create the JSP and ensure that it is written in accessible language. 4. RELEVANT DATA AND INDICATORS • Joint Strategic Needs Assessment. • Data and indicators from the Integrated Performance Framework • Financial Data: Analysis of budgets and actual expenditure; procurement information. • Service data. • User experience and provider feedback. Page 92
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3 5. CONTRIBUTION TO STRATEGIC PRIORITIES The plan sets out the Strategic Priorities of the Integration Joint Board which will inform the operational delivery of the delegated services. 6. GOVERNANCE IMPLICATIONS 6.1 Financial Impact – Financial planning remains challenging within an annual budgetary allocation. With a focus on sustainable service as a draft priority the Strategy will require to plan for a period beyond its lifetime. 6.2 Staff Governance – Workforce remains a strategic risk and a risk to the delivery of the plan. The Joint Workforce Strategy should align with long term joint planning so requires to look outwards to place and partners. 6.3 Clinical and Care Governance – Safe delivery of care is essential. We will work with communities and partners to support modernisation of care consistent with wider policies of reform, sustain access to services and develop innovative rural roles and practice. 7. PROFESSIONAL ADVISORY The senior leadership has met specifically to jointly address the required strategic direction using the identified data and noting the strategic and operational risk to sustainable delivery. 8. EQUALITY & DIVERSITY IMPLICATIONS The Strategic Plan will be subject to rigorous review to ensure it meets the highest standards. 8. GENERAL DATA PROTECTION PRINCIPLES COMPLIANCE No current impact on GDPR however wider partnership may impact data sharing agreements. 9. RISK ASSESSMENT There is substantial risk to the sustainability of the delivery of health and social care services in the strategic and operational risk environment without addressing changing demographics, their needs and workforce. Embedding rural flexibility in our planning approach will be key to delivering sustainable services in rural and island communities and preserving access to services. 10. PUBLIC & USER INVOLVEMENT & ENGAGEMENT The Integration Joint Board is developing its approach to collaborating with communities undertaking an asset based approach which is key to sustaining population and resilient communities. We will embed this approach in our engagement and consultation ensuring this is in line with national guidance. 11. CONCLUSIONS The Integration Joint Board is asked to note the JSP Progress report for Year 3 and discuss the future priorities which will be taken forward for the current year of 2025-26 and the future JSP. Page 93
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4 12. DIRECTIONS Directions required to Council, NHS Board or both. Directions to: tick No Directions required Argyll & Bute Council NHS Highland Health Board Argyll & Bute Council and NHS Highland Health Board x 13. PREVIOUS REVIEW OF THE REPORT Meeting Title of report Date Output (if relevant) N/A REPORT AUTHOR AND CONTACT Author Name Alison Ryan Email alison.ryan@argyll-bute.gov.uk Page 94
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Page 1 of 46 Year Three Progress Report Page 95
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Page 2 of 46 Table of Contents Children and Young People ................................................................................ 3 Child poverty ..................................................................................................... 4 Child Protection ................................................................................................. 6 Violence Against Women and Girls .................................................................... 8 Adult Protection............................................................................................... 10 Community Justice ........................................................................................... 12 Public Health .................................................................................................... 15 Right Care Right Time ...................................................................................... 20 Adult Care –Older Adults/Adults and Hospitals ................................................ 21 Learning Disability & Neurodiversity Services .................................................. 23 Mental Health .................................................................................................. 25 Primary Care (general practice) ....................................................................... 27 Dentistry .......................................................................................................... 29 Alcohol and Drug Partnership .......................................................................... 32 Allied Health Professionals (AHP) ..................................................................... 37 Carers .............................................................................................................. 39 Prevention Programme .................................................................................... 40 Digital Health and Care Strategy ...................................................................... 42 Technology Enabled Care (TEC) ........................................................................ 44 Corporate Services ........................................................................................... 45 Page 96
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Page 3 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. (previous updates below) Previous Service Update The Children’s Services commission services on an as needed basis. The services which are commissioned are dominated by external specialist placements costing up to £500k a year. Despite tight governance these placements are increasing in number. It is clear that the damage down by public health lockdowns is now showing through increasing need. This is does not feel like a ‘blip’ in the level of need but the new norm. This need will have to be met as often the issues are coming through at the level of child protection. Through the Whole Family Wellbeing Fund in conjunction with education & police colleagues we have commissioned the TSI to consider how we facilitate and mobilise the third sector in A&B. It is clear that funding streams for children come via Social Work, Education, Health, CPP and other routes. This can lead to a piecemeal approach. There is an imperative to look at how we consider commissioning and budgeting beyond professional or organisational boundaries. We need to be acting as a unitary children’s authority no matter where the organisational boundaries land. There is now a requirement for all funding to ensure it is child based. Children should not be disadvantaged by budgetary processes. Current Update from Commissioning There is currently a mapping of children and young people services being undertaken by A&B TSI as well as a review of all external placements. This will involve capacity building in the third and community sector. Engagement Activities Taken Place in 2024/2025 Engagement continues, a good example is: Child-friendly Reporting in Argyll & Bute Council | Improvement Service Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Continue to deliver on the priorities within the Children and Young Peoples Service Plan (CYPSP). No update provided, however CYPSP priorities continue to be delivered. Yes Continue to monitor and evaluate progress in all our service plans. No update provided, however all service plans continue to be monitored and evaluated. Yes Continue to deliver on the Corporate Parenting Plan. No update provided, however the Corporate Parenting Plan continues to be delivered. Yes Develop programme of change in relation to the Children’s Promise Change programme. No update provided, however the programme of change continues to be delivered. Yes Continue to engage with Children and staff on transformation agenda. Engagement continues, a good example is: Child-friendly Reporting in Argyll & Bute Council | Improvement Service Yes Page 97
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Page 4 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Look at how best to utilise progress we have achieved in data analysis in order to target those in not fully claiming benefit entitlement and advise them accordingly. Considerable progress has been made with improving ways of identifying those not in full receipt of benefit entitlement, enabling the benefits service and advice services to focus on them. Argyll & Bute has made an important contribution to data work on child poverty at the national level and continues to do so, helping to identify and work towards achieving legal gateways as well as improved use of data sets. Yes Employability Partnership to employ a Poverty Coordinator to work with those experiencing poverty and look at ways to improve their access to employment. This action was completed, and the Poverty Coordinator has contributed to improving access to employment, including producing a leaflet to support understanding, choice and decision making in this area. Yes Financial Advice and Inclusion Group and Child Poverty Action Group to continue to work together to identify and tackle factors that contribute to local cost of living concerns. This has continued to happen, and this working relationship is proving effective in identifying need, encouraging joint working, and monitoring change. Yes Review and revise the Communications and Engagement Plan and use to improve community engagement with child poverty work in Argyll and Bute. This has not progressed as was hoped in terms of direct work by the Child Poverty Action Group and this needs to go forward in the coming year. However, the Poverty Alliance have worked with the group on their project “Taking Action on Rural Poverty”. This project has set up a lived experience group that is now actively engaged, giving opinions and advocating actions. Yes Review staff training and development needs in the area of child poverty and begin to roll out poverty awareness training to staff. Money Counts Training has continued to be rolled out. However, funds have not been available to roll out other training, such as awareness raising etc. that would contribute to service improvement. Yes Look at changes in Argyll and Bute over the last three years, in terms of demographics and the economy / employability. How do these changes impact on the work and actions of the Child Poverty Action Group and its members? Considerable challenges to economies worldwide and continued instability has made it difficult to meet targets nationally. In Argyll and Bute transport and childcare provision remain key issues when addressing both the cost of living and employability, particularly in remote, rural and island places. Demographic issues, including an aging and reducing population, combined with housing shortages in some areas, to produce key worker shortages. The Child Poverty Action Group and its members continue to work together to address employment, benefit and cost of living challenges whilst identifying ways to tackle the impacts of child poverty. Yes Further develop the role and purpose of the Child Poverty Action Group and consider resource issues. The Child Poverty Action Group has welcomed new members. It has also played a key role on a national basis, with improving the use of data analysis in tackling child poverty. It has also partnered with the Poverty Alliance to establish a lived experience group to directly hear their views. On a national level, group members have taken part in important consultations and given evidence to government committees. Resource issues are currently being looked at as it is recognised that areas like training and coproduction require a budget. Yes Review the Child Poverty Action Plan and consider what is required to meet This took place and key areas identified, such as transport, housing, childcare provision and the islands premium were looked at. There Yes Page 98
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Page 5 of 46 Engagement Activities Taken Place in 2024/2025 Group members worked with the Poverty Alliance to forward the “Taking Action in Rural Poverty Project” and create and engage with a lived experience group. Children and young people were also asked their views on what would help to tackle child poverty for the 2023 – 2024 Child Poverty Action Plan Review. In addition, a graphic version of the Children’s Rights Plan and a graphic Early Years Plan were coproduced, both giving relevant visual information and pointing to advice / resource websites via QR codes. For the 2024 – 2025 review, the graphic Plan on a Page version of the review will be coproduced with children and young people. the Scottish Government final targets in 2030. Child poverty reduction targets in 2023. are external factors that mean that child poverty has risen slightly in nearly every region of Scotland and the Scottish Government will not reach its interim targets. However, Scotland is doing significantly better than England and Wales in this respect. Begin to develop a Data Base to improve monitoring and focus of resources locally. Begin to use it to improve the work of the Child Poverty Action Group and services locally. It has not been possible to progress this target this year and it requires to be carried forward. Yes Page 99
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Page 6 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Local Initial Case Review / Significant Case Review guidance will be updated to reflect changes in national practice and to provide practitioners with clear learning pathways (this work will be undertaken with APC colleagues. The guidance was updated and shared with relevant agencies to reflect any changes. This included a 7minute briefing paper. Further changes were announced last month when considering the interface between ASP and CP; including a change to reporting instructions to the care inspectorate. The guidance will need further amendments to reflect this. Yes Receive, evaluate and act on Child Protection Committee (CPC) & Performance, Quality and Assurance reports. Quarterly CPC will have a framework to implement good practice and develop QI approaches to improvement based on existing good practice. Multi agency dataset developed based on national minimum dataset and used by CPC to analyse data. Use improvement methodology and test of change to dig deeper into the data. There has been agreement to migrate to version 2 of the National minimum dataset, a report has been completed and will be shared with CPC next week (8/5). Managers have met collectively to create an additional analytic list of data that would be helpful when considering the data to inform local priorities and inform of key trends within CP activity. Further meetings are arranged to implement version 2 of NMDS. Following an audit of inter-agency child protection standards in March 2024 we established a senior leadership group to identify and improve standards. This also led to the development of a inter-agency front line managers group. Yes All new CPC members will receive a CPC induction pack and will meet with Lead Officer to discuss the role of the CP and expectations of CPC members All CPC members will attend CPC development sessions to contribute to the role and function of the CPC members will be required to demonstrate through the delivery of the CPC improvement plan that information is being disseminated within their organisation and that actions attributed to their organisation are progressed and reported to CPC. This is complete and all CPC members have met with the Lead Officer. There is a newly appointed CP Lead Officer in place who will continue with this role of supporting new members of the CPC and their induction. No Produce and implement a biennial strategic improvement plan which will be monitored by the Performance, Quality and Assurance using a RAG system. Red actions will be reviewed by Performance, Quality and Assurance and reported to CPC. The Strategic Leadership Plan and the CPC Improvement Plan have been merged. Mechanisms to monitor the progress of the plan (RAG system) has not yet been put in place but incomplete actions are discussed directly with CPC quarterly. Further considerations are needed to put a system in place to record this visually within the plan to report on and measure outcomes in a quantitative way. Yes Multi agency training will be delivered using a tiered approach to learning which will include: General contact workforce, Specific contact workforce and Specialist contact workforce. Level 1 and Level 2 CP training is in place and available on the training calendar. This is being provided in person in various locations across the partnership with all agencies/services encouraged to attend Yes Develop and implement training framework which supports practitioner knowledge and confidence in working with Child Sexual Abuse which includes Input has been provided to the management group to raise awareness of CSE and CSA but this has not been extended to practitioner training. The YPSP processes are currently being updated and this will inform future briefings and training sessions. This is an active plan for Yes Page 100
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Page 7 of 46 Engagement Activities Taken Place in 2024/2025 CPC Practitioner Forums arranged to take place: 30th April 25 at 12.30pm – Oban 13th May 25 at 12.30pm – Lochgilphead 22nd May 25 at 9.30am – Helensburgh 28th May 25 at 9.30am – Dunoon Bimonthly First Line Managers Meetings Bimonthly Strategic Leadership Meetings CPC Online Training Calendar – multiagency Multi agency briefing sessions were put in place to update on the IRD and Pre-Birth Processes Child Sexual Exploitation and child trafficking . implementation. Domestic Abuse Guidance and Flowchart implementation to be evaluated and regular audits of referrals to be carried out. DA guidance has been implemented, and full CP audit undertaken in March included cases chosen because of DA. Yes Improved interface between children & adult services particularly where parental mental health substance misuse and domestic abuse are present. Multi-Agency practitioner events are arranged, and all services are encouraged to come along to the training provided by CPC Training Coordinator. The CPC and APC have joint meetings every year. Further sessions and development required to align the child protection and adult protection processes, including updating the transitions procedures for children moving from children services to adult services. Yes Advocacy services will engage with children on the Child Protection register to understand their experience and to provide the CPC with recommendations as to how things can be improved. Advocacy remains in place with feedback from young people, families and agencies being very positive. Children are receiving a timeously service and building positive relationships with the advocate to ensure their views are represented within the CP process. Reports to CPC via report biannually. Yes Page 101
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Page 8 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Completion of the Transforming Responses to Violence Against Women and Girls Project. Project Board to carry out the Domestic Abuse-Informed Practice and Systems: Self-Assessment Tool and evaluate progress. The Transforming Responses to Violence Against Women and Girls Project was not concluded because Developing Equally Safe Funding was continued for another year. Project board did not carry out the Domestic Abuse-Informed Practice and Systems: Self-Assessment Tool and evaluate progress. Initial survey parts of the assessment process were completed. However, staff issues meant that the board was unable to meet to complete the process. Yes Completion of the Research Project. This is to be published and add to the evaluation process relating to the Transforming Responses to Violence Against Women and Girls Project. The research was completed in 2023, but decisions were made not to publish at that point. It will be published in 2025. No Consider the funding needs of the Violence Against Women and Girls Partnership in relation to key work areas and develop and submit a further bid to the next round of the Developing Equally Safe Fund. This process has not been possible or necessary. The Scottish Government did not make a final decision on the funding of the Violence Against Women sector and continued Developing Equally Safe Funding for another year. No Review the Argyll and Bute Equally Safe Plan. The Equally Safe Plan was reviewed and a new one completed; this is awaiting sign off by Chief Officers Group Public Protection. No Deliver Annual Return from Argyll and Bute to the Improvement Service / National Violence Against Women Forum. This was completed and delivered on time. No Roll out of the Safe and Together Model to continue and this to include 2 in-house Trainers to be trained. An in-house trainer did complete the trainer’s course but has subsequently left the Council. The roll out of Safe and Together has stalled due to unavoidable staffing issues. Yes Other training areas to be delivered including: Awareness Raising; Routine Enquiry; Harmful Traditional Practices; The Impact of Domestic Violence on Children and Working with Men. 2024 – 2025 saw the delivery of a very full and active Training Calendar. Between 1/04/2024 and 31/3/2025 a total of 20 training events took place, with 319 attendances. Yes Achieve improvement in services and pathways relating to women and girls with a Learning Disability experiencing or, at risk of experiencing domestic abuse. Whilst national training and awareness raising events were attended and information from these passed onto relevant staff, it is felt that sufficient progress has not been made in this area. Further work remains to be done. Yes Review progress of the transformation project and the delivery of the Equally Safe Plan. The Transformation Project was not formally reviewed but continued forward with Developing Equally Safe Funding. It was noted that the Safe and Together roll out was not able to move forward and this point due to staffing issues. The Delivery of the Equally Safe Plan was reviewed in the Annual Reporting process and the completion of an updated Argyll and Bute Equally Safe Plan and Strategy. Yes Have in place a Communications and engagement plan. This has not been properly developed, and work is required here. Staffing issues have been the main delaying factor. Yes Use the Domestic Abuse-Informed Practice and Systems: Self-Assessment Tool to establish a baseline for services prior to training and service change measures. This still requires to be done Yes Page 102
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Page 9 of 46 Engagement Activities Taken Place in 2024/2025 Whilst engaging with a broader range of staff in terms of domestic abuse awareness raising did take place, engagement / coproduction with lived experience women did not, beyond the activity of individual partnership members. This needs to happen in the coming year. It is hampered by the absence of any budget for this process. Research to assess the impact of the Transforming Responses to Violence Against Women and Girls Project, to begin. Some research has been done with regards to the wider training delivery. More requires to be done but the project is to continue for another year. Yes Review the Argyll and Bute Equally Safe Plan. This is completed. No Development of Data Base that will assist us to monitor trends in Domestic Violence and other gendered violence. A Data Group has been created but has yet to meet. Yes Deliver Annual Return from Argyll and Bute to the Improvement Service / National Violence Against Women Forum. This has been completed, annual process that will continue. Yes Page 103
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Page 10 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Monitor likely impact of national developments, mental health law review, national care service and other safety activity in trafficking etc. The Chair of the Adult protection Committee and Lead Officer continue to monitor national developments impacting Adult Support and Protection services in Argyll and Bute via their membership of the Adult Support and Protection Scotland Convenors group, The National Implementation Groups (resulting from the Revised Code of Practice), Social Work Scotland, Adult Support and Protection Subgroup and the National ASP Minimum Dataset sessions. Yes Develop enhanced service user/citizen involvement in processes and policy. The revised Code of Practice for Adult Support and Protection together with the recently developed Care Inspectorate Quality Improvement Framework (QIF) for Adult Support and Protection documents have guided us in developing enhanced service user, carer and citizen involvement in processes and policy. Ensuring meaningful involvement in adult protection case conferences remains a priority activity working with our colleagues in Advocacy services to ensure their voices are heard. The QIF has identified for the Adult Protection Committee what ‘very good’ involvement of adult at risk and their unpaid carers should look like. Ensuring meaningful involvement is a significant APC agenda item running through 2025/26 Yes Continue process of review and audit. We are currently undertaking a substantial review of our ASP service. Staffing challenges across social work have required us to evaluate our processes and develop new way of working. The QIF again is serving as an excellent tool to identify where improvements can be made in our activity. We are now preparing for our next substantial audit planned for May. We will be using the Care Inspectorate audit tool which we have revised, together with our method of file reading, to enable us to analyse particular areas of activity. Yes Develop improved data collection based on national dataset activity. The Scottish Government has continued to develop the ASP minimum dataset, via the Institute for Research and Innovation in Social Services (IRISS), with the aim of having a shared understanding of information. To generate more robust meaningful and comparative data. Collecting our data remains challenging as we adjust to the national dataset requirements as modifications are required to our File Recording system – Eclipse. The Lead Officer, colleagues from our Performance and Data Team and The Eclipse IT team all contribute to strive to meet these challenges, recognising the value of improved understanding of our services activity, and the ability to plan future services. Yes Review Significant Case Review (SCR) guidance and Code of Practice changes. We have now ratified and adopted Joint Child Protection and Adult Protection Guidance on Learning Reviews which have replaced Significant Case Reviews. We have received several notifications requesting consideration of a Learning Review and have been able to effectively use the guidance. No Develop protection links with Child Protection, Alcohol and Drug Partnership and Violence to Women. The Adult Protection Committee Chair and The Lead Officer maintain vital links with the Lead Professionals for Child Protection, Alcohol and Drug Partnership and Violence against Yes Page 104
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Page 11 of 46 Engagement Activities Taken Place in 2024/2025 National Implementation Group Chronologies - 10/04/2024 Joint Child Protection (CPC) Scotland and Adult Support and Protection (ASP) Convenors Scotland Group Meeting - 17/04/2024 ASP Quality improvement Framework Self Evaluation Guidance Workshop – 07/05/2024 Joint APC/CPC Meeting – 09/05/2024 Community Justice Partnership consultation and Engagement Session - 21/04/2024 Women and Girls. The Lead Officer is a member of their committees and contributes to events and activities. Continue staff support and contact programme. Staff support and contact has become more important than ever as we tackle the staffing shortages within social work, particularly the challenges this presents in ensuring safe and effective adult support and protection action. Team Manager, Council Officer Forums and the recent introduction of a daily ASP huddle are all designed to support staff in the completion of adult protection activities. Yes Meet the Improvement Plan targets arising from Inspection. We continue to strive to meet our Improvement Plan targets. Improvement in ASP is not a single step activity, rather an ongoing process. We have successfully introduced the requirement for Chronology and Risk Assessments however ensuring their quality will require continuous monitoring via regular review and audit. The Lead Officer is undertaking an overhaul of the original Improvement Plan to include the key guidance now addressed within the QIF. It is recognised that this document was prepared reflecting potential next stages for Inspection. Yes Implement Code of Practice changes. The Code of Practice changes continue to be addressed on a daily basis via 1-1 worker consults, social work supervision, specific ‘bitesize’ staff training sessions and at the quarterly ASP Forums. The changes have been substantial and have required significant re-evaluation of the way in which ASP activities have been historically undertaken. Yes Implement guidance for Primary Care and GP’s. The Adult Support and Protection Guidance for General Practitioners and Primary Care Teams continue to be promoted throughout primary care. Planned promotion of this guidance through direct contact with surgeries has been limited owing to competing priorities and further work in this area is required. Yes Progress audit activity, case files. We continue to request that SW Teams undertake monthly single agency case audit on a single ASP intervention and we are committed to ongoing annual case file auditing after our internal audit completed in March 2024. Yes Develop issues arising from Initial Case Reviews, Large Scale Investigation findings. We continue to use the findings from nationally reported Learning Reviews to inform our ASP practice through our ASP Forums, training sessions and supervision activities. We have focused particularly on ensuring most effective interagency communication and improving case recording, not least evidencing defensible decision making. Yes Develop ‘escalation’ policy. We regularly escalate concerns through the formal ASP Inquiry process as required. A draft escalation policy is currently being developed which will need to be adopted by a number of services, all having significant roles in the support and protection of adults at risk of harm. Yes Page 105
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Page 12 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Implement and monitor our local Community Justice Improvement Plan and performance framework. The publication of the Community Justice Improvement Plan has been delayed, expected May/June 2025. However, the Community Justice Partnership has been continuing to focus on progression of 10 national outcomes, 4 national aims and 13 priority actions. Multi-agency activity is ongoing across all the Community Justice Pathways: Point of Arrest, Through Prosecution (including Bail, Electronic Monitoring), At Court, Community Sentences and Liberation from Prison (including Remand). Production of the Argyll & Bute Community Justice Annual Report 24/25, submitted to Community Justice Scotland, is underway. The CJ Annual Report for 2023/2024 can be found here, page 104. (Public Pack)Agenda Document for Argyll and Bute Community Planning Partnership - Management Committee, 16/04/2025 10:00 Future reporting will be formatted around the Community Justice Pathways Yes Review the progress of the Justice Social Work (Community Justice) Service Plan, support future developments. The JSW service plan 2025 – 28 is being developed to establish new priorities and areas for development in line with Scottish Government policy and revised national guidance. The service plan will be linked into a wider overarching Performance and Quality Assurance Framework for the service. The need for an overarching framework was identified as a need following the self evaluation of JSW by Care Inspectorate in the latter months of 2024. We are still awaiting formal feedback from the Care Inspectorate on this. In relation to the JSW Service Plan 2022 – 25, I can report that most areas were achieved including • Improvements in Diversion from Prosecution practice, • Successful Implementation of new national Justice Social Work report template • Successful Implementation of new national Throughcare and Aftercare Release Licence Reports and protocols. • Continued rollout of Bail Supervision Scheme and use of Structured Deferred Sentences as per national policy direction • All Justice Social Work Staff trained in Schema Therapy and DBT to improve interventions and trauma responsive services • Implementation of Justice Eclipse system • Monthly Audit Programme ensuring regular audits across all areas of JSW activity • Completion of the LAAS pilot project to deliver voluntary throughcare service Notable areas of focus for the 2025 – 28 Service Plan include Pilot of Advance-D Domestic Abuse Perpetrator Programme Implementation of the suite of new/revised national guidance Yes Page 106
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Page 13 of 46 which will be introduced throughout 2025: Diversion from Prosecution, Bail Supervision, Home Detention Curfews, National Outcomes and Standards for Community Sentences Development of Unpaid Work Joint work with Recovery services Continuation of audit programme and focus on quality assurance Implement and monitor the improvements related to the jointly commissioned Violence Against Women & Girls research. There has been a delay in publishing the study, due in part to wanting to demonstrate progress on some of the recommendations so that this could be seen alongside the study. In the interim progress has been made in: • Awareness Raising and understanding of the Safe and Together model. • Developing a trauma informed workforce. • Informing staff skills base and understanding of the lived experience of women and children through a range of training events in key areas; these include: ➢ Trauma Impacts of domestic abuse on women and children and how to work with these. ➢ Routine Enquiry; asking the question. ➢ How the Police Deal with Domestic Abuse and support victims. ➢ Domestic Abuse and Child Contact Issues. ➢ Domestic Abuse in Single Sex, Female Relationships. ➢ Dealing with Disclosure of Sexual Assault. ➢ Animal Abuse as a Form of Coercive Control. ➢ Human Trafficking. ➢ Commercial Sexual Exploitation. ➢ Harmful Traditional Practices. ➢ Working with Perpetrators Towards Change. ➢ Working with Men; working with Fathers. Other things that have happened to improve staff awareness and skills and, hence, improve services to lived experience women, have included: • The increase in the number of key agencies who are members of the Violence Against Women and Girls Partnership. This supports better communication and joint working. • Information / leaflets for both staff and lived experience women are currently being developed. No refer to VAWG Section Carry out a validated self-evaluation of our Community Justice Partnership in line with the Care Inspectorate guidance. Ongoing. Prioritising of Legal Compliance; Leadership, Engagement & Partnership Planning; and Public Protection sections. Justice Social Work carried out a self-evaluation for the service during 2024/2025, awaiting feedback from the Care Inspectorate. No included as part of implementation of CJ Plan Review the learning from the first phase jointly commissioned research report for Violence Against Women & Girls and implement key recommendations. Refer to update above No Page 107
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Page 14 of 46 Engagement Activities Taken Place in 2024/2025 During 2024/2025 engagement continued the wide range of organisations and services included national and local public and third sector, this was based around the four aims, thirteen priority actions and ten national outcomes for community justice. Engagement with a range of representatives from the following: Children, Families & Justice Social Work Employability Partnership Housing Community Planning Area Planning Groups Police Scotland We Are With You Scottish Fire & Rescue Service Carr Gomm Skills Development Scotland Hope Kitchen Third Sector Interface Lomond and Argyll Advocacy Service Drug & Alcohol Recovery Service Blue Triangle Mental Health Service Inspiralba Health & Social Care Partnership Bute Advice Alcohol & Drugs Partnership Community Justice Scotland Violence Against Women Partnership Scottish Prison Service Scottish Government Scottish Violence Reduction Unit The activity focused on reviewing the requirements within the national documentation, creating baselines for where we are and identifying where there is capacity for improvement within current resources and what requires additional national resources. Page 108
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Page 15 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Continuation of previous year’s activity and new activity to be agreed in partnership. Argyll and Bute HSCP Public Health team continued to work on the below activities, agreed according to national priorities, assessment of local need and through joint working with a range of partners. Yes Deliver on joint Health Improvement plan between Argyll and Bute and north Highland. A joint Health Improvement plan has been developed between Argyll and Bute and Highland, with a view to delivering some activity NHS Highland-wide. The aim is to share learning and streamline pieces of work where relevant. In year three of this workplan, joint training continues to be delivered as follows: • Money Counts – virtual training opportunity which is available for any staff and partner organisations across NHS Highland and Argyll and Bute. This is delivered by Health Improvement staff and in year 3 was also supported by Argyll and Bute Council staff. It aims to raise awareness of poverty, how to raise the issue of money worries, and where to signpost/direct people for additional support. It also raises awareness of the Argyll and Bute Worrying About Money leaflet. In 24/25, 4 courses were delivered across NHS Highland, with 27 attendees. MAP of Health Behaviour Change – The aim of this course is to give practitioners skills and confidence to notice, discuss and support opportunities for patients to make and maintain behaviour changes. The course focuses on person-centred communication skills. In 24/25 3 courses were delivered to 27 attendees. The course continues to be delivered quarterly across NHS Highland and in 25/26 will be complemented by skills coaching sessions and training additional trainers. Yes Addressing inequalities: child poverty; poverty; children’s rights; equalities; The Public Health team have continued to undertake work addressing inequalities. This is threaded throughout all our work, and includes specific action as detailed below: • In partnership with Scottish Government Screening Inequalities Fund, we were able to increase capacity dedicated to reducing inequalities in screening programmes. A Health Improvement Officer worked with 3rd sector organisations in Argyll and Bute to build capacity for promotion of screening programmes using a £7500 grant fund. Projects included Wellbeing Walks, a community wellbeing festival, an art-based community engagement programme and producing culturally appropriate screening information for Gypsy/Traveller community. • The team has led on developing new Equality Outcomes for Argyll and Bute HSCP and completing an equalities mainstreaming report. This involved aligning to NHS Highland & Argyll and Bute Council equality outcomes, consulting with staff, services and public. These will be published in June 2025 with the Equalities Mainstreaming report 2021-2025, which details how the HSCP has mainstreamed equalities over this time period. • The team support the Welfare Advice and Health Yes Page 109
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Page 16 of 46 1 Note that some practices merged in 24/25, hence the change in GP practice number from 14 to 12. There was no reduction in service. Partnership (WAHP) in Argyll and Bute. This initiative aims to address financial insecurity for individuals who may not seek support from other means of welfare advice and in doing so contribute to improvements in health and reduce demands on Primary Care services. Funding was allocated to Argyll and Bute Council for additional resource for welfare advice specialists, for a 2-year remote and rural pilot for five GP practices.57% of clients had a long-term condition. Total client financial gain from Welfare Rights intervention from the start of the project is £315,560.50. The team play a role in supporting the HSCP with their statutory duties under the United Convention for the Rights of the Child (UNCRC). In 24/25 this has involved supporting the Argyll and Bute UNCRC group. The team have led a project on integrating ‘child rights and wellbeing impact assessments’ (CRWIA) into the existing impact assessments. This integrated impact assessment will be available to HSCP staff from 2025 onwards. Support the strategic direction and delivery of the Living Well Programme board and initiate implementation of the refreshed Living Well Strategy. Within this programme of work, projects include workforce development; self-management; community link working; physical activity; mental wellbeing. The Public Health team continue to support the Living Well programme board with strategic direction and operational delivery. This programme board uses the background of the Living Well strategy to inform a 5-year plan of prevention, by focusing on wellness, not illness, empowering and enabling those within Argyll and Bute to live well. Specific detail on activities is provided below: • Supporting Living Well Programme by providing Health Behaviour Change training to new Wellbeing Practitioners. • Supporting ‘Community Assets for Living Well’ workstream, which includes development of a new Walking Development Officer Post, rolling out Art of Hosting methodology across Argyll and Bute, and exploring opportunities for ‘single point of access’ to statutory and community services. • Evaluation of the 2019-2024 Living Well Strategy through focus groups with key stakeholders • Development of a strategy refresh plan for the Living Well Strategy 2025-2030. • Leading the tender process for the new Community Link Worker contract 2024-2028. This was informed by evaluation of the previous service and engagement with CLW and primary care staff. During 24-25, the service was available in 121 GP practices. Between March 2022 and December 2024, the service received 1224 referrals & 90% of those who received the service and completed an outcome questionnaire reported an increase in their wellbeing. In addition, the Public Health team worked with Living Well partners to draw in external funding for the service. This has resulted in a remote and rural service expansion from 2024 onwards and resource for evaluating CLW in island communities. • Work has continued to embed RSPB Nature prescriptions across Argyll and Bute. RSPB Nature Prescriptions are a free, non-medical approach based on accessible connections to nature that will improve wellbeing by engaging with nature in a personal and meaningful way. In Yes Page 110
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Page 17 of 46 24/25 these were used by Community Link Workers to connect people to nature and increase their wellbeing. • Living Well Community Capacity fund awarded Living Well grants to community projects and services which met the aims and outcomes of the Living Well strategy. In 2024- 2025, the grants focused on improving health and wellbeing in rural island communities through ‘connecting people to community activities’. £23,000 of grants were awarded • Support the delivery of the local suicide prevention action plan working with Argyll and Bute Strategic Suicide Prevention Group. In 24/25, capacity to support this work was increased via a new dedicated Health Improvement Senior post. Since September 2024, a range of suicide prevention and mental health training opportunities have been delivered across Argyll and Bute. These include 115 people trained in ASIST (Applied Suicide Intervention Skills Training), 41 in Scotland’s Mental Health First Aid (SMHFA), and 53 in Youth Mental Health First Aid (YMHFA). In addition, a group of 12 frontline staff took part in an "Ask, Tell" workshop – a training programme developed by NES and Public Health Scotland to improve understanding of suicide, self-harm, mental health, and compassionate conversations. • On World Suicide Prevention Day (10 September), council buildings were lit up in purple and a social media campaign helped raise awareness of available support. By the festive period in December, the Argyll and Bute Mental Health Hub had been developed to provide a centralised online resource for those experiencing distress or needing crisis support: https://www.ablivingwell.org/mental-health-hub. Recognising that not everyone has internet access, printed leaflets were also produced and distributed through third sector partners to ensure wider reach and inclusion. • The Public Health team continues to take an evidence- informed approach to all actions, and is committed to using timely and relevant data to support decision-making. With this in mind, links have been strengthened with Police Scotland, and more detailed data is now being received regularly to help us monitor local trends and shape targeted prevention activity. • The Smoking Cessation team within Public Health continue to deliver a service across A&B that targets the 40% most deprived communities but is available to all residents. There are 4 smoking cessation advisors within the team and during 24-25, they supported 76 people in their efforts to stop smoking. The team also promoted their service and highlighted the dangers of smoking at a number of community events. Work undertaken to scope sexual health promotion needs across Argyll and Bute including small focus groups with young people. A new Condoms by Post scheme has been developed in conjunction with NHS Highland and delivered by Health Information Resources Service (HIRS). ‘Speakeasy’ training for trainers has been commissioned from NHS Tayside. Speakeasy is a preventative community education programme which helps parents and carers tackle issues around children growing up, including body changes, safety, relationships & sexual health. Page 111
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Page 18 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. In 24/25, the Public Health team supported several contracts, and further detail is provided below: Heartstart: SLA with Greater Glasgow and Clyde - continues Living Well Network Coordinators: contracts ended in March 2025 following a review. In 25/26 team are exploring new ways of working with communities. Community Link Workers: 21-24 contract with We Are With You came to an end in December 2024. New tender process undertaken with revised specification. We Are With You were the successful organisation and now delivering the service from December 24. Cool2Talk: annual grant payment to Mid Argyll Youth Development Services and SLA with NHS Tayside ended in March 2025 following a review. Waverley Care: note that this contract was commissioned and managed by NHS Highland and was a pan-Highland service which ended in December 2024. Distress Brief Interventions: Due to operational reasons, the Public Health team have temporarily taken on oversight and support of the Distress Brief Intervention contract. This has included evaluation of the 25/25 contract and appropriate contracting process for the 25/26 contract. Engagement Activities Taken Place in 2024/2025 The Smoking cessation team continue to undertake engagement and awareness raising events throughout the year. This includes engagement with various professions to raise awareness of the service and increase referrals – including local pharmacies, AHPs, Social Work, Specialist Nurses, Primary Care, Community Link Workers, Midwifery, disability employment officers etc…The team also undertake community engagement, attending community events such as wellbeing festivals and engaging with Children and Young People during the S2 Drama productions. Every March there is a No Smoking Week, which sees awareness raising events of the service and the benefits of quitting across Argyll and Bute. This year smoking cessation advisors attended events in each community hospital, local shops and supermarkets and worked with Oral Health Improvement colleagues. The course helps parents to build on what they already know about growing up relationships and sex. Fifteen individuals representing a diverse range of professions which work with families and young people attended the initial training sessions and we are currently developing a plan for roll out. Building capacity for health improvement: education; community planning; locality planning; encouraging and supporting cross sectoral collaboration and community empowerment; engagement; place-based work. The Public Health team continued to build capacity for health improvement in partners and our communities. Our Living Well networks held quarterly meetings within their local areas and coordinators also attended Locality Planning Groups. In addition, communications, surveys, consultations etc from various sources (e.g. Public Health team, Locality Planning Groups, Third Sector) were sent out by email and social media via the Networks. The Public Health team regularly attended Area Community Planning Groups, relevant thematic Community Planning groups and Locality Planning groups to build capacity for health improvement and coproduction The Public Health team arrange webinar sessions open to HSCP staff and Third Sector. These have included webinars on: suicide prevention services by Breathing Space. The team have also built capacity through training delivery and commissioning for a range of topics including health behaviour change, suicide prevention, financial inclusion and sexual health. Further engagement activity is described below. Yes Page 112
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Page 19 of 46 There are four Living Well Networks throughout Argyll and Bute, with a dedicated LWN Coordinator for each Locality funded by the Public Health Team. The purpose of the Networks is to develop local partnership working and planning for health improvement activity. Although these networks came to an end in March 2025, they undertook a number of community events in 24/25 including partnering with Helensburgh Community Hub for a wellbeing festival and hosting a health and wellbeing day in Tiree. Engagement has driven the suicide prevention work delivered by the team. In 24/25 suicide prevention training was refreshed across Argyll and Bute and was informed by community and staff engagement which sought to find out training needs and preferred locations. Engagement also drove the development and launch of a new Mental Health Hub — Living Well in Argyll and Bute, a dedicated space on the Living Well in Argyll and Bute website to find support and resources for mental wellbeing and suicide prevention. This was developed following a needs assessment and is continuously updated following feedback from engagement. As part of the engagement work for the new Community Link Working contract, information sessions have been held for remote and rural GP practices. This is part of ongoing engagement with GP practices to scope and ensure the service best meets the needs of remote and rural communities. Three drop-in information sessions have been set up to provide an overview of the current service, discuss what the future remote and rural service will look like, and gather feedback from GPs about aspects of the service. In order to reduce inequalities in accessing screening programmes and following a request from Public Health Scotland, engagement was undertaken with the Gypsy/Traveller community via 3rd sector organisation MECOPP. This feedback will be fed back to PHS and used to tailor screening literature and identify new initiatives. Work has continued in 24/25 to engage on lessons learned from the Living well strategy and to inform the next iteration of the strategy. To-date relevant stakeholders have been invited to provide their view on what worked well, lessons learned and what could have been better. Previous health and wellbeing-related engagement has also been reviewed, in order to identify where there are gaps in ‘what we know’. Sexual health focus groups were carried out in an Argyll & Bute secondary school with a total of 11 young people in secondary 4 & 5. This was a lively discussion in order to understand their experiences of sex education, sexual health promotion and issues someone their age might have accessing contraception, condoms, emergency contraception and other sexual health related services. The feedback from this was used to inform initiatives. Page 113
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Page 20 of 46 Engagement Activities Taken Place in 2024/2025 Noted below in older adults/adults and hospitals. Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Consider models for community services with the aim of minimising different services/staff visiting people in community and improving flow through hospital. Assessment and care coordination reform. Focussed work around the review and redesign of extended community care teams, with re-ablement. Review and redesign of systems and processes for assessment and care coordination, including assessment and care review. TEC and Digital care. Introduction of reviewing officers and Discharge Flow coordinator role (whole system). Yes Plan and progress spend on the recurring funding from Scottish Government. All funding linked to KPIs and strategic older adult work. Sitting within a finance group. SG whole system action plan and funding bid has been progressed which is liked to ongoing CfSD leverage points and strategic drivers. No Enhancing multi-disciplinary community teams to be responsive, flexible, highly skilled, continually assessing with a re- abling and rehabilitation ethos and high quality end of life care with the skills to provide simple care that currently involves a hospital admission. Part of integrated processes and community standards work. Good progress in terms of mapping barriers and areas of change. Also considered above in terms of ‘’models for community services’’. Yes Enhance clinical education for all staff, develop skill mix, apprenticeships and health care support worker skilled roles. Sitting under any service change/governance. No Provide enabling care at home that is effectively commissioned and planned for those who need it, with enough capacity to be provided following assessment at home and at the point of need. These needs to link to the wider issue of the strategic approach to care at home (see below) and integrated approaches of how assessment and review of care is carried out. Discharge to Assess, focussed remodelling of reablement, TeC and digital are all key factors. Link with Care at Home below. Yes Page 114
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Page 21 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. (previous update below) Current Update from Commissioning Care at Home Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Extend the Community Hospitals into the community and provide a greater range of health related skills and services at home. Urgent Community Response and Hospital at Home ongoing development. Ambulatory Care. Virtual ward, OPAT and near patient testing. Yes Develop a community assets approach and identify a way in which people can be supported as much as possible within their own community before needing statutory services. Single Point of Contact review and redesign. Links with Living Well Programme and TSI. Ongoing work round the development of a ‘one front door approach’ which will be co- produced across all sectors. Standardisation of materials and processes currently in use. Assessment ethos to be enabling, with strengths and assets based approaches. Yes Developing a meaningful conversation with islands around our health and care services. Specific island work has been carried out on Mull and Tiree in relation to specific service developments. These needs widened to our overall island approaches. Link with overall islands approach No Set up a Self-Directed Support Steering Group in order to embed Self-Directed Support Improvement Standards. Standards are being reviewed but no steering group has been established. Consider integration of SDS across all areas of assessment and care coordination. Yes Support care at home through a challenging winter, linking unscheduled care elements to limit duplication and make best use of the total resource available. Link all these care at home actions into one key action for care at home. Links with Care at Home strategic development and community services redesign. Yes Develop a care at home strategy to agree and monitor key developments to build a flexible and sustainable service. Strategy developed and 4 sub-groups linked to organisational redesign; financial sustainability; training; digital. Pathways in and out of the service underway and the integrated processes work reducing duplication. Yes Develop an Older Adult Strategy. Completed and agreed. One year action plan to be completed. Review process to review and refocus actions has been developed to support the delivery of the strategy for its whole lifespan. Yes Develop a robust plan around winter planning, mapping out all elements of service delivery, what the pressures are and how they impact on each other. Completed – reviewed annually. No Work in partnership with providers, supporting elements such as recruitment, training to ensure best use of resources. Continuous, would see this as part of ongoing good governance work rather than a development in its own right. No Review the use of Extended Community Care Teams and link them to other community services. Underway, again linking with care at home and community developments. Yes Complete a building appraisal for internal care homes and develop an overarching care home and housing strategy. This will include the position of intermediate care within Argyll and Bute. The strategic work on care homes and housing is well underway with a demographic modelling and the development (underway) of options appraisal to inform future models. Closely linked with housing under the Care Homes and Housing Programme Board. The work on intermediate care has not yet begun in terms of its scope. Yes Page 115
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Page 22 of 46 There is a lot of agency use in OLI care at home due to issues with recruitment and retention. Options to resolve this are being looked at. Review of Community Resources Group (CRG) process to ensure equity of services and ensure that there are links to community assets Link to discharge protocol and establishment of single point of access; responder; enablement & re-ablement; palliative care model Ensure these services are part of a continuum of service Engagement Activities Taken Place in 2024/2025 Specific engagement with staff groups across the HSCP as part of the older adult strategy. This included a locality webinar for all LPGs; staff and professional leads workshops; work with the Older Adult Reference Group. Two provider forums were established for care at home and care homes. Page 116
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Page 23 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. (previous update below) Current Update from Commissioning Increased need for specialist neurodiversity services within Argyll and Bute in order to prevent requirement for out of area placements and support the repatriation of individuals back to the area, where appropriate Priorities Year 3 Progress Update Carried over 2025/26 Yes/No R A G Further development of specialist Core and Cluster housing to support individuals with complex needs and reduce the requirement for individuals to be placed out with the area. Core and cluster for 6 has been developed in Dunbeg and is at full occupancy. 4 person individual supported adapted tenancies, new build properties at the Sawmill site Helensburgh as a replacement for the Campbell St. service now operational in Partnership with Scottish Autism and Loretto Housing. 6 person individual supported tenancies in Rothesay currently being developed in partnership with ACAH and Affinity Trust. Direct replacement of the Morningside service with increased capacity. Other options for new build in Argyll and Bute also currently under consideration. Yes A Development of short, medium and long term housing strategy to ensure appropriate accommodation models for services users and affordable housing for H&SC staff. Involved with Corporate Services and other A&B and NHSH Departments to promote available and affordable housing options in a range of localities. No great movement to date but reasonable prospect of small scale limited success in 2 localities. Yes A Sustain and further improve on the positive feedback from external regulators regarding the quality of service provision (both internal and external). All internal services, the 5 day Services in Oban, Lochgilphead, Campbeltown, Rothesay and Dunoon, and the HMO, Greenwood in Campeltown have all been inspected with improvements across the grades in all. Further work being undertaken aligned to the priorities of the Services 3 year Improvement Plan. Yes G Reduce stigma in relation to learning disability and autism through delivery of joint training and/or awareness raising for staff across the HSCP. Limited training has been undertaken however a more comprehensive set of objectives are currently being worked up in respect of the Strategy developments referenced in the following section below. Yes A Development of A&B specific Learning Disability and Autism Strategies, in line with the A&B HSCP Engagement Framework. The Learning Disability and Neurodiversity Strategies are currently being refreshed with representation and support from Service users, families, carers, individuals with lived experience, NAIT, NHSH, A&B, 3rd and Independent Sector partners. Timescale for completion January 2026. Yes A Continue to utilise technology and telecare where appropriate to increase independence, whilst ensuring the safety and wellbeing of service users. The use of technology for individuals and service support providers is a central essential consideration in all our Service User focussed activity. The commitment is to maximise Independence, independence and safety within all situations, models of care and to recognise the financial challenges across the Partnership in relation to economies and budget considerations. In particular the use of Tech can help build confidence for individuals and their carers/families as we work in partnership to develop new models of care. Yes A Page 117
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Page 24 of 46 Review of Day Service provision across A&BHSCP to ensure equity, sustainability and services are fit for the future. Review all pre-placements residential care contracts for out-of-area placements, if not covered by SXL. Review all supported living contracts. Lead update: There have been no contract terminations. All services whether internal or contracted are subject to a programme of review/refreshment as required. Engagement Activities Taken Place in 2024/2025 Contract/service reviews with all commissioned providers. Development of new Respite opportunities with Key Housing and Enable. Development of new outreach Autism support service in H&L Scoping activities undertaken with HSCP Departments and 3rd/Independent sector providers for Supported Living, personal care and all the aforementioned. Page 118
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Page 25 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Consider and consolidate standardisation of processes; roles and responsibilities; care and support co-ordination and utilisation of effective training and delivery models (i.e. specialist / generic). Community guidelines are progressing well and will examine interface with other services across the mental health landscape. Team are progressing with scoping variance and impact of same Yes Further scoping of leadership and management of teams have enabled operations managers across the service. Full embedded No Establish clear pathways to keep patients in local hospitals before transferring to acute units and further develop community supports and strategies. A oversight looking at inpatient IPCU and inpatient dementia beds has been progressed, although at an early stage Yes Progress planned developments associated with Transforming Together agenda for mental health. Core and cluster not progressed – requires dedicated support to develop Yes Community Mental Health Services review and outcomes. Completed – this is several years on, the majority of outcomes have been met and those now not relevant noted No Psychological Therapies – we are working with the Scottish government to develop a business case to enhance and develop our PT services across A&B and to assist us to meet the expectations and demand for services in a timely and effective manner. The teams are now realigning to make an A&B wide service under one management structure to ensure better oversight of waitlist and service delivery at tier 3 and 4. Psychological therapies is now 1 team and managed by Consultant Psychologist, we have developed a successful partnership with Xyla to assist in wait times across A&B No The primary care mental health team have also realigned to work across GP surgeries and to support those presenting with mild and moderate mental health concerns. This team have a Multidisciplinary Team approach and have a wellbeing nurse, Occupational Therapy , guided self-help worker and primary mental health worker in each locality. This is fully embedded No Care Reviews. Required resource to support, scoping commenced Yes Inpatient services – addition of a consultant psychiatrist for the inpatient unit 3 days per week. Recruitment of Registered Mental Health Nurses remains fragile due to the national shortage and the inpatient environment holds large vacancies, support around recruitment and retention is well under way across NHS Highland. No progress in Consultant recruitment, currently sector consultants in reach to the ward. Recruitment in Mental health remains fragile and challenging across disciplines. We have the privilege to welcome International nursing colleagues over the last 2 years which has positively impacted and are supporting 4 earn to learn students. Retention premium is in situ until 2026. Yes Standardisation of processes; roles and responsibilities; care and support coordination and utilisation of effective Dementia team are offering inreach, training and support, variation will continue to be monitored and assessed by Clinical service managers No Page 119
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Page 26 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. New contract with Xyla for primary and secondary psychological interventions training and delivery models (i.e., specialist / generic), as appropriate to support mental health and dementia services locally Page 120
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Page 27 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Assess the impact on GP practices following the service redesign of Pharmacotherapy using a remote hub model. The hub is now fully staffed from March 2025 and a new skill mix has been introduced to provide input into the practices remotely. Systems and processes are still in development and referrals into the pharmacotherapy service are being looked at to identify which team member is the most appropriate to undertake the task. Once this is completed there will be consultation with the GP practices. There are also 2 development posts for pharmacy technicians in the hub and these reduce the input to practices. Yes Delivery of a strategy for island health and social care provision specifically for out of hours and urgent care. The draft Island Strategy has been completed and fully engaged on and awaiting decision on governance and accountability for actions prior to full publication. Yes Actions within strategy Establish a sustainable GP out of hours service for Jura, linking it with Islay and building community resilience. The Jura Out-of-Hours (OOH) working group has successfully reached a consensus on a new model for service delivery. This agreement marks a significant milestone since last years update, allowing the project to transition into the design and implementation phase. In this next phase, an implementation group composed of key stakeholders has been established. This group is tasked with the responsibility of taking the new model forward. Their role involves detailed planning, designing the operational aspects, and overseeing the implementation to ensure the model meets its intended goals of providing a sustainable primary care out of hour’s model of care. This phase will involve continuous engagement with all relevant parties to address any challenges and make necessary adjustments, ensuring the model's sustainability and effectiveness in improving out-of-hours services. Yes Implement transitional arrangements where practices continue to provide some services. In 2022, the National GMS Oversight Group approved a Rural Flexibility options appraisal submitted by the HSCP. The business case focused on 18 of our more remote and rural practices where it was clear that an HSCP delivered Community Treatment and Care(CTAC) and Vaccination service was neither cost effective or sustainable. 12 practices now receive a rural flexibility payment and claim reimbursement for vaccinations under an Item of Service arrangement. The HSCP agreed with NHS Highland Local Medical Committee (LMC) to regularly review these arrangements with all 18 practices. This process commenced in February 2025 and is ongoing with the full report to be submitted to the Primary Care Modernisation Programme Board and NHSH LMC in June 2025. The HSCP is committed to delivery of the other workstream services agreed under the 2018 GMS contract ( Pharmacotherapy, First Contact Practitioner Physiotherapy, Primary Care Mental Health and Community Link Workers) across urban and rural practices. Geographical and resource challenges have seen ongoing development of locally designed solutions including hub and digital infrastructure across the multi disciplinary teams. Where possible, measures have been implemented to improve equity between remote and rural and urban GP practices. Yes Page 121
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Page 28 of 46 Engagement Activities Taken Place in 2024/2025 • Jura Out of Hours Public Engagement event in September 2024 with follow up article inviting further feedback from Island residents in Jura Jottings following the event • Patient engagement done in both Inveraray and Furnace in 2024 • Coll and Colonsay Engagement for GP Interviews in 2024 Contribute to review of sustainable services on the island of Coll. We have recently appointed new independent General Practitioners for the Coll General Medical Services contract, which took effect on 1st April 2025. This new contract introduces a change from the previous model, with three GPs rotating to cover both in-hours and out-of-hours care on the island. This new approach offers a more robust and sustainable healthcare model compared to the previous system, where a single GP was responsible for delivering services year-round, often with limited time off and little reprieve from the demands of the role. The rotation system ensures that the GPs can better manage their workload, reduce the risk of burnout, and maintain a healthy work-life balance, ultimately improving the quality of care provided to the community. With this model, we anticipate increased stability in healthcare provision, offering residents and visitors to Coll a reliable and accessible service. Yes Co-location of Cowal Medical Practice and Church St Surgery in the Cowal Community Hospital, Dunoon. Due to the funding freeze on Premises Improvements last year, the original plans for moving GP practices into Cowal Community Hospital was paused. However, alternative plans are currently being considered. Yes Page 122
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Page 29 of 46 Dentistry Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Identification of service needs and associated development. Senior Dental Officer post fixed term recruited part time. Remainder of post reallocated to fixed term DO post Oban, 0.4WTE due to go to advert imminently. Work to increase service provision to Oban, Mid Argyll areas continues. DHT post recruited, NDIP provision now shared between DHT and DO which allows for more clinical availability. Yes Development of current services for Island communities and priority groups Shared mobile dental unit with Highland HSCP refurbished. Working with Estates team to ensure water safety and electrical safety compliance between HSCP areas. Joint project. Direct collaboration between Coll and Colonsay to identify services connections for MDU continues. Tiree – Regular visits from Dental Officer and DHT (Dental Hygienist Therapist), subject to flights and ferries timetable. Dental chair identified for refurbishment/replacement. Working with Estates colleagues to enable installation. Mull – Tobermory clinic remains extremely busy. Again, Estates Team input required to improve fabric of building. Dental Chairs in both surgeries and x-ray unit in one surgery replaced in 2024. IT/Network connection remains challenging, other items listed require Estates team input to progress (staff changing and kitchen/handwashing facilities, x-ray machine wall support). Bute – PDS clinic remains busy. General Dental Practitioner with enhanced ability to provide care for residents of care homes on Bute. Priority Groups/Secondary care options –GA or IV sedation services for complex care cases/anxiety cases: Currently no provision for this within A&B staffing cohort. External referral to NHSH North or GGC is only route for these patients. SLA and boundaries are unclear. Discussion and informal agreement with NHSH North, who will provide this service for Oban and will accept referrals to Inverness. Discussion with GGC on a case by case basis. Will accept from geographical area near to GGC but boundaries not set and SLA is unclear. Board input required to determine SLA with GGC and NHSH North. Collaboration with NHSH N SCP staff and A&B SDO and DO in Oban to assist with these cases locally in Oban, and provide robust referral pathway. Orthodontics: service is maintained within Primary Care, unlike other board areas where this service is delivered in secondary care setting. Currently supported by two Consultants (one GG&C and one Highland) on a rolling 6-monthly commitment basis. Service development includes up skilling of SDO to move into orthodontic care. Appropriate PG course identified and SDO enrolled in PGDip programme. Up skilling of one Dental nurse to Orthodontic Therapist underway (NES course) and expected completion Spring 2026 Oral Health Improvement: Looking to recruit to vacant post to cover Oban, recruited to cover Islay vacancy from Mid Argyll Yes Increasing access for patients in assisted and looked after accommodation Domiciliary dental care has resumed. Caring for Smiles Programme for Care Home staff has resumed and is now expanding to include Yes Page 123
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Page 30 of 46 Engagement Activities Taken Place in 2024/2025 Collaborative working with General Dental Services in co-located sites and the associated Bodies Corporate to assist with pressures around delivery of care. Continued engagement with Pharmacy team and Child Protection services to ensure robust policies are in place which are aligned with wider HSCP policy. Oral Health Improvement Team: Continue to be at the forefront of engagement throughout different sectors – Education, Health Partners, Social Work colleagues, Care Home Teams, Care at Home Teams, Addictions Teams, Forces Families settings. the ‘care at home’ sector. Oral health care shop to provide oral healthcare items at cost price to care homes piloted and successful. Expanded to other PDS locations in A&B. Feedback remains good. Increase skill mix in association with in- house training and also NES partners. Three Dentists and one Dental Hygienist Therapist are now providing Inhalation Sedation in PDS settings. All Dentists have the opportunity to complete AWI training. One clinician on waiting list for this. Clinician’s peer group meetings provide PDS focused CPD and learning. Child Was not Brought protocol developed in collaboration with A&B Child Protection Services, cascaded out to all team members, local familiarisation sessions to all team members. Yes Team building. Regular Team meetings and one to one meetings continue. SMT in person site visits occurring regularly. Monthly whole team cascade brief/PDS team brief via Teams to increase team cohesion. Face to face annual clinician meetings adopted to reduce professional isolation, along with virtual clinician meetings bi- monthly. SMT have established connections with other Primary Care Teams Leads via Primary Care meetings. Yes Standardising processes. SOP development continues across service to continue to improve service provision and ensure best practice is consistent across the service. Use of Datix incident reporting tool has been encouraged and is well used by the Team. This assists with learning and identification of SOP projects. Yes Fixed term recruitment in Orthodontic services. Weekend Consultant led clinics continue. Local service development and virtual consultation in progress to allow more non-Consultant activity during weekdays – end goal to have a weekday service led remotely by Consultant with regular but less frequent in-person visits, and staffed by Orthodontic Therapist and SDO with interest in Orthodontics. Yes In- house development of SDO for Orthodontic services. Enrolled in PGDip course. Currently Year one – PGCert on satisfactory completion. University of Plymouth course provider. Increased Orthodontic case mix locally available. Yes Move to baseline funding Baseline funding in operation Work underway to align SDS and CDS pays templates to reflect current staffing compliment. Yes Capital funding application for service improvements Capital Funding bids active currently: Autoclave replacement across all sites. LDU facilities failing. Ageing stock at end of lifespan. Dental Chair, Lochgoilhead clinic. Catastrophic failure necessitates replacement. Yes Page 124
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Page 31 of 46 Federation, Refugee and displaced persons population, Service providers for Adults with Additional Care Needs & third sector colleagues and families associated with the above groups locally over Argyll and Bute. The Oral Health Improvement team provides accredited training in oral healthcare in the Care Home setting and for those who Care at Home. Page 125
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Page 32 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Develop the ADP strategy. The final draft of the ADP Strategy Refresh 2025 until 2027 was presented at the ADP Strategy Group in March 2025 and the final version will be published after the ADP Strategy meeting in May 2025. The refresh work was lead by a steering group to who met 3 times during the project, at beginning, mid-point and end of the process. 11 national strategies and policy documents were identified of relevance to alcohol and drugs partnerships. 13 local (Argyll and Bute) strategy and planning documents were identified which showed clear connections to ADP current priorities. A wide range of engagement detailed below was conducted including semi structured interviews with ADP members, people with lived experience and engagement workshops. The areas of priority are Strengthening the Partnership, Prevention, Strengthening Recovery Orientated Systems of Care and A Public Health Approach to Justice. A Health Needs Assessment has been carried out in 2024 until 2025 and on track to be finalised by May 2025. Identification of the key areas will be progressed with the partnership aligning which the partnerships strategy and development of short to long term delivery plans. · Any specific findings highlighted in the HNA or focus groups in relation to JSP will be aligned and incorporated into this work. No Develop community hubs throughout Argyll and Bute. Recovery Café’s and Hubs have been supported by grant funding, enabling them to develop a wide range of work to support people in recovery. The Service Level Agreement with Community Learning Development 2024 until 2025 has enabled dedicated support to recovery communities in Helensburgh and Dunoon whilst supporting a test of change in Oban and an Argyll and Bute wide network. Yes Expand on the whole families approach. Scottish Families Affected by Alcohol and Drugs (SFAD) were commissioned in 2024 until 2025 to raise awareness and engage with families and services in Argyll and Bute. The high level goal of this work is to grow a model of family support that is connected and effective, utilises community assets, sustains, strengthens and upskills communities to create a cohesive and effective Whole Family Approach. SFAD in collaboration with stakeholders have developed a partnership plan informed by the gathering of evidence from families and those in services and supported by grant funding. SFAD have listened directly to people personally impacted and to professionals working within the community to reduce alcohol and drug harms, have held many conversations, 4 shorter hybrid workshops, and a conference. Yes Page 126
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Page 33 of 46 Through engagement, they identified priorities to support the development of a Whole Families Approach. A Whole Families Group has been re-established to continue to take forward this approach in Argyll and Bute. Community Reinforcement and Family Training (CRAFT) was commissioned by the ADP, and to date 20 attendees participated in the two day training course. Continue to deliver to the requirements of the National Mission. The ADP continues to work towards delivering the requirements of the National Mission, primarily through a range of sub groups identified to take forward the ADP action plan and progress MAT standards, ADP grant funding have supported activity in relation to the sub groups and work streams. Commissioned Community Alcohol and Drug Recovery WithYou commissioned work continues to deliver a wide range of outreach, training, support and services throughout Argyll and Bute. With You contribute to prevention, recovery, supporting those preparing, going through and coming out of residential rehabilitation accommodation, as well as the delivery of MAT services. A new “Recovery Skills” structured 10 week group work programme in 4 localities was provided and introduced some group work evaluation that will be gathered at week 1 and week 10. This will enable attendees to see progression and also help us to look at the content and see if there is anything that perhaps is not working well. So far verbal feedback has been very positive. A showing of Outrun was provided in collaboration with Campbeltown Cinema and provided an opportunity for celebration and With You supported people with Lived Experience of Alcohol and Drugs from each locality attend the Recovery Walk in Glasgow. This year With You celebrated their 20 year birthday with a heart warming event in Lochgilphead. Recovery groups attended with some confident enough to stand up and talk about their Recovery journeys, the event also enabled them to meet people from other recovery communities in A&B. Drug Death Reviews - A review of the Drug Death Review Group are meeting monthly to review drug related deaths. A pathway is being developed to ensure governance and utilisation of existing structures, the review had identified existing good practise and areas requiring improvement. The altered pathway will address some of the findings from the review. The terms of reference for the meetings are also under review. Twenty cases have been reviewed and concluded since 2022. Four reviews are in progress; while nineteen cases are awaiting review. Drug Alerts and Harm Reduction The local multi-agency group for Local Early Warning Systems has continued to meet monthly. Improvements to the groups communication has been implemented including a system of recording drug related incidents. This group links with Public Yes Page 127
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Page 34 of 46 Health Scotland’s Rapid Action and Drug Alerts Response (RADAR) team to develop local processes for drug alerts. Increased Naloxone supplies were purchased alongside increased Naloxone Training as part of a plan to mitigate against potential overdoses from drugs containing nitazenes. Planet Youth The ADP agreed to support the Planet Youth Icelandic programme with five secondary schools currently involved in the pilot. The Icelandic prevention model aims to keep young people safe, healthy and happy. Within the five schools, S3 and S4 pupils have completed a questionnaire and the results have been sent back for the local coalition groups to review and discuss how to make this a community wide programme. This work is supported by a full time health improvement officer and a Health Improvement advisor. Daniel Spargo Mabbs (DSM) Productions The DSM Foundation is a drug education organisation. Their drama production entitled “I love you mum – I promise I won’t die” was piloted in the Oban and Helensburgh communities. The hard hitting drama tells the story of Daniel with the aim to help other young people learn the lessons he sadly no longer could, and make choices that can keep them safe. The title takes Daniel’s joking last words to his mum, before he left home for what turned out to be the last time. Further planning is underway on how to develop this work to introduce it to other audiences and areas within Argyll and Bute. The School Drama Productions Programmes The ADP continues to contribute funding to the school Drama programme “You Are Not Alone” which is delivered across seven secondary schools. The performances provide an opportunity for young people to engage in questions with service providers, understand support that is available and connect with other services. The production for 2024 was performed for S2 and S3 and the feedback from the S2’s was much more informative. Following this review future delivery of this programme is aimed at the S2 cohort. Alcohol Brief Interventions Recordings of Alcohol Brief Interventions (ABIs) have been increasing in Argyll and Bute. The publication of new guidelines ceased reporting of ABI number to the Scottish Government. Argyll and Bute will continue to develop and raise profile of ABI’s in the wider settings. Developing Recovery Communities The recovery communities have been supported by the Argyll and Bute Council, Community Learning Development team in Cowal, Helensburgh and Oban. This has given dedicated local support to each of the groups and helping establish more of a Recovery Community. We have also been supporting a test of change in Oban to scope what each of the services do to support drug and alcohol recovery and how we can bring that together. With the support from Scottish Recovery Consortium we are supporting people with lived experience to be more involved in Page 128
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Page 35 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. • Community Addictions Recovery Contract with With You extended until March 2026 • New SLA with Argyll and Bute Council, Community Learning and Development for a Test of Change • New contract for the Delivery of Community Reinforcement and Family Training Programme • New contract for the Delivery of School Support Services until September 2026 with a range of local services • New contract for the MAT Experiential Programme with Scottish Drugs Forum • New contract for developing the Whole Family Approach with Scottish Families Affected by Alcohol and Drugs Engagement Activities Taken Place in 2024/2025 ADP Strategy Engagement Stakeholder interviews: A rolling interview programme was established, building from the ADP support team out to key partner representatives and including other stakeholders. Interviews began in August 2024 and ran to November 2024. Overall, 23 representatives were interviewed. Lived experience input was included through partners’ existing links at key points in the process. A focus group was held in Helensburgh recovery café and interviews were held at Dunoon recovery café and Inverary Whole Family Approach conference. Lived experience/frontline worker input was also sought through third sector partners With You (in Dunoon) and LAAS (online). The priorities of the emerging strategy were refined through 3 workshops which took place online in October-November 2024. All partners were invited, plus a range of wider public and third sector stakeholders. 10-14 people attended each one. Health Needs Assessment A HNA was carried out in 2024 to 2025. The surveys were distributed through the HSCP networks and the ADP networks resulting in 98 online surveys being submitted from Argyll and Bute. The survey consisted of 7 questions and were also used in the work of the ADP and provide feedback on the work we are doing in Argyll and Bute. Residential Rehabilitation For the period of 2024 to 2025, 19 placements for drugs and alcohol were funded by the multi-agency and multidisciplinary Residential Rehab Steering Group totalling £164,557. The ADP has also been working alongside Health Improvement Scotland to develop an action plan for the group. Bespoke training for GPs and Prescribers Training was commissioned from the Scottish Drugs Forum following the identification of learning needs by the Drug Related Deaths Review Group, and in consultation with GP colleagues. The three training sessions were held in February and March on the topics of Gabapentin, Ketamine and Benzodiazepines. Implement the revised approach to children and families. Following a review of the School Support Services a new specification which was developed in partnership with Education, Education Psychology, and the ADT Support Team. The contracts commenced for all council secondary schools in Argyll and Bute in August 2024 and data and contract monitoring is ongoing. The contracts provide specialist educational support, supporting young people engage with services, the Planet Youth project and the Violence Prevention Programme. This test of change is commissioned until August 2026. Yes Initiate MAT standards. Progress towards MAT Standards 1 to 10 continued in 2024- 2025. The MAT Standards Steering Group had oversight of this progress and fed into Scottish Government reporting as required. Grants were provided to ADP sub groups associated with the ADP Strategy priorities and MAT to support them progress actions plan. Remote and rural issues and sufficient resourcing to meet all the standards remains a challenge. Yes Page 129
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Page 36 of 46 focus group discussions which were held in the communities across Argyll and Bute, those who participated did so with lived experience of substance use. The aim of the focus groups was to understand community concerns, identify priorities, and determine indicators of progress in reducing substance-related harm. There were 9 Focus Groups with 94 participants of which one group of 8 high school children, 15 years old and over with lived experience of substance use in the home. Whole Families Approach SFAD have held 24 engagement meetings with service providers and families affected by alcohol and drugs to raise awareness of the Whole Family Approach and scope priorities for Argyll and Bute. An engagement event was held in Inveraray in July with 10 participants, following which a survey was distributed. In September SFAD hosted a Whole Families Approach Conference in Inveraray with 37 participants, thereafter two design events were held on the days following the conference. The priorities have been consulted upon and a group has been established to drive these forward. Addictions Recovery Bill Consultation The ADP hosted a consultation which was done in an online event on 16th December 2024, with 17 attendees present. Attendees were a wide range of partners from the ADP and HSCP. Following the consultation event and circulation of draft response, the final response as attached was submitted to the Scottish Government. Charter of Rights Consultation Consultation was done by the Independent ADP Chair and LAAS at the ADP Meeting on 20th May 2024. This was an in person meeting at Lochgilphead with 13 attendees. The consultation provided information and background on the Charter of Rights for People Affected by Substance Use and Ailsa provided a presentation on her involvement in the process nationally. The meeting noted that: ➢ MATSIN would be focussed on the Charter of Rights; ➢ That the Draft Charter was currently out for consultation, and AM / TM did a consultation exercise to seek the views of the ADP Members present on this. Following this consultation exercise, which asked specific questions, the responses were collated and fed back to the national group. Planet Youth The Planet Youth team held an event in Dunoon in September 2024 where we had over 20 stall holders show casing when activities they had to offer for Children and Young people in the local area. The day was well attended by 25 families. We also held a similar event in Lochgilphead where all the sports and clubs came along to give people taster sessions on what they had to offer and they also presented the volunteers with a certificate of thanks for all their hard work over the years. 15 families attend the event with most clubs getting new members signing up. Page 130
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Page 37 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Establish DCAQ or establishment setting cycles (as per the Health Care Staffing Act implementation).including development and high-level data quality for AHP dashboard. There is an established AHP dashboard based on a minimum dataset, taken from multiple systems and paper records. This has been made available to team leads, professional leads and managers and it is collated into a set of KPI’s that report to the IJB. These measures are currently being evaluated with a move towards a mixture of quantitative and qualitative data. As part of the boards implementation of the health & Care Staffing act five teams, one per large profession, have carried out a annual tool-run and establishment report. Findings and learning are currently being collated. Yes Deliver remote and rural MSK triage offer through PHIO App. Agreement has been achieved to fund the PHIO App for the next year to test its use as the front door to all MSK services across Argyll and Bute which ensures there is a self-management option for all patients, not just those in rural smaller practices. This will improve access to first contact physio and mainstream physio due to a large % of patients being managed with early self- management. This roll-out will be robustly evaluated. Yes Primary Care-increase of first contact to other professions.eg Dietetics. Our Dietetics service are involved in national discussions about expansion of primary care to other professions as part of the MDT. National negotiations for the next GP contract are underway; any expansion of the MDT will be dependent on the outcome of this. Yes New priority-develop Safe Quality Care structure to demonstrate quality metrics to support professional assurance. This programme is underway with an agreed annual audit cycle to gather relevant quality metrics and share across managers and professional leads. Yes Agree service specifications for all AHP Services and roll-out Job planning within teams. Service specifications are being drafted. Job Planning tool developed and is being rolled-out informally. Yes Address long waits-all over 52 weeks become priority 1. Establish rigorous triage in all AHP teams. Due to service pressures and recruitment issues it has not been possible to reduce all waits over one year. Yes Build in capacity for universal and targeted intervention with groups e.g. Aging adults, nursery children – whole population approaches to healthy living. The Living well programme has been implemented in each locality offering adults a physical-activity based prevention programme. Robust evaluation is in progress with consideration of longer-term service sustainability models. Work is developing with partners like Live Argyll to consider this type of offer for children and young adults. All professions are considering universal approaches but the system pressures described above mean it is difficult to change focus from reactive to preventative work. Yes Delivery of actions e.g. Guest lecturing, increase in student placement offers, progress of therapy apprenticeships. National discussions progressing about work-based training offers. We have robust practice placement support and coordination in place. Yes Continue to develop standard tools and process for establishment setting ready for cycle three. Agree establishments for A&B teams. As part of the boards implementation of the Health & Care Staffing act five teams, one per large profession, have carried out a annual tool-run and establishment report. Findings and learning are currently being collated. Yes Develop a dashboard for visible demand and activity data for AHP teams. There is an established AHP dashboard based on a minimum dataset, taken from multiple systems and paper records. This has Yes Page 131
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Page 38 of 46 Engagement Activities Taken Place in 2024/2025 There has been a focussed exercise, as part of the Safe Quality Care programme, to increase patient feedback through a Forms Survey. Most professions are now collecting feedback routinely. Outputs are being evaluated. been made available to team leads, professional leads and managers and it is collated into a set of KPI’s that report to the IJB. These measures are currently being evaluated with a move towards a mixture of quantitative and qualitative data. All AHP staff to do Health Behaviour Change training and review the professions offer to prevention. 4 courses have been offered. Yes Page 132
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Page 39 of 46 Please outline any activity in relation to service commissioning, i.e. revisions to specifications, new services, reviews of existing contracts. Terminations of contracts. (previous update below) Current update from Commissioning A new contract was developed and commenced in March 2023; the contract ends on 31st March 2026. This contract introduced a new service specification, updated terms and a clear and robust framework for contract monitoring. Planning for March 26 will commence in 2025. A new contract following feedback from unpaid carers was awarded for Money, Welfare and Related Advice for Unpaid Carers, delivered by ABCAB (2 year contract, ending January 2027) A contract is under development for additional Parent Carer Support and expected to be in 2025/26. Update Current contracts which provide Carer Services, remain in place until 31st March 2026. The current contracts provide the provision of support to individuals identified as unpaid carers, and in line with the statutory obligation as set out in the Carers (Scotland) Act 2016. During 2025, we will engage in contract discussions. Following feedback from the unpaid carers consultation in 2023, ABCAB have been awarded a contract to provide Unpaid Carers with Money, Welfare and Related Advice for Unpaid Carers. This is a 2-year contract and will run until 2027 Work has started to look at an information provision for A&B Parent Carers, who support Children and Young People with Additional needs in early years and schools. This work will conclude during 2025, with a contract being awarded to support parent carers. This piece of work follows on from a number of Parent Carers, who advised us of their need for accessible advice, information, and advocacy appropriate for their needs as parent carers Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Implementation of the Caring together Strategy. The Caring Together Strategy was published in 2024 . We are currently in the 2nd year of implementing the actions and commitments No Review of our Short breaks statement. Section 38 of the NCS (Scotland) Bill introduces significant changes to the current Carers (Scotland) Act 2016. It introduces a new legal entitlement: the right to personalised short breaks for unpaid carers. Nationally work has started to address this new piece of legislation. Whilst this is being carried out, we will not go out to review and engage on our SBS, we will wait the new regulations and guidance and ensure Carers from within A&B are involved in the national engagement. Our current SBS remains in use. Yes We will work with educational, cultural and leisure organisations to improve access for Carers to programmes and establishments across Argyll and Bute and beyond. Carer Organisations have expanded services across all areas of A&B and Carer number have increase by 19%. Education services now have a Young Carers policy and there are a growing number of schools involved in the Carers Trust Young Carers Challenge. No Review of the current Eligibility Criteria for Adults and Young People. This will be aligned with the new regulations and guidance that will be releases with NCS Bill- Right to a break. Yes Page 133
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Page 40 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Establish evaluation framework. An evaluation subgroup was established to deliver on the priority of an evaluation framework. The work in the Community Rehab and Wellbeing stream has robust evaluation plans in place both Qualitative and Quantitative. The Evaluation group will continue to develop an evaluation framework for the whole Prevention/Living Well Programme. Yes Work in parallel on delivery of community rehab and wellbeing service and developing sustainable model eg. Social enterprise. The delivery of the community rehab and wellbeing service commenced in January 2025 with good feedback already. Work is ongoing to develop the long term sustainable model for the programme with a Sustainability group meeting to be held in June 2025 to establish options and ensure cohesion between the community rehab and wellbeing stream and the community assets stream. Yes Continue Health Behaviour Training and consider workforce development of prevention /public health agenda. The Public Health team continues to deliver MAP of Health Behaviour Change training across NHS Highland/Argyll and Bute. Training is available quarterly and a number of new trainers have been trained in late 24/25. In 24/25, 4 courses were delivered. Yes Continue work outlined in two subgroups To enable the delivery of the rehab and wellbeing stream, Tier 1 and 2 were merged and these are being delivered by HSCP staff in liveArgyll facilities with support from liveArgyll staff. The Tier 3 continues to be carried out in the community assets for Living Well stream. Progress update relating to the Community Assets for Living Well includes: • Walking Development Officer Post – A Walking Development Post has been developed to promote walking initiatives as a means of improving health, social cohesion, and climate awareness in Argyll and Bute. The post will coordinate health walk initiatives at a regional level, develop communities of practice and provide overarching guidance and support for health walks and related activities across Argyll and Bute. This post is in the process of being recruited to. • One Front Door – The 'One Front Door to Wellbeing for All' project aims to improve how individuals in Argyll and Bute access health and wellbeing services. The current landscape of services, while diverse and comprehensive, can be difficult to navigate due to the region's geography and the number of service providers working across various sectors. People often find it challenging to know where to turn for the support they need, leading to confusion, duplication of efforts, and gaps in service provision. We are currently building a business case and engaging with HSCP groups to determine whether to move forward as a distinct third-sector health and wellbeing initiative or explore a broader, multi-agency, cross-sector approach. The latter would significantly widen the project’s reach but also require a much larger-scale effort Working with Communities - Art of Hosting is a participatory leadership method designed to empower community leaders. This Yes Page 134
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Page 41 of 46 Engagement Activities Taken Place in 2024/2025 The AHP Prevention Lead engaged with several key groups prior to the launch of the community rehab and wellbeing physical activity programme. Most notable were the Health Professional forums, as they would be providing the referrals into the programme. Ongoing engagement is required with GPs to ensure they are informed about the programme and are supported with making referrals. Engagement has also taken place on some of the islands to support delivery of physical activity programmes on Islay and develop delivery of community rehab and wellbeing physical activity on Coll. There will continue to be engagement with island groups to further progress delivery options in these remote and rural areas. project aims to cascade the training across Argyll and Bute, enabling local leaders to host workshops that strengthen community resilience. Art of Hosting training has been delivered to a range of partners, and work is ongoing to expand this ‘working with communities’ approach locally. Page 135
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Page 42 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Progress the National Care Service Implementation programme once primary legislation is in place from June 2022. Implement when defined single integrated digital services for health and social care staff as part of new Community Health and Social Care Boards. As the National Care Service will now be established through both legislative and non-legislative means, with reform of social care at the centre it is proposed the Bill will be known as the “Care Reform (Scotland) Bill”. If agreed by Parliament, as amended, the Bill will also bring forward significant reforms to social care, including: • Anne’s Law being enshrined into legislation to uphold the rights of people living in adult care homes to see loved ones and identify an essential care supporter • ensuring all those working in or supplying services to the health and social care sector follow the same information standards allowing easier communication • the creation of a National Chief Social Work Advisor post, in statute, to bring strategic leadership at a national level. The Bill will also retain measures to establish a legal right to breaks for unpaid carers. Ahead of the legislation, the Scottish Government has identified an additional £5 million in the draft 2025-26 Budget to support 15,000 carers to take short breaks from their caring responsibilities. The bill is currently at Stage 3 in consideration and in current form is likely to have less impact structurally as first anticipated. However Public Sector and NHS Reform are picking up pace and these will be featured in the renewed strategic plan. No Complete the digital modernisation transformation projects within our records and appointment services within the NHS and social care. Roll-out of CIVICA electronic document management system continues with scheduled completion of adult social care for June 2025. The next phase will be Children & families. Trak EPR programme in progress. Oban site due to go live summer 2025. Yes Contribute towards the achievement of net zero carbon emissions across HSCP services, working in partnership with Argyll & Bute Council and NHS Highland. Progress towards net zero carbon emissions across HSCP services continues albeit there is limited funding to improve the efficiency of properties in any meaningful way. Yes Complete our digital transformation where more is accomplished with less because of new ways of working by enhancing the Digital literacy and skills of our workforce - “Our people will need to train in new skills and adopt working in different ways- collaboration”. eHealth continue to provide up to date training around established IT systems, and future new systems to support the ongoing development of digital skills for our workforce. Yes Join up our HSCP teams by improving NHS systems and Council systems for easier data sharing. Enhance communication and collaboration using MS Teams federation. New and innovative ways to increase sharing of information is ongoing. Use of MS365 power apps. Yes Complete the final phase of our “Drone” beta service for clinical logistics in the West of Argyll leading national innovation in the use of this technology in the Scottish Health service. The drone trial using the Speedbird DLV2 drone delivered by Skyports between Islay and Jura has now been completed. Data from the trial has been thoroughly analysed, and feedback has been provided. This initiative, funded by the Regulatory Pioneering Fund, aimed to demonstrate the safe integration of drones in shared No Page 136
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Page 43 of 46 airspace and their potential for transporting school meals, Royal Mail goods, and NHS medical supplies. Our part in the Trial focussed on analysis of temperature control of selected medication and medical supplies during flight. The analysis and feedback will inform future decisions on the broader use of drones in healthcare logistics, enhancing service delivery and community resilience in Argyll & Bute. Page 137
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Page 44 of 46 Engagement Activities Taken Place in 2024/2025 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Ensure all Telecare clients have a digital solution in place. We are continuing to ensure Technology Enables Care (TEC) is a core service embedded in all aspects of delivery of care, which involves the promotion of all available services throughout patients/clients' journey and supporting colleagues to feel more comfortable using TEC available as a resource to support their delivery of care and free up time for direct patient care Yes Continue to develop NHS Near Me clinics to support clinicians in delivering remote clinics and supporting patients to attend appointments without the need to travel. o Continued promotion of NHS Near Me clinics to support clinicians in delivering remote clinics and supporting patients to attend appointments without the need to travel o Supporting roll out of further Silvercloud pathways o Trial and evaluation of digital homecare solutions including remote medication prompts and digital hydration kits. o Work with GP practices to promote further uptake of remote health monitoring for blood pressure. o Scope utilisation of remote health monitoring for asthma and heart in A&B HSCP and develop plans for subsequent years. • Ensure all telecare clients have a digital solution in place in time for switch-over from analogue to digital telephone lines Yes Expand digital solution across Argyll and Bute. See above Continue to develop NHS Near Me clinics to support clinicians in delivering remote clinics and supporting patients to attend appointments without the need to travel. See above Page 138
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Page 45 of 46 Priorities Year 3 Progress Update Carried over 2025/26 Yes/No Progress the National Care Service Implementation programme once primary legislation is approved. Support when defined single integrated corporate services for health and social care staff as part of new Community Health and Social Care Boards. As the National Care Service will now be established through both legislative and non-legislative means, with reform of social care at the centre it is proposed the Bill will be known as the “Care Reform (Scotland) Bill”. If agreed by Parliament, as amended, the Bill will also bring forward significant reforms to social care, including: • Anne’s Law being enshrined into legislation to uphold the rights of people living in adult care homes to see loved ones and identify an essential care supporter • ensuring all those working in or supplying services to the health and social care sector follow the same information standards allowing easier communication • the creation of a National Chief Social Work Advisor post, in statute, to bring strategic leadership at a national level. The Bill will also retain measures to establish a legal right to breaks for unpaid carers. Ahead of the legislation, the Scottish Government has identified an additional £5 million in the draft 2025-26 Budget to support 15,000 carers to take short breaks from their caring responsibilities. The bill is currently at Stage 3 in consideration and in current form is likely to have less impact structurally as first anticipated. However Public Sector and NHS Reform are picking up pace and these will be featured in the renewed strategic plan. No Progress the achievement of net zero carbon emissions across NHS commercial fleet, working in partnership with Argyll & Bute Council and NHS Highland. Progress towards net zero carbon emissions across HSCP services continues albeit there is limited funding to improve the efficiency of properties in any meaningful way. Yes Complete our digital transformation where more is accomplished with less because new ways of working with or without technology. Digital transformation is not about technology only – Our people will need to train and adopt working in different ways- collaboration. eHealth continue to provide up to date training around established IT systems, and future new systems to support the ongoing development of digital skills for our workforce. Yes Implement the new ECLIPSE IT system and increase the number of health staff using the single health and social care IT system. Eclipse Phase 2 implementation- OLM have provided a project plan for discussion at April Eclipse Board. Discovery session are being set-up to support MH and Child Health Teams as the last stage of the Eclipse roll-out across community health teams. This will mean that all community health teams will be using Eclipse by June 2026. Yes Join up our HSCP teams by improving NHS systems and Council systems for easier data sharing. Enhance communication and collaboration using Microsoft Teams federation. Awaiting future update from digital services on second phase of federation. Yes Complete the final phase of our “Drone service” beta service for clinical logistics in the West of Argyll leading national The drone trial using the Speedbird DLV2 drone delivered by Skyports between Islay and Jura has now been completed. Data from the trial has been thoroughly analysed, and feedback has No Page 139
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Page 46 of 46 innovation in the Scottish Health service. been provided. This initiative, funded by the Regulatory Pioneering Fund, aimed to demonstrate the safe integration of drones in shared airspace and their potential for transporting school meals, Royal Mail goods, and NHS medical supplies. Our part in the Trial focussed on analysis of temperature control of selected medication and medical supplies during flight. The analysis and feedback will inform future decisions on the broader use of drones in healthcare logistics, enhancing service delivery and community resilience in Argyll & Bute. Page 140
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# ID Date of Meeting Title of Report EQIA Required Author/Contact Presented By Decision (with/without Direction) / Info Comments Date 1 27/03/2024 Budget Proposal Yes James Gow James Gow Instructed the Chief Officer to accept Funding Offers from NHS Highland and Argyll and Bute Council and issue formal directions as detailed in the draft of the submitted report with proposed amendment. Complete 26/03/2025 2 27/03/2024 Budget direction James Gow James Gow Argyll and Bute Integration Joint Board (the IJB) Written Directions to NHS Highland This Direction is written under sections 26 and 27 of the Public Bodies (Joint Working) Scotland Act 2014. This direction will be for the period from 1 April 2025 to 31 March 2026. 4. Functions and Services to be delivered by NHS Highland NHS Highland will carry out the functions specified in Annex 1 and Annex 2 of the Integration Scheme dated March 2021. NHS Highland will deliver the services to which those functions relate. 5. Delivery of Functions and Services NHS Highland will carry out the functions and deliver the services in a way which complies with all legal and regulatory requirements and having regard to: e) The Integration Delivery Principles f) The National Health & Wellbeing Outcomes g) The Integration Scheme; and h) The Argyll and Bute HSCP Joint Strategic Plan 6. Finance The opening payment that will be made to NHS Highland for the period 1 April 2025 to 31 March 2026 will be £298,184,000 inclusive of the funds transfer to Argyll & Bute Council. The IJB has an un-identified savings target of £4,240,000 at the start of the financial year. The Health Board receives a wide variety of in-year allocations, therefore the budget allocation outlined above may be subject to change. The most up to date financial position will be reported to the IJB and the Council as agreed in the Integration Scheme. NHS Highland and the IJB will observe the roles and responsibilities as set out in the Integration Scheme for the management and the development of the budget. A further Direction will be issued following the financial year-end to set out the final payments. Complete 26/03/2025 3 27/03/2024 Budget direction James Gow James Gow Argyll and Bute Integration Joint Board (the IJB) Written Directions to Argyll and Bute Council This Direction is written under sections 26 and 27 of the Public Bodies (Joint Working) Scotland Act 2014. This direction will be for the period from 1 April 2025 to 31 March 2026. 1. Functions and Services to be delivered by Argyll and Bute Council Argyll and Bute Council will carry out the functions specified in Annex 1 and Annex 2 of the Integration Scheme dated March 2021. Argyll and Bute Council will deliver the services to which those functions relate. 2. Delivery of Functions and Services Argyll and Bute Council will carry out the functions and deliver the services in a way which complies with all legal and regulatory requirements and having regard to: a) The Integration Delivery Principles b) The National Health & Wellbeing Outcomes c) The Integration Scheme; and d) The Argyll and Bute HSCP Strategic Plan 3. Finance The opening payment that will be made to Argyll and Bute Council for the period 1 April 2025 to 31 March 2026 will be £99,887,000. This is in respect of the following: Argyll and Bute Council Requisition £82,058,000 Funding transfer from NHS Highland, initial estimate £14,865,000 Contribution from SPF Saving £2,500,000 Contribution from Reserves £464,000 A cash payment will be made by NHS Highland to Argyll and Bute Council to the value of the funding transfer. The budget allocation outlined above may be subject to change. The most up to date financial position will be reported to the IJB and the Council as agreed in the Integration Scheme. The Council and the IJB will observe the roles and responsibilities as set out in the Integration Scheme for the management and the development of the budget. A further Direction may be issued following the financial year-end to set out the final payments. Complete 26/03/2025 Page 141 Agenda Item 10
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