Strategic Risk Register
North Ayrshire Council · 20 March 2025
Back to Integration Joint Board — 20 March 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Integration Joint Board 20th March 2025 Subject : Strategic Risk Register Purpose : To present the updated IJB Strategic Risk Register for consideration and approval. Recommendation : To approve the updated IJB Strategic Risk Register including the addition of two new risks and the removal of one risk. Direction Required to Council, Health Board or Both (where Directions are required please complete Directions Template) 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 IJB Integration Joint Board NHS National Health Service PAC Performance and Audit Committee PSMT Partnership Senior Management Team 1. EXECUTIVE SUMMARY 1.1 This report provides an update on the strategic risk register, to help ensure the IJB are proactive in identifying and managing the risks to the successful delivery of our Strategic Plan. 2. BACKGROUND 2.1 A Strategic Risk Register is a requirement of the Clinical and Care Governance Framework and as part of our Risk Management Strategy, which was last approved by the IJB in September 2024. The review focussed on updating previous risks and identifying new risks.
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2.2 New Risks: Ref Title Description Gross Risk Residual Risk SRR15 Risk of Harm A lack of resources combined with an increase in both demand and complexity is leading to increasing numbers of residents waiting for services. This results in a greater likelihood of residents experiencing harm as a result. 16 High 16 High SRR16 Growth and expansion of specialist complex care developments There has been a rapid increase across the independent sector in North and South Ayrshire since 2020 which lack alignment with local commissioning plans. This results in an exponential growth in un- forecasted referrals to community and inpatient Mental health and Learning disabilities services leading to an impact on capacity and demand on MDT's and inpatient occupancy levels when placements breakdown. 25 Very High 15 High 2.3 Risks with an increased score: Ref Title Description SRR05 Transformational Change Programme The gross risk increased from 9 to 12 which reflects the current challenges around the increased pace of change required to deliver against the financial position, with a risk of short term savings potentially being at the expense of long- term sustainability and transformation. SRR13 Provider Failure (commissioned services) The gross risk increased from 12 to 16 which reflects the current challenges in the provider market including the increased employers’ NI rates. 2.4 Risks with a reduced score: No risks reduced in gross score. 2.5 Risks recommended for removal from the register: Since the last report to the IJB there is one risk recommended for removal from the register which is outlined below: Ref Description Reason for Removal SRR11 National Care Service The introduction of the National Care Service has been scaled back. Instead the government have proposed the introduction amended legislation which
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removes any structural change to accountabilities with the establishment of a non-legislative national oversight instead. The full details of this are not clear at this stage but the risk of structural change and disruption at a local level has now been minimised, if a new strategic risk is identified then it will be added to a future update of the Strategic Risk Register. 2.6 The actions required to manage and control the risks have been identified and they will be subject to ongoing monitoring and review by the PSMT with an update to be reported to the Performance and Audit Committee. 2.7 There are 12 risks noted on the Strategic Risk Register, with a number of these graded as very high or high risk. While there are a number of controls and mitigations in place there may be further actions required to reduce the risks further in line with the level of risk tolerance. The current Strategic Risk Register is included as Appendix A. The risks are summarised below: Ref Title Gross Risk (score pending further controls) 2024 Residual Risk (score after further controls) 2024 Gross Risk (score pending further controls) 2025 Residual Risk (score after further controls) 2025 SRR01 Financial Sustainability 25 Very High 12 High 25 Very High 20 Very High SRR02 Infrastructure (ICT Integration) 12 High 9 Moderate 12 High 9 Moderate SRR05 Transformational Change Programme 9 Moderate 6 Moderate 12 High 6 Moderate SRR06 Governance 9 Moderate 3 Low 9 Moderate 3 Low SRR07 Demography and Inequality Pressures 16 High 12 High 16 High 12 High SRR08 Workforce 12 High 9 Moderate 12 High 9 Moderate SRR09 Local Impact of Scottish Government Policies 16 High 12 High 16 High 12 High SRR12 Clinical and Care Governance 9 Moderate 9 Moderate 9 Moderate 9 Moderate SRR13 Provider Failure (commissioned services) 12 High 12 High 16 High 16 High SRR14 Asylum Arrivals 12 High 12 High 12 High 12 High
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SRR15 Risk of Harm n/a n/a 16 High 16 High SRR16 Growth and expansion of specialist complex care developments n/a n/a 25 Very High 15 High 2.8 The scoring of the risks is based the severity of the risk multiplied by the likelihood of it happening. The background to this is given in the extract of the approved risk management strategy in Appendix B. 2.9 The operational risks of the partnership are regularly reviewed and considered at service management meetings. The Clincial and Care Governance Group is responsible for the oversight of operational risks within the partnership. The Group consider any High or Very High risks (as defined by the approved risk management strategy) and if required esalate these to the Partnership Senior Management Team (PSMT) for consideration for inclusion on the Strategic Risk Register. 3. PROPOSALS 3.1 It is proposed to approve the risk register detailed in Appendix A including the action required to manage, mitigate and control the risks. 3.2 Anticipated Outcomes Risk management is an integral part of governance and it is essential that the IJB has assurance that risks are identified and managed appropriately to ensure the safe and sustainable delivery of services. 3.3 Measuring Impact The risk register will be monitored with the individual risk owners being responsible for keeping the register up to date under the overview of the Principal Manager – Finance. It is recommended that risk assessments be reviewed on an annual basis as a minimum. PAC will monitor the register to ensure the actions required to manage and control the risk are being progressed, with updates provided to the IJB and PAC at least annually. 4. IMPLICATIONS 4.1 Financial None 4.2 Human Resources None 4.3 Legal None 4.4 Equality/Socio-Economic None 4.5 Risk
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The report falls in line with the agreed risk appetite statement which is low-risk appetite in respect to adherence to compliance duties. 4.6 Community Wealth Building None. 4.7 Key Priorities Appropriate and effective risk management practice will deliver better outcomes for the people of North Ayrshire, protecting the health, safety and wellbeing of everyone who engages with the IJB or for maximising opportunity, delivering innovation and best value, and increasing performance. 5. CONSULTATION 5.1 The strategic risks have been reviewed and agreed by the PSMT. For more information please contact: Eleanor Currie, Interim Chief Finance Officer – Finance at eleanorcurrie@north- ayrshire.gov.uk
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Appendix A Strategic Risk Register Glossary of Terms Term Definition Term Definition NAHSCP North Ayrshire Health and Social Care Partnership ARG Allocation of Resources Group SAHSCP South Ayrshire Health and Social Care Partnership ICT Information and Computer Technology EAHSCP East Ayrshire Health and Social Care Partnership MDTs Multi-Disciplinary Teams NHS/ NHS AAA NHS Ayrshire & Arran EKSF Electronic Knowledge and Skills Framework MTFP Medium Term Financial Plan TURAS Training Management System CRES Cash Releasing Efficiency Savings SPOG Strategic Planning Officers Group LD Learning Disability ICF Integrated Care Fund IJB Integrated Joint Board RMP Records Management Plan PSMT Partnership Senior Management Team CPAG Child Poverty Action Group NAC North Ayrshire Council
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Appendix B Extract from the Risk Strategy on Risk Scoring
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SEVERITY CONSEQUENCE MATRIX - Description and definition of the CONSEQUENCE / IMPACT of the risk should it occur (these are a guide) Severity “Domains” 1 Insignificant 2 Minor 3 Moderate 4 Major 5 Extreme Objectives and projects Barely noticeable reduction in scope / quality / schedule Minor reduction in scope / quality / schedule Reduction in scope or quality, project objectives or schedule. Significant reduction in ability to meet project objectives or schedule. Inability to meet project objectives, reputation of the organisation seriously damaged and failure to appropriately manage finances. Injury (physical and psychological) to patients/staff. Adverse event leading to minor injury not requiring first aid. Minor injury or illness, first-aid treatment needed. No staff absence required. Significant injury requiring medical treatment and/or counselling. Major injuries or long- term incapacity/ disability (loss of limb), requiring medical treatment and/or counselling. Incident leading to death or major permanent incapacity. Patient experience / outcome Reduced quality of 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 < 1Wk Unsatisfactory patient experience / clinical outcome, long term effects - expect recovery > 1Wk Unsatisfactory patient experience / clinical outcome continued ongoing long-term effects.
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Complaints / claims Locally resolved complaint Justified complaint peripheral to clinical care Below excess claim. Justified complaint involving lack of appropriate care. Claim above excess level. Multiple justified complaints. Multiple claims or single major claims. Staffing and competence Short term low staffing level (< 1 day), where there is no disruption to patient care. Ongoing low staffing level results in minor reduction in quality of patient care Minor error due to ineffective training / implementation of training. Late delivery of key objective / service due to lack of staff. Moderate error due to ineffective training / implementation of training. Ongoing problems with staffing levels Uncertain delivery of key objective / service due to lack of staff. Major error due to ineffective training / implementation of training. Non delivery of key objective / service due to lack of staff. Loss of key staff. Critical error due to insufficient training / implementation of training. 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. 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 or facility. Disruption to facility leading to significant “knock on” effect. Financial Negligible organisational financial loss (£< 1k). Minor organisational financial loss (£1- 10k). Significant organisational financial loss (£10-100k). Major organisational financial loss (£100k- 1m). Severe organisational financial loss (£>1m). Inspection / assessment / audit Small number of recommendations which focus on minor quality improvement issues. Minor recommendations made which can be addressed by low level of management action. Challenging recommendations but can be addressed with appropriate action plan. Enforcement Action. Low rating. Critical report. Prosecution. Zero Rating. Severely critical report.
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Adverse publicity / reputation No media coverage, little effect on staff morale. Local Media – short term. Minor effect on staff morale / public attitudes. Local Media – long term. Impact on staff morale and public perception of the organisation. National Media (< 3 days). Public confidence in the organisation undermined. Usage of services affected. National Media (> 3 days). MP / MSP Concern (Questions in Parliament). Organisational / Personal Security, and Equipment Damage, loss, theft (£< 1k). Damage, loss, theft (£1-10k). Damage, loss, theft (£10-100k). Damage, loss, theft (£100k-1m). Damage, loss, theft (£>1m). 1 Remote 2 Unlikely 3 Possible 4 Likely 5 Almost Certain Probability Will only occur in exceptional circumstances. Unlikely to occur but definite potential exists. Reasonable chance of occurring – has happened before on occasions. Likely to occur – strong possibility. The event will occur in most circumstances.
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Risk Rating LIKELIHOOD SEVERITY 1 Insignificant 2 Minor 3 Moderate 4 Major 5 Extreme 5 Almost Certain 5 10 15 20 25 4 Likely 4 8 12 16 20 3 Possible 3 6 9 12 15 2 Unlikely 2 4 6 8 10 1 Remote 1 2 3 4 5
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North Ayrshire Integration Joint Board Strategic Risk Register Risk Ref Description of Risk Mitigations/Control Measures Previous Score Severity Probability Score Rating Proposed New Control Measures Previous Score Severity Probability Score Rating Risk Tolerance / Appetite SRR01 Financial Sustainability of the Health and Social Care Partnership - Resources have not kept pace with the demand for and cost of social care services. The budget settlement for 2024- 25 was extremely challenging with a gap of over £10m across the IJB. Financial modelling suggests significant ongoing challenges across the medium-term. The 25/26 budget is even more challenging including the impact of Employers NI contributions for the partnership and providers. There is no certainty around future funding against growing demand, increasing costs and demographic pressures, with one- year budget settlements remaining in place. The ongoing work to review the Integration Scheme and to develop new risk-sharing arrangements between the Council and Health Board in relation to the acute set aside and primary care prescribing present a financial risk to the Partnership and Council. An overspend in the region of £4.980m; the reserves held by the Partnership are being fully utilised to support the 2024/25 outturn, with the recommended minimum level being 2%. Low-volume high- cost care packages and care placements and an increasing reliance on agency staff continue to present a particular financial challenge to the Partnership. The IJB actively monitors the financial position with regular detailed reporting. Directors of Finance of the Council and Health Board have oversight and regular updates are provided to the Council's Cabinet. There is an integrated approach to managing the totality of NHS and Council resources delegated to the IJB. A three-year Medium-term Financial Outlook is updated on a rolling basis each year. Previous financial settlements have seen both partners meet the Scottish Government settlement conditions with any additional resources passed to the IJB. A financial recovery plan has been in operation since June 2024 and has targeted reductions in care at home, care homes, supplementary staffing costs including in ward areas and children's residential placements. Review of expenditure authorisation levels across the Partnership and escalation of specific decisions to senior officers. In particular, a new governance group has been introduced, involving the Director and Heads of Service, to oversee the agreement of higher value packages of care (above £40,000 per annum).· Staff communication in relation to discretionary/non-essential spend.· Review of temporary posts and robust vacancy management/approval. The vacancy scrutiny group now has representation from all of the Heads of Service and a recruitment freeze will be implemented for all but essential frontline posts.· Restrictions on all but essential overtime working.· Ongoing review of future year savings or transformation programmes to identify scope for acceleration.· In order to facilitate greater scrutiny of the financial position and the delivery of the financial recovery plan during 2024/25, the IJB agreed at the June meeting to establish a ‘Finance Working Group’, chaired by the IJB Vice Chair. The Director and Heads of Service will be members of the group. This group meets monthly to facilitate increased oversight and scrutiny of the financial position and transformation programme as well as detailed budget planning for future financial years. 25 5 5 25 Very High Transformation Plan 2024-2027 - targets are being set against the transformation plan and these will be included in the 2025-26 budget setting paper. Savings for 2025/26 to be aligned to tranformation plan but also service and capacity reductions to reduce spend, particularly for areas of recurring overspend. All recovery plan actions will be maintained into 2025/26 as will the operation of the high cost care package group and vacancy controls. The finance working group will continue to meet throughout 2025-26 and assist in the planning of the 2026-27 budget setting. The Chief Officer and Chief Finance officer will continue to lobby the Scottish Government and make the case for investment in community based Health and Social Care and to recognise the demographic impact of demand and resources in North Ayrshire. 12 4 5 20 Very High Treat SRR02 Infrastructure - ICT System Integration and Property - lack of an integrated IT system to meet the needs of NAHSCP leading to non-robust and inefficient information recording and sharing resulting in inefficient business models, duplication of effort, inaccurate or lack of data on service demand and delivery and risk to service users, patients and staff. * Some pockets of agile and remote working have been implemented and work continues to roll these initiatives out to improve efficiency. * Access to systems can be requested to allow NHS-Partnership staff access to NAC systems, and NAC- Partnership staff access of NHS systems. * Work has progressed to reduce the number of MH ancillary recording systems and consolidate data on centralised systems. * Working from home has accelerated the use of technology with more business being conducted via MS Teams. * HSCP systems and performance team supporting work across the partnership and progressing developments and issues with systems * Agreeing final training requirements for the new Eclipse implementation - replacing CareFirst. * NHSAAA are undertaking a review of all MS Access databases in use for removal to centralised systems. - local review linked to MH reporting completed to plan removal * Implementation of Trakcare functionality within Adult Community Mental Health Services to manage patient clinics across all three Partnerships. * Ensure that there are local arrangements in place to manage local risk. * MH Digital Transformation board established * MH digital business case being developed to address future planning needs. * Digital pilot for CYP neurodevelopment transformation with Strata Health. * Optimising existing estate to address complex care needs. 12 4 3 12 High * Develop NAHSCP Digital & Data Strategy * Develop strategic direction with NHSAAA, EAHSCP and SAHSCP. * Replacement of the current social care system will include consideration of functionality which will support health service data requirements * A pan-Ayrshire initial meeting took place with NHS in Jan 2023 to agree that the use of the NHS Orion platform for data integration would be of benefit to partnerships teams - a scoping exercise is now underway by NHS IT to review how this platform works in practice within Glasgow for implementing locally - NHS have provided the 2024 development roadmap for an Integrated Care Record - NHS networks investigating how to improve connectivity to social work employees from Ayrshire Central Hospital 9 3 3 9 Moderate Tolerate SRR05 Transformational Change Programme - failure to deliver the transformational change required to meet current and future demands and ensure our long term financial sustainability. * Senior Manager leading on the delivery of the Transformation Plan. * NAHSCP Transformation Board for oversight of programme development and delivery. * Reporting regularly to NAHSCP Integration Joint Board. * Development of Workforce Plan, and Digital and Data Plan, to ensure alignment with transformed products and services. * Risk register to manage risks escalated to the Board. * Alignment of service change/transformation plans to Strategic Plan priorities * Scheduled meetings with Planning Managers to ensure effective communication throughout the change process on a 4 weekly basis. * Cross fertilisation and knowledge transfer of Planning Managers. * Raise awareness of Programme within the three parent organisations (including elected members and board members) via established reporting arrangements. 9 4 3 12 High * Development of Transformation Board tracker and dashboard for both high level oversight and instant access to latest updates from planning managers at project level. * Review plan and approach ahead of 25-26. * Incorporate any recommendations from internal audit. * Link Transformation Plan with review and update of Strategic Commissioning Plan to ensure the plan balances the need for short terms savings with long term financial sustainability, balancing 'current and future demands'. * Pan-Ayrshire Digital & Data Group to develop digital capability. * Closer monitoring of engagement with transformation projects to ensure work is prioritised appropriately in the current operating context. 6 3 2 6 Moderate Treat SRR06 Governance - IJB governance arrangements are not conducive to effective working and decision making, Leading to a lack of confidence in the IJB and reputational damage. Failure to comply with governance requirements such as Freedom of Information, Complaints and other regulations laid down within the Public Bodies (Scotland) Act. This could lead to a breach of specific regulations resulting in enforcement action from governing bodies, adverse public reaction and/or prosecution. * Appropriate arrangements in place for representation at the IJB and sub-committees * Integration Scheme, Strategic Plan, Standing Orders and Code of Conduct in place. * Policies and procedures developed and in place for each function including Complaints, FOIs/Adverse Events for both HSCP and IJB. * Operational Governance / Delivery groups in place to ensure appropriate action planning and monitoring including Performance and Audit Committee, Clinical and Care Governance Group, Adverse Events Review Group, Health and Safety Groups and the Staff Partnership Forum. * IJB receives 6 monthly updates on Clinical and Care Governance activity including details of adverse events; significant case review; complaints. This update includes details of outcomes and lessons learned. The Adverse Event Review Group now includes a fortnightly update for all AERs across the North HSCP. *Approved a Risk Management Strategy, Strategic Risk Register and risk appetite statement. *Health and Care Governance Framework in place 9 3 3 9 Moderate * Development of IJB member induction programme was paused during pandemic but has now been finalised and two sessions have taken place with a further two planned for May and September. * IJB Carer Representative was appointed following a successful recruitment campaign. Additional stakeholder appointments still to be confirmed. * HSCP reviewing resourcing and capacity for demand to undertake SAERs. Proposal to enhance process with training and reviewing capacity across the three HSCPs. * Pan Ayrshire Review of Integration Schemes is underway. *Pan Ayrshire Working Group on Directions has been established focusing on governance, joint commissioning plans, set aside and lead partnership arrangements. * Refresh of induction programme for new IJB members and refresher of code of conduct and standing orders planned during 2025. 3 3 1 3 Low Treat Gross Risk Residual Risk
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North Ayrshire Integration Joint Board Strategic Risk Register Risk Ref Description of Risk Mitigations/Control Measures Previous Score Severity Probability Score Rating Proposed New Control Measures Previous Score Severity Probability Score Rating Risk Tolerance / Appetite Gross Risk Residual Risk SRR07 Demography and Inequality Pressures - failure to adequately plan for and respond to changes in our population profile and in the levels of poverty in North Ayrshire will result in more people experiencing higher levels of physical and mental ill health, resulting in increasing demand on services, an inability of services to provide adequate care and negative impact on health and wellbeing. • The HSCP Strategic Plan ‘Caring Together’ 2022-30 shows the HSCPs commitment to addressing local inequalities by retaining the key priority of Tackling Inequalities. It also identifies early and effective support as a priority which includes early and effective support to ensure we are monitoring how demographic changes may influence future needs • Demography increases are factored into budget planning to ensure the resource requirements are understood and funding is identified to meet needs • The transformation programme is focused on reviewing services and ensuring transformation of services is focussed on meeting the needs of service users • Equality and Children’s Rights Impact Assessments are carried out for new policies, proposed projects and service change proposals which are considered by IJB to inform decision making. These integrated assessments consider impacts for protected characteristics, socio-economic disadvantage, island consideration and impacts on consumers of services. • The HSCP has carried out engagement with groups with shared characteristics in order to revise the Equality Outcomes and set new outcomes for 2025-2029 which focusses on inequalities for faced by people with shared characteristics • The Community Link Worker service is now embedded in localities to assist individuals to understand the full range of formal and informal community-based services available to them • The HSCP is an active participant of the North Ayrshire Community Planning Partnership contributing to the delivery of the identified local outcomes of the Partnership Plan: Work, World and Wellbeing. This plan aims to identify local inequalities and make improvements through partnership working • Many HSCP services target inequalities as part of their business as usual, such as the Money Matters service to support financial inequality, Justice services which offers greater support for those with experience of the justice system, the Carers service, and the Alcohol and Drug Partnership 16 4 4 16 High • The Strategic Plan is due to be reviewed in 2025 to ensure it is still fit for purpose and responsive to changing needs. This includes consideration of a Strategic Needs Assessment to monitor changing demographics and plan for services that meet changing needs. The strategic needs assessment is in development and due for completion in Autumn 2025 • The HSCP will review the priorities of the Strategic Plan to factor in sustainability of the organisation, including demographic and workforce challenges and transformation and respond to new demographic data from the Census through the strategic needs assessment. • The Equality Outcomes for 2025-2029 will be published in spring 2025 which will aim to address health and care inequalities form protected groups • We will develop a Participation and Engagement Strategy which will outline our approach to ensuring active participation with disadvantaged groups, as well as how we will generally collect and respond to the voices of our service-users. This will help us identify inequalities and respond. • We will publish a new Learning Disability strategy to ensure people with a learning disability will have greater opportunities to develop skills and access meaningful paid employment • We work closely with Housing colleagues to ensure formerly looked after young people can access a positive and stable housing destination. We are currently revising the Housing Contribution statement to ensure housing and the HSCP work together and respond to changing demographic needs. 12 3 4 12 High Treat SRR07 (cont) • Our commissioning and procurement process adopt ethical approaches, ensuring all commissioned services do not discriminate against any particular groups and provide real actionable community benefits • We have increased support for carers by investing in the carers gateway service which has allowed additional recruitment and a locality-based model, which has led to increased new referrals and carer support plans being carried out • We have reduced Occupational Therapy waiting times through additional investment, which can support people to live independently for longer, which is responsive to our ageing population with increasingly more complex needs • We have embedded the Money Matters service into GP practices and secondary schools to improve access to financial advice and income maximisation services for local families. • In our Drug and Alcohol Services, we are implementing actions to reduce the number of local drug and alcohol related harms and deaths. This includes implementing the national MAT (Medicated Assisted Treatment) standards and increasing the number of ABIs (Alcohol Brief Interventions) delivered across North Ayrshire. * North Ayrshire is one of 3 areas in Scotland as part of the CHES programme (Collaboration for Health Equity Scotland) which launched in February 2025 - this programme is a partnership between NAC and the IJB and will involve all public sector partners to determine: - What are the most impactful areas for intervention for Scotland to make meaningful progress in closing the inequalities gap in healthy life expectancy? - What action can be taken to enable national and local organisations to work more effectively together to close the recognised implementation gap between policy intent and impact? SRR08 Workforce - failure to recruit and retain and plan workforce requirements effectively leading to an insufficient workforce (number of staff, key roles and competency levels), resulting in a reduction in capacity to safely and effectively care for local people and a negative impact on service user and patient's needs being met • The Workforce Plan for 2022-2025 aims to address the changing needs due to demographic changes, and challenges with recruitment and the workforce. It is in its final delivery year. • HR and Service leads meet and will continue to meet on a quarterly basis to update, review and amend work force plan in accordance with service demands and future planning requirements in mind. • A new Learning and Development Strategy was published for 2023-2028, outlining how we will ensure a trained and supported workforce. • A number of ongoing measures are being taken to improve recruitment in care: Locality based recruitment events are hosted by the Care at Home service, engagement with local secondary schools to expand the range of work experience and modern apprentice options that are available to promote a career in care, engagement with Ayrshire College to refine and expand the range of options available for students to experience service delivery in North Ayrshire. • A new workforce data analyst post was created and was recruited in 2024. This will allow better coordination of workforce data and will support services to use this data to respond to changing needs • The iMatter staff experience survey and What Matters to You? Engagement continues, to ensure senior managers are able to get feedback from employees about what is important to them in the workplace. • Collaborative recruitment in A&A for areas including ICT, Primary Care Implementation plan, Mental Health and Clinical Leadership • Exit interviews with staff to understand reasons for leaving, using this intelligence to inform plans to improve working conditions and role satisfaction • We work with local providers to understand the pressures they face and support them, supporting the implementation of the Scottish Living Wage and fair work agenda • The vacancy scrutiny group identifies key issues and ensures essential posts are recruited timeously. 12 4 3 12 High • The current Workforce Plan is in place until October 2025. The Scottish Government has recognised the pressures HSCPs and NHS Boards are under and have instead circulated a template to highlight workforce challenges to the Government, such as hard to fill posts, managing vacancies, supply challenges. It is anticipated that this will lead to further guidance from the Government and a replacement workforce plan will be pursued following advice, when resources allow. • The strategic needs assessment being developed for the Strategic Plan will inform future demographic challenges for the workforce. • Some actions identified in the Workforce Plan 2022-2025 have not been concluded, such as Succession Planning guidance or career pathway planning, those will remain priority actions. • Workforce service plans being reviewed developed in alignment with national and local strategy with service redesign to optimise existing workforce capacity and address demand. This is across all areas starting with high priority risks. * Increased focus on vacancy management and recruitment alongside service impact and for service areas with workforce shortage proactively looking to skill mix and different roles to address recruitment challenges - examples being SLT and OT. 9 3 3 9 Moderate Treat SRR09 Local Impact of Scottish Government Policies: risk of further legislative, policy developments or change which impacts on the IJBs ability to deliver on strategic objectives, examples include the Promise, the Living Wage, Free Personal Care and other future policy developments including the now amended National Care Service. The impact being the inability to deliver on these alongside strategic plan commitments and objectives and the impact of funding for new policy and legislative commitments. * Horizon scanning for policy developments through partners, professional networks including links with Scottish Government policy teams * Regular liaison with Scottish Government and COSLA senior officers * Attendance and participation at the national Chief Officer network. * Responses to consultations on potential implementation of new policy areas * Early impact assessments locally for national policies, including operational and financial service impact * Financial modelling to respond to requests for information to support full funding * Fully brief IJB members and wider partners on policy implications for the IJB to gather support and awareness of any implementation issues or concerns 16 4 4 16 High * Promote and develop pan-Ayrshire approaches to impact assessment of policy implementation * Reinforce the role of Elected Members and IJB members to influence Scottish Government decision making through political routes. * Ensure appropriate representation and views in the development of the National Care Service Advisory Board when established. 12 4 3 12 High Treat
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North Ayrshire Integration Joint Board Strategic Risk Register Risk Ref Description of Risk Mitigations/Control Measures Previous Score Severity Probability Score Rating Proposed New Control Measures Previous Score Severity Probability Score Rating Risk Tolerance / Appetite Gross Risk Residual Risk SRR12 Clinical and Care Governance: Failure to have an appropriate framework in place leading to an adverse impact on the culture resulting in a reduction in the quality of the delivery of the highest quality of care and support is understood. *continuous review of arrangements for Clinical and Care Governance are essential for the delivery of statutory, policy and professional requirements and the achievement of our quality ambitions. *ongoing review of established structures and processes to assure Integration Joint Boards, Health Boards and Local Authorities *empowering clinical and care staff to contribute to the improvement of quality *making sure that there is a strong voice of the people and communities who use our services. * ensure that professional leadership develops good governance for each of the following components: culture, systems, practices, performance, vision and leadership. * delivery of the highest quality of care and support is understood to be the responsibility of everyone working in the organisation - built upon partnership and collaboration within teams, and between health and social care professionals and managers. * Health and community Care have developed a governance Board to ensure feedback to the overarching Clinical and Care Governance arrangements. 9 3 3 9 Moderate * Continue to develop and monitor key performance indicators and report effectively through governance framework. * Ensuring we further develop clear and consistent reporting frameworks acknowledging the growing risks posed to service delivery due to financial and resource contraints. 9 3 3 9 Moderate Tolerate