Agenda Document Pack - Moray Integration Joint Board - 25/09/2025
Moray Council · 25 September 2025
Back to Moray Integration Joint Board — 25 September 2025 and its agenda
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Moray Integration Joint Board Thursday, 25 September 2025 Council Chambers NOTICE IS HEREBY GIVEN that a Meeting of the Moray Integration Joint Board, Council Chambers, Council Office, High Street, Elgin, IV30 1BX on Thursday, 25 September 2025 at 10:00 to consider the business noted below. AGENDA 1. Welcome and Apologies 2. Declaration of Member's Interests 3. Minute of meeting of 19 June 2025 5 - 8 4. Action Log of 19 June 2025 9 - 14 5. Minutes - for noting 5a Minute of meeting Clinical and Care Governance Committee of 27 February 2025 15 - 18 5b Minute of meeting Audit Performance and Risk Committee of 27 March 2025 19 - 22 6. Membership of Board and Committees 23 - 28 7. Chief Officer Report 29 - 36 8. Revenue Budget Monitoring Quarter 1 for 2025-26 37 - 58 Page 1
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9. Moray Integration Joint Board Strategic Risk Register 59 - 92 10. Childrens Services Plan 2023-26 - Year 2 Annual Report for Year 2024-25 93 - 160 11. Health and Social Care Moray Annual Complaints Report 2024-25 161 - 190 12. Members Expenses 191 - 198 Watching the Meeting You can watch the webcast live by going to: http://www.moray.gov.uk/moray_standard/page_43661.html Webcasts are available to view for 1 year following the meeting. You can also attend the meeting in person. If you wish to attend in person, please come to the High Street entrance door and a member of staff will let you into the Chamber. Page 2
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MORAY INTEGRATION JOINT BOARD SEDERUNT Councillor Bridget Mustard (Chair) Councillor Peter Bloomfield (Voting Member) Councillor Scott Lawrence (Voting Member) Mr Derick Murray (Voting Member) Mr Sandy Riddell (Voting Member) Mr Dennis Robertson (Voting Member) Mr Alex Stephen (Voting Member) Councillor Ben Williams (Voting Member) Dr Adam Coldwells (Ex-Officio) Ms Karen Greaves BEM (Ex-Officio) Mr Ivan Augustus (Non-Voting Member) Professor Duff Bruce (Non-Voting Member) Mrs Sheila Brumby (Non-Voting Member) Mr Sean Coady (Non-Voting Member) Ms Sonya Duncan (Non-Voting Member) Ms Jane Ewen (Non-Voting Member) Dr Robert Lockhart (Non-Voting Member) Mr Jim Lyon (Non-Voting Member) Ms Deborah O'Shea (Non-Voting Member) Ms Judith Proctor (Non-Voting Member) Mr Michael Ritchie (Non-Voting Member) Ms Elizabeth Robinson (Non-Voting Member) Clerk Name: Caroline O'Connor Clerk Telephone: 07779 999296 Clerk Email: committee.services@moray.gov.uk Page 3
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MINUTE OF MEETING OF THE MORAY INTEGRATION JOINT BOARD Thursday, 19 June 2025 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Mr Ivan Augustus, Councillor Peter Bloomfield, Mrs Sheila Brumby, Mr Sean Coady, Ms Sonya Duncan, Councillor Elaine Kirby, Councillor Scott Lawrence, Dr Robert Lockhart, Mr Jim Lyon, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Mr Sandy Riddell, Mr Dennis Robertson, Mr Alex Stephen, Councillor Ben Williams APOLOGIES Professor Duff Bruce, Dr Adam Coldwells, Ms Jane Ewen, Ms Karen Greaves BEM, Ms Deirdre McIntyre, Ms Elizabeth Robinson IN ATTENDANCE Corporate Programme Manager; Self-Directed Support and Unpaid Carers Team Manager and Caroline O'Connor, Committee Services Officer ALSO IN ATTENDANCE Councillor Tracy Colyer 1. Chair The meeting was chaired by Councillor Elaine Kirby. 2. Declaration of Member's Interests The Board noted there were no declarations of member's interests. 3. Minute of meeting of 29 May 2025 The minute of the meeting of 29 May 2025 was submitted and approved. 4. Action Log of 29 May 2025 The Action Log of the meeting of 29 May 2025 was discussed and updated accordingly. Item 3. Page 5
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5. Revenue Budget Outturn for 2024-25 The meeting had before it a report by the Chief Financial Officer informing the Board of the unaudited financial outturn for the core budgets and the impact this outturn ill have on the 2025/26 budget. In introducing the report, the Chief Financial Officer apologised for an error in paragraph 9.1 with reference to the Asylum Seekers Grant of £701,000 which should have been classed as a grant carried forward rather than being included in ear marked reserves, and therefore the closing financial position on Reserves for 2024/25 should read £1,450,636 rather than £2,151,636 as stated in the report. Following consideration the Board unanimously agreed to:- (i) note the unaudited revenue outturn position for the financial year 2024/25; (ii) note the impact of the 2024/25 outturn on the 2025/26 revenue budget as detailed in paragraph 7; and (iii) approve for issue, the Directions shown in Appendix 4 to NHS Grampian and Moray Council. 6. Unaudited Annual Accounts The meeting had before it a report by the Chief Financial Officer informing the Board of the Unaudited Annual Accounts of the Moray Integration Joint Board for the year ended 31 March 2025. In introducing the report, the Chief Financial Officer apologised for an error in paragraph 4.3 noting the figures in the paragraph had been amended to reflect the amended Asylum Seekers Grant error referenced in the Revenue Budget Outturn report and the updated Reserves figure, however the sentence "this increase is primarily due to transfer of reserves from Moray Council to MIJB relating to Asylum Seekers granted during the year" should have been removed from the paragraph. Following consideration the Board unanimously agreed to:- (i) approve the unaudited Annual Accounts to be submitted to the external auditor, noting that all figures remain subject to audit, in Appendix 1; (ii) note the Annual Governance Statement contained within the unaudited Annual Accounts and in Appendix 3; (iii) note the accounting policies applied in the production of the unaudited Annual Accounts, pages 47 to 48 of the accounts; and (iv) approved the updated Local Code of Corporate Governance which supports the Annual Governance Statement, in Appendix 2. 7. Proposed Revision to the Moray Integration Joint Board Meeting Schedule The meeting had before it a report by the Chief Officer presenting the Board with a revised meeting scheduled for Moray Integration Joint Board and its Committees, with Page 6
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the aim of reducing the number of meetings held on the same day, minimising member fatigue, and enhancing the strategic focus of meetings. In response to a question from Mr Murray asking on days where only one meeting is to be held, if the start time could be pushed back from 9.30am to 10am, the Chair confirmed there was nothing in the Standing Orders stating that meetings require to start at 9.30am and sought the Board's approval to agree a 10am start on days when only meeting is being held. Following discussion and there being no one otherwise minded the Board unanimously agreed to:- (i) approve the proposed reduction in the number of formal meetings from 18 to 15 per year as per Appendix 1 and meetings to start at 10am on days where only one meeting is being held; (ii) note that the number of Development Sessions will remain at a minimum of four per year; (iii) amend Standing Orders and the Scheme of Administration to reflect the revised schedule, subject to approval; and (iv) note that the revised scheduled has been reviewed and agreed, in principle, by the Chairs of the Board and its Committees, Legal Services and the Internal Auditor. 8. Annual Performance Report 2024-25 The meeting had before it a report by the Chief Officer presenting the Board with the draft Annual Performance Report 2024/25. Following consideration the Board unanimously agreed to:- (i) note the draft Annual Performance Report 2024/25 at Appendix 1; (ii) note National Indicator information will be updated in July; and (iii) approve the publication of the Annual Performance Report 2024/25 by 31 July 2025, following approval of the final version by the Chair and Depute Chair. 9. Annual Progress Update on the Delivery of the Unpaid Carers Strategy The meeting had before it a report by the Service Manager, Provider Services providing an annual update on the implementation of the Moray Unpaid Carers Strategy. Following consideration the Board unanimously agreed to:- (i) acknowledge the progress made in delivery the Strategy's objectives; (ii) note the capacity challenges that have impacted delivery; (iii) instruct the Lead Officer for Unpaid Carers to provide 6 monthly updates to the Audit, Performance and Risk Committee, with annual reports to the Moray Integration Joint Board; following discussion with the Chair and Depute Chair on Page 7
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16 January it was agreed for updates to to to Audit, Performance and Risk Committee moving forward; and (iv) approve a two-year extension to the current Moray Carers Strategy 2023-26 extending its term to March 2028. Page 8
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MEETING OF MORAY INTEGRATION JOINT BOARD Thursday 19 June 2025 ACTION LOG ITEM NO. TITLE OF REPORT ACTION REQUIRED DUE DATE ACTION BY UPDATE FOR 25 SEPTEMBER 2025 1. Options for Ward 4 Inpatient Unit for Patients with Mental Illness Further development work to be undertaken in order to prepare a full detailed report which would be brought back to the Board for consideration in approximately 3 months. Update 28/11/24: Development session to be scheduled to be held before the strategic delivery plan progress update comes back to the Board in 6 months, to provide more details on progress and engage with members of the Board. TBC TBC SC JP Bed base review ongoing and date with Board to be scheduled. There will be a Grampian wide mental health inpatient bed base review and any recommendations in relation to Ward 4 will be included within this Item 4. Page 9
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ITEM NO. TITLE OF REPORT ACTION REQUIRED DUE DATE ACTION BY UPDATE FOR 25 SEPTEMBER 2025 2. Chief Officer Report 26/09/24 • Interim Chief Officer provide an update in relation to progress made resulting from the external inspection of Children's Services in relation to children and young people at risk of harm, through the governance structures of the MIJB; • Interim Chief Officer would provide a report in relation to how the rights and supported needs of unpaid carers are met in Moray; • Interim Chief Officer would arrange a development day for a demonstration in relation to Digital Health and Care TBC JP Paper presented to APR Cttee on 30 January 2025 Action Closed MIJB approved a two year extension to the current Unpaid Carers Strategy, extending its term to March 2028. Agreed that 6-monthly updates would be provided to APR Cttee. Action Closed Scheduled for January 2026 Development Session Action Closed 3. Chief Officer Report 30/01/25 Chief Officer to arrange development session on the positive change work being done in relation to discharges, with a further report to come back to the Board. 30/10/25 JP Scheduled for October’s Development Session Action Closed 4. Code of Conduct Update Refresher training in terms of the enhanced Code to be scheduled for one of the Board's development sessions. Summer 2025 SD/AMcE Timetabled August 2025 Completed Action Closed Page 10
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ITEM NO. TITLE OF REPORT ACTION REQUIRED DUE DATE ACTION BY UPDATE FOR 25 SEPTEMBER 2025 5. Equalities Mainstreaming Progress Report 2021-24 Future reports to the Board, regardless of subject, to include reference to equalities within the body of the report rather than only in the Summary of Implications section. Update 29/05/25: Prompts to be added to report template to remind authors of need to include specific reference to equalities in body of report. Ongoing ALL IW Now implemented as business as usual Action Closed 6. Chief Officer Report 29/05/25 i) Update report relating to the work being undertaken in relation to strategic change at Dr Grays to be prepared for future meeting of the Board. ii) Strategic awareness of unpaid carers capacity to be considered at next IJB Development Session. TBC JP JP In progress Topics for future development sessions being considered Page 11
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ITEM NO. TITLE OF REPORT ACTION REQUIRED DUE DATE ACTION BY UPDATE FOR 25 SEPTEMBER 2025 7. HSCM Strategic Delivery Plan 2025-2028 Erskine / Veteran Care i) Mr Lockhart agreed veteran care was important and undertook to consider how to promote through general practice. ii) Deputy Head of Service to extend an invitation to Erskine to be part of the Forres locality planning group which meets bi- monthly to enable them to engage with third sector providers in the area and connect to a wider strategic plan. iii) The Chair asked an update be provided to the next meeting of the Board to provide assurance of progress. 19/06/25 19/06/25 19/06/25 RL IMcD IMcD/RL Erskine staff are participating in a discussion on support for veterans at a Moray GP Cluster group meeting on Wednesday 22 October 2025. The Deputy Head of Service visited Erskine Veterans Activity Centre, Forres, on the morning of 25 June 2025 and met with the Erskine management team, staff members and veterans. A broad discussion was had, potential supports identified, and contact details were shared. Page 12
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ITEM NO. TITLE OF REPORT ACTION REQUIRED DUE DATE ACTION BY UPDATE FOR 25 SEPTEMBER 2025 8. MIJB Strategic Risk Register i) Youth representation – consideration to be given to a robust process to include youth representation. ii) Risk 3 – add reference to what is being done to support unpaid carers. TBC JP/JL JP Considered the possibilities of someone from the Champions Board but have not identified anyone suitable. Liaising with Education Services to see if there is anyone who may be suitable – Youth Parliament or Debating Society. Updated Strategic Risk Register on today’s agenda Action Closed 9. Moray Adult Mental Health Strategic Group Progress Report Mental Health Quality Standard 4: Workforce in Appendix 1, Outcome namely the workforce feels valued and respected, unpaid carers to be included in the workforce survey planned for later in the year. 2025 IM/ER The survey will be actioned later in the year. Page 13
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MINUTE OF MEETING OF THE CLINICAL AND CARE GOVERNANCE COMMITTEE Thursday, 27 February 2025 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Councillor Peter Bloomfield, Mrs Sheila Brumby, Mr Sean Coady, Councillor Scott Lawrence, Dr Robert Lockhart, Mr Jim Lyon, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Ms Elizabeth Robinson APOLOGIES Mr Ivan Augustus, Professor Duff Bruce, Ms Helen Chisholm, Dr Malcolm Simmons, Mr Alex Stephen, Mr Kevin Todd IN ATTENDANCE Allied Health Professional, Sector Lead Moray; Corporate Manager; Lead Dietitian Moray; Interim Primary Care Development Manager and Caroline O'Connor, Committee Services Officer. SUBSTITUTES Mr Sandy Riddell (for Mr Alex Stephen) 1. Chair The meeting was chaired by Mr Derick Murray. 2. Declaration of Member's Interests There were no declarations of Member's interests in respect of any item on the agenda. 3. Minute of meeting of 28 November 2024 The minute of the meeting of 28 November 2024 was submitted for approval. The Chair stated that Councillor Elaine Kirby was not included in those present at the meeting however noted the minute would be amended. Item 5a Page 15
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Subject to the amendment above, the Committee unanimously agreed the minute of the meeting. 4. Action Log - 28 November 2024 The Action Log of the meeting of 28 November 2024 was discussed and updated accordingly. 5. Complaints Report for Quarter 3 2024-25 The meeting had before it a report by the Chief Nurse - Moray informing the Committee of complaints reported and closed during Quarter 3 (1 October 2024 - 31 December 2024. Following consideration the Committee unanimously agreed to note the totals, lessons learned, response times and action taken for complaints completed within the last quarter. 6. Health and Social Care Moray Clinical and Care Governance Group Escalation Report The meeting had before it a report by the Chief Nurse - Moray informing the Committee of progress and exceptions reported to the Clinical and Care Governance Group since the last report to Committee in November 2024. Councillors Lawrence and Warren entered the meeting during discussion of this item. Councillor Lawrence asked if there were figures for the uptake of the drop in sessions at the Aberlour Health Hub referenced at paragraph 4.2 and whether the hub model was specific to Speyside or if it could be replicated in other areas of Moray. In response, the Deputy Chief Officer agreed to share figures of uptake at the drop in sessions with the Committee following the meeting as he did not have the detail to hand. He further advised the model was not unique to Speyside and could be rolled out to other suitable areas in Moray. In response to a question from the Chair asking if there were plans to refresh the Terms of Reference of the Clinical and Care Governance Group referenced in paragraph 3.4, the Corporate Manager confirmed work would be undertaken to refresh the Terms of Reference in April following conclusion of national work relating to the practice governance elements and reported back to this Committee in due course. Following consideration the Committee unanimously agreed:- (i) to note the contents of the report; and (ii) that the Clinical and Care Governance Group will monitor progress of the Multi- Agency Adult Support and Protection Improvement Action Plan going forward, reporting only by exception to Committee. 7. Developing a digitally-enabled universal service model to reduce Type 2 diabetes related Risk Page 16
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The meeting had before it a report by the Lead Dietitian Moray informing the Committee of work undertaken by the Primary Care Team at Maryhiill and the Moray Dietetic Department in the testing of a digitally-enabled, low cost prevention and support model for reducing type 2 diabetes-related risk and improving readiness for lifestyle change in high priority patient groups. Following consideration the Committee unanimously agreed to:- (i) note the proposed model in the “Developing a Digitally-Enabled Universal Service Model to Reduce Type 2 Diabetes-Related Risk: Impact of the Prevent the Progress of Diabetes App and Brief Dietitian Call on Patient Readiness for Lifestyle Change” report attached as Appendix 1; and (ii) acknowledge this Test of Change may offer further transformation opportunities, with a focus on Prevention and Proactive Care. 8. Items for Escalation to MIJB The Committee noted there were no items for escalation to the Moray Integration Joint Board. 9. Primary Care Update [Para 6.2.5] The meeting had before it a report by the Primary Care Development Manager informing the Committee of issues identified within Moray Primary Care. Following consideration the Committee unanimously agreed to acknowledge the present position pending the completion of a review, which is currently being progressed. Page 17
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MINUTE OF MEETING OF THE AUDIT, PERFORMANCE AND RISK COMMITTEE Thursday, 27 March 2025 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Mr Sean Coady, Ms Sonya Duncan, Councillor Scott Lawrence, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Mr Sandy Riddell, Councillor Ben Williams APOLOGIES Ms Deirdre McIntyre IN ATTENDANCE Interim Chief Social Work Officer/Head of Service; Chief Internal Auditor; Self- Directed Support and Unpaid Carers Team Manager; Angela Pieri, Engagement Lead, and Andrew Wallace, Senior Audit Manager, both Grant Thornton; Service Manager - Provider Services and Caroline O'Connor, Committee Services Officer. 1. Chair The meeting was chaired by Mr Sandy Riddell. 2. Declaration of Member's Interests The Committee noted there were no declarations of member's interests. 3. Minute of meeting of 30 January 2025 The minute of the meeting of 30 January 2025 was submitted and approved. 4. Action Log of Meeting of 30 January 2025 The Action Log of the meeting of 30 January 2025 was discussed and updated accordingly. 5. Quarter 3 (October - December 2024) Performance Report - Adult Services Item 5b Page 19
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The meeting had before it a report by the Corporate Programme Manager updating the Committee on adult services performance as at Quarter 3 2025 (October - December 2024). In response to Councillor Lawrence's concerns relating to the regression in mental health indicators, the Chair confirmed the Moray Integration Joint Board had been advised at their meeting that morning that a report is to be presented to the meeting of the Board in May providing clarity on planned developments and how they will be implemented. The Chief Officer further advised that the deterioration in that particular indicator related to the commencement of treatment under psychological therapies within 18 weeks of referral which is a challenge across Grampian and largely related to availability of workforce. Councillor Lawrence asked, with reference to paragraph 5.12, whether there was evidence of the effectiveness of the initiatives to address staff absence. In response, the Chair agreed it would be useful to include reference in future reports specifically relating to take-up and their impacts. Following consideration the Committee unanimously agreed to:- (i) note the performance of local indicators for Quarter 3 (October to December 2024) as presented in the Performance Report at Appendix 1; (ii) note the analysis of the highlighted local indicators and actions being undertaken to address performance that is outside of acceptable target ranges as detailed in Appendix 1; and (iii) note the initiatives ad progress in reducing unmet need as outlined in paras 5.3, 5.4 and in Appendix 2. 6. Quarter 3 Performance Report for Children and Families and Justice Social Work The meeting had before it a report by the Interim Chief Social Work Officer informing the Committee on Children and Families and Justice Social Work performance as at Quarter 3 (October to December 2024). The Chair noted the figure of 13.6% of individuals supported by Justice Social Work were females in Appendix 1 along with previous research relating to re-offending which demonstrated access to health services was a block to them being successfully rehabilitated. He suggested it may be useful to check with Justice Service Social Work whether there are such issues to ensure individuals are supported and solve the cycle of reoffending. In response, the Interim Chief Social Work Officer agreed future reports would quantify the data if possible or include reference to the research. During the course of discussion Councillor Lawrence, noting The Promise was initiated five years ago when Children's Services was under the remit of the Council and now sits under the auspices of the Moray Integration Joint Board, asked if there was something the Board could do to demonstrate its continued commitment to The Promise. In response the Chief Officer agreed to discuss the most suitable approach with the Chair and Depute Chair of the Board. Following consideration the Committee unanimously agreed to:- Page 20
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(i) note the performance of local indicators for Quarter 3 as presented in the Performance Report at Appendix 1; and (ii) note the analysis of the local indicators as detailed in Appendix 1. 7. Update on the Delivery of the Unpaid Carers Strategy The meeting had before it a report by the Service Manager Provider Services informing Committee of the progress made towards achieving the objectives outlined in the Unpaid Carers Strategy. Following consideration the Committee unanimously agreed to:- (i) acknowledge the progress made in meeting the objectives of the Strategy; (ii) recognise the challenges faced regarding capacity in delivering key objectives to date outlined in paragraph 4.3; and (iii) instruct the Lead Officer for Unpaid Carers to provide quarterly updates to this Committee to monitor ongoing progress in implementing the Strategy. 8. Internal Audit Section - Update Report The meeting had before it a report by the Chief Internal Auditor providing Committee with an update on the work of the Internal Audit Section. In response to a question from the Chair asking what the process is for escalation of outstanding actions, the Chief Internal Auditor advised where implementation dates for particular recommendations require to be changed, Internal Audit agree a revised date with the service which is then communicated to the Head of Service and Chief Officer. In terms of transparency the revised date is then reported back to this Committee. As a further update from an operational perspective, the Chief Officer confirmed she had asked for an overview of all outstanding audit actions for regular consideration by senior management team to ensure there was oversight of implementation dates. Following consider the Committee unanimously agreed to note the contents of the report. 9. External Audit Plan for the Year Ending 2024-25 and Update on Recommendations from 2023-24 The meeting had before it a report by the Chief Financial Officer informing the Committee of the External Auditor's Annual Plan for 2024/25 and updating on the recommendations following last years' audit. Following consideration the Committee unanimously agreed to note the contents of the External Auditor's Annual Plan for 2024/25 attached as Appendix 1 and update on audit recommendations from 2023/24 attached as Appendix 3. 10. Internal Audit Plan Year Ending 31 March 2026 The meeting had before it a report by the Chief Internal Auditor providing the Committee with information on the proposed internal audit coverage for the 2025/26 financial year. Page 21
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Following consideration the Committee unanimously agreed the proposed audit coverage. 11. Moray Integrated Community Equipment Store Audit The meeting had before it a report by the Service Manager, Provider Services updating the Committee on the last audit completed by the Internal Audit Section for the Moray Integrated Community Equipment Store. Following consideration the Committee unanimously agreed to:- (i) note the outcome of the Internal Audit for the Moray Integrated Community Equipment Store; and (ii) note the work being undertaken to take forward the Audit Recommendations. 12. Internal Audit Section - Completed Projects - NHS Grampian Reviews [Para 6.2.5] The meeting had before it a report by the Chief Internal Auditor providing Committee with an update on the internal audit work completed on NHS Grampian systems and practices. Following consideration the Committee unanimously agreed to note the audit update. Page 22
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: MEMBERSHIP OF BOARD AND COMMITTEES BY: CORPORATE MANAGER 1. REASON FOR REPORT 1.1 To inform the Board of changes to Membership of the Moray Integration Joint Board (MIJB), Audit, Performance and Risk (APR) Committee and Clinical and Care Governance (CCG) Committee. 2. RECOMMENDATION 2.1 It is recommended that the Board notes: i) the Chair and Vice-Chair are due to rotate on 1 October 2025; ii) the requirement to appoint a new Chair of the APR Committee; iii) the update regarding vacancies in Unpaid Carers and Third Sector representative position; iv) the appointment of Michael Ritchie as the new NHS Staff Partnership representative; and v) the updated membership of Board and Committees attached at Appendix 1. 3. BACKGROUND 3.1 The Public Bodies Joint Working (Scotland) Act 2014 (“the Act”) and the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014 (“the Order”) make provisions about various matters including the membership of the MIJB. As a minimum this must comprise voting members nominated from the NHS Board and Council; co-opted non-voting members who are holders of key posts with the NHS and Council or the MIJB; and co-opted non-voting members who are representatives of groups who have an interest in the MIJB. There is flexibility to appoint additional non-voting members as the Board sees fit. The Moray Health Item 6. Page 23
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and Social Care Integration Scheme (“Integration Scheme”) outlines certain agreed provisions re membership (and includes the specific provisions taken from the Act and the Order). 3.2 At the meeting of the Board on 25 January 2024 (para 9 of the minute refers) the Board approved the rotation of Chair from a Health Board Member to a Council Member from 1 April 2024, for 18 months. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 As the current Chair of the Board, Councillor Bridget Mustard will take on the role of Vice-Chair with effect from 1 October 2025. 4.2 As the current Vice-Chair of the Board, Dennis Robertson will take on the role of Chair with effect from 1 October 2025. 4.3 The Chair and Vice-Chair of the Board is allocated on a rotational basis every 18 months. The next rotation is due on 1 April 2027. 4.4 Due to the rotation of Chair/Vice-Chair of the Board there is a requirement to appoint a Council voting member as Chair of the APR Committee to take up post with effect from 1 October 2025. This cannot be the Chair or Vice-Chair of the Board. 4.5 The Chair of the APR Committee requires to be appointed from a member of the organisation which does not Chair the Board. As a Health Board Member is the incumbent Chair of the Board, the new Chair of APR Committee must be a Council voting member. 4.6 Councillor Ben Williams was nominated and has accepted the role of Chair of the APR Committee. The current Council members serving on the APR Committee are Councillor Ben Williams and Councillor Scott Lawrence, both of whom were eligible for the Chair position. 4.7 Derick Murray is the current Chair of the Clinical and Care Governance Committee. This committee is required to be chaired by a NHSG voting member. No further action is required. 4.8 Recruitment process is underway for an Unpaid Carer representative and a Third Sector representative to join the Board as stakeholder members for a three-year turn. 4.9 Kevin Todd stood down as Moray Council Staff Representative on 19 May 2025. Processes are underway to identify an appropriate staff representative for Moray Council staff. 4.10 Michael Ritchie replaces Deirdre McIntrye as the NHS Grampian Staff Representative Stakeholder Member from 16 July 2025. 5. SUMMARY OF IMPLICATIONS Page 24
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(a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” Effective governance arrangements support the development and delivery of priorities and plans. (b) Policy and Legal The Board, through its approved Standing Orders for Meetings, established under the Public Bodies (Joint Working) (Integration Joint Board) (Scotland) Order 2014, ensures that affairs are administered in accordance with the law, probity and proper standards. (c) Financial implications There are no financial implications arising as a direct result of this report. (d) Risk Implications and Mitigation There are no risk implications arising as a direct result of this report. (e) Staffing Implications There are no staffing implications arising as a direct result of this report. (f) Property There are no property implications arising as a direct result of this report. (g) Equalities/Socio Economic Impact An Equalities Impact Assessment is not required as the report is to inform the Board of changes required to membership of the Board and CCG Committee. (h) Climate Change and Biodiversity Impacts None arising from this report. (i) Directions None arising from this report. (j) Consultations Consultation on this report has taken place with Chief Officer – Health and Social Care Moray and Caroline O’Connor, Committee Services Officer, Moray Council, who are in agreement with the report. 6. CONCLUSION 6.1 This paper sets out the position in relation to the membership of MIJB. Author of Report: Isla Whyte, Interim Support Manager Background Papers: None Ref: Page 25
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APPENDIX 1 Moray Integration Joint Board – as at 1 September 2025 Moray Integration Joint Board 4 Council voting members Bridget Mustard (Chair) Ben Williams Peter Bloomfield Scott Lawrence 4 NHS Grampian voting members Dennis Robertson (Vice-Chair) Derick Murray Sandy Riddell Alex Stephen Third Sector Stakeholder Vacancy NHS Grampian Staff Representative Stakeholder Member Michael Ritchie Unpaid Carer Stakeholder Ivan Augustus User of Services Stakeholder Sheila Brumby Moray Council Staff Representative Kevin Todd Chief Officer Professional Judith Proctor Chief Social Work Officer Jim Lyon (interim) Lead Nurse Jane Ewen GP Lead Dr Robert Lockhart Non Primary Medical Services Lead Mr Duff Bruce Additional Member Elizabeth Robinson Audit, Performance and Risk Members (note chair needs to be alternate partnership member to the Chair of MIJB) 2 Council voting members Ben Williams Scott Lawrence 2 Health Board voting members Sandy Riddell (Chair) Derick Murray Third Sector Stakeholder Vacancy NHS Grampian Staff Representative Stakeholder Member Michael Ritchie Clinical and Care Governance Members 2 Council voting member Cllr Peter Bloomfield Cllr Scott Lawrence 2 Health Board voting member (Chair) Derick Murray (Chair) Alex Stephen (Sandy Riddell 25/1/24 temporary) Unpaid Carer Stakeholder Ivan Augustus User of Services Stakeholder Sheila Brumby Third Sector Stakeholder Vacancy Moray Council Staff Representative Kevin Todd Chief Officer Professional Judith Proctor Chief Social Work Officer Jim Lyon (interim) Lead Nurse Jane Ewen Page 26
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GP Lead Dr Robert Lockhart Non Primary Medical Services Lead Prof Duff Bruce Additional Member Elizabeth Robinson Page 27
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: CHIEF OFFICER REPORT BY: CHIEF OFFICER 1. REASON FOR REPORT 1.1 To inform the Board of the Chief Officer activities that support the delivery against the Moray Integration Joint Board’s (MIJB’s) strategic priorities articulated in the Strategic Plan, and the delivery against the 9 Health and Wellbeing outcomes. 1.2 The focus on delivery of the Strategic plan objectives, through the implementation of the Delivery Plan will maintain a focus for transformational change of services to our community. MIJB continue to experience significant financial challenges, alongside the two funding partners Moray Council and NHS Grampian, to deliver services within the budget, but remain committed to working in partnership to deliver within the resources available. 2. RECOMMENDATION 2.1 It is recommended that the Board: i) consider and note the content of the report; and ii) agree that transforming services to meet the aspirations of the MIJB’s Strategic Plan remains a priority. 3. BACKGROUND Escalation from MIJB Clinical and Care Governance Committee 3.1 At the August Clinical and Care Governance Committee, it was agreed to escalate concerns about Mental Health and Primary Care to the Board. These concerns reflect ongoing pressures and risks, including limited access to specialist psychiatry services and increasing demand on General Practice. A report outlining the nature of the escalation and providing an update on the issues will be presented to the Board in November. Item 7. Page 29
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Home First/Discharge without Delay (DWD) 3.2 The average number of patients whose discharge is delayed has reduced during this reporting period, although a number of challenges remain, the innovative solutions implemented within the Homefirst theme has had a significant impact on the aim to sustainably lower the number delayed. 3.3 Moray’s Home First Programme was re-launched on 20 August 2025 with the aim of ensuring that all our teams consider ‘Home First’ when supporting people who are facing challenges. In addition to the previous workstreams, Discharge without Delay (DWD), Multi-Disciplinary Teams (MDTs)’s, Community Response Team, Data and Finance, Getting it Right for Everyone (GIRFE), Risk Thresholds, Assessment Assurance and Prevention and Self-Care have also been added as workstreams. Each workstream lead will be hosting a workshop with stakeholders. The Home First programme will present information to the IJB Development day in October on progress, and a winter planning event is arranged in November. Additionally, as part of wider, pan-Grampian Unscheduled Care improvement actions, Moray Health and Social Care Partnership (HSCP) have submitted an ambitious bid for further funding from Scottish Government (SG) to improve unscheduled care performance. Plans are being developed to introduce a new pathway that will ensure that people are discharged from the Emergency Department or from secondary care quickly, avoiding assessment for long term care or care at home while they are in hospital. This will also create opportunities to support admission avoidance as a system response. This work has been taken forward at pace and final confirmation is awaited from SG that funding will be made available for it. The Plan will come to the next meeting of the Board in November following the themed workshop in October. 3.4 The National DWD programme is now fully established with teams representing Moray within the four work streams (Planned Date of Discharge, Community Hospitals, Discharge to Assess (D2A) and Frailty at the Front Door), at National, Regional and Local levels. This programme is hosted by NHS Grampian, with local meetings taking place regularly to ensure Moray teams are updated with progress. Vaccination Programme 3.5 The winter programme commences in September, starting with the child flu programme and the flu offer to pregnant women. Co-administration of the flu vaccine and COVID-19 vaccine will begin at the end of September. A number of staff clinics are being offered throughout the programme, along with an offer to support enhanced peer to peer flu vaccination. Below are the key dates for the programme:- • 6 September: Start of child flu programme • 8 September: Start of flu offer to pregnant women • 15 September: Adult flu programme begins • 29 September: Beginning of co-administration to those groups eligible for both flu and COVID-19 • Saturday 31 January 2026: COVID-19 programme ends • Sunday 29 March 2026: Flu programme end. Page 30
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3.6 On the advice of the Joint Committee on Vaccination and Immunisation (JCVI) Eligibility for COVID-19 vaccination has changed for winter 2025/26 when compared to winter 2024/25, with the following groups being eligible for COVID-19 vaccination this winter:- • Residents in care homes for older adults • All adults aged 75 years and over • Individuals aged 6 months and over who are immunosuppressed. 3.7 The groups who were eligible for COVID-19 vaccination in winter 2024/25 but are no longer eligible this winter (unless they fall into any of the 3 eligible groups listed above) are: • Those aged 65-74 years • Those in a clinical risk group (as defined in tables 3 and 4 in the COVID-19 chapter of the Green Book), including pregnant women • Frontline Health and Social Care Workers Moray Vaccination Centre 3.8 The vaccination service has expanded their hub and spoke model across three of the four Moray localities to allow the service to deliver vaccination clinics across Moray. However, it continues to be extremely challenging to find premises within the Elgin locality for both the delivery of vaccination clinics and as a base for the admin and management team. 3.9 A review of all premises within the NHS Grampian and Moray Council asset base has been completed and presented to the Senior Management Team. Not all assets have been deemed fit for purpose and work continues on the identification of potential options. 3.10 There may be a requirement for funding for this, for example for fit out costs to fulfil Health, Safety, and infection control legislation, this will be determined once the final option is agreed. 3.11 If for any reason, these options are deemed not possible, then it will be necessary to progress with market search to identify premises out with NHS Grampian and Moray Council asset base. 3.12 The current interim base at Beechbrae has been extended to March 2026. 3.13 The vaccination programme continues with a mixed model of delivery with outreach and ad-hoc/pop up clinic delivery planned alongside the main centre at Beechbrae. Palliative Care Review 3.14 The review of palliative care services and pathways across Moray is currently underway. The project is still in the scoping and collation of information phase. This includes identifying strengths, areas for improvement and gaps in provision. When this phase is concluded the findings will be collated in a report, focusing Page 31
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on the three areas stated. The report will seek to demonstrate where provision can work seamlessly between primary and secondary care services giving a better experience for people who require support from Palliative Care services. The development of Community Appointment Days to allow outreach to more remote parts of Moray is already underway, taking some of the opportunities available at the Oaks to local communities. This is one example of strength based developments that the report will seek to highlight. The Strategic Palliative Care Group Moray is the forum established to monitor the delivery of palliative care services in Moray, drive forward new initiatives and ensure that we are developing services in line with the Scottish Government Palliative Care Strategy: Palliative Care Matters for All. This forms the terms of reference for the future delivery of services. Within the project, budget savings will also be identified for consideration by the Board. Care at Home 3.15 The transition for Care at Home towards a framework model continues with Internal Services and CQS being joined by other providers to deliver on self- directed support options. As anticipated, an early increase has been seen in the amount of Home Care available in Moray and new providers moving into Moray. 3.16 More services have now made application to join the Scotland Excel Framework, which will be mandatory for the delivery of Care at Home, however this process is taking longer than first expected due to the conditions which have to be met by providers. Interim measures have been agreed through the local Community Asset Framework to support temporary provision of additional Care at Home through Self-Directed Support (SDS) Options in order to allow due process to be completed through Scotland Excel. 3.17 After a review and relaunch of Home First, START (care at home enablement team) are working in partnership with D2A to move people from a hospital environment to assess more effectively at home, together with improved Resource Allocation Meetings, both community and hospital-based provision increased. 3.18 The Care at Home Steering Group has refocussed and will provide regular updates through the Home First Project as a specific work stream as well as providing a comprehensive update and brief through the IJB development session in October, and an update report at the Board Meeting in November. Review of Social Work Governance and Assurance Arrangements across Scotland 3.19 The SG undertook a review on social work governance and assurance in Scotland between July to December 2024, conducted by the Care Inspectorate, and published the findings in May 2025. The findings were reassuring and, although social work governance arrangements were complex, they were mostly effective with social work leaders making them work. 3.20 Having awaited the findings of the national review, a local Social Work and Social Care Practice Governance Framework was concluded, approved by the Senior Management Team on 20 August 2025, and circulated for immediate Page 32
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implementation. The Framework was presented at the MIJB Development session on 21 August 2025 and a report on this and our local social work governance arrangements will come to a future meeting of the Board or relevant committee. Strategic Change Board Update 3.21 The MIJB approved partnership working across the North-East in relation to the Strategic Change Board (SCB) at its meeting on 30 January 2025 (para 9 of minute refers). The SCB was established to drive transformational change across NHS Grampian and its partner IJBs, ensuring alignment of ambition and approach. 3.22 At its May meeting, the SCB reflected on the need to recalibrate IJBs collective approach to transformation in light of the sustained pressures facing the health and care system. The discussion highlighted the risk of remaining focused solely on short-term responses and reinforced the importance of progressing toward longer-term, system-wide change. 3.23 Since then, a shared model of change has been developed and is currently being tested across the system. This model aims to provide a clearer articulation of priorities, strengthen engagement with staff and partners, and support practical steps toward transformation. 3.24 The first of three cross-system workshops, held on 16 May and co-led with Healthcare Improvement Scotland (HIS), brought together colleagues from across health and care – including Third Sector Interfaces (TSIs) – to begin co- designing a shared vision, guiding principles, and cultural shifts. 3.25 The next major milestone was the “Shifting the Balance of Care” workshop on 12 September 2025, which focused on community-based options, including Hospital at Home, and explored how the model of change could support practical redesign. This session intended to move from intent to impact, with an emphasis on shared ownership and honest conversations about what change will mean in practice. 3.26 Further updates on the SCB’s work will be brought to IJBs as the testing of the model progresses and opportunities for alignment emerge. Stakeholder Representation Update 3.27 The recruitment process is progressing for the recruitment to the vacant Unpaid Carer and Third Sector stakeholder positions on the Board. These roles are essential in ensuring that a broad range of perspectives and lived experience inform the Board’s work. A separate paper is on today’s agenda providing an update on the staff representation positions for Moray Council and NHS Grampian. Carefirst Replacement 3.28 The identification of a replacement for Carefirst is progressing well, with support from Moray Council procurement officers. A Project Board led by Jim Lyon, Interim Chief Social Work Officer / Head of Service and Working Group have Page 33
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been established to progress the project to complete procurement. The Outline Business Case identified the scope as replacement of a system for Adult Services, Children and Families and Justice Services and a finance module that serves all. Four systems were identified that met the specification criteria and who provided responses to our requirements. Three companies ultimately provided a demonstration to a large group of officers, representing all teams and job roles, and feedback from this has been collated to inform the evaluation process. Site meetings have been held with HSCPs in other areas who have migrated from Carefirst to a new system, to obtain insight to the companies and to take advice on lessons learned. Clarification questions have been issued to the potential suppliers and, once responses are received, will form part of the evaluation. Once the evaluation and moderation process is completed it is hoped to have determined a preferred supplier by end of September. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 To support the acceleration of the MIJB ambitions set out in the Strategic Plan the Delivery plan is currently being refreshed to support next steps. 4.2 The challenge of finance persists and there remains the need to address the underlying deficit in core services. The development of a Programme Management Office well progressed to support our financial savings. 5. SUMMARY OF IMPLICATIONS - (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” Working with our partners to support people so they can cope with, and where possible, overcome the health and wellbeing challenges they may face. Ensuring that the right care is provided at the right place at the right time when people are in need. Ensuring that our systems are as simple and efficient as possible. (b) Policy and Legal The Chief Officer continues to operate within the appropriate level of delegated authority, ensuring that the MIJB is sighted on key issues at the earliest opportunity, and continues to influence and agree the strategic direction. (c) Financial implications There are no financial implications arising directly from this report. The Chief Finance Officer continues to report regularly. There is an ongoing requirement to find efficiencies and to demonstrate best value for money. (d) Risk Implications and Mitigation The risk of not redesigning services will mean that HSCM cannot respond adequately to future demands. Page 34
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(e) Staffing Implications Staff remain the organisation’s greatest asset, and engagement with all sectors must continue to ensure full involvement, which will create the best solutions to the challenges faced. HSCM staff are facing continued pressures on a daily basis, and effort into ensuring staff well-being must continue. (f) Property There are no issues arising directly from this report. (g) Equalities/Socio Economic Impact Any proposed permanent change to service delivery will need to be impact assessed to ensure that HSCM are not disadvantaging any section of our community. HSCM will continue to work closely with all our partners to ensure that we contribute to the health and well-being of the community. (h) Climate Change and Biodiversity Impacts Care closer to and at home, delivered by teams working on a locality basis, will reduce HSCM’s reliance on centralised fixed assets and their associated use of utilities. (i) Directions There are no directions arising from this report. (j) Consultations The Moray HSCP Senior Management Team, the Legal Services Manager and Caroline O’Connor, Committee Services Officer have been consulted in the drafting of this report. 6. CONCLUSION 6.1 The Board are asked to acknowledge the significant efforts of staff, across in-house providers, externally commissioned services, the Independent and Third Sector, who are supporting the response to the recovery, and the drive to create resilience and sustainability through positive change. 6.2 The size of the financial challenge facing the MIJB, and also its two funding partners, means that redesign and transformation is not an option but a necessity. HSCM’s approach will be to prioritise quality, safety, and good outcomes in all service redesigns. Author of Report: Judith Proctor, Chief Officer, Moray HSCP Page 35
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DRAFT REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: REVENUE BUDGET MONITORING QUARTER 1 FOR 2025/26 BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To update the Moray Integration Joint Board (MIJB) of the current Revenue Budget reporting position as at 30 June 2025 for the MIJB budget. 2. RECOMMENDATIONS 2.1 It is recommended that the Board: i) consider and note the financial position of the MIJB as at 30 June 2025 is showing an overspend of £1,425,931 on core services; ii) approve the budget realignment as detailed in paragraph 5 and Appendix 3; iii) consider and note the progress against the approved savings plan in paragraph 6, and Appendix 5; iv) consider and note the budget pressures and emerging budget pressure as detailed in paragraph 7; and v) note the revisions to staffing arrangements dealt with under delegated powers and in accordance with financial regulations within the Council (MC) and NHS Grampian (NHSG) for the period 1 April to 30 June 2025 as shown in Appendix 4. 3. BACKGROUND 3.1 The financial position for the MIJB services at 30 June 2025 is shown at Appendix 1. The figures reflect the position in that the MIJB core services are currently over spent by £1,425,931. This is summarised in the table below. Item 8. Page 37
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Annual Budget £ Budget to date £ Expenditure to date £ Variance to date £ MIJB Core Service 185,994,166 46,218,061 47,643,992 (1,425,931) MIJB Strategic Funds 8,478,209 548,059 1,140,463 (592,404) Set Aside Budget 15,638,000 - - - Total MIJB Expenditure 210,110,375 46,766,120 48,784,455 (2,018,335) 3.2 Due to the current financial situation of the partners, a first provisional forecast to 31 March 2026 is summarised below: Annual Budget £ Forecast expenditure to 31 Mar 25 £ Variance to 31 Mar 25 £ MIJB Core Service 185,994,166 191,532,223 (5,538,057) MIJB Strategic Funds 8,478,209 6,273,099 852,725 Set Aside Budget 15,638,000 15,638,000 0 Total MIJB Expenditure 210,110,375 197,805,322 (4,685,332) 3.3 A list of services that are included in each budget heading are shown in Appendix 2 for information. 4. KEY MATTERS/SIGNIFICANT VARIANCES FOR 2025/26 Community Hospitals 4.1 The Community Hospital and services budget is overspent by £192,690. This includes overspends in community administration costs totalling £87,682, relating to increased energy and other utility costs. The Community Hospitals were overspent overall by £41,019 primarily relating to Buckie. Moray vaccinations were overspent by £63,453, of which £53,769 was nursing cost and other minor overspends totalling £536. 4.2 The balance between opening extra capacity (which requires extra staffing) and the exceptional challenges around the flow of patients out of secondary care has impacted on Seafield Hospital (Buckie) as this is the site of Health and Social Care Moray’s (HSCM) surge capacity. When the surge beds are open this causes a budget pressure which is then considered with the patients that are delayed. 4.3 Work continues to monitor staffing levels in all community hospitals to ensure additional hours and bank are kept to the minimum possible but also ensuring that these levels are safe. Care Services Provided In-house 4.4 The Care services provided in-house is overspent by £313,345. This is as expected due to recruiting to this service. The regrading of the care at home workers last year has impacted favourably upon the latest recruitment round. 4.5 Savings and surplus have been transferred across to other services which has now resulted in the service being overspent. When the budget was set this was Page 38
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based on 2024/25 figures these have changed in 2025/26 due to being able to recruit to vacancies in care at home. Older People and Physical Sensory Disability (Assessment & Care) 4.6 This budget is overspent by £529,764 to 30 June 2025. This primarily relates to overspends for domiciliary care in the area teams and permanent care. The variances within this overall budget heading reflect the shift in the balance of care to enable people to remain in their homes for longer. 4.7 This overspend is expected to continue and will be monitored throughout the next quarter. The monitoring of this budget includes work underway to review a substantial number of care packages with a view to release further capacity within the care at home service to meet the demand of the increasing frailty need within our population. In addition Moray is embarking on a Proportionate Care Project which also will be looking to reduce the double handling of care packages within the community reaching better outcomes for people. Admin & Management 4.8 This budget is overspent by £224,985 to 30 June 2025. Within this budget heading for this financial year includes the budget heading of externally commissioned services, since all the commissioning budgets have been realigned to the services, all that is left under this heading relates to staff infrastructure and systems. The overspend primarily relates to savings that have been allocated during the realignment and the timing of the savings actually being achieved. This budget is expected to improve over the next quarter. Primary Care Prescribing 4.9 The primary care prescribing budget is underspent by £122,471 to 30 June 2025, this position is based on only one month’s actuals for April and an accrued position for May and June as information is received two months in arrears. To June 2025 the estimate of items increase at 2.29% is greater to date than anticipated, with higher volume in April. The emerging volume pattern for 2025/26 will require to be monitored. An average item price of £11.19 has been used to estimate position to June. 5. BUDGET REALIGNMENT 5.1 When the budget for 2025/26 was set, it included the provision for the recurring deficit, which has been an issue since the outset of the MIJB and has been increasing year on year. In order to provide budget managers with a more realistic budget to work within, it has been necessary to realign the budgets to reflect the recurring surplus and deficits, £5,987,722. However, the recurring surplus/deficit is based on a point in time in December when the budget is set and budgets are moving targets. Also as the recurring deficits have been dealt with, then it is also necessary to look at the savings proposals that are able to be allocated to individual budgets to remove from the core budget, a total of £5,214,557 is to be removed. 5.2 A detailed breakdown per service line is attached in Appendix 3 and also a reconciliation of other movements that have occurred during the first quarter to Page 39
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reconcile the approved budget to the budget as at 30 June 2025. As the movements are of a significant value, approval of the MIJB is required for this budget realignment. 6. STRATEGIC FUNDS 6.1 Strategic Funds is additional funding for the MIJB, they include: • Additional funding received via NHS Grampian and Moray Council (this may not be fully utilised in the year resulting in a contribution to overall MIJB financial position at year end which then needs to be earmarked as a commitment for the future year. • Provisions for earmarked reserves has been made to fund unutilised allocations additional investment funding and others in 2024/25, identified budget pressures, new burdens, savings and general reserve that were expected at the start of the year. 6.2 Within the strategic funds are earmarked reserves totalling £1,450,304. However, there will not be enough reserves to cover the overspend in total if the level of spend continues till the 31 March 2026. 6.3 Also within strategic funds are provisions for known budget pressures at the start of the financial year including a provision for recurring budget over and underspends totalling £18,416,862. 6.4 By the end of the financial year, the Strategic Funds will reduce as the commitments and provisions materialise and the core budgets will increase correspondingly. 7. PROGRESS AGAINST THE APPROVED SAVINGS PLAN 7.1 The Revenue Budget 2025/26 was presented to the Board on 27 March 2025 (para 11 of the minute refers). The paper presented a balanced budget through the identification of efficiencies through savings and the use of reserves. 7.2 The progress against the recovery plan is detailed in Appendix 5 and summarised in the table below and will continue to be reported to the Board during the 2025/26 financial year. The table details progress during the first quarter against the original recovery plan. The majority of the recovery plan is not expected to materialise until later in the financial year and a significant number related to reductions in overspending rather than being actual savings to be taken. Page 40
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Efficiencies Para Ref Full Year Target Savings expected progress at 30 June 2025 Savings actual progress at 30 June 2025 £’000 £’000 £’000 Building Resilience 6.3 2,626 656 227 Home first 6.4 1,445 361 69 Partners in Care 6.5 2,021 505 214 Already implemented 3,377 844 844 Total Projected Efficiencies 9,469 2,366 1,354 7.3 There are 8 projects under the heading of building resilience. Of which 5 have been allocated and expected to be achieved. Of the remaining 3 projects, 1 has not yet been allocated but is expected to be achieved by the end of the financial year and the remaining 2 (Review of care and review of care purchasing) savings have not yet been allocated and are not expected to be achieved until later in the year. 7.4 There are 4 projects under the heading for Home First, of which 2 have been allocated and expected to be achieved. Of the remaining 2 projects, 1 has been reclassed as an efficiency rather than a saving (proportionate care), with the other (Short breaks provision) being delayed until later in the year. 7.5 There are 11 projects under the heading of partners in care, of which 7 have been allocated and expected to be achieved. 1 project relating to commissioning contracts has not yet been allocated but is expected to be achieved during the year. Another project relating to transport has been delayed although expected to be achieved. The final 2 projects, although the right thing to do, have been delayed until next financial year. 7.6 Projects are detailed in Appendix 5, all projects have been reviewed for progress and have been appropriately RAG status for risk of achieving the savings on target. When the budget was set there was a risk of not achieving the savings within this financial year of £1.507m, however, after the latest review, the potential risk of not achieving savings in this financial year totals £2.6m. 7.7 A Budget Savings Oversight Group continues to meet regularly to strengthen governance, provide support to the Senior Responsible Officers (SRO) and provide a project management approach. The Group is chaired by the Chief Officer and comprises of members of the Senior Management Team (SMT). Page 41
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8. BUDGET PRESSURES 8.1 Budget pressures recognised when the budget was approved on 27 March 2025 are released when the pressure crystallises to the extent that it can be accurately quantified. Provisions to meet budget pressures totalling £11,110,050 have been released in quarter 1. 8.2 Provisions still held centrally at the end of quarter 1 total £7,306,811 and are detailed in the table below. Description Para Ref £’000 Pay inflation 8.4 2,006 Contractual inflation & Scottish Living Wage 8.3 1712 Prescribing & Community Pharmacy 8.3 1,153 Balance of FPNC & NCHC 8.3 175 Learning Disability & Mental Health Clients 8.3 1,041 Occupational Therapy equipment 8.3 100 Hosted Services 8.3 122 eNIC 8.4 957 Other 8.3 41 TOTAL BUDGET PRESSURES 7,307 8.3 These budget pressures have not yet been drawn down as they have not yet materialised in the budgets. At this stage these are all intended to be fully required in this financial year. 8.4 These budget pressures have been partly drawn down in quarter 1. NHS pay award has been actioned but the Council pay award has been approved and will be drawn down in quarter 2. The eNIC budget pressure has also been partly drawn down and the balance will be required over the rest of the financial year. 8.5 Emerging budget pressures have materialised since the budget was set and these are detailed in the table below: Description Para Ref £000’s High cost care packages 8.6 62 Total emerging budget pressures 8.6 Emerging budget pressure for high cost care packages relating to older people and learning disability that have been approved at the High Cost care packages meeting and Resource Management Group. These costs relate to 12 cases that Page 42
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10 that required an increase in packages and 2 for one off costs, which total £61,641 in the first quarter. All these packages will be reviewed regularly. 9. CHANGES TO STAFFING ARRANGEMENTS 9.1 At the meeting of the Board on 30 November 2023, the Financial Regulations were approved (para 12 of the minute refers). All changes to staffing arrangements with financial implications and effects on establishment are to be advised to the Board. 9.2 Changes to staffing arrangements as dealt with under delegated powers through appropriate Council and NHS Grampian procedures for the period 1 Apr to 30 June 2025, are detailed in Appendix 4. 10. UPDATED BUDGET POSITION 10.1 During the financial year, budget adjustments arise relating in the main to the allocation of non-recurring funding that is received via NHS Grampian. In order to establish clarity of these budget allocations a summary reconciliation has been provided below. 10.2 In addition, the MIJB, are still waiting for some funding to come through that was included in the budget and that is reconciled at the bottom of the table below. 10.3 £’s Approved Funding 27.3.25 187,737,377 Set Aside Funding 15,638,000 IJB reserves used to fund budget gap 1,000,000 Balance of IJB reserves c/fwd to 25/26 187,022 Amendment to NHS Grampian core 1,245,457 Revised funding at the start of Qtr 1 205,807,856 Budget adjustments M01-M03 Pay Award 751,816 Hosted Services 33,912 Delayed Discharge (295,000) IFRS 16 (262,945) GVIP 573,797 PCIF Allocation 3,132,000 Moray ADP Funding 25/26 651,193 Primary Care 255,309 Out Of Hours 86,437 Diabetes Nurse 6,157 Regrading 13,699 Appropriate Adult funding (2 years) 36,000 Other 765 Core uplift 7,000 eNIC (413,621) Page 43
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Childrens funding not yet received (229,000) Reserves utilised (45,000) Revised Funding to Quarter 1 4,302,519 Funding expected in quarter 2 210,110,375 10.4 In accordance with the updated budget position, but due to funding not fully being received, there will be no revised Directions issued this quarter. 11. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan ‘Moray Partners in Care 2022-2032 This report is consistent with the objectives of the Strategic Plan and includes budget information for services included in the MIJB Revenue Budget 2025/26. (b) Policy and Legal It is the responsibility of the organisation receiving the direction to work with the Chief Officer and Chief Financial Officer to deliver services within the resources identified. The Moray Integration Scheme (para 12.8 of the 2015 Integration Scheme) makes provision for dealing with in year variations to budget and forecast overspend by reference to agreed corrective action and recovery plans. It also makes provision for dealing with year-end actual overspend where such action and plans have been unsuccessful in balancing the relevant budget by reference to use of MIJB reserves and additional payments from NHS Grampian and Moray Council. (c) Financial implications The financial details are set out in sections 3-10 of this report and in Appendix 1. For the period to 30 June 2025, an overspend is reported to the Board of £2,018,334 in totality. A straight line forecast to end March 2026 has been included in section 3 and Appendix 1, which gives the provisional year end position of £4,685,332 if spend continues as it has been in quarter 1. There is also the assumption at this early stage that some savings RAG status of red will not be fully achieved. The potential impact to the partners has been communicated however, the monitoring of the recovery plan will be brought to a future meetings of this Committee. The staffing changes detailed in paragraph 9 have already been incorporated in the figures reported. The movement in the 2025/26 budget as detailed in paragraph 10 have already been incorporated in the figures reported. Page 44
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(d) Risk Implications and Mitigations The most significant risk arising from this report is the control and management of expenditure to provide the Health and Social Care services required for the Moray Area, within budget. There are earmarked reserves brought forward in 2025/26. Additional savings continue to be sought and service redesign are under regular review. Progress reports will be presented to this Board throughout the year in order to address the financial implications the MIJB is facing. The level of reserves carried forward into 2024/25 was £1,450,304 of which £1,000,000 was used to balance the budget. As well as additional pressures arising from the cost of living crisis, increasing energy bills, emerging budget pressures and inflation puts a risk on the budget. The early provisional forecast is a potential overspend position, this has been communicated to both partners and the recovery plan will be closely monitored as well as additional savings identified to counteract and potentially reduce this position as both partners are under severe financial pressures. The Budget Saving Oversight group continues to support the delivery of projects and look at savings for the next financial year. There is a risk of the red RAG savings not achieving in this financial year, and work is already begun looking at savings for next year and mitigations for this current year. (e) Staffing Implications There are no direct implications in this report. (f) Property There are no direct implications in this report. (g) Equalities/Socio Economic Impact There are no direct equality/socio economic implications as there has been no change to policy. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy (i) Directions There are no amendments to Directions as part of this report. (j) Consultations The Chief Officer, the Health and Social Care Moray Senior Management Team and the Finance Officers from Health and Social Care Moray have been consulted and their comments have been incorporated in this report where appropriate. 12. CONCLUSION Page 45
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12.1 The MIJB Budget to 30 June 2025 has an over spend of £1,425,931 on core services. Senior Managers will continue to monitor the financial position closely and continue to report on the Recovery and Transformation Plan. 12.2 The first provisional financial position to 31 March 2026, is an overspend of £4,685,332. Author of Report: D O’Shea Chief Financial Officer Background Papers: Papers held by respective Accountancy teams Ref: Page 46
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APPENDIX 1 JOINT FINANCE REPORT APRIL 2025 - JUNE 2025 DO NOT CHANGE Para Approved Annual Annual Budget (Net) Actual Most recent Variance Forecast Ref Net Budget Net Budget To Date To Date Variance Variance Forecast To Budget Variance £'s £'s £'s £'s £'s % £'s £'s % 2025-26 2025-26 2025-26 2025-26 2025-26 2025-26 2025-26 2025-26 2025-26 Community Hospitals 4.1 6,600,692 7,334,690 1,964,851 2,157,541 (192,690) (3) 8,105,450 (770,760) (11) Community Nursing 6,484,911 6,194,711 1,534,260 1,539,506 (5,246) (0) 6,215,695 (20,984) (0) Learning Disabilities 17,865,037 20,066,159 4,528,208 4,407,413 120,795 1 19,582,981 483,178 2 Mental Health 11,945,985 11,906,709 3,047,551 3,043,521 4,031 0 11,890,587 16,122 0 Addictions 1,221,222 1,238,382 304,925 446,942 (142,017) (11) 1,640,785 (402,403) (32) Adult Protection & Health Improvement 265,307 273,454 62,457 60,900 1,558 1 267,223 6,231 2 Care Services provided in-house 4.4 25,594,449 22,865,584 5,574,405 5,887,750 (313,345) (1) 24,118,963 (1,253,379) (5) Older People & PSD Services 4.6 25,172,334 27,823,280 6,670,307 7,200,071 (529,764) (2) 29,942,336 (2,119,056) (8) Intermediate Care & OT 1,904,400 1,927,282 483,378 624,278 (140,900) (7) 2,490,883 (563,601) (29) Other Community Services 10,220,408 10,099,636 2,504,705 2,562,125 (57,420) (1) 10,329,316 (229,680) (2) Admin & Management 4.8 1,401,172 2,757,182 1,132,602 1,357,587 (224,985) (8) 3,657,123 (899,941) (33) Other Operational Services 1,253,043 1,490,367 371,050 365,920 5,130 0 1,469,847 20,520 1 Primary Care Prescribing 4.9 18,727,506 21,718,506 5,405,912 5,283,441 122,471 1 21,228,622 489,884 2 Primary Care Services 20,020,057 21,314,118 5,328,530 5,378,456 (49,926) (0) 21,513,822 (199,704) (1) Hosted Services 5,906,873 5,551,813 1,419,760 1,454,698 (34,938) (1) 5,691,565 (139,752) (3) Out of Area 720,131 1,780,000 419,118 399,712 19,406 1 1,702,376 77,624 4 Improvement Grants 1,060,200 1,060,200 214,271 214,270 0 0 1,060,200 0 0 Childrens & Justice Services 19,482,682 20,592,093 5,251,772 5,259,861 (8,089) (0) 20,624,450 (32,357) (0) Total Moray IJB Core 178,049,573 185,994,166 46,218,061 47,643,992 (1,425,931) (1) 191,532,223 (5,538,057) (3) Other non-recurring Strategic Funds in the ledger 1,194,806 4,097,819 1,401,859 1,359,225 42,634 1 3,793,975 170,538 4 Total Moray IJB Including Other Strategic funds in the ledger 179,244,379 190,091,985 47,619,920 49,003,217 (1,383,297) (1) 195,326,198 (5,367,519) (3) Other resources not included in ledger under core and strategic: 18,960,861 4,380,390 (853,800) (218,762) (635,038) (14) 2,479,124 682,187 16 Total Moray IJB (incl. other strategic funds) and other costs not in ledger 198,205,240 194,472,375 46,766,120 48,784,455 (2,018,334) (1) 197,805,322 (4,685,332) (2) Set Aside Budget 15,638,000 15,638,000 - 15,638,000 0 0 Overall Total Moray IJB 213,843,240 210,110,375 46,766,120 48,784,455 (2,018,334) (1) 213,443,322 (4,685,332) (2) Funded By: NHS Grampian 120,508,039 Moray Council 89,602,336 Total 210,110,375 Page 47
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APPENDIX 2 Description of MIJB Core Services 1. Community Hospitals includes community hospitals, community administration and community Medical services in Moray. 2. Community Nursing related to Community Nursing services throughout Moray, including District Nurses and Health Visitors. 3. Learning Disabilities budget comprises of:- • Transitions, • Staff – social work and admin infrastructure, • External purchasing of care for residential & nursing care, • External purchasing of care for respite, day care and domiciliary care, • Medical, Nursing, Allied Health Professionals and other staff. 4. Mental Health budget comprises of:- • Staff social work and admin infrastructure, • External purchasing of care for residential & nursing care, • External purchasing of care for respite, day care and domiciliary care, • In patient accommodation in Buckie & Elgin. • Medical, Nursing, Allied Health Professionals and other staff. 5. Addictions budget comprises of:- • Staff – social work and admin infrastructure, • Medical and nursing staff • External purchasing of care for residential & nursing care, • External purchasing of care for respite, day care and domiciliary care, • Moray Alcohol & Drugs Partnership. 6. Adult Protection and Health Improvement 7. Care Services provided in-house Services budget comprises of:- • Employment Support services, • Care at Home service/ re-ablement, • Integrated Day services (including Moray Resource Centre), • Supported Housing/Respite and • Occupational Therapy Equipment Store. 8. Older People & Physical Sensory Disability (PSD) budget comprises of:- • Staff – social work infrastructure (including access team and area teams), • External purchasing of care for residential & nursing care, • External purchasing of care for respite, day care and domiciliary care and • Residential & Nursing Care home (permanent care), 9. Intermediate Care & Occupational Therapy budget includes:- • Staff – OT infrastructure • Occupational therapy equipment Page 48
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• Telecare/ Community Alarm equipment, • Blue Badge scheme 10. Other Community Services budget comprises of:- • Community services for each locality (Allied Health Professionals (AHP’s), Dental services, Public Health, Pharmacy and other specialist nursing roles). 11. Admin & Management budget comprises of :- • Admin & Management staff infrastructure, • Commissioning and Performance team, • Carefirst team, • Older People development, • Community Care finance, • Self Directed support & Carers • Target for staffing efficiencies from vacancies 12. Other Operational Services - range of operational services including – • Community Response Team • Child Protection • Winter Pressures • Clinical Governance • International Normalised Ratio (INR) blood clotting test Training • Moray Alcohol and Drug Partnership (ADP) 13. Primary Care Prescribing includes cost of drugs prescribed in Moray. 14. Primary Care Services relate to General Practitioner GP services in Moray. 15. Hosted Services, comprises of a range of Grampian wide services. These services are hosted and managed by a specific IJB on a Grampian wide basis and costs are re-allocated to IJB budgets. These services include:- Moray IJB Hosted & Managed services: • GMED out of Hours service. • Primary Care Contracts Team Aberdeen City/Aberdeenshire IJB Hosted & Managed services: • Intermediate care of elderly & rehab. • Marie Curie Nursing Service – out of hours nursing service for end of life patients • Continence Service – provides advice on continence issues and runs continence clinics • Sexual Health service • Diabetes Development Funding – overseen by the diabetes Network. Also covers the retinal screening service • Chronic Oedema Service – provides specialist support to oedema patients Page 49
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• Heart Failure Service – provided specialist nursing support to patients suffering from heart failure. • Police Forensic Examiner Service • HMP Grampian – provision of healthcare to HMP Grampian. 16. Out of Area Placements for a range of needs and conditions in accommodation out with Grampian. These are managed centrally within NHS Grampian and charged to IJB’s. 17. Improvement Grants managed by Council Housing Service, budget comprises of:- • Disabled adaptations • Private Sector Improvement grants • Grass cutting scheme 18. Children Services & Criminal Justice budget includes the following areas: a) Children Services area teams budget includes:- • Staff – social work (including access team, area teams, disability team, SCIM and Child Protection Unit) • Self directed support • Fostering home to school transport • Support to families b) Quality Assurance team budget includes:- • Staff – social work • Locality management groups funding c) Reviewing Team d) Commissioned Services budget includes:- • Commissioning team • Contracts for all services e) Corporate Parenting budget includes:- • Staff – social work (including fostering, adoption and throughcare/aftercare) • Continuing care payments, income maintenance, supported lodgings and throughcare/aftercare grants • Fostering/kinship fees and allowances. Placements with external fostering agencies. • Adoption allowances • Adoption fees to other local authorities f) Children Services Residential Unit - Cala g) Justice Services budget includes:- • Staff – social work • Youth Pod • Out of Hours team • Community Justice Reform Page 50
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• Criminal Justice Services h) Children Services Strategy and Support budget comprises of:- • Central management staffing • Trauma Informed Practice • Community Mental Health and Wellbeing Supports and Services • Target for staffing efficiencies from vacancies i) Additional grant funding • Unaccompanied asylum seeking children • Corra Foundation Other definitions: Tier 1- Help to help you (information and advice), universal services to the whole community and an emphasis on prevention. Tier 2- Help when you need it (immediate help in a crisis, re-ablement) and regaining independence. Tier 3- Ongoing support for those in need through the delivery of 1 or more self-directed support options. Page 51
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APPENDIX 3NT FINANCE REPORT APRIL 2025-MARCH 2026 Appendix 3 Para Approved Annual Recurring deficit/surplus Savings Amended Approved Net Budget Other budget adjustments Annual Budget as at 30.6.2025 Ref Net Budget £'s £'s £'s £'s £'s £'s 2025-26 2025-26 2025-26 2025-26 2025-26 2025-26 Community Hospitals 6,600,692 375,954 (258,000) 6,718,647 616,043 7,334,690 Community Nursing 6,484,911 (318,220) (207,161) 5,959,530 235,181 6,194,711 Learning Disabilities 17,865,037 2,128,693 (198,000) 19,795,730 270,429 20,066,159 Mental Health 11,945,985 42,315 (371,430) 11,616,871 289,838 11,906,709 Addictions 1,221,222 (229,115) (25,638) 966,469 271,913 1,238,382 Adult Protection & Health Improvement 265,307 5,424 0 270,731 2,723 273,454 Care Services provided in-house 25,594,449 (2,071,331) (721,000) 22,802,118 63,466 22,865,584 Older People & PSD Services 25,172,334 1,499,151 0 26,671,485 1,151,795 27,823,280 Intermediate Care & OT 1,904,400 166,961 (134,070) 1,937,291 (10,009) 1,927,282 Other Community Services 10,220,408 (263,108) (352,711) 9,604,589 495,047 10,099,636 Admin & Management 3,604,337 372,197 (2,357,017) 1,619,517 1,137,665 2,757,182 Other Operational Services 1,253,043 195,622 (42,811) 1,405,854 84,513 1,490,367 Primary Care Prescribing 18,727,506 3,175,000 (169,000) 21,733,506 (15,000) 21,718,506 Primary Care Services 20,020,057 (181,386) 0 19,838,671 1,475,447 21,314,118 Hosted Services 5,906,873 29,696 (177,000) 5,759,569 (207,756) 5,551,813 Out of Area 720,131 1,059,869 0 1,780,000 0 1,780,000 Improvement Grants 1,060,200 0 0 1,060,200 0 1,060,200 Childrens Services 19,482,682 0 (550,719) 18,931,963 1,660,130 20,592,093 Total Moray IJB Core 178,049,572 5,987,723 (5,564,557) 178,472,739 7,521,427 185,994,166 Other recurring Strategic Funds in the ledger 1,194,806 0 0 1,194,806 2,903,013 4,097,819 Total Moray IJB Including Other Strategic funds in the ledger 179,244,378 5,987,723 (5,564,557) 179,667,545 10,424,440 190,091,985 Other resources not included in ledger under core and strategic: 18,960,862 (5,987,723) 0 0 0 4,380,389 Total Moray IJB (incl. other strategic funds) and other costs not in ledger 198,205,240 0 (5,564,557) 179,667,545 10,424,440 194,472,374 Set Aside Budget 15,638,000 15,638,000 15,638,000 Overall Total Moray IJB 213,843,240 0 (5,564,557) 195,305,545 10,424,440 210,110,374 Funded By: NHS Grampian 113,215,806 0 0 0 0 120,508,038 Moray Council 90,159,571 0 0 0 0 89,602,336 Savings identified 9,467,863 Use of ear marked reserves 1,000,000 IJB FUNDING 213,843,240 0 0 0 0 210,110,374 Reconciliation Page 52
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APPENDIX 4 HEALTH & SOCIAL CARE MORAY DELEGATED AUTHORITY REPORTS - PERIOD April to June 2025 Title of DAR Summary of Proposal Post(s) Permanent/ Temporary Duration (if Temporary) Effective Dates Funding Transfer staff and funds from Cedarwood Day Service to Care at Home Convert Grade 7, Day Centre Officer 36.25 hours post at Cedarwood Day Service to increase Grade 8 hours under Care at Home from 18.25 hours to 36.25. Delete Grade 7 36.25 hours Transfer 18.25 hours to grade 8 Remainder will be a saving Permanent N/A ASAP Funding already in place and this will release a saving Close Greenfingers Close and delete both Greenfingers budgets Delete all posts/positions linked to Greenfingers project, which are: 1 x vacant grade 8 Day Service Coordinator (36.25) 1 x grade 7 Day Centre Officer (36.25 hours) 1 x grade 3 Clerical Assistant (18 hours) 1 x grade 4 Training Support Worker Driver (36.25 hours) Permanent N/A ASAP Savings taken Page 53
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Title of DAR Summary of Proposal Post(s) Permanent/ Temporary Duration (if Temporary) Effective Dates Funding 1 x grade 4 Training Support Worker Driver (32.25 hours) 1 x vacant grade 4 Training Support Worker Driver (36.25 hours) Direct Payment Financial Reviews To establish 1 FTE permanent Grade 4 Financial Review to lead on the completion of Direct Payment financial reviews. In line with the internal audit, the outstanding reviews have been prioritised and are being addressed efficiently by the post holder. Create Grade 4 36.25 hours Permanent N/A ASAP Funding will come from the monies reclaimed by the post holder Commissioning & Quality Assurance Post (Remove from structure for Budget Saving) Removal of the Grade 8 Commissioning & Quality Assurance Post from the structure as a budget saving for Performance and Commissioning Remove grade 8 post Permanent N/A ASAP Savings taken Page 54
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Title of DAR Summary of Proposal Post(s) Permanent/ Temporary Duration (if Temporary) Effective Dates Funding team for a recurring saving from April 2025. Page 55
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MIJB Budget 2025/26 APPENDIX 5 MIJB proposed savings Ref Service Brief Description Full year effect £000s Saving expected for 2025/26 Saving likely to be achieved in 2025/26 Planned Implementation Date Risk Level Risk Description BR 1 Internal Care at Home review Review of Internal care at home including redesign 122.00 122.00 122.00 Apr 25 Red Timeline Continuation of 24/5 saving BR 4 &5 Removal of locum / implement CESR Cease locum use - gradual & implement 2 CESR fellows 1,044.00 261.00 217.00 Jan-26 Green Recruitment Taking longer than expected and not both vacancies at the same time continuation of 24/5 saving BR 6,7,8 GMED redesign Relocation from Health Village, redesign of clinical & admin staffing model, Ad astra Ehealth system 110.00 110.00 110.00 Apr 25 Green Workforce Impact Parking Footfall dependent on location Delayed for 3 months BR 9 Pool car vs expenses review Review into all teams transport and expenses to evalaute best options 20.00 20.00 20.00 Apr-25 Green Time and capacity – will be spend to save in the first instance BR 10,12 Cessation of leases and relocation Southfield, Strathisla dental practice 63.00 63.00 63.00 Apr-25 Green none Lease cessation delayed by a month BR 14 Review of Care spot purchasing & review care packages 1,000.00 1,000.00 250.00 Jan-26 Red Reviews commenced in Jan 2025 and this is the continuation of that work already started BR 15 Review of Care Purchasing 700.00 700.00 350.00 Oct-26 Red BR 42 *new SDS recovery Review packages to increase recovery 350.00 350.00 350.00 Apr-25 Green Reviews are not completed timeously HF 16 Short Breaks provision Review into planned and emergency short breaks - change in model 413.00 413.00 213.00 Apr-25 Amber Time to implement fully Care home bed shortage Care Home Provider monopoly Competition from other boards Time heavy paperwork for care homes HF 17 Proportionate care Redesign model 555.00 555.00 - Apr-25 Red Time to fully implement Needs full EQIA Service user safety Internal progressing slower than expected and external delayed until next financial year Page 56
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APPENDIX 5 HF 18 Night Time Responder (LD) Redesign LD nighttime model of care delivery 277.00 277.00 77.00 Apr-25 Amber Organisational change More complex than expected and delayed from 24/25 HF 20 Community hospital redesign Redesign of inpatient services supporting Home First 200.00 200.00 200.00 Apr-25 Amber Contentious – public opinion Reputational damage Impact on secondary care Progressing but other pressures on the budget PIC 23 Commissioning and contracts review Review of all contracts and redesign of provisions 350.00 350.00 350.00 Apr-25 Green Time and capacity, reputational damage Balance of needs versus costs Continuation of last years work with providers PIC 21,24 Day Services review MRC catering & infrastructure 220.00 220.00 220.00 Apr-25 Amber Reputational damage Impact on Unpaid carers Downstream impact Impact on MH of service user PIC 25 Complex & challenging behaviour unit Review Review into Woodview and change management 657.00 159.00 159.00 Apr-25 Green Organisational change, continuation of 24/5 proposal PIC 26 Care home bed usage - LD review care home bed utilitsation 182.00 121.00 121.00 Apr-25 Amber PIC 27 LD review & review Internal review and redesign, review care home bed utilitsation 554.00 370.00 - Apr-25 Red need to carry forward to 26/27 Any care package savings has implications for safety. Requires care home registration change and agreed costings . Continuation of 24/5 saving PIC 28 Review of step down building based facilities Review into model of care 118.00 69.00 40.00 Apr-25 Amber Lack of step down facility Impact on acute /secondary care/ primary care Continuation of 24/5 saving PIC 30 Prescribing efficiencies -GP Medication cessatio,switches within GP services and work with Care Homes 669.00 100.00 100.00 Apr-25 Green Pan Grampian approach may take tme to implement Progressing but other pressures on the budget Continuation of 24/5 saving PIC 43*new Prescribing efficiencies -Care home 69.00 69.00 Apr-25 Green Pan Grampian approach may take tme to implement Progressing but other pressures on the budget PIC 31 Digital Support efficiencies - NO TEMPLATE REQUIRED As part of DHI (Moray Growth Deal and Analogue To Digital Proposal) 100.00 100.00 - Apr-25 Red Pan Grampian approach may take time to implement Page 57
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APPENDIX 5 PIC 33 Transport contract Review fo how we contract for transport for childrens and adult services 292.00 146.00 146.00 Oct-25 Amber Time and resources AI 44 *new Reduction in overtime reduce the amount spent on overtime during the year 200.00 200.00 200.00 Apr-25 Green Recruitment levels PIC 46 *new Review of palliative care services Review of provision of palliative care in Moray to improve outcomes 117.00 117.00 117.00 Apr-25 Amber Contentious – public opinion Reputational damage Impact on secondary care AI 38 No non-essential travel (I year) Non essential travel ban (out of area) 30.00 30.00 30.00 Apr-25 Green Impact on staff development AI 38 No non-essential training (I year) Non essential training ban (conference attendance etc) 20.00 20.00 20.00 Apr-25 Green Impact on staff development AI 41 *new Vacancy target NHS & increase on Council in line with pay award increase Already implemented 1,135.00 1,135.00 1,135.00 Apr-25 Green AI 47* new Healthcare system reduced payment Refund due for system 20.00 20.00 20.00 Apr-25 Green Implemented - refund received AI 48* new 3.42% budget cut on other services not included above 3.42% reduction in expenditure across a variety of budget headings 2,172.00 2,172.00 2,172.00 Mar-25 Green Implemented TOTAL 11,690.00 9,469.00 6,871.00 KEY BR Building Resilience HF Home First PIC Partners in Care 2,598.00 AI Already implemented Page 58
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: MORAY INTEGRATION JOINT BOARD STRATEGIC RISK REGISTER BY: CHIEF OFFICER 1. REASON FOR REPORT 1.1 To present the Board with an updated Strategic Risk Register, providing a clear overview of current strategic risks, their assessments, and mitigating actions. This supports informed decision-making, strengthens strategic planning and reinforces effective risk governance aligned with the Strategic Plan. 2. RECOMMENDATION 2.1 It is recommended that the Board: i) Scrutinise and approve the updated Strategic Risk Register (Appendix 1), including the adequacy of the identified mitigating controls identified; and ii) Scrutinise and approve the inclusion of a new risk related to the limited assurance position given by the Moray Integration Joint Board Auditor. 3. BACKGROUND 3.1 The Strategic Risk Register is reviewed regularly by the Senior Management Team, as part of a robust risk monitoring framework. 3.2 The Moray Integration Joint Board (MIJB) Strategic Risk Register is attached at Appendix 1, and outlines the current risks being faced by the MIJB, their assessments, and mitigating actions. 3.3 Risk scores are determined using the MIJB Risk Policy (Section 5), based on likelihood and impact. 3.4 As agreed at Audit, Performance and Risk Committee 26 October 2023 (para 8 of the minute refers), reporting frequency was amended from quarterly to biannually unless significant changes arise. Item 9. Page 59
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4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The Risk Management Framework review approved by the Board on 25 June 2020 (para 9 of the minute refers). Risk Appetite Statements are included in Appendix 1. 4.2 The updated Strategic Risk Register incorporates feedback from the October 2024 hybrid session with Board members, ensuring alignment with strategic priorities and operational realities. 4.3 The approved Risk Appetite Statements guide decision making and balance innovation with compliance and continuity. 4.4 The financial position of the Board poses significant complexity to service planning. The updated risk register highlights the financial pressures experienced by funding partners and their potential impact on strategic planning and decision-making. The updated register includes detailed assessments and mitigations to address the risk, resulting in the risk being downgraded from Very High to High. 4.5 The workforce strategy is critical to maintaining the quality of paid and unpaid Health & Social Care. Mitigations and current controls are outlined to address these challenges and secure the sustainability of the workforce. This has resulted in a reduction of High to Medium. 4.6 Effective governance and compliance with legislative and regulatory requirements are paramount. The register includes risks related to governance functionality, stakeholder engagement, and compliance with statutory obligations. Mitigations and assurances have improved to ensure robust governance structures and processes are in place. This has resulted in a reduction from High to Medium. 4.7 The Board’s strategic aspirations must be sufficiently transformative to deliver sustainable outcomes for people. The register addresses the challenges and mitigations, including the recent approval of the Strategic Delivery Plan, focus on aligning financial decisions with strategic goals and implementing proactive risk strategies. This has resulted in a reduction from High to Medium. 4.8 The Board must exert influence on services delegated but hosted within another organisation. Collaborative approach and oversight has reduced the risk from High to Medium. 4.9 The MIJB Internal Auditor recently issued a ‘Limited Assurance’ rating for MIJB (para 8 of the minute of Audit, Performance and Risk Committee on 19 June 2025 refers). A new risk has been added to the Register, outlining mitigation actions and a clear plan to achieve an ‘Assured’ position by 2026. This risk is currently graded as Medium. Page 60
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5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” The MIJB requires effective governance arrangements for those services and functions delegated to it and Risk Management systems are integral to this. (b) Policy and Legal As set out in the terms of reference, the Board has responsibility to provide assurance of the adequacy of the risk management framework. There are no legal implications arising from this report. (c) Financial implications There are no direct financial implications arising from this report however, the Board should note the failure to manage risks effectively could have a financial impact for the MIJB. (d) Risk Implications and Mitigation This report forms part of the governance arrangements for identifying and managing strategic risks of the MIJB. The risks are outlined in the body of the report in section 4. (e) Staffing Implications There are no additional staffing implications arising from this report. (f) Property There are no property implications arising from this report. (g) Equalities/Socio Economic Impact An Equalities Impact Assessment is not required because there are no service, policy or organisational changes being proposed. However, Impact Assessments will be core to any decision making process. (h) Climate Change and Biodiversity Impacts There are no impacts arising from this report. (i) Directions None arising from this report. (j) Consultations Consultation on this report has taken place with the Board members, and Senior Management Team. 6. CONCLUSION 6.1 The updated Strategic Risk Register reflects a collaborative approach to risk management. It aligns with strategic priorities and operational realities, and Page 61
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the Board is asked to approve the updated register to reinforce its commitment to effective governance. Author of Report: Sonya Duncan, Corporate Manager Background Papers: held by HSCM Ref: Page 62
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IJB RISK REGISTER SUMMARY – September 2025 APPENDIX 1 Risk Assessment Table – Multiply likelihood score by impact score to determine the risk rating (score). Risk No Risk Risk Owner Previous Risk Rating Last Reviewed Change Current Rating 1 There is a risk that the MIJB does not function as set out within the Integration Scheme, Strategic Plan and in-line with its Governance Framework and fails to deliver its objectives or expected outcomes. Chief Officer Contributor: Senior Leadership Team Error! Reference source not found. September 2025 Medium 2 The MIJB must operate within the resources allocated to it by the partner bodies and it is good financial practice to set a balanced budget at the start of each financial year. There is a risk that Financial pressures being experienced by the funding partners will directly impact the MIJB’s strategic planning of services and its decision-making Chief Officer Contributor: Chief Finance Officer/ Heads of Service/ Chief Nurse Very High September 2025 High 3 There is a risk that the MIJB’s workforce strategy is not delivered, affecting the quality of paid and unpaid Health & Social Care. Chief Officer Contributor: Heads of Service/ Chief Nurse High September 2025 Medium 4 There is a risk that the MIJB is unable to operate effectively as a Public Body. Chief Officer Contributor: Corporate Manager/ Chief Finance Officer Medium September 2025 Medium 5 There is a risk that the MIJB does not comply with the necessary legislative and regulatory requirements in which it operates. Chief Officer Contributor: Senior Leadership Team High September 2025 Medium 6 There is a risk that the MIJB’s strategic aspirations are not sufficiently transformative and as a result, that it is unable to deliver outcomes for people in a sustainable way. Chief Officer Contributor: Senior Leadership Team High September 2025 Medium 7 There is a risk that the MIJB is unable to exert influence on services delegated but hosted within another organisation. Chief Officer Contributor: Heads of Service High September 2025 Medium Page 63
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8 There is a risk that the MIJB’s internal control and governance arrangements are not sufficiently robust, as evidenced by the 2024/25 Internal Audit opinion of ‘limited assurance’ Chief Officer Contributor: Senior Leadership Team September 2025 n/a Medium Page 64
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Risk 1: There is a risk that the MIJB does not function as set out within the Integration Scheme, Strategic Plan and in-line with its Governance Framework and fails to deliver its objectives or expected outcomes. Consequence: Legal and Regulatory Implications, Reputational Damage, Loss of Stakeholder Trust, Resource Challenges, Service Disruption, Failure to deliver Health Outcomes Risk Rating: Medium Risk Appetite: Moderate-High Risk Movement: Historical Risk Rating: Medium September 2025 Rationale for Risk Appetite as reflected by MIJB in Appendix 2: • Strategic Priorities require innovative approaches to integration that may involve governance development • Outcomes depend on our ability to make timely decisions through efficient governance structures • The board recognises that complete risk aversion would prevent necessary transformation of services • A Moderate appetite allows for controlled governance exploration while maintaining core statutory compliance Rationale for Risk Rating: MIJB is committed to maintaining appropriate standards of care and governance through: • Proactive regulatory compliance • Robust operational policies • Adaptive approach to emerging healthcare challenges MIJB will only accept regulatory risks after: • Thorough consultation with regulatory bodies • Comprehensive risk assessment • Development of clear mitigation strategies • Ensuring minimal potential for service disruption Risk scoring before mitigations/controls Mitigations / Current controls in place Risk scoring after mitigations/controls 4 5 20 1. Integration Scheme is in place, approved March 2023. 2. Consultation with legal representative for all reports to committees and attendance at committee for key reports. 3. Induction sessions are held for new MIJB members. 2 3 6 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 65
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Assurances: • MIJB Scheme of Integration • Audit, Performance and Risk Committee (APR) provides quarterly scrutiny of governance compliance with minutes to the Board. • Internal Audit conducts reviews with formal recommendations and monitoring to APR • Budget Savings Oversight Group monitors financial governance monthly with escalation pathways to SMT and MIJB. • Service Reporting to Board for strategic decisions and updates. • The Moray Transformation Board and Strategic Planning and Commissioning Group provides oversight of planned business across HSCM. • Budget Savings Oversight Group on monthly basis. • Monthly Tri-partite partnership performance meetings with partner CEOs, Finance Directors and Chair/Vice Chair of MIJB • Care Inspectorate assessment of services, including governance impact on service delivery. • Annual governance statement for external audit. • Strategic Delivery Plan (approved June 2025) incorporates the work being driven across all areas of the MIJB’s Strategic Plan priorities and will be reported regularly to AP&R Committee Gaps in Assurance: Mapping of the recently delegated services will take place to ensure the statutory governance requirements and those of MIJB are robust. Current Performance: • The Scheme of Administration is updated as required. • The Governance Framework was approved by MIJB on 28 January 2021. • Re-appointment of Standards Officer agreed by MIJB 28 March 2024. • Members Handbook updated and circulated to 100% of members in June 2022 • Quarterly performance to APR including benchmarking and targets. • All committees submitted required reports on schedule in 2024/25 • 100% of new members received induction on appointment • Standards training was delivered to all members in February 2024 with an update during MIJB Development session in August 2025 4. Conduct and Standards training held for MIJB Members in June 2022 and February 2024 provided by Legal Services. 5. Programme of Development Sessions held throughout the year with all MIJB members and Officers 6. Regular Senior Management Team (SMT) and Operational Management Team (OMT) meetings to provide direction and support to managers and teams, with agreed focus and priorities aligned to the Strategic Delivery Plan 7. Implementation of HSCM Internal Audit Process providing assurance and escalation process to SMT Page 66
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• Development sessions: 5 planned for 2025/26, 3 completed to date, with the most recent in August 2025, next one scheduled for October 2025. Further Controls Required Further Controls Owner Full integration of Childrens, Families and Justice services to be realised HoS/CO To be agreed Review of MIJB Members Handbook Required – in progress Corporate Manager/Legal Services 30/12/25 Target Date Page 67
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Risk 2: The MIJB must operate within the resources allocated to it by the partner bodies and it is good financial practice to set a balanced budget at the start of each financial year. There is a risk that Financial pressures being experienced by the funding partners will directly impact the MIJB’s strategic planning of services and its decision-making Consequence: Inability to deliver strategic priorities, potential statutory service cuts. Reduced service capacity, financial instability, compromised care delivery Risk Rating: High Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Very High September 2025 Rationale for Risk Appetite (as detailed in Appendix 2) • Willing to accept moderate financial risks in pursuit of strategic objectives • Conservative approach to core budget management • Higher tolerance for innovative projects with clear benefits • Low tolerance for financial decisions that could threaten long-term sustainability Rationale for Risk Rating: The Board’s financial risk management approach emphasises: • Absolute commitment to financial sustainability • Minimising wherever possible risk to essential service delivery • Protecting vulnerable persons using services Financial risks will only be tolerated when: • A comprehensive business case demonstrates clear, measureable benefits (i.e. spend to save initiatives) • The initiative directly supports long-term health and social care sustainability • Robust risk mitigation strategies are in place • Stakeholder consultation ensures transparency and collective understanding • Willing to accept moderate financial risks in pursuit of strategic objectives • Conservative approach to core budget management • Higher tolerance for innovative projects with clear benefits • Low tolerance for financial decisions that could threaten long-term sustainability Unprecedented financial pressures on public sector funding: • Challenging economic environment • Rapidly increasing service demand Strategic financial principles and prioritisation: • Sustainable Financial Planning • Develop robust, realistic financial plans • Align budgets with long term sustainability • Focus on highest and best value initiatives • Align financial decisions with strategic goals Comprehensive Risk Mitigation: • Implement proactive financial risk strategies Page 68
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• Protect critical service delivery Stakeholder Engagement: • Transparent financial communication • Collaborative decision making processes • MIJB Board Members Development Sessions Assurances: • Quarterly Budget monitoring reporting to MIJB • Financial Reporting through MIJB, NHS Grampian and Moray Council • The Project Management Office will support the Budget Savings Delivery as part of the budget setting for 2025/26 onwards. • Financial Development Sessions with MIJB members. • Internal Audit quarterly reporting to APR • External Audits presented to MIJB/ Committees as appropriate. • Six weekly Tri-partite partnership performance meetings with partner CEOs, Finance Directors and regular meetings with the Chair/Vice Chair of MIJB • Strategic Delivery Plan (approved June 2025) incorporates the work being driven across all areas of the MIJB’s Strategic Plan priorities and will be reported regularly to AP&R Committee Gaps in Assurance: • Senior Management Team (SMT) continues to work to build further capacity within the current workforce to support the planning, consultation and implementation required to deliver the financial savings. • Current Performance: The Revenue Budget Outturn for 2024/25 was presented and a balanced budget for 2025/26 was agreed by MIJB on 27 March 2025 A Financial Savings Plan for 2025/26 was agreed by MIJB on 27 March 2025. Comments: Further Controls Required Further Controls Owner Target Date Managing the risk - Current controls in place 5 5 25 1. Medium Term Financial Framework (MTFF) approved by MIJB on 30th March 2025. 2. Additional resource to support the Budget Savings Delivery was agreed until September 2025. This has been extended to March 2026. 3. Tri-partite partnership performance meetings with partner CEOs, Finance Directors and Chair/Vice Chair of MIJB. 4. Operational financial monitoring undertaken by Chief Finance Officer (CFO), Heads of Service (HOS) and Budget Managers. 5. Budget Savings Oversight Group chaired by Chief Officer, attended by HOS, CFO and Service Managers as appropriate. 6. Monitoring of MIJB Strategic Delivery Plan ensuring all projects are aligned with savings plans. 3 5 15 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 69
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APR committee to receive biannual updates on Strategic Delivery Plan CO October 2025 Review Date Review Notes / Decisions Risk 3: There is a risk that the MIJB’s workforce strategy is not delivered impacting the quality of paid and unpaid Health & Social Care. Consequence: Service disruption and reduced capacity, Increased Workload and staff burnout, Significant Financial impact, Deteriorating Staff and Unpaid Carers Morale and Engagement, Compromised Patient Safety and Care Quality, Negative Public Perception and Reputation Damage Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: High September 2025 Rationale for Risk Appetite (as detailed in Appendix 2) MIJB will only accept minimal risk to people accessing services, unpaid carers or staff when the comparative risk of doing nothing is higher than the risk of intervention. Safety risks inherent in Health and Social care services demand exceptional management and clinical care standards. The Board recognises that: • Individual safety is paramount • Person-centred care involves supporting informed decision-making, which may introduce nuanced risk scenarios A balanced approach is critical, considering both individual and community safety risks Rationale for Risk Rating: Recruitment Difficulties: • Persistent challenges in recruiting skilled professionals in critical areas: o Allied Health Professions o Social Work o Dental Services Pandemic-Induced Complications: • Reduced graduate numbers due to Covid-19 disruptions • Ongoing strain on partnership resources across frontline and support functions • Staffing Instability • High proportion of fixed term and seconded contracts due to financial constraints • Potential workforce instability as temporary contracts conclude • Need for significant organisational transformation • High proportion of an aging workforce by NHSG and MC is increasing with more staff opting to retire early or requests for reduced working hours. Geographical and Structural Barriers: • Lack of suitable housing for healthcare professionals in Moray • Challenges in Care Homes recruitment and retention Strategic Workforce Transformation: Page 70
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• Capacity constraints in delivering financial recovery initiatives • Potential requirement for internal role allocation • Alignment needed between workforce strategy and financial sustainability National Context: • Ongoing GP sustainability challenges Assurances: • Operational oversight by Moray Workforce Forum. • The HSCM Response Group continues to focus on leadership around emerging issues and resolving them, including staffing. • The Carers Strategy extension was approved by MIJB June 2025, extending to March 2028. The focus is on developing support to the large, valued workforce of unpaid carers within Moray. • The Resource Management Group (RMG) considers all vacancies before being considered for external advertisement. Gaps in Assurance: • Further capacity will be required to develop and implement workforce plans to reflect updated delivery plans to reflect the financial savings required. • Due to the required scrutiny and control of financial spend, there continues to be a delay in recruitment processes often taking in excess of 8 weeks, which can cause additional pressure on staff and service delivery. Managing the risk - Current controls in place 5 5 25 1. Ongoing review of HSCM Structure to identify areas for consideration, development, reconfiguration 2. Moray Council conducted an assessment of needs, including people working in the Health and Care sector. 3. Staff wellbeing is a key focus and there are many initiatives across both parent organisations offering information, support and access to activities. 4. Collaborative approaches with educational institutions e.g. intakes and programmes for future workforce development. 5. Professional Development and retention programmes; Incentives have been secured to attract additional NHS dentists and dental practices to Moray. The Scottish Dental Access Initiative includes Moray, with grants of £50,000 and above available to allow dental practices to be established or extended, provided there is a seven-year commitment to providing NHS treatment. A recruitment and retention bonus is also being offered to eligible new dentists in Moray 6. GP sustainability Group and Primary Care Vison for the Future Groups now progressing across Grampian. 7. iMatter reports are an opportunity for staff’s opinions on the MIJB and wider organisation. 8. Recruitment process underway for MIJB Unpaid Carer Representative. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 71
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• There can be a lack of suitable applicants for some posts, which affects the ability to appoint to some roles. • Current Performance: Comments: Staffing issues are monitored by the Operational Management Team (OMT) working collaboratively to seek opportunities to make jobs more attractive where it has proven difficult to recruit in the past. There is the risk that staff move from one position to another within HSCM, as in unintended consequence creating a vacancy elsewhere in the system. This needs to be considered when fixed term contracts and secondments are planned; consideration needs to be given to the whole of HSCM and not services in isolation. Many of our staff may have transferrable skills and experience. Further Controls Required Further Controls Owner Target Date Review and update of the Workforce Plan TBC TBC Review Date Review Notes / Decisions Sept 2025 The Public Dental Service have been successful in their recruitment drive and dentist numbers are now reasonably stable. Page 72
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Risk 4: Inability to demonstrate effective governance and effective communication and engagement with stakeholders. Consequence: Suboptimal outcomes for people, Erosion of organisational trust and credibility, Increased legal and regulatory compliance risks Workforce demotivation and disengagement, missed strategic opportunities and collaborative potential, reduced organisational responsiveness and adaptability Risk Rating: Medium Risk Appetite: Low-Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium September 2025 Rationale for Risk Appetite (as detailed in Appendix 2) The Board acknowledges the critical importance of: • Robust stakeholder relationships • Effective collaboration and co-production • Adaptive partnership working • Recognising diverse stakeholder capacities and readiness for change Strategic principles guiding stakeholder engagement: • Maintaining constructive, transparent relationships • Balancing organisational objectives with collaborative dynamics • Ensuring inclusive and meaningful engagement processes • Protecting long-term partnership sustainability Continuous Improvement in communication processes Rationale for Risk Rating: Comprehensive Governance and Engagement Challenges: Stakeholder Feedback and Engagement Gaps • Potential weaknesses in: o Communication clarity issues o Engagement process inefficiencies o Unclear outcome expectations o Perceived disconnect between organisational intentions and practical implementation o Cost of living and digital exclusion are potentially additional barriers for engagement Governance and Communication Structural Challenges • Potential weaknesses in: o Interdepartmental communication channels – staff communications across two different parent organisations o Stakeholder consultation mechanisms o Transparent reporting and accountability processes o Strategic alignment communication Collaborative Partnership Dynamics o Varied stakeholder readiness and capacity for change o Potential misalignment of expectations o Complex interdependencies across different organisational contexts Risk of Disengagement • Inadequate communication may lead to: Page 73
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o Reduced stakeholder trust o Diminished collaborative potential Increased resistance to organisational initiatives Assurances: • Oversight and scrutiny by Clinical and Care Governance Committee, Audit Performance and Risk Committee and MIJB • Strategic Planning & Commissioning Group (SPCG) • MIJB Audit, Performance and Risk Committee • 3rd Sector and Stakeholder Representatives on MIJB and committees • Local Outcome Improvement Plan (LOIP). • Community Planning • ADP • Locality Reporting to MIJB • Stakeholder Representative on GP Vision Board • Summary reports of MIJB submitted to Moray Council and NHSG committees Gaps in Assurance: • Seek to improve the level of engagement across Moray • Communication and Engagement Strategy was approved in 2019 and is in the process of being updated. • More systematic approach to stakeholder consultation required. • Establish a more robust process for youth representation Current Performance: • SPCG meets quarterly • Locality Plans reviewed with the Strategic Delivery Plan • LOIP plans linked to MIJB Strategic Plan • Annual Performance Report for 2024/25 published in July 2025. • Community engagement in place for key projects areas such as Forres, Keith and Lossiemouth Managing the risk - Current controls in place 4 4 16 • Refocus of Strategic Planning & Commissioning Group (SPCG) to support locality engagement. • Continued working with Community Planning colleagues to oversee the development of locality planning. • Grampian Joint Strategic Needs Assessment Group, including participation from community groups. • Engagement with diverse groups across Moray e.g. Alcohol & Drug Partnership, School Nurses. • Continued development of HSCM/MIJB webpages and Facebook • ‘Planning with People’ principles adopted as per Healthcare Improvement Scotland (HIS) 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 74
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Comments: • A communication cell was established as part of the Local Resilience Partnership response. This forum provides assurance that messages to all stakeholders are consistent. • Early conversations are planned to discuss a Grampian partnership communications group to ensure consistent messaging regards service redesign and changes, ensuring a consistent message to all citizens of Grampian, in particular for area wide changes. Further Controls Required Further Controls Owner Target Date Update Communication and Engagement Strategy Improve Stakeholder Consultation Corporate Manager December 2025 Review Date Review Notes / Decisions Page 75
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Risk 5: There is a risk that the MIJB does not comply with the necessary legislative and regulatory requirements in which it operates. Consequence: Significant reputational impact and potential resource allocation challenge and possible financial and operational strain, potential impact on communities and staff, potential compromise of statutory Category One Response obligations, reduced organisational resilience Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: High September 2025 Rationale for Risk Appetite (as detailed in Appendix 2) The MIJB has minimal tolerance of harm happening to people as a result of its actions, recognising the need to balance the risk of doing nothing and the risk of action or intervention. The Moray Integration Joint Board (MIJB) recognises the statutory obligations under the Civil Contingencies Act 2004, including Category 1 Responder responsibilities (since March 2021) Rationale for Risk Rating: Performance Indicators: There are a variety of performance standards set both by national and regulatory bodies as well as those determined locally and there are a range of factors which may impact on service performance against these. Poor performance will in turn impact both on the outcomes for people accessing services and on the reputation of the MIJB/partnership. Given current situation with increased demand and staffing pressures there might be times that the likelihood of services not meeting standards is possible. IJB works within a range of regulatory of frameworks and it is a legislative requirement to comply, non-compliance would potentially impact the following: 1. Annual Performance Reporting 2. Robust financial monitoring and compliance with standards 3. Delivery of key reporting requirements 4. Category One Responder Resilience Duties 5. Climate Change Reporting 6. Delivery of sound and robust decision making and scrutiny Therefore, there is a need to ensure requirements are in place and regularly monitored. Managing the risk - Current controls in place 5 5 25 1. NHS Grampian Resilience Standards Action Plan approved (3 year). Scottish Government is drafting new standards and these are expected in 2025 and will replace the current standards. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 76
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Assurances: • Quarterly reporting to Clinical and Care Governance and Audit, Performance and Risk Committees • Annual Performance Report – published July 2025 • Chief Social Work Officer’s Report • Internal and External Audits • Senior Management Meetings fortnightly • Joint meeting of MIJB Chief Officer with two Partner Body Chief Executives. • Annual report on MIJB activity developed and reported to Moray Council and NHSG • All Inspection reports reported to APR Committee with action plans developed and monitored Gaps in Assurance: Business Continuity (BC) Planning – work is underway to ensure HSCM has a register of all plans and timescales – to be monitored by OMT and escalations to SMT. Current Performance: There are Resilience and Business Continuity processes in place and these are reviewed regularly. Annual Performance Report for 2024/25 was approved by the MIJB and published in July 2025. Unaudited annual accounts June 2025. Category One Responder duties incorporated in the role of Corporate Manager. Comments: Structure review of HSCM to mitigate the governance risk of services not meeting standards and adequate service delivery The Manchester Arena and Grenfell Inquiry has resulted in a focus on Category 1 responders’ responsibilities, together with an increase of additional policies/procedures to be developed, implemented and exercised with no additional resource. 2. Continuous emergency preparedness awareness with partners in Grampian Local Resilience Partnership (GLRP) – including exercises and debriefs. 3. Learning from Inspection Reports, Adverse Events, Complaints, actions plans and performance measures monitored by Clinical Risk Management (CRM), Clinical and Care Governance Group (CCGG) and Operational Management Team (OMT) with oversight by SMT. 4. HSCM Civil Contingencies group review specific risks and action plans to mitigate, developing plans and testing arrangements in partnership with NHSG and Council. 5. Annual review of internal resilience and emergency processes with Senior Managers on Call. 6. Timetable of statutory reporting across the financial year. 7. Implementation of regular progress reports on audit at OMT, with oversight at SMT. Page 77
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Further Controls Required Further Controls Owner Target Date Business Continuity Planning Corporate Manager December 2025 Review Date Review Notes / Decisions Risk 6: There is a risk that the MIJB’s strategic aspirations are not transformative and as a result, we are unable to deliver outcomes for people in a sustainable way. Consequence: Persistent health inequalities, erosion of public trust and organisational reputation, potential legal challenges, significant reputational damage to MIJB, potential long-term negative impacts on community health outcomes, reduced effectiveness of healthcare resource allocation Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: High Rationale for Risk Appetite (as detailed in Appendix 2) The Moray Integration Joint Board (MIJB) faces significant challenges in maintaining service delivery across its delegated services from NHS Grampian and Moray Council. These challenges stem from three key areas: Resource Constraints Budgetary pressures are leading to reduced staffing resources, affecting service delivery capacity and quality. This situation requires careful management to maintain essential services while operating within financial constraints. System Pressures The healthcare system continues to experience significant strain from high levels of unplanned admissions and delayed discharges. While teams across the care pathway are working collaboratively to address these issues, the complexity of the situation, combined with limited community care availability, makes sustainable improvement challenging. Service Redesign The financial recovery plan necessitates fundamental service redesign to deliver outcomes more efficiently. While the aim is to enhance service quality through these changes, public expectations may need to adjust to align with what is deliverable within budget constraints. This requires careful management of both service transformation and stakeholder expectations. The Moray Integration Joint Board (MIJB) is committed to: • Maintaining exemplary standards of governance • Balancing innovative approaches with robust regulatory compliance • Proactively managing emerging risks in a dynamic healthcare landscape • Prioritisation of Moray’s unique community needs Regulatory risks will only be considered with: 1. Comprehensive consultation with relevant regulatory bodies 2. Clearly defined and documented defensible risk mitigation strategies 3. Transparent decision-making processes Page 78
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4. Thorough impact assessments MIJB will only take regulatory risks knowingly, following consultation with the relevant regulatory body and where we have clear risk mitigation in place. Potential impacts to the wide range of services in NHS Grampian and Moray Council commissioned by the MIJB arising from reductions in available staff resources as budgetary constraints impact. Unplanned admissions and delayed discharges place additional cost and capacity burdens on the service. The level of delayed discharges has remained challenging, reflecting the sustained pressure in the system and the lack of availability of care in the community. There are sustained focussed and collective efforts by all those working in the pathway. However, this is a complex area and will require continued effort to realise reductions and maintain them. The financial recovery plan will require some service redesign to meet outcomes in alternative ways. It is hoped that this will always provide an improved service but it must be recognised that public expectations may differ to what can be delivered within budget. The Moray Integration Joint Board (MIJB) faces significant challenges in maintaining service delivery across its commissioned services from NHS Grampian and Moray Council. Rationale for Risk Rating: Contributing Factors: • Systemic resource constraints across internal and external services • Complex regulatory environment • Increasing expectations from external inspection bodies • Rapid evolution of healthcare delivery models • Predicted demographic changes • Financial Challenges, including cost of living • Increasing demand and staffing challenges are likely to impact transformational projects and plans Mitigating Strategies: • Regular compliance audits • Continuous staff training on regulatory requirements • Robust documentation and decision-making frameworks • Proactive engagement with regulatory bodies • Risk reassessment Resources are stretched thin across all services, both internal and external, which may result in the inability to meet expected standards despite the best efforts of everyone involved. Managing the risk - Current controls in place Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 79
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Assurances: Audit, Performance and Risk and Clinical and Care Governance Sub-Committees oversight and scrutiny. The Clinical and Care Governance Framework was refreshed and presented to CCG Committee in November 2023. The Strategic Delivery Plan was approved by MIJB June 2025 Gaps in Assurance: Process for highlighting recurring themes or strategic expectations from external inspections requires further development to ensure Committee has sight of significant issues. Current Performance: External inspection reports are scrutinised and actions arising are allocated to responsible officers. A summary of inspections is included in the Annual Performance report. Risk Management session delivered for managers in HSCM in September 2023, by the NHSG Risk Advisor. Comments: No major concerns identified for HSCM services in any audits or inspections during 2023/24. An inspection of Childrens Services commenced in August 2023, the final report was presented to the board and a Service Improvement plan commenced and reported to APR on a quarterly cycle. The current financial pressures will impact HSCM’s ability to deliver on the priorities set out in the strategic plan and requires a level of transformation to match this. Further Controls Required Further Controls Owner Target Date 5 4 20 1. Clinical and Care Governance (CCG) Committee. Clinical Risk Management and Practice Governance group has oversight of their respective professional standards and links into Clinical and Care Governance Group, which escalates to CCG Committee as necessary. 2. HSCM Clinical Risk Management (CRM) Group and NHS Grampian CRM Group review High and Very High operational health service risks. 3. Annual Performance Reports 4. Internal and External Audit 5. Internal/External Inspection reports are scrutinised by appropriate operational groups and by exception to SMT for subsequent reporting to CCG or APR Committee as appropriate. 6. Care Home Collaborative Support Group meets to oversee and manage risks in care homes. 7. Children and Adult Protection services report to their respective committees. 8. Governance Structure and Process (Senior Management Team meetings, Operational Team Meetings, Daily Huddles) 3 3 9 Page 80
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Review Date Review Notes / Decisions Page 81
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Risk 7: There is a risk that the MIJB is unable to exert influence on services delegated but hosted within another organisation. Consequence: Legal challenge from Moray citizens and staff, potential intervention or censure from Scottish Government, systemic service failures, particularly in areas such as IT, Human Resources, Legal and compliance services Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: High Rationale for Risk Appetite (as detailed in Appendix 2) Extremely low tolerance for: • Systemic support service failures • Potential compromise of organisational effectiveness • Risk of legal and regulatory non-compliance • Diminished service delivery capacity Low tolerance in relation to not meeting requirements. Rationale for Risk Rating: Parent organizations experiencing: • Significant financial constraints • Staffing challenges • Potential resource allocation limitations The projected overspend in hosted services sits within each MIJB and HSCM is one of the partners who can influence decisions. Assurances: These largely come from the systems, process and procedures put in place by NHS Grampian, which are still being operated, along with any new processes which are put in place by the lead MIJB. North East System Wide Transformation Group (Officers only) led by the 4 pan- Grampian chief executives. The aim of the group is to develop real top-level leadership to drive forward the change agenda, especially relating to the delegated hospital-based services. Both the CEO group and the Chairs & Vice Chairs group meet quarterly. The meetings are evenly staggered between groups, giving some six weeks between them, allowing progressive work / iterative work to be timely between the forums. The Portfolio approach and wider system approach demonstrates closer joint working across the 3 Health and Social Care Partnerships and the Acute Sector. Managing the risk - Current controls in place 5 4 20 1. Chief Officer regularly meets with Chief Officers of Aberdeen City Health and Social Care Partnership and Aberdeenshire Health and Social Care Partnership. 2. Significant changes to service delivery are discussed across all three HSCP’s 3. Agreement that proposals regards significant service changes are presented to all three MIJB’s for approval. 4. Internal Audit of MIJB Hosted Services 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 82
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Gaps in Assurance: Ongoing implementation of internal audit recommendations. Current Performance: Officers are currently implementing the recommendations from the Audit on Hosted Services. Standardised service templates have been implemented and sent to all hosted services and information is being gathered in preparation to presenting proposals to the Chief Officers, MIJB’s and NHS Grampian. Comments: Further Controls Required Further Controls Owner Target Date Review Date Review Notes / Decisions Page 83
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Risk 8: There is a risk that the MIJB’s internal control and governance arrangements are not sufficiently robust to provide full assurance, as evidenced by the 2024/25 Internal Audit opinion of ‘limited assurance’ Consequence: • Weaknesses in internal controls may lead to financial mismanagement, service delivery failures, reputational damage, and non-compliance with statutory duties. • Delays in implementing audit recommendations may result in prolonged exposure to known risks and inefficiencies. • A continued ‘limited assurance’ position may reduce stakeholder confidence in the MIJB’s governance and oversight arrangements. Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: N/A Historical Risk Rating: NEW RISK September 2025 Rationale for Risk Appetite (as detailed in Appendix 2) • The MIJB recognises the importance of strong internal controls and governance to support safe, effective, and sustainable service delivery. • While some risk is accepted in the pursuit of transformation, assurance processes must be timely, transparent, and responsive to audit findings. Rationale for Risk Rating: • The 2024/25 Internal Audit Annual Report concluded with a ‘limited assurance’ opinion. • Several audits identified significant issues, including delays in implementing recommendations, weaknesses in contract management, and challenges in information governance and digital infrastructure. • The findings collectively indicates a measurable risk to the MIJB’s ability to demonstrate effective governance and assurance. Assurances: • Internal Audit Annual Report presented to APR Committee (June 2025). • Quarterly reporting of audit progress and follow-up to APR Committee. • Oversight by SMT. • Internal audit process implemented, providing operational assurance to SMT as per agreed timescales. Managing the risk - Current controls in place 4 5 20 1. Implementation of an ‘end to end’ process for agreeing, implementing and tracking audits is now established operationally with regular updates to SMT highlighting progress, challenges, and emerging risks and any escalations as required. 2. Governance statement prepared in line with CIPFA/SOLACE guidance 3. Internal audit invited to SMT to discuss audit plan work and any emerging risks. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 84
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Gaps in Assurance: Delays in implementing some audit recommendations. Current Performance: • Implementation of Adult Social Care Commissioning audit recommendations nearing completion. • Audit plan for 2025/26 includes follow-up reviews to verify progress. • Improved partnership working with Internal Audit and SMT. Comments: Further Controls Required Further Controls Owner Target Date • Continue to identify capacity to progress the Digital work stream, including digitalisation where possible • Progress development of unified case recording system CFO/HoS HoS March 2027 March 2027 Review Date Review Notes / Decisions Page 85
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MIJB Risk Appetite Statement The Moray MIJB recognizes that effective risk management is fundamental to achieving its strategic objectives in delivering integrated health and social care services. This statement defines the level and type of risk the MIJB is willing to accept in pursuit of achieving the outcomes defined in the strategic plan, Partners in Care 2022-2032. Moray MIJB adopts a balanced approach to risk-taking, acknowledging that transformation, innovation and service improvement often require managed risk-taking while ensuring the safety and wellbeing of its staff and the public remains paramount. Strategic Risk: MODERATE-HIGH • Higher appetite for strategic initiatives supporting integration • Willingness to innovate in service delivery • Acceptance of calculated risks in pursuit of transformation • Support for pilot projects with clear business case and evaluation criteria At this appetite level, the board is willing to accept some uncertainty in governance processes where: - Clear oversight mechanisms remain in place - Core statutory obligations continue to be met - Potential benefits to service delivery are significant - Learning opportunities from governance adjustments can be captured Financial Risk: MODERATE • Willing to accept moderate financial risks in pursuit of strategic objectives • Conservative approach to core budget management • Higher tolerance for innovative projects with clear benefits • Low tolerance for financial decisions that could threaten long-term sustainability Clinical Safety Risk: LOW • Minimal appetite for risks affecting patient/service user safety • Strong controls and monitoring required for all clinical activities • Zero tolerance for non-compliance with clinical governance standards • Comprehensive risk assessments required for any service changes • Operational Risk: MODERATE • Moderate tolerance for operational changes that improve efficiency • Willing to consider new service delivery models • Acceptance of short-term disruption for long-term benefits • Regular monitoring and review of operational changes Reputational Risk: LOW-MODERATE • Conservative approach to actions that could damage public trust • Proactive stakeholder engagement in major decisions Page 86
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• Low tolerance for activities that could undermine partnership working • Emphasis on transparent decision-making Workforce Risk: MODERATE • Moderate appetite for workforce development initiatives • Innovation in recruitment and retention strategies • Support for new ways of working • Low tolerance for risks affecting staff wellbeing Risk Governance • Regular review of risk appetite by the MIJB Board • Clear escalation procedures for risks exceeding appetite levels • Integration of risk appetite into decision-making processes • Regular reporting on risk profile against appetite Implementation • Risk appetite to be considered in all significant decisions • Regular training for staff on risk management • Clear communication of risk appetite across the organization • Annual review and update of risk appetite statement Monitoring and Review • Bi-annual review of risk register against appetite levels • Annual review of risk appetite statement • Regular reporting to Audit and Risk Committee • Adjustment of appetite levels based on changing context This statement will be reviewed annually and updated as required to reflect changes in the operating environment and strategic priorities. Page 87
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Likelihood – What is the likelihood of the risk occurring? Assess using the criteria below. Rare (1) Unlikely (2) Possible (3) Likely (4) Almost Certain (5) Don’t believe this event would happen Will only happen in exceptional circumstances Not expected to happen but definite potential exists Unlikely to occur May occur occasionally Has happened before on occasions Reasonable chance of occurring Strong possibility that this could occur Likely to occur This is expected to occur frequently/ in most circumstances more likely to occur than not Impact – What could happen if the risk occurred? Assess for each category and use the highest score identified. The impact scale is from an organisational level perspective. It reflects the key areas that if impacted could prevent the organisation achieving its priorities and objectives. The scale is a guide and cannot cover every type of impact therefore judgement is required. Category Negligible (1) Minor (2) Moderate (3) Major (4) Extreme (5) Patient or Service user Experience Reduced quality patient experience/clinical outcome not directly related to delivery of clinical care Unsatisfactory patient experience/clinical outcome directly related to care provision – readily resolvable Unsatisfactory patient experience/ clinical outcome, short term effects – expect recovery less than 1wk Unsatisfactory patient experience /clinical outcome, long term effects - expect recovery over more than 1week Unsatisfactory patient experience/clinical outcome, continued ongoing long term effects Objectives/ Project Barely noticeable reduction in scope/quality/ schedule Minor reduction in scope/quality/schedule Reduction in scope/quality/project objectives or schedule Significant project overrun Inability to meet project/corporate objectives, reputation of organisation seriously damaged Page 88
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Injury /illness (physical and psychological) to patient/service user/visitor/staff/carer Adverse event leading to minor injury not requiring first aid Minor injury or illness, first aid treatment required Agency reportable, e.g. Police (violent and aggressive acts) Significant injury requiring medical treatment and/or counselling Major injuries/long term incapacity /disability (e.g. loss of limb), requiring, medical treatment and/or counselling Incident leading to death(s) or major permanent incapacity Complaints/Claims Locally resolved verbal complaint Justified written complaint peripheral to clinical care Justified complaint involving lack of appropriate care Claim above excess level. Multiple justified complaints Multiple claims or single major claim Complex Justified complaint Service/ Business Interruption Interruption in a service which does not impact on the delivery of patient care or the ability to continue to provide service Short term disruption to service with minor impact on patient care/service provision Some disruption in service with unacceptable impact on patient care Temporary loss of ability to provide Service. Sustained loss of service which has serious impact on delivery of patient care resulting in major contingency plans being invoked Permanent loss of core service/ facility Disruption to facility leading to significant “knock on” effect -- to function Staffing and Competence Short term low staffing level temporarily reduces service quality (less than 1 day) Short term low staffing level (>1 day), where there is no disruption to patient care Ongoing low staffing level reduces service quality Minor error due to lack of/ ineffective training/ implementation of training Late delivery of key objective/service /care due to lack of staff Moderate error due to lack of/ ineffective training / implementation of training Ongoing problems with staffing levels Uncertain delivery of key objective/service/care due to lack of staff Major error due to lack of/ ineffective training / implementation of training Non-delivery of key objective/ service/care due to lack of staff. Loss of key staff Critical error due to lack of/ ineffective training/ implementation of training Page 89
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Financial (including Damage/Loss/Theft/ Fraud Negligible organisational/ personal financial loss up to £1k Minor organisational/ personal financial loss of £1-10K Significant organisational/personal financial loss of £10- 100k Major organisational/personal financial loss of £100k- 1m) Severe organisational financial loss of more than £1m Inspection/ Audit Small number of recommendations which focus on minor quality improvement issues Recommendations made which can be addressed by low level of management action Challenging recommendations that can be addressed with appropriate action plan Improvement Notice Enforcement/prohibition action Low Rating Critical report Prosecution Zero rating Severely critical report Adverse Publicity/ Reputation Rumours, no media coverage Little effect on staff morale Local media coverage – short term. Some public embarrassment Minor effect on staff morale/public attitudes Local media – long term adverse publicity Significant effect on staff morale/public perception of the organisation National media adverse publicity less than 3 days Public confidence in the organisation undermined Use of services affected National/International media/ adverse publicity, more than 3 days MSP/MP/SEHD concern (Questions in Parliament) Court Enforcement/Public Enquiry/FAI Risk Scoring Consequences/Impact Likelihood Negligible Minor Moderate Major Extreme Almost Certain Medium High High V High V High Likely Medium Medium High High V High Possible Low Medium Medium High High Unlikely Low Medium Medium Medium High Rare Low Low Low Medium Medium Review Timescales – When a risk rating has been assigned the criteria below should be used to assess the review timescales. Page 90
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Very High or High Requires monthly monitoring and updates. Medium Requires quarterly monitoring and updates. Low Requires 6 monthly monitoring and updates. Page 91
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: CHILDREN SERVICES PLAN 2023-2026 - YEAR 2 ANNUAL REPORT FOR YEAR 2024-2025 BY: INTERIM CHIEF SOCIAL WORK OFFICER 1. REASON FOR REPORT 1.1 To present the 2024-2025 Children Services Plan Annual Report to the Board. 2. RECOMMENDATION 2.1 It is recommended that the Board note and approve the Children Services Plan 2024-2025 Annual Report, attached as Appendix 1. 3. BACKGROUND 3.1 Part 3 of the Children and Young People (Scotland) Act 2014 places a statutory duty on both the local authority and the relevant health board to prepare a Children Services Plan (CSP) for the area of the local authority, in respect of each three-year period. It is expected that they will work collaboratively with other members of the Community Planning Partnership (CPP), as well as with children, young people, and their families at various stages of the plan’s development and review. There is a statutory duty to provide an Annual Report on progress of the delivery of the Plan, attached as Appendix 1. 3.2 Part 3 of the Act seeks to improve outcomes for all children and young people in Scotland by ensuring that local planning and delivery of services is integrated, focused on securing quality and value through preventative approaches, and dedicated to safeguarding, supporting, and promoting child wellbeing. It aims to ensure that any action to meet need is taken at the earliest appropriate time and that, where appropriate, this is taken to prevent need arising. 3.3 Moray’s Children Services Plan 2023-26 is based upon the Children and Families Joint Strategic Needs Assessment, including the results of the Health and Wellbeing Survey 2022 completed across Moray schools. Moray’s Plan Item 10. Page 93
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incorporates the following statutory plans within one CSP with the aim of streamlining reporting: • Child Poverty Plan (requirement as per Child Poverty Act, 2017) • Corporate Parenting Plan (Part 9, Children & Young People’s Act 2014) • Children’s Right’s Plan (Section 18, UNCRC (Incorporation) SCOTLAND Act 2024 3.4 In addition, it is Moray’s Plan to deliver The Promise and contains Moray’s Child Protection Improvement Plan. 3.5 All local authorities are required to include their Whole Family Wellbeing Fund return either within or alongside the CSP Annual progress report. 3.6 A post inspection Improvement Plan was developed in 2023 for children services; this remains separate to this plan. 3.7 The CSP 2023-26 was approved at the Community Planning Board on 17 May 2023 (para 6 of the minute refers). 3.8 The Scottish Government reviews all CSPs within 6 months of submission against 15 assessment criteria. Moray’s Plan was very positively received, fully meeting 14/15 of the criteria with no alterations required. 3.9 The Plan was positively received by the Care Inspectorate during the Children Services Partnership Inspection. 3.10 The Community Planning Board approved the first annual report on 4 June 2025 and agreed for a draft version of the report to be submitted to the Scottish Government prior to full approval of the committee to support Children Services to meet national reporting expectations (para 5 of draft minute refers). 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The annual reports continue with the same format as the Children Services Plan 2023-2026, with the progress of the priority areas outlined individually, ensuring the reporting requirements of the various statutory plans is evident (overall progress towards to deliver The Promise is evident). 4.2 The progress outlined with regard to Child Poverty has been sighted and approved by the appropriate NHS Grampian Board as responsibility is jointly shared. 4.3 The key areas of progress to note are: i. Self-evaluation has evidenced that children’s views are central to decision making within the child protection process. New tools for capturing the voice of non-verbal and infant children have been embedded across health and community engagement work undertaken has focused on hearing less represented voices for example LGBTQ+, Page 94
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asylum-seeking, and neurodiverse children to understand their support needs. ii. Moray’s poverty data set has been used to target resources with examples of various community-based engagement and activities provided to reach out to families. Income maximisation services helped families gain nearly £100K of income and focused project work on the priority family types identified in the national Child Poverty Strategy continues. iii. A new moray wide parent focused support service has been established to support parents/carers to understand and support their children’s mental health and wellbeing needs. The Child and Adolescent Mental Health Service (CAMHS) across Grampian continues to be in the top 3 performing health boards in regard meeting the 18-week standard for children to receive support, with most children referred receiving their initial consultation appointment within 4-6 weeks. Collaborative working continues across mental wellbeing services to ensure smooth transitions between services are experienced. iv. All child protection procedures and training have been updated to reflect new child protection and Getting it Right for Every Child (GIRFEC) guidance. The online safety campaign has been successfully extended and partnership-based sextortion training introduced. The Scottish Child Interview Model has been fully implemented, and funding has been secured to develop the Bairns’ Hoose approach further within Moray. v. Moray’s adapted curriculum within Education has been launched to increase the options available to meet the educational needs of children with additional support needs. Inclusivity across sport for the disabled and those with additional support needs has increased further. There has been a significant increase in the number of neurodiversity diagnoses completed over the reporting period and parents of earlier age children have accessed support through the Early Bird family programme, focused on children with an early autism diagnosis. vi. Family support ranging from prevention to intensive family support has increased, 93% of pregnant women were invited to join the universal peep pathway, a family learning programme being upscaled to be a universal offer from pre-birth to school start age. New child planning documentation has been introduced and a GIRFEC website launched to support both families and professionals to understand what GIRFEC means in Moray, including a directory of support. The Moray Advocacy Service introduced during this CSP period supported 259 children and 175 parents/carers during this reporting period. vii. Moray continues to make progress to deliver the promise, with a 57% reduction in school exclusions of looked-after children and with an average the national average rate of siblings being kept together when Page 95
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requiring care. There has been a 34% increase in the take up of the independent advocacy offer. viii. 650 members of the children services workforce have accessed a range of training over the reporting period, and a new training framework implemented. ix. Funding leveraged for youth participation, transitions, and trauma- informed practice x. A review of progress has led to the reduced focus of work outlined progress over the final year of the plan 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” Several of the actions within the Children Services Plan contribute to the delivery of the Corporate Plan and will be reported appropriately. (b) Policy and Legal Policy based work is being undertaken in line with the appropriate processes and governance. There are no legal implications currently. (c) Financial implications There are no financial implications from this report however work is required within the actions agreed to develop and resource joint commissioning process in the future (d) Risk Implications and Mitigation No implications arising from the report (e) Staffing Implications Capacity to deliver the plan is a challenge, work is ongoing to explore if prioritisation of actions is required in the second part of the delivery period (f) Property No implications on property (g) Equalities/Socio Economic Impact None arising directly from this report (h) Climate Change and Biodiversity Impacts None arising directly from this report (i) Directions None arising from this report (j) Consultations Page 96
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Each children services strategic group have provided the information included in this report 6. CONCLUSION 6.1 Progress continues to be made, however capacity has been a challenge, a streamlined governance and set of outcomes has been proposed for the final year. Work will begin to produce the next Children Services Plan in Quarter 3 onwards. Author of Report: Lindsay Nelson (Improvement Officer Wellbeing) Background Papers: Appendix 1- Children Services Plan Annual Report Ref: Page 97
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2 Table of Content Introduction……………………………………………………………………………………………………………………….3 Strategic Outcomes…………………………………………………………………………………………………………….5 Voice…………………………………………………………………………………………………………………………………8 Family……………………………………………………………………………………………………………………………….11 Tackling Child Poverty 11 Improving the mental and emotional well-being of children young people and their families 21 Keeping children and young people safe 24 Supporting children and families who experience challenges due to disability or neurodiversity 29 Strengthening family support 33 Care………………………………………………………………………………………………………………………………… 37 People………………………………………………………………………………………………………………………………45 Scaffolding……………………………………………………………………………………………………………………….47 Next Steps ………….…………………………………………………………………………………………………………….50 Appendix 1 Whole Family Wellbeing Report …………………………………………………………………………………51 Page 99
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3 Introduction Welcome to Moray’s Children's Services Plan, Our Promise to the Children of Moray, annual report for 2024 -2025. Moray’s Children Services Plan and reporting also incorporates the other key partnership plans that have an exclusive focus on children, young people and their families. They are: • Child Poverty Plan • Children's Rights and Participation Plan • Corporate Parenting Plan • Child Protection Improvement Plan Progress in the delivery of the plan was showcased at a family fest event ran in partnership with employability, with child poverty prioritised at the event in response to the rising rate. A total of 330 people attended the event which included a marketplace showcasing the range of free family activities and services available in Moray including those offering families financial support. The second year of our plan has coincided with some key challenges felt both locally and nationally both families and our children’s workforce are facing: • Increased violence and aggression within and outside the school community has continued, with school attendance and meaningful engagement remaining an issue, • The struggles of neurodiverse parents and children remain prominent, with diagnosis, support and education attainment being the concerns of families, • challenges associated with cost-of-living and child poverty continue, escalating costs and changes to national insurance have resulted in additional pressure within the 3rd sector with some smaller organisations in Moray folding. Our action plans are structured around the five foundations of The Promise with children’s rights underpinning every foundation. Page 100
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4 Voice Explains how we will seek out and act on the voice of children, young people and their families Family Details the actions we will take to; tackle child poverty, improve the mental wellbeing of children, young people and families, keep children and young people safe from harm, strengthen support for families and meet the challenges children, young people and families face due to disability and neurodiversity Care Outlines how we will support our looked after and care experienced children and young people to reach their full potential People Describes how we will support the workforce to listen and be compassionate in their decision making, develop trusting relationships with our children, young people and families and deliver the services and support they need Scaffolding Outlines the key actions strategic leaders will take together to ensure that the ‘system’ supports the delivery of improvements outlined within this plan Our strategic outcomes are outlined below, followed by individual progress reports for each of the 9 priority areas. Page 101
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5 PRIORITY AREAS Voice Hearing children’s voice • The voice of children and young people is evident in all things that impact on them • Adults successfully seek out and hear the voices of children and young people of all levels of ability • Engagement activities are more co-ordinated, minimising the risk of children and young people being over consulted Family Tackling Child Poverty • Parents claim all the welfare benefits to which they are entitled and do not feel stigmatised when seeking support • The impact of poverty on children, young people and their families is minimised • Young adults and parents experience no poverty related barriers to entering and sustaining training and employment Improving Mental Wellbeing of Families • Parents are confident and able to support their child(ren) to sustain good mental wellbeing • The right mental health and wellbeing support is available to children, young people and their parents as soon as they need it • Community based mental wellbeing support is strengthened • Children, young people and their parents experience a smooth transition between support services, including transition to adult services Keeping Children Safe • Children’s Services Workers are confident and supported to identify and understand risk • Children, young people and families are empowered to participate in child protection processes • Children and young people develop healthy relationships with peers, online and in the community • Children and young people are safer because risks have been identified early and responded to effectively • Children and young people at risk of or who come into conflict with the law are supported with compassion and care Page 102
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6 • Children and young people are supported through recovery and do not experience further trauma related to the causes of their trauma or recovery Overcoming Challenges Experienced by Children with Disability or Neurodiversity • Children and young people’s education and care needs are met, regardless of need • Parents and young people with neurodiversity challenges can access early help and support • Children, young people and families with additional support needs have improved access to support, leisure and community-based activities • Families can access a neurodiversity diagnosis in a timely way • Children with additional support needs experience a smooth transition to adult services Strengthening Family Support • Children’s and families’ needs are addressed early through implementation of effective child’s planning processes • There is a clear pathway of non-stigmatised support available to parents throughout Moray. • Children’s transition into Nursery is consistently good. • Parents are supported and enabled to be the best parents they can be. Care Page 103
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7 Improving Outcomes for Care Experienced Young People • The gap in educational outcomes of looked after and care experienced young people is reduced • Looked after and care experienced young people enter and sustain education, training or employment after leaving school • The health needs of looked after children and young people are met • Looked after and care experienced young people, and their parents/carer feel their voice has been heard through the provision of independent advocacy • The number and range of placements available meets the needs of children and young people in need of care • Life transitions feel and are experienced as integrated, with maintaining relationships being paramount • Brothers and sisters are supported to maintain positive relationships with one another • Children and young people seeking asylum are fully integrated into school and community life • Looked after and care experienced young people are not overrepresented in the criminal justice system • Our improvement activity is shaped by the voice of our looked after and care experienced young people People Supporting our Workforce • Integrated working practice is enhanced through joint development opportunities which supports our shared vision, core principles and values • Staff facilitate and enable the relationships, networks and connections that support our children, young people and families Scaffolding Working in Partnership • As a partnership, we are aware of the changing needs of children, young people and their families • As a partnership, we maximise all opportunities to lever in additional funding and work together to ensure it supports the delivery of our shared priorities • The risk of silo working across children and adult services is minimised • We more consistently and effectively measure the impact of the actions we are taking to improve outcomes for children, young people and families • The co-ordination of continuous improvement activity improves Page 104
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8 The voice of the child is more than seeking their views, it is about enabling children and young people to take as active a role as possible in making decisions about things which affect them Voice: Hearing children and young people’s voices Our focus for improvement Our actions and progress The voice of children and young people is evident in all things that impact on them. “We are delighted E got to take part in the nativity play. She is never included in anything except activities in Options Moray. It was wonderful.” Parent When asked was he ready for the Nativity play the young people were presenting a young person was observed to smile, threw up his arms In Moray, children’s voices are captured through a variety of approaches, with a strong focus on improving the coordination and impact of how these voices influence decision-making. At the child protection level, processes have been strengthened, and hearings and child protection meetings now do not proceed unless the child’s voice has been captured to inform decisions. The implementation of the Better Meetings guidance and continued investment in a solution-oriented approach have created supportive conditions for children to express their views, particularly when involved in processes addressing their additional needs. Tools for capturing children's voices have been compiled and integrated into updated child planning documentation. The new paperwork was piloted in two school ASG areas and, following refinements, will be fully launched to replace previous documentation. Additionally, a pilot project aimed at capturing the non-verbal communication of infants has been introduced, building on successful work previously carried out in Aberdeenshire. Moray’s locality planning structure continues to engage professionals providing direct services to gather insights into the experiences and concerns of families. Wellbeing Co-ordinators collate themes from child planning meetings and share them to support a partnership-based approach to identify areas for improvement. One example of this in action is a partner-led initiative which established a regularly accessible safe space for parents of children with complex needs. This space allows parents to share concerns, receive peer support, and access relevant information. Page 105
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9 Voice: Hearing children and young people’s voices Our focus for improvement Our actions and progress in a happy gesture and said “aye”. Worker Parent voices are gathered and used by the Locality Networks to co-develop solutions, raise issues at a strategic level, and highlight examples of good practice. A notable example is Aberlour Options children’s nativity play, designed for children with complex needs, including non-verbal children. In this initiative, children were supported to direct and participate in their own nativity performance for their families. One parent shared, “It’s great for V to be part of the activities at Halloween and the Nativity—it allows me to meet other parents.” Looking ahead, Moray’s Children’s Services partners are exploring a new model: a central exchange point where young people can share their views and where organisations can connect to hear from them. This model will be supported by a multi-agency youth participation strategy. Its aim is to reduce over-consultation of individuals, ensure broader representation of views, and provide a clear mechanism for young people to reach those who need to hear them. This initiative will be a key focus in the final year of the current plan. Adults successfully seek out and hear the voices of children and young people of all levels of ability. Work has been undertaken to improve how we hear the voices of those with barriers in being heard. Voice of the Infant A tool was initially developed and piloted in Aberdeenshire, with further testing extended to Moray in 2024. Designed for use in early years settings, the tool supports practitioners in capturing the perspectives of babies and pre-verbal children. Now integrated into a wider toolkit, it is actively used by health professionals across Moray. To support implementation, 92% of health team staff completed dedicated training. An audit of health service records conducted in December 2024 demonstrated a positive impact on practice. Key findings included: ✓ Descriptions of infant body language and facial expressions increased from 19% to 40%. ✓ Documentation of what infants or young children enjoy rose by 10%. ✓ Observations of play and social interactions improved from 34% to 49%. These outcomes highlight the effectiveness of both the tool and the associated training in enhancing practitioners’ ability to interpret and record infant communication cues. Ongoing audit activity is planned to ensure the tool continues to be embedded in practice and to promote sustained positive outcomes for infants, children, and young people. Page 106
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10 Voice: Hearing children and young people’s voices Our focus for improvement Our actions and progress “We need information about safe sex.” LGBTQ+ youth. “Sexual health services are hard to access—services with an LGBTQ+ focus are non-existent.” Young person, Moray Pride. Asylum seekers and refugee children Dedicated processes have been developed to ensure that unaccompanied asylum seekers and refugee children are supported in expressing their views and identifying any barriers they face in having their needs met. The resettlement team and the education-based English for Speakers of Other Languages (ESOL) team has worked closely with these children and their families, where appropriate, to gain a deeper understanding of their experiences and challenges. LGBTQ+ young people Targeted efforts have amplified LGBTQ+ youth voices on sexual health, with outreach during Moray Pride activities revealing concerns about unmet needs. These insights are shaping NHS Health Improvement Team content for Personal and Social Education (PSE) classes. School nurses have also introduced drop-in sessions and partnership working has piloted sexual health focused events, advancing inclusive, accessible education for all young people. Engagement activities are more co-ordinated, minimising the risk of children and young people being over consulted “I was delighted to see some of the things suggested had been able to be included.” – Parent, Children 1st feedback on GIRFEC website “…particularly pleased with the introduction section on Developing the Youth Voice Model and Community Engagement in Moray We continue to strengthen the Youth Voice model, with a focus on minimising the risk of over-consultation. Current developments include exploring the introduction of a Youth Ambassador role for Moray, aimed at ensuring meaningful representation and leadership opportunities for young people. In addition, two key areas of work are progressing: GIRFEC in Moray Website: Children, young people, and families have played a central role in shaping a new Getting It Right for Every Child (GIRFEC) website for Moray. This platform will serve as a single point of reference for families to access clear, accessible information and support. Moray Engage – Community Engagement Platform: Moray Engage is a new online tool designed to gather feedback, ideas, and opinions from the community in an organised and interactive way. It provides a centralised space where community voices can be heard and ensures transparency by offering a full overview of consultation activities. Although progress has been slow, it had initially been put on hold last year for financial reasons, therefore we are Page 107
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11 Voice: Hearing children and young people’s voices Our focus for improvement Our actions and progress child’s planning – the role of the Named Person service is now clearer.” – Parent, Children 1st happy to be able to report progress. These developments reflect our commitment to co-production and inclusive practice, ensuring the voices of children, young people, and families are embedded in the design and delivery of services. Page 108
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12 Poverty impacts on the health and wellbeing of the whole family and for children it can have long term effects on outcomes in adulthood. Family: Tackling Poverty Our focus for improvement Our actions and progress What poverty looks like in Moray is understood by all Despite a low unemployment rate of 3.0% (May 2024), economic inactivity in Moray has risen to 24.7%, exceeding the national average. Moray’s average working week is longer than the national one and the average full time weekly wage is lower (£647.20 compared to £702.80), evidencing Moray’s low-income economy. Between 2014 and 2022, child poverty increased to 24.1%, although below the national average of 24.5%, this was the fastest increasing rate. Moray’s Poverty Ranking (based on the Child Poverty After Housing Costs data) is 14 of 32 local authorities and rated second highest against the 8 comparable areas. Early indications show the rate is expected to decrease slightly this year. Moray includes areas ranked in the Scottish Index of Multiple Deprivation (SIMD) decile 1, with more families now in Quintile 1 following Scottish Government reclassification. Four areas are among the most deprived in Scotland. In 2023/24, 383 pupils (3.2%) were in SIMD Quintile 1 and 1,722 (14.2%) in Quintile 2. However, SIMD does not fully capture rural and urban poverty in Moray, therefore a bespoke data set was developed in 2024, dividing Moray into 126 zones, rating them on a combination of poverty and financial vulnerability factors. The dataset shows that: • More people in Moray (41.3%) live in rural areas compared to the national average of 17% • 26% of children living in urban areas are in poverty, in contrast to 21% who live rurally • 48% of the 66% of the children experiencing poverty are living in urban areas and living in just 30% of the most deprived areas (as opposed to the 14.5% identified if we use the SIMD ranking system only) • 85.5% of children in Moray live out with the most deprived areas • the level of poverty experienced ranges from 0% to 64.8% in different areas of Moray Factors like rural isolation, high transport costs, higher food costs in rural areas and higher numbers of households which rely on alternative fuels for heating significantly affect family income. This data is enabling more targeted engagement. Page 109
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13 Family: Tackling Poverty Our focus for improvement Our actions and progress “Thank you for providing such delicious food for free and organising activities for the children during school holidays.” Lunch attendee Thank you for all your hard work—it's such a nice thing to do for the families in our local community.” Event Attendee We connected with multiple internal and external partners, shared our service, learned about others, and even gained four potential volunteers. The event had a great buzz, was well- planned, relaxed, and welcoming. We’d attend again.” Stall holder, Family Fest. Place-Based Community Events Using insights from the dataset, a series of community events were organised during the October school holidays in areas identified as having the highest levels of need: Lossiemouth, New Elgin, Forres, Keith, and Buckie. These events aimed to initiate early engagement with families through a place-based approach. Local community groups were invited to participate, alongside key partners such as Public Health, Childsmile, and the Period Poverty Team—organisations that play a vital role in mitigating the impact of poverty. Over the course of the week, 270 people attended community breakfasts. Sustaining Local Support: Community Space Grant Through conversations with community groups, a clear need emerged for financial support to sustain their presence in high-need areas. In response, the Community Space Grant was developed, allocating just under £70,000 to enable services to access and use local community spaces. This funding has supported both individual and group-based meetings, helping to bring services closer to the communities they serve. Family Fest: Supporting Families Through Connection, Wellbeing, and Opportunity The Family Fest event attended by 330 people, was a collaborative initiative between the Children’s Services Team (who share progress of the Children Services Plan) and Moray Pathways (Employability Partnership), designed to support families by: • Promoting ways to maximise household income • Encouraging positive mental wellbeing • Showcasing low-cost or free family activities Examples of the range of provision included income maximisation support, play activities like Lego, STEM and messy play, family themed mental wellbeing services and free products like fruit, period products and pre-loved (pre-owned) sport kits. Page 110
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14 Family: Tackling Poverty Our focus for improvement Our actions and progress What poverty look like in Moray is understood by all (cont.) “As a single mum, I loved this event. Thank you for all the useful info—this was awesome.” Parent Professional feedback focused on networking and connecting while families focused on the availability of information, the fun activities and a desire for repeat events. Poverty Toolkit and Community Support The Poverty Toolkit, developed with support from the Independent Food Aid Network and Moray Council, continues to be a valuable resource. During this reporting period the “Worrying About Money?” leaflet received 881 views, and 255 individuals made phone calls seeking financial advice or support. Child Poverty Self-Evaluation As directed by the Community Planning Board, members of the Child Poverty Strategic Group collaborated with the Improvement Service to develop a Child Poverty Self-Evaluation system for the entire Community Planning Partnership (CPP). This was distributed to over one hundred managers across public and third sector organisations. Unfortunately, the response rate was below 4%, making the results non-representative. Further work will be needed to improve engagement and gather meaningful insights. Next Steps ➢ Move beyond data by directly involving families affected by poverty to ensure services reflect real, local needs and create ongoing opportunities for families to share experiences and co-design solutions that lead to change ➢ Recognise that while common themes exist, solutions must be adapted to the unique circumstances of each community ➢ Drive forward the objectives of Tackling Child Poverty work through collaboration, shared learning, and community-led action Page 111
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15 Family: Tackling Poverty Our focus for improvement Our actions and progress Parents claim all the welfare benefits they are entitled to and do not feel stigmatised when seeking support Income Maximisation and Financial Support in Moray Income maximisation support is now embedded within several intensive family support services. To improve access and streamline referrals, the Money Advice Moray Team is actively reviewing referrals from Health Visiting and the Family Nurse Partnership teams, ensuring families receive timely and appropriate financial guidance. Key Referral Data (This Year) includes 749 referrals to Money Advice Moray, 542 for financial guidance with the Income Maximisation Team and 207 for debt advise via the Money Advice Service. The main sources of referrals are housing services, the Citizens Advice Bureau (CAB), and social work services. The total financial gains for families through welfare benefits was £99,800.96. These figures highlight the growing demand for financial support and the importance of coordinated referral pathways. Mapping Support Services Across Moray In collaboration with the Fairer Moray Forum Action Group, a comprehensive mapping exercise was completed to identify all available support services across Moray. This work provides a clearer understanding of what services were available and where and service gaps. The findings were shared with the Strategic Child Poverty Group. To maximise impact, going forward a centralised resource needs to be identified to support better co-ordination, reduce duplication, and help families and professionals navigate available support more effectively. Child Poverty Accelerator Funding (CPAF) Project: Maximising Incomes for Families with Disabilities Moray successfully secured Child Poverty Accelerator Funding through a joint bid by the Children’s Services and Employability teams. The project focused on exploring how to better support families with disabilities in maximising their household income. Phase 1: Lived Experience Engagement Families of children with Additional Support Needs (ASN) were engaged through face-to-face sessions, online discussions, and surveys to better understand the financial challenges they face. Page 112
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16 Family: Tackling Poverty Our focus for improvement Our actions and progress Parents claim all the welfare benefits they are entitled to and do not feel stigmatised when seeking support (cont.) The findings revealed that income-related challenges were more complex and interconnected than initially anticipated. Four key themes emerged: • The cost of accessing health services • The monetary impact of limited educational opportunities • The complexity of claiming Self-Directed Support (SDS) and other disability-related benefits • A strong need for free or subsidised activities during term time and school holidays Phase 2: Action and Collaboration Health and Education: insights were shared with service managers. NHS Grampian used the data to secure additional CPAF funding for the Health Equity & Learning Project (HELP), focused on reducing barriers to NHS access. Social Work teams also used the findings to inform planning. Access to Activities: A multi-agency test-of-change project is planned for summer in two SIMD-priority areas. A schedule of free/subsidised activities is in development. Active Schools Coordinators, in partnership with Disability Sport Scotland, are training session leaders to ensure inclusive delivery. Phase 3: Raising Awareness and Building Capacity Child Disability Payment: Updates on changes to the Child Disability Payment were shared at Locality Network meetings with Family Support Workers and other direct service professionals. These professionals are now better equipped to inform and support families in applying for the benefit. The information was shared at ASN Parent Drop-In sessions, where local authority staff provided one-to-one support. As a result, awareness of the Child Disability Payment and other financial supports has increased significantly. Step by Step is a local charity supporting vulnerable families by building confidence, friendships, and life skills. Through partnerships with services like Moray Citizens Advice Bureau and Moray Food Plus, it offers informal group sessions where families access support and referrals in a welcoming setting. The charity also promotes Social Security Scotland benefits, including the Scottish Child Payment, encouraging families to claim their entitlements. Page 113
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17 Family: Tackling Poverty Our focus for improvement Our actions and progress Parents claim all the welfare benefits they are entitled to and do not feel stigmatised when seeking support (cont.) Positive Indicators of Impact Current trends show a decrease in the number of referrals to external organisations and a reduction in emergency voucher distribution. While further analysis is needed, this may indicate that household incomes are improving— potentially because of increased benefit uptake and better access to financial support. Next Steps ➢ Improve understanding across services to reduce duplication, better support families and strengthen awareness of tools such as ALISS to promote support ➢ Evaluate the financial inclusion pathway through the midwifery service ➢ Raise awareness of the infant feeding in crisis pathway further and extend to wider NHS services supporting families with young children ➢ Strengthen monitoring of referrals from family support services to Money Advice Moray for better follow-up and outcomes The impact of poverty on children, young people and their families is minimised. Expanding Access to Family Activities At the Family Fest event, families were introduced to a range of services, including Libraries, Active Schools, Peep Groups, and PlayTalkRead. In New Elgin, a LOIP priority area, The Link Project provides free after-school and holiday activities, offering vital out-of-school support. The Sport Development and Active Schools teams have expanded free activity sessions, resulting in an 18% overall increase in participation, including a 9% rise among children eligible for free school meals. A new partnership with Stella’s Voice has launched a free bike initiative for children, with 18 applications received to date. Centralised Holiday Activity Information Locality Networks collected holiday activity details from various services and shared them via the Active Schools “Sports in Moray” platform, ensuring families had easy access to a single, centralised source of opportunities. Page 114
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18 Family: Tackling Poverty Our focus for improvement Our actions and progress The impact of poverty on children, young people and their families is minimised (cont.) Transport was a key barrier identified in relation to accessing holiday activities. M: Connect briefed the locality networks and have now introduced a group booking system to support service coordination which services can promote. Progress has been made through a standardised process introduced to ensure all P7 pupils receive bus passes before secondary school. A challenge remains regarding low uptake among under-12s, and further awareness and support is needed. Housing and Child Poverty Improved strategic alignment through housing services is now being represented at the Child Poverty Strategy Group. Downsizing Incentive Scheme: 27 households rehoused in 2024/25, highest uptake since 2012, reducing energy costs and easing overcrowding. Local Housing Strategy (LHS) 2025–2030 is in development with poverty a key consideration. Fuel Poverty (ECO4 Flex) £808K in energy efficiency upgrades and 45 low-income households have been supported, with the average investment being £18K per home and ongoing investment continues. Affordable Housing: the open market purchase scheme has added 4 family homes and supported homelessness prevention and reuse of empty homes. Period Plus Project The project is co-designed with young people to address period poverty with dignity. A new co-ordinator was employed in January 2025. The key actions: • Free single-use and reusable products in public buildings • Community feedback gathered during Challenge Poverty Week • Promotion of eco-friendly options and the PickupMyPeriod app Page 115
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19 Family: Tackling Poverty Our focus for improvement Our actions and progress The impact of poverty on children, young people and their families is minimised (cont.) • Collaborative delivery, e.g., distribution via Moray Food Plus’s Big Blue Bus Next Steps ➢ Promote and monitor uptake of bus entitlement cards ➢ Consider any poverty related issues identified in the current Housing Survey ➢ Gain an understanding of the number of vulnerable priority groups within temporary accommodation and what, if any, additional targeted support requires to be implemented ➢ Record the impact of the trained digital champions Young adults and parents experience no poverty related barriers to entering and sustaining training and employment. The Local Employability Partnership in Moray, known as Moray Pathways, is funded through the Scottish Government’s Child Poverty Funds and No One Left Behind initiative. The partnership collaborates to allocate this funding strategically, ensuring it addresses identified local needs. Moray Pathways (employability consortium) including Progress for Parents offer Progress for Parents, formed under the banner of Moray Pathways continues to deliver personalised support to families experiencing multiple barriers to employment and wellbeing. The service has finished the reporting period with 123 active cases, which included 63 participants carried over from the previous year and 60 new referrals. The case load through the year has includes 126 participants from the poverty related priority family types. There are a wide range of referral partners established with an active programme of awareness raising at community events. Support services developed in response to barriers to employment include counselling, group work, creative arts and volunteers. Outcomes over this reporting period include: • 27 parents have moved into employment of which 21 are part time • 13 of these roles were supported through MERI funding • 10 individuals began volunteering Page 116
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20 Family: Tackling Poverty Our focus for improvement Our actions and progress Young adults and parents experience no poverty related barriers to entering and sustaining training and employment (cont.) “I know I am happier. I have a much greater sense of self- worth and achievement. I feel proud that I can provide for my family, and my mental health continues to improve.” Parent “As I became stronger, both physically and mentally, my pathway became clearer and so I made my application to UHI and was accepted onto the BSc (Hons) Integrative Healthcare course.” • 3 progressed into further education In total of 47 cases have been successfully closed. Childcare Access to school-age childcare remains a major challenge in Moray, particularly in rural areas, with recent closures, such as at Kinloss Barracks, and staffing shortages further limiting availability. A Project Officer is now leading efforts to expand provision, with two pilot areas identified. A successful collaboration between a childcare provider, M: Connect transport, and employability services has improved access and reduced costs for families, supporting the sustainability of rural childcare. This model may be extended to other areas. Local and regional working groups, with national input, continue to address these issues, now raised to ministerial level. Two test-of-change pilots are planned, and the “Step into Childcare” course continues to support workforce development. Young People A total of 377 young people engaged with the Employability Partnership—156 new starts and 221 carried over. The Young Person Service is fully integrated into education’s Pathways Planning, supporting school leavers without a clear post-school plan. Keyworkers provide holistic support, including access to financial advice, digital tools, ID documentation, tenancy preparation, and financial literacy training. Outcomes include: • 43 into employment • 140 referred to SWAP for vocational training • 30 supported by CLD • 28 referred for counselling • 78 joined the Creative Skills Network • 46 progressed to Further or Higher Education Page 117
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21 Family: Tackling Poverty Our focus for improvement Our actions and progress Young adults and parents experience no poverty related barriers to entering and sustaining training and employment (cont.) “Thanks for sticking by me, it’s been a bumpy ride” Young Person Strategic Equity Funding (SEF) in Moray has enabled schools to implement targeted, relationship-based inter- ventions that address poverty-related barriers to learning, engagement, and wellbeing. • In Buckie, youth workers supported P5–S2 pupils through one-to-one and group sessions, leading to im- proved attendance, wellbeing, and 18 youth awards • New Elgin Primary School embedded a youth worker to support P6 pupils at risk of exclusion, focusing on resilience and communication, which resulted in increased engagement, wellbeing, and 22 awards • Lossiemouth ASG used SEF to fund a Home School Link Worker and Project Coordinator, delivering tar- geted support to pupils and 20 families, boosting attendance by 17% and laying the groundwork for a com- munity wellbeing hub • At Elgin High School, a wide range of SEF- and PEF-funded interventions—including literacy and numeracy support, wellbeing groups, and a breakfast club—led to reduced exclusions, improved attendance, and strong pupil and parent feedback Collectively, these projects demonstrate how SEF is effectively tackling the impact of poverty on education through tailored, community-driven support. Next Steps Next Steps ➢ Increase referrals to the Parent Employability Team and continue to collaborate with partners to tackle lack of school age childcare provision Page 118
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22 Positive mental wellbeing greatly improves the experience of growing up and provides a solid foundation upon which a person’s lifelong health and wellbeing outcomes Family: Improving the mental and emotional wellbeing of children, young people and their families Our focus for improvement Our actions and progress Parents are confident and able to support their children to sustain good mental wellbeing A gap in parent-focused support led to the Moray Parent Project, launched initially as a 6-month pilot. During this time, 235 parents, mostly self-referred (98%), accessed the service. 76% reported improved confidence, with main concerns around children’s self-esteem and confidence. 46% of parents reported their own mental health struggles. The project has now been extended for two years and is open to all parents and carers of children aged 4–18. Workshop topics have expanded and are tailored to children’s developmental stages. Feedback from parents and schools shape session content and delivery. The number of 1-to-1 sessions has increased, and peer support groups have been trialled. Virtual sessions remain the most popular. This project continues to develop, we have expanded the opportunities for parents to receive more focus on their own mental wellbeing to support building resilience within the family. Since October 2024, 249 parents and carers have accessed the service, with anxiety and emotional regulation being key concerns. 15% reported being either formally or informally the carer of a child (rise since the pilot), 47% are single parents, and 72% report having low confidence in supporting their child. Following support, 88% report improved confidence. Additionally, for families with children under 5, a universal Peep family learning programme is being developed to support emotional and social wellbeing. The Early Birds autism programme offers targeted support to families with young children recently diagnosed with autism. The right mental health and wellbeing support is available to children, young people and their parents as soon as they need it. A survey of staff and parents showed good awareness of available support but highlighted concerns regarding high demand and waiting times. Demand has risen, but most services maintain an average 4–6 week wait. CAMHS sees most children within 5–6 weeks, with 97–99% starting treatment within the 18-week target. Redirected CAMHS referrals have dropped from 21% to 18%. School counselling saw a 13% rise in demand, with 35% more referrals for primary pupils, showing earlier inter- vention. Community mental health services are being re-commissioned following engagement work and market Page 119
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23 Family: Improving the mental and emotional wellbeing of children, young people and their families Our focus for improvement Our actions and progress The right mental health and wellbeing support is available to children, young people and their parents as soon as they need it (cont.) exploration, with a focus on aligning with our developing family support hubs. An evaluation of an under 10’s counselling pilot showed an unmet emotional regulation-based need in children with ASN. This need is not best met by counselling services. Moray is strengthening a system-wide approach to mental health, with regular partner meetings and plans to ex- plore a single referral point in 2025–2026 after the completion of procuring new community mental wellbeing ser- vices. Key progress this year includes: • Developing the counselling model to include family sessions when appropriate and linking to the parent project so parents felt more included without compromising the client/counsellor relationship • More school-based staff accessing LIAM training to support symptoms of anxiety earlier • Ensuring all MH service staff are suicide and self-harm safety planning trained • Case-based discussions to smooth service transitions • Life skills courses piloted for S3 pupils to boost resilience prior to the senior school phase • A trial of an online emotional school avoidance programme in 6 primary schools • ASIST suicide training prioritised for residential and social care staff from through care and after care social work teams, a programme of suicide awareness involving more than 500 students at Moray University of Highlands and Islands has been delivered and work exploring creating suicide safe schools incorporated into an all-age Suicide Prevention Delivery Plan • £16K ring-fenced to support care leavers, to respond to mental health needs timely and address loneliness in the first year of leaving care Community based mental wellbeing support is strengthened A survey by Quarriers, discussions in PSE classes, and feedback from young people in our social prescribing project revealed barriers to accessing community services, such as anxiety, cost, transport, and wanting to attend with friends. There were also gaps in the services young people wanted. Page 120
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24 Family: Improving the mental and emotional wellbeing of children, young people and their families Our focus for improvement Our actions and progress Our response includes: • Children's Services partnering with Moray Wellbeing Hub, Sports Development Team, and CAMHS to create a training programme for community and sports organisations. This programme aims to build confidence in engaging with young people struggling with mental health and neurodiversity. The pilot is ongoing, with plans to explore course accreditation for Moray groups • The Locality Networks organised a fresher style showcase event for free activities • Decider skills: A 6-week group activity for S1 pupils, with almost all attendees reporting increased management of anxiety, feeling more confident, increased focus on learning, and the majority reported they felt happier. Action for Children continues to pilot these groups in various settings Children, young people and their parents experience a smooth transition between support services, including transitions to adult services. Progress has been made in creating strategic governance for both adult and children's mental health, allowing for better collaboration. We continue developing a system that ensures smooth transitions between services. The Digital Health Institute is setting up a mental health living lab to focus on the needs of teenagers and young adults, including transitions from child to adult services. Care leavers feel vulnerable when leaving care and transitioning to adult services. Many do not qualify for adult mental health support and only receive help during a crisis. Action for Children has secured funding to pilot a transition worker to support care-experienced young people during their first year after leaving care. We have ringfenced financial resources to purchase immediate mental health and wellbeing support if required and to help minimise the impact of loneliness. Page 121
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25 To be safe means growing up in an environment where a child or young person feels secure, nurtured, listened to and enabled to develop to their full potential Family: Keeping Children and young people safe Our focus for improvement Our actions and progress Workers are confident and supported to identify and understand risk “The insights into what stops children from coming forward and how we can shift the focus from relaying on children to tell” The multiagency approach to child sexual abuse and how it highlights how other agencies approach this” Learning reviews and new case review approaches have led to plans for refreshing the national risk assessment framework and developing an inter-agency assessment protocol. The PRISM approach is used to share learning. Updated procedures for Sudden Unexplained Death in Infants and parental drug use have been launched, and child sexual abuse training has been introduced. Basic child protection training has been updated, with 80 practitioners trained. Feedback from sexual abuse training showed high relevance and improved understanding among attendees, and senior management reported confidence to support other staff. Responses to the Question “what is the most valuable aspects of the course?” are included. Two more learning reviews have been agreed upon. These reviews improve safety, identify evolving risks, and ensure practices align with current legislation and national guidance. The ongoing work aims to provide better support, incorporate children's perspectives into decision-making, and empower families to understand their rights and participate in assessments. Learning reviews promote transparency, continuous improvement, better multi-agency communication, and a more integrated system. Children, young people and families are empowered to participate in Child Protection Processes “I actively seek solutions to problems. I carefully consider the language I am using. I listen to the problem, validate pain before helping Solution orientated Child Protection Planning Meetings (CPPM) are fully implemented, and regular quality assurance dip sampling is reported to the Child Protection Committee. 125 practitioners have attended training this year. All CPPMs subjected to quality assurance in this period were held in a solution orientated manner. Examples of feedback on the training are included. “I listen carefully and do not interrupt with questions. When setting goals, I make them relevant, manageable and achievable.” “I feel more confident in chairing meetings with parents and feel that there is a more positive outcome for all involved.” Page 122
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26 Family: Keeping Children and young people safe Our focus for improvement Our actions and progress to find a solution” Training attendee The new Advocacy service and contract monitoring are now in place. The Child Protection Committee (CPC) and commissioned services are working on how to quantify, evaluate, and report activities. During this period, half of the quality-assured CPPMs reported the advocacy service was available to the child, and in 5 cases, it was available to the parent. In 2 cases, the child was too young to understand the process, and in 1 case, the team felt they could advocate well for the child (accepting this is not independent advocacy) due to strong working relationships. Examples of feedback include: “I don’t know where I would be without you explaining all the things I have to do to help get my kids back” – Parent. “I wouldn’t have managed my children being removed without your support and guiding me through my rights in this awful situation I’m in. Thank you.” – Parent. “I have never said what I want or who I want to live with as it always causes a fight between my mum and dad, but I can tell you now”. – Young Person Children and young people develop healthy relationships with peers, online and in the community. “I can talk about my feelings...I don't feel like walls are caving in anymore.” (Young survivor aged 13) The Moray – Let’s Chat Online Safety Campaign, which officially ended in Februaury 2024 has been extended through school sessions, information stalls at events and both professionals and parent/carers sessions held online and in person. Focus has been increased on sharing nude images and sextortion and new materials are being developed to explore mysogynistic influences. Awareness has been rasied of the role of the CPC, and of the new Moray Protects information website. 128 S4 pupils were involved in sextortion sessions delivered by the CPC in partnership with Police Scotland and 42 campaign leaflets and 73 top tips leaflet were distributed at the RAF Lossiemouth Friends & Families Day, with the leaflet on how to manage screen time with children proving the most popular. Sexual violence prevention work with young people in Moray Moray Rape Crisis delivers the national Sexual Violence Prevention Programme to young people aged 11–25 across Moray. The programme includes four age-appropriate workshops tailored to different year groups, aiming to prevent sexual abuse by increasing understanding of key issues like consent. Between April 2024 and March 2025, 119 workshops were delivered to 2,054 young people. Page 123
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27 Family: Keeping Children and young people safe Our focus for improvement Our actions and progress “This has helped me be able to talk to someone instead of bottling it all up and the support I've been getting has helped me a lot with liking myself again.” (Young survivor aged 15) Therapeutic and advocacy support for young people in Moray affected by sexual violence. The Rise Up project at Moray Rape Crisis offers trauma-informed support, advocacy, and information to young people aged 11–18 affected by sexual violence. In 2024–25, 38 young people were supported through 1,436 appointments and contacts. There were 28 new referrals from various partners, with 15 currently on the waiting list. From a sample of 19 evaluation forms, 87% felt more able to interact with others, 67% more able to cope, 60% reported increased self-esteem, and 60% felt more hopeful. Children and young people are safer because risks have been identified early and responded to effectively. Graded Care Profile 2 training continues alongside briefing sessions for the wider workforce. Safe & Together training continues, an evaluation report has been completed and presented to the CPC. A retrospective file audit is planned to evaluate the difference in practice and impact on children & families, this is to be led by social work staff. Following CPC self assessment of implementation in 2023, Moray procedures were updated and re-launched, August 2024. A Contextual safeguarding short life working group has been established to conduct a self evaluation exercise, which will inform the plan for adopting a framework locally, utilising the scale up toolkit from the Contextual Safeguarding Network. A self-evaluation exercise is underway to review our approach to safeguarding young people at risk of harm within the community. Those who come into conflict with the law are supported with compassion and care Moray’s Protection from Serious Harm process (equivalent of Care and Risk Management) was agreed by CPC in April 2024 and operational from 30 August 2024 as part of Moray’s revised multiagency child protection procedures. The first protection from serious harm meeting was held in Moray towards the end of the reporting period, which has enabled the team to follow the new procedures, and Social Work Services and Police will meet to discuss, reflect and de-brief on the process. Page 124
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28 Family: Keeping Children and young people safe Our focus for improvement Our actions and progress Following this there will be a session developed for IRD (Inter-agency Referral Discussion) chairs and service managers to distribute the learning. Children and young people are supported through recovery and do not experience further trauma Scottish Child Interview Model (SCIM) in Moray is fully implemented. Annual Evaluation report completed and presented to CPC and regular evaluation reports will be provided to CPC utilising the national SCIM QA and data framework. Between 1st April 2024-31st March 2025 100% of joint interviews in Moray were conducted by the SCIM team. Feedback from older children and young people in the Northeast (due to low numbers, feedback is not broken down by area) included: • 100% felt interviewers worked with them, gave them choices, made them feel safe, and helped them tell their story • 94% would be happy to talk to the interviewers again Feedback for younger Children included: • 72% were happy with the interview process explanation, 21% were okay with it • 79% felt happy speaking with the interviewers, 21% felt okay • 100% felt safe/happy in the room and would speak to the interviewers again A trauma informed development officer post has been recruited. Moray’s application for 2025/26 Bairns’ Hoose funding at the end of this reporting period has been confirmed as successful. The application was completed in collaboration with Police, Health, Social Work Services and Quarriers, our commissioned Children’s Rights service provider. Our application builds on learning from pathfinder sites and includes a test of change to align with Aberdeen City and Aberdeenshire project plans in 2025/26. In addition to the Development Fund application, Moray has applied for test of change funding to include a Health Coordinator post and specialist Speech and Language Team (SLT) provision. Based on learning from other Page 125
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29 Family: Keeping Children and young people safe Our focus for improvement Our actions and progress Children and young people are supported through recovery and do not experience further trauma (cont.) pathfinder sites, proposals were initially developed by NHS Grampian to cover Aberdeen City and Aberdeenshire. If the Moray application is successful, it will maintain consistency for the SCIM team in all three authority areas and ensure equity of healthcare coordination and specialist SLT service provision for children and young people in Moray. Moray’s application represents a strategic move to transform how we support children impacted by trauma, particularly those involved in abuse investigations. The Bairns’ Hoose model aims to reduce anxiety and build trust, fostering a more positive and productive experience for the child. The inclusion of a dedicated health co- ordinator and specialist speech and language therapy within the application underscores a commitment to addressing the holistic needs of traumatised children, recognising that trauma often manifests in both physical and communication-related challenges. Page 126
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30 Children with disability and neurodiversity and their families will receive the support they need to enable the children to reach their potential Family: Supporting children and families who experience challenges due to disability and neurodiversity Our focus for improvement Our actions and progress Children and young people’s education and care needs are met, regardless of need. The ASN education review is ongoing, focusing on adapted curriculums, resource allocation, policy guidance, training, and ASN provision in Moray. A survey of parents and carers received 800 responses, which are being analysed. Progress includes: ➢ All education staff completed a 5-component training program before the 2024/25 academic year to better support a variety of young people's needs ➢ The Moray Adapted Curriculum (MAC) was launched for children with the most complex and varied support needs, when either mainstream or enhanced provision may not be suitable. The focus is on individual learning plans managed through the child planning process. Currently, 14 children are supported by MAC, 11 of whom were previously not attending school ➢ The Flexible Framework: Curriculum for All was introduced to provide education out with school settings, with 12 approved providers. Evaluation and a promotional video are in progress Parents and young people with neurodiversity challenges can access early help and support We continue to deliver the Early Bird programme for families of children under 5 with neurodiversity challenges, supporting 33 families to date. Partners have restarted ASN parent drop-ins with the support of the locality networks. These sessions help families discuss available support and activities, including financial assistance. Based on parent feedback, they will now be held monthly. The Moray Parent Project has introduced neurodiversity workshops to build parents' skills and confidence. These workshops are very popular, with 15 held in the last 6 months. We are working to combine these workshops with Page 127
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31 Family: Supporting children and families who experience challenges due to disability and neurodiversity Our focus for improvement Our actions and progress self-care sessions for parents to emphasise positive mental wellbeing. These sessions are now linked with schools to provide more peer support and improve home to school communication. The workshop has also been adapted for community organisations to increase understanding and inclusion of neurodiversity. Children, young people and families with additional support needs have improved access to sport, leisure and community- based activities “It was amazing to see a pupil with complex ASN struggling to learn to cycle to the develop into a safe, competent cyclist. His parents, myself and other staff have noticed that his overall confidence and maturity has grown as a direct result of this cycling project” School staff lead A system-based approach has been used to create a plan to improve physical activity in Moray developed with various partners. In 2025/2026, they will focus on improving access for individuals with additional support needs (ASN). A pilot project using the new flexible framework is developing at Mortlach Primary School and focuses on care- experienced young people, including those with ASN/disabilities. The project uses sports to boost confidence and positive school experiences as part of an alternative curriculum provision. The Moray Disability Sport Hub was created to develop more opportunities for individuals with ASN/disabilities through collaborative working. Twenty adults completed a disability inclusion course by Scottish Disability Sport. The Moray Active Schools Programme tracks participation rates of young people with ASN or disabilities in extracurricular activities. Of 3749 pupils, 1109 have ASN and 112 are assessed as disabled. Moray's ASN rate is 41.6%, with 32.9% accessing the programme. The gap in participation is -8.7% for ASN and -1.5% for disabilities, compared to national gaps of -14% and -0.8%, respectively. New activities include relaxed sports for neurodiverse children at Keith Primary ASN base and an ASN cycling project. So far, 179 participants have attended 48 cycle sessions, with 98% feeling healthier, 96% more confident, 80% making friends, and 82% feeling their needs were met. Social Work Services commissioned a 3rd sector organisation to provide fun-based group sessions for children with disabilities between the age of 5-18 years afterschool, on weekends and during holidays to help further address the gap of accessing suitable provision. The preparation is complete, and sessions begin in April 2025. Page 128
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32 Family: Supporting children and families who experience challenges due to disability and neurodiversity Our focus for improvement Our actions and progress Families can access a neurodiversity diagnosis in a timely way Work in relation to a Grampian neurodevelopmental pathway has been slow to progress. However, there has been learning from a pilot project which ran in Aberdeen. The project utilised a multidisciplinary team to assess children in schools, with a family link worker supporting the family. This reduced the referral-to-diagnosis time from 34 weeks to 6 weeks. Funding has now been secured to extend the pilot which will include a family link worker covering Moray. In Moray, diagnosis has remained possible through, the Autism Diagnosis Assessment Pathway Team (ADAPT) in addition to children with complex needs, who receive a diagnosis through CAMHS. In 2024, ADAPT received 182 referrals—an increase of 37.7% compared to the previous year. Very few (1%) referrals were declined. During the same period, 85 children received a diagnosis, representing a 165% increase from the previous year. However, the number of referrals has continued to rise, up by 38% from 2023. This trend highlights a persistent challenge: demand continues to outpace capacity, resulting in long waiting times for diagnosis in Moray. Children with additional support needs experience a smooth transition to adult services. A review of continuing care for young people with complex needs is being led by Social Work Services. So far, they have reviewed case samples, developed a draft continuing care policy, and updated the transition policy. Transition planning starts when the transition screening tool is completed by education services and the team around the child at age 14. The next step is a procedure within the child planning review to ensure application of "getting it right" principles, supporting effective transitions which reflect the needs of young people. Page 129
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33 SPOTLIGHT ON Young Carers Quarriers provide Moray’s carers service and currently have 199 young carers (YC) on their register. 119 referrals were made to the service this year. For those young carers who go on to register (which may include completing a young carer statement) a range of support is available. • Information and advice, 48 YC received information including referrals to appropriate agencies, 15 YC supported with emergency planning for when not at home • peer and social activities, 33 YC enjoyed activity theme days out or to shows like the Christmas pantomime • emotional support,16 YC were supported one-to-one including completing resiliency workbooks (developed through MHWB funding) • skills development, 2 YC were supported to manage their feelings regarding being at school while their parent was at home • access to small grants and short breaks, 16 YC in total attended two residential camps and £4831 in grants awarded Feedback includes: ‘It was an amazing experience and nice to meet other kids, it was fun being a kid for a couple of days.’ (YC who attended SYCF), ‘YC had a fabulous time at the art workshops. It was such a nice way for them to express themselves, and I loved seeing her work with everyone else’s.’ (Parent). 16 young carers attending residentials with either the Scottish Youth Carers festival or the Hopscotch residential in Nov 24 to have a break from their role, 16 worked on their mental wellbeing using Page 130
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34 We want to make sure families can access the help they need, where and when they need it. Family: Strengthening family support Our focus for improvement Our actions and progress Children and their family’s needs are addressed early through implementation of effective child’s planning processes There has been a continued rise in the number of children and young people entering the child planning process. A review of this trend highlighted the need for clearer guidance and training on when child planning is appropriate. Consultation on the new child planning paperwork continued this year. The Child Planning Thematic Group engaged children and young people throughout the process, including incorporating design input from a young person on work experience with the Children’s Services Network Team. The paperwork has been piloted across several Associated School Groups, Health Visiting Teams, and Early Learning and Childcare centres. Feedback from these pilots has informed further improvements. Multi-agency training in Solution-Oriented approaches to meetings is underway, with a rolling programme in place. Currently, 12 trainers are delivering sessions, and 75% of key education staff have received the refreshed training. Third sector partners are also included in these opportunities to ensure a consistent approach across all contributors to the child planning process. To support families and professionals, a dedicated GIRFEC in Moray website has been launched providing local and national information on the GIRFEC approach, the child planning process, and available support. The site is linked to the national ALISS platform, enabling broader searches for services and community-based provision. Next steps include audit and self-evaluation to explore how effective the paperwork, and the wider child planning process is at responding to and supporting children to have their needs met. Further training will be developed specific to the process and learning. A multi-agency self-evaluation calendar will be incorporated into our wider performance and self-evaluation framework. There is a clear pathway of non-stigmatised support available to parents throughout Moray Family support remains a key priority in Moray. Multi-agency funding has been invested throughout the current Children’s Services Plan to develop support across various settings, with ongoing work to align these efforts into a single, coordinated pathway. Page 131
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35 Family: Strengthening family support Our focus for improvement Our actions and progress Parents are supported and enabled to be the best parents they can be “She has helped X in situations where people often automatically blame X and has taken the time to listen and hear his version of events” Parent feedback, New Elgin Primary School SEF based work “The information has been rich & very helpful as a first- time mum. The professionals are knowledgeable & the practical demonstrations were very valuable.” Parent to be, PEEP Family Support in Moray: A Coordinated and Evolving Approach Family support remains a central priority in Moray, with multi-agency investment driving the development of services across a range of settings. Throughout the current Children’s Services Plan, efforts are being made to align these supports into a single, coordinated pathway. Education’s Role in Strengthening Family Engagement Education has played a pivotal role using Pupil Equity Funding (PEF) and Scottish Equity Funding (SEF) to support initiatives such as parent coffee mornings, and weekly newsletters. The roles of Home School Link Workers and Family Link Workers have been enhanced through increase family engagement, home visits and tailored support. Lossiemouth High School is advancing plans to create a one-stop wellbeing hub for the wider Associated School Group (ASG) community, further improving local access to integrated family support. Early Intervention: The Peep Programme At the foundation of Moray’s emerging family support pathway is the universal Peep offer—a family learning approach that strengthens parent-child relationships and recognises parents as a child’s first educator. Peep availability is being increased to all families from pregnancy until school entry. Key developments include a 150% increase in Peep groups since April 2023, £180,000 of Whole Family Wellbeing Funding (WFWF) being invested to establish Moray’s first dedicated Peep team, delivery of sessions across Moray through partnership working with a further 35 additional staff and volunteers trained in March 2025 and 7 new partners joining the delivery network. By February 2025, 93% of pregnant women in Moray were invited to begin their Peep journey. Feedback highlights the value of relaxed, informal sessions where parents can ask questions, build peer networks, and better understand their baby’s needs. In addition, peep can be offered in one-to-one or very small groups over a longer period where more need is identified. We continue to offer this support through the Equity & Excellence Lead in the Forres Area currently. Page 132
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36 Family: Strengthening family support Our focus for improvement Our actions and progress “After every session, I felt far more uplifted. The things you (Therapist) said has helped us to see things in a different way” – Parent, Functional Family therapy. May 2024 It’s been really helpful to have a sounding board, someone outside of the family to talk to and to feel like we are involved, part of something” – Parent, Families Together, March 2025 I had not heard of Youthpoint before and was sceptical, the staff were warm and soft spoken, they seemed to have an understanding of what family life was like for us and yet we were all strangers, I appreciated the support from the very first hello” – Parent, AYP. 07/03/2025 “I have never been able to say what I think or what I want to happen. I can tell Tier 2 Support: AB56 Futures Delivered by Action for Children and funded through early years investment, AB56 Futures provides holistic, tailored support to families with children aged 0–12, where a child aged 0–5 is present. Operating from hubs in Elgin and Buckie, the service offers parenting guidance, learning through play, strengthening family relationships, help with forms and appointments, signposting to financial and food support. Between April 2024 and March 2025, 81 families were referred, and the following outcomes achieve: ➢ 90% improvement in parenting skills, community engagement, and social connections ➢ 75% improvement in financial management ➢ 85% improvement in school attendance, practical skills, play, and emotional wellbeing Intensive Family Support Children and Families Social Work invests £1 million annually into three intensive family support services and one advocacy service. These services support families at higher risk of breakdown, justice involvement, or care proceedings. They work with families both pre- and post-statutory intervention using evidence-based approaches. Key highlights include: ➢ 328 referrals received across the three services ➢ The Family Together Service includes a financial support component, helping 30 families gain £56,304 and reduce debt by £9,517.81 ➢ 28 families received Functional Family Therapy ➢ 24 families participated in Family Group Decision Making Advocacy Service is an independent service provided by Quarriers. Launched in October 2023, the advocacy service has supported 259 children and young people and 175 parents, carers, or siblings. Further details are available in the Safe and Care priority sections. Page 133
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37 Family: Strengthening family support Our focus for improvement Our actions and progress you and everyone listens and things are getting better”- Young Person August 2024 I feel more able to go out and do things because of the time we spend together” Young Person, Aberlour Youth Point. August 2024 Additional Services: • Aberlour Youth Point’s Early Help and Mentoring: Offers personalised, relationship-based support to around 125 young people annually, including holiday activities • YPZone: A drug and alcohol risk reduction service funded through a unique match-funding model. Since October 2022, 183 young people have accessed the service, which includes education, outreach, and one-to-one support. A local parent-led support group also meets regularly at the service’s premises The Parent Project is detailed further in the Mental Wellbeing and WFWF report sections. The key next steps is the quality assurance of these services and the coordination into support pathway which has no gaps and is easily accessible. Children’s transition into Nursery is consistently good “The phone calls and visits from Health Visitor to discuss new children's work. It would be great to continue collaborating in this way” ELC provider feedback. A new template has been developed to share outcomes from the 27–30-month child development review between health visitors and nurseries. After a successful pilot in one ASG and refinements in a second with more nurseries, the process is being trialled Moray-wide during summer 2025 transitions. Nursery feedback has been very positive, particularly for transition planning, with full impact evaluation planned post-summer. The Early Bird programme, supporting parents of children diagnosed with autism or neurodiversity, has reached 33 families since staff training, including 7 this year. While uptake is low due to later diagnoses, feedback is highly positive. However, delivery has been limited by staff cuts linked to funding constraints. A parent “I’ve enjoyed attending the EarlyBird programme. It’s been so nice to listen and share our experiences and strategies with other parents. It’s helped me feel just a little bit more normal being around others in the same boat. I’ve learned a few tips and got a better understanding in autism.” A parent stated “Great programme, non-judgemental and safe place to share ideas and tips and stories and get advice while learning about autism” Page 134
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38 As Corporate Parents we are committed to working together in partnership to ensure our children and young people with experience of care receive the right support to reach their full potential and can be all they want to be Care: Improving Outcomes for looked After and Care Experienced Children and Young People Our focus for improvement Our actions and progress The gap in educational outcomes of looked after and care experienced young people is reduced. “Many of our pupils are within the care experienced statistics and as a team we were reminded of the immense responsibility we all have as corporate parents. Every action and interaction with our children and young people became part of a reflective review, to ensure we were not only offering, but also providing the most positive experiences possible.” Feedback on Promise training award Case Study (Exlusions).docx Under the leadership of the Virtual School Head Teacher and strengthened partnership working, steady progress continues in improving outcomes for care-experienced children and young people. Enhanced data has enabled more targeted support. Key improvements include: • Information sharing through the Head Teachers’ handbook and briefings. Co-ordination with Quality Improvement officers to direct support appropriately to schools, this includes for CSP’s, Child’s Plans and SEEMIS data • A corporate parent self-evaluation toolkit piloted in secondary schools to enable secondary schools to track, and quality assure their processes in school • Rollout of the Education Scotland Keeping the Promise Training Award, now completed by 40% of schools. This supports inclusion and early intervention for all care experienced children & young people • Support for young people most at risk through attendance at children’s hearings, review meetings, child’s planning and education planning meetings, this in turn supports information sharing through the CARE Priority Group • The Children at Risk in Education (CARE) Priority Group, established in February 2024, ensures coordinated multi-agency responses for vulnerable pupils. Targeted interventions and advice and guidance have led to a 57% reduction in exclusions among looked-after children over the past year • Moray’s quarterly Scottish Attainment Challenge report shows that the combined impact of Strategic Equity Funding (SEF), Pupil Equity Funding (PEF), and the Care Experienced Children and Young People Fund (CECYPF) is showing Moray is on track to meet our poverty and care experienced related stretch aims are on track Page 135
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39 The gap in educational outcomes of looked after and care experienced young people is reduced. Attendance: The ongoing review of attendance data highlights that, while Moray continues to exceed national averages for both primary and secondary sectors, the attendance of care-experienced young people—particularly those looked after at home or previously looked after at the secondary stage remains an area of focus. Page 136
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40 Empowering Care-Experienced Young People in Moray through Promise Groups: Following a successful £75,000 funding bid from the Corra Foundation—driven by the voices of care- experienced young people—Moray has established a network of Promise Groups. These groups offer safe, inclusive spaces for care-experienced children and young people to share their views and influence change in their school communities. There are currently six active groups across primary and secondary schools, plus one at Moray College UHI. Highlights include: • Primary schools offering enhanced opportunities such as cooking, sports coaching, and outdoor learning with Outfit Moray and Wildthings • Buckie High School students leading their own Promise Group, supported by Youthwork, and collaborating with Wildbird Visual Arts on a film project • Moray College UHI group reflecting on educational barriers and working to raise awareness of support pathways for care-experienced learners transitioning to further education Active Schools We have worked closely with Active Schools colleagues to raise awareness of The Promise and the unique needs of our care-experienced children and young people. This collaboration has led to steady and meaningful progress. Participation from care-experienced young people has increased from 50 to 67 individuals in the 2023/24 academic year. Active schools have supported Champions Board events to explore further opportunities with young people. Encouragingly, some care-experienced young people are now involved as young leaders within the programme—an area identified for further development in 2025/26. Page 137
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41 Looked after and care experienced young people enter and sustain education, training, or employment after leaving school. In the 2023/24 academic year, 70% of Looked After Children (14 out of 20) progressed to a positive post- school destination—a slight increase from previous years. Six young people did not, highlighting the continued need for sustained post-leaving support and the challenges faced during transition. Further Education remains the most common pathway, representing 45% of all leavers and 64% of positive outcomes. Over the reporting period, 36 care-experienced young people engaged with Moray Pathways, including 19 supported through the Mentoring Young Talent programme. The below cares studies demonstrate how the support can be impactful. Megan.docx Case Study (Henry).docx The health needs of looked after children and young people are met. Health needs of looked after children continue to be addressed through a coordinated, multi-agency approach. Initial Health Assessments (IHAs) are completed when a child or young person becomes looked after. 72% of IHAs are now completed in four weeks, up from 56%, with delays only occurring when young people declined the assessment. Emotional wellbeing is monitored using the Strengths and Difficulties Questionnaire (SDQ), though further work is needed to ensure consistent completion to support timely referrals. Joint working remains strong across children’s homes, fostering, adoption, kinship care, CAMHS, and education. Monthly consultations with a CAMHS psychotherapist for children in residential care provides expert guidance and tailored support. Carer feedback continues to be positive, reflecting the value of this collaborative approach. Looked after and care experienced young people, and their parents/carer feel their voice has been heard through the provision of independent advocacy. Moray’s Children’s Rights Service continues to support the rights and voices of young people, and their families. Over the past year, the service has engaged with 162 young people and 86 parents, carers, and brothers and sisters, including 82 looked after children. During the last year there has been a 34% increase in looked after children accessing independent advocacy. This rise reflects systems improvements, ensuring timely and consistent access to independent Amy.docx Case Study (Tom).docx Page 138
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42 “I feel a lot better about my Education. I feel more supported by school, and I want to try and return as I know I have choices and a voice to say when it is too overwhelming.” [Millie 12years old] “I’m happy to stay with my family.” [ Lily, 8 years old] advocacy throughout young people’s care journey, including young people preparing to leave care and care leavers. All children and young people have had their voices heard and represented at statutory review meetings and Children’s Hearings, reinforcing our commitment to upholding their rights. “We have made more progress in the last month with Moray Children’s Rights thank in the last two years. The support has been life changing not only for our daughter but us as parents. We can’t recommend this service enough.” [Parent of Looked After Child] The number and range of placements available meets the needs of children and young people in need of care. The number of approved foster carer households in Moray has seen a slight decline during 2024. While our ongoing carer recruitment campaign continues to bring in new fostering households, this progress is offset by others ceasing to foster or changing the type of care they provide. This challenge reflects a wider issue, locally and nationally, on the recruitment and retention of foster carers. Despite these challenges, the carer recruitment campaign remains a key priority in the year ahead. Alongside recruitment, efforts to improve support for carers are being prioritised. These include enhanced supervision, access to bespoke training, and improved financial support for carers. Over the past year, four new fostering households have been approved. During this reporting year we have seen a reduction in the number of care disruptions and unplanned endings for children and young people. Work is underway to limit the number of young people cared for out with Moray. We recognise that out-of-area care can disrupt important relationships and access to local support services, including health care, education, and connections with family and friends. Transitions feel and are experienced as integrated, with maintaining relationships being paramount. The Maintaining Relationships Project is a grass roots project that secured Corra funding for an Improve- ment Officer to develop a policy that alongside young people and practitioners to ensure relationships are protected during and after transitions. During the last year 11 young people were supported to raise awareness of the project, undertaken a range of engagement events to gather stories of transitions and are currently working with our local policy team to Page 139
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43 co-design the policy. A celebration event is planned for the end of the year and will include an evaluation of the impact of the project. Our local children’s house has developed their own maintaining relationship’s protocol to ensure young people do not lose connections with those who cared for them, they continue to support 9 young people who have left care over the past 2 years. Additionally, Action for Children have received funding to employ a care worker with a specific role to support transitions, commencing in the summer of 2025. Siblings are supported to maintain positive relationships with one another. Moray benefits from being a small, rural area. Almost all of brothers and sisters have been able to stay together in homes found by our Fostering and Adoption teams, the numbers are small for those who cannot live together with plans in place to support brothers and sisters. On average 86% of brothers and sisters are accommodated together in Moray, the national average as of 2023 is 79%. We have undertaken awarenss raising sessions across the partnership to upskill Corporate Parents on brothers and sisters rights. This includes targated work with: Fostering and adoption team 9 Action for Children workers Social work leadership team 2 parent participation groups – Children 1st 6 Foster carers 6 Birth parent groups- Children 1st 19 Young people Locality planning network- brothers and sisters’ workshop Children and young people seeking asylum are fully integrated into school and community life. Over the past year, Moray has supported nine New Scots (formerly Unaccompanied Asylum-Seeking Children) through the National Transfer Scheme. Allocated by the Home Office, these young people are classed as looked after and supported by the Throughcare and Aftercare Team. Initially placed in Supported Lodgings or Accommodation, they are successfully supported into independent housing once asylum is granted. COSLA has recognised Moray’s flexible, needs-led approach as a good practice model. New processes have been introduced to ensure timely access to health, wellbeing, education, and training for all newly arrived young people. Engagement in community life has grown, with increased participation in events such as the Moray Champions Board, helping young people connect with peers and build a sense of belonging. Page 140
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44 Looked after and care experienced young people are not overrepresented in the children and family’s justice system. Care-experienced young people (CEYP) remain overrepresented in the justice system. As of 2024/25, 8.3% (44 of 532) of individuals in the justice system up to age 26 were CEYP, with 13 children receiving Youth Justice support. These figures have remained below 12% throughout the year. Early identification and intervention remain key, with partners working to reduce reoffending and time spent in justice services. Police Scotland has expanded its Prevention and Intervention Team, including a Youth Engagement Officer who now acts as a single point of contact for local children’s houses and the Throughcare and Aftercare Team and an Early and Effective Intervention Worker. Moray continues to embed trauma-informed practice across services. A dedicated Trauma-Informed Lead has consulted with 47 teams across children’s, adult, justice, health, education, housing, and internal services. This approach has contributed to a reduction in the use of restraint—no incidents were recorded in local children’s houses over the past year. These homes use therapeutic approaches such as Dyadic Developmental Psychotherapy to provide nurturing care. For children out of area, a robust tracking system ensures restraint reduction plans are in place where appropriate. Our improvement activity is shaped by the voice of our looked after and care experienced young people. “I did not notice any difference during the transition. My relationship with my foster carers stayed the same.” (Young person in continuing care) Care-Experienced Young People: Driving Change Care-experienced young people play a vital role in shaping their services. Key participation highlights from the past year include: Digital Access - All care leavers now receive Wi-Fi and mobile data support to ensure digital inclusion Champions Board Podcast - Created to amplify young voices across Moray Service Design - Young people helped redesign Youth Justice feedback forms and co-developed the Better Ideas Group Recruitment - Actively involved in staff selection processes Language Matters - Promoted trauma-informed language, helping young people feel “cared for” and “heard” Mentoring Young Talent - Informed model improvements and now co-deliver mentor training Continuing Care - Consultations led to clearer information and a new leaflet co-designed by young people. Page 141
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45 These initiatives reflect a strong commitment to co-production and ensuring young people’s voices lead to meaningful change Next Steps …. The Corporate Parenting Strategic Group, responsible for delivering the care priorities outlined in the Children’s Services Plan, has undertaken a streamlining exercise to review current data and identify key actions for the year ahead. Priorities include: • Improving educational outcomes and supporting positive post-school destinations for care-experi- enced children and young people • Roll out and implementation of the Maintaining Relationships Project to help young people sustain important connections • Enhancing data collection and analysis through a robust data and self-evaluation model • Promoting better health outcomes for care-experienced young people • Increasing support for foster and kinship carers to improve care stability and outcomes Page 142
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46 Our workforce includes all volunteers, carers and employees who have a role in improving the wellbeing of children, young people and their families People: Supporting Our Workforce Our focus for improvement Our actions and progress Integrated working practice is enhanced through joint development opportunities that supports our shared vision, core principles and values. In 2024/2025, over 300 practitioners attended various multiagency training sessions, including child protection and online safety. An additional 350 attended specialised training on gangs, county lines, and child sexual abuse. A new training framework has been developed focused on four priority areas: mental health, substance use, parenting, and vulnerability & exploitation. It identifies six practice areas: relationships, record keeping, trauma- informed practice, challenging conversations, boundaries, and strengths-based working. This framework helps map existing training, identify gaps, and plan future training. Practitioner feedback confirms the content is relevant to their day-to-day work. We are aligning new training with National Child Protection Guidance and GIRFEC Policy to enhance practice- based learning. Stronger partnerships and increased cross-sector training sign-ups reflect the feedback when staff see how the training will benefit their day-to-day roles, and they feel their needs have been heard. Page 143
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47 Staff facilitate and enable the relationships, networks and connections that support our children, young people and families Since May 2024, the dedicated Trauma Informed Development Officer has been working to embed trauma- informed practices across our partnership. All existing training has been updated to include trauma-informed and strengths-based principles, and these are now part of all new learning opportunities. Additional we have focused on the importance of language, introduced more relational language that reflects our core values of kindness, compassion and connection. A Trauma Implementation Group was formed, and Moray joined a national pilot. So far, 36 teams have received introductory briefs, and 12 teams have completed the full reflective process using the "walk through lens" tool. A training plan is being developed to ensure access to informed, skilled, or enhanced level training. A trauma- informed practice page has been added to the Moray Interchange, and tools to evaluate the impact of these practices are being explored. This role is helping to embed a trauma-informed approach across our children's services partnership with shared responsibility for being trauma informed. Consistent shared language acquired through shared learning sessions is strengthening trust between services when working together to support the same child or family. Work continues the implementation of a new Children Services Partnership Self- Evaluation and Continuous Improvement Approach. We have introduced more formal audit activity into learning & development as opposed to evaluation on initial training feedback and attendance by utilising reflective tools like the walk-through lens. We are more able to identify which parts of training require reinforcement and consider the impact of training over time. Page 144
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48 We will strive to ensure that our governance, culture, systems and processed empower our paid and voluntary workforce and local communities to deliver the improvements children and young people have told us matter most to them Scaffolding: Working in Partnership Our focus for improvement Our actions and progress As a partnership, we are aware of the changing needs of children, young people and their families. Partners collaborated to produce a comprehensive Joint Strategic Needs Assessment (JSNA) for the Children’s Services Plan. In 2024, the adult JSNA was updated, offering deeper insight into the challenges facing families and communities. Our governance structure brings together cross-sector data and insight. We are preparing to update both the JSNA and wellbeing indicators through the upcoming Health & Wellbeing Survey to inform the next Children’s Services Plan. Emerging data includes a sharp rise in poverty, Moray ranking fifth in Scotland for suicide rates, and persistent issues of violence, anti-social behaviour, and contextual safeguarding. There has been an increase in children entering care and being placed out of area, affecting wellbeing and budgets. Progress from the ASN review has enabled more children with complex needs to engage in education, though staffing shortages continue to limit progress. Moray relies heavily on small, community-based organisations for local support, with fewer national providers than other areas. Financial pressures, reduced volunteering, and rising costs have led to service closures. Many small providers are struggling to sustain their workforce and access training to meet the increasingly complex needs of children, young people, and families. Page 145
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49 Scaffolding: Working in Partnership Our focus for improvement Our actions and progress As a partnership, we maximise all opportunities to lever in additional funding and work together to ensure it supports the delivery of our shared priorities. Moray has intentionally focused on a small number of priority areas within children’s services, recognising the challenges of recruitment and securing the right expertise, which can impact delivery and funding. Key areas of progress include: Youth Participation - £75K was secured from Corra to develop a youth participation model, focused on care- experienced young people. Building on Aberdeenshire’s Promise Group model, six local groups have been established. Funding is devolved to each group, enabling young people to identify and act on local priorities. Activities to date include filmmaking, art, sports, and community trips, with summer opportunities identified as a key focus. This work is delivered in partnership with Education, the Children’s Services Network, and community youth workers Transitions Support - Action for Children secured Williamson Grant funding to pilot a transition worker post. Additional funding from the Mental Wellbeing Partnership supports care leavers facing mental health challenges during the transition to adulthood—an especially vulnerable period Bairns’ Hoose - both development and test for change funding has been confirmed to ensure consistency in the SCIM team activities across all 3 areas of Grampian and to complete a test for change to transform howe we support children impacted by trauma, particularly those involved in abuse investigations, addressing the holistic needs of traumatised children, recognising that trauma often manifests in physical and communication-related responses Maintaining Relationships: Ongoing work with Corra supports care-experienced young people in maintaining important relationships, including brothers and sisters, through improved procedures and practice Community-Led Mental Health Research: Moray Wellbeing Hub secured long-term funding to lead community- driven mental health research and co-create solutions. The focus is on building “mental wealth” and reducing stigma through locally informed, participatory approaches Page 146
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50 Scaffolding: Working in Partnership Our focus for improvement Our actions and progress The risk of silo working across children and adult services minimised. A partnership-based governance structure has been established to support children’s services planning. However, limited capacity has been a significant barrier to progress. In response, the structure is being temporarily streamlined to focus efforts on delivering key actions within the current plan. Amid change and challenges across all three lead partners—Moray Council, NHS Grampian, and Health & Social Care Moray—silo working remains a risk. To address this, partnership chairs and improvement officers are empowered to identify and challenge siloed approaches, promoting greater collaboration and alignment. We more consistently and effectively measure impact of the actions we are taking to improve outcomes for children, young people and families. Our recent inspection recognised the ambition of our Children’s Services Plan (CSP), while also highlighting the need to support our workforce through change. In response, we are refining our focus for the remainder of the year, with key priorities outlined at the end of this report. A new self-evaluation and performance framework is being embedded. To strengthen our impact, we recognise the need to become more outcome-focused, with clearer, measurable indicators. Our aim is to make meaningful progress in the final year of the current plan and carry forward learning into the next planning cycle. The co-ordination of continuous improvement activity improves Work continues to establish a more coordinated approach (see the previous outcome) with a cross-sector development session scheduled as part of our effort to achieve this. Page 147
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51 Next Steps For the final year of our CSP, we have streamlined our focus to two key outcomes in most priority areas. To support delivery, a temporary streamlined governance structure will also be introduced to target staffing capacity to drive forward the outcomes identified. We are continuing to embed our performance and self-evaluation framework to better evidence what’s working well and where improvement is needed. This will include work to ensure regular updates on how we are doing against the national wellbeing indicators. Work has begun on the next CSP with the next iteration being more streamlined and outcome-driven, ensuring we build on key successes while maintaining a clear focus for the next 3–5 years. The following areas of improvement will be focused upon by: ✓ Developing a youth voice network and youth participation and voice strategy ✓ Tackling child poverty by working to minimise impact on families by tackling barriers to young adults and parents to entering and sustaining learning, training and employment through employability support and addressing childcare challenges ✓ Improving access to the right mental health & wellbeing support for children, young people and their parents at the time they need it and continuing to strengthen community based mental wellbeing ✓ Empowering children, young people and families to participate in child protection processes and identifying risk earlier and responding effectively ✓ Continuing work to ensure children and young people’s education and care needs are fully met regardless of them nature of need and continuing to improve access to neurodiversity diagnosis in a timely manner ✓ Developing a clear pathway of non-stigmatised family support for parents to be the best parents they can be ✓ Continuing to close the educational outcomes gap between looked after and non-looked after children and support care experienced young people to sustain post school destinations ✓ Expanding the range of care available when a child needs care and continuing to maintain their important relationships ✓ Delivering the workforce development priorities including trauma informed practice ✓ Ensuring we consistently and effectively measure impact of improvement actions through coordinated improvement activity ✓ Evidencing how children, young people and families’ voices are shaping services Page 148
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52 Appendix I Whole Family Wellbeing Report Section 1: Outline the individual activity being undertaken and how it related to the Outcome logic model including evidence of impact and detail of cost and % of funding used on each activity. Activity 1: Based on evidence from parent surveys, JSNA family engagement and service feedback a gap highlighted the need for a parent-focused service aimed at building parental confidence and skills to support both parental wellbeing and child’s mental wellbeing and resilience. Parent Wellbeing and Resilience Project The service offer consists of a combination of group workshops, 1-1 wellbeing consultations, and 1:1 support offers to parents of children 4-18 years. To date we have strong evidence of positive outcomes for parents of increased knowledge of mental wellbeing and resilience, greater confidence and self-esteem in parenting, improved strategies to support children’s mental health and reported enhanced empathy, understanding and connection with their children. Following a successful 6-month pilot, the project was extended into a 2-year development phase through WFWF funding. The pilot included 235 parents, with a 98% self-referral rate and included 19% single parents, 11% of parents reporting financial hardship, and 20% experiencing mental health challenges of their own. Six months into the second phase (WFWF supported), 249 parents have participated of which 47% are single parents, 20% report having financial struggles and 38% report mental health challenges of their own. Impact Highlights include positive changes on all measures in self-reported knowledge, parental self-esteem, in use of supportive strategies and parent-child relationships. As shown in the figure below Page 149
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53 Additionally: • 14% of referrals involve children in formal/informal care arrangements • 76% of children have become engaged in school-based interventions. Page 150
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54 The project not only upskills parents but also enhances the effectiveness of child-focused interventions, reinforcing a whole-family approach. Aligned with WFWF outcomes, the service is co-designed with families, stigma-free, preventative, and accessible—offering flexible support that meets families’ needs and evidenced improved family wellbeing. The next stages include co-developed support offers for foster carers and increased connections to financial support provision. Included is the presentation shared at the Community MH national forum. COSTS OF £29,143 THIS ANNUM, 5.6% OF ANNUAL FUNDING, COMMITED TO TOTAL OF £120K OVER 2 YEARS. Activity 2: PEEP Universal Pathway (also see family section of annual report) Over the past 18 months, we have built a robust, partnership-based model to deliver early, preventative family learning support. Starting with core partners—NHS, Health Improvement, Early Years, a national third sector charity, and employability services—we have expanded to include libraries, family learning, Army Welfare, local charities, childminders, and early years providers, all now trained in Peep. A key milestone was securing a space on the nationally funded Peep Learning Together Programme. We also commissioned the third sector using local WFWF to develop front-facing Peep roles and resources, coordinating delivery and working to embed key messages, including financial support, into sessions. A quality assurance framework is in development to ensure consistency as staff and volunteers become established, ensuring equity of offer and experiences across Moray. In just two years, we’ve progressed from no provision to 93% of pregnant women in Moray (as of Feb 2025) being invited to join Peep sessions, continuing until their child turns five. Group numbers have grown from 6 to 15–18 sessions running most weeks, with a further 30% increase planned by September. A summer programme will launch for the first time this year. This model represents a strategic shift toward sustainable, community-led early help. It empowers families and communities, with Moray’s approach now showcased nationally and drawing interest from other local authorities. We are also developing a parent-led “experts by experience” group to shape future delivery. Pre- and post-session feedback is now collected, enabling us to track immediate impact and against long-term outcomes such as reduced developmental concerns and fewer children entering P1 needing wellbeing support. Page 151
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55 Core components (WFWF outcomes) include increased access and availability of family support, families are at the centre of service design with the model developed ensuring support for all as close to home as possible, and workforce development including upskilling community-based organisation and community volunteers. PEEP FLT Expression of interest .pdf COSTS: £37,500 THIS YEAR, 7.2% OF CURRENT YEARS FUNDING, COMMITMENT IS 2 YEARS: TOTAL OF £180K. Activity 3: Employment of a Learning & Development Officer The role has focused initially on the collation and analysis of a range of information sources to develop a training needs-based framework. It is intended to support the embedding of principles of family support across multi-agency practice. The role is taken the lead within our learning & development group, with the purpose of shifting emphasis from remedial and reactive practice to prevention, early support and diversion. Priority areas have been identified of mental health, substance use, parenting and vulnerability and exploitation. The Learning & Development Officer has developed a new suite of training covering risk, harm and vulnerability, child sexual exploitation and gangs. The suite of training is in part is responding to increased contextual safeguarding concerns evidence in rising anti-social behaviour, drug use and risk-taking behaviours and associated training needs. The role holder has specific experience in relation to contextual safeguarding, supporting developing new processes and policy within this area which will help all to safeguard children and families. This work relates to WFWF outcomes of leadership, workforce and culture. Activities have been recruitment to create capacity to undertake the needs analysis and develop a plan in relation to training across whole sector. Training has been both developed and procured. Next steps are the training roll out and evaluation of impact on practice to see if families are better supported and have increased wellbeing. COST; £27,868 (COVERS FIRST 6 MONTHS OF 18 MONTH POST). 5.3% OF CURRENT YEARS FUNDING COMMITMENT TO 18 MONTH POST. TOTAL COST OF £85,193. Page 152
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56 Activity 4: Investment in 3rd sector to lead the locality networks. The networks are made-up of community organisations and frontline practitioners from across children services who have a remit to improve outcomes for children and families within the individual communities which make up Moray. The networks are focused on two-way communication, sharing practice and supporting the operationalisation of CSP strategic priorities while gathering local intelligence on emerging issues. A range of issues have been supported this year at an early stage including developing ASN family peer support, improving access to sexual health information for teenagers including the LGBTQI+ community, supporting collaborative responses to emerging community based anti-social behaviour and trialling low level intervention approaches in schools to improve community engagement. The development of paid chair positions was a recommendation within the external evaluation of the locality planning structure, ensuring 3rd sector leadership, prioritisation of support and strengthening the capacity of the 3rd sector to take the lead in responding to issues. COSTS: £18,247 (3.5% OF CURRENT YEARS FUNDING), CONTRACT TO END JUNE 2025, REMAINING COSTS FOR 25/26 ARE £4,971.24. Activity 5: Wellbeing Coordinators The roles were expanded to better support the team around the child, removing barriers to access and ensuring timely, appropriate support. This approach replaces previous scattergun methods that overwhelmed families, instead acting as both gatekeeper and bridge to specialist services. By improving referral quality and accuracy, the roles help streamline the process of accessing support, enabling quicker assessments and reducing unnecessary waits for unsuitable services. They have contributed to the development and rollout of new child planning paperwork in Moray and delivered solution-focused training to enhance the quality of meetings and the overall experience for families. This year saw a 28% increase in referrals to wellbeing coordinators and a 31% rise in child planning meetings, totalling 298. A key focus has been supporting new education staff in their named person roles and increasing awareness of available support. In addition to family support, key issues addressed include school attendance, additional support needs, and behavioural challenges. We believe the role has reached its current potential and are now reassessing needs with families and professionals to explore support access routes further. Despite improved referral accuracy, service capacity remains strained. As a result, we are developing additional support roles and reviewing existing service offers. This work aligns with outcomes under availability and access, enhancing support for children, young people, and families through improved workforce knowledge, refined processes, and more effective gatekeeping. While access to the right support has improved, ongoing high demand highlights the need for continued development Page 153
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57 Cost: £119.975 PER ANNUM PLUS TRAVEL EXPENSES. 22.9% OF CURRENT ANNUAL FUNDING, ROLES ARE CURRENTLY UNDER REVIEW. Activity 6: Mentoring Young Talent: Expanding Opportunities for Young People A successful mentoring programme originally designed for care-experienced young people has been expanded to support a broader group of young people aged 12 and over. The initiative employs dedicated keyworkers who carefully match young people with trained volunteer mentors. These mentors provide consistent support, encouragement, and inspiration—often engaging in new activities together to build confidence and broaden horizons. Each mentoring relationship lasts a minimum of one year, with a particular focus on key life transition points. This programme forms part of a wider employability pathway that also supports post-school transitions and parental employability. Positive outcomes have included improved school attendance, enhanced engagement in learning, increased rates of positive post-school destinations, and measurable personal growth. Progress is tracked using self-assessment tools focused on wellbeing and social intelligence. Former mentees have also contributed to service development, helping to shape a more responsive and impactful programme. Although funding from the WFWF officially began in September 2024, the revised approach was piloted from April 2024. This included expanding eligibility to young people aged 12+ and exploring new methods for involving parents. Since these changes were introduced, 64 young people have been referred to the Mentoring Young Talent programme. Although funding from the WFWF officially began in September 2024, the revised approach was piloted from April 2024. This included expanding eligibility to young people aged 12+ and exploring new methods for involving parents. Since these changes were introduced, 64 young people have been referred to the Mentoring Young Talent programme. This initiative is one example of how family-focused services are addressing poverty-related challenges by connecting both young people and their parents to employability support. Looking ahead, we plan to continue exploring the role of befriending and mentoring approaches in strengthening family support over the coming year. Please see the case studies within the care section of the annual report and a selection of additional feedback quotes are included. Mentoring Young Talent feedback.pdf Page 154
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58 FUNDING- £53,158 FROM THIS YEAR FUNDING, 10.1 % OF ANNUAL FUNDING. COMMITTED TO £77,312 IN 25/26. Context: In response to rising youth risk-taking linked to substance use, staff training gaps, and family’s concerns about losing control, we implemented a multi-component drug education programme. Its goals are to empower young people to make informed decisions, boost awareness and use of local support services, and build the confidence of both staff and families to engage constructively with young people on these issues. Activity 7: Daniel Spargo-Mabbs Drug Education Programme – Moray Implementation The Daniel Spargo-Mabbs (DSM) Drug Education Programme is a flexible, multi-component initiative tailored to meet the specific needs of each school community. Designed to increase knowledge, life skills, and resilience, the programme empowers young people to make informed, safer choices around substance use. A key focus is equipping both school staff and parents with the tools to have supportive, open conversations about drugs. Following a successful Grampian-wide pilot involving three Moray schools, a local decision was made to roll out the programme to all secondary school communities across Moray. The programme includes tailored delivery across school groups, interactive workshops, talks, and forums, a powerful theatre production, “I Love You, Mum – I Promise I Won’t Die. Interim reports show: 1,347 students had attended the theatre production and participated in follow-up workshops and forums. Surveys showed significant increases in students’ understanding of drug-related consequences with most students reported feeling more confident resisting peer pressure and more able to talk to parents/carers. Young people shaped delivery to focus on ketamine and cannabis, with key takeaway identified of where to find reliable information, the importance of knowing what you're taking and where to seek help Staff training focused on the current data on substance exposure and availability, practical harm-reduction strategies for young people, understanding risk factors influencing drug and alcohol misuse, Alignment to WFWF outcomes relates to those under leadership, workforce, and culture delivered through upskilling staff, young people, and parents and enhancing awareness of and access to early and intermediate support services Page 155
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59 DSMF Moray Interim Report December 2024.pdf FUNDING: £17,818, FROM THIS YEARS FUNDINGS, 3.4% OF ANNUAL FUNDING, COMMITTED TO SPEND A FURTHER £30K in 25/26. Section 2: Progress Narrative for your overall WFWF plans Question 4. Please consider the key recommendations from the Year 2 Evaluation report that are most relevant for your area. From your activities in Section 1, please provide any specific examples of how they are responding to these issues (or planning to do so during Year 4), this does not need to be comprehensive but focused on the most important recommendations. Moray has focused on improving awareness, access to support, and addressing challenges such as scattergun referrals, which previously led to families missing timely, appropriate help. We’ve strengthened the child planning process, enhanced staff knowledge of services, and promoted solution-focused practices through training and support for managing difficult conversations. Services have been adapted to embed whole family support principles. Where services are protected spaces, like counselling, we’ve developed ways for parental involvement. New local websites and digital pathways have improved signposting and access, including wider use of ALISS across child and adult services. Over the past two years, we’ve expanded support at both ends of the family support pathway—from universal prevention to intensive interventions nearing social work thresholds. Families report that services feel more stigma-free, rights-led, and equitable across localities. A new performance and self-evaluation framework in children’s services is helping us assess the impact of our investments and improvements in outcomes. In response to evaluation recommendations, we’re monitoring service visibility through digital and service use data and plan to introduce community hub drop-ins. While differing case information systems remain a challenge, we’re increasing co-working and shared locations to bridge gaps. We’re also mitigating the third sector interface’s withdrawal by strengthening multi-agency collaboration through locality networks. Page 156
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60 The 10 principles of family support are now embedded in procurement and commissioning, supporting a system-wide approach. We plan to adopt the revised “How Good is Our Family Support” tool in 2025/26. Our performance framework is also enhancing data collection and multi-agency improvement efforts Question 5 Based on your evidence provided in Section 1, please describe how the activities of the WFWF Programme overall are supporting services to shift towards (1) more preventative interventions and (2) early interventions. While a full family support pathway remains in development (see challenges), two key early help approaches have emerged, both focused on prevention and accessibility without requiring families to meet thresholds. The parent-focused service was developed in response to families seeking a better understanding of how their children are supported. It provides a safe, non-judgemental space for parents to explore personal and family wellbeing, access information on child and adolescent issues, and receive support across a range of needs. Recognised as good practice and now commissioned in other areas, the service is designed with flexibility, allowing it to adapt to families’ evolving circumstances. For example, it has recently supported parents directly in cases involving contextual safeguarding concerns. The partnership Peep model is evolving into a universal offer from pre-birth to age five, shifting the culture of support from reactive to proactive. It is becoming the foundation of our family support pathway, with targeted interventions to follow once the universal offer is fully embedded. Both approaches aim to identify concerns earlier, improve access to specialist support when needed, and reduce long-term negative impacts on children’s wellbeing. By embedding flexibility into procurement and strengthening partnerships with providers, we are creating more accessible entry points and building a whole-system approach. This is expected to reduce demand for specialist services and lower the number of families reaching crisis point Question 6: Describe the main successes to delivery and how specific factors enabled these successes. The children’s workforce-wide, needs-based training framework is aligning development across the system with priority areas, enhancing staff skills and knowledge. A new annual audit will ensure the local training offer remains current and responsive. A recent example is the success of a pilot manosphere workshop—due to high demand, additional sessions are already planned. Ongoing feedback and uptake monitoring help drive continuous improvement and identify access barriers early. Page 157
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61 Flexible, community-based approaches are also progressing, with increased partnership working and innovation in service delivery. More adaptable procurement processes have enabled greater collaboration, including with smaller organisations that previously felt unheard. Our locality planning model, with a strong focus on third sector involvement, is central to this progress. In response to parents’ calls for more involvement and opportunities to upskill, we are reshaping our model to prioritise early, inclusive support. Historically, support was reactive and often excluded parents—especially in school-based or protected interventions like counselling and mentoring. Our parent-focused service now shares the knowledge behind these interventions, increasing transparency and helping families sustain positive outcomes. We are also adapting the mentoring programme to better involve families, fostering a more collaborative and proactive approach to children’s wellbeing. Question 7: Describe the main challenges to delivery, and how these have been mitigated or plans to mitigate them. Since our original proposal, Moray has experienced significant change, including leadership transitions, staff turnover, structural reorganisation, and ongoing financial pressures. These shifts have created substantial challenges for the workforce, particularly while exploring system-wide transformation. Early progress included embedding key aims into the Children’s Services Plan, establishing a new governance structure and engagement with families to understand the challenges of the pre-existing provision. However, leadership changes across the council, Health & Social Care Moray, and Children’s Services have taken time to stabilise, with temporary arrangements still transitioning to permanence. Simultaneous structural changes and financial constraints have also impacted the third sector, which is struggling with rising costs, reduced capacity and all our larger 3rd sector partners also undergoing leadership change. While initial momentum slowed, we are working hard to regain pace with limited capacity, focusing on embedding our hub and spoke model and developing a plan to deliver a central family centre. Some core assumptions of the Whole Family Wellbeing Fund (WFWF) have not held true locally. Despite investment in prevention and early help, rising adult mental health issues, youth violence, and drug availability have led to crisis spikes and contextual safeguarding challenges, all leading to increased demand and costs for care. Procurement flexibility has improved, but commissioning evolution to engage successfully with funding which is not long term remains a challenge. Short-term financial pressures hinder the third sector’s ability to attract and retain staff, limiting sustainability and willingness to accept shorter term funding arrangements. Leadership of the WFWF has been challenging to maintain due to key staff absences. However, under new leadership, we are continuing our locality planning approach, ensuring the third sector voice remains central. The hub and spoke model is progressing, with a physical family centre at its core. Page 158
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62 Delays have opened new opportunities for deeper family, community, and third sector involvement, and with larger contracts approaching renewal, we are well-positioned to explore more sustainable, long-term solutions. Question 8: Please give details of your spend for 24/25 and your expected spend in the following financial years. This remains an evolving situation as we have changed direction and are currently exploring costs associated with developing a family centre along supporting hubs across Moray. Therefore, these are proposals FY 24/25: £349.962 or 67% of these years budget used (this included £46,254 of a contract ending from previous year) FY 25/26: Current forecast associated with contracts and current staff are to spend £486.869 of the £619K. (79%). We are however expecting staffing changes and looking to invest into hubs and a family centre development utilising our unallocated funding to date. FY 26/27: It is difficult to forecast this far ahead, with that funding only being confirmed in the last few months and contracts we have are shorter than that period. We will be evaluating that work further prior to extending commitments. FY 27/28: We have not received any clarification of funding for this year. Page 159
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: HEALTH AND SOCIAL CARE MORAY ANNUAL COMPLAINTS REPORT 2024/25 BY: CHIEF NURSE, MORAY 1. REASON FOR REPORT 1.1 To provide the Board with the Health and Social Care Moray Annual Complaints Report for 2024/25. 2. RECOMMENDATION 2.1 It is recommended that the Board:- i) consider and note the contents of the annual report; and ii) approve the publication of the annual report on the Health and Social Care Moray website. 3. BACKGROUND 3.1 At their meeting on 28 August 2025 (para 7 of draft minute refers), the Clinical and Care Governance (CCG) Committee agreed that the Health and Social Care Moray (HSCM) Annual Complaints report for 2024/25 be submitted to Moray Integration Joint Board (MIJB) at their meeting on 25 September 2025 for approval prior to publication. 3.2 A report to CCG Committee on 25 August 2022 (para 6 of minute refers) provided information on the agreed Complaints Key Performance Indicators (KPIs) for the Model Complaints Handling Procedures for Local Authorities (LA), which were published in March 2022 on the Scottish Public Services Ombudsman (SPSO) website (this includes Health and Social Work Partnerships, in relation to social work functions delegated from LAs). The Committee also received information detailing the 9 NHS performance indicators. 3.3 In March 2022 the SPSO confirmed the annual report publication deadline is the end of October each year. Item 11. Page 161
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3.4 The NHS Grampian Annual Complaints report provides information on all complaints, concerns, comments, and feedback recorded on Datix, this includes any recorded under HSCM. The Annual Complaints Report produced by the Council includes all council related complaints recorded on Lagan, this includes any Council related services under HSCM. 3.5 The SPSO have advised to ensure there is no double reporting of figures, but it should be made clear where partnerships’ complaints performance information is published. 3.6 Given the importance HSCM places on receiving comments and feedback to use to continuously improve services, the experience and satisfaction of service users, along with their families and carers, the Committee agreed, at their meeting on 25 August 2022 (para 6 of minute refers) to continue to publish annual complaints performance information to demonstrate HSCM’s commitment to valuing complaints. 3.7 The annual report pulls together and builds on the quarterly complaints’ reports produced for CCG Committee. It includes details about the number of complaints received and information about the stage at which complaints were resolved, the time taken to do so, and the actions that have been or will be taken to improve services as a result of complaints. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The information from complaints from 1 April 2024 to 31 March 2025 has been collated and presented following the LA KPIs and NHS Performance Indicators. The HSCM Annual Complaints Report for 2024/25 is attached at Appendix 1. 4.2 This will be the fifth published HSCM Annual Complaints Report – all previous versions can be found on the HSCM Website - https://hscmoray.co.uk/complaints.html 4.3 The annual report includes links to Moray Council’s and NHSG’s Annual Complaints Performance Reports and provides supplementary information specific to HSCM. 4.4 There have been no complaints received relating to the dissatisfaction with the MIJB’s policies, decisions or administrative or decision-making processes followed by the MIJB. The MIJB’s definition of a complaint is: “An expression of dissatisfaction by one or more members of the public about the MIJB’s action or lack of action, or about the standard of service the MIJB has provided in fulfilling its statutory responsibilities.” 4.5 Figures reported do not include any complaints that might have been raised regarding the vaccination appointments or processes as these are being dealt with through a dedicated team covering the Grampian area. Any complaints or comments specific to the Moray Vaccination Centre in Elgin are included in reported figures. Page 162
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4.6 All figures presented in Appendix 1 are correct at the time of reporting. There may be some small variations when data is reviewed and systems updated to ensure accuracy. 4.7 A total of 136 complaints were received by HSCM during 2024/25. 4.8 It should be noted the figures reported for 2023/24 onwards include Children and Families and Justice Social Work Services, as these services were delegated to the MIJB on 16 March 2023. This explains the increase in complaints recorded on Lagan from 2023/24 onwards. 4.9 The number of complaints recorded in DATIX include the Out of Hours Primary Care Service (known as GMED) for the whole of Grampian, not just Moray. This is because the MIJB host the service for Grampian. The GMED service cares for patients who have urgent primary care needs and cannot wait until their GP Practice is open. GMED operates from 18:00 until 08:00 each weekday, weekends and public holidays including the festive period. The service has on average 90,000 contacts annually (this equates to 1/6th of the population of Grampian). 4.10 In 2024/25, 23% (27) complaints were upheld fully, with the remainder being partially or not upheld. 4.11 Complaints often arose from unclear or inconsistently followed processes, communication issues where messages or guidance were not sufficiently clear, and situations where people were not informed in a timely manner. 4.12 HSCM governance structures allow ongoing review of complaints and incidents to identify areas for improvement and learning opportunities, to drive positive change. 4.13 It is positive to note that complaints regarding provision of care are small in number and that very positive feedback is regularly received from people receiving support from services. 4.14 When a complaint is straightforward and does not require investigation, HSCM aim to respond within 5 working days (referred to as frontline or early resolution complaints). For complaints requiring investigation, the target response time is 20 working days. During 2024/25, HSCM did not consistently meet these targets. For social work and social care services, the average response time was 18 working days for early resolution complaints and 51 working days for investigative complaints. For health related services, the average was 3 working days for early resolution and 45 working days for investigative complaints. Improving response times remains a priority. Internal processes continue to be reviewed to ensure they are as streamlined and efficient as possible. 5. SUMMARY OF IMPLICATIONS Page 163
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(a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” As set out within Annex C of the Health and Social Care Integration Public Bodies (Joint Working) (Scotland) Act 2014 CCG Framework. Effective handling of complaints is used to ensure the efficient and sustainable delivery of services to meet priorities. (b) Policy and Legal Clinical and Care Governance requirements are set out within the Moray Health and Social Care Integration Scheme. Appropriate arrangements must be in place to ensure and evidence good governance in meeting duties under the Public Bodies (Joint Working) (Scotland) Act 2014. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation There are systems and processes in place across service areas to support clinical governance, providing assurance to the HSCM Senior Leadership Team and to the CCG Committee. There are platforms within Health and Social Care to discuss and share good practice, learning and challenges. MIJB, Moray Council and NHS Grampian could find themselves exposed to significant risks if good governance is not in place. The purpose of this report is to oversee the processes to ensure that appropriate action is taken in response to adverse events, scrutiny reports/action plans, safety action notices, feedback, complaints and litigation, and those examples of good practice and lessons learned are disseminated widely. (e) Staffing Implications This activity is core to all practitioners in the front line both in terms of their professional competence and assurances in care delivery. (f) Property None directly arising from this report. (g) Equalities/Socio Economic Impact Not required as there are no changes to policy. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None directly arising from this report. (j) Consultations Page 164
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Consultations have been undertaken with the following staff who are in agreement with the content of this report where it relates to their area of responsibility: • Corporate Manager, Health and Social Care Moray • Caroline O’Connor, Committee Services Officer, Moray Council • Clinical and Care Governance Group 6. CONCLUSION 6.1 The governance and monitoring of complaints forms part of core business for teams and services and provision of a good quality, effective and safe service is a key priority for all staff. Monitoring and learning from all feedback is an ongoing process. Author of Report: Isla Whyte, Corporate Business Support Manager Background Papers: with author Ref: Page 165
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APPENDIX 1 Annual Report on Complaints and Feedback 2024 – 2025 01/04/24 – 31/03/25 Page 166
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2 Table of Contents HEALTH AND SOCIAL CARE MORAY 3 INTRODUCTION TO THE REPORT 3 THE MODEL COMPLAINTS HANDLING PROCEDURE 4 COMPLAINTS HANDLING TIMESCALES 5 KEY PERFORMANCE INDICATORS 6 WHAT IS INCLUDED 8 SUMMARY 9 LEARNING FROM COMPLAINTS 10 COMPLAINT PROCESS AND EXPERIENCE 16 COMPLIMENTS 16 INDICATOR 1 18 INDICATOR 2 22 INDICATOR 3 22 Page 167
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3 INDICATOR 4 24 Health and Social Care Moray Health and Social Care Moray (HSCM) brings together the NHS and Council to provide a wide range of social work, social care, community health and primary care services. In Moray, the partnership includes: • Adult Services, including older people • Children and Families Services • Justice Services The work of HSCM is governed by the Moray Integration Joint Board – a public body formed in 2014 through Scottish Government legislation. Introduction to the Report This Complaints Handling Annual Report provides a summary of people who use services’ feedback and complaints recorded by Health and Social Moray (HSCM) in the period from 1 April 2024 to 31 March 2025. Within HSCM, complaints received by NHS Grampian (NHSG) and Moray Council (the Council) are recorded on 2 separate systems, in accordance with the appropriate policy and procedure of these organisations. The NHSG Annual Complaints report provides information on all complaints, concerns, comments and feedback recorded on Datix (electronic risk management information system), this includes any recorded under HSCM. The Annual Complaints Report produced by the Council includes all council related complaints recorded on Lagan (communication management system), this includes any Council related services under HSCM. Links to these annual reports can be found here: (TO BE ADDED WHEN AVAILABLE) Page 168
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4 The Model Complaints Handling Procedure The original Model Complaints Handling Procedures (MCHPs) were first developed by the SPSO in collaboration with complaints handlers and key stakeholders from each sector and were published in 2012. The MCHPs were produced taking account of the Crerar and Sinclair reports that sought to improve the way complaints are handled in the public sector, and within the framework of the SPSO’s Guidance on a MCHP. The MCHPs also reflect the SPSO Statement of Complaint Handling Principles approved by the Scottish Parliament in January 2011. Following recommendations from the Scottish Government’s social work complaints working group in 2013, a separate MCHP for social work was developed. The ‘Public Services Reform (Social Work Complaints Procedure) (Scotland) Order 2016’ (the Order) brought social work complaint handling under the remit of the SPSO Act and subsequently the separate documents for Local Authorities (LA) and Social Work sectors were combined into a single document, the LA MCHP. The SPSO revised and reissued all the MCHPs (except the NHS) in 2020 under section 16B(5) of the Scottish Public Services Ombudsman Act 2002 on 31 January 2020 to give public sector organisations time to implement any changes by April 2021. The revised Local Authority MCHP, published 2020, applies to social work complaints, whether they are handled by local authority or health and social care partnership (HSCP) staff. The NHS was the last public sector to adopt the MCHP on 1 April 2017 and it has not yet been revised since it was first published. Page 169
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5 Complaints Handling Timescales There is a standard approach to handling complaints across the NHS and Local Authority, which complies with the SPSO's guidance on a model complaints handling procedure and meets all of the requirements of the Patient Rights (Scotland) Act 2011, and accords with the Healthcare Principles introduced by the Act. The complaints process followed by both NHSG and the Council have the same target response timescales. Early resolution, or front line, complaints will be responded to within 5 working days and complaints handled at the investigation stage have a response time of 20 working days. Where it is not possible to complete the investigation within 20 working days an interim response should be provided with an indication of when the final response should be provided. The decision as to whether the complaint is upheld or not will be made by the manager or Head of Service. If the person raising the complaint is not satisfied with the outcome then they many contact the Scottish Public Services Ombudsman (SPSO) for an independent review and assessment, however prior to this, every effort is made to engage with the complainant to resolve the matter to their satisfaction. Page 170
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6 Effective governance and monitoring of complaints forms part of core business for health and social care teams; ensuring services are safe, high-quality, and responsive to the needs of the people they support. Key Performance Indicators Performance Indicators are measures and targets that help assess and demonstrate how functions are carried out. In March 2022 the agreed Complaints Key Performance Indicators (KPIs) for the Model Complaints Handling Procedures for Local Authorities (LA) were published on the SPSO website. There are four mandatory KPIs for LAs (this includes Health and Social Work Partnerships, in relation to social work functions delegated from LAs). These are: Indicator One The total number of complaints received The sum of the number of complaints received at Stage 1 (this includes escalated complaints as they were first received at Stage 1), and the number of complaints received directly at Stage 2. Indicator Two The number and percentage of complaints at each stage which were closed in full within the set timescales of five and 20 working days The number of complaints closed in full at stage 1, stage 2 and after escalation within MCHP timescales as % of all stage 1, stage 2 and escalated complaints responded to in full Indicator Three The average time in working days for a full response to complaints at each stage The average time in working days to respond at stage 1, stage 2 and after escalation Indicator Four The outcome of complaints at each stage The number of complaints upheld, partially upheld, not upheld and resolved at stage 1, stage 2 and after escalation as % of all complaints closed at stage 1, stage 2 and after escalation Page 171
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7 The qualitative indicator on learning from complaints was part of the published draft indicators but has now been removed. However, Part 4 of the SPSO Model Complaints Handling Procedure on Governance stresses the importance of learning from complaints, and the requirements to record and publicise learning. With regard to Indicator Four, the updated MCHP has provided a definition of “resolving” a complaint. “A complaint is resolved when both the organisation and the customer agree what action (if any) will be taken to provide full and final resolution for the customer, without making a decision about whether the complaint is upheld or not”. This focusses efforts to, wherever possible and appropriate, resolving complaints to the service user’s satisfaction. To do this it is necessary to identify and clarify what outcome the service user wants at the start of the process which maybe a change in process for some people currently involved with complaints. It will also change the number of categories of outcomes for complaints to:- • Upheld • Not upheld • Partially upheld and • Resolved The above KPIs are applicable for data collected from 1 April 2022. Complaints about a service that is provided by HSCM on behalf of the NHS, require to be captured using the 9 NHS performance indicators. These are: • Learning from complaints • Complaint process experience • Staff awareness and training • The total number of complaints received • Complaints closed at each stage • Complaints upheld, partially upheld and not upheld • Average time to close complaints at each stage • Complaints closed in full within the timescales • Number of cases where an extension is authorised Page 172
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8 The data detailed in this report is based on the four KPIs detailed above and also includes information pertaining to some of 9 NHS performance indicators. For detail on staff awareness and training and the number of cases where an extension is authorised, please refer to the NHS Grampian Annual Complaints report. There is a challenge for reporting of complaints for HSCM due to the fact that there is a need to use two recording systems which then requires collation and as the systems hold data in slightly different ways. This means that there are differences in how the information is reported for some of the indicators. What is Included This is HSCM’s fifth published annual complaints performance report. It includes performance statistics, in line with the complaints performance indicators detailed for complaints received about community health and social care services under the direction of the Moray Integration Joint Board. Any complaints received relating to the dissatisfaction with the MIJB’s policies, decisions or administrative or decision-making processes followed by the MIJB will be reported, even if the number is nil. The MIJB’s definition of a complaint is: “An expression of dissatisfaction by one or more members of the public about the MIJB’s action or lack of action, or about the standard of service the MIJB has provided in fulfilling its statutory responsibilities.” Information about complaints referred to the Ombudsman are also included. Figures reported do not include complaints raised regarding the vaccination appointments or processes as these are being managed through a dedicated team covering the Grampian area. Positive feedback enables us to understand what services and behaviours people value. Capturing compliments data across the partnership, which has a wide range of services and two different recording systems, can be challenging. Our staff and services receive compliments in a range of ways and there is no mandatory reporting requirements. Data that has been recorded centrally is captured in this report. Page 173
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9 Summary Our Model Complaints Handling Procedure reflects the partnership’s commitment to serving the public by valuing complaints. It seeks to resolve issues through local, early resolution and, where necessary, to conduct thorough, impartial and fair investigations of complaints. All feedback helps to guide improvements, reveal training needs and supports performance monitoring. Our website Feedback - Health and Social Care Moray provides information about how people can provide feedback or raise formal concerns. Complaints can be submitted in person, by phone, by email or by post. There are also Feedback Cards throughout NHS sites that can be completed and submitted using the business reply paid envelopes. Page 174
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Complaints Data 2024/25 – Annual Report (01/04/24 – 31/03/2025) Learning from Complaints Teams and services actively review the outcomes of complaints to see where improvements can be made and learn from the feedback. Complaints provide valuable information which can be used to continuously improve services, the experience and satisfaction of people along with their families and carers. The tables 1a, 1b and 2 below set out the stages the complaints were closed and what the complaint was about and what action taken. Table 1a - Complaints Information Extracted from Datix – Actions Taken/Stage (closed complaints) Stage 1 - Early Resolution Stage 2 - Escalated Stage 2 - Non Escalated Ombudsman Total Communication - Improvements in communication staff-staff or staff- patient 4 19 4 2 29 Education/training of staff 0 6 5 1 12 Access - Improvements made to service access 1 3 0 0 4 Action plan(s) created and instigated 1 0 2 0 3 No action required 2 12 10 0 24 System - Changes to systems 0 1 1 0 2 Conduct issues addressed 0 1 1 0 2 Share lessons with staff/patient/public 0 4 1 0 5 Waiting - Review of waiting times 0 4 2 0 6 No value 1 0 1 0 2** Total 9 50 27 3 89* *figures do not directly correlate with number of closed complaints as there may be more than one action selected per complaint. There were 65 complaints closed on Datix during 2024/25. Page 175
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11 **one record relates to a complaint that was closed as an adverse event investigation will take place instead and one has been incorrectly recorded as a complaint when it was a concern. Table 1b Complaints Information Extracted from Lagan – reason for complaint (closed complaints) Early resolution Investigation Total Complaint against service – assessment 1 0 1 Complaint against service – self-directed care 1 0 1 Complaint against staff 5 7 12 Other 3 3 6 Policy and Procedure 3 2 5 Process / Procedure 10 20 30 Total 23 32 55 Noted below are some actions arising from the review of complaints received during the last financial year (data extracted from Lagan). Decision Note / Learning Outcome (lagan) Process / Procedure Enhance communication between professionals involved in care package Relook at all components of the planning for the care and support offered Increased oversight of the care package to be provided Continue to explore alternative options with family Reminder to staff about the importance of timely communication with people who use our services Ensure all information provided is clear and transparent Procedure to be put in place to facilitate timely decision making Policy Communicate policy around sharing of minutes with attendees Communication Communication clearly role and purpose of panel and how attendees participate Page 176
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12 Reflect on language used Staff training to be undertaken Page 177
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13 Table 2 Complaints Information Extracted from Datix – Actions Taken by Service (closed complaints) Allied Health Professional s Communit y Hospital Nursing Communit y Nursing Communit y Pharmacy General Practic e GME D Grampian Vaccination and Immunisatio n Programme Menta l Health - Adult Menta l Health Mental Health - Old Age Psychiatr y Mental Health - Specialism s Primar y Care Tota l Access - Improvements made to service access 1 0 1 0 1 0 1 0 0 0 0 4 Action plan(s) created and instigated 1 0 0 0 0 1 0 0 0 0 1 3 Communication - Improvements in communication staff-staff or staff- patient 5 1 2 0 5 7 2 6 0 0 1 29 No action required 1 0 2 1 1 3 4 10 1 1 0 24 Waiting - Review of waiting times 1 0 0 0 0 3 0 2 0 0 0 6 Education/training of staff 0 1 2 0 2 5 1 0 0 0 1 12 Share lessons with staff/patient/publi c 0 1 1 0 1 0 0 1 0 0 1 5 Conduct issues addressed 0 0 0 0 0 1 0 0 0 0 1 2 System - Changes to systems 0 0 0 0 2 0 0 0 0 0 0 2 Page 178
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14 Total 9 3 8 1 12 20 8 19 1 1 5 87* *Figure more than total number of closed complaints as there could be multiple actions taken for each complaint Page 179
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15 Active review of complaints through reporting and investigation is a useful tool to identify learning and improve services. Below are some of the actions and learning from complaints closed between 01/04/2024 and 31/03/2025 (data extracted from Datix). Communication Ensure patients have a clear understanding of procedure Improved communication with patient Continue to ensure all contacts are recorded in case notes Reminder sent to all clinicians to ensure they communicate clearly with patients Staff to signpost to website as opposed to having printed materials which can become outdated Call centre staff to be made fully aware of eligibility criteria Improvements to communication between primary and secondary care Clear and respectful language to be used at all times System/Process change Reintroduce safety calling to ensure patients are aware of delays Education / training / share lessons learned Always expand on differentials and consider other possibilities even when symptoms are vague Reminder medication to be dispensed from centre only if it cannot wait to be collected from the pharmacy the following day Training on signs and symptoms of pertussis Reminder about appropriate PPE Further learning about meningitis presentation Values based reflective practice Training and education on caring for people with a brain injury Reminder all telephone consults to start with identifying caller Training / education around clinical history note taking Page 180
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16 Adverse events are defined as incidents that result in or could have resulted in harm, and reviews are triggered based on severity and nature of the event, and not on whether a complaint was made. However some adverse event reviews are triggered by a complaint, or a complaint may help inform an adverse event review that is already underway. In such cases complainants can be invited to participate in the adverse event review, and pause or close the formal complaint procedure to support a more integrated and person-centre approach to learning and improvement. Complaint Process and Experience NHS Grampian issue an experience survey to participants 2 months after their complaint was closed. Information is available from complainants whose complaint was closed during the last financial year in NHS Grampian’s Annual Complaints Report. NHS Grampian are also signed up to Care Opinion. Through this website patients and carers can share their stories, experiences and thoughts online. To find out more about Care Opinion and to see stories shared about NHS Grampian, please visit https://www.careopinion.org.uk/opinions Moray Council issue a customer satisfaction survey to all complainants once their complaint is closed. Many of the customer satisfaction surveys are completed as anonymous. Unless the customer chooses to insert their complaint reference, there is no way of knowing who the return survey is from or which service it was about. More information on this can be found in the Moray Council Complaints Performance Report (see page 3 for link). Compliments Compliments can be provided verbally to staff, via emails or letters. When compliments are received they are shared with staff and teams. Whilst there is no mandatory requirement to report compliments in the same way as complaints some compliments are recorded on our electronic systems. Data recorded for our health related services, for the period 1 April 2024 to 31 March 2025, is detailed overleaf. Page 181
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17 18% 23% 47% 6% 6% Compliments (datix) Community Nursing GMED Moray Vaccination Centre Phlebotomy Service Community Hospital Nursing Positive feedback was received about staff and about the care and treatment received. Staff receive compliments verbally and many of these do not get formally recorded but are shared with teams. Page 182
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18 Indicator 1 - The total number of complaints received The sum of the number of complaints received at Stage 1 (this includes escalated complaints as they were first received at Stage 1), and the number of complaints received directly at Stage 2. Table 3 – total number of complaints (received) System recorded Early Resolution / Frontline Investigation Not marked (at time of reporting) Total NHS - Datix 46 25 0 71 Moray Council - Lagan 26 38 1 65 Total 72 63 1 136 Datix – Complaints Received by Year: Lagan - Complaints Received by Year: Year Total 2018/19 31 2019/20 25 2020/21 32 2021/22 24 2022/23 30 2023/24 80 2024/25 65 Year Total 2018/19 62 2019/20 62 2020/21 33 2021/22 68 2022/23 78 2023/24 67 2024/25 71 Page 183
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Graph 1 - Complaints Received by Year There was a drop in the number of complaints NHS received during 2020/21, for health services, which is likely due to the Covid-19 pandemic; in 2020 there were many services that were suspended and many others where service delivery was altered in some way to accommodate the requirements for social distancing. It should be noted the figures reported for 2023/24 onwards include Children & Families and Justice Social Work Services, as these services were delegated to the Moray Integration Joint Board on 16 March 2023. This accounts for the increase in complaints recorded on Lagan from 2023/24 onwards. 0 20 40 60 80 100 120 140 160 2018/19 2019/20 2020/21 2021/22 2022/23 2023/24 2024/25 Complaints Received by Year Datix Lagan Combined Combined (Datix and Lagan) Complaints received by year: 2018/19 93 2019/20 87 2020/21 65 2021/22 92 2022/23 108 2023/24 147 2024/25 136 A total of 138 complaints were received by Health and Social Care Moray in 2024/25. A breakdown of complaints received is detailed on the next page. Page 184
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20 Page 185
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21 Table 4 – combined data from Datix and Lagan (complaints received) for 2024/25 Health and Social Care Moray (Datix) Allied Health Professionals 8 4Community Hospital Nursing 4 Community Nursing 4 Community Pharmacy 1 General Practice 7 GMED 18 Moray Vaccination Centre 7 Mental Health - Adult Mental Health 19 Mental Health - Old Age Psychiatry 2 Mental Health - Specialisms 1 Health and Social Care Moray (Lagan) Access Team 19 Care at Home 7 Community Care Finance 2 Drug and Alcohol 1 Learning Disability 1 Moray East 1 TMC Specialist Unit 1 Children and Families and Justice Social Work Access Team 19 Children and Families Area Teams 8 Criminal Justice 2 Fostering and Adoption and Supported Lodgings 4 136 Page 186
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22 Indicator 2 - The number and percentage of complaints at each stage which were closed in full within the set timescales of five and 20 working days The number of complaints closed in full at stage 1, stage 2 and after escalation within MCHP timescales as % of all stage 1, stage 2 and escalated complaints responded to in full Table 5 – number and percentage of complaints at each stage closed within timescales Early Resolution/Frontline with timescale Investigation within timescale Escalated Investigation within timescale NHS - Datix 6 out of 6 (100%) 9 out of 17 (53%) 8 out of 35 (23%) Moray Council - Lagan 7 out of 23 (30%) 3 out of 25 (12%) 2 out of 7 (29%) Indicator 3 - The average time in working days for a full response to complaints at each stage Table 6 – average time in working days to respond Early Resolution/ Frontline Investigative Escalated Investigation NHS - Datix 3 days 45 days 75 days Moray Council - Lagan 18 days 51 days 27 days During 2024/25, HSCM did not meet the target timescales for responding in all cases. Many complaints received are complex and involve more than one service, which can impact on response times due to the level of investigation and coordination required. Improving the timeliness and quality of complaints responses remains a priority. Work is ongoing to identify barriers, streamline processes, and promote early resolutions that meets the needs of complainants. In some cases, complaints cannot be closed until other processes, such as adverse event reviews, HR processes or information governance checks are completed. These dependencies can significantly extend response times. Page 187
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23 Additionally, some complaints are initially resolved within target timescales but are later reopened following further correspondence from the complainant, sometimes months after closure. Indicators 2 and 3 do not account for these reopened phases, as response times are calculated from the original date of receipt through final closure. Page 188
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24 Indicator 4 - The outcome of complaints at each stage The number of complaints upheld, partially upheld, not upheld and resolved at stage 1, stage 2 and after escalation as % of all complaints closed at stage 1, stage 2 and after escalation Graph 2 below shows the number of complaints fully upheld, partially upheld and not upheld as recorded in Datix during 2024/25. Out of 65 closed complaints on the system 1 complaint was incorrectly recorded as a complaint (should be a concern),1 was closed due to an adverse event review taking place and 3 were closed as consent was not received. From the remaining 60 complaints closed during 2024/25 - approximately 33.3% were fully upheld, 33.3% were partially upheld and 33.3% were not upheld 0 2 4 6 8 10 12 14 16 Fully Upheld: Complaint is accepted Partially Upheld: Complaint is partly accepted Not upheld: Complaint is not accepted Datix - Outcome of Closed Complaints Early Resolution Investigative Escalated Investigative SPSO From all early resolution complaints closed 33.3% were upheld, 33.3% partially upheld and 33.3% not upheld. From all investigative complaints closed 18% were upheld, 41% were partially upheld and 41% were not upheld. From all escalated investigative complaints 40% were upheld, 29% were partially upheld and 31% were not upheld. Page 189
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25 Complaints Information Extracted from Lagan: 55 complaints were closed during 2024/25: 15% were upheld, 33% were partially upheld, 43% were not upheld and 9% were resolved. Graph 3 below shows the number of complaints upheld, partially upheld and not upheld as recorded in Lagan. 0 2 4 6 8 10 12 14 Upheld Partially Upheld Not upheld Resolution Lagan - Outcome of Closed Complaints Frontline Investigative Escalated Investigative SPSO From all frontline complaints closed 17% were upheld, 13% partially upheld and 48% not upheld. 22% were resolved. From all investigative complaints closed 12% were upheld, 52% were partially upheld and 36% were not upheld. From all escalated investigative complaints 14% were upheld, 29% were partially upheld and 57% were not upheld. Page 190
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REPORT TO: MORAY INTEGRATION JOINT BOARD ON 25 SEPTEMBER 2025 SUBJECT: MEMBERS’ EXPENSES BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To inform the Board of amendments to the policy for reimbursement of expenditure incurred by individuals discharging their duties in relation to Moray Integration Joint Board. 2. RECOMMENDATION 2.1 It is recommended that the Board note the changes made to the Members’ Expenses Policy (Appendix 1). 3. BACKGROUND 3.1 Members of the Moray Integration Joint Board (MIJB), its Committees and supporting groups, will from time to time incur expenses in performing their duties as members. A policy was developed to ensure that members are fairly reimbursed for expenditure necessarily incurred in performing these duties. 3.2 MIJB approved this policy at its meeting on 31 March 2016 (para 13 of the minute refers) and forms part of the Members’ Handbook. It was updated on 24 September 2020 (para 18 of the minute refers) and 29 September 2022 (para 14 of the minute refers). 3.3 The policy applies only to members who are not already covered by their organisations respective expenses policies. Where appropriate, Members of the MIJB, will continue to claim business expenses in accordance with the policy of their respective organisations. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 Changes have been made to the travel expenses and subsistence allowance section and are tracked for ease of reference. Item 12. Page 191
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4.2 These amendments are in line with Moray Council’s travel expenses and subsistence rates. 4.3 Expenses will only be reimbursed where wholly, exclusively and necessarily incurred on MIJB, Committees and supporting working groups business and must be supported by receipts or other evidence. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” Effective procedural arrangements support the development and delivery of priorities and plans (b) Policy and Legal This policy provides a robust mechanism that ensures all representative members of the specified groups are equitably reimbursed for expenses incurred whilst discharging their responsibilities. (c) Financial implications The costs of expenses claimed will be met by the MIJB. (d) Risk Implications and Mitigation Without effective procedural arrangements in place to deal with issues such as expenses, there is a risk that members will be financially penalised for their representation on MIJB business. The absence of a written policy and procedure may leave the MIJB open to misinterpretation. (e) Staffing Implications There are no staffing issues arising directly from this report. (f) Property There are no property implications arising directly from this report. (g) Equalities/Socio Economic Impact An Equalities Impact Assessment is not required because there are no service, policy or organisational changes being proposed as a direct result of this report. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy (i) Directions There are no direct Directions implications. (j) Consultations Page 192
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Consultation has taken place with the Chief Officer and the Health and Social Care Moray Senior Management Team, who are in agreement with the report. 6. CONCLUSION 6.1 The updated expenses policy will ensure that members are reimbursed for expenses incurred on MIJB, Committees and supporting working group business while at the same time keeping control of costs. Author of Report: D O’Shea Chief Financial Officer Background Papers: attached at Appendix 1 Ref: Page 193
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APPENDIX 1 Owner of Policy Chief Financial Officer Author Deborah O’Shea Date of Review September 2025 Date of previous version 29 September 2022 Policy Approved 29 September 2022 Next Review Date September 2027 MORAY INTEGRATION JOINT BOARD MEMBERS EXPENSES POLICY Page 194
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[Type here] Introduction Individuals discharging their duties in relation to the Moray Integration Joint Board (IJB), its Committees and supporting working groups, will from time to time incur expenses in performing their duties. This policy has been developed to ensure that members are fairly reimbursed for expenditure necessarily incurred in performing their duties. This policy applies only to members who are not already covered by their respective organisation’s expenses policies. Members of the IJB, its Committees and supporting working groups or employees of organisations where an expenses policy exists will continue to claim business expenses in accordance with the policy of their respective organisations. To qualify for reimbursement, expenses must be incurred wholly, exclusively and necessarily in the performance of the Board members duties and must be supported by receipts. Claimable Expenditure Travel expenses Travel expenses will be reimbursed subject to the mode of travel being the most economical and efficient in view of all the circumstances. Where a journey involves more than one member, car sharing should always be considered. Vehicle mileage will be reimbursed at the HMRC rate in force at the time when the expenditure was incurred (currently 45p per mile). Prior to claiming mileage for the first time and annually thereafter members will have to demonstrate that they hold a valid driving licence and motor insurance covering business travel. Travel by motorcycle is reimbursed at 24p per mile and travel by bicycle is reimbursed at 20p per mile. Mileage claims should be accompanied by a VAT receipt for fuel sufficient to cover the miles claimed to allow for VAT to be reclaimed where allowable. The VAT receipt must be dated before the first journey claimed. Travel by public transport on the business of the group that they are a member of will normally be booked on the IJB, its Committees and supporting working group Members. Where the Member makes his or her own transport arrangements reimbursement will be made for standard class travel only. Parking and Other Fees Parking charges will be reimbursed on production of the appropriate receipts. Parking fines or similar penalties will not be reimbursed. Subsistence When travelling outside Moray on IJB business and where meals are not provided; Members may claim the actual cost of meals purchased up to the maximum amount allowed, which are currently: Page 195
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[Type here] Exceeding 4 but no more than 8 hours Maximum of £6.17 £8 Breakfast Lunch rate Exceeding 8 but no more than 12 hours Maximum of £8.60 £12 Lunch & Tea rate Exceeding 12 hours Maximum of £13.81 £25 Dinner Lunch & Evening rate Receipts must be provided for all expenditure incurred and attached to claims. Support for Carers Carer representatives who need support for their caring responsibilities in order to participate in the business of the IJB will be invited to discuss their needs with the Chief Officer so that appropriate support can be provided. Claiming Expenses Expenses should be claimed monthly using the standard claim form, which will be supplied to all members covered by this policy. Claims delayed by more than three months will not normally be paid. Receipts should be attached and the completed claim form sent for the attention of the relevant senior manager for authorisation. Version Control March 2016 Policy developed by Chief Financial Officer, reviewed by Chief Officer and approved by MIJB April 2016 Policy implemented August 2020 Moray Council logo updated, subsistence section updated and version control table added. September 2022 Travel expenses and subsistence section updated September 2024 Travel expenses and subsistence section updated March 2028 Next policy review date Concern in relation to expenses not covered within this policy should be raised with the Chief Officer or Chief Financial Officer of the MIJB Page 196
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[Type here] MORAY INTEGRATION JOINT BOARD Volunteering Expenses Subsistence Form All expenditure must be agreed in advance, supported by valid vat receipts and attached to this form where appropriate. Claimant Details Claimant Name: Claimant Address: Postcode: Telephone: Base (if relevant) Date Journey Details (to / from and reason for journey – meeting, event etc.) Method Of Travel Mileage Travel Fares £ Other Expenses Details Other Expenses £ Official use only Sub Totals £ Claimant: I declare that the expenses claimed above have been incurred by me and that reimbursement has not or will not be made to me by any other public or charitable funds in respect of this claim. Signed : _____________________________ Date : ________________ FOR OFFICIAL USE ONLY Payment Agreed by : ____________________ Date : _________________ Approved by : ____________________ Date : _________________ Cost Centre / Management Centre: ___________/___________ Page 197
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