Transformation Plan Q3 Update
North Ayrshire Council · 6 February 2025
Back to Integration Joint Board — 6 February 2025 and its agenda
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Integration Joint Board 6th February 2025 Subject : Transformation Plan Q3 Progress Update Purpose : This update is for awareness and to assure IJB of progress. Recommendation : The IJB should note the progress to date. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required x 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership IJB Integrated Joint Board PID Project Initiation Document SDS Self Directed Support 1. EXECUTIVE SUMMARY 1.1 The North Ayrshire HSCP Transformation Plan 2024-27 is an ambitious programme of change consisting of a range of improvement and reform projects across all service areas, each aiming to improve the quality of our services and contribute to the long- term sustainability of health and care in North Ayrshire. This report highlights key activity and general updates on progress made in the six months since approval. Work is ongoing alongside budget planning for 2025-26 to align financial impacts to the transformation plan. T 2. BACKGROUND 2.1 The Transformation Plan was approved by IJB in March 2024. There are 77 change projects and programmes on the plan, from across every area of the partnership. 2.2 A six-month progress update was provided to IJB in September 2024, after which the Board requested ongoing reports, in a similar format, every quarter. 2.3 Through 2024-25 the financial outlook has deteriorated, and the need for transformation and the redesign of services has become more urgent and more important to the long-term sustainability of the services for which we are responsible. At the same time our capacity for change is diminishing due to increasing demands on people’s capacity including the short-term actions required to deliver the financial recovery plan.
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Key Activity 2.4 In September a new online Tracker was launched to provide ongoing real time monitoring of projects (Screenshot in Appendix I). The Tracker is linked to a dashboard to provide a visual representation (screenshot in Appendix II). 2.5 In October the Transformation Board was updated on the progress of the new Digital and Data Plan which consists of a Landscape Review and a Phase 1 Delivery Plan. The Landscape Review includes: an outward look across the sector, including national digital and data strategies; and inward look incorporating the staff digital experience survey, case studies, and local plans and strategies. The Delivery Plan, informed by the Landscape Review, aims to address immediate priorities and establish a solid foundation for longer term transformative improvements. Priorities for this plan include improving access and supporting the workforce to develop essential digital and data skills. An overview will be presented to the Strategic Planning Group in March. 2.6 Also, in October the Senior Manager (Strategic Planning and Transformation) was successful in securing a funded place on MSc in Leading Digital Transformation in Health and Social Care in Scotland delivered by the Usher Institute at University of Edinburgh, and aims to “enhance the ability of current and future leaders to drive, deliver and embed digital transformation across Scotland’s health and social care services”. 2.7 In December the Transformation Board focused on some key partnership-wide programmes including an update on the Carers Strategy and an update on the Self- Directed Support Learning Review Implementation, as well as an overview of the initial findings from the Accessing Health and Care Service Review. 2.8 Also in December, the Service Lead for the Tech First Programme in Health and Community Care was successful in achieving a fully funded place the Professional Development Award Technology Enabled Care starting in January 2025. The qualification is designed to “empower individuals to evaluate and adopt technologies that support health and care delivery while reflecting on how these could be used to assist people to self-manage and live independently”. 2.9 The third Ayrshire-wide Innovation Event took place on the 3rd December and included: an overview of the new Digital Capability Framework and supporting resources from the Digitally Enabled Workforce Team at NHS Education Scotland; a demo of the Seer 2 platform which provides national technology and infrastructure capabilities for data management and analytics for health and social care across Scotland; and an overview of how NearMe is used in South Ayrshire. Service Updates 2.10 Health and Community Care
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• The Blue Badge Review to streamline processes has concluded with successful outcomes. • The Analogue to Digital work continues to roll out • The Tech First project has produced an Options Appraisal with proposed next steps. • The Packages of Care Project has convened with subgroup leads to establish their action plans. • The Palliative and End of Life Care Group has proposed with East and South the "implementation of the Pan Ayrshire End of Life and Palliative Care Programme to deliver improvements in patient care; through the identification of evidence based sustainable models of care, effective staff training and efficient delivery of equipment and support". The North subgroup "Education & Training" has been established and a work plan will be taken forward by a dedicated lead, reporting back to the programme board. • The Day Service Review has produced and Options Appraisal with proposed next steps. • The multi-agency Delayed Discharge and Winter Preparedness Project continues and includes support to 'MADE & Safer", investigating and improving referral pathways from acute to HSCP, and a service wide action plan which is updated weekly to ensure momentum and progress. A performance monitoring framework is in place. • The Home First Strategy is being explored. • The Arran Single Point of Contact is also delayed, this is due to funding delays and IT infrastructure issues. • The Enhanced Intermediate Care Team review is advancing with four subgroups established. • The Community Rehab work has been focussing on good practice and mapping services. This will culminate in a workshop with all relevant services. A visioning group has been convened who will oversee preparation of the recommended model for service delivery. 2.11 Children, Families and Justice • Brighter Pathways Board and workstreams are meeting regularly. Housing and Throughcare are developing a Housing Protocol and have developed a Tracker for prioritised applications, in this case care-experienced young people. Engagement has been undertaken with foster carers and the new digital site is live, and new Foster Schemes are being develop. Meetings continue with Education to develop pathway to residential school placements and a position paper is being developed. A position paper is also being developed to provide strategic direction on next steps in terms of reconfiguring the model of care in Children’s Houses. It is hoped that Psychological Services can work alongside staff and young people within the Residential Houses to improve supports/outcomes.
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• Neuro Developmental Supports (this is a lifespan focus not just Children’s) is progressing: • The Multi-Agency Panel test of change is almost complete, the workstream will assess the findings with a view to informing the Business Case being developed. • Parents & Carers Engagement Report will be presented to the North Implementation Group next week, there are twenty-three actions to be considered by the Group. • Family Supports - List has been published on NEST website, further communication is being developed by way of a Video that will go on the site, to assist service users/parents in accessing supports. • A review of the North Ayrshire Justice Court team has been carried out and now service user testimonies are being sought. It is anticipated that the preferred option will be signed off early 2025. • The Transport Provision PID has been approved and the workstream is being set up aiming to reduce costs by reconfiguring how service is provided and moving away from single journey taxi provision. 2.12 Mental Health and Learning Disabilities • Continuing to monitor and make improvements on the delivery of all MAT Standards. Regular Support to Report meetings with the national support team (MIST) have taken place who continue to be reassured at local progress. A formal update report to the Scottish Government being collated. • Since establishment the Learning Disabilities Intensive Support Team have had 20 referrals and currently have 13 active cases, 2 of which are delayed discharge in hospital. Review of out of area placements is being carried out. • A review of the Adult Community Mental Health Service is underway. Data and research has been gathered and staff and service user engagement is complete. The project is on track to deliver recommendations by early 2025. Workshop of solutions pushed back to Q4 to bring into alignment with Wellbeing project timelines. • The Community Wellbeing services are being looked at through a cross-functional project bringing together Mental Health and Learning Disabilities and Health and Community Care. A workshop was held with project team to agree the future model of Wellbeing Services. Options are being developed and presentations were given on all existing Wellbeing Services to inform decision making. • Work continues for the Digital Programme with a review of the entire digital landscape for Mental Health services across Ayrshire and Arran. Outline findings were reported to the Mental Health Digital Transformation Group. TrakCare Implementation continues with progression of solutions for Learning Disabilities
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Service and improvements to Care Partner forms for Psychological Services teams. • The Extreme Team implementation plan and recommendations to improve support for people with disabilities throughout their life course work are now being operationalised across services. The Children with Disabilities team and Adult Learning Disabilities team has now integrated into a single leadership structure within adult services and will continue to progress and implement recommendations with details of future pieces of work will follow. • As part of the models of care work at Woodland View, an Ayrshire Central Hospital Inpatient Site review has commenced to reduce overspends, and a bimonthly group is meeting to review all persons subject to high-cost placements. • A Programme Board has been established to review the LD Acute Assessment model based at Woodland View alongside community models and in alignment with IST service. Feeding into that are three main areas workstreams. 1) Workforce 2) Environment 3) Delayed Discharges. In addition to that, work is ongoing to build a communication plan for all pieces of work to appraise all stakeholders of progress. A weekly risk meeting is in place to address and mitigate more immediate operational challenges and bring pace to discharge planning. 2.13 Partnership-wide • The Carer Partnership focus continues to reach more people, in more places, in more ways with activity on a range of areas including: o North Ayrshire Short Breaks Services Statement has been drafted. o Communication and marketing materials - Carer Pack aligned with the self- help resource o Wider carer engagement including development of a Carer Champions Board. First meeting before Christmas. o Continued networking, mapping and partnership building. o Continued work on Bridgit (digital self-help portal for carers) and use of digital/ social media. Development of a young carer section. o Improved strategies to identify and support hidden or minority carer groups. o Improved process and pathways for identification, registration and completion of Adult Carer Support Plans and Young Carer Support options from Gateway Service. o Development of Section 28 – Identifying & Involving Carers in Hospital Discharge. o Clarity on the Gateway role and offer to be embedded across schools. • The implementation of the recommendations from the SDS learning review continued through Q3 with: o A policy review o Design sessions: to identify areas to progress.
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o Staff Interviews: Interviewed senior staff to understand the future direction of SDS, barriers and current organisational cultures. o Service User Interviews: Captured user experiences to use as case studies for training. o Team Manager Sessions: Discussed SDS progress and improvements. o Brand Kit: Created a design kit for clarity. o Graphic Design: Supported related work in other areas such as unpaid carers and learning disability. o SDS Microsite: Designed a site for SDS information and resources. o Value-based Leadership Programme: Developed a programme to consider the culture and behaviours required to bring about system level changes. o Ethical Framework: Started a new overarching ethical framework for SDS. • The Front Door Review had a joint meeting of the Board and Reference Group on Monday 25th November, where workstream representatives presented their recommendations. These were deliberated by the Board and amended to reflect their comments. • The Year 2 report for the Workforce Plan 2022-25 has been completed and presented to the Transformation Board and PSMT. The report will be published and also taken to the Performance and Audit Committee. Work to replace the Workforce Plan has not yet commenced, and the HSCP has been informally advised that the Scottish Government will be looking for interim updates for 2025 instead. • The implementation of our new case management system for social care, Eclipse, is progressing with go-live later in 2025. 3. PROPOSALS 3.1 It is proposed that IJB note the progress to date. 3.2 Anticipated Outcomes Informing IJB and the people of North Ayrshire on the progress of the Transformation Plan, and also providing assurance of the governance arrangements and that the Transformation Board has appropriate oversight. 3.3 Measuring Impact Stakeholders are assured of progress. 4. IMPLICATIONS 4.1 Financial
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A number of the transformation projects will deliver financial savings; some financial targets have been identified as part of the budget development for 2025/26 (and will be reflected in the Medium-Term Financial Outlook). Identified savings and overspend reductions are tracked in the online trackers. 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk None. 4.6 Community Wealth Building None. 4.7 Key Priorities None. 5. CONSULTATION 5.1 Consultation has taken place with Planning Managers in the Transformation Team, and with the Transformation Board which includes representation from across services. Lee Ballantyne, Senior Manager (Strategic Planning and Transformation) LeeBallantyne@north-ayrshire.gov.uk Appendices • Online Tracker [screenshot] • Online Dashboard [screenshot]
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Appendix I: Online Tracker [Screenshot]
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Appendix II: Online Dashboard [Screenshot]