Agenda Document Pack - Integration Joint Board - 19/06/2025
North Ayrshire Council · 19 June 2025
Back to Integration Joint Board — 19 June 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 Meeting Thursday, 19 June 2025 at 10:00 Council Chambers, Cunninghame House, Irvine / Hybrid via Microsoft Teams Meeting Arrangements - Hybrid Meetings This meeting will be held on a predominantly physical basis but with provision, by prior notification, for remote attendance by Elected Members in accordance with the provisions of the Local Government (Scotland) Act 2003. Where possible, the meeting will be live-streamed and available to view at https://north -ayrshire.public-i.tv/core/portal/home. 1 Apologies 2 Declarations of Interest Members are requested to give notice of any declarations of interest in respect of items of business on the Agenda. 3 Minutes The accuracy of the Minutes of the meeting held on 1 May 2025 will be confirmed and the Minutes signed in accordance with Paragraph 7 (1) of Schedule 7 of the Local Government (Scotland) Act 1973 (copy enclosed). 4 Director’s Report Submit report by Caroline Cameron, Director (NAHSCP) on developments within the North Ayrshire Health and Social Care Partnership (copy enclosed). 5 Children’s Services Plan Performance Report 2024-25 Submit report by Caroline Cameron, Director (NAHSCP) on the Children’s Services Plan Performance Report 2024-25 (copy enclosed). 6 Allied Health Professions within Acute Settings Submit report by Alistair Reid, Director of Allied Health Professions, NHS Ayrshire & Arran on Allied Health Professions within Acute Settings (copy enclosed). 7 Montrose House Appraisal (Copy to follow) 1
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8 Older People’s Day Service Review Submit report by Kerry Logan, Head of Service (Health & Community Care) on the review of the delivery of day services for older people in North Ayrshire and the proposed options to IJB to identify a service model for day services (copy enclosed). 9 2024-25: Year End Financial Performance Submit report by Eleanor Currie, Interim Chief Finance Officer (HSCP) to provide an overview of the Integration Joint Board’s financial performance for the year ended 2024-25 and the implications for the overall financial position (copy enclosed). 10 Risk Appetite Statement Submit report by Eleanor Currie, Interim Chief Finance Officer (HSCP) on the IJB Risk Appetite Statement (copy enclosed). 11 Risk Management Strategy Submit report by Eleanor Currie, Interim Chief Finance Officer (HSCP) on the IJB Risk Management Strategy (copy enclosed). 12 Urgent Items Any other items which the Chair considers to be urgent. Webcasting Please note: this meeting may be filmed/recorded/live-streamed to the Council's internet site and available to view at https://north-ayrshire.public- i.tv/core/portal/home, where it will be capable of repeated viewing. At the start of the meeting, the Provost/Chair will confirm if all or part of the meeting is being filmed/recorded/live-streamed. You should be aware that the Council is a Data Controller under the Data Protection Act 2018. Data collected during the webcast will be retained in accordance with the Council’s published policy, including, but not limited to, for the purpose of keeping historical records and making those records available via the Council’s internet site. Generally, the press and public will not be filmed. However, by entering the Council Chambers and using the press or public seating area, you acknowledge that you may be filmed and that any information pertaining to you contained in the video and oral recording of the meeting will be used for webcasting or training purposes and for the purpose of keeping historical records and making those records available to the public. In making this use of your information the Council is processing data which is necessary for the performance of a task carried out in the public interest. 2
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If you have any queries regarding this and, in particular, if you believe that use and/or storage of any particular information would cause, or be likely to cause, substantial damage or distress to any individual, please contact dataprotectionofficer@north-ayrshire.gov.uk 3
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IJB Sederunt Voting Members Joyce White (Chair) NHS Ayrshire & Arran Cllr Margaret Johnson (Vice- Chair) North Ayrshire Council Cllr Tom Marshall North Ayrshire Council Cllr Anthea Dickson North Ayrshire Council Cllr Nairn Angus-McDonald North Ayrshire Council Linda Semple NHS Ayrshire & Arran Tom Hopkins NHS Ayrshire & Arran Marc Mazzucco NHS Ayrshire & Arran Professional Advisors Caroline Cameron Director Eleanor Currie Interim Chief Finance Officer Aileen Craig IJB Monitoring Officer Iain Jamieson Clinical Director Scott Hunter Chief Social Work Officer – North Ayrshire Thelma Bowers Mental Health Adviser Darren Fullarton Associate Nurse Director/ Lead Nurse Vacany Acute Services Representative Dr Louise Wilson GP Representative Sharon Hackney Lead Allied Health Professional Lynne McNiven Public Health Representative Wendy Van Riet Director of Psychological Services Stakeholder Representatives Lorna Sim Staff Rep - NHS Ayrshire and Arran Lynda MacFarlane Staff Rep Paul Smith Carers Representative Clive Shephard Service User Representative Vacancy Independent Sector Representative Vicki Yuill Third Sector Representative 4
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North Ayrshire Health and Social Care Partnership Minute of Integration Joint Board meeting held on Thursday 1 May 2025 at 10.00 a.m. involving participation by remote electronic means and physical attendance within the Council Chambers, Irvine. Present (Physical Participation) Voting Members Joyce White, NHS Ayrshire and Arran (Chair) Councillor Margaret Johnson, North Ayrshire Council (Vice-Chair) (Chair) Councillor Nairn Angus- McDonald, North Ayrshire Council Councillor Anthea Dickson, North Ayrshire Council Sharon Morrow, NHS Ayrshire and Arran Professional Advisers Caroline Cameron, Director of Health and Social Care Partnership Thelma Bowers, Head of Service (Mental Health) (NAHSCP) Darren Fullarton, Associate Nurse Director/ Lead Nurse Eleanor Currie, Interim Section 95 Officer Scott Hunter, Chief Social Work Officer Sharon Hackney, Lead Allied Health Professional Stakeholder Representative Lynda McFarlane, Staff Representative Paul Smith, Carer Representative Present (Remote Participation) Voting Members Tom Hopkins, NHS Ayrshire and Arran Marc Mazzucco, NHS Ayrshire and Arran Professional Advisers Lynne McNiven, Public Health Representative Stakeholder Representative Hazel Brown, Third Sector Representative Lorna Sim, Staff Representative NHS Ayrshire and Arran Agenda Item 3 5
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In Attendance (Physical Participation) Elizabeth Stewart, Head of Service (Children, Families and Justice) Kerry Logan, Head of Service (Health and Community Care) Michelle Sutherland, Partnership Facilitator (Health & Community Care) Joanne Inglis, Senior Manager (Children and Families) Lee Ballantyne, Senior Manager (Strategic Planning & Transformation) Seony Ross, Team Manager (Strategic Planning & Equalities) Karen Andrews, Team Manager (Governance) Raymond Lynch, Senior Manager (Legal Services) Hayley Young, Senior Committee Services Officer Claudia Cheung, Digital, Media and Marketing Analyst Apologies Councillor Tom Marshall, North Ayrshire Council Iain Jamieson, Clinical Director Vicky Yuill, Third Sector Representative Aileen Craig, IJB Monitoring Officer 1. Apologies for Absence Apologies for Absence were noted. 2. Declarations of Interest There were no declarations of interest in terms of Standing Order 7.2 and Section 5.14 of the Code of Conduct for Members of Devolved Public Bodies. 3. Minutes The accuracy of the Minutes of the meeting held on 20 March 2025 were confirmed and the Minutes signed in accordance with Paragraph 7(10 of Schedule 7 of the Local Government (Scotland) Act 1973. It was noted that Agenda Item 7 (Revenue Budget 2025-26 and beyond report) was subject to confirmation by NHS Ayrshire and Arran, which was recently approved. 4. Director’s Report Submitted report by Caroline Cameron, Director (NAHSCP) on the developments within the North Ayrshire Health and Social Care Partnership. Officers responded to members’ questions on various aspects of the report. Noted. 6
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5. Enhancing the Delivery of the Health Visiting Service : Scotland’s Health Visiting Action Plan 2025-2035 Submitted report by Caroline Cameron, Director (NAHSCP) on the recently published plan and implications for the health visiting service in North Ayrshire. The national actions together with a narrative around current local activity within the Health Visiting service in North Ayrshire was set out at Appendix 1 to the report. Officers responded to members’ questions on various aspects of the report. Noted. 6. Appointments Submitted report by Caroline Cameron, Director (NAHSCP) on the recent appointments and changes to IJB membership. Officers responded to members’ questions on various aspects of the report. The report detailed the appointments as follows:- Joyce White OBE, as the non-Executive NHS Ayrshire and Arran member of the IJB to assume the role of Chair of the IJB following the rotation of the roles of Chair and Vice-Chair, and also Vice-Chair of the Strategic Planning Group; Councillor Margaret Johnson, as Vice-Chair of the IJB, following the rotation of the roles of Chair and Vice-Chair, and also Chair of the Strategic Planning Group; Councillor Nairn Angus-McDonald rotating to assume the role of Chair of the IJB Performance and Audit Committee; and Marc Mazzucco rotating to assume the role of Vice-Chair of the IJB Performance and Audit Committee. The Board agreed to approve the recent changes and appointments to IJB and the related governance groups. 7. Enhanced Mental Health Outcomes Framework Budget Submitted report by Thelma Bowers, Head of Service (Mental Health) on the future priorities for the Enhanced Mental Health Outcomes Framework budget and service changes in alignment with Scottish Government strategic priorities. Details of the objectives and expected outcomes was set out at Appendix 1 to the report. Officers responded to members’ questions on various aspects of the report. Noted. 8. North Ayrshire – The Promise Submitted report by Caroline Cameron, Director (NAHSCP) on the ongoing work within North Ayrshire to deliver “The Promise” to our Children and Young People. The Oversight board report three was set out at Appendix 1 to the report. Officers responded to members’ questions on various aspects of the report. 7
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Noted. 9. Equality Outcomes 2025-2029 Submitted report by Lee Ballantyne, Senior Manager (Strategic Planning and Transformation) on the new Equality Outcomes for the IJB set out at Appendix 1 to the report. The Policy review list was set out at Appendix 2 to the report. Officers responded to members’ questions on various aspects of the report. The Board agreed to approve proposed Equality Outcomes set out at Appendix 1 to the report. 10. Strategic Planning Group Meeting Minutes Submitted, for information the minutes in relation to the Strategic Planning Group Meeting on 19 November 2024. Noted. The meeting ended at 11.30 pm. The full meeting proceedings can be viewed at https://north-ayrshire.public-i.tv/core/portal/home 8
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Integration Joint Board 19th June 2025 Subject : Director’s Report Purpose : This report is for awareness to advise members of North Ayrshire Integration Joint Board (IJB) of developments within North Ayrshire Health and Social Care Partnership (NAHSCP) Recommendation : IJB members are asked to note progress made 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 IJB Integration Joint Board HSCP Health and Social Care Partnership SDS Self Directed Support PA Personal Assistant PVG Protection of Vulnerable Groups CEDS Community Eating Disorder Service CHES Collaboration for Health Equity in Scotland NEST Neurodevelopmental Empowerment and Strategy Team ADP Alcohol & Drug Partnership PSST Prevention and Service Support Team NADARS North Ayrshire Drug and Alcohol Rehabilitation Services PEAR Prevention, Early Intervention and Recovery Service COSLA Convention of Scottish Local Authorities 1. EXECUTIVE SUMMARY 1.1 This report informs members of the Integration Joint Board (IJB) of the work undertaken within North Ayrshire Health and Social Care Partnership (NAHSCP), nationally, locally and Ayrshire wide. Agenda Item 4 9
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2. BACKGROUND 2.1 This report provides IJB with up to date information on recent activity across the HSCP since the last IJB. The report will also provide COVID related information by exception. 3. CURRENT POSITION National Developments 3.1 Social Work Governance Thematic Review The Review of Social Work Governance and Assurance across Scotland was published on 6th May 2025. The report presents the key messages from the review of how well social work governance and assurance arrangements support leaders to ensure statutory duties are carried out safely and effectively, enable staff to be supported and effective in their practice and assist staff to uphold core social work values. It includes reflections for social work services and partners Scotland wide to consider in order to improve outcomes for people. The review found that overall, social work leaders and managers in Scotland worked effectively within often complicated governance arrangements. In most cases these arrangements were well understood by staff. Social work assurance was mostly effective and overall staff felt supported to deliver effective services. However, inspectors also found that Scotland’s social work services were finding it challenging to match supply with demand and this was exacerbated by increased levels of complexity of need and risk. This meant that social work was at risk of being unable to fulfil its statutory duties in some service areas. North Ayrshire was highlighted as an area of good practice within the report. 3.2 Care Reform (Scotland) Bill The Care Reform (Scotland) Bill passed Stage 3 in Parliament on 10th June 2025, the Bill was previously known as the National Care Service (Scotland) Bill. The Bill has significantly changed from that proposed as part of the NCS Bill, with legislation now focussing on: • Delivery of Anne’s Law which will uphold the rights of care home residents to see their loved ones. • Establishes a legal right to unpaid breaks for unpaid carers. 10
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• Creates a Chief Social Work Advisor role to provide professional leadership and champion the sector as part of a National Social Work Agency. • Improve access to independent advocacy. • Bring forward a new digital integrated health and care record through information sharing improvements, including sharing of information with individuals. • Changes to procurement and commissioning of social care services with a focus on ethical commissioning through the development of tools and guidance to support delivery at a local level. A National Care Service Advisory Board is currently being established to drive progress and scrutinise reform, replacing an interim board which met in May 2025. 3.3 Charter for Rights for People Affected by Substance Use As part of the Scottish Government’s National Mission on Drugs to reduce drug related deaths and improve lives, a National Collaborative was established to integrate human rights into drug and alcohol policy, leading to better outcomes for people affected by substance use. A Charter of Rights and supporting Toolkit have been co-designed by a Change Team with life experience and through extensive consultation with people affected by substance use and with people responsible for design, delivery and monitoring of substance related support services. The Charter outlines key rights which are drawn from both national and international law and describes how they apply to people affected by substance use. It also contains general information on feedback, complaints and advocacy. The Toolkit provides practical guidance to both duty-bearers and rights-holders, including guidance on taking a Human Rights-Based Approach and a checklist to support assessment of the right to health in practice. Emerging practice will be captured to share ideas and learning as a human rights- based approach is developed and delivered by duty bearers. The Scottish Government has made a commitment to bring forward the Human Rights Bill in the next parliament if they are returned to government. Using a human-rights- based lens now will help in preparation for any new legislation. The Charter and Toolkit are a guide to good practice and align with the Scottish Government’s key priority of ensuring high quality and sustainable public services. 3.4 Drugs and Alcohol Workforce Knowledge and Skills Framework The Scottish Government has now published the Drugs and Alcohol Workforce Knowledge and Skills Framework. The Framework serves as a guide for practitioners, 11
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commissioners, managers and service providers to understand the knowledge and skills required by the drugs and alcohol workforce, in addition to any professional or clinical standards. The Framework is not mandatory and does not affect the rights and duties of employees and employers. The Framework does not replace existing standards. The Framework allows practitioners to demonstrate how they meet existing standards within their scope of practice. This is complemented by the Drugs and Alcohol Learning Directory. The Learning Directory gives staff access to a wide range of resources to help develop knowledge and skills. It’s designed to support personal and professional growth by providing the most up-to-date and relevant learning opportunities. 3.5 Rethink Dementia – New Campaign The Scottish Government's 'Rethink Dementia' campaign, in partnership with COSLA, has been launched and aims to challenge the stigma surrounding dementia. Dementia affects an estimated 90,000 people in Scotland, 3,000 of whom are under the age of 65. Insight informing the campaign highlighted that many people associate dementia with the later stage of the illness and therefore change their behaviour towards a friend or family member who has been diagnosed. Further information on supporting someone with a dementia diagnosis, can be found on the campaign page on the NHS Inform website. 3.6 Changes to PVG for Personal Assistants under SDS A new law came into force in April 2025 that makes it a legal requirement for Personal Assistants employed through Self-directed Support to join the PVG scheme. Disclosure Scotland, which manages the PVG scheme, has prepared information for Employers through Self-directed Support and PAs to help them understand the changes. More information, including the answers to some frequently asked questions, can be found in the PA Employer and PA handbooks below, or at the Disclosure Scotland website. Protecting Vulnerable Groups (PVG): For PAs Protecting Vulnerable Groups (PVG): For PA Employers 4. Ayrshire Wide Developments 4.1 Webinar Series Community Justice 12
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The Community Justice Ayrshire Partnership’s Community Justice Outcomes Improvement Plan contains a priority action to ‘support integration and reduce stigma by ensuring the community and workforce have an improved understanding and confidence in community justice’. To support this action, a Community Justice Information Series has been developed, which will involve a series of webinars being held throughout the year. The webinars are open to all partners and stakeholders working across Ayrshire, places can be booked for any of these by following the links below: What are community sentences? Wednesday 17 September, 2pm to 3pm Community justice – facts, figures and myth busting Wednesday 29 October, 2pm to 3pm How do we support people when they are leaving prison? Wednesday 3 December, 2pm to 3pm 5. North Ayrshire Developments 5.1 Membership Following a recent review by Lesley Bowie, Chair of NHSAA Board of Board member representation on IJBs across Ayrshire, Sharon Morrow, our NHS Board member will be replaced by Linda Semple, the current Chair of South Ayrshire IJB with effect from 12th June 2025, with Sharon joining South Ayrshire IJB from that date. Thanks to Sharon for her input over her short time on the North IJB and a warm welcome to Linda. 5.2 CHES Update The second North Ayrshire Collaborating for Health Equity Steering Group met on the 4th June 2025 to identify key priorities and areas of focus to be taken forward across partner agencies as part of the programme. A local data group has been established to identify key deprivation, health outcome and social determinants of the health indicators in North Ayrshire to ensure an evidenced based approach to the programme. 19 data representatives from across a range of partners met to identify and map at three geographic levels: • Local Authority • Locality (total of 6) • Intermediate zones (total of 38) 13
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The following approach was used: From the evidence available the Steering Group agreed to and enhanced focus initially on Marmot Principles: 1. Give every child the best start in life, 3. Create fair employment and good work for all, and 6. Strengthen the role and impact of ill health prevention. The Steering Group then prioritised by localities with Irvine, the Three Towns, and the Garnock Valley identified to deliver the biggest gains through proportionate universalism, resource realignment and enhanced supports. The next steps are to adopt a ‘deep dive’ approach for the three identified principles across the agreed geographies, which will include partners providing further management and locally available information to develop further understanding of local challenges and opportunities. An engagement working group has also been formed and will meet on the 24th June 2025 with leads from the Third Sector Interface, The Ayrshire Community Trust, HSCP, Public Health and North Ayrshire Council Connected Communities to inform and co-produce the involvement of the community in the CHES programme. The programme continues to be supported by Public Health Scotland and the Institute of Health Equity with a national CHES External Advisory Group also established. 5.3 Peace of Mind Drop in Event Peace of Mind is an innovative programme aimed at reducing social exclusion and isolation as a result of a disability, impairment or long-term health condition, with a 14
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particular emphasis on people who do not receive statutory services but still need support. The service is holding its next drop-in information event on Tuesday 24 June from 1pm to 4pm at the George Steven Centre, Craigton Road, Kilbirnie, where anyone can go along and find out more about how it works, pick up some leaflets and learn how to get involved. 5.4 Practice Standards Learning and Development Update Recent activity within the Practice Standards Learning & Development Team during the first quarter of 2025 has centred around the continuing “Growing our Own” annual sponsorship opportunities for the Social Work Degree. There are currently 12 employees being sponsored to undertake the degree qualification; they are all at varying stages of the process with four qualifying as social workers in the summer of this year and a further two in the summer of 2026. This and the recent application process for the 2025/26 cohort where three employees were successful in gaining a place on the programme contributes to the ongoing drive to increase staff sufficiency across social work services. Recent SSSC Annual Workforce Data Report shows there was an increase of 23% in the social work workforce in NAHSCP. This is testament to the implementation of the “Be the Best You can Be” Learning and development Strategy 2023/28 which outlines the qualification pathways and annual development offers to staff. Our Commitment to developing and valuing the workforce also extends to additional post qualifying opportunities where there is a theme of increasing demand and uptake of qualifications including Child and Adult Protection Post Qualifying Certificates and the uptake of the Professional Development Award in Practice Learning which again supports the sustainability of robust social work student placement opportunities. During the past few months two Social Work employees embarked on a pilot programme from Robert Gordon University to deliver a local bespoke MHO Award which offers the opportunity for learning directly related to local practice. Both are nearing completion of the qualification and will then practice as dispersed MHO’s in North Ayrshire and a further two employees will commence the award in September. 5.5 New Video – NEST The Neurodevelopmental Empowerment and Strategy Team (NEST) has produced a new video to help members of the public get the most out of searching for local sources of support via the NEST website. The video, which is on the NEST website and NAHSCP YouTube channel, looks at how to use the search function to find specific services in your area, how to browse all services if you’re not sure which type of support could be useful, and where to find 15
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accessibility options on the site. It also highlights how to get in touch if you can’t find the support you are looking for. The video will be shared regularly on the NAHSCP Facebook and X pages. The NEST Hub is full of useful resources for neurodivergent people and their families, and a diagnosis isn’t required to access it. Individuals can also find lots of helpful advice and tips, as well as news on upcoming workshops and activities, on the NEST Facebook page. 5.6 Opening of West Road, Irvine A new centre that aims to change the way the residents of Ayrshire and Arran receive mental health care has been officially opened by North Ayrshire Provost Anthea Dickson. The West Road Centre in Irvine is our new base for outpatient services for the all-age Community Eating Disorder Service (CEDS) and the Neuro-CAMHS team (Child and Adolescent Mental Health Service), providing a modern space for individuals to receive the support they need. The building, which is owned by North Ayrshire Council, was previously used by North Ayrshire Health and Social Care Partnership’s Child and Family Disability Service. It has recently undergone an extensive refurbishment to create a calm and welcoming environment designed specifically to suit the needs of clients and staff teams, with a treatment room, kitchen area, clinical rooms, and a sound-proof therapeutic room that can be used for activities such as music therapy. 16
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5.7 Donation for young People in Care Many young people coming into care often do so with their belongings in carrier bags. While searching for reusable bags to be given to young people in this situation, a social worker from the Garnock Valley Children and Families Team came across the award-winning bag brand Madlug. The Madlug movement came about in 2015, after founder Dave Linton was saddened to hear about children having their belongings moved in this way and set out to make a difference. The company now operates on a ‘buy one, wear one, help one’ basis, where for every bag sold through the website, a free travel bag is donated to a child in care. It worked with care experienced young people, as well as health trusts and local authorities, to develop a pack-away bag that is centred around the needs of children and young people in care. The bag itself is unbranded to avoid stigma, with each bag also having a label that reads “you are incredible,” reminding every child and young person that they have value and dignity. After a successful application, Madlug has now very kindly donated two large boxes of bags to the team. 5.8 ADP Early Intervention and Prevention Schools Partnership This year saw the first Education and Prevention Roadshow for all S1 pupils across our North Ayrshire schools with around 1,285 participants. Partners from PSST, Children First, KA Leisure, NADARS, Turning Point PEAR, Police Scotland and Trading Standards were keen to be involved and deliver workshops about vaping, stigma, keeping safe, lived experience, myth busting and getting a better understanding of the impact of alcohol and drugs on health, families and our communities. The feedback from schools and young people has been positive and plans are underway to further develop and deliver the roadshow in session 2025/26 for the new S1’s. A six-week alcohol and drug prevention programme has been developed and delivered for our young people attending Extended Outreach this has been requested again and will be delivered to a new cohort of young people in the new session. 17
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In October 2025, all North Ayrshire secondary schools have been offered a performance for S3 pupils from the TIE theatre company funded by the ADP. Mark Wheellers ‘I Love You, Mum - I Promise I Won’t Die’ promises to be moving and thought-provoking to prompt discussion about the impact of recreational substance use exploring risk and the impact on families and communities. School staff will deliver a series of 4 lessons linked to the play to embed learning. In response to staff engagement the ADP in partnership with education is hosting an Education and Prevention conference on the 25th of November 2025 at the Riverside Lodge Hotel in Irvine. This multi-agency event will provide an opportunity to upskill staff and facilitate networking opportunities. Emily Broadis and Megan MacPherson, paediatricians and public health experts from NHS Ayrshire and Arran will attend to share the impact of vaping on children’s health outcomes. They will also talk about the progress being made within Ayrshire’s vaping taskforce. 5.9 New Poster Signposts to Youth Supports The recent NAHSCP Youth Engagement Survey highlighted some calls for support and the need for youth friendly resources. While we continue to analyse the data gathered from the survey in detail, we’ve created a poster featuring QR codes that link to sources of support across all of the topics raised. We’d really appreciate it if you could share this poster through any of the same channels where the original survey was distributed - whether that’s newsletters, social media, websites, or physical spaces. Our aim is to ensure that information and support are accessible to all young people who may need it. If anyone would like a PDF copy of the poster to print off and display, please contact nicolateager@north-ayrshire.gov.uk 5.10 Open Day Event – Castleview The HSCP Moving and Handling Team held an open day for unpaid carers on Wednesday 11th June, Castleview Hub, 97 Glasgow Street, Ardrossan. The event showcased the support available to carers from a wide range of organisations, including dementia support services, Scottish Fire & Rescue, SP Energy Networks, AILN, Lemon Aid, and many more. 18
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6. IMPLICATIONS 6.1 Financial None 6.2 Human Resources None 6.3 Legal None 6.4 Equality/Socio-Economic None 6.5 Risk None 6.6 Community Wealth Building None 6.7 Key Priorities None 7. CONSULTATION No specific consultation was required for this report. User and public involvement is key for the partnership and all significant proposals will be subject to an appropriate level of Consultation. Caroline Cameron, Director [Carolinecameron@north-ayrshire.gov.uk/01294 317723] Appendices Nil 19
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North Ayrshire Integration Joint Board 19th June 2025 Subject : Children’s Services Plan Performance Report 2024- 25 Purpose : • Awareness Recommendation : The Integration Joint Board are asked to: a) Note the key achievements contained in the North Ayrshire Children’s Services Plan Performance Report 2024-25 and; b) Note that the report will be submitted to the Scottish Government. 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 CPP Community Planning Partnership CSSP Children’s Services Strategic Partnership GIRFEC Getting it Right for Every Child FCWS Family Centred Wellbeing Service WRO Welfare Rights Officer ASN Additional Support Needs 1. EXECUTIVE SUMMARY 1.1 Every Local Authority and relevant Health Board are required to jointly prepare a Children's Services Plan for the area of the local authority for each three-year period. Plans are developed 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 development and review of the Plan. We published our Children’s Services Plan 2023-26 in June 2023. 1.2 Our Children’s Services Plan Performance Report 2024-25 is prepared in collaboration with the Children’s Services Strategic Partnership (CSSP) which consists of representatives from our Community Planning Partners. We have a duty under the Children and Young People (Scotland) Act 2014 to produce a Children’s Services Plan Performance report at the end of each year. Agenda Item 5 21
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1.3 Our Children’s Services Plan Performance Report 2024-25 highlights some of the key achievements and areas of work which impact on Infants, Children, Young People and their families. 2. BACKGROUND 2.1 Part 3 of the Children and Young People (Scotland) Act 2014 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. The aims are about creating and maintaining a local environment which facilitates Getting it Right for Every Child Practice (GIRFEC) for individual children and young people. 2.2 Section 13 (1) of the Act requires that as soon as practicable after the end of each one-year period, a local authority and the relevant health board must publish (in such manner as they consider appropriate) a report on the extent to which: a) children’s and related services have, in that one-year period, been provided in accordance with the Children’s Services Plan; and b) that the provision of services has achieved – i. the aims of children’s services planning (section 9(2)), and ii. such outcomes in relation to the wellbeing of children in the area as the Scottish Ministers may by order prescribe. 2.3 The “one-year period” runs from 1 April to 31 March. Each Children’s Services Plan must be prepared in relation to a specific “three-year period”, so over the course of a Children’s Services Plan there will be three annual reports. 2.4 Our 2023-26 Children’s Services Plan continued our vision 'For all our children and young people to have the best start in life and for North Ayrshire to be the best place in Scotland to grow up'. The Performance Update Report 2023-24 has been structured in line with our five priorities set out in the Plan. These are – 1. The rights of children and young people are promoted and protected. 2. Acting early to improve what happens next. 3. Making Things Fairer 4. Promoting good mental health and wellbeing 5. Inspiring children and young people to be active 2.5 A set of actions were identified to be delivered by CPP partners. Updates on the progress of the actions has been included in Appendix 1 of the report. We have established an initial set of indicators to measure progress, as attached in Appendix 2 of the report. 22
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2.6 At the end of April 2024, the Scottish Government provided feedback on our 2023-26 Children’s Services Plan. Feedback is intended to support us to consider areas of strength and areas for development. Overall, feedback concluded that the Plan is comprehensive, ambitious and informative. It is well linked to other local and national plans and frameworks, including the National Performance Framework, GIRFEC and Child Poverty Action Plan. Strategic priorities and actions are clear, and there is clear evidence that children, young people and families have contributed to the development of the plan. 2.7 Areas for development were to provide information about monitoring and evaluation of progress, including a set of specific and measurable progress indicators linked to each priority. Partners have identified a set of relevant measures which are included as Appendix 2 to the report. These are intended to act as a baseline and will be reviewed and updated regularly to assist with improvement activity. 2.8 A summary version of the report will be produced over the summer months to ensure it is fully accessible and engaging for our young people. Some of our key highlights from the 2024-25 Performance Report include: • 97% of our education establishments were engaged in the Rights Respecting Schools accreditation process (2023-24 academic year). • St Matthew’s Academy, Saltcoats, has become the first secondary school in Scotland to receive a prestigious accolade for digital education - the Digital Schools Endorsement Award. • The Executive Youth Council has 12 active members from across North Ayrshire, representing the views and voices of our young people across schools and communities. Currently the group are working in partnership with Education staff to design and launch a Pupil Council Toolkit that will give schools the tools and resources to support pupil voice structures. • 115 children and young people have accessed the Young Carers Fund this year, helping to improve or maintain the young person’s physical, emotional mental health and wellbeing or life chances, reduce social isolation, and improve attainment. • The annual Promise Conference was held in December 2024. 73 Care Experienced young people from across our Secondary Schools joined the conference to learn about The Promise Scotland Plan 24-30, meet local Corporate Parents and connect with each other. • The Signs of Safety practice model has been implemented across our Children and Families Service from the point of referral to Service Access. The Signs of Safety model works in collaboration with families to identify strengths and family and wider support networks who can assist to support the children’s wellbeing or child protection plan that has been established. • Over 5,000 children aged 0-4 years in North Ayrshire are supported by either a Health Visitor or a Family Nurse • The Family Centred Wellbeing Service (FCWS) are a team of 14 wellbeing workers who support supported over 170 families, with sessions provided within the family’s homes, within our offices, community buildings and schools. 23
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• 96% of our school leavers moved into an initial positive destination, in line with session 2022-23. • 424 young people engaged with the MCR Pathways Young Talent Programme • Our Welfare Rights Officers (WROs) provide support and help to identified families regarding possible access to and/ or changes to benefits. This year, Welfare Rights Officers delivered training and provided briefings for education staff, and in 2024-25 the service was expanded to include all Educational Establishments. In total, the financial gains for families since the project began is over £1.8 million, with a further £818,000 coming in financial year 2024-25. • Whole school approaches to supporting positive relationships and behaviour have been taken forward across the authority with policy and practice being developed on universal, targeted and intensive approaches. Building on positive relationships (BPR) family groups have been extended with 18 groups being run this session. Active Schools key focus has remained on getting ‘More Kids, More Active, More Often’. Extra-curricular provision has been delivered across all primary, secondary and ASN establishments. Over 9,200 young people have attended a variety of sport and physical activity sessions across this year, which is over 52% of the whole young people population. • There are 1024 active Duke of Edinburgh participants where physical health is part of all participants award. • The Children and Young Peoples’ Community Mental Health and Wellbeing Supports and Services funding has supported 6527 children and young people and 1212 family members through a range of programmes. 2.9 The Children’s Services Strategic Partnership also monitors the Whole Family Wellbeing Fund. The Whole Family Wellbeing Fund is a £500 million investment over the life of the Scottish Parliament (2022 to 2026). Appendix 3 of the Report provides a summary of progress to date including updates on the previously agreed proposals and new developments, as well as the current funding position. It also highlights the annual report which is in line with the North Ayrshire Whole Family Wellbeing Fund Monitoring and Evaluation Framework, as well as the Scottish Government monitoring requirements. 3. PROPOSALS 3.1 It is proposed that IJB notes the key achievements contained in the attached North Ayrshire Children’s Services Plan Performance Report 2024-25 and; notes that the report will be submitted to the Scottish Government by the end of June 2025. A child friendly version of the report will be published as soon as possible. 3.2 Anticipated Outcomes Publication of the report will meet the statutory reporting requirements laid out in Section 13(1) of Part 3 of the Children and Young People (Scotland) Act 2014. 24
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The Report will inform the residents of North Ayrshire about progress related to our Children’s Services Plan and raise awareness of the key priorities that link to everything we do. These are – 1. The rights of children and young people are promoted and protected. 2. Acting early to improve what happens next. 3. Making Things Fairer 4. Promoting good mental health and wellbeing 5. Inspiring children and young people to be active 3.3 Measuring Impact Impact is measured by the Performance Indicators contained in the report and also by the use of narrative and case studies to describe impact on families, children and young people. 4. IMPLICATIONS 4.1 Financial None 4.2 Human Resources None 4.3 Legal We have a duty under the Children and Young People (Scotland) Act 2014 to produce a Children’s Services Plan Performance report every year detailing the activities undertaken in relation to Children’s Services. 4.4 Equality/Socio-Economic None 4.5 Risk None 4.6 Community Wealth Building None 4.7 Key Priorities This report directly supports our Council’s vision of creating ‘a North Ayrshire that is Fair for All’ and our mission of ‘Working together to improve the lives our people in North Ayrshire’. It demonstrates how we are contributing all of our priorities ‘Wellbeing’, ‘Communities and Local Democracy’, ‘Climate Change’ and ‘A Sustainable Council’ in ensuring children’s rights are embedded throughout our services. This report directly supports the Health and Social Care Partnership Strategic Plan and vision to ensure that ‘People who live in North Ayrshire are able to have a safe, healthy and active life’. This report directly supports the North Ayrshire Community Planning Partnership Plan and three key themes of ‘Wellbeing’, ‘Work’ and ‘World’. 25
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5. CONSULTATION Contributions from services across our Council and Partners have been included in this report. Services regularly consult with children, young people and families. A Young Person’s version of the report will be developed over the summer months to ensure it is fully accessible for our young people. The Annual Report will also be presented to the Children's Services Strategic Partnership, North Ayrshire Council Cabinet and NHS Ayrshire and Arran. Caroline Cameron, Director (North Ayrshire Health and Social Care Partnership) Lauren McMath, Policy Officer (Childrens Services), 01294 324160 or email: laurenmcmath@north-ayrshire.gov.uk Appendices • North Ayrshire Children’s Services Plan Performance Update report 2024-25 • Appendix 1: Children’s Services Action Report 2024-25 • Appendix 2: Children's Services Performance Indicators Report 2024-25 • Appendix 3: Whole Family Wellbeing Fund Annual Summary Report 26
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Children’s Services Plan – Performance Report 2024-25 27
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2 Welcome Welcome to our 2024-25 annual report. This report will demonstrate some of the key work of the North Ayrshire Children’s Services Strategic Partnership and shows our progress and achievements over the past year. We have been working towards our shared vision for ‘North Ayrshire to be the best place in Scotland to grow up’ and continuing to focus on promoting children and young people’s wellbeing, underpinned by Getting it Right for Every Child (GIRFEC) and the United Nations Convention on the Rights of the Child (UNCRC). We recognise that our strong partnership foundation in North Ayrshire provides continued commitment to collectively focus on improving outcomes for our infants, children, young people and their families. We will continue to strive to ensure we place them at the very heart of service delivery so we can provide the right support at the right time. I would like to thank all those who deliver the amazing work every day to ensure our infants, children, young people and their families have the best opportunity to live safe, healthy and active lives and achieve their full potential. Caroline Cameron Director North Ayrshire Health and Social Care Partnership (Chair of North Ayrshire Children’s Services Strategic Partnership) 28
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3 Introduction This report focuses on the collaborative working of the partner members over the past year and has been organised around the five Children’s Services Plan Priorities. We are currently reporting on the second year of our Children’s Services Plan which covers the period of 2023 to 2026. Our 2023-26 Children’s Services Plan has five Strategic Priorities which are shown below. Our Children’s Services Strategic Partnership is the responsible group providing leadership in the delivery of the Children’s Services Plan’s vision of our children and young people having the best start in life and for North Ayrshire to be the best place to grow up. This strategic group includes members from: o North Ayrshire Council o NHS Ayrshire and Arran o North Ayrshire Health & Social Care Partnership o Police Scotland o Scottish Children’s Reporters Administration o Care Inspectorate o Children’s Panel o Third Sector o Scottish Fire and Rescue o Ayrshire College o KA Leisure Appendix 1 provides detailed updates for the 2023-26 Children’s Services Plan Actions Appendix 2 provides Performance Indicator data For any further information please contact Lauren McMath, laurenmcmath@north- ayrshire.gov.uk 29
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4 Priority 1: The rights of children and young people are promoted and protected Key Highlights and Progress Children’s Rights We have been working to champion the United Nations Convention on the Rights of the Child (UNCRC), ensuring that all children in North Ayrshire have their rights met, protected and advocated for. In July 2024, the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024 came into effect. The Act provides protection for the human rights of children and young people in Scotland. Young people have been actioning UNCRC Article 12 (right to be heard) through a host of events, activities and online engagements. Our Executive Youth Council are in the process of designing and developing a Pupil Council Toolkit in partnerships with Education. The incorporation of UNCRC is a key focus of training staff and young people in UNCRC awareness, realising rights and child friendly reporting. Rights Respecting Schools remained a focus during academic session 2023-24 with 97% of establishments engaged in the accreditation process. This number is significantly higher than the Scottish average of 78%. LGBT Youth Scotland Charter North Ayrshire secondary schools are championing equality as they work to maintain their LGBT Youth Scotland Charter of Education status. Guided by the Equality Act 2010 and known in schools as the LGBT Charter, the programme is based on the Universal Declaration of Human Rights and the United Nations Convention on the Rights of the Child. 30
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5 Being accredited enables schools to share a positive message championing the LGBT community, with confidence, where all LGBTQ+ staff, parents and learners can be safe, supported and included. Six North Ayrshire secondary schools have now either achieved or are on their journey to achieving their next level LGBT Charter for Education accreditation. There are four LGBT Charter award levels offered - Foundation, Bronze, Silver and Gold - with accreditation taking anywhere between 12 and 18 months to complete. Greenwood Academy currently hold Silver Level accreditation and are working towards the highest accolade of Gold. Although not a school – the Youth Services team part of the council’s Community Learning and Development team and should still be recognised equally for their accomplishments to achieve the Silver Level. Arran High School, Garnock Community Campus, Largs, Kilwinning, Irvine Royal (pictured above) and Auchenharvie Academies who currently hold Bronze, are the schools working hard this year to level-up to Silver accreditation. We understand that many young LGBT people can often experience a sense of isolation and unfortunately can face many barriers in life including feeling discriminated against or being socially disconnected from their peers. 31
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6 Examples of recent status work include: The Umbrella Group’s Purple Friday Bake Sale at Garnock Academy raising £70 for LGBT Youth Scotland Irvine Royal’s LGBT film screening and LGBT Icons History session A series of creative workshops run by North Ayrshire Youth Services to encourage their Modern Apprentices and Joint Youth Forum to create positive poetry and messages to be shared on social media during LGBT History Month The LGBT Charter is just one of the many ways we are working to safeguard young people with protected characteristics so that they can become confident learners and empowered citizens who can be their true, authentic selves. 32
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7 Engagement and Consultation Our Youth Services Team are central to the engagement and consultation with our young people through various methods including community-based youth forums, executive youth council, thematic youth work groups, Joint Cabinet (pictured below), P7 youth council and various other events. We also actively engage with young people to gather their views and opinions through online methods and social media. These topics are co designed and produced with young people and provide valuable data to inform polices, plans and service delivery. We continue to work with a range of partners to ensure young people are given the opportunity to be involved in their local community. Nationally this includes Youth Scotland, Youthlink, Young Scot and Scottish Youth Parliament. We work with a range of third sector organisations to support youth work delivery including Arran Youth Foundation, Police Scotland, Beith Trust, PRYDE, Irvine Youth Legacy Hub and many more. 33
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8 Through consistent engagement and consultation, we identify local need, service provision gaps and needs and wants of young people. Fire and rescue, Police Scotland, Education and KA leisure partnered with us to lead a S3 Leadership programme. Within the 2024-25 academic year, there is an on-going pilot of Education Scotland’s Young Leaders of Learning programme across 8 secondary schools, 10 primaries within a single cluster and an early years establishment. This programme seeks to strengthen learner participation and support improvement through pupil led improvement activities, which ensures pupil voices are heard and views are respected. The Executive Youth Council has 12 active members from across North Ayrshire. This overarching youth voice structure represents the views of our young people across schools and communities. Currently the group are working in partnership with Education staff to design and launch a Pupil Council Toolkit that will give schools tools and resources to support pupil voice structures. The group have recently held their AGM where the board were elected. The group have recently led our Joint Youth Forum that brings all of our youth voice groups together from each locality to work on common aims and receive training. Executive Youth Council is the overarching youth voice structure representing the views of young people across our schools and communities. 34
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9 The session held in February included an introduction to the Mental Health and Wellbeing pilot of financial literacy and wellbeing, working on the pupil council toolkit and creating poems and literature to support the LGBT work we do locally. Young people also had the opportunity to update us on what UNCRC means to them which will be used to create a comms media plan for the future. Our MSYPs continue to be the representative voice for young people and have been working to gather views for the Scottish Youth Parliament Manifesto. Furthermore, they are working on their national campaign priorities around access to youth work, mental health and wellbeing and gender-based violence. Various Youth Forums sit on working groups – Through Our Garnock Valley, MSYPs sit on Irvine Town Board, North Coast Youth Forum are supporting Helter Skelter issue funds through their funding applications. 35
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10 Digital Learning St Matthew’s Academy, Saltcoats, has become the first secondary school in Scotland to receive a prestigious accolade for digital education - the Digital Schools Endorsement Award. The Digital Schools Awards (DSA) is a national awards scheme that promotes, recognises and encourages a whole-school approach to the use of digital technology. By June 2024, a total of 22 schools have achieved their Digital Schools Award with almost all schools registered and on their journey towards completion of the Award. An established network of Digital Coordinators continued to meet termly to develop digital skills and cascade these within their school contexts. To support the development of our learners’ digital skills, 26 courses were delivered with over 560 teaching staff involved. St Matthew’s Academy in Saltcoats has become the first secondary school in Scotland to receive a prestigious accolade for digital education. 36
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11 Sustainability and outdoor learning We are supporting schools to engage with partner organisations and national programmes that enhance learning for sustainability. Engagement with Keep Scotland Beautiful Climate Action Schools is very positive. During the 2023-24 academic session, 24 primary schools participated in Climate Ready Classrooms. A further 25 schools hold a current Eco-schools accreditation and 3 schools are participating in the Learning about Forests programme. Improving teaching and learning outdoors has been supported through the Go Wild professional learning programme that was delivered to two early years settings and nine primary schools during 2023-24 school year. The Go Wild programme supported early years practitioners and primary teaching staff with a variety of practical activities to support the delivery of literacy and STEM (science, technology, engineering and maths) activities outdoors. Training was delivered jointly by North Ayrshire Countryside Rangers and the STEM Education Support Officer and focussed on: activities for speaking and listening outdoor areas as a context for creative writing den building fire lighting activities to deepen understanding of biodiversity STEM Awareness: British Science Week (7-16 March) North Ayrshire STEM team also recently raised awareness via social media of biodiversity, renewable energy and conservation during British Science Week (7-16 March). This year had the theme ‘Adapt and Change’ and schools across North Ayrshire participated in a range of live lessons, visits from industry professionals and STEM activities delivered by the STEM team and classroom teachers. 37
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12 Highlights included: STEM team visiting 5 primary schools during the week and provided P1 and 2 learners with play experiences to develop understanding of forces and energy changes P3 and 4 learners explored energy changes and were able to use equipment purchased with ‘Clean Air Day’ funding to generate their own carbon free electricity P5-7 learners investigated climate change, with a focus on how increased carbon dioxide levels in oceans is causing ‘ocean acidification’ British Science Week is an annual event aimed at inspiring the next generation of STEM professionals while challenging existing stereotypes around STEM careers and pathways. Photo highlights from the schools the STEM team visited are above, including Montgomerie Park, St John's and Loudoun Montgomery Primary Schools. West Kilbride Primary Wildflower Meadow Pupils at West Kilbride Primary School have supported the Ayrshire Nectar Network. The Network is a project that is being spearheaded by the Scottish Wildlife Trust, with backing from partners including North and South Ayrshire councils. North Ayrshire Council has contributed £100,000 to the Network through the Scottish Government’s Nature Restoration Fund (NRF), which helps local authorities fund projects that help tackle the nature emergency we are currently experiencing. 38
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13 The number of pollinators – including bees is in severe decline and they need human help to survive. The Network is also seeing the creation and connection of nectar and pollen-rich habitats across North and South Ayrshire, with wildflower meadows and trees being planted to establish pollinator “highways”. Land – from small pockets of grass to large swathes of fields – is being linked up to create a corridor of flowers that bees, butterflies, moths, bats and birds will benefit from. This will ensure that they don’t go hungry and, in turn, help provide the food we eat and the flowers we see, while also boosting biodiversity. At the school, pupils and volunteers have been working hard to create a wildflower meadow within the grounds to provide shelter and food for important pollinators including bees, forming part of the larger pollinator highway. Excited P3 and P4 children have been planting wildflower seeds and bulbs for their meadow and they should see the results of their efforts in spring. Children are learning about their rights and Article 29 of the Convention highlights that they have the right to an education, which should develop their respect for the environment. 39
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14 Headteacher Gemma Carson said: “The Wildflower Meadow is part of a larger piece of work in developing our outdoor learning programme, with enhance opportunities for planting and growing being offered to pupils across the school in line with the Royal Horticultural Gardening Awards programme. As part of this process, pupils recently grew and harvested their own vegetable product to cook soup, with P7 buddies helping our P1 pupils to learn how to cut and grate. We have also been ambitious in our outdoor learning provision, with pupils learning fire and den building skills outdoors. P1 pupils also recently enjoyed toasting marshmallows for an outdoor snack.” Young Carers North Ayrshire Council signed up to the Young Carers Covenant in 2024. The carer Team are supporting primary and secondary schools across North Ayrshire to sign up and to be part of the Young Carers in Schools challenge. It involves a set of outcomes that young people have highlighted as being key to improving their lives. This shows our commitment to identifying young carers at the earliest opportunity, ensuring they feel safe and secure and have choices in their lives. Each school has a nominated Young Carers Champion who are supported by Young Carer Locality Officers from the Carers Gateway North Ayrshire (CGNA). An agreed CGNA offer has been communicated to all schools with the provision of 1 to 1 support and drop-in sessions, Young Carer Awareness Training and Young Carers Statement Training. The Young Carers Education Information Pack was launched in October 2024 to provide staff within education with an overall understanding of the duties and approach in North Ayrshire to identifying, working with and supporting young carers. A programme of engagement and review on the current Young Carers Statement (YCS) has been progressed with final sign off from Social Work Governance Board in April 2025. CGNA Young Carers Team facilitated face to face sessions with 55 young carers aged 6 – 15 across North Ayrshire schools. 36 families also engaged with an online survey. Feedback was also offered from Children and Families Services. The updated YCS was shaped through a range of consultations, activities, and surveys to ensure the voices and lived experiences of young carers were at the heart of its design. The aim was to create a more 40
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15 meaningful, accessible, and supportive tool that better reflects the needs and aspirations of young carers. As a result, the updated statement is more user-friendly and person-centred, supporting improved identification, planning, and delivery of appropriate support for each young carer. Since January 2025, Carers Gateway has also been involved in completing and reporting on Young Carers Statements. In addition to collaborating with educational institutions, they place a strong emphasis on supporting young carers who face challenges with school attendance, have left formal education, or are being home educated. Young carers reported that the YCS is valuable to them. It ensures at least one staff member is informed about their personal circumstances. Young carers reported that their voices had been heard after completing their statement, they feel listened to and supported. They would appreciate the removal of the future/ emergency planning section, language was in places complex and questions repetitive. Overall, young carers wanted a shorter, more accessible YCS would be appropriate to assist in better caring conversations. All participants were happy for the original separate primary and secondary YCS to be condensed into one document. At 31/03/2025, 549 young carers were recorded on Seemis (education system) and 492 registered with CGNA, crossover information means there is an estimated 650 identified young carers. In the reporting period 1/4/2024 - 31/03/2025 Education staff offered 406 young carers the opportunity to prepare a YCS. To date 366 were accepted and completed via schools and an additional 5 completed by CGNA. Young Carers have once again benefitted from the Young Carers Education Fund. The fund can be used for anything that will improve or maintain the young person’s physical, emotional mental health and wellbeing or life chances, reduce social isolation, and improve attainment. 115 children and young people have accessed the fund this year. Young Carers work with a key adult to complete a young carers statement and co-design any supports. Funds have been used for driving lessons, days out to have a break from caring. A cinema pass was provided to allow a young person to have time away from caring responsibilities each week and one young person asked for cookbooks and utensils so they could pursue their love of cooking. 115 children and young people in North Ayrshire have accessed the Young Carers Education Fund this year. 41
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16 The Promise We continue to welcome the findings of the Independent Care Review and subsequent publication of The Promise and the call to action that lies within. We continue to remain committed to improving outcomes for children, young people and families in our communities and recognise that, whilst progress has been made in the first five years, there are many areas we will continue to develop and improve over the remaining life span of this 10-year ambitious plan. Plan 24-30 is Scotland's most current strategic roadmap to fulfil the commitments made in The Promise, by 2030. Launched on June 20, 2024, this plan outlines the necessary actions, responsible parties, and timelines to ensure that all children in Scotland grow up loved, safe, and respected. The plan is structured around five key foundations: Voice: Ensuring children and young people are heard Family: Supporting families to stay together Care: Providing high-quality care when needed. People: Empowering those who work with children and families. Scaffolding: Building the systems and structures to support these changes All the conclusions of the Independent Care Review have been organised and grouped under these foundations in a way that makes sense for the work still required. Plan 24-30 is dynamic website (www.plan2430.scot) rather than a traditional strategy document as Plan 21-24 was. It will be updated to reflect progress and ongoing needs at various points throughout its lifespan. It aims to create a collaborative effort across various sectors, including education, health, housing, justice, and local government. Champions Board for Care Experienced Children and Young People North Ayrshire Champions Board are a group of care experienced young people that take part in groups within their local secondary schools during either lunchtimes or within a school period. The aim of the groups is to allow young people to speak about their experience within a safe space if they choose to do so and to allow them to work or plan projects that may positively impact them. They act as the youth voice for care experienced young people within North Ayrshire. Currently we have these groups running in all secondary schools. We hosted our latest Primary 7 youth council with 140 young people from across all localities focussing on cyber resilience, physical exercise and wellbeing, positive mindset and child poverty. Our Care Experienced week celebration event celebrated the work of the Corporate Parenting Team, North Ayrshire wide Corporate Parents and the achievements of our Care Experienced young people over the past year. 42
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17 We highlighted our Team’s development of the Champions Board and Promise Champions Network, we had a feature on employability support, shout outs to North Ayrshire-wide Corporate Parents, an introduction from our Promise Delivery Partner, and an on-stage discussion with Corporate Parents from MCR Pathways, Active Schools, Educational Psychology, Dance Therapy and the ESOL Hub based in Auchenharvie Academy. The event was well attended with great engagement from both Corporate Parents and young people. 61 adults and young people attended. Attendees commented on there being a good balance of content between our work, North Ayrshire-wide work and young people’s work. There was a mixture of content applicable to a variety of ages. Young people have taken part in a co-design opportunity with Children’s Hearings Scotland, have been planning fundraising events/assembly presentations and creating school-wide charters and will be approving/wording questions for our collaboration with Canmore Children’s House around language. The annual Promise Conference was held in December 2024. 73 Care Experienced young people from across our Secondary Schools joined the conference to learn about The Promise Scotland Plan 24-30, meet local Corporate Parents and connect with each other. Plans are in place for a 2nd Promise Conference to take place later this year for primary aged children. Launch of new app for Care Experienced Young People In February 2025, we launched a brand-new mobile app for care experienced young people. The new app has been developed with the help of pupils from local secondary schools over the past 18 months. Called ‘CE4U’ (Care Experience for You), the mobile app has been designed specifically for care experienced young people. # Free to download, its aim is to provide a hub of useful information and helpful advice on everyday topics including housing, travel, mental and physical health, recipes, job opportunities and entitlements. Developed by young people for young people, the app collaboration was made possible due to fortnightly Champions Board meetings that take place in our secondary schools. These drop-ins provide a safe space for care experienced pupils to get advice, plan peer events and access scaffolding and support to help them succeed. 43
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18 The new app is a brilliant example of how we are adapting the support we provides to meet the needs of our young people. It also demonstrates our commitment to #Article20 of the United Nations Convention on the Rights of the Child ‘Children and young people in care have right to special protection and help if they can’t be looked after by their own family.’ As Corporate Parents, we are committed to ensuring that everyone who is care experienced feels safe, nurtured and supported. Promise Champion Staff Network In March 2024 we launched a Promise Champion network - a supportive, collaborative staff network of Corporate Parents led by our Corporate Parenting Engagement and Participation Lead. The network encourages sharing of best practice and partnership working. Promise Champions are enthusiastic about their roles and have been instrumental in raising awareness of The Promise and Corporate Parenting with their colleagues and wider communities. 44
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The Promise Champions staff network has 75 Corporate Parents across North Ayrshire involved (as of March 2025) and continues to grow The network also met in smaller sector-focused groups in June 2024, where Promise Champions gained an understanding of using trauma-informed language when speaking or writing about care experienced people. They also looked at how to reduce stigma and discrimination for the care experienced community. Brighter Pathways – remodelling outcomes on the edge of care Our Brighter Pathways transformation activity commenced in April 2024 with the aspiration of taking collective action to improve outcomes for our care experienced children and young people and those young people on the edge of care. The transformational work required has been addressed through the implementation of various focussed workstreams looking at how services can be delivered differently to ensure that children and young people have access to appropriate supports at the right time. The work undertaken within the workstreams has strategic oversight from the Brighter Pathways Programme Board. Some key changes to practice and service delivery have already been made, for example, enhancements to our Supported Carer scheme, a new digital approach to Foster Care Recruitment, enhanced collaboration and partnership working with our education colleagues, with further proposals being scoped out and/ or finalised with regards to a range of activity including the development of a new Foster Care scheme and the development of a local, bespoke model of supported care specific to young people who are on the brink of transitioning to adulthood. Advocacy Independent, community-based advocacy continues to be provided via Barnardo’s Hear 4U service. It provides one to one advocacy to children and young people and priority is given to children and young people who: Are involved in the Child Protection process and/or Children’s Hearing system Are care experienced in Foster Care, Residential Care and/or Kinship Care Are on the periphery of Secure Care Were previously looked after and accommodated Have additional support needs They continue to support young people to ensure they are aware of their rights. They are committed to ensuring that the voices of children and young people are heard, in a way which builds their confidence, also ensuring that they are listened to and their rights are appropriately represented, when decisions are made. 45
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20 Priority 2: Acting early to improve what happens next Key Highlights and Progress Additional Support for Learning Working in partnership with two Ayrshire based parental support groups (ASN Support Ayrshire and ASN Parents and Kids Irvine & 3 Towns), the Education Service has designed and delivered a series of engagement hubs focusing on the key challenges families face when navigating their child’s journey through education. These run monthly and feedback has been 100% positive with a calendar of events being designed for session 2025-26. Updated literature around how needs are supported within early years settings and schools has been refreshed and distributed through this forum. Our Community Learning and Development Mental Health and Wellbeing work is inclusive of supporting young parents through group work and events. Our Take Time Families provision brings primary aged young people together with their parents and carers to provide support, training and a safe space to connect and learn vital skills around resilience, wellbeing and building strong family connections. Support is also given through our Grandparents group that builds connections through an intergenerational group. The Inclusion Ambassadors programme piloted in almost all secondary schools alongside the Success Looks Different Awards which were publicised to all establishments and support was available for those who wished to apply. Secondary schools have been linking with the Scottish Government in the codesign of the national measurement framework and dashboard with a specific focus on capturing the successes and achievements of young people who are following different pathways. 46
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21 Child Protection A full multiagency approach was taken to the implementation of new Child Protection National Guidance. Briefings were created by the Child Protection Committee (CPC) around all aspects of changes required to implement the guidance in September 2023. Since then, further pathways have been developed and our Child Protection training for social work staff has been updated to reflect the National Child Protection guidance. The Signs of Safety practice model has been implemented across our entire Children and Families Service from the point of referral to Service Access. Partner briefings have continued to be provided through the Child Protection Committee training calendar to assist all other agencies to understand the practice model. Leaflets have been developed that are shared with both families and partner agencies on what to expect. Assessments and plans have been redesigned and implemented using a Signs of Safety practice approach. The Signs of Safety practice model has been implemented across our entire Children and Families Service from the point of referral to Service Access. The Signs of Safety model works in collaboration with families to identify strengths and family and wider support networks who can assist to support the children’s wellbeing or child protection plan that has been established. All Children and families team paperwork identifies family strengths and “what is working well”. Equally core partners, including Education have adapted the child protection concern referral to incorporate what is working well in addition to what we are worried about. Children and Families Health Support There are over 5,000 children aged 0-4 years in North Ayrshire, all of whom are supported by either a Health Visitor or a Family Nurse. In addition to following the nationally agreed Universal Health Visiting Pathway from the antenatal period through to a child commencing school, children under 5 and their families continue to have access to additional support from the wider, integrated early years team. During 2024-25 (as at 24 March 25), 914 requests for assistance from the various members of the integrated team were made. This included: 546 for Health Visiting Support Workers for areas such as communication, sleep, toileting, infant feeding and behaviour 103 for the Perinatal Wellbeing Team, supporting new and expectant mums experiencing low level mental health difficulties 91 for Early Years Social Workers supporting with domestic violence, parental mental health difficulties amongst others 72 for the Family Nurturers who offer support around bonding and attachment, routines, home conditions and community integration 40 for the Healthcare Support Worker who provides additional support to the Perinatal Wellbeing Team as well as baby massage 38 for support to dads via our partnership with national charity Dads Rock 24 for specialist infant feeding support 47
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22 Our peer support service has been expanded to all breastfeeding mothers. For the first three quarters of 2024-25: 81.3% of breastfeeding mothers in North Ayrshire engaged in peer support 83% of breastfeeding mothers in Scottish Index of Multiple Deprivation (SIMD) area 1 who are discharged engage with peer support 81.9% of breastfeeding mothers in SIMD 2 who are discharged engage with peer support In March 2025, the announcement was made that NHS Ayrshire & Arran and the three Ayrshire Health and Social Care Partnerships have retained the UNICEF Baby Friendly Gold Award Accreditation. The top accolade demonstrates our continued high- quality care for families to support breastfeeding. 48
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The Health Visiting service continues to fully implement the national Universal Health Visiting Pathway, with all children under 5 and their families offered a minimum of 11 visits from the ante-natal period through to the child starting school. Developmental assessments are undertaken at 13-15 months; 27-30 months and 4-5 years. Since 2020, the percentage of children with one or more developmental concern at these assessments has increased. A slight improvement in developmental concerns at the 27-30 month assessment has been observed in the last twelve months but a significant increase in concerns at the 4 year review have also been noted, as well as a slight increase in concerns at the 13-15 month review. This trend is not unique to North Ayrshire and the Scottish Government has set out actions to attempt to address this nationally within the recently published Enhancing the Delivery of the Health Visiting Service: Scotland’s Health Visiting Action Plan 2025-2035 (Scottish Government, 2025). Locally, we have undertaken a review of our Early Years Support Team and have established closer working relationships with early years education colleagues to take forward a programme of work that includes improved information sharing about developmental concerns at an earlier stage; enhanced links between the HV service and early years establishments; a focus on communication needs in children as a priority within our Getting it Right for Every Child (GIRFEC) Steering Group; and shared work around supporting more children to be toilet ready in the early years. Our Early Years Support Team works alongside the Health Visiting team to provide support to families when developmental concerns are identified or when a family requests additional support in other areas. During 2024/25, 933 children and their families were supported, an increase of 10.3% from 2023/24, in areas such as communication, sleep, toileting, home conditions, parental mental health and routines. During 2024/25 we expanded our partnership with national charity Dads Rock to bring a second dads’ worker to the area. This has allowed us to offer 1-1 and group support to dads in the Irvine and Kilwinning areas, as well as the original Three Towns area. During 2024/25, 53 dads have been supported with 81 children being positively impacted. Child healthy weight Over the last three decades, obesity levels in children have increased, with inequalities observed across our communities. Maintaining a healthy weight throughout childhood is associated with many health benefits both in the short-term and the medium term. Child healthy weight is monitored throughout the universal Health Visiting pathway but also when a child moves into Primary 1. The most recent data for 2023/24 was released in December 2024. For North Ayrshire: 74.8% of P1 children measured were of a healthy weight. This is a reduction of 1.9% on 2022/23 figure; however, it is still the second highest percentage in the last five years. 12.4% of P1 children measured were at risk of overweight. This is a 0.3% improvement on the 2022/23 figure and the lowest % since 2008/09. 11.9% of P1 children measured were at risk of obesity, a 1.8% increase since 2022/23. Early Learning and Childcare The funded 1140 hours of Early Learning and Childcare is now being delivered with flexibility and choice for parents across localities. Our models offer a blend of full year and term time places with various patterns in establishments delivering 8am-6pm and 9am-3pm. 49
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24 Allocations have taken place for session 2025-26 and 87% of parents have been offered their 1st choice of early years establishment. The early years team is working in partnership with services to increase the number of funded childminders with particular focus on the islands and the North Coast. Dental Health The Childsmile programme is delivered on an Ayrshire wide basis, receiving referrals from multiple sources including health visitors, school nurses and via dental services. We continue to develop the programme to meet the needs of the population and have recently completed a service evaluation of the service provided by the Dental Health Support Workers, which will feed into our strategic plans for the next 3-5 years to ensure a high quality and meaningful service. Our National Dental Inspection Programme (NDIP) figures indicated a marginal improvement on the previous inspections, but overall improvements have slowed, and careful consideration of next steps to be taken to improve oral health further. In 2025, we will be commencing a new Oral Health Improvement Action Plan- which is designed to set the strategic direction in oral health improvement for the next 10 years. Speech and Language Therapy All Early Years establishments have a nominated Communication Champion who links closely with the Children and Young People’s Speech & Language Therapy (CYP SLT) Team, receiving accredited Hanen Learning Language and Loving It training for enhancing the environment in early years to be communication friendly. The team also offers training sessions on specific speech, language and communication areas which are open to all early years and primary staff. The CYP SLT team offers both virtual and in person drop-in slots where any parent or carer with a concern about their child's speech, language and communication can request a half hour slot during which they receive advice, resources or completion of a request for assistance if the child is requiring a SLT assessment. Early Years establishments and Primary schools can also request these drop-ins for children in their care. CYP SLT are part of a recently created North Ayrshire Early Language Network (created May 2024) with a focus on 0-5 years. The Network has representatives from Education in the Early years, Psychology, Health Visiting, Speech & Language Therapy, Family Nurse Partnership and the third sector. The focus of the Network is to look at the pathways for infants and children and their families seeking advice or support for speech, language and communication, map what is working well and where the gaps in these pathways are and co-produce solutions. The Network meets on a regular basis. CYP SLT work closely with the Ayrshire Neurodevelopmental Empowerment and Strategy Team (NEST) to provide in person workshops on "Supporting your autistic child's communication", providing information and an opportunity for families to discuss their concerns about their autistic child's communication. A virtual drop in (over Attend Anywhere) for families of children with social communication differences is run jointly with our partners in Occupational Therapy. 50
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25 Speech and Language Therapy assistants link closely with our partners in libraries delivering Bookbug sessions and attending Breastfeeding network sessions to share key messages for developing all children's speech, language and communication. Two Speech and Language Therapists work as part of a multi-disciplinary team who offer assessment and diagnosis of neurodevelopmental conditions, mainly Autism for children aged 3-6. This is a pan Ayrshire service. The CYP SLT Team is working to reduce the Wait Times for SLT assessment and subsequent specialist support through the initiatives already highlighted. An increase in staffing and a more balanced skill mix has supported service improvement plans. As a result the waiting times have steadily reduced. Between February 2024 and February 2025, the Children and Young People waiting times reduced by 64% from 138 weeks to 50 weeks. ESOL (English for Speakers of other Languages) and Asylum Seekers and Refugee support The New Scots ESOL Hub finished its first academic term in June 2024. The 'test of change' for providing education to Unaccompanied Asylum Seeking Children and Trafficked Young People which ran from late February to June 2024 proved highly successful. 51
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26 Six of our dedicated young people from the New Scots ESOL Hub were supported to apply for full time ESOL courses and were successful. Six of our young people were supported to apply for full time ESOL college courses and were successful. A number of these young people were placed in higher level courses than they had initially applied for. The New Scots ESOL Hub is more than just English lessons, it provides the opportunity for our young people to be part of a community. They also receive ongoing support with any issues and with their wellbeing. Two sessions of sport are provided per week. Recently, there has been a focus on football and basketball. The students have learned vocabulary relating to football, practised various drills and worked on their team skills. They have developed their ability to communicate during play, and how to pass, shoot and defend correctly. They are also learning how to play basketball. This has proven to be more challenging to play than football but we are all gradually learning the rules and skills required and having fun while doing so. Whilst supporting our Syrian Families, we identified a need to raise awareness around Oral Health and how to engage with Dental Services. Also to encourage more play within the family home in early child years. 52
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27 We worked in partnership with the Childsmile Team, Dietetic Health and Improvement Team also a support worker of the health visiting team to promote Health and Wellbeing. We targeted some families and were hosted at the Syrian Hub by service users who regularly meet there every two weeks. One of our service users took part in the planning of the event and volunteered on the day. The Childsmile Team brought information in Arabic and interactive quizzes for the parents and children. Dental packs were provided for the families to take home to promote good oral hygiene. The team were also able to promote fluoride varnishing programme to the parents through our Bilingual Support as the uptake was very low due to the letters from the school being in English. The day was well attended, and all the families enjoyed learning about the Childsmile service, playing the sugar game with the Dietetic team, and exploring activities they could play with the children within the home that don’t cost anything but support health and wellbeing. 53
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28 Family Centred Wellbeing - Improving Mental & Physical Health and Wellbeing The Family Centred Wellbeing Service (FCWS) are a team of 14 wellbeing workers who support families with children between the ages of 5-18. We currently support over 170 families, with sessions provided within the family’s homes, within our offices, community buildings and schools. We seek to build on existing parenting capacity and provide practical support, advice, and guidance that will enhance family wellbeing and relationships. The team use the facilities in Meadowcroft to bake and cook with our families, giving them an opportunity to connect, bond and learn life skills that can have a positive impact on their wellbeing and finances. We use the garden to develop play-based skills and to encourage positive mental health and wellbeing. Over the summer, the team devised and facilitated a summer programme that ran twice a week for the full summer. They utilised accessible community resources in every area and did free activities with families to help build their confidence and show parents and carers how to access outdoor activities that will have a positive impact on their physical and emotional health. It also encouraged families to access local community resources and build further contacts within the community, reducing the impact of social isolation. Working in partnership with KA Leisure and their young leaders, our children and families were supported to learn sports skills. We took kites to the local beach and learned how to fly them, we did chalk art with the families on the rocks, we paddled in the water and most of all, we spent time with each other. The team have a good social media presence (800 followers across both platforms) and they utilise that to share and promote upcoming events, local groups and activities and to promote social inclusion and wellbeing. The team have established a group that meets weekly with the Three Towns Growers, which has allowed our families to learn how to grow and sustain food. Some of this produce also goes to the local Foodbanks and it has been a great way to build a sense of community spirit and capacity. 54
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30 Priority 3: Making things fairer Key Highlights and Progress Educational Attainment A new data visualisation tool has been launched with all schools to support the tracking and analysis of progress in learning across the Broad General Education stages. This will support more effective targeting of interventions and raising attainment strategies. Trackers have also been developed for Early Years establishments to track progress across Literacy, Numeracy and Health and Wellbeing which align more closely with Curriculum for Excellence (CfE). A Data Service Improvement Group has been created in session 2024-25 which consists of senior leaders across Primary and Secondary schools focussing on the use of data to collaboratively support improvements for raising attainment and closing the poverty-related attainment gap. Data clinics have also taken place to offer support in this area. Early Years and Primary senior leaders have worked collaboratively to create consistency of approach and resource in the tracking of Literacy and Numeracy. The annual leavers attainment and positive destinations statistics were published nationally at the end of February 2025. This follows the annual publication of Curriculum for Excellence attainment data in December 2024. There is a varied picture across a range of measures, with some clear strengths and areas for further improvement. The latest published achievement figures are for 2023-24. Combined Numeracy achievement for P1, P4 & P7 is 76%, in line with attainment in the previous year. Similarly, combined Literacy achievement for P1, P4 & P7 is 69%, again in line with attainment in the previous year. Performance of all school leavers in attaining Literacy at Level 4 and Level 5 displays a positive 5-year picture. In 2023-24, our school leavers have outperformed all other comparators at level 5, with 93% achieving literacy at level 4 or better and 81% achieving literacy at level 5 or better. The performance of our school leavers in attaining Numeracy at Level 4 and Level 5 also displays a positive 5-year trend. For Level 4, 90% of leavers achieved this and 71% of all leavers achieved Level 5. The performance of all school leavers with 1 qualification at Level 5 and 1 qualification at Level 6 continues to improve. In session 2023-24, 87% of all school leavers achieved at least one qualification at Level 5 which is broadly in line with the previous year. 68% of school leavers achieved at least one qualification at Level 6 which is almost 2 percentage points higher than in session 2022-23. In terms of school leaver destinations, an initial positive destination means that a school leaver has gone on to further or higher education, training, skills development or employment immediately after leaving school. At 96%, the proportion of our leavers moving into an initial positive destination is in line with 2022-23. To maximise the percentage of school leavers entering and sustaining positive destinations, schools continue to work in strong partnership with Skills Development Scotland and Developing the Young Workforce (DYW) Ayrshire. 56
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31 The links between Developing the Young Workforce (DYW) Ayrshire and our schools continue to be further strengthened and supported by a range of vocational courses and work placements delivered across all secondary schools. In total, 486 young people participated in work placements which allowed them to develop a range of key employability skills such as teamworking, communication and interpersonal skills. Our schools also held a range of DYW activities to support learners and their next steps such as: careers events; employability workshops; mock interviews and how to write CV/ application forms; site visits; Further and Higher Education engagement and women into STEM events. Our schools continue to benefit from close partnership working with local businesses to support the development of skills for learning, life and work. In session 2023-24, planning began between NAC and Ayrshire College for piloting the Performing Engineering Operations course. This qualification is a requirement for entering further study of engineering disciplines and will support learners who progress to Further or Higher Education. Connected to this, links have now been formed with a subsea cabling company operating in North Ayrshire which will further support learner pathways as well as graduate apprenticeship and wider employment opportunities in our local authority. Our Learning Estate We have an excellent record of continuous improvement across our Learning Estate, and Academic Year 2023-24 saw a number of major projects progressed which strengthen that commitment: Completion of new build Montgomerie Park Primary School, Irvine Completion of major refurbishment of Marress House, Early Years Centre, Irvine Final stages of the new build replacement of Moorpark Primary School, Kilbirnie Site works underway for a new Ardrossan Community Campus, which will replace Ardrossan Academy and Winton Primary School Kitchen and servery works in preparation for the roll out of Universal Free School Meals in Garnock Community Campus, Hayocks Primary School, Corsehill Primary School and Whitehirst Park Primary School Significant replacement programme of ICT devices (laptops/PCs/ipads/Smartboards) Completion of the internal upgrade works at Kilwinning Academy Professional Learning A full professional learning programme is in operation, including programmes for teachers, early years practitioners and pupil support assistants. The Professional Learning Academy (PLA) has a well-regarded in-residence delivery model to ensure training can be adopted, practised and embedded in individual establishments. The Professional Learning Academy work in partnership with the Educational Psychology Service to deliver a breadth of professional learning opportunities including supporting neurodivergent learners and promoting positive relationships and behaviour which are two of our key priorities within education. Excellence and Equity Leads (EELs) in early years establishments (allocated to those with higher levels of deprivation) continue to focus on raising attainment and closing the poverty- related attainment gap. More focused training with these Leads has provided ongoing 57
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32 consistency of delivery and data collection. Work with the EELs and Education Scotland is providing support and frameworks to ensure Early Years establishments can measure the attainment in relation to the poverty related attainment gap. MCR Pathways Programme In the 8 mainland Secondary schools, the MCR Pathways Young Talent programme continues to be delivered to care-experienced learners and those at risk of being placed into care. (North Ayrshire’s MCR Pathways team pictured at Annual Promise Conference 2024). During the 2023-24 academic session, the MCR Pathways Young Talent programme supported our young people in, or on the edges of care within 6 secondary schools with a total of 424 young people engaged. This is a significant increase from 229 young people engaged in session 2022-23. There has been collaboration with the Corporate Parenting Team to help support schools with engagement with “Keeping the Promise” award of which 2 Secondary Schools are currently involved. S1 and S2 learners involved in the programme participated in group work which focussed on building self-esteem and confidence, strengths and interests, teamwork, problem solving and employability skills. MCR Pathways Co-ordinators, who are members of the schools’ extended pastoral support teams, provide an enhanced and integrated level of support, liaising with partners and preparing young people for engagement with a Mentor. Using their wealth of experiences and life skills, mentors share the same desire to support a young person in their local community and give something back. Early Learning and Childcare Our early years staff are working with our funded providers who contribute to the early childhood development and education of our young people. We have provided training and engagement sessions to ensure the delivery of high-quality experiences for all. 58
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33 There is ongoing work with other sectors and the Scottish Childminding Association (SCMA) to encourage North Ayrshire residents to become childminders. This is aimed at a targeted group and support will be provided to encourage people to venture into this career pathway providing more choice for families with regards to their funded childcare options. Whole Family Approaches Through the Whole Family Wellbeing Funding, grants have been awarded to eight third sector organisations during this financial year with the aim of testing or expanding early intervention projects which support a whole family approach. Some of these projects include support to kinship families, the use of art therapy in early years, transition support to young people with additional support needs and intensive therapeutic counselling support to children who have been sexually abused or experienced other significant trauma. Young Parents Group A Young Parents Group has been established and designed by our Mental Health and Wellbeing Project Delivery Officer. The group splits into activities suitable for the learning and development of babies attending and also parents interacting in sessions. Using the first hour to focus on the baby/ child development through activities which is led by the lifelong learning team and using the second hour for the development of the parents. The group is well established and sessions have been created to encourage learning for both parents and their babies, within a range of different topics including Messy Play, What is mental health and how can this be linked between you and your baby, Multiply input, Book Bug, Worry and Fears session for parents (creating a social network), Resilience of a parent, Baby Sensory, Crafting, Relax, Kids Baking, Baby Massage- attachment process and postnatal depression. The group is designed to be fun and exciting for both parents and their little ones. They provide a great opportunity to try new activities and meet new people, creating lasting memories. The programme encourages parents to interact with each other and share a variety of good and bad experiences. It creates opportunities to get advice, meet new friends and catch up with peers at each session. A young mum shared: “The Young Parents Group is a lifeline to me as I don’t get to see anyone anymore since the baby came along. I look forward to it every week, the support from everyone is amazing. I’m sad it will only be lasting ten weeks. We need more of this in our communities! 59
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“The group always has something on for the kids but also an activity for the parents too. I really hope it can be extended as I have made friends for life and our mental health is just as important as our babies. The impact it has had on myself and the other parents is more than words can say. As a result of the programme, the young parent’s attending have increased confidence, created a support network within the group and enjoy each session. 15 young parents have joined the group and this increases each week. Attending these sessions allows the children to interact with other babies and their parents, promoting socialisation and interaction. This can help to develop parents and babies’ social skills and build confidence in this new chapter of their lives. 60
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35 Financial Inclusion A North Ayrshire Financial Inclusion Partnership was established in May 2023 with membership including financial inclusion service providers and key stakeholders. The Partnership developed and delivered a Community Consultation at the end of 2023, the findings of which will be incorporated into an update of the Financial Inclusion Strategy to be produced late spring 2025, for 2025-30. The consultation found that advice/financial inclusion services are highly rated by those who had used them, but in response to a question relating to barriers to accessing advice services, there are a number of areas to be addressed in the promotion and development of services: The range of platforms available for access services for people who don’t like using the phone/internet That advice services are available for people in all housing tenures including owner- occupiers Stigma/self-stigmatising Fear of the situation getting worse Services available to island communities Improved engagement with gypsy/traveller communities A Communications sub-group of the Partnership has now been established to address the above. Another key finding, which reflects wider national research, is that where both debt and welfare rights advice is required, accessing both through one referral/service is preferred. In response, it has now been agreed that to supplement the debt advice service available to council tenants from the HSCP Financial Inclusions service, an additional welfare rights and debt adviser will be recruited for non-council tenants, to provide a service for those who seek welfare rights advice from Money Matters but also require help with debts. This will then eliminate the need to refer on to another service for this support. Welfare Rights Officers in Schools Project 2024 -25 Following a successful recruitment process we were pleased to expand our Welfare Rights Officers in Schools team to 3. From August 2024 they have been available to all families with children in educational establishments including Early Years. The team received extensive training during August and September and started to engage with families from October. The team have received a total of 259 referrals this financial year, an increase of 144%, with combined financial gains of £818,636.32, this is an increase of 46% from last financial year. This takes the total financial gains since the inception of the service to over £1.8 million. They are seeing an increasing number of referrals coming in for families with Primary School age children and are working hard to engage with more families through our Early Years establishments. 61
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36 Their marketing campaign has been successful with 51% of referrals coming directly from families. Family members who have engaged with the service have commented that it’s not just about the financial gains they have seen a positive impact on family wellbeing due to reduced stress, worry and anxiety over benefit issues and money. An example of the difference that can be made to a family can be seen by the support provided to a local secondary school parent. Following a benefit check, the Welfare Rights Officer was able to maximise the family income. Benefits were identified, support with claims, redeterminations and mandatory revisions against both DWP and Social Security Scotland were undertaken and the family is now better off by £271.18 a week and has received arrears of benefits totalling £14,122.23 62
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Leadership Opportunities Our leadership opportunities allow young people to become peer mentors and role models through our youth voice provision (youth forums, junior youth forums, Scottish Youth Parliament and executive youth council). These young people co design service delivery and support the work being delivered. Our Modern Apprenticeship programme takes young people through and SCQF Level 7 in youth work, participants design, produce and deliver work with young people across North Ayrshire around all areas of CLD and youth work. This year has seen Active Schools employ our first Modern Apprentice, who will start their journey of SCQF Level 6 in Sports Coaching. The funding for this post has come from ENABLE and sportscotland. As part of the criteria from the funders the candidate had to have a disability. They are working across our team but their role has a particular focus on ASN provision. Photo caption: Smiles all round at Youth Services Modern Apprenticeship celebration. Since coming on board in August 2023, the team have been a vital part of the council’s Community Learning and Development team, delivering over 2,000 youth groups and activities across North Ayrshire’s six localities. They leave the programme with a SCQF Level 7 in youthwork. 63
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38 Elderbank Primary School Fruit Growing Colleagues at an Irvine school are growing grapes and tangerines with help from pupils – and a talented parent. Children and staff at Elderbank Primary, Irvine, have teamed up with dad Yousif Al Ahmed to create a garden inside a polytunnel. The growing area was created a few years ago through the Pupil Equity Fund and it has gone from strength to strength. The polytunnel gardens was developed by Yousif with support from the children, and they have been growing produce and then using it within the school to cook. Pupils have learned how to grow their own produce and have seen the whole process – from seed to plate. Pupils Cody Lee (10) and Charlie (11) are among children who enjoy rolling their sleeves up and growing produce in the polytunnel. Cody Lee said: “We love growing pumpkins, apples and oranges in the garden” while Charlie said his nan’s love of gardening inspired him. Talented gardener Yousif from Syria, said: “It is good for all children to learn about how fruit and vegetables are grown, and is especially good for children with sensory needs – like my own son who has autism and is an Elderbank pupil 64
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Priority 4 Promoting good mental health and wellbeing Key Highlights and Progress Counselling support and community wellbeing supports The School Counselling Service continues to support children aged 10-18. This financial year we have supported 477 children and young people and have offered 152 hours of counselling per week. 99.4% of children and young people reported an improvement in their wellbeing following counselling. Children and Young People presented with a range of concerns most notably, depression/low mood, anxiety and self-worth. Younger Primary children have also been able to access counselling through Crisis Counselling with 38 children under 10 years accessing support. Through the Children and Young People’s Community Mental Health and Wellbeing Supports and Services Framework grant funding we have supported 6527 children and young people and 1212 family members through a range of programmes. 6283 children and young people have engaged with positive mental health and wellbeing services highlighting the focus on early intervention and prevention. 94% have reported an improved outcome. We have engaged with Third Sector partners through a collaboration with the adult community mental health fund processes. Examples of projects include the Empower project run by KA Leisure. They have engaged with 126 young people through both group work and 1-1 support. The focus is to use physical activity to promote and maintain positive mental wellbeing. They have made links with Tourette’s Scotland and supported this group who are higher risk on poorer mental wellbeing. Through engaging with some of our Secondary establishments they have also supported those young people struggling with lower attendance. One teacher has described the impact below. “This project has been massive for the young people I have referred. One of the pupils I referred had very poor attendance, he only started attending regularly on a Thursday to attend the gym, this allowed him to create a routine with a soft start and develop a better relationship towards school. Since returning from the school holidays, he has only missed one day and is now on a full timetable! He is continuing with gym too and enjoying it very much! The other pupil we referred was on a reduced timetable and had to be picked up from his house and taken to school, he would not leave the house independently. Since completing the Elevate programme he now leaves home independently to attend 3-4 times per week, this is huge for him and been a massive confidence boost. He is still on a reduced timetable but attends all scheduled classes which is more than before. We feel like this project offers an olive branch to school and helps pupils build a better relationship with school in a healthy manner and at a steady pace. We would definitely recommend this project.” 65
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40 Additional projects include Dance Therapy with 27 Care Experienced children and young people benefitting from this intervention. The group leader describes the positive impact on wellbeing. “Dance therapy has been an amazing way to watch all of these children develop socially, emotionally, cognitively, and physically over the weeks, months and some years who have been attending. Our collaboration with small grass roots Third Sector Partners has continued to provide supports and services which promote positive mental health and wellbeing to children young people and families across the authority. Examples include the Lorretta Doyle Judo Foundation who have worked with Syrian, Afghani and Ukrainian families with 120 children and young people participating this year. most of the delivery has been, this year, for Syrian, Ukrainian and New classes were developed for families where there are additional support needs identified including Autism, ADHD, Visual & Hearing Impairment. Elderbank Primary School 36 children, 16 were children with Hearing Impairment and were subsequently supported with “Guide Dogs for the Blind” another 8 Visually Impaired children joined a new series of programmes. Our Area Inclusion Workers (AIW) continue to support children, young people and families with their wellbeing through a range of 1-1 and group approaches. Interventions include Let’s Introduce Anxiety Management (LIAM), KitBags and Building on Positive Relationships Family groups. Families and children report positive impacts on their mental health and wellbeing with one AIW reporting “Due to home visits, check ins and LIAM I was able to build a positive relationship with a family and pupil who hadn't attended school in a year due to severe anxiety. With help and support from myself I was able to arrange an adjusted time table and supported the pupil in class that his attendance did improve slowly and hopefully will get better with time.” Your Resilience – The Hive – Ayrshire College Your Resilience supports young people’s mental health resilience. The education programme is focused on building resilience through life’s transitions for 14 to 20 year-olds, equipping them with the tools and resources to manage their mental health now and in the future. The HIVE (Hope, Inspiration, Vision in Education) is a facility within Ayrshire college that many of the students arrive with no qualifications, and often no clear idea of what they want to do next. 66
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41 The HIVE aims to help you to achieve next steps and using the Your Resilience programme, we dedicated time to help these young people in their journey towards positive destinations. Strong relationships have been established between the Youth Work Team and Ayrshire College to support the young people that attend in helping them with their mental health and emotional awareness to move onto future courses or employment. The programme was run weekly in Ayrshire College with current HIVE pupils (Intro to careers and bridge to careers). Sessions are 1–2-hours covering Resilience, Exam Pressure, Friendships/Decision Making, Social Pressures, Managing Studies and Juggling Time. Along with open conversation work through the appropriate workbook for groups age ensuring the group understand the tasks and the tool kits provided to help them manage their own life scenarios and support their Mental Health and Wellbeing. At the end of the completed sessions and workbooks the young people have an opportunity to give feedback, they will then receive their certificate. Your Resilience – The Hive – Ayrshire College Caroline McCulloch - Employability & Engagement Officer working at The Hive shared: “Working with young people who have previously disengaged from education within the HIVE at Kilwinning Campus, Ayrshire College, our course's aim is to prepare students to enhance their Employability skills, Confidence, Teamwork, Communication, self-esteem, and motivation which will support them into employment or mainstream courses. “Many of our students are Care experienced, have ASN, ADHD, Behavioural issues, Autism, Anxiety, Depression, Trauma and Mental Health issues. Vicki has been delivering Resilience sessions to over 50 of our students. “The sessions have been invaluable for our students, through completing the workbook it has provided the students with an opportunity to take part in open discussions with relatable topics. 67
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42 “Youth Worker Vicki and her staff have been amazing and were able to create a safe environment, build positive, trusting relationships with our young people, equip them with the tools and knowledge to reach out with any concerns and have better resilience which has had a positive effect on their mental wellbeing. I am hoping this partnership can continue, which will enable us to reach out to a lot more young people who will benefit from these sessions.” I liked this course because I learned more about mental health. My favourite part was the friendship session because it made me think about who I spend my time with.” HIVE student age 18 Building on positive relationships and whole school nurture Whole school nurture was delivered across the whole education service at the close of last session to ensure all staff in our provisions have the necessary skills and experience to offer a nurturing environment for all children and young people. In order to build on this work and respond to the Scottish Governments Action Plan on Improving relationships and behaviour in schools a collaborative event took place to set the wider context and gather practitioners views. Following this we have established 3 working groups to update our LA policy on relationships and behaviour; develop a professional learning guide and update our professional learning offer in this area as well as establishing a clear process for developing planning and risk assessments. Extensive stakeholder consultation has also taken place with feedback indicating the need for greater consistency around expectations and consequences and practical support. Professional learning in this area and is being shared with establishments. 68
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43 In parallel to embedding a whole school nurturing approach, we have continued to develop our building on positive relationships approach (which is based on the principles of non- violent resistance). As well as the principles in this approach forming part of our overall offer to educational establishments, we have expanded our offer to parents and carers with 18 groups taking place this session including one specifically to target attendance issues. We have also run facilitators sessions for BPR so that we can build capacity for staff to deliver the parent groups with these being positively evaluated by all that attended. Analysis of surveys completed before and after the Building on Positive Relationships parent groups has demonstrated a significant impact on the understanding and knowledge of our parents in terms of applying this approach to strengthen positive outcomes for their children. Feedback from parents included: • “The way we were made to feel included and listened to. We weren't alone In our struggles and felt a part of something that would help. The difference in thinking before we react to challenging behaviour has changed to involve different ways of coping and positive strategies of dealing with it as a family.” • “Realising others are going through similar things. That situations can be worse. That things can improve. Techniques to help and support each other.” Attendance We have continued to focus on school attendance as a priority in education with small improvements being seen in both our overall attendance figures and a reduction in our persistent absence figures. Work has included an update of policy and guidance on Seemis codes; key messaging being made available to promote positive attendance across the authority and the development of supports for early intervention and targeted support for those experiencing difficulties with attendance including those experiencing emotionally based school non-attendance. Other health and wellbeing supports Over this year other health and wellbeing work had focussed on supporting schools by delivering our Bounceback mental health and wellbeing programme. The Take Times Families Group work with 15 parents/ carers and children looking at anxiety, emotions, and resilience in fun understandable ways. Both Joint Youth Forum and Primary 7 youth council featured mental health and wellbeing workshops for young people to look at resilience, wellbeing and positive mindset. 69
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44 Our Cyber Explorers programme supports young people gaining a cyber resilience qualification and supports wellbeing and online safety with 755 registered on the system, 129 young people achieving SCQF Level 4 and 57 young people achieving SCQF Level 5. There are 1024 active DofE participants where mental and physical health and wellbeing questions are regularly answered by participants on their DofE app showing improving their mental/ physical health whilst taking part in the Award. Our Community Learning and Development Team supports and leads on initiatives such as Our Scottish Sports Future, Community Schools for non-attenders, New Scots Girls football, adventure group and volleyball. Park Lives – Dalry Community Sports Club Taboo Topics Group – which focusses on wellbeing podcasts and North Coast Media Studio with. Our games group supports young people with additional support needs with wellbeing and resilience through gaming. All Active Schools activity supports positive mental health for all participating children and young people. Our extra-curricular provision, events and leadership programmes across the year all help to reduce stress, boost mood and enhance self-esteem. In addition, our staff have developed a guide for schools to raise awareness on how the work of Active Schools contributes to positive mental health. Furthermore, the coaches and volunteers have been part of a robust training programme around mental health and how to support young people during their weekly sessions. School Nursing Service Mental and emotional wellbeing is one of the ten priority pathways in the school nursing service. During 2024-25 we have undertaken work within the school nursing service to clearly define what support is able to be offered in relation to mental health and wellbeing and agreed across Ayrshire that the following areas can be supported: low level anxiety, low mood, bereavement support, self-harm and low self-esteem. Staff have received additional training in relation to bereavement support whilst continuing to deliver Let’s Introduce Anxiety Management (LIAM) where capacity allows. 70
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45 North Ayrshire’s Children and Young People’s Neurodevelopmental Implementation Group All North Ayrshire family supports for children with neurodevelopmental differences (NDD) have been mapped and uploaded onto the NEST (Neurodevelopmental Empowerment & Strategy Team) website. A third phase of engagement work was undertaken with parents/carers around their experiences of NDD support and services, following on from the focus groups undertaken in 2023-24. A summary report of the findings has been developed and will be shared with those who attended. The focus groups have been a helpful reference point to sense-check progress to date, to get feedback and to consider and respond to this. Following the 2023-24 training needs analysis of the children’s services workforce, an agreement to create a NDD Learning and Development Adviser post (fixed term) was made. This post will support building capacity and capability of all agencies working with children and young people in relation to NDD. Due to delays in processes, this post will be recruited in the next financial year and will be funded through the Whole Family Wellbeing Fund. A test of change involving the creation of a multi-agency panel (MAP) to review all children and young people who had been referred to CAMHS since August 2023 but who no longer met the CAMHS criteria. In addition, pan-Ayrshire discussions regarding what a potential ND service would look like have been ongoing, with a draft business case being completed currently. North Ayrshire Wellbeing Alliance KA Leisure continues to work with partners to establish the strategic priorities of the North Ayrshire Wellbeing Alliance. The aim is to bring key partners together and coordinate efforts to support individual, family, and community health and wellbeing. One of our current priorities is the co-design and delivery of a pilot project in Kilwinning. A diverse mix of partners from across North Ayrshire came together at the recent workshop to help shape the early development of the Kilwinning Pilot. This included representatives from health, employability, education, community organisations, and local services- all with a shared commitment to improving access to employment, training, volunteering, and wellbeing opportunities within the community. The workshop provided a valuable opportunity to align around a shared ambition: strengthening community wellbeing through more connected and accessible support. There was strong consensus that beginning with a series of informal, community-based events would be the right approach which would help to build relationships, foster trust, and create a welcoming introduction to the wider offer. 71
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46 Priority 5 Inspiring children and young people to be active Key Highlights and Progress Active Schools We have continued to support more young people to be active both within a school and community settings. We have worked in partnership to make sure there are school to community links in all six localities. Across this year we have also worked together to fill any gaps in provision to ensure all localities have an equitable number of opportunities for all young people to take part in. Our pathways between school to club/ community sport has been strengthened to allow a better transition for our young people. Active Schools have continued to focus on those who most need our support to access sporting opportunities. The Active Schools and Communities Partnership Officers have played a crucial role in this and have removed any barriers to participation for those that are care-experienced, living in poverty, non-attenders or other targeted reasons. We are working to remove barriers for the young people and families with care experience to take part in Sport and Physical Activity using a Whole Systems Approach to lead a healthier Lifestyle. This last year has seen the delivery of 31 different experiential opportunities to 273 young people. The opportunities are wide and varied and range from water sports, climbing, sailing to residentials and fun days. On completion of their experiential activity the young people are then supported into more frequent activity within their own school and/ or community of which 59% currently have taken this opportunity on. Active Schools key focus has remained on getting ‘More Kids, More Active, More Often’. Extra-curricular provision has been delivered across ALL primary, secondary and ASN establishments. Over 9,200 young people have attended a variety of sport and physical activity sessions across this year, which is over 52% of the whole young people population. There were 10,420 sessions delivered across the year with 217,225 visits in total taking place (if 10 young people attended 10 times it is counted as 100 visits). We had 663 deliverers of which 98% of them are volunteers, the highest recorded in Scotland. Our Active Schools Calendar of events this year has seen over 5,300 young people take part in a variety of sports across 63 events. The events calendars run in clusters, localities as well as North Ayrshire wide. In addition to these events, we have supported our ASN pupils 72
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47 to attend the Ayrshire Sports Ability and Scottish Disability calendar of events to make sure ALL young people have the opportunity to perform and compete at the appropriate level. St Matthews Academy Residential Trip We also partnered with the team at Sport Scotland’s National Sports Training Centre in Inverclyde to provide a residential trip for young people. Supporting twelve S1 pupils from St Matthews Academy, the overnight residential trip took place in early November 2024. Staying for two days, the experience offered an opportunity for the pupils to meet new friends, discover ways to lead healthier lives and consider coping strategies to improve their mental health. It was also a chance to find out what sports they enjoy via the sports centre’s nationally renowned facilities and professional coaches. The trip was organised by the Active Schools community partnership team, a dedicated service working closely with schools and communities to develop sporting opportunities in school and beyond. A highlight of the recent residential was exclusive use of the impressive gymnastics facility. The pupils also had the chance to try out archery, boccia (a kind of lawn bowls for the ASN community), pickleball, the climbing wall and many more activities. Our young people thoroughly enjoyed the opportunities this experience presented. However, the true success of this work with Active Schools is the increased sense of belonging, self-confidence and self-esteem evident in the pupils who participated. Strong friendship groups have been established and the S1 pupils involved feel more settled and secure in the school as a result. It is hoped that the St Matthews pupils from the latest residential will now participate in sports within their own school and community too. Leadership Pathway Active School have a sector leading leadership pathway from P6-S6 and beyond. The P6 Move and Improve programme has seen 1003 young people trained as leaders. Their role is to deliver quality sports and physical activity lunchtime session to their peers. We have also had 36 teaching staff members trained through this programme to support the delivery. Our S1-S6 Young Ambassador programme has 148 representatives. Their role is to promote sport and encourage others to be more Active. Our S5-S6 North Ayrshire Sports Academy 73
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48 programme has 168 young people engaged. Each participant will have gained a minimum of 8 and a maximum of 12 qualifications. These range from their Saltire Awards, National Governing Body Qualifications all the way through to and SQA in Higher Leadership. This programme has seen the young people volunteer over 5500 hours within their local schools and communities. KA Leisure KA Leisure offers a diverse range of programmes that include sport and general physical activity. We collaborate with communities and partners to provide term-time activities and holiday programmes. Our term time programme is spread across all localities with over 100 classes per week. KA Leisure continues to deliver innovative marketing campaigns to encourage participation across the general public. We also collaborate with partners to provide targeted approaches to encourage harder to reach young people to participate in our programmes. KA Leisure promotes the INSPIRE programme by offering a comprehensive membership that provides children and young people with access to a wide range of activities, including arts, drama, dance, and music. We ensure visibility through community engagement, partnerships, and targeted marketing. The programme includes term-time activities and holiday programmes. Outdoor Activities There are 1024 active DofE participants where physical health is part of all participants award. The Duke of Edinburgh's Award (DofE) has four core sections: Volunteering, Skills, Physical, and Expedition, with a Residential section added at the Gold level. 74
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49 Our outdoors for wellbeing programme gave 30 primary aged young people a weeklong programme of outdoor activities that supported wellness which included yoga, tree planting, nature walks and more. We work in partnership with Scottish Ports Futures to provide the Twilight Basketball programme that incorporates physical health with youth work issue-based programmes throughout the year. Working with our New Scots girls group we also support the Swans Girls Football Team. Community Sports Hub Our North Ayrshire Community Sport Hubs are flourishing. We have been supporting clubs with training, venues and one to one development sessions. In collaboration with selected affiliated clubs, we have been supporting the delivery of satellite clubs to encourage more localised participation. In addition, we have supported the development of additional ASN sessions at North Ayrshire Athletics club. Badminton has also been a focus this year with the employment of a racket sports officer who sits within the KA Leisure team to develop school to community clubs in targeted localities. Early Learning and Childcare All early year’s establishments have access to outdoors at all times of the year. All early year’s establishments provide learning environments which provide opportunities for physical play both indoors and outdoors. All staff are aware of the importance of developing gross motor skills and ensure experiences offered support development of core strength, stability, balance, spatial awareness, co-ordination and agility. JumpStart Child Healthy Weight Programme The Child Healthy Weight team continue to support children and their families to achieve a healthy weight via the Jumpstart programme. The programme works with families of children aged 5 to 17 years old. Programmes provided are: Jumpstart Junior: Aged 5 – 9 Jumpstart Senior: Aged 10 – 13 Jumpstart Teens: Aged 14 – 17 75
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50 There were 85 group based physical activity and health education sessions were delivered along with attendance at 7 promotional events over the last year. The Child Healthy Weight Team continue to partner with the Trinity Active Travel hub and education colleagues to support events and initiatives aimed at promoting active lifestyles and healthy habits. Participating families also make use of a free leisure pass to access amenities such as the KA Leisure Centres which would normally not be within their financial ability. Other activity focused on three Fun with Food groups at two early years centres and engaged with approximately 25 families. Further groups are planned for summer 2025. North Ayrshire Athletics Club - Funding success The North Ayrshire Athletics Club successfully secured a funding bid from North Ayrshire Ventures Trust (NAVT). The local group will receive £27,000 over three years to help support an additional member of staff who will help to promote the sport to young people. As well as building on the work already being carried out, the post will help provide athletics opportunities for people living in the most deprived areas and for people living in poverty. They also hope to provide training, volunteering and employment opportunities with a particular focus on young people. The club, along with North Ayrshire Council, North Ayrshire Active Schools, KA Leisure and Scottish Athletics, has been working hard to expand provision and reach more young people than ever before. A significant expansion of all programmes: pre-school, 5 to 8-year-old programme, additional support needs sessions, holiday provision and a range of curricular and extra-curricular athletics sessions has seen over 1,000 young people given the opportunity to participate. Since the programmes started, 250 young people are now taking part on a regular basis. 76
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Appendix 1 – Children’s Services Plan Action Updates 2024-25 Priority 1: The rights of children and young people are promoted and protected No. Action Update 2024-25 1 Implement the North Ayrshire UNCRC Plan actions, ensuring the rights of all children and young people are protected. We continue to champion the United Nations Convention on the Rights of the Child (UNCRC), ensuring that all children in North Ayrshire have their rights met, protected and advocated for. In July 2024, the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024 came into effect. The Act provides protection for the human rights of children and young people in Scotland. Following implementation of the Act, a working group has been set up with officers from across North Ayrshire Council services to deliver improvements. This group is currently developing a workplan that aims to ensure children’s voices are considered in decisions that impact them; there are enhanced approaches to children friendly reporting and procedures for potential children rights breaches; our communities and workforce have increased awareness of children’s rights; and children can further benefit from education on their rights. 2 Ensure the voices of children and young people are heard and influence the work of the Community Planning Partnership. The Executive Youth Council (Exec) has 12 active members from across North Ayrshire. This overarching youth voice structure represents the views of our young people across schools and communities. Currently the group are working in partnership with Education to design and launch a Pupil Council Toolkit that will give schools tools and resources to support pupil voice structures. The group have recently held their AGM where the board were elected. The group have recently led our Joint Youth Forum that brings all of our youth voice groups together from each locality to work on common aims and receive training. February session included an introduction into MHWB pilot of financial literacy and wellbeing, working on the pupil council toolkit and creating poems and literature to support the LGBT work we do locally. Young people also had the opportunity to update us on what UNCRC means to them living in North Ayrshire which will create a comms media plan for the future. Our MSYPs continue to be the representative voice for young people and have been working to gather their views for the Scottish Youth Parliament Manifesto. Furthermore, they are working on their national campaign priorities around access to youth work, mental health and wellbeing and gender-based violence. The North Ayrshire Champions Board are a group of care experienced young people that take part in groups within their local secondary schools during either lunchtimes or within a school period. The aim of the groups is to allow young people to speak about their experienced within a safe space if they choose to do so and to allow them to work or plan projects that may positively impact them. They act as the youth voice for care experienced young people within North Ayrshire. Currently we have these groups running in all secondary schools. We hosted our latest Primary 7 youth council with 140 young people from across all localities focussing on cyber resilience, physical exercise and wellbeing, positive mindset and child poverty. Various Youth Forums sit on working groups – Through Our Garnock Valley, MSYPs sit on Irvine Town Board, North Coast Youth Forum are supporting Helter Skelter issue funds through their funding applications. 3 Provide opportunities for children and young people to develop their citizenship skills, including active democratic participation opportunities. See Action no 2 above. In addition, we hosted our latest Primary 7 youth council with 140 young people from across all localities focussing on cyber resilience, physical exercise and wellbeing, positive mindset and child poverty. Young people are supported in achieving the Personal Development Award, involvement in PB through shortlisting applications to the public vote and locality based for example the design of STEM at Bourtreehill Park. 77
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2 No. Action Update 2024-25 4 Equality and Children’s Rights Impact Assessment (ECRIA) will be carried out on all new policies that affect the lives of our children and young people. The United Nations Rights of the Child (UNCRC) are embedded in our Equality and Children’s Rights Impact Assessment (ECRIA) process. Our impact assessment tool matches the rights against the Getting It Right for Every Child (GIRFEC) Wellbeing indicators to help narrow and define the children’s rights that could be affected by any proposal or development. Each of the Rights are matched against the wellbeing indicators of Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included. Some rights can be matched against more than one indicator. During 2024/25, 14 full assessments and 15 pre-assessment screening forms were completed, each of which asks about potential impact on Children’s Rights. In addition, the equality and diversity part of the impact assessment process, has age as a protected characteristic, to which young people would be a sub-category within this. Across the completed full impact assessments, 11 indicated an impact to some degree on children’s rights and these were considered in detail as part of the assessment process. The Council has an online ECRIA training programme and we are aiming to supplement that in the future with face-to- face awareness sessions on Children’s Rights and the impact assessment process. 5 Through the engagement workstream of the care experienced task force, work proactively with Children and Young People. The North Ayrshire Champions Board are a group of care experienced young people that take part in groups within their local secondary schools during either lunchtimes or within a school period. The aim of the groups is to allow young people to speak about their experienced within a safe space if they choose to do so and to allow them to work or plan projects that may positively impact them. They act as the youth voice for care experienced young people within North Ayrshire. Currently we have these groups running in all secondary schools. We have hosted our Care Day Event bringing care experienced young people, parents, carers and invited guests to an evening of connection, dinner and activities that support our work around care experience. Our North Ayrshire Champions Board relaunched a Care Experienced App named "CE4U". The app has lots of tips, advice, and information that we believe will help Care Experienced young people throughout their journey and beyond. The app has a little bit about everything from housing support, learning how to cook using recipes, tips on how to look after yourself physically and mentally, travel support as well as key contacts and events happening in our area. North Ayrshire Champions Board used their own experiences and journeys to produce the idea for an app and is the only app of its kind in Scotland We support the Auchenharvie Hub for unaccompanied young people and groups and support is given to our New Scots unaccompanied adults through individual and group work sessions. 6 Co-create with children and young people new, systematic mechanisms for maximising learner participation and voice and create a new Learner Participation Policy. The new Learner Participation policy and procedure (POP) by the Council’s Service Improvement Group (SIG), has now been fully launched across all establishments. An audit will be carried out across the service to evaluate the impact of this if part of the Establishment Improvement Plan 2024-25. This will include The Young Leaders of Learning programme which is currently being piloted with up to 11 Early Years centres and schools. This pilot should enhance opportunities to maximise learner participation and learner voice across the pilot establishments. A sharing practice event will be planned for later in the year. 7 Ongoing consultation with children and their families on service design and delivery. We are central to the engagement and consultation with our young people through various different methods including community-based youth forums, executive youth council, thematic youth work groups, Joint Cabinet, P7 youth council and various events. We also actively engage with young people to gather their views and opinions through online 78
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3 No. Action Update 2024-25 methods and social media. These topics are co designed and produced with young people and provide valuable data to inform polices, plans and service delivery. Within the 2024-25 academic year, there is an on-going pilot of Education Scotland’s Young Leaders of Learning programme across 8 secondary schools, 10 primaries within a single cluster and an early years establishment. This programme seeks to strengthen learner participation and support improvement through pupil led improvement activities, which ensures pupil voice are heard and views are respected. While the focus of the programme varies across establishments, initial engagement suggests this may have a focus on tackling this area of the equality duty in some establishments through an emphasised focus on protecting children’s rights. 8 Ensure that Children’s engagement forums focus on rights, helping children and families understand UNCRC and what this means. A key focus for engagement and consultation has been based around UNCRC. Young people have been actively actioning Article 12 through a host of events, activities and online engagements. Our Executive Youth Council are in the process of designing and developing a Pupil Council Toolkit in partnerships with Education. The incorporation of UNCRC is a focal point focusing on training staff and young people in UNCRC awareness, realising rights, child friendly reporting. 9 Work with local partners/members to identify opportunities for children and young people to become involved locally. We work with a range of partners to ensure young people are given opportunity to be involved in local community. Nationally this includes Youth Scotland, Youthlink, Young Scot and Scottish Youth Parliament. We work with a range of third sector organisations to support youth work delivery including Arran Youth Foundation, Police Scotland, Beith Trust, PRYDE, Irvine Youth Legacy Hub and many more. Through consistent engagement and consultation, we identify local need, service provision gaps and needs and wants of young people. Fire and rescue, Police Scotland, Education and KA leisure partnered with us to lead a S3 Leadership programme. 10 Through our Advocacy Strategy prioritise community-based advocacy to children and young people ensuring they are aware of their rights and are appropriately represented. Independent, community based, advocacy continues to be provided via Barnardo’s Hear 4U service. It provides one to one advocacy to children and young people from North Ayrshire and priority is given to children and young people, who: • Are involved in the Child Protection process and/or Children’s Hearing system • Are care experienced in Foster Care, Residential Care and/or Kinship Care • Are on the periphery of Secure Care • Were previously looked after and accommodated • Have additional support needs They continue to support young people to ensure they are aware of their rights, as defined within the United Nations Convention on the rights of the Child (UNCRC). They are committed to ensuring that the voices of children and young people are heard, in a way which builds their confidence, also ensuring that they are listened to and their rights are appropriately represented, when decisions are made. 11 Implement learning and improvements identified through the HSCP SDS Learning Review Board for the Children with a Disabilities Team. Ongoing. Phase 2 work nearing completion in relation to policy, information and training. 12 Include young carers in the planning and shaping of their services. Young Carers have once again benefitted from the Young Carers Education Fund. The fund can be used for anything that will improve or maintain the young person’s physical, emotional mental health and wellbeing or life chances, reduce social isolation, and improve attainment. 115 children and young people have accessed the fund this year. Young Carers work with a key adult to complete a young carers statement and co-design any supports. Funds have been used for driving 79
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4 No. Action Update 2024-25 lessons, days out to have a break from caring, a cinema pass to allow the young person set time away from caring responsibilities each week and one young person asked for cookbooks and utensils so they could pursue their love of cooking. 13 Develop a young people users forum for KA Leisure and ensure their views and opinions are considered when developing programmes and initiatives. We have worked with groups to develop our programme and also delivered surveys within specific communities and target groups. However, a specific forum is yet to be established but is a priority for 2025-26. Priority 2: Acting early to improve what happens next No. Action Update 2024-25 14 Work with our partners to keep all children and young people safe, with the robust implementation of the new National Guidance for Child Protection. A full multiagency approach was taken to implementation of Child Protection National Guidance. Governance of this was from the Child Protection Committee (CPC) and preparation was done to create briefings around all aspects of changes required to implement in September 2023. Since then, further pathways have been developed with oversight from and ratified by the CPC. This includes the pathway for 16–18-year-olds with the various legislative routes that may be appropriate but with recognition that National CP guidance and UNCRC identify this group as children. There are Pan Ayrshire revision of Child Protection procedures that have been undertaken by the CPC Lead officers and will be progressed to CPC in each respective LA by June 2025. IRD Strategic oversight group oversees the changes to IRD in line with National CP guidance. Child Protection training for social work staff has been updated to reflect the National CP guidance. Within the Education Service all staff receive annual Child Protection training. Child Protection co-ordinators attend termly meetings where national safeguarding and child protection updates are shared. The CPC training calendar is shared and staff are encouraged to attend course particularly those around the implementation of Signs of Safety. 15 Support families with children aged 0-5 through our integrated universal early years’ service. There are over 5000 children aged 0-4 years in North Ayrshire, all of whom are supported by either a Health Visitor or a Family Nurse. In addition to following the nationally agreed Universal Health Visiting Pathway from the antenatal period through to a child commencing school, within North Ayrshire, children under 5 and their families continue to have access to additional support from the wider, integrated early years team. During 2024/25 (as at 24 March 25), 914 requests for assistance from the various members of the integrated team were made. This included: • 546 for Health Visiting Support Workers for areas such as communication, sleep, toileting, infant feeding and behaviour • 103 for the Perinatal Wellbeing Team, supporting new and expectant mums experiencing low level mental health difficulties • 91 for Early Years Social Workers supporting with domestic violence, parental mental health difficulties amongst others • 72 for the Family Nurturers who offer support around bonding and attachment, routines, home conditions and community integration 80
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5 • 40 for the Healthcare Support Worker who provides additional support to the Perinatal Wellbeing Team as well as baby massage • 38 for support to dads via our partnership with national charity Dads Rock • 24 for specialist infant feeding support 16 Increase access to early learning and childcare. The 1140 funded hours is now being delivered with flexibility and choice for parents across localities. Our models offer a blend of full year and term time places with various patterns in establishments delivering 8am-6pm and 9am – 3pm. Allocations have taken place for session 25-26 and 87% of parents have been offered their 1st choice for establishment. Work is ongoing to increase the uptake of eligible 2s and this will continue into next year. The early years team is also working with services to increase the number of funded childminders in partnership with NAC with particular focus on the islands and the North Coast. 17 Work together with parents or carers to provide support to their children. Working in partnership with two Ayrshire based parental support groups (ASN Support Ayrshire and ASN Parents and Kids Irvine & 3 Towns), the Education Service has designed and delivered a series of engagement hubs focusing on key challenges families face when navigating their child’s journey through education. These run monthly and feedback has been 100% positive with a calendar of events being designed for session 2025/26. Updated literature around how needs are supported within early years settings and schools have been refreshed and distributed through this forum. Our work around mental health and wellbeing is inclusive of supporting young parents through group work and events. Our Take Time Families provision brings primary aged young people together with their parents and carers to provide support, training and a safe space to connect and learn vital skills around resilience, wellbeing and building strong family connections. Support is also given through our Grandparents group that builds connections through an intergenerational group. Support is given to ASN parents and carers to provide provision of transport. Fullterton Hub is supported to look at holistic therapies for ASN Young people. Support is given to BABAC and Minds of Recovery to establish a community cafe for families in recovery. 18 Improve outcomes for care-experienced young people. A transformation programme to improve outcomes and opportunities for care experienced children and young people has been progressing since April 2024 with the establishment of a Programme Board which provides strategic leadership to the Programme Manager. Position papers for each workstream were presented at the programme board with recommendations and strategic direction. The transformation and service developments were delivered through focussed workstreams on the following areas: 1. Housing and Throughcare 2. Fostering and Kinship 3. Education including Residential School Placements 4. Internal Children’s Houses – Model of Care 5. Early Intervention & Intensive Family Support 6. Strategic Needs Assessment/Data/Workforce 7. Best Practice Models and Research The Brighter Pathways work has involved all corporate parents which has assisted in a shared awareness of the challenges and opportunities to improve the provision of services for families, looked after children and care experienced young people. It can be evidenced through the workstreams and programme board that there is increased joint working, improved relationships and collaboration between agencies at all levels and a move away from silo working relating to care experienced young people. 81
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6 Our Care Experienced learners are among our most disadvantaged learners, whilst there remains a gap between them and our non-care experienced learners. Care experienced school leavers in North Ayrshire are continuing a positive 5-year trend of attainment. In 2022-23, 87% of North Ayrshire’s care experienced school leavers attained at least 1 qualification at SCQF Level 4 or better, the second highest performance in the last five years. 19 We continue to develop and implement the Childsmile programme, focussing on early referral and preventive advice for all families. The Childsmile programme is delivered on an Ayrshire wide basis, receiving referrals from multiple sources including health visitors, school nurses and via dental services. We continue to develop the programme to meet the needs of the population and have recently completed a service evaluation of the service provided by the Dental Health Support Workers, which will feed into our strategic plans for the next 3-5 years to ensure a high quality and meaningful service. Nationally, there are some anticipated changes to the Childsmile programme, which we have commenced local planning to address and will communicate with partners in due course. Our National Dental Inspection Programme (NDIP) figures indicated a marginal improvement on the previous inspections, but overall improvements have slowed, and careful consideration of next steps to be taken to improve oral health further. In 2025, we will be commencing a new Oral Health Improvement Action Plan- which is designed to set the strategic direction in oral health improvement for the next 10 years. 20 We will continue to deliver Jumpstart, a family centred healthy lifestyle programme for children aged 2-17, who are above a healthy weight. The Child Healthy Weight team continue to support children and their families to achieve a healthy weight via the Jumpstart programme. The programme works with families of children aged 5 to 17 years old. Programmes provided: • Jumpstart Junior: Aged 5 – 9 • Jumpstart Senior: Aged 10 – 13 • JumpStart Teens: Aged 14 – 17 There were 85 group based physical activity and health education sessions were delivered along with attendance at 7 promotional events over the last year. The Child Healthy Weight Team continue to partner with the Trinity Active Travel hub and education colleagues to support events and initiatives aimed at promoting active lifestyles and healthy habits. Participating families also make use of a free leisure pass to access amenities such as the KA Leisure Centres which would normally not be within their financial ability. Moving forward early years child healthy weight work will focus on developing the universal, Tier 1 group approach ‘Fun with Food’. This is a collaborative partnership approach with early years and Peeple to use the established peep parenting programme to support families with nutrition and food behaviours and contribute to child healthy weight. Three Fun with Food groups at two early years centres engaged with approx. 25 families. Further groups within North Ayrshire planned summer 2025. 21 Expand our peer support service to all breastfeeding mothers as part of our integrated infant feeding service working alongside the Breastfeeding Network. Peer support service has been expanded to all breastfeeding mothers. Following a tender process, NCT will become the new provider of the peer support service from July 2025. A 3-month contract extension for the Breastfeeding Network has been offered until the end of June 2025. For the first three quarters of 2024/25: • 81.3% of breastfeeding mothers in North Ayrshire engaged in peer support • 83% of breastfeeding mothers in Scottish Index of Multiple Deprivation (SIMD) area 1 who are discharged engage with peer support • 81.9% of breastfeeding mothers in SIMD 2 who are discharged engage with peer support 22 Continue working with whole families, whole systems and whole communities to provide Through our work with wellbeing, early intervention is key to all areas of this. Through work like Take Time Families, school- based provision in primaries and secondaries and youth work provisions we focus on wellbeing, early intervention, resilience 82
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7 early intervention support to all of North Ayrshires Children. and confidence building with young people and their networks. School holiday provision across all of our localities provides activities and access to free holiday meals in partnership with community associations and local organisations. The Whole Family Wellbeing Fund has now been in implementation for 3 years. A separate report on progress in relation to WFWF is in the process of being compiled and will sit alongside the Children’s Services Plan. 23 Providing training/guidance to families, schools, partners and communities that enhances the understanding of early intervention and provides skills needed for families to feel confident and equipped to manage family life. Please see response to Action 15. This session we have continued to roll out our Building on Positive Relationships parenting approach. We have trained education staff including Area Inclusion Workers, and worked alongside the Family Centred Wellbeing Support team to deliver 33 family groups. Across the multi-agency we now have 77 members of staff trained to deliver the programme. Feedback is positive and families feel better equipped to manage family life. 24 We will implement the Signs of Safety approach to social work practice. Signs of Safety has been implemented across Children and Families service from the point of referral to Service Access. Partner briefings have continued to be provided through the CPC training calendar to assist all other agencies to understand the practice model and contribute. Leaflets have been developed that are shared with both families and partner agencies on what to expect. A signs of Safety Steering group was developed for HSCP implementation and in the latter half of 2025 we will be establishing a bi yearly multiagency Steering group. The Signs of Safety baseline assessment undertaken with 10% of families and children open to social work support has been completed and findings will be presented to the Child Protection Committee by June 2025. Child protection and Children and Family Assessment and plans have been redesigned utilising a Signs of Safety practice approach and implemented. 25 Improve planning for transitions of care to ensure children and young people are able to thrive moving into adulthood. Prior to commencing an active role with the children with a disability team, a baseline of current functioning was obtained. The qualitative data for baseline was obtained through staff caseload reviews this included reviewing assessments and care plans, in addition to case notes. This evidenced that current supports available to children, young people and their families is not sufficient in providing adequate support. The supports available are mainly social supports and residential respite. Although these supports offer families a short break from their caring responsibility, it is not fully addressing issues in relation to daily management of personal care and behaviours that challenge, leading to carer burnout and young people reaching crisis. Further findings of the service review found that current factors impacting transition planning include late referrals to Transition Planning Group (TPG) and an inability to screen/allocate staff in adult social work teams to screen referrals and/or allocate workers for assessments. This approach ultimately has a negative impact on a young person's transition, with often late and/or rushed assessment and resource allocation. Current processes were not undertaken in a person-centred manner. In order for young people to thrive as they transition to adulthood, the following improvements were identified: • Assessment and case note training for staff. • Outcome and Goal Setting training for staff. • Review eligibility criteria for children and adult social work. • Collaborative work with our partner agencies to promote skill generalisation between school, community supports and respite for better outcomes for young people. • Personal Care needs to be addressed to support families in the day-to-day care of children and young people with disabilities, through a Care at Home type service. This is multifaceted in relation to relieving carer burnout and also developing and promoting independent life skills in young people, which will support their transition to adulthood. 83
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8 • Proactive use of legislative measures to ensure children and young people are protected. • Review TPG and its Terms of Reference to return to a person-centred decision-making forum. • Referral screening processes to be developed. • Increased joint working from the age of 14-years from adult social work to provide advice and guidance. • Review age restrictions in children and adult social work to allow transitions to happen at the right time, between ages 16-years and 21-years. • Review of resource allocation processes for a more standardised approach. It was agreed, March 2025, that in order to make such significant changes, a report will be submitted to Social Work Governance Board and Partnership Senior Management Team. 26 Invest in premises infrastructure to support children and young people experiencing distress in appropriate environments. Bairns’ Hoose is a European concept with Nordic inspired roots. It is a care, justice and recovery model for children and young people who - • have been victims or witnesses of abuse • are under the age of criminal responsibility • whose behaviour may have caused harm Bairns’ Hoose aspires to have all the specialist services co-located in one building to put the child at the centre of any intervention or treatment, meaning child protection, health, holistic services, court and third sector all in the one shared space. The model is trauma informed, holistic and nurturing to ensure children are supported in the aftermath of their experience and get the expertise input and support they require. In March 2024 a Pan Ayrshire application for Bairns’ Hoose was made, resulting in an initial funding stream to upgrade the Scottish Child Interview Model (SCIM) room at Meadowcroft and develop a second room. The rooms were previously typical office style, basic and functional. To begin to subscribe to the principles of the Bairns' Hoose model we needed to create a safe, nurturing and trauma informed environment that would allow children to share their experience of abuse, or crime either as a victim, witness or if the child has committed a serious offence under the age of criminal responsibility. The SCIM model joint investigative interview room is used by specially trained Police Officers and Social Workers to gather forensic video evidence to establish if there has been a crime committed against the child and, if so, submit the video evidence to Court in a bid to prevent children giving evidence at Court. The Ayrshire Crown Office and Procurator Fiscal Service (COPFS) confirmed earlier this year (March 2025) that evidence from SCIM interviews has continued to improve and over the past year there was no need to call children to Court as witnesses as the defence was accepting of the quality of evidence recordings of the children’s interviews. Therefore, we are beginning to see tangible evidence of Bairns’ Hoose standards being implemented. The second room provides a space for wellbeing and comfort and is used before and after the child’s video evidence. It’s a homely, comfortable, and holistic space to support the child having their voice heard. The room includes an array of sensory equipment such as weighted blankets, toys and fidgets. There is also a sensory garden to allow children to go outside. Outdoor space and nature are important to enhance the child’s wellbeing and resilience as they recall traumatic events. Children First are key partners in devising and implementing the Bairns’ Hoose concept. They sit across all the strategical working groups and deliver a care, support and recovery service which any child being referred for a SCIM joint investigative interview can access. The support begins at the referral stage, the team offer practical and emotional support with the process, interview and court proceedings. 84
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9 We have also opened a new centre to change the way the residents of Ayrshire and Arran receive mental health care has. The West Road Centre in Irvine acts as a base for outpatient services for the all-age Community Eating Disorder Service (CEDS) and the Neuro-CAMHS team (Child and Adolescent Mental Health Service), providing a modern space for individuals to receive the support they need. As the lead partnership for mental health in Ayrshire, this investment shows our commitment to improving the experiences of those using our mental health services, allowing us to provide crucial support in a more welcoming and familiar space. 27 Work across partners to develop robust pathways of support for infants, children and young people and their families seeking support for speech, language and communication development support. All Early Years establishments have a nominated Communication Champion who links closely with the Children and Young People’s Speech & Language Therapy (CYP SLT) team receiving accredited Hanen Learning Language and Loving It training for enhancing the environment in early years to be communication friendly. The Communication Champions are invited to 3 monthly meetings where they receive updates from the CYP SLT team, access a bitesize learning session on a speech, language or communication theme and share good practice with each other. The team also offers training sessions on specific speech, language and communication which are open to all early years and primary staff. The CYP SLT team offers both virtual and person drop-in slots where any parent/carer with a concern about their child's speech, language and communication can request a half hour slot during which they receive advice, resources or completion of a request for assistance if the child is requiring an SLT assessment. Early Years establishments and Primary schools can also request these drop-ins for children in their care and they host the sessions. CYP SLT are part of a recently created North Ayrshire Early Language Network (created May 24) with a focus on 0-5 years. The Network has representatives from Education in the Early years, Psychology, Health Visiting, Speech & Language Therapy, Family Nurse Partnership and the third sector. The focus of the Network is to look at the pathways for infants and children and their families seeking advice or support for speech, language and communication, map what is working well and where the gaps in these pathways are and co-produce solutions. The Network meets on a regular basis. CYP Speech and language therapy work closely with NEST to provide in person workshops on "Supporting your autistic child's communication", providing information and an opportunity for families to discuss their concerns about their autistic child's communication. A virtual drop in (over Attend Anywhere) for families of children with social communication differences is run jointly with our partners in Occupational therapy. SLT assistants link closely with our partners in libraries delivering Bookbug and attending Breastfeeding network sessions to share key messages for developing all children's speech, language and communication. Two SLTs work as part of a multi- disciplinary team who offer assessment and diagnosis of neurodevelopmental conditions, mainly Autism for children aged 3-6. This is a pan Ayrshire service. 28 Improve access to Speech and Language therapy for children and young people who require specialist support. The in-person drop-ins provide an opportunity for children, young people and their parents/carers to access the service when they have most concern. If the families access the drop in repeatedly and there is still a concern and a significant impact on the child due to their speech language and communication needs, they may require an assessment by SLT and may require specialist support. Some children and young people will require a robust assessment of their speech, language and communications needs. If intervention is recommended following assessment, the SLT will work with those closest to the child i.e. parents, carers and education staff to set targets and to share helpful strategies to maximise the child /young person’s communication potential. As a team we are working to reduce the Wait Times (WTs) for SLT assessment and subsequent specialist support through the initiatives already highlighted. An increase in staffing and a more balanced skill mix has supported service improvement plans. 85
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10 As a result, the WTs have steadily reduced. Between February 2024 and February 2025, the CYP WTs reduced by 64% from 138 weeks to 50 weeks. 29 Develop a trauma informed workforce by rolling out trauma aware and trauma skilled resources. Level 1,2,3 training in place along with a PDA in trauma. We have incorporated trauma informed and trauma skilled information and resources in our whole school nurture approaches as well as including it in our extended training offers, including our CALM training and work on functional behavioural analysis and Building on Positive Relationships (based on Non-Violent Resistance). We continue to work collaboratively with our education workforce to ensure that up to date trauma informed training is made available to support the individual needs of establishments. We are currently updating our supporting relationships and behaviour policy, training and guidance and will include this within it. 30 Develop an evaluation framework to maximise resources to support children and young people, to enable system partners to invest and sustain early intervention approaches. A monitoring and evaluation framework has been developed to support implementation of the Whole Family Wellbeing Fund. All funded elements provide 6 monthly reports setting out how they are meeting the aims and outcomes of the WFWF, involvement and impact on children, young people and their families, and sustainability. This is in line with the annual Scottish Government reporting expectations. 31 Reach and identify all young carers earlier in their caring role and promote increased uptake of Young People’s Carer Support Plans. Education Staff have been supported to identify an increasing number of young carers, 406 Young Carers have been offered Young Carer Statements with 366 completing. North Ayrshire Council signed up to the Young Carers Covenant in 2024. The Carer Team are supporting our primary and secondary schools to sign up and to be part of the Young Carers in Schools Challenge. It involves a set of outcomes that young people have highlighted as being key to improving their lives. This shows our commitment to identifying young carers at the earliest opportunity, ensuring they feel safe and secure and have choices in their lives. Each school has a nominated Young Carers Champion who are supported by Young Carer Locality Officers from Carers Gateway North Ayrshire (CGNA). An agreed CGNA offer has been communicated to all schools with the provision of 1 to 1 support and drop-in sessions, Young Carers Awareness Training and Young Carers Statement Training. The Young Carers Education Information Pack was launched in October 2024 to provide staff within education with an overall understanding of the duties and approach in North Ayrshire to identifying, working with and supporting young carers. A programme of engagement and review on the current Young Carers Statement (YCS) has been progressed with final sign off from Social Work Governance Board in April 2025. CGNA Young Carers Team facilitated face to face sessions with 55 young carers aged 6 – 15 across North Ayrshire schools. 36 families also engaged with an online survey. Feedback was also offered from Children & Families Services. Young carers reported that the YCS is valuable to them. It ensures at least one staff member is informed about their personal circumstances. Young carers reported that their voices had been heard after completing their statement, they feel listened to and supported. They would appreciate the removal of the future/ emergency planning section, language was in places complex and questions repetitive. Overall, young carers wanted a shorter, more accessible YCS would be appropriate to assist in better caring conversations. All participants were happy for the original separate primary and secondary YCS to be condensed into one document. At 31/03/25, 549 young carers were recorded on Seemis (education system) and 492 registered with CGNA, crossover information means there is an estimated 650 identified young carers. 86
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11 In the reporting period 1/4/2024 - 31/03/2025 Education staff offered 406 young carers the opportunity to prepare a YCS. To date 366 were accepted and completed via schools and an additional 5 completed by CGNA. Priority 3: Making things fairer No. Action Update 2024-25 32 Implement the North Ayrshire Child Poverty Action Plan. We have a key ambition to transition to a wellbeing economy, delivering prosperity, wellbeing and resilience for local people. Eradicating child poverty is a key component of that priority, and we continue to make strong progress in delivering the objectives of our Child Poverty Strategy 2023-26, including within this most recent year. We have transferred governance from the previous Tackling Child Poverty and Cost of Living Board to become a key priority for the Community Planning Partnership. This will provide sharper focus, greater impact and direct engagement with relevant partners. To further progress our ambitions for a fully joined- up approach, a new Child Poverty Strategy Team was established with funding from Scottish Government’s Fairer Futures Partnerships to bring coherence and oversight to continue reducing child poverty in North Ayrshire. Adding to the many existing services supporting children and families experiencing poverty, we have been undertaking research in preparation for the next phase of evidence-led systems change, recognising complexities in current mechanisms that can present barriers to families accessing support. For our commitment towards a No Wrong Door approach, our Customer Services team have trained and raised awareness directly with frontline staff across housing and social work services. Alongside this continues the technical developments as we strive towards creating a Single Shared Assessment to maximise benefit entitlements. Our Transformation Team streamlined supports such as free school meals, school clothing grants and council tax reductions, while also making access easier through the Cost-of-Living webpage. The Welfare Rights Officers in Schools team grew from one to three members of staff, and the team have helped financial gains of £818,636 going back into the pockets of families. This represents a 46% increase from 2023/24 to 2024/25. Since August 2024, the extension of the team increased its provision to now include Early Years Centres and primary schools, in addition to the secondary schools who have been supported since 2022/23. Key allocations from the £1.2m Child Poverty and Early Intervention Fund (CPEIF) being utilised in 2024/25 included: • £50,000 towards the provision of computer equipment for our communities to tackle digital exclusion, • £61,322 to remove school meal debt, • £50,000 for initiatives to support travel for training and employment; and, • £20,000 for our targeted Active Schools programme removing poverty as a barrier to accessing sport. A sub-group from the Third Sector Chief Officers Group alongside some of our Connected Communities and Employability representatives began working together in December 2024. This identified the key issues of Childcare, Employment Support and Financial Inclusion as priorities where proposals were co-designed for allocation of the CPEIF for 2025/26. The Child Poverty Strategy Team welcomed the opportunity to learn from young people attending the P7 Youth Council in March 2025 as supported by the Youth Participation and Democracy team. The interactive workshops gave the pupils the chance to be the first contributors to Community Conversations on Fairer Futures, as we heard their voice and views on the stigma of child poverty, which will inform future developments. 87
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12 No. Action Update 2024-25 33 Improve attainment and achievement for all. A new data visualisation tool has been launched with all schools to support the tracking and analysis of progress in learning across the Broad General Education stages. This will support more effective targeting of interventions and raising attainment strategies. In addition, there have been trackers developed for Early Years establishments to track progress across Literacy, Numeracy and Health and Wellbeing which align more closely with C. An increased focus on data for improvement has provided senior establishment leaders with opportunity to use data and linking with this, a Data Service Improvement Group has been created in session 2024-25 which consists of senior leaders across Primary and Secondary schools working collaboratively to support improvements in the use of data for raising attainment and closing the poverty-related attainment gap. Data clinics have also taken place to continue to offer support in this area. Early Years and Primary senior leaders have worked collaboratively to create consistency of approach and resource in the tracking of Literacy and Numeracy. These resources will be launched to Early Years Heads and Primary Head Teachers in May 2025. Annual leavers attainment and positive destinations statistics were published nationally at the end of February 2025. This follows the annual publication of Curriculum for Excellence attainment data in December 2024. There is a varied picture across a range of measures, with some clear strengths and areas for further improvement. Attainment dialogues took place in October 2024 and March 2025 with senior Secondary School senior leaders where there was analysis of our areas of strength and areas for improvement in terms of attainment and will feed directly into improvement plans for 2025-26 at both service and school level. The Education Service Digital Learning Strategy was launched at an event for school and early years’ leaders, members of the strategy development group and colleagues from IT Services. Colleagues from across NAC establishments are involved in the national curriculum review cycle and we also have representation on the national implementation group. A full professional learning programme is in operation, expanding our focus on building the capacities and skills of our workforce in effective techniques in the classroom. This includes programmes for teachers, early years practitioners and pupil support assistants and. The Professional Learning Academy (PLA) has a well-regarded in-residence delivery model to ensure training can be adopted, practised and embedded in individual establishments. Attainment The latest published achievement figures are for 2023-24. Combined Numeracy achievement for P1, P4 & P7 is 76%, in line with attainment in the previous year. Similarly, combined Literacy achievement for P1, P4 & P7 is 69%, again in line with attainment in the previous year. Improving leavers’ attainment in literacy and numeracy Performance of all school leavers in attaining Literacy at Level 4 and Level 5 displays a positive 5-year picture. In 2023-24, our school leavers have outperformed all other comparators at level 5, with 93% achieving literacy at level 4 or better and 81% achieving literacy at level 5 or better. The performance of our school leavers in attaining Numeracy at Level 4 and Level 5 also displays a positive 5-year trend. For Level 4, 90% of leavers achieved this and 71% of all leavers achieved Level 5. In addition, the performance of all school leavers with 1 qualification at Level 5 and 1 qualification at Level 6 continues to improve. In session 23-24, 87% of all school leavers achieved at least one qualification at Level 5 which is broadly in line 88
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13 No. Action Update 2024-25 with the previous year. 68% of school leavers achieved at least one qualification at Level 6 which is almost 2 percentage points higher than in session 2022-23. School Leavers entering an initial positive destination An initial positive destination means that a school leaver has gone on to one of the following activities immediately after leaving school: further or higher education, training, skills development or employment. At 96%, the proportion of our leavers moving into an initial positive destination continues to outperform the virtual comparator. To maximise the percentage of school leavers entering and sustaining positive destinations, schools continue to work in strong partnership with Skills Development Scotland and DYW Ayrshire. 34 Close the poverty related attainment gap. Excellence and Equity Leads (EELs) in EY establishments (allocated to those with higher levels of children residing in Q1) continue to focus on raising attainment and closing the poverty-related attainment gap. More focused training with these Leads has provided ongoing consistency of delivery & data collection across the authority. Work with the EELs and Education Scotland is providing support & frameworks to ensure Early Years establishments can measure the attainment in relation to the poverty related attainment gap. In the 8 mainland Secondary schools, the MCR Pathways programme continues to be delivered to care-experienced learners and those at risk of being placed into care. To date, over 400 young people have been supported through the programme in this academic session, participating in activities such as group work and mentored relationships. There has been collaboration with the corporate parenting team to help support schools with engagement with “Keeping the Promise” award of which 2 Secondary Schools are currently involved. An increased focus on the use of data for improvement has allowed for a greater focus on closing the poverty-related attainment gap. The Education Scotland Attainment Advisor, working closely with Senior Managers, has provided targeted support to schools with a higher number of learners in Q1 to support increased attainment in session 2024-25. There is ongoing analysis of schools’ Pupil Equity Funding (PEF) evaluations of impact of spend to analyse interventions and their impact on closing the poverty-related attainment gap. 35 Implement the recommendations from the Independent Care Review (Scotland), The Promise. We have fully committed to #KeepThePromise which provides a benchmark for corporate parents, carers, practitioners, managers, care experienced community, and decision makers in fulfilling the goal to meet the collective and individual needs of all of our Care Experienced infants, children and young people. Promise drop in information events for staff are continuing to be held regularly. Our 3rd annual Promise Conference was held on 9th December 2024. 73 Care Experienced young people from across our Secondary Schools came together to learn about The Promise Scotland Plan 24-30, meet corporate parents and connect with each other. The HSCP and multi-agency partners across North Ayrshire have worked hard since 2020 to promote and implement The Promise locally. Agreement was reached at the Children’s Services Strategic Partnership in June 2024 that the work of the former Promise Oversight Group in North Ayrshire would be incorporated into the overarching Corporate Parenting Steering Group. The Corporate Parenting Action Plan was revised as necessary in August 2024 to capture all activity associated with The Promise. The action plan has been aligned with the 5 key foundations upon which The Promise is built - Care, Voice, Family, People and Scaffolding. 89
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14 No. Action Update 2024-25 36 Implement the recommendations from the Additional Support for Learning Review (Scotland). Significant work is underway to review and refresh out Positive Relationships and Behaviour policy including a focus on tackling violence and aggression within establishments. A new family engagement hub has been launched in partnership with two support groups who represent and work with parents and families of children with additional support needs. These will act as a focus for conversation, problem solving, information, co-creation and collaboration. Inclusion Ambassadors programme piloted in almost all secondary schools alongside the Success Looks Different Awards which were publicised to all establishments and support available for those who wish to apply. High profile given to language used to describe needs and how they are supported – example needs are not considered additional as everyone has needs, some require a more intensive level of support which can be part of our universal offer within all establishments. Secondary schools linking with Scottish Government in the codesign of the national measurement framework and dashboard with a specific focus on capturing successes and achievements of young people who are following different pathways. All Classroom Assistants have been re-graded as Pupil Support Assistants with an up-to-date role profile and professional learning calendar. Work to lay out a strategy for deployment in underway. We continue to develop good practice based on the ASL Review within North Ayrshire. We have developed a Family Engagement Hub where we engage with our parents to understand the issues and concerns that they have with regard to supporting children with ASN, including streamlining our placement process and complaints process. We have updated our literature on this also and have made this available to all parents. We continue to monitor and review the level of need within NA and have worked to update our offers of support based on this need, building upon our outreach services offer, our provision to support children with complex needs and our support for children with attendance and behaviour issues. We have several working groups looking at attendance and relationships and behaviour in order to develop policies and practice that will support children and young people. 37 Build strong collaborative partnerships in local areas to ensure we deliver high-quality services for all of our children, young people, and families. Please see actions 33 and 34 for detail. NAC Early years staff are working with our funded providers who contribute to the early childhood development and education of our young people. We have provided training and engagement sessions this session to ensure the delivery of high-quality experiences for all. There is ongoing work with other sectors within NAC and SCMA to encourage North Ayrshire residents to become childminders. This is aimed at a targeted group and support will be provided to encourage people to venture into this career pathway providing more choice for families with regards to their funded childcare. 38 Create a new 3 year Raising Attainment Strategy. See action 33 for detail. Activity in this area will be captured and synthesised in June 2025 and shared with senior leaders of all educational establishments. 39 Maximise opportunities to work with Third Sector providers to provide early intervention and prevention supports, with a particular focus on primary prevention approaches. Through Whole Family Wellbeing Funding, the Children’s Services Strategic Partnership has awarded grants to eight third sector organisations during this financial year with the aim of testing or expanding early intervention projects which support a whole family approach. Some of these projects include support to kinship families, the use of art therapy in early years, transition support to young people with additional support needs and intensive therapeutic counselling support to children who have been sexually abused or experienced other significant trauma. 90
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15 No. Action Update 2024-25 Through the Children and Young People’s Community Mental Health and Wellbeing Supports and Services Framework grant funding we have supported 6527 children and young people and 1212 family members through a range of programmes. 6283 children and young people have engaged with positive mental health and wellbeing services highlighting the focus on early intervention and prevention. 94% have reported an improved outcome. We have engaged with Third Sector partners through a collaboration with the adult community mental health fund processes. 40 Providing a robust ‘peer’ support model that upskills parents and carers, providing training and volunteering opportunities and enhances employability skills as well as building self-esteem and confidence. In 2024/25, the Employability service has registered 794 new parents who are engaging, developing skills, confidence, and resilience to secure and sustain employment in the future. In this period 80 parents have secured paid work experience through placements in third sector organisations, the council and 50 more have progressed into employment, with 130 more families in employment with increased household income this will contribute directly to addressing child poverty. Three new Peer Navigators have been recruited to engage and support parent to engage in training, volunteering and the range of opportunities provided by Your Next Move Working North Ayrshire to prepare and progress to employment. 41 Take an asset-based approach to communities/children and families and build upon the skills and strengths that exist. The Signs of Safety model works in collaboration with families to identify strengths and family network and wider support networks who can assist to support the children wellbeing or child protection plan that has been established. All Children and family paperwork identifies family strengths and “what is working well”. Equally core partners e.g. Education have adapted the child protection concern referral to incorporate what is working well as well as what we are worried about. All referring partners are being asked to identify if this issue arose in the past who or what helped support and scaffold it. These strengths-based questions assist us to be curious about family asset and ensure the best approach is taken to working in collaboration with those in our communities. 42 Establish a Financial Inclusion Partnership in North Ayrshire to better support access to support for families. A North Ayrshire Financial Inclusion Partnership was established in May 2023 with membership including financial inclusion service providers and key stakeholders. The Partnership developed and delivered a Community Consultation at the end of 2023, the findings of which will be incorporated into an update of the Financial Inclusion Strategy to be produced late spring 2025, for 2025-30. The consultation found that advice/financial inclusion services are highly rated by those who had used them, but in response to a question relating to barriers to accessing advice services, there are a number of areas to be addressed in the promotion and development of services: • The range of platforms available for access services for people who don’t like using the phone/internet • That advice services are available for people in all housing tenures including owner-occupiers • Stigma/self-stigmatising • Fear of the situation getting worse • Services available to island communities • Improved engagement with gypsy/traveller communities A Communications sub-group of the Partnership has now been established to address the above. Another key finding, which reflects wider national research, is that where both debt and welfare rights advice is required, accessing both through one referral/service is preferred. In response, it has now been agreed that to supplement the debt advice service available to council tenants from the HSCP Financial Inclusions service, an additional welfare rights and debt adviser will be recruited for non-council tenants, to provide a service for those who seek welfare rights advice from Money Matters, but also require help with debts. This will then eliminate the need to refer on to another service for this support. 91
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16 No. Action Update 2024-25 43 Develop peer support models. Our leadership opportunities allow young people to become peer mentors and role models through our youth voice provision (youth forums, junior youth forums, Scottish Youth Parliament and executive youth council). These young people co design service delivery and support the work being delivered. Our Modern Apprenticeship programme takes young people through and SCQF Level 7 in youth work, participants design, produce and deliver work with young people across North Ayrshire around all areas of CLD and youth work. This year has seen Active Schools employ our first Modern Apprentice, who will start their journey of SCQF Level 6 in Sports Coaching. The funding for this post has come from ENABLE and sportscotland. As part of the criteria from the funders the candidate had to have a disability. They are working across our team but their role has a particular focus on ASN provision. 44 Strive for parity of access to support and services for our Island Communities including for Children and Young People. Cumbrae and Arran are supported to deliver youth work provision. Through a Service Level agreement with Arran Youth Foundation this provides a variety of youth work opportunities for young people in Arran. Specific measures were implemented to deliver the holiday meals programme. 45 Provide multiple points of access for young carers into carer support services. Effective access points available for young carers in North Ayrshire are: • Designated young carer leads from CGNA staff covering school cluster areas. • Carer Champions in each school with a specific role/ skill to identify and support young carers. • Awareness raising of young carers in schools through posters and leaflets, assemblies, parent’s evenings or PSHE lessons to inform young people and parents about the information and support available. • Drop-in sessions or dedicated groups established within some schools for young carers. • Bridgit’s new online platform for young carers was launched in March 2025, offering a wide range of resources and support designed for young carers available 24/7. • March 2025 saw Carers Gateway support 230 young carers within a group setting and 59 on a 1 to 1 basis. • An improved online registration for young carers for professionals and self-referrals has been established. • For young carers aged 16 – 18 and not in school NAHSCP Carers Team have a Carer Support Officer who can offer and support the completion of a YCS and provide access to support. Priority 4: Promoting good mental health and wellbeing No. Action Update 2023-24 46 Develop our nurturing approach across all Children’s Services. Our nurturing and trauma informed approaches are intertwined and we have ensured that all our training offers incorporate the key concepts from both. In addition, we continue to offer support in nurturing approaches to our Children’s Houses to ensure they offer attuned and developmentally appropriate support for children and young people in their care. We have also invited a range of professionals across the HSCP to our training sessions on Building on Positive relationships to ensure they have a basic understanding of attachment, positive relationships and authoritative parenting. Staff involved in the training include Area Inclusion workers, Family Centred Wellbeing Service, Fostering and adoption services and Rosemount. In addition, we invited our HSCP colleagues to attend our recent collaborative event on relationships and behaviour. 92
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17 No. Action Update 2023-24 47 Work with children, young people, families, and communities to improve mental health and wellbeing through physical activity and social participation. Over this year our health and wellbeing work had focussed on supporting schools by delivering our Bouceback mental health and wellbeing programme. We have supported learners at the Hive, Ayrshire College with Your Resilience workshops and training. The Take Times Families Group work with 15 parents/ carers and children looking at anxiety, emotions, and resilience in fun understandable ways. Both Joint Youth Forum and Primary 7 youth council featured MHWB workshops for young people to look at resilience, wellbeing and positive mindset. Our Cyber Explorers programme supports young people gaining a cyber resilience qualification and supports wellbeing and online safety with 755 registered on the system, 129 young people achieving SCQF Level 4 and 57 young people achieving SCQF Level 5. There are 1024 active DofE participants where mental and physical health and wellbeing questions are regularly answered by participants on their DofE app showing improving their mental/ physical health whilst taking part in the Award. CLD Supports and leads on initiatives such as Our Scottish Sports Future, Community Schools for non-attenders, New Scots Girls football, adventure group and volleyball. Park Lives – Dalry Community Sports Club Taboo Topics Group – which focusses on wellbeing podcasts and North Coast Media Studio with. Our games group supports ASN young people with wellbeing and resilience through gaming. All Active Schools activity supports positive mental health for all participating children and young people. Our extra-curricular provision, events and leadership programmes across the year all help to reduce stress, boost their mood and enhance their self-esteem. In addition, our staff have developed a guide for schools to raise awareness on how our work contributes to positive mental health. Furthermore, the coaches and volunteers have been part of a robust training programme around mental health and how to support young people during their weekly sessions. 48 Continue to have appropriate pathways in place for supporting mental wellbeing. Our mental health and wellbeing staff support early intervention and wellbeing to secondary and primary aged young people. Pathways to further services are in place for young people needing more support with links to school councillors, LIAM training and conflict resolution sessions. Mental and emotional wellbeing is one of the 10 priority pathways in the school nursing service. During 2024/25 we have undertaken work within the school nursing service to clearly define what support is able to be offered in relation to mental health and wellbeing and agreed across Ayrshire that the following areas can be supported: low level anxiety, low mood, bereavement support, self-harm and low self-esteem. Staff have received additional training in relation to bereavement support whilst continuing to deliver Let’s Introduce Anxiety Management (LIAM) where capacity allows. 49 Work together with children, young people, and their families to help build resilience. Our Building on Positive relationships programme has been delivered to around 30 families to help build resilience in families. We have developed resources to support anxiety to help improve attendance in our primary and secondary schools. Five of our schools have been involved in a national programme to build resilience in schools. We have continued to support and expand our LIAM and Project Restore Programme to help support children’s anxiety. We continue to develop resources to capture children and young peoples views to help them share their experiences. We have recently invested in Emotion Coaching training to help young people express their emotions whilst setting clear boundaries. 50 Improve services for children with neuro- developmental conditions, implementing a whole system approach with partners across Health, Education, Social Services and the Third Sector. (Implementation of Through North Ayrshire’s CYP Neurodevelopmental Implementation Group, the following progress has been made during 2024/25: • All North Ayrshire family supports for children with neurodevelopmental differences (NDD) have been mapped and uploaded onto the NEST website. 93
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18 No. Action Update 2023-24 the National CAMHS and Neurodevelopmental Specifications). • A third phase of engagement work was undertaken with parents/carers around their experiences of NDD support and services, following on from the focus groups undertaken in 2023/24. A summary report of the findings has been developed and will be shared with those who attended. The focus groups have been a helpful reference point to sense-check progress to date, to get feedback and to consider and respond to this. • Following the 2023/24 training needs analysis of the children’s services workforce in North Ayrshire, an agreement to create a NDD Learning and Development Adviser post (fixed term) was made. This post will support build capacity and capability of all agencies working with children and young people in relation to NDD. Due to delays in processes, this post will be recruited in the next financial year and will be funded through the Whole Family Wellbeing Fund. • A test of change involving the creation of a multi-agency panel (MAP) to review all children and young people who had been referred to CAMHS since August 2023 but who no longer met the CAMHS criteria. In addition, pan-Ayrshire discussions regarding what a potential ND service would look like have been ongoing, with a draft business case being completed currently. 51 Public Health will implement a life course approach to Mental Health and Wellbeing, focusing on the first thousand and one days, infancy and Children and Young People. Public Health continues to socialise the life course approach to mental health and has presented to a range of colleagues and partners this year including the Integrated Children and Young People's Transformational Change Board. Public Health continues to co-chair the North Ayrshire Wellness Model group alongside Education with a view to improving access to tier one supports for children and young people across North Ayrshire. In addition to our MHWB resources 'A Guide for Children' and 'A Guide for Young People' a new 'Children's Workbook for Mental Wellbeing' has been developed and is being promoted for use by all front-line staff working with young children and families. 'A Workbook for Mental Wellbeing' is available to support older children, young people and young adults. Public Health staff work closely with NA Education Mental Health and Wellbeing Operational Lead to provide training, resources, expertise and support with a Whole School Approach to supporting mental health. 'Mental Health Improvement- a practical approach' training has been delivered to the MHWB Operational Lead as well as Area Inclusion Workers who continue to cascade the training and use learning to facilitate work with children and families. This training is available through the PH Training Brochure for others who wish to access it. An MHI-apa training session was delivered to school nurses from across Ayrshire, including those from North Ayrshire. All health information, resources and self-management tools to support CYP and family MHWB were highlighted during the session. There is now a network of facilitators delivering Time, Space, Compassion workshops which are open to staff working across children's and young people's services. More information is available via the previously attached poster and people can register an interest in the workshops using the QR code. Since October 2024, Public Health has organised and delivered 9 TSC workshops across Ayrshire and Arran. Three of these sessions were in North Ayrshire. However, staff from North Ayrshire have accessed all sessions. 97 staff members from various have registered for the sessions with 75 attending and completing these sessions. (Please let Nicola Tomkinson know if you would like any specific information about these sessions- an evaluation report will be written soon). Within North Ayrshire the TSI have worked with Public Health and a number of partner and community groups to develop a suicide prevention toolkit for the third sector. While this is not specifically aimed at CYP the staff working with them could use this as it contains links in the apps list for CYP. The toolkit can be accessed here: Projects - Arran CVS 94
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19 No. Action Update 2023-24 52 Establish a Community Planning Partnership led Health and Wellbeing Alliance to bring key partners together to co-ordinate approach to targeting support to improve individual, family and community health and wellbeing. KA Leisure continues to work with partners to establish the strategic priorities of the North Ayrshire Wellbeing Alliance. Meanwhile we have collaborated with partners to deliver two pilot projects – Garnock Valley Task Force A collection of partners working to deliver an intervention project for young people disengaged in the classroom. The aim of the collaboration is to encourage the young people to return to the classroom, make better more informed decisions and connect with their communities. Kilwinning Wellbeing and Employability Pilot A collaboration between wellbeing and employability to increase opportunities and reduce inequalities of residents in Blacklands and Kilwinning West. 53 Build on services that encourage parenting skills and interactions with between family members. Please see actions 15 and 23. 54 Build on the National CAMHS Specification through the 3 established pathways (core, unscheduled care, neuro), ensuring young people are on the correct pathway at a much earlier stage. 3 teams are now operational and unscheduled care provide a 7-day service. Pathways between the three teams have been developed to ensure that the young person is assessed and advice given and or referral to the appropriate pathway of care. 55 Continue to provide ‘worry workshops’ e.g. identifying key issues raised as worries by North Ayrshire children and young people and using this to develop targeted workshops on these issues. No longer required. 56 Be responsive and pro-active in responding to and learning from Young Person’s Suicide through our Young People’s Suicide Prevention Taskforce. The Young People’s Suicide Prevention Taskforce continued to meet regularly during 2024-25. The group have reflected on learning and practice. It has been agreed that the Young People’s Suicide Prevention Taskforce will move to be incorporated in the overarching Suicide Prevention Taskforce. Work is ongoing to integrate these strands into one strategic group. 57 Deliver the new National Secure Adolescent Inpatient Secure Unit (Foxgrove) for children across Scotland, which will also benefit young people in North Ayrshire. Work within Foxgrove is ongoing. 58 Explore opportunities to ensure young people are not admitted to non-specialist environments including options to develop and in-house CAMHS inpatient provision. Conversations started and Business Case developed. 59 Building on the success of the Kilwinning Wellness Model, the Revised Wellness The revised wellness model is now in place in all localities except the Three Towns. Plans are in place to complete the roll out early in the next school session. Education and Primary Health care colleagues have commented on the positive relationships 95
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20 No. Action Update 2023-24 Model working group will now seek to roll out the approach across all North Ayrshire localities. being developed through the model. This ensures children and young people are receiving mental health and wellbeing support timeously with robust referrals to CAMHS in place when required. 60 Enable young carers to have a quality of life outside caring and ensure support when moving through key life stages. Please see Action 12 Our HSCP Young Carers Education Fund received 119 requests between 1/4/2024 and 31/3/2025. Young carers were supported to receive a break from caring, look after their own health and wellbeing via KA Leisure Memberships, sports equipment etc. and improve life opportunities such as representing their country at sport or dance or commencing driving lessons. Carers Gateway North Ayrshire (CGNA) supported 94 requests from young carers via their Time to Live funding to support a break from caring, which was just under 25% of all funding allocated. CGNA hosted a range of young carer/ family events and activities over spring, summer and festive holiday periods and at key national points like Young Carers Action Day, Carers Week and Carers Rights Day. There have been woodland wake ups at Eglinton Park, Maritime Museum trips, a Hopscotch residential, movie nights, Christmas and Halloween parties as well as the Scottish Young Carers Festival which takes place every year in August allowing young carers to come together, have a break from caring, meet new friends and take part in national consultation but mostly, have fun. CGNA and HSCP supported the formation of a Transition Together Group in late Summer 2024. The Young Adult Carers Transition Plan, developed by the Carers Gateway Team, is designed to support positive and meaningful conversations with young carers at key transition points. It focuses on providing holistic support across areas such as education, employment, finances, peer networks, and community engagement. This plan is available to young carers either moving into the Young Adult Carers service or those aged 16 and leaving full-time education. The Carers Gateway Education Offer, along with established working agreements between the CGNA Team and education providers, places a strong emphasis on supporting young carers during the transition from Primary 7 to Secondary 1. The focus is on ensuring they receive appropriate information and guidance, and are aware of how to access or continue support as they move into secondary education. The Young Carers Champions Board is in its early stages, with key planning underway for an initial residential at the Arran Outdoor Activity Centre. This residential trip aims to ensure that young carers remain at the heart of decision-making, helping to shape support, services, and future developments. Priority 5: Inspiring children and young people to be active No. Action Update 2024-25 61 Create innovative physical activity and sports opportunities with communities and partners. Active Schools and KA Leisure have continued to support more young people to be active both within a school and community settings. We have worked in partnership to make sure there are school to community links in all six localities. Across this year we have also worked together to fill any gaps in provision to ensure all localities have an equitable number of opportunities for all young people to take part in. Our pathways between school to club/community sport has been strengthened to allow a better transition for our young people. In addition, Active Schools have continued to focus on those who most need our support to access sporting opportunities across our system. The Active Schools and Communities Partnership Officers have played a crucial role in this and have 96
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21 No. Action Update 2024-25 removed any barriers to participation for those that are care experienced, living in poverty, on the cusp, non-attenders or targeted. Furthermore, the team have continued their support to the HSCP, third sector partners and ASN young people. KA Leisure offers a diverse range of programs that include sport and general physical activity. We collaborate with communities and partners to provide term-time activities and holiday programs. Our term time programme is spread across all localities with over 100 classes per week. There are 1024 active DofE participants where physical health is part of all participants award Duke of Edinburgh's Award (DofE) which has four core sections: Volunteering, Skills, Physical, and Expedition, with a Residential section added at the Gold level. 62 Adopt a whole systems approach to diet and healthy weight. In relation to the healthy weight whole systems work, an event is being planned by Connected Communities for mid-late June 2025 to discuss how to remobilise the work. 63 Design opportunities into the whole system to enable children, young people, and their families to access supported physical activity opportunities and have a healthy lifestyle. Active Schools key priority is still to support ALL schools in North Ayrshire to deliver high quality extra-curricular programmes that are open to ALL. Across the year the top 5 sports participated in by our schools are – football, netball, rackets sports, dance and Multisports. Our events calendars this year have seen over 2003 young people take part in a variety of sports across 25 events. In addition to these events, we have supported our ASN pupils to attend the Ayrshire Sports Ability and Scottish Disability calendar of events to make sure ALL young people have the opportunity to perform and compete at the appropriate level. 64 Ensure all our early years indoor and outdoor learning environments and activities enable children to be physically active. All early year’s establishments provide learning environments which provide opportunities for physical play both indoors and outdoors. All staff are aware of the importance of developing gross motor skills and ensure experiences offered support development of core strength, stability, balance, spatial awareness, co-ordination and agility. 65 Promote access to leisure services for children and young people to encourage participation in physical activities. KA Leisure continues to deliver innovative marketing campaigns to encourage participation across the general public. We also collaborate with partners to provide targeted approaches to encourage harder to reach young people to participate in our programmes. 66 Promote the introduction of the INSPIRE programme to improve opportunities for alternative activities, including arts, drama and music. KA Leisure promotes the INSPIRE programme by offering a comprehensive membership that provides children and young people with access to a wide range of activities, including arts, drama, dance, and music. We ensure visibility through community engagement, partnerships, and targeted marketing efforts. The programme includes term-time activities and holiday programmes. 67 Create and protect safe spaces for children to play and enjoy being outdoors. There are 1024 active DofE participants where physical health is part of all participants award Duke of Edinburgh's Award (DofE) which has four core sections: Volunteering, Skills, Physical, and Expedition, with a Residential section added at the Gold level. We led a consultation around the national Play Strategy engaging with primary and secondary young people through a variety of events that supported young people voice in North Ayrshire. Our outdoors for wellbeing programme gave 30 primary aged young people a weeklong programme of outdoor activities that supported wellness which included yoga, tree planting, nature walks and more. We work in partnership with Scottish Ports Futures to provide the Twilight Basketball programme that incorporates physical health with youth work issue-based programmes throughout the year. Working with our New Scots girls group we support the Swans Girls Football Team. All early year’s establishments have access to outdoors at all times of the year. 97
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22 No. Action Update 2024-25 68 Support parents to understand the importance of movement and enjoyment for children and young people. KA Leisure encourages this through ongoing marketing campaigns, open days and targeted programmes. 69 Work with local small business/ fitness team to provide access to activity and nutrition information. Partners of KA Leisure support funded memberships for young people from the age 12. Any young person from the ages of 12 – 15 looking to use our gyms must first take part in our Elevate Academy. This 4-week programme provides 12–15-year- olds with an introduction to a Gym Environment. These sessions will provide information on how to exercise safely and effectively whilst looking to Inspire, Educate and Challenge the Future Generation. 70 Creation of new and local growing spaces to support communities to grow foods, to upskills families, enhance family time and connection. New Community Gardens are underway in Beith, Bourtreehill, and Largs. A new outreach programme managed by The Three Towns Growers and supported by The Community Campaigner from North Ayrshire Foodbank has started in the Three Towns. Six new sites have been identified within the three towns and link in with existing facilities. These include Ardeer Primary, The Hub on the Prom, Doon the Beach and Argyle Community Centre. Local families and individuals will be encouraged to get involved and learn new skills in food growing, and any leftover produce will support the Fairer Food Network of larders. Existing allotments and growers continue to develop a year round series of community events and themed days to encourage public interest and support. These include plant sales, themed event such as Halloween and Christmas, Duck Races and Tattie day, which encourages local people to grow their own potatoes. This year, households using Ardrossan South Larder were able to get a free potato growing pack including grow bag, seed potatoes, compost and instructions. In addition, school visits to local sites encourage an interest in growing from a young age which is then nurtured and supported through school learning. 71 Ensure all primary, secondary and ASN schools are provided with quality extra- curricular opportunities in sport and physical activity that are open to all. Active Schools key focus has remained on getting ‘More Kids, More Active, More Often’. Extra-curricular provision has been delivered across all primary, secondary and ASN establishments. 9201 young people have attended a variety of sport and physical activity sessions across this year, which is over 52% of the whole young people population. There were 10,420 sessions delivered across the year with 217,225 visits in total taking place (if 10 kids attended 10 times that's 100 visits). We had 663 deliverers of which 98% of them are volunteers, this highest in recorded in Scotland. 72 Ensure all young people have the opportunity to compete and perform regardless of what level they are at. Our Active Schools Calendar of events this year have seen over 5300 young people take part in a variety of sports across 63 events. The events calendars run in clusters, localities as well as North Ayrshire wide. In addition to these events, we have supported our ASN pupils to attend the Ayrshire Sports Ability and Scottish Disability calendar of events to make sure ALL young people have the opportunity to perform and compete at the appropriate level. 73 Create and support a school to community club pathway for sport across North Ayrshire. Last academic year Active Schools supported 52 North Ayrshire clubs to engage in schools. Clubs delivered the following: • Curriculum enhancement sessions (PE slots over and above the schools 2 hours of PE) • Health week sessions • One off days in schools • Visits to the club • Promotion of club through distribution of flyers Furthermore, Our North Ayrshire Community Sport Hub are flourishing. In partnership with KA, we have been supporting clubs with training, venues and one to one development sessions. In collaboration with selected affiliated clubs, we have 98
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23 No. Action Update 2024-25 been supporting the delivery of satellite clubs to encourage more localised participation. In addition, we have supported the development of additional ASN sessions at North Ayrshire Athletics club. Badminton as also been a focus this year with the employment of a racket sports officer who sits within the KA team to develop school to community clubs in targeted localities. 74 Ensure an effective leadership pathway is developed for P6 through to S6 and beyond to develop transferable skills. Active School have a sector leading leadership pathway from P6-S6 and beyond. The P6 Move and Improve programme has seen 1003 young people trained as leaders. Their role is to deliver quality sports and physical activity lunchtime session to their peers. We have also had 36 teaching staff members trained through this programme to support the delivery. Our S1-S6 Young Ambassador programme has 148 representatives. Their role is to promote sport and encourage others to be more Active. Our S5-S6 North Ayrshire Sports Academy programme has 168 young people engaged. Each participant will have gained a minimum of 8 and a maximum of 12 qualifications. These range from their Saltire Awards, National Governing Body Qualifications all the way through to and SQA in Higher Leadership. This programme has seen the young people volunteer over 5500 hours within their local schools and communities. 75 Ensure we remove any barriers to participation for care experienced young people to take part in sport and physical activity. The role of the Active Schools and Community Partnership to work with key partners and stakeholders to remove barriers for the young people and families within Care Experience across North Ayrshire to take part in Sport and Physical Activity using a Whole Systems Approach to lead a healthier Lifestyle. This last year has seen the delivery on 31 different experiential opportunities to 273 young people. The opportunities are wide and varied and range from water sports, climbing, sailing to residentials and fun days. On completion of their experiential activity the young people are then supported into more frequent activity within their own school and or communities of which 59% currently have taken this opportunity on. The work of this team has grown to supporting non-attenders, those living in poverty, ASN (244 of which 90% have moved into frequent activity), young people supported by the Drug and Alcohol team (16), New Scots (10) and Unaccompanied Asylum-Seeking Children/ Trafficked Young People (16). 76 Expand and develop the Health and Wellbeing Service to accommodate children and young people, with a focus on partnership working within the Mind and Be Active programme to establish an early intervention approach that provides supported physical activity opportunities for children and young people who are experiencing poor mental health. KA Leisure has delivered targeted interventions to secondary schools and collaborated with partners to encourage the use pf sport and physical activity to improve young people’s mental health. 77 We will work with Community Planning Partners to establish a set of outcome indicators to measure progress on each of the priorities and actions. The Children’s Services Strategic Partnership agreed a set of performance measures to ensure we are monitoring progress of our Children’s Services Plan and this will be reported as part of our performance reporting. 99
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APPENDIX 2: Childrens Services Plan Performance Indicators 2024-25 Priority 1: The rights of children and young people are promoted and protected Indicator 2021/22 2022/23 2023/24 2024/25 Children and Young People receiving Advocacy Support 178 TBC TBC TBC Number of young people taking part in influence and engagement through CLD (Community Learning and Development) (e.g. engagement, youth participation and citizenship work) 12,749 20,694 15,202 11,746 Proportion of child protection re-registrations within 18 months 17.8% 10.8% N/A N/A Priority 2: Acting early to improve what happens next Indicator 2021/22 2022/23 2023/24 2024/25 Percentage of children with one or more developmental concerns at their 27-30 month review (Calendar year) (2022) 19.96% (2023) 21.6% (2024) 20.8% N/A Babies who have always been exclusively breastfed (reported at 6/8 weeks) (Calendar year) (2022) 20.1% (2023) 20.3% (2024) 25.6% N/A Children referred to Reporter for offences (aged 8-15) (rate per 1000) 5.23 N/A N/A N/A Children referred to Reporter for care and protection (aged 0-15) (rate per 1000) 16.26 N/A N/A N/A Immunisation uptake for 6-in-1 - children (aged 24 months) (3 year rolling average) 96.95% 96.7% N/A N/A Immunisation uptake for MMR - children (aged 24 months) (3 year rolling average) 94.2% 93.1% N/A N/A Number of Requests for Assistance received - referred to Specialist Services - for Speech and Language 61 26 46 12 Number of Requests for Assistance received – referred to HV support workers within UEY (Universal Early Years) team in the period for Speech and Communication 193 139 157 171 Percentage of Primary 1 Children free from dental decay 71.16% 73.32% 69% N/A Percentage of Primary 7 Children free from dental decay N/A 77.34% 70.1% N/A Uptake of the HPV vaccine in S3 girls (3 year rolling average) 75.20% 78.23% 79.3% N/A Deaths from suicide (aged 11-25) (rate per 100,000) (5 year rolling average) 15.9 N/A N/A N/A Alcohol-related hospital admissions (aged 11-25) (rate per 100,000) (3 year rolling average) 216.75 N/A 151.9 N/A Drug-related hospital admissions (aged 11-25) (rate per 100,000) (3 year rolling average) 164.48 147.1 114.7 N/A Smoking during pregnancy as reported at antenatal booking (3 year rolling average) (Calendar year) 21.46 15.6 N/A N/A Priority 3: Making things fairer Indicator 2021/22 2022/23 2023/24 2024/25 Proportion of Looked after Children with more than 1 placement in the last year 18.8% 17.4% N/A N/A Children looked after by the local authority as at 31st July (aged 0-17) 446 404 409 N/A Children on the child protection register as at 31st July (rate per 1,000 children) 4.2 3.5 4.1 N/A School attendance rate for whole population N/A 89.0% 89.1% N/A School attendance rate for looked after children N/A 84.2% N/A N/A Number of families receiving cash payments for Free School Meals during holiday periods (school year, snapshot of data) 3,120 2,706 2,626 2,690 Combined Numeracy achievement for P1, P4 & P7 (expected CFE level) 75.5% 75.9% 76.2% N/A Combined Literacy achievement for P1, P4 & P7 (expected CFE level) 67.3% 68.5% 68.6% N/A Percentage of pupils gaining 5+ awards at SCQF Level 5 (LGBF) 67% 63% 65% N/A 100
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Indicator 2021/22 2022/23 2023/24 2024/25 Percentage of pupils from 20% most deprived areas gaining 5+ awards at SCQF Level 5 53% 52% 53% N/A Annual participation measure for all 16-19 year olds (calendar year) 90.84% 92.0% 91.7% N/A School leavers entering an initial positive destination 96% 96.5% 95.6% N/A Percentage of Children living in poverty after housing costs 29.0% 29.2% N/A N/A Priority 4: Promoting good mental health and wellbeing Indicator 2021/22 2022/23 2023/24 2024/25 Number of referrals to CAMHS (ISD Child and Adolescent Mental Health Services in Scotland) 2,178 2,166 2,741 1,194 Percentage of referrals to CAMHS started treatment within 18 Weeks 99% 95% 99% 99.6% Number of children and young people accessing Community Mental Health and Wellbeing Supports and Services 3,093 6,038 5,962 6,527 Total number of children accessing counsellors (school year) 549 666 379 477 Percentage of children who have reported an improved outcome following access to a counsellor 100% 100% 100% 99.4% Priority 5: Inspiring children and young people to be active Indicator 2021/22 2022/23 2023/24 2024/25 Child healthy weight in Primary 1 (5% to 95% centile) 72.1 N/A N/A N/A Number of young people (Distinct participants) engaged with Active Schools during Extra Curricular (school year) 6,570 9,285 9,201 N/A Number of Young people who are leaders in our key Active Schools programmes (school year) 556 1,171 1,327 N/A Number of Active Schools experiential opportunities offered to Care experienced young people (school year) 9 31 31 N/A Number of ASN (Additional Support Needs) pupils engaging with Active Schools extra-curricular and through experiential opportunities (school year) 55 140 213 N/A KA Leisure memberships distributed either free or funded by partners N/A 69 TBC TBC Active travel to school 51.70% 47.49% 48% N/A Please note – data that is not available yet is due to timescales of national data releases or variations in reporting schedules, for example, academic years. Data will be reviewed and updated when available. 101
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Whole Family Wellbeing Fund (WFWF) Annual Summary 2024/2025 Overview The Whole Family Wellbeing Fund (WFWF) continues to enable the development of strong foundations for transformational change to ensure preventative whole family support measures to help families overcome challenges before they reach crisis point. In its third year of implementation, the developments in North Ayrshire reflect a collective commitment from statutory services, the third sector and the independent sector to create sustainable, family-centred support systems. The Scottish Government has recently reaffirmed their commitment to the Whole Family Wellbeing Fund programme and confirmed a Ministerial decision to elongate the timeframe of the Programme beyond this Parliament. COSLA and the Scottish Government have agreed that from the 1st April 2025 the total funding for the WFWF will increase from £32m to £38.1m for both this current 2025/26 and 2026-27 financial years. Therefore, extending the programme from 4 years to 5 years. Key achievements During this reporting period, 14 new and existing projects and services have benefitted from WFWF funding, demonstrating a broad and positive impact across North Ayrshire. The developments in North Ayrshire reflect a collective commitment from statutory services, the third sector and the independent sector to create sustainable, family-centred support systems. These initiatives are crucial in addressing complex family needs and fostering a collaborative, integrated approach to service delivery. The third year of the WFWF has not only facilitated scaling up of essential services but has also supported the establishment of key roles and teams, including the WFWF Programme Lead and the Neurodevelopmental Empowerment and Strategy Team (NEST). The Dads Rock service’s success highlighted the need for expansion, leading to funding and recruitment of an additional support worker to extend the service into Irvine. This growth reflects the increasing demand for dedicated support for fathers in the community. Implementation of the Building on Positive Relationships (BPR) parenting approach withing the Family Centred Wellbeing Service has significantly improved family support by involving parents in group work and one-to-one interventions. During this reporting period, three BPR groups ran simultaneously, each involving 4-6 families, with all team members trained in BPR. With 172 active cases, the FCWS delivers extensive daily interventions, supported by Educational Psychology partners. The approach is also being extended to schools to train pastoral staff, aiming for consistent support across educational and family Services and for dedicated support for fathers in the community. In January, 79 practitioners attended the Whole Family Wellbeing Fund event at Saltcoats Town Hall. The idea was formed by the WFWF Forum, where the group felt it would be useful to showcase and connect the funded projects and services with practitioners at an interactive meeting and networking event. Attendees, which included those from the Third 102
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and Independent Sectors, Education, HSCP, NHS and NAC, had the opportunity to hear from 11 of the funded services in addition to finding out further information at the market place stalls. Challenges In early December 2024, the Chair of Ayrshire Rape Crisis confirmed that re-recruitment for the WFWF funded family support worker had been on hold due to core funding uncertainty. Separately to this, the unexpected resignation of the Star Centre manager in February meant the funded role could not be recruited and managed withing the remaining timeframe. As a result, £34,000 of unspent funds were returned. Due to Saltcoats Link-up having to withdraw from the WFWF, a review of the third sector applications previously received was undertaken. An approach was made to Beith Trust to ascertain whether they would still be interested in utilising the funding for the scale-up of the Baby Bundles project into other areas of North Ayrshire. The fund has enabled Beith Trust to employ a project worker for an additional 25 hours per week to ensure the Baby Bundles project is accessible outwith the Garnock Valley and expand into the Three Towns locality. Outcomes and Impact During 2024/25, a total of 550 children and young people across North Ayrshire accessed WFWF funded services or programmes. Furthermore, 688 families have been impacted by the WFWF proposals during the 12 month period. It is promising to note that most funded projects address three to four local priorities, reflecting a strategic alignment with broader community needs. These targeted efforts play a vital role in addressing specific challenges faced by families and ensuring they receive the tailored support required. In terms of the geographical spread of the WFWF proposals, the majority are operating in the Three Towns locality and on a North Ayrshire wide basis. Although Arran does not have any specific services delivered on the island, Arran is covered by the North Ayrshire wide services. Overall, the WFWF’s progress in North Ayrshire underscores the importance of a holistic, community driven approach to family wellbeing, demonstrating both immediate benefits and laying the groundwork for long term, sustainable change. Financial position The current financial position as of March 2025, is described below. The table sets out the spend to date and projected spend based on confirmation that the annual SG allocation of funds for Year 4 of the Fund. Year 3 24/25 Year 4 Projections 25/26 Brought Forward from previous year £ 1,313,000.00 £ 933,999.96 SG Allocation £ 954,000.00 £ 1,119,000.00 Total Funds Available In Year £ 2,267,000.00 £ 2,052,999.96 103
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Family Centred Wellbeing Service £ 575,503.28 £ 600,000.00 Expansion of EY Social Workers £ 154,004.79 £ 55,000.00 Dads Rock £ 68,095.00 £ 70,138.00 Neighbourhood Networks £ 50,312.00 £ - Vicarious Trauma £ 8,169.00 £ 8,000.00 Notre Dame £ 54,060.33 £ - Programme Lead £ 53,536.81 £ 55,143.00 Neuro allocation £ 27,728.69 £ - Third sector allocation £ 292,979.80 £ 233,012.00 Educational Psychologist £ 47,888.84 £ 75,160.00 To be confirmed £ 511.50 £ - Total Spend £ 1,332,790.04 £ 1,096,453.00 Funds Remaining £ 934,209.96 £ 956,546.96 Allocations for CSSPs for years 4 and 5 have now been confirmed following conclusion of the Scottish Parliament’s consideration of the Scottish Budget. WFWF allocation for North Ayrshire has been increased from £954,000 to £1,119,000. This is an increase of £165,000 per annum for years 4 and 5. The financial position will continue to be monitored and reported back to the CSSP. Learning To ensure accountability and measure progress, all funding recipients are required to complete an evaluation template every 6 months. This comprehensive template captures vital information about each project, including intended outcomes, progress made, areas for improvement and any challenges or barriers encountered. WFWF recipients have come together 3 times during this reporting period to network, share learning, discuss challenges and project sustainability. The Whole Family Wellbeing Fund Forum will continue to meet quarterly. The first edition of the WFWF newsletter was published in September. The newsletter provides details on all the projects and services supported by the Fund and relevant contact details. This was circulated electronically to WFWF partners, the third sector and in the HSCP news bulletin. The WFWF Programme Lead attends the Learning into Action (LiA) Network. The purpose of this group is to allow CSSP’s and other relevant stakeholders to access information such as briefings, policy updates, upcoming events, case studies and other useful resources regarding the WFWF. 104
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Next steps The annual report for 2024/25 is currently being drafted and will provide more detail to the high level summary provided in this report. This will be submitted to the Scottish Government in June and shared with the Children’s Services’ Strategic Partnership. The WFWF logic model, created by Scottish Government, is a visual representation of how the funding is intended to impact its beneficiaries (children, young people, and families and CSSP staff). It captures the sequence of events expected to lead to outcomes that together, if achieved, are expected to lead to the impacts. It summarises the rationale for providing the funding and shows some of the mechanisms by which change might come about. As we approach the fourth year of the programme, we aim to create a North Ayrshire specific WFWF logic model. Finally, we will continue to focus on sustainability and longevity of projects beyond the life of the WFWF. Author: Fiona Pow, Whole Family Wellbeing Fund Programme Lead (Children and Families Health Team) Senior Manager: Joanne Inglis, Senior Manager – Children and Families (Children and Families Health Team) 105
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Integration Joint Board 19th June 2025 Subject: Allied Health Professions within Acute Settings Purpose: • Awareness Recommendation: It is recommended that the Integration Joint Board a) Note the contents of this report. 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 Please use this box to ensure that all acronyms etc are set out in full. All acronyms must be set out in full the first time they appear in a paper with the acronym following in brackets. Some examples have been listed below. AHP Allied Health Professions CMT Corporate Management Team HSCP Health and Social Care Partnership NHS AA NHS Ayrshire and Arran SPOG Strategic Planning and Operational Group 1. EXECUTIVE SUMMARY 1.1 The purpose of this report is to provide an update to members of the IJB in relation to work that has been progressing to optimise arrangements for Allied Health Professionals working within the acute setting. Whilst these services are currently under the remit and management of East and South Ayrshire HSCPs they are effectively led and delivered within acute services on behalf of all three HSCPs. In addition, the anticipated benefits of the proposed changes will also benefit the residents and patients from North Ayrshire. There are no direct changes proposed currently to any AHP services in North Ayrshire currently managed by Sharon Hackney as our Lead AHP, including our AHPs who support inpatient areas including community hospitals and Mental Health settings. Agenda Item 6 107
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2. BACKGROUND 2.1 NHS Ayrshire & Arran hosts nine Allied Health Professions (AHPs) delivering services across health and care: diagnostic radiographers, dietitians, music therapists, occupational therapists, orthoptists, orthotists, physiotherapists, podiatrists, and speech and language therapists. AHPs work with people of all ages, often within multidisciplinary teams, across hospitals, community settings, prisons, and outpatient services. With the integration of health and social care, the majority of AHP services including dietetics, occupational therapy, orthotics, physiotherapy, podiatry, and speech and language therapy were devolved to the Health and Social Care Partnerships (HSCP) under lead partnership arrangements. Each HSCP hosted a Senior AHP Manager led by and professionally accountable to the Associate Director of AHPs. Radiography and Orthoptics remained within Acute Services, each led by a Head of Service, also professionally accountable to the Associate Director of AHPs. In 2017, a principle of maximum devolution was applied to further integrate AHP services within the HSCPs. This was with the exception of MSK and Orthotics which were retained as pan-Ayrshire services hosted by East Ayrshire HSCP due to their strong links with primary care. It was also agreed in 2017 that responsibility for AHPs within acute settings would align with the HSCP in which the hospital site was located; South Ayrshire HSCP for University Hospital Ayr and East Ayrshire HSCP for University Hospital Crosshouse. Despite these arrangements, challenges emerged in ensuring appropriate leadership, visibility, and strategic alignment of AHP services within acute services. In 2023, in response to consistent feedback, a temporary Chief AHP role was introduced within Acute Services. This role enhanced visibility, influence, and access to AHP leadership, but challenges remained, particularly regarding decision making proximity, AHP workforce integration into acute transformation, and the optimal utilisation of resource. In July 2024 NHS Ayrshire & Arran’s Strategic Planning and Operational Group (SPOG) approved the establishment of a stakeholder group to: • Map current AHP resources in acute. • Define a future and transitional model for AHP services in acute. • Consider a commissioning model with clearer expectations and measurable outcomes. • Clarify professional leadership and management arrangements. A Steering Group, and an Expert Reference Group, were subsequently convened to lead this review. Key findings and themes from the initial Acute AHP review included: 108
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• Lack of alignment between where acute AHP services are delivered and where decisions are made. • A sense of limited influence within Acute Services over AHP provision, despite daily impacts and associated risks. • Missed opportunities to fully embed AHPs within acute leadership models and associated transformation. • Ongoing staff stress and operational pressures. • AHPs as the only professional group delivering services in acute settings whilst being managed through the HSCPs. There has been clear consensus on the need for change. While it is acknowledged that structural shifts alone may not deliver transformation, closer alignment of leadership and decision making to service delivery has been agreed as essential. To progress beyond the initial review, a number of further workshops, listening sessions and engagement sessions were progressed between October 2024 and March 2025 in ensuring wide contributions and exploring potential ways forwards. With support of Viridian, several potential ways forward were considered with a multi stakeholder group. Several options, including a lead partnership model, and change only for one acute site were discounted by the group early in the process. Although not unanimously, it was noted that the establishment of clear service level agreements and formal commissioning expectations was expressed as the preferred route for the majority of the AHP Senior and Service Managers; with the HSCPs retaining accountability for acute AHPs. An Acute led model was consistently expressed as the preferred way forwards for Acute colleagues from both a multidisciplinary clinical, and management perspective. The current disconnection was regularly highlighted as a barrier to realising the full contribution of AHPs within acute transformation. While the merit in supporting a service level agreement/commissioning approach was acknowledged, this was judged to not go far enough in ensuring that decisions are made as proximally to service delivery as possible, or to adjust the fundamental issues of AHPs in acute being disconnected from the wider acute management team, and from ongoing transformation activity. To retain accountability for acute AHPs within the HSCPs, the existing HSCP AHP management teams would require to significantly increase presence and strategic input within acute divisional transformation. This has the potential to occur at the expense of focus and attention on community based services, which is where such input is required in ensuring continued progress towards early intervention, prevention and enhanced community provision. 109
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On balance, and with consideration, the Corporate Management Team agreed a move to an Acute Led model for acute AHP staff as the preferred way forwards – in maximising the contribution of AHPs in both the HSCPs and Acute services as part of a whole system, and considering experience and outcomes for both staff and service users. 3. PROPOSALS Responsibility and accountability for AHP services currently delivered within the acute setting, inpatient and front door will transfer to acute services. The resource currently supporting the Chief AHP role in acute will be utilised to recruit to a permanent AHP Senior Manager role for acute. The acute AHP Senior Manager, and three HSCP AHP Senior Managers will continue to work as a whole system collective professionally with the Director of AHPs, in maximising the contribution of AHPs for the people of Ayrshire and Arran. Further engagement is progressing with the AHP leadership team in refining the detail of an Acute led AHP Structure. The Organisational Change policy will then be followed in ensuring no staff are disadvantaged through these changes. It should be underlined that there is no intention to reduce the number of AHP staff, or to change staff bases through this process. 3.1 Anticipated Outcomes In summary of the rationale for change, and intended benefits for the people of North Ayrshire: • Strengthen Quality, Safety and Clinical Voice: In the current context, with persistent challenge across health and care, quality, patient safety and strong clinical voice is imperative. The planned changes ensure strong AHP professional voice and influence within each part of the health and care system in Ayrshire and Arran. • Manage Risk Proactively: Acute AHP risk at University Hospital Ayr (UHA) and University Hospital Crosshouse (UHC) are currently held by South and East Ayrshire HSCPs respectively, despite risk exposure and impact being felt within acute services. The proposed model aligns accountability with the setting of service delivery, enabling faster, more responsive decision making and more effective risk mitigation. • Maximise Leadership Focus and Capacity: With responsibility for acute and community AHP services currently sitting with the South and East Ayrshire HSCP AHP Senior Managers, there is an expectation of visibility and responsiveness within acute, whilst also progressing the AHP contribution to early intervention and prevention, population health and community services. The planned changes support clarity of role and focus, with attention of the HSCP AHP Senior managers centred on community activity, and additional AHP senior leadership capacity in acute. 110
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• Embed AHPs within Acute Transformation: The critical function of AHPs in the acute setting is recognised in supporting rehabilitation, reducing the potential of deconditioning, reducing length of stay, supporting system flow and minimising impact on delayed transfers of care. The disconnection between operational management and service delivery has hindered AHP integration within acute transformation programmes. By embedding acute AHPs directly into the acute leadership structure, the model ensures their contributions are harnessed as part of multidisciplinary planning and delivery, positioning AHPs as integral to the redesign and improvement of hospital-based care. • Address Inequity: There has been varied investment in acute AHPs by South and East Ayrshire HSCPs in recent years. There have also been several shifts within acute services, with Orthopaedic trauma, acute stroke care and the highest levels of critical care now delivered at UHC for all Ayrshire residents, including those from North Ayrshire. While this proposal does not seek to redistribute the full AHP workforce across both acute sites, there are ambitions around reducing the current inequity, and managing risk, which oversight of the full acute AHP workforce will enable. • Strengthen Clinical and Operational Governance: AHPs are the only professional group working in acute services while managed externally. This model strengthens governance by aligning professional accountability and service management within the acute structure, enhancing oversight, assurance, and the ability to respond to clinical issues as they arise. This proposal is fully supported by both the Executive Nurse Director and the Director of Allied Health Professions, who recognise the change as a clinically necessary step to improve safety, effectiveness, and quality of care. Both agree that aligning AHP services more closely with acute service delivery strengthens clinical governance, enhances accountability, and ensures AHPs are optimally positioned to contribute to whole-system transformation. The model addresses current gaps in leadership proximity, supports more agile decision making, and ensures AHP expertise is embedded within acute redesign and improvement activity. 3.2 Measuring Impact Staff and patient experience will be key indicators of success. In addition, embedding acute AHPs directly into the acute leadership structure, this model ensures their contributions are harnessed as part of multidisciplinary planning and delivery, positioning AHPs as integral to the redesign and improvement of hospital-based care. Maximised AHP contribution in the acute setting: • supports rehabilitation, • reduces the potential of deconditioning, • impacts positively on length of stay, • supports system flow, and 111
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• minimises impact on delayed transfers of care. 4. IMPLICATIONS 4.1 Financial This proposal seeks to make best use of available finance. No additional resource is being requested from North Ayrshire IJB, or NHS Ayrshire & Arran Board for this proposal. There will be no financial detriment to North Ayrshire HSCP as a result of this change. Any adjustments required for safe AHP leadership arrangements within acute would be absorbed through multidisciplinary workforce planning within acute services. The South and East Ayrshire HSCP AHP Senior Managers are supporting due diligence in clarifying the HSCP AHP resource currently delivering service within acute services, which would transfer to Acute under these changes. 4.2 Human Resources This proposal seeks to maximise the contribution of AHPs to whole system service delivery and ensure best use of resource available in the current context. This proposal creates clarity of role, stability and positions AHPs as key, integrated elements of their respective directorates, HSCP and Acute for workforce planning and diversification within existing resource. Partnership representation has been provided throughout the exploratory, informal stages of this process to date. The formal organisational change process will be followed in enacting this change. 4.3 Legal None. 4.4 Equality/Socio-Economic The activity outlined in this report has been progressed with the ambition of improving access to AHP services and to ensure sufficient strategic focus across all parts of the health and care system. 4.5 Risk There are a number of acute AHP workforce risks currently being held on HSCP risk registers in South and East Ayrshire HSCPs. Whilst accountability for these risks, and the approach being taken to treat or tolerate currently sits with the relevant HSCPs, the impact of these risks is experienced within acute service delivery. The intended changes seek to balance risk, accountability, and proximity to service delivery. Enacting this proposal transfers the accountability for acute AHP services, and any associated risk to Acute services. 4.6 Community Wealth Building None. 112
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4.7 Key Priorities Planned next steps are as follows: • Update on these planned changes are being brought to all three Ayrshire IJBs in June 2025, for awareness. • The final detail of the proposal is being refined with the AHP Senior and Service Managers. • The final version of proposed acute AHP structure will require approval of the Director of Acute Services prior to initiation of formal process. • Due diligence is progressing with support of finance and HR colleagues. • The formal notification of organisational change will be made in June 2025, with subsequent process followed thereafter. • It is intended that these new arrangements will commence in September 2025. 5. CONSULTATION There has been significant engagement with all parties through this process, including a number of recent workshops facilitated by Viridian, and robust discussions at SPOG and CMT. AHP Trade Union and Professional Committee colleagues have been actively engaged through the informal process to date. Regular email communication has been distributed to all AHP staff throughout the timeline of the Acute AHP review. These communications have been sent jointly from the Director of Acute services, Director of Allied Health Professions, AHP Trade Union and Professional Committee representatives. Specific informal information sessions have been held with AHP service Managers, AHP Team Leads, and AHP front door colleagues. The AHP Senior Leadership Team have met with AHP Service Managers in their pan ayrshire uni-professional groups to ensure contribution to defining the detail of the final proposed structure. Early guidance and support has already been sought from Human Resources. The need for continued, transparent and sensitive communications around this matter is appreciated. The formal organisational change process will be initiated once the final proposed structure is confirmed. Alistair Reid, Director of Allied Health Professions, NHS Ayrshire & Arran, Alistair.Reid@aapct.scot.nhs.uk Sharon Hackney, AHP Senior Manager/ Lead Allied Health Professional, North Ayrshire HSCP Sharon.Hackney@aapct.scot.nhs.uk 113
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Integration Joint Board 19 June 2025 Subject: Older People’s Day Service Review Purpose: To present to IJB the outcome of the review of the delivery of day services for older people in North Ayrshire and to outline proposed options to IJB to identify a service model for day services that supports older people across North Ayrshire whilst meeting identified savings target. Recommendation: IJB to approve the recommendations: - (i) note the outcome of the older people’s day service review completed in February 2025 (ii) consider the option(s) detailed within this report for future delivery and provide approval for the preferred option, noting the described impact on service users and all other relevant stakeholders. (iii) note the requirement for a temporary pause on new day service admissions whilst teams reconfigure service delivery and where possible accommodate any service users affected by service change. (iv) consider and approve the preferred option between Option 1 and Option 2 as set out in the report. (v) Note that the revised service model will undergo a formal evaluation six months after reopening. This evaluation will assess the effectiveness of service delivery, the impact on unmet need, and identify any further areas for improvement. 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 Integration Joint Board PSMT Partnership Senior Management Team 1. EXECUTIVE SUMMARY 1.1 The current model of delivery of older people’s day services has been identified within the Health and Social Care Partnership’s transformation plan for review and has been allocated a target to achieve a recurring annual financial saving – this was initially identified as £200k however was increased to £307k as agreed by IJB in March 2025. This has been implemented so far in a phased basis, with £100k saving in year one Agenda Item 8 115
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and a further £207k saving now required in year two, over the period 2024/25 – 2025/26. The full review paper attached was completed prior to the final savings target being determined, and as such there are some variations in detail. 1.2 Year one savings were achieved by pausing the Partnership’s day services outreach development and by not recruiting to vacant outreach posts; as the future of the outreach service required to be considered as part of the full review. A recurring saving of £307k is required to be identified and achieved from year two onwards to deliver the full savings target. There are risks to achieving this full saving from year 2 due to timescales in implementing any service change. 1.3 Budget savings within older people’s day services totalling £126k have previously been implemented between 2019 and 2022 – these savings saw an overall reduction in day care provision at the time. It was always the intention to undertake a further phase of review particularly as the new service provision leaves an inequity of provision with two building-based services in the Three Towns locality. 1.4 A comprehensive consultation on day services was completed in 2021 to facilitate the remobilisation of day services (post covid). The most recent review of day services (2024/25) focussed on effective engagement with staff, service users, families and carers. In December 2024, service users were surveyed to gain an understanding of the quality of the day service intervention. Day service aims, outcomes and criteria for access were reviewed. Service demand, attendance figures and financial costs were all taken into consideration at this review. 1.5 Following the outcome of the review earlier this year, three options for Day service delivery were presented to the Partnership Strategic Management Team on 27 February 2025 for consideration. The full review document is included as Appendix 1, a summary of the options presented at that time is detailed below: Closure of Thistle Day Service (HSCP operated day service) • Thistle Day Service in Stevenston was viewed as an option for closure due to its proximity to the Alzheimer Scotland service in Ardrossan. • The closure of Thistle Day Service would result in the loss of 70-day service placements per week, reducing local support in the Three Towns locality, particularly for frail elderly residents who do not have a memory impairment. • This option would provide an annual saving of circa £145k. Discontinuation of Alzheimer Scotland Daycare Contract • This option proposed discontinuing the Alzheimer Scotland daycare contract at its expiry date (currently extended until August 2025), the service operates from a NAC owned property. This would generate current contract savings of approximately £276k per year and approximately £54K in income from service-user charges - this income is currently retained by Alzheimer Scotland. • This option would most likely result in the closure of the Alzheimer Scotland service in Ardrossan and would result in the loss of 63 commissioned day care places on a weekly basis. Redesign of both the Partnership and Alzheimer Scotland’s older people’s day service delivery functions This option proposed a significant shift and change in the delivery of both day services and dementia services in North Ayrshire. 116
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These changes would include: • Alzheimer Scotland would move away from a traditional day service model and instead focus on a model of delivery prioritising befriending services, dementia daycare outreach at home, and provision of increased support for carers of loved ones with dementia. • Outreach day services previously planned for Partnership delivery would now be provided by Alzheimer Scotland under this revised model only for adults with a memory impairment – there would be no outreach provision for frail older people. • All older people's (building based) day services would be delivered by the Partnership. • Saving of approximately £212k would be generated by not recruiting to Partnership vacancies identified for Outreach provision and a reduction in Alzheimer Scotland funding from £276K to £140K per annum. • Funding would be allocated to increase staffing levels within existing HSCP day services to mitigate some of the impact of the loss of 63 commissioned day care placements. The PSMT favoured the option to redesign the Partnership and Alzheimer Scotland’s day service delivery functions as it was considered that whilst there would be an overall reduction in day service provision and net reduction in weekly day care places available, this option served to both satisfy the requirement associated with savings and also maintain maximum service delivery within the financial resource available, whilst retaining the service and partnership with Alzheimer Scotland. After discussions at PSMT in February 2025, an additional £107k savings target was approved as part of the IJB budget in March 2025 from the Day Service budget and as such this report will provides alternative options to deliver the savings in full. 1.6 Taking the feedback from consultation and the full day service review into consideration, it is deemed critical that in-building day services remain available to older people that are locality based and in their own communities. 1.7 The HSCP has commenced initial discussions with Alzheimer Scotland on a proposed new model based on the feedback from the Partnership’s Senior Management Team and the alignment of this with Partnership operated day services. Further meetings are expected to take place with representatives from Alzheimer Scotland in the coming weeks to discuss options. The current contract with Alzheimer Scotland expires at the end of August 2025. 1.8 The IJB are asked to consider two Options presented in this paper and following the review: Option 1: Discontinuation of Alzheimer Scotland Day Care Contract in full from the end of August. Removal of plans to introduce any outreach day care opportunities in North Ayrshire, with some reinvestment of funding directed to enhance staffing within building-based day care resource. Financial Impact – delivers full year saving of £340k, above the £307k target. Option 2: Redesign of both the Partnership and Alzheimer Scotland’s older people’s day service delivery functions. Commissioned provider would transition from traditional day service model and instead focus on a model of delivery prioritising befriending services, dementia daycare outreach at home, and provision of increased support for carers of loved ones with dementia. All older people's (building based) day services would be delivered by the Partnership. Financial Impact - delivers full year saving of £212k, a shortfall of £95k and would require the recurring savings target to 117
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be formally reduced by the IJB with savings identified from other areas, this should be considered in the context of the wider financial challenges facing the IJB. IJB are asked to consider the two options presented and agree the preferred way forward, noting the financial and service implications of both. 2. BACKGROUND 2.1 Day services in North Ayrshire provide activities and support for adults assessed as requiring support who may feel isolated and lonely, have mobility issues and would benefit from regular social contact with others with transport provided from the person’s home to the day centre if appropriate. The aim of day services is: • to provide a safe, flexible, therapeutic and homely environment for service users, their families and significant others, according to their assessed care needs; and • to provide the highest possible quality social care and act in the best interest of people, by maximising their independence and helping them participate fully in their family and community. The Partnership’s in-house day service provision is delivered within identified day service premises which are open 9am to 4.30pm, Monday to Friday, staffed by specially trained professionals. These day services are delivered by social care staff from sites in Largs, Irvine, Garnock Valley and the Three Towns. Previously, a service was delivered in Cumbrae, but this service is no longer operational. Stronach Day Service on Arran, located within Montrose House Care home, has been closed since the pandemic. A recent review led to a pilot outreach model which ran from May 2023 to March 2024 and was conducted in two phases in two localities on the island. The pilot served a small number of users and received positive feedback for its social benefits and respite for carers. However, it relied on existing staff, making it unsustainable due to the current and ongoing workforce challenges on the island. It is therefore recommended to fully adopt an outreach model for day services on Arran, removing onsite day care. However, the service should only be provided when staffing allows thus addressing recruitment and resource challenges. A phased implementation should aim to serve up to six users by the end of 2025, noting however this will be entirely staffing dependent. It is suggested that a short life working group is established to develop detailed plans and oversee the phased implementation of this. 2.2 The 4 mainland Partnership day services provide supports from Monday to Friday and offer a total of 350 spaces each week. On average these units run at over 95% capacity and provide services to both frail older adults as well as older adults with dementia. The current capacity of the mainland in-house day service provision is detailed below: Day Service Locality Capacity per day Total weekly places 118
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Burns Irvine 22 110 Gowanlea Kilbirnie 20 100 Thistle Stevenston 14 70 Stevenston Day Care and Resource Centre Largs 14 70 2.3 In addition to the Partnership operated day services, there is one externally provided day service located in North Ayrshire which is operated by Alzheimer Scotland. This service is in the Harbour Centre, Ardrossan. This service is delivered 7 days per week and provides services to older adults with dementia. Day Service Locality Capacity per day Capacity per week The Harbour Centre Ardrossan 9 63 2.4 The Partnership currently funds the provision of this day service alongside funding provided by Alzheimer Scotland. The building is owned and maintained by North Ayrshire Council. Whilst no revenue is received by North Ayrshire Council for this property it should be recognised that Alzheimer Scotland have invested in this building which includes the installation of a new kitchen in 2024 and garden improvements. 3. CURRENT SITUATION 3.1 The Partnership is committed to promoting independence across all areas of service provision and seeks to ensure as many people live as independently as possible within their own communities. In line with the aspirations of the Partnership’s Strategic Plan, the Partnership is developing modern, flexible, financially sustainable approaches that will support people and their carers to remain independent and enabled to lead fulfilling lives. The demographic projections of the rise in older people, health outcomes for people living in North Ayrshire, the pressure on financial resource and changing expectations, means that services must be redesigned to meet demand and minimise unmet need within our older population whilst operating within the resources available. Services also need to ensure that capacity is aligned to meet the needs of the individuals who require to access services. Building based day services, while beneficial for some, may not be suitable for everyone due to barriers such as accessibility, transportation challenges, sensory sensitivities, or social anxiety. These settings can unintentionally exclude individuals who find structured environments overwhelming or who live in remote areas. Outreach day services offer a more flexible and person-centred approach by bringing support directly into the community or home. This mixed model allows for tailored engagement that respects individual preferences, cultural backgrounds, and unique needs, fostering greater inclusion. A mixed model of day service provision can ensure that support is accessible and inclusive for all. 3.2 Workforce There are 36 posts associated with the Partnership’s inhouse older people’s day services within North Ayrshire including transport staff who provide transport for the majority of service users to and from the day centres. The current Day services staffing compliment consists of: • Day Care Co-ordinator • Senior Day Care Officers 119
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• Day Care Officers • Drivers • Day Care Escorts 3.3 There are 9 posts associated with the delivery of the Alzheimer Scotland Day service. The impact of the proposal on these posts is not known currently as these staff are employed by Alzheimer Scotland. 3.4 Waiting List There are currently 103 people on the waiting list for the older people’s day services as outlined below however this can change on a weekly basis: 4 ASSESSMENT 4.1 This report, based on the findings contained within, would summarise that older people day services within North Ayrshire are a vital service and support in achieving the Partnership’s strategic aims of “all people who live in North Ayrshire are able to have a safe, healthy and active life”. 4.2 By ensuring building-based day service provision continues in all localities, across all groups for adults over the age of 65, travel time and associated barriers are significantly reduced, enabling easier and more consistent access for frail older adults and those living with dementia, whose needs could best be met by a building-based day service delivery model. These services foster stronger community connections, reduce isolation, and promote a sense of belonging and continuity for service users. In-house day services offer the most cost-effective model, delivering best value through efficient use of resources and robust waiting list management. Location Unit Provider Weekly Capacity Daily Capacity Spaces Allocated (May 2025) Ardrossan Harbour Centre Alzheimer Scotland 63 9 46 (73.0%) Irvine Burns Day Service In-House (NAHSCP) 110 22 104 (94.5%) Kilbirnie Gowanlea Day Service In-House (NAHSCP) 100 20 92 (92%) 120
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Largs Stevenson Day Service In-House (NAHSCP) 70 14 67 (95%) Stevenston Thistle Day Service In-House (NAHSCP) 70 14 66 (94%) Partnership day service staff play a critical role not only in direct care delivery but also in supporting wider service continuity plans, stepping in during periods of staff shortages or emergencies to maintain consistent care across the system. This integrated, community-based approach ensures resilience, responsiveness, and a high standard of care for North Ayrshire’s older population. 4.3 Alzheimer Scotland are Scotland’s national dementia charity and its work both nationally and throughout North Ayrshire is recognised and valued. Alzheimer Scotland have provided supports and services to older people in North Ayrshire for several years and are a key component in supporting people living with dementia in the North Ayrshire community. 4.4 In consideration of the recent review, and views gathered through the Partnership’s Senior Management Team, the below final recommendations are presented to the IJB for final consideration. 4.5 Option 1 Discontinuation of Alzheimer Scotland Day Care Contract in full - this option would see the end of the Alzheimer Scotland daycare contract at its renewal date at the end of August 2025 and would result in the closure of the Alzheimer Scotland day care provision within The Harbour Centre in Ardrossan. This option would require permanent removal of plans to introduce any outreach day care opportunities in North Ayrshire, with some of the funding for previously allocated outreach supports in the Partnership directed to enhance staffing within building-based day care resource. Pro’s • Potential to over-achieve full year savings target from 26/27 (dependent on additional income). • Will ensure retention of building-based day services (provided by HSCP) in each of the mainland locality areas to adults over 65 with both memory impairment and physical disability. • Streamline resources and ensure flexible, resilient in-house day service provision. • Opportunities to mitigate some of the risk of increased waiting lists and service closure by enhancing capacity in Partnership day services. Con’s • Negative impact on current provider, Alzheimer Scotland. • Impact on current users of the Alzheimer Scotland service and families/carers. • Loss of weekend provision. • No outreach supports. • Loss of specialist service and Alzheimer Scotland provision in North Ayrshire. • Loss of 63 weekly day care placements. • Increase in waiting lists and unmet need for access to day care provision. Mitigation • Funding will be directed to the Partnership’s inhouse day care centres to enhance capacity and offer building-based day care opportunities for adults 121
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affected by the Alzheimer Scotland closure – the has the potential to limit the impact of an overall reduction in day care places for older people to around 30 places on a weekly basis. • A review of day care support for any affected service users will be undertaken prior to any service change -which would include consideration of reinvestment in day services or our Dementia Support Service. • Alzheimer Scotland currently provides day services over a 7-day period whilst the Partnership’s day services are delivered Monday to Friday; however, uptake for weekend services has been consistently low, with poor attendance observed during these times. Given this trend, it is anticipated that the impact of discontinuing building-based provision over the weekend would be minimal. • Currently, in-house day services have a greater capacity and make more efficient use of available spaces daily – operating at 95% capacity compared to Alzheimer Scotland who have been operating at 73% capacity. Shifting to a fully in-house daycare service model will offer opportunities for enhanced flexibility in service delivery and staffing. Financial Implications • This would generate current contract savings of approximately £276k per year with potential for approximately £54k additional income from service-user charges if existing Partnership Day services can be expanded to provide additional day care placements - this income is currently retained by Alzheimer Scotland. • It is anticipated that 3 x additional part-time Day Care Officers would be required to supplement additional attendees within NAHSCP day services. Total cost for this provision per annum would be £87,000 and has been accounted for in savings projection. • Full in year savings are unlikely to be achieved for 2025/26 due to the part year impact of the service with a shortfall of around £90k. 4.6 Option 2 Redesign of both the Partnership and Alzheimer Scotland’s older people’s day service delivery functions - this option proposes a significant shift and change in the delivery of both day services and dementia services in North Ayrshire. Under these changes Alzheimer Scotland would move away from a traditional day service model and instead focus on a model of delivery prioritising befriending services, dementia daycare outreach at home, and provision of increased support for carers of loved ones with dementia. Outreach day services previously planned for Partnership delivery would be provided by Alzheimer Scotland under this revised model only for adults with a memory impairment – there would be no outreach provision for frail older people. All older people's (building based) day services would be delivered by the Partnership. Pro’s • Will ensure retention of building-based day services (provided by HSCP) in each of the mainland locality areas to adults over 65 with both memory impairment and physical disability. • Streamline resources and ensure flexible, resilient in-house day service provision. • Continues specialist dementia service. • Facilitates outreach and befriender service. • Support for family and carers. • Opportunities to mitigate some of the risk of increased waiting lists and service closure by enhancing capacity in Partnership day services. • Alzheimer Scotland would continue to retain use of the Harbour Centre as a 122
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base for which to deliver their services. • Savings would be made by Alzheimer Scotland in terms of transport and meal provision costs if the service were to move to an outreach model. • There are benefits of a blended approach to day service delivery through supporting more individuals via remote support and outreach visits which would reduce levels of unmet need. Con’s • Negative impact on current provider, Alzheimer Scotland who may not choose to enter a contract to deliver an alternative model. • Impact on current users of the Alzheimer Scotland service and families/carers • Loss of weekend provision. • Loss of 63 weekly day care placements. • Increase in waiting lists and unmet need for access to day care provision. • Would not achieve full savings target. Mitigation • Funding will be directed to the Partnership’s inhouse day care centres to enhance capacity and offer building-based day care opportunities for adults affected by the change in Alzheimer Scotland service – the has the potential to limit the impact of an overall reduction in day care places for older people to around 30 places on a weekly basis. • A review of day care support for any affected service users will be undertaken prior to any service change. • Alzheimer Scotland currently provides day services over a 7-day period whilst the Partnership’s day services are delivered Monday to Friday; however, uptake for weekend services has been consistently low, with poor attendance observed during these times. Given this trend, it is anticipated that the impact of discontinuing building-based provision over the weekend would be minimal. • Currently, in-house day services have a greater capacity and make more efficient use of available spaces on a daily basis – operating at 95% capacity compared to Alzheimer Scotland who have been operating at 73% capacity. Shifting to a fully in-house daycare service model will offer opportunities for enhanced flexibility in service delivery and staffing. • Savings would be made by Alzheimer Scotland in terms of transport and meal provision costs if the service were to move to an Outreach model. • If current provider does not choose to enter into an alternative model and funding arrangement through a revised contract from September 2025, alternatives will be considered including an open procurement process or through an in-house delivery model through day services and dementia support. Financial Implications • This option would generate savings of approximately £212k per year, £95k less than the identified saving of £307k – this saving would be generated by not recruiting to Partnership vacancies identified for Outreach provision and a reduction in Alzheimer Scotland funding from £276K to £140K per annum. • It is anticipated that 3 x additional part-time Day Care Officers would be required to supplement additional attendees within NAHSCP day services. Total cost for this provision per annum would be £87k and has been accounted for in savings projection. • Full in year savings are unlikely to be achieved for 2025/26 due to the part year impact of the service with a shortfall of around £107k. 123
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4.7 Discussions with Alzheimer Scotland have already commenced and in consultation with the Partnership, Alzheimer Scotland have agreed to provide an outline proposal for a potential future service delivery model within North Ayrshire in line with Option 2. 4.8 Considerations for future commissioning are ongoing and it has yet to be confirmed whether a full tender for the future provision of any agreed commissioned service would be required. This may have an impact on who the future provider of Option 2 is, should this be the outcome. 4.9 In order to ensure capacity within the Partnership’s day services for any service users affected by the service change it will be required to pause any new admissions to from end June 2025, with all non-critical referrals being added to a day services waiting list. 4.10 Anticipated Outcomes It is anticipated that this proposal will ensure a more financially sustainable model of day service provision within North Ayrshire, whilst protecting the delivery of crucial day service supports for residents of North Ayrshire and their carers. By continuing to work in partnership with all stakeholders, the described approaches will promote the ongoing sharing of knowledge and expertise and a more equitable approach to access to services across North Ayrshire. 4.11 Measuring Impact The service will continue with an ongoing programme of stakeholder engagement – including engagement with day service staff, service users, carers and care providers, to gather feedback on any changes made to the day service model. 5. RECOMMENDATIONS This report, in consideration of current needs across Health and Community Care Services, would recommend that the IJB: • note the outcome of the older people’s day service review completed in February 2025. • (consider the option(s) detailed within this report for future delivery and provide approval for the preferred option, noting the described impact on service users and all other relevant stakeholders. • note the requirement for a temporary pause on new day service admissions whilst teams reconfigure service delivery and where possible accommodate any service users affected by service change. • consider and approve the preferred option between Option 1 and Option 2 as set out in the report. • Note that the revised service model will undergo a formal evaluation six months after reopening. This evaluation will assess the effectiveness of service delivery, the impact on unmet need, and identify any further areas for improvement. 6. IMPLICATIONS 6.1 Financial Option 1 would deliver the full approved savings target for the day services review. Option 2 would not meet the approved savings target of £307k and would leave a recurring budget gap of £95k which would require to be added to the IJB overall gap with savings identified from other services. 124
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6.2 Human Resources There may require to be recruitment to address gaps in staffing in Partnership Day services. The effect on staffing within Alzheimer Scotland day service provision is not known at this time and would be managed as part of any exit from or change to contract. 6.3 Legal Potential impact in relation to Alzheimer Scotland workforce. 6.4 Equality An Equalities Impact Assessment has been completed in relation to these proposals. 6.5 Children and Young People None. 6.6 Environmental & Sustainability None. 6.7 Key Priorities This report, based on the findings contained within, would summarise that older people day services within North Ayrshire are a vital service and support in achieving the Partnership’s strategic aims of “all people who live in North Ayrshire are able to have a safe, healthy and active life”. 6.8 Risk Implications The risk implications are detailed within the report. 6.9 Community Benefits Revised model(s) of services will allow for continued opportunities to build strategic links between the Partnership including other Community Care Services, Housing and Connected Communities. 7 CONSULTATION 7.1 The options were considered and future provision discussed with stakeholders as part of the recent review of day services for older people in North Ayrshire. 7.2 The PSMT has been consulted on the options described within this report. 8. CONCLUSION 8.1 IJB are asked to consider the outcome of the day services review, and considering the two Options presented for consideration within the report advise on which Option is preferred to allow for an effective implementation period. For more information, please contact Kerry Logan, Head of Service, HCC on [01294 317805] or [klogan@north-ayrshire.gov.uk] 125
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February 2025 North Ayrshire Health and Social Care Partnership Older Peoples Day Service Review AN OPTIONS APPRAISAL 126
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1 Contents Introduction .................................................... 2 Engagement ............................................... 4 Landscape Review ........................................ 5 Service Overview .......................................... 6 Aims ............................................................ 7 Access Criteria .......................................... 8 Service User Experience.......................... 9 Feedback ................................................ 9 Transport .............................................. 14 Catering ................................................ 14 Referrals ................................................... 15 Staffing ...................................................... 15 Demand ........................................................ 16 Attendance ............................................... 16 Options Appraisal ........................................ 20 Status Quo / Do Nothing ........................ 20 Relocate Day Services to Community Hubs .......................................................... 20 Cease Outreach Daycare Provision ..... 20 Increase Charge for Service .................. 21 Three Towns Colocation ........................ 22 Permanently Close Thistle Day Service ................................................................... 23 Discontinue Alzheimer Scotland Daycare Provision ................................................... 24 Redesign Partnership & Alzheimer Scotland Service-Delivery Roles ........... 26 Appendices .................................................. 28 Charter of Rights ..................................... 28 Day Service Space Requirements ........ 29 References ................................................... 32 127
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2 Introduction 1. The current model of delivery of older people’s day service has been identified within the HSCP transformation plan for review and has been given a target to achieve a recurring financial saving of £200,000. This has been implemented in a phased basis, with £100,000 saving in year one and a further £100,000 saving in year two, over the period 2024/25 – 2025/26. Year one savings were achieved by pausing the day services outreach development and by not filling outreach posts; however, the future of the outreach service requires to be considered as part of this review. A recurring saving of £200,000 must be identified from year two onwards. 2. This paper will consider the day services model across North Ayrshire and describe the options appraisal exercise (see Chapter ‘Options Appraisal’) that evaluated several options to identify a sustainable service model for introduction in the short to medium term, one which would realise the necessary savings and ensure the ongoing provision of valued day service supports to older people in North Ayrshire. 3. The recommended option as an outcome of this review is to Remove Outreach & Change Alzheimer Scotland’s Role. This approach would achieve the necessary budget savings while continuing to offer a wider range of services and supports to the families of older people across North Ayrshire and specifically for those with dementia. Careful management on this proposal and resultant service change would be required to mitigate the negative impacts on service users, including familiarising them with alternative units and managing the transition smoothly. Further engagement with stakeholders is essential to ensure a successful implementation and to address any concerns that may arise. This option balances the need for cost savings with the goal of maintaining service quality and accessibility for users. TABLE 1: SUMMARY OF OPTION'S APPRAISAL RECOMMENDATIONS Option Summary Recommended Status Quo / Do Nothing Continue with current model of delivery inclusive of Daycare provision across all mainland localities and contracted Alzheimer Scotland provision with the full roll out of the Outreach service. This would not generate any financial savings. No Relocate to Community Hubs Move physical location of day service provision into the community hubs (within sheltered housing units). This may realise some building-based savings however this would be minimal, and a review has taken place confirming the physical layout of the community hubs do not meet the requirements for daycare provision. No 128
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3 Option Summary Recommended Cease Outreach Day care provision Continue with current model of delivery inclusive of Daycare provision across all mainland localities and contracted Alzheimer Scotland provision with the permanent removal of the planned Outreach service. This would not achieve the full financial saving and loss of this service will increase demand on other, more costly, services. No Permanently close Thistle Day Service Permanently close Thistle Day Service which currently operates in the Three Towns locality providing approx 70 day service places on a weekly basis. The cons significantly outweigh the benefits in this option and introduce the risk of negative publicity, increased demand on other more expensive services, increased social isolation for service-users and inequality in access to services for those living in the Three Towns locality. SMT Consideration Discontinue Alzheimer Scotland Daycare provision Alzheimer Scotland currently provide daycare services to adults with Dementia in the Three Towns locality. Whilst the cons of this option significantly outweigh the benefits, many could be managed and mitigated. This option would achieve the necessary savings however there would be significant impact on overall service provision moving forward. PSMT have agreed to a contract extension of six months, which will reduce Year 2 savings by approximately £121k. Conversely, discontinuing Alzheimer Scotland could send the message to local people that the HSCP do not feel it is necessary or appropriate to employ nationally recognised specialist Dementia care in the area. SMT Consideration Three Towns Colocation Co-locate Three Towns Daycare provision by merging day services provided by the Partnership and Alzheimer Scotland in the Thistle Day Service building in Stevenston. This may realise a level of savings due to economies of scale for example transport, meals and staffing however having scoped this it is unlikely to be viable. This is due to the layout of the unit meaning it would not be possible to operate two separate services using common facilities simultaneously whilst employing different policies and procedures. No 129
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4 Option Summary Recommended Redesign Partnership and Alzheimer Scotland delivery roles. This is the only option where the ‘pros’ outweigh the ‘cons’. Moving forward, this option would achieve the necessary savings and, if managed effectively, limit the impact on the displaced service users who would be introduced to alternative day services or receive alternative services from Alzheimer Scotland. This option allows the Partnership to offer a wider range of services to the families of people with Dementia, mitigating the loss of Outreach Support whilst offering a solution to those people who cannot access traditional Day Services. This option would also allow HSCP the opportunity to review current dementia service provision, minimising duplication of provision and offer a wider range of services to the residents of North Ayrshire. SMT Consideration *LIMITED INTRODUCTION OF THESE OPTIONS COULD BE USED IN THE SHORT-TERM TO ‘SHORE UP’ PREFERRED SOLUTIONS WHICH MAY FALL SLIGHTLY SHORT OF THE YEAR 2 SAVING TARGET 4. The paper also considers known challenges to service delivery, and where action is required to address these a ‘To Do’ icon is placed in the margin. 5. While this is a standalone project, its outcomes will link to, and flow into, forthcoming ‘Dementia Support and Respite Models of Care’ work. 6. This project supports HSCP strategic delivery stated in the Strategic Commissioning Plan, that “Our Transformation Plan sets out our key areas of focus for redesigning and improving our services and business processes… across all service areas with the aim of ensuring the Partnership continues to deliver effective and cost-efficient services.” Engagement 7. It is recommended that consideration is given to the preferred option and if deemed suitable, further engagement is undertaken with key stakeholders in 2025: Alzheimer Scotland, Carers Development Officer, Carers Service, Day Services Staff, Dementia Support Staff, Mental Health Team, SDS Policy Review Manager, Service Users and their families, Social Work. TO DO 130
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5 Landscape Review 8. A 2018 paper [1] found that “for older people with long-term conditions, regular structured activities within a community setting meeting others are thought to improve well-being and quality of life.” However, it also noted that “there is little known about outcomes of day care provision.” The study examined the outcomes of day care provision, focusing on three areas: Physical functioning: Findings from limited studies indicated a “trend for positive impact… when activities are incorporated into a day care programme.” Intergenerational provision: a “small number of studies suggest positive benefits.” Measurement of outcomes: One study suggested that “attendance at day care could reduce hospital attendance and admissions.” 9. Another 2018 study [2], found that “day centres are life-enriching gateways,” with benefits felt by attenders, their family carers, and centre volunteers. The paper notes that day centres “offer added value beyond the purposes for which they are commissioned or funded, beyond what may be assumed to be covered by an aim of improving quality of life or supporting people to remain at home, beyond what attenders may have expected, given their reasons for attending.” The study found that “day centres are not stigmatised or perceived as outdated.” 10. A 2020 [3] study states that day centres “were found to play a variety of roles for individuals and in care systems,” with most evidence pointing to “social and preventive outcomes.” The study found that “attendance and participation in interventions…impacted positively on older people's mental health, social contacts, physical function, and quality of life.” However, the report also noted that the research was based on evidence sourced outside the UK, and that the impact of day centres on “older people without dementia” is under-researched. 11. Given the limited evidence to support day services through research, it is imperative that consideration is given to service-user feedback for HSCP- provided day services (see page 9). 131
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6 Service Overview FIGURE 1: MAP OF NORTH AYRSHIRE WITH DAY SERVICE UNITS INDICATED 12. North Ayrshire Health & Social Care Day Services are currently provided at five locations across the area (Figure 1). The daily charge for service-users is £16.49, it is anticipated charge will rise to £19.79 from April 2025 with further increases anticipated throughout 2026/27. 13. Previously, a service was delivered in Cumbrae, but it has been confirmed that this is no longer operational. 14. The day service on Arran has been closed since the pandemic. A review led to a pilot outreach model from May 2023 to March 2024, conducted in two phases: Blackwaterfoot and Stronach Day Service in Montrose House, Brodick. The pilot served a small number of users and received positive feedback for its social benefits and respite for carers. However, it relied on existing staff, making it unsustainable. Burns Day Services, Irvine Stevenson Day Services, Largs Gowanlea Day Services, Kilbirnie Thistle Day Services, Stevenston Harbour Centre (Alzheimer’s. Scotland), Ardrossan 132
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7 15. It is therefore recommended to adopt a fully outreach model for day services on Arran, eliminating onsite day care. However, service should only be provided when staffing allows thus addressing recruitment and resource challenges. A phased implementation should aim to serve six users by the end of 2025. It is suggested that a short-lived working group is established to develop detailed plans and oversee the phased implementation. FIGURE 2: PROFILE OF MAINLAND SERVICES (SOURCE: HSCP DAY SERVICES TEAM) Location Ardrossan Irvine Kilbirnie Largs Stevenston Unit Harbour Centre Burns Day Service Gowanlea Day Service Stevenson Day Service Thistle Day Service Provider Alzheimer Scotland In-House (NAC) In-House (NAC) In-House (NAC) In-House (NAC) Hours 09:00 – 16:30 09:00 – 16:30 09:00 – 16:30 09:00 – 16:30 09:00 – 16:30 Days 7 day (less 2 weeks at Christmas) Mon-Fri (less 8 public hols per annum) Mon-Fri (less 8 public hols per annum) Mon-Fri (less 8 public hols per annum) Mon-Fri (less 8 public hols per annum) No of Staff (FTE)* n/a 8 7 5.5 5.5 Capacity (weekly) 63 110 100 70 70 Capacity (daily)** 9 22 20 14 14 Current Waiting List (and those waiting on 2nd day) on 26 Feb 2025 6 (1) 54 (36) 15 (14) 9 (5) 14 (6) Total Places Allocated (February 2025) 50 (80% capacity) 110 (100% capacity) 100 (100% capacity) 70 (100% capacity) 70 (100% capacity) Income Generated (current rate £16.49 per day) n/a £94,322 £85,748 £60,024 £60,024 Income Generated (new rate £19.79) n/a £113,198 £102,908 £72,036 £72,036 Expenditure £242,153 £338,640 £265,841 £208,207 £286,582 *ALL UNITS ALSO HAVE AN ADDITIONAL 2 BUS DRIVERS ALLOCATED TO THEM ** CAPACITY FOR BURNS & GOWANLEA IS UNDER REVIEW BUT IS LIMITED BY THE TRANSPORT AVAILABLE FOR SERVICE USERS WHO REQUIRED TO BE COLLECTED AND DROPPED OFF. STEVENSTON RESOURCE CENTRE, LARGS IS ALSO CURRENTLY UNDER REVIEW DUE TO STAFFING LEVELS AND BUILDING SPACE. THISTLE DAY SERVICES, STEVENSON IS CURRENTLY AT FULL CAPACITY. BUDGET CODES FOR DAY CARE INCOME ARE 10 218043/044/045 & 046 ACCOUNT CODE 60145. INCOME RECEIVED TO THESE CODES IN FY 2324 WAS £118,421 BUT ALSO INCLUDES COSTS FOR NON-PC - ANALYSIS AVAILABLE VIA BUSINESS UNIT [4] Aims 16. The aim of the Day Service is described in both the most current Policies and Procedures [5] and in the leaflets issued to service-users about the service. The leaflets offer the most current definition. TO DO 133
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8 TABLE 2: DEFINED AIMS OF DAY SERVICE & SOURCE OF INFORMATION Day Service Policy & Procedure Service-User Information Leaflet Maintain older people at home in their local community by promoting/maintaining their independence through therapeutic interventions which meet their physical, social, and psychological needs. Service provision should be of a high standard, flexible in its approach with an emphasis on value for money and delivered in a safe environment. Provides day services for adults aged 65 and over, offering a homely and therapeutic environment. We aim to support people to remain in their own homes and to be part of their wider community. Our objectives are: To assist people to remain in their own home To promote social stimulation and prevent isolation. To provide a source for social care and health To promote the maintenance of daily living skills To contribute to rehabilitation To provide specialist care for people with cognitive impairment To provide support and information to carers 17. Service delivery is centred on an established ‘charter of rights’ [5] for service- users. These rights are predicated on the belief that each person is an individual and that society should respect that individual and his or her fundamental rights as a citizen (see Appendices, page 28). 18. It should be noted that the Policy & Procedures governing Day Services should be refreshed, as the most current version dates to 2005. There is a need to ensure they continue to comply with current legislation, guidance, and corporate policies. Access Criteria 19. Clients referred to day services will be accepted if they [5]:: Are aged 65 years or over at the time of referral. However, younger clients may be considered if their needs can be met through day services activities on a short-term basis. Require reintegration into the community (eg. post-hospital discharge) Are in bereavement. Are recovering from a debilitating illness. Require rehabilitation in activities of daily living. Are socially isolated from their peer group. Are physically disabled, sensory impaired, or have poor mobility. Need promotion of mental health status (e.g., depression, low self- esteem) Are suffering from mild to moderate dementia. Have mild to moderate learning disabilities and suffer from one or more of the above conditions. TO DO 134
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9 Service User Experience 20. In December 2024, service users in each unit were surveyed to gain an understanding of the quality of the Day Service intervention. Service users were asked a series of questions by staff from their own unit and required to give those staff members their response in order that an e-form could be completed. 21. This approach could introduce some anomalies if service users were reluctant to criticise staff or the service they provide directly. This is potentially apparent in the analysis of the responses received, where only very occasional negative comments have been provided. However, care must also be taken not to assume that this is the case; it may well be that service users are wholly happy with the day service being offered. 22. It must also be noted that staff’s interpretation of people’s answers could also skew results. For example, service users were asked if they would be willing to transfer to a day service in another location. Most respondents answered yes or no, or gave a reason for their answer (e.g., lack of transport, wanting to stay in the town, etc.). However, 27 out of the 36 respondents at Gowanlea Day Service all referenced Gowanlea in their answers (e.g., "I’m happy at Gowanlea," "Not at the expense of Gowanlea," "I don't see the point in travelling a distance when I can get the best care here at Gowanlea"). There was a uniformity to these answers as well, with many people answering this question using the same phrases. The Gowanlea responses to some ‘free text’ questions are so different from those of other units that they stand out. Feedback 23. The feedback from the service-user survey carried out in December 2024 noted that when asked to rate the service, over 99% of all service users rated it as a four- or five-star service (Figure 3). 135
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10 FIGURE 3: SERVICE USER RATINGS FOR DAY SERVICES FROM 1 START TO 5 STARS (BEST) (SOURCE: DAY SERVICE SURVEY, DECEMBER 2024) 24. When asked to rate the service, the response from service-users was almost universally positive with only 1 person noting they disagreed with a single statement (Figure 3). 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Burns Gowanlea Stevenston Thistle All 5* 4* 3* 2* 1* 136
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11 FIGURE 4: SERVICE USER FEEDBACK ON A SERIES OF QUALITY QUESTIONS WHERE RESPONSES WERE MEASURES ON A 5-POINT SCALE FROM STRONGLY AGREE TO STRONGLY DISAGREE (SOURCE: DAY SERVICE SURVEY, DEC 2024) 25. When asked if they agreed with a series of questions with a YES/NO/Maybe answer, service users again responded in an overwhelmingly positive manner (166 respondents). FIGURE 5: SERVICE USER FEEDBACK ON A SERIES OF QUALITY QUESTIONS WHERE RESPONSES WERE MEASURED AGAINST YES/NO ANSWERS (SOURCE: DAY SERVICE SURVEY, DEC 2024) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% I am encouraged to move around whilst at the Day Service I am treated fairly I am treated kindly I am treated with respect I feel the staff protect me by wearing their PPE when suitable I make my own choices with my diet and fluid If I am unwell, staff can recognise this and help me get the right help The staff are aware of the PPE they require to wear Strongly Agree Agree Disagree 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% Do you feel the staff support you to meet your goals and outcomes whilst attending the service? Is your care provided by staff who understand and are sensitive to your needs and wishes When attending the day service do you feel safe and secure in these surroundings? Yes Maybe No 137
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12 26. Most service users (88%) indicated they did not wish to move to another locality for Day Service provision, with 1 in 10 willing to attend an alternative location. The remaining respondents gave vague answers, making it unclear if they would relocate or not (Figure 6). However, it's important to interpret these figures carefully - many responses seemed to show loyalty to the unit they were attending. It could be that since respondents had to give their answers directly to staff in their units, they might have been reluctant to offend or hurt the feelings of people who provided care to them on a weekly basis. Furthermore, in the days following this survey, the service received several phone calls from service users who were clearly worried that their local service might close. FIGURE 6: RESPONSES TO THE QUESTION "WOULD YOU BE INTERESTED IN ATTENDING ANOTHER DAY SERVICE OUTWITH YOUR LOCAL AREA?" (SOURCE: DAY SERVICE SURVEY, DEC 2024) 27. Most respondents (90%) relied on supplied transport, though this varies slightly across each location. No Unclear Yes 138
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13 FIGURE 7: RESPONSES TO THE QUESTION "DO YOU USE THE DAY SERVICE TRANSPORT?" (SOURCE: DAY SERVICE SURVEY DEC 2024) 28. When asked if there was anything they would like to change or improve about the service, again service-users responded overwhelmingly in the positive, with only a few suggestions for improvements. Enhance Meal Variety 29. Several respondents indicated a need for more variety in meals provide, though none felt there was an issue with food quality. Burns Day Service: 5 respondents. Gowanlea Day Service: 3 respondents Stevenson Day Care & Resource Centre: 2 respondents Thistle Day Service: 4 respondents 30. It is recommended that more varied meal options are introduced to cater to different dietary preferences. This recommendation applies to all units, with Burns Day Service and Thistle Day Service having the highest number of comments. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Burns DS Gowanlea DS Stevenson DS Thistle DS All No Yes TO DO 139
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14 Diversify Activities 31. A small number of respondents commented about the activities. This isn’t a significant issue for any unit, but it is recommended that an ongoing programme of new activities are introduced to keep the day service engaging and stimulating for attendees. 32. During a self-evaluation away day on 30 April 2024, Senior Day Care Officers reviewed the main challenges faced by each unit. While they noted that the programmes of activities were good and the service model was adaptable to the needs of service users, they also identified several areas of concern including concerns about the poor quality of referrals being received and staffing challenges. Transport 33. Within the current model, each HSCP Day Service unit has two allocated bus drivers and two buses. However, any issues which arise with buses, and vacancies, directly impact the transport capacity within each unit. There is also a general lack of commercial buses available for hire, meaning if the corporate buses allocated to the Day Service units are being repaired, there is no scope for alternative transport. Additionally, the allocated buses have a large step into the bus, which service users can find difficult to manage. There is also limited space available, for example, the most recently procured electric bus can only accommodate two people if two wheelchairs are also required. The seats on the bus are covered in fabric, which introduces potential continence issues. 34. To scope options to address these issues, the team approached another Local Authority to ascertain if there was any good practice that could be adopted. A review of Day Care transport will be required going forward. Catering 35. Providing a nutritious meal to service users during their time in day service is essential for meeting their overall nutritional needs. A review of the catering within each unit was conducted, focusing on the 3-week rotating meal plan provided by HSCP Facilities Management. 36. The review found that, during a single 3-week cycle, the majority of meals were good. Thistle Day Service in Stevenston reported no issues with the food. However, the remaining units experienced several problems and there is ongoing engagement with relevant teams to improve catering provision. TO DO TO DO 140
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15 Referrals 37. During the April 2024 away-day Senior Day Care Officers also identified poor quality of referrals. A review of the forms during the Eclipse process has addressed this issue. Staffing 38. A number of staffing issues were identified; however, the management team have worked to address these and are monitoring the situation. TO DO 141
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16 Demand Attendance 39. Attendance figures (Jan 24 to Feb 25) indicate that in the main, the number of day care places being offered at each unit is fairly stable, after an increase in number during the first quarter of 2024 (Figure 8). FIGURE 8: NUMBER OF DAY CARE PLACES OFFERED JAN 2024 TO FEB 2025 (SOURCE: STATS DAY CARE 29/05/2023 DOCUMENT, EXTRACTED 19 FEB 2025) 40. Staff who manage the Day Services have indicated that referrals into the service are becoming increasingly complex, putting pressure on service delivery. The risk status of current service users shows that most have been assessed as at least a ‘substantial’ risk. It is important to note that at time of referral assessment of risk may be low however this often increases as service users’ conditions deteriorate. 0 50 100 150 200 250 300 350 400 01-Jan 08-Jan 15-Jan 29-Jan 12-Feb 26-Feb 11-Mar 25-Mar 08-Apr 22-Apr 06-May 20-May 03-Jun 17-Jun 01-Jul 15-Jul 29-Jul 05-Aug 19-Aug 02-Sep 16-Sep 30-Sep 14-Oct 28-Oct 11-Nov 25-Nov 09-Dec 23-Dec 06-Jan 20-Jan 03-Feb 2024 2025 Alz Scotland Burns DS Gowanlea Stevenson Thistle 142
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17 FIGURE 9: CURRENT SERVICE-USERS BY ASSESSED RISK ON 19 FEBRUARY 2025 (SOURCE: DAY SERVICES LIST, SHAREPOINT) 41. A high proportion of those attending day-services experience symptoms of dementia. In 2024, almost 2 in 3 referred to day services experience symptoms of dementia (Figure 11) 42. Figure 10). Though, this figure varies by unit with all of those attending Alzheimer Scotland’s Day Service experiencing symptoms of dementia, compared to around half of the service users attending Burns Day Service and a third of those attending Thistle Day Service (Figure 11) Alz Scot Burns Gowanlea Stevenson Thistle Total# (blank) 4 57 11 7 11 90 Low 1 1 10 7 2 21 Moderate 3 5 15 28 10 61 Substantial 71 230 132 135 129 697 Critical 14 26 9 4 26 79 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 143
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18 FIGURE 10: SERVICE-USERS WHO EXPERIENCE SYMPTOMS OF DEMENTIA BY REFERRAL DATE (SOURCE: DAY SERVICES LIST, SHAREPOINT, EXTRACTED 19 FEB 2025) FIGURE 11 CURRENT SERVICE-USERS WHO EXPERIENCE SYMPTOMS OF DEMENTIA BY UNIT (SOURCE: DAY SERVICES LIST, SHAREPOINT, EXTRACTED 19 FEB 2025) 43. On 19 February 2025, there were 101 people on the waiting list for a place in one of the day services units, and a further 53 people are waiting on a second day of day services (Figure 12). Demand is highest for Burns Day Services. 2023 2024 2025 (blank) 24 12 Yes 238 188 12 No 109 135 12 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% No Yes (blank) Alz Scot Burns Gowanlea Stevenson Thistle Yes 29 48 38 36 41 No 44 32 22 19 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 144
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19 FIGURE 12: NUMBER OF PEOPLE CURRENTLY WAITING FOR DAY SERVICES ON 19 FEB 2025 (SOURCE: DAY SERVICES LIST, SHAREPOINT) 0 10 20 30 40 50 60 70 80 90 100 Alz Scot Burns Gowanlea Stevenson Thistle 145
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20 Options Appraisal All options were firstly considered against the primary goal of this project, to achieve the necessary savings. Any which did not meet this objective were deemed unviable and not explored further. Status Quo / Do Nothing 44. The ‘status quo’ option is included as a baseline comparison for other options; to help understand the relative benefits and risks associated with a proposed change against the current level of service provision. 45. NOT RECOMMENDED: Doing nothing is not a viable approach as it will not achieve the necessary savings. Relocate Day Services to Community Hubs 46. A number of sheltered housing units have community hub spaces included. In the past, work has been undertaken to ascertain if relocating day services to these locations would be viable. However, there are a significant number of requirements set out by the Care Inspectorate, which must be met, before such a move could be made. It has been confirmed that the likelihood of achieving the required criteria has been discussed with PMI colleagues in the past, and it was established that none of the hubs met the required specification [6]. 47. NOT RECOMMENDED: Relocation to community hubs is not a viable option and has not been considered in any further detail. Cease Outreach Daycare Provision 48. This option considers placing a permanent pause on recruitment – effectively opting not to establish an outreach service. In 2024/25, the Outreach budget was £165k [4]. Therefore, opting not to introduce an Outreach Service would realise most, but not all, of the necessary savings from year 2 onwards, therefore, it this option were chosen, another option would also need to be partly adopted. Pros Cons Contribute towards the £200k saving requirement Would not achieve 100% of the required saving requirement. A number of people who would meet outreach criteria would have no service to access, and therefore demand pressure on other, more costly, services would increase. 146
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21 The work already done to develop the Outreach service for implementation would be abortive. People who are unable to attend mainstream Day Service would be negatively impacted, losing out on this potential care and support offer. 49. NOT RECOMMENDED: On its own, permanently pausing outreach is not recommended as it will not achieve all the necessary savings whilst also increasing demand on other more costly services and negatively impacting those who cannot attend mainstream day service, introducing an equality concern. Increase Charge for Service 50. At the moment service users currently pay £16.49 for day services, amounting to £300,118 per annum assuming 100% occupancy. The income generated by this recharge is not paid into the day service budget, instead being logged to the Charges to Users Community Care Service Delivery budget lines. 51. To achieve the necessary savings using this options alone, the charge would increase from £16.49 to £27.80 per session, This figure assumes 100% occupancy and charging may need to be varied to reflect a reduction in occupancy and account for anyone who is exempt from charging. It must be noted that an increase to charges is also being proposed as a separate 2025/26 proposal. Pros Cons Contribute towards the £200k saving requirement via income generation To achieve the necessary saving, the cost of a session would have to increase by at least c.70% - more when reduced occupancy and exemptions are factored in. It would introduce a potential equalities issue by presenting a barrier to those who cannot afford to attend The risk of negative publicity when increasing charges to vulnerable people during a cost of living crisis. If higher recharges resulted in lower attendance at Day Service, this would mean increased reliance amongst service-users for Care at Home and other interventions. Many service-users have multiple services involved in their care and support. They will already be impacted by planned increased via the charging policy. 52. NOT RECOMMENDED: Increasing the charge to c.£28 per session is likely to introduce a barrier to those on low incomes, and in turn would increase crisis situations, carer exhaustion and demand on other more costly services. [7] 147
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22 Three Towns Colocation 53. This option considers co-locating Thistle Day Services and Alzheimer Scotland in the same location – the Thistle Day Services unit. The unit could accommodate such a move. 54. It should be noted, however, that if Alzheimer Scotland is expected to provide the same service, with any contract savings arising from their lack of accommodation costs – this is unlikely to be achieved. This is because NAC own the Alzheimer Scotland building and covers the repair expenses. The rent is believed to be minimal, if not entirely waived [7]. If Alzheimer Scotland vacate the building, it will revert back to NAC. 55. Alzheimer Scotland have a staffing compliment as noted, they also have a few seasonal bank staff [7]: 1 x Practice Team Leader 2 Day Care Organisers (21hrs) 3 Day Care Support Workers (28hrs) 1 Day Care Support Worker (21hrs) Pros Cons Potential saving to contract but unknown how much benefit would be achieved. Unlikely to achieve the necessary level of savings required Service users would still have access to services in the same vicinity as previously. It is unlikely to be viable due to the layout of the unit that two separate services could be co-located and continue to operate independently. There is only one dining room, lounge etc, meaning both services would be seeking to use these at the same time. Furthermore, Alzheimer Scotland have their own policy and procedures and employment conditions that would differ from those used by HSCP. No job losses Alzheimer Scotland may not want to relocate Alzheimer Scotland employ different policies and procedures to HSCP and this may hinder service delivery The change of environment for service- users with a memory impairment could have a negative impact on their well-being. A number of people who would meet outreach criteria would have no service to access, and therefore demand pressure on other, more costly, services would increase (most significantly Day Services ) The work already done to develop the Outreach service for implementation would be abortive. People who are unable to attend mainstream Day Service would be 148
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23 negatively impacted, losing out on this potential care and support offer. 56. NOT RECOMMENDED: This option is unlikely to be viable. The layout of the unit means it would not be possible to run two separate services in this location, both functioning at the same time (ie. both sharing the same lounge, dining room etc), using different policies and procedures. Permanently Close Thistle Day Service 57. This option would see the current service, located in Stevenston, close. The rationale being the proximity of Alzheimer Scotland who are also based in the Three Towns locality (Ardrossan). NB: Alzheimer Scotland only service people with memory impairment and only have 9 spaces per day available. They could not compensate for the resulting shortfall of spaces in the Three Towns, with further detriment incurred by people living in the Three Towns who do not have a memory impairment as there would be no delivery of this provision within the Three Towns locality. 58. Whilst Thistle Day service has capacity for 24 spaces per day (120 spaces per week) these spaces are currently not filled due to current staffing levels implemented following previous budget savings. Instead, it would result in a loss of 70 day service sessions a week. 59. There is currently a £235K budget allocated for Thistle Day Service, however, the loss of income secured via recharging (at 100% occupancy) would reduce the saving by £60k based on 2024/25 charging rates. Therefore, at 100% occupancy, closing Thistle Day Service would achieve a saving of around £175k. Pros Cons Contribute towards the £200k saving requirement Closing Thistle Day Service would not achieve 100% of the savings requirement and other options would also need to be partly adopted. There would be no place for frail elderly service users in the Three Towns introducing an equality issue (based on postcode). Job losses for staff could be politically sensitive and result in negative publicity Negative publicity resulting from the closure of a second day service in the Three Towns. (previously closed Castleview). The current case load of service-users attending day services includes people who have attended for many years and realise significant benefit. The impact of removing the service from them is likely to also be significant (eg social interactions, nutrition, monitoring of situation etc). 149
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24 Service-users in the Three Towns are unlikely to want to travel to a unit in another locality. Loss of this service would increase crisis situations, carer exhaustion and possibility of more demand on more costly services. 60. FOR SMT CONSIDERATION: The cons significantly outweigh the benefits in this option and introduce risk of negative publicity, increased demand on other more expensive services, increased social isolation for service-users and inequality in access services for those living in the Three Towns. Discontinue Alzheimer Scotland Daycare Provision 61. This option looks at discontinuing the Alzheimer Scotland daycare provision contract at the point of renewal and transferring those service users into alternative HSCP’s Day Service units. Service users moving from Alzheimer Scotland would pay their Day Service charge to HSCP, resulting in an additional c.£54k via income from recharges . 62. Alzheimer Scotland provide services to people with a memory impairment. Our contract with the organisation provides 9 spaces each day of the week (63 spaces overall). The intention is that the contract ensures service provision for individuals across North Ayrshire, however restrictions in this regard are imposed by the organisation. 63. The current contract with Alzheimer Scotland runs to end 28 February 2025 with an annual value for 2024/25 of £241,471. There is a further 6-month extension option that would extend the contract to 31 August 2025; the value of which would require to be confirmed through the fee uplift process in 2025, but for planning purposes can be assumed to be around 50% of the 2024/25 cost (ie. C.£121k). PSMT have agreed to this contract extension. 64. It should also be noted that Alzheimer Scotland often decline to accept people who live within North Ayrshire, but beyond the area they deem viable in terms of transport (most recently in January 2025 a service user living in Springside). 65. There would be an impact on all Day Service units, as Alzheimer Scotland has a client group from across North Ayrshire, and these individuals would be eligible for continued service delivery in one of the HSCP units. Thistle Day Service is currently under capacity due to staffing, if they absorbed the displaced service- users, there would be a cost to HSCP that should be factored in. The cost of one Day Care Officer is £31,514, based on 2024/25 costs [4]. Additional transport costs should also be considered to support this option. Pros Cons Would fully achieve the £200k saving requirement from year 3 If this contract ceases, consideration must be given to increasing Thistle Day Services 150
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25 capacity to mitigate the shortfall in care provision that would result. This would mean additional staffing allocated to Thistle Day Services, increasing the cost of that service. There is capacity in Thistle Day Services to absorb the service gap that would result. The change of environment for service- users with a memory impairment could have a negative impact on their well-being. More income would be generated for HSCP from the recharge to service-users who would transfer into the HSCP Day Service (c.£54k per annum at current rates and 100% occupancy) There is a risk of negative social media fall out (reputational, political etc). Loss of a nationally recognised specialist service operating in North Ayrshire – for people with dementia Potential for job losses (could this be mitigated by offering employment in HSCP Day Services) The loss of weekend provision There is no guarantee that the displaced service-users would be able to secure an alternative place in their own locality (current lack of capacity) so additional transport costs may be incurred Service users, who currently enjoy Alzheimer Scotland service during a Saturday or Sunday would be required to change their attendance day to between Mon-Friday Does not achieve all necessary savings in year 2 due to the contract extension 66. FOR SMT CONSIDERATION: Moving forward, this option would achieve the necessary savings with minimal impact on overall service provision. Whilst the cons significantly outweigh the benefits of this option, many could be managed by increasing HSCP spaces to offset the loss of Alzheimer Scotland and seeking to employ staff faced with redundancy in HSCP services. The team could also consider ways of familiarising displaced service users with the HSCP unit they would move to. Nonetheless, adopting this option could send a message to the people of North Ayrshire, that employing the services of a nationally recognised Dementia provider is not necessary. Regardless, as PSMT have agreed to a contract extension of six months, it is further recommended that should this option be considered most suitable, that in Year 2 it is supplemented by another cost- saving measure.[7] 151
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26 Redesign Partnership & Alzheimer Scotland Service- Delivery Roles 67. A final option could be to review and change the specification of services being delivered by Alzheimer Scotland in North Ayrshire. The Partnership would no longer procure external Day Services or introduce an Outreach service. Instead all Older People Day Care services will be provided by in-house services with the remit of Alzheimer Scotland changing to a model which would include Befriending, Dementia Daycare Outreach at Home services and increased provision of services to support carers of loved ones living with dementia. This service specification change would enable a reduction in current spend to Alzheimer Scotland, as the service will see reduced expenditure in building costs, transport, and meal provision. This budget saving would be used to increase staffing levels within NAHSCP day services ensuring capacity for transferring Alzheimer Scotland service users and further potential increase in capacity from waiting lists. 68. The loss of Outreach would achieve over £100k per annum in savings, and when it is time to renew the Alzheimer Scotland contract, HSCP would offer a fixed price contract (set at a level within budget parameters) to seek a provider that could offer a more mobile service to both service users and their families/carers – effectively widening the scope of support that is available in the area to everyone affected by Dementia, and offsetting the impact of losing Outreach Support. 69. However, if this is deemed a viable and desirable option, a move should be taken immediately to ensure the accommodation of displaced service users resulting from changing the Alzheimer Scotland model. Work would also have to commence to familiarise those service users who would be displaced with the alternative units in their locality (ie. the HSCP run unit). This would also require a more significant adjustment for the service users who currently access Alzheimer Scotland at the weekend, as not only would the location but also the day of the week change for them. Pros Cons Would ensure the necessary budget savings are achieved. Alzheimer Scotland may not want to bid for a detailed and specific model of service delivery or deem it undeliverable within the budget parameters set. Service users would still have access to specialist service and day services There would be a loss of service delivery for up to 63 service users per week – who already enjoy day services with Alzheimer Scotland, including the loss of weekend provision. (It should be noted that a number of these service users already also attend an in-house Day service. 152
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27 No job losses The change of environment for service- users with a memory impairment could have a negative impact on their well-being. HSCP would avoid negative publicity around budget cuts The waiting list for HSCP run Day Services would continue to increase until 63 new spaces were available within the existing HSCP run units. This will be minimised by the increase in staffing within specific units. More support for those close to people with Dementia (eg. family, carers) in the area. A new service model which would include Befriending and Dementia Outreach Day services delivered via Alzheimer Scotland could offset the impact of losing a Partnership Outreach Service whilst also ensuring the specialist knowledge and skills held by Alzheimer Scotland are being optimally used. 70. FOR SMT CONSIDERATION: This is the only options where the ‘pros’ outweigh the ‘cons’. Moving forward, this option would achieve the necessary savings and, if managed effectively limit the impact on the displaced service users. It also allows the HSCP to offer a wider service to the families of people with Dementia, mitigating the loss of Outreach Support. It would offer a solution to those people who cannot access Day Services and who would have otherwise been suitable for Outreach. 153
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28 Appendices Charter of Rights SOURCE: NORTH AYRSHIRE COUNCIL: SOCIAL SERVICES POLICIES AND PROCEDURES, DAY SERVICES, JUNE 2005. The right to be treated with dignity at all times and to be treated as an individual, whatever disabilities and frailties one may have. The right to pursue independence, responsibilities, and choice where they do not infringe the rights of others. The right to privacy in relation to one’s own space, one’s own belongings, one’s own financial and personal affairs. The right to have one’s cultural and religious needs accepted and respected. The right to have one’s physical, sexual, and emotional needs accepted and respected. The right to care for oneself as far as possible and have appropriate assistance if required. The right to be informed of new procedures and have these made explicit, the right to comment and have one’s expressed opinions heard and listened to. The right to mix with other people in the community, either by going out or by inviting others into the residential home. The right to have assistance where necessary and practicable to access facilities available within the wider community, medical, social, educational, leisure and other services. The right to establish a service user’s group and freely nominate a representative to serve on such a group. The right to have free and clear access to the complaint’s procedure. The right to confidentiality in relation to medical and personal information, access to information on file and to know on what basis information is shared with others. The right to have a personal advocate (representative) to safeguard one’s interests if required. The right to take appropriate risks in relation to the exercising of one’s rights. 154
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29 Day Service Space Requirements SOURCE: KERRY RENNIE, TEAM MANAGER OLDER PEOPLE SERVICES/CARE AT HOME) Q1. The building and grounds are designed to comply with all relevant legislation and guidance documents. Certificates and commissioning documents with regard to engineering services and plant, approval letters and letters certifying completion of works and arrangements from other agencies and authorities confirm this. Q2. There are suitable car parking arrangements for service users, visitors, and staff. Q3. There is clear access to and egress from the setting for emergency and other vehicles, and there are suitably sized turning spaces for service vehicles using the site. Q4. There are areas for service users to get on and off transport safely that are illuminated and offer some protection against the elements. Q5. Where the day care setting’s programme includes outdoor therapeutic and leisure opportunities, the space is accessible to all service users. In settings registered to provide services to people with dementia, there is a secure perimeter. Q6. Front entrance doors are semi-automatic as a minimum and in facilities where people need assistance with walking or use wheelchairs, consideration should be given to having doors in activity areas fitted with hold open devices or that are free to swing and linked to the fire alarm. Q7. The doorways in activity areas used by service users have a clear opening width of at least 800mm, but in settings where service users need assistance when walking or use wheelchairs, wider doorways are recommended. Corridor doors have vision panels and in day care settings where service users need assistance when walking or using wheelchairs, there are level access thresholds at all doors. Q8. The minimum corridor width is 1.2m unobstructed between handrails, but in day care settings where service users need assistance when walking or use wheelchairs a minimum width of between 1.5m and 1.8m is recommended. Q9. All activity areas are accessible to service users through the provision, where necessary, of ramps, lifts (large enough to accommodate a stretcher), other facilities and signage. Q10. According to the service user groups offered services in the day care setting, there are suitably positioned hand and grab rails, hoists, communication aids and other equipment, including assistive technology, which meet the general needs of the service user group and promote independence in all the areas accessed or used by service users. Q11. According to the service user groups offered services in the setting, service user/staff call points, accessible to service users are provided in areas where service users are likely to be alone, toilets and washrooms. These are linked to a system that alerts staff a call is being made or assistance is required. Q12. There is both natural and good quality artificial lighting in all areas suitable for the needs of service users and any activities organised in each room. The artificial lighting in areas used by service users is sufficiently bright and positioned to facilitate activities. The recommended lighting level in toilets is between 100 – 200 lux. Q13. All activity areas used by service users are naturally ventilated, have opening windows with safety glazing and guarding where necessary. Window openings are controlled to a safe point of opening of no more than 100mm and cannot be overridden by service users. Frosted or obscured glass is fitted as required to ensure privacy. Q14. The heating system can be controlled within safe limits for the service users’ comfort in areas accessed and used by them and is able to provide a range of temperatures throughout the setting. Q15. Furniture and fittings are suitably designed for the activities that take place in the room and incorporate ergonomic design principles that promote user independence and safe handling. 155
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30 They, and any equipment or mobility aids, are positioned to take into account the mobility and overall needs of the service users, including those with sensory impairments. Q16. Floor coverings and wall finishes are suitable for the purpose of each room and meet health and safety and infection control requirements. Finishes that produce glare, dazzle and optical illusions are avoided, and where service users use wheelchairs floor coverings have non- directional pull. According to the service user groups offered services in the day care setting, for example those with a visual impairment, changes in the texture of floor coverings or other indicators should be considered to identify key areas in the setting, for example doorways or the top or bottom of stairs. Space for activities Q17. The minimum space per service user (excluding corridors and circulation areas) is 4.5m² in general activity areas, except for computer suites where 3.0m² is adequate. Where service users have high dependency needs, a minimum space of 7.5 m² is recommended. Q18. Having a range of size of rooms provides flexibility for organising activities and where the varied needs of service users can be met. According to the service user groups offered services in day care setting, this can include: • A room where meetings can take place. • A facility for service users to make or get drinks and snacks. • A quiet room with something suitable to rest on; and • A room where telephone calls can be made or received in private. Q19. The design of the dining space takes into consideration the number of service users who can eat comfortably together at one time. The space required for dining is at least 1.5 m² per person, but where service users have high dependency needs the space will be greater. Toilet and washing facilities. Q20. There are separate toilets for ambulant males and females, at least one wheelchair accessible unisex toilet that complies with the Building Regulations and a toilet facility identified for visitors. Q21. Each toilet facility: • is clearly marked and conveniently located to rooms used by service users. • is fully and separately enclosed. • has suitable hand washing and drying facilities to meet infection control guidelines; and • has a door that opens outwards. Toilets for ambulant, semi and assisted ambulant people are a minimum of 3m². Toilets for people who use a wheelchair independently or require the assistance of one person are a minimum of 4.5m² and at least 2m long. Toilets for people who use a wheelchair and require the assistance of two people are a minimum of 5.5m² and at least 2m long. Q22. Where the day care setting provides personal care there is an adequate number of bath and shower facilities. Bathrooms for ambulant people, people who require assistance and people who use a wheelchair independently are a minimum of 8.5m². Bathrooms for people who require the use of a hoist are a minimum of 16m². Shower rooms are 7m² (non-linear layout) or 7.5m² (linear layout) and are level access. Q23. Locks and handles on toilets, bathroom and shower room doors are easy to operate and allow staff immediate access in an emergency. Medicines Q24. There is an identified area where medicines can be stored, in accordance with the manufacturers’ instructions. This has: 156
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31 • cupboards conforming to British Standards for the storage of medicines. • space to safely store, access, and administer medicines and medicinal products. • sufficient work surfaces for the tasks required; and • hand washing facilities in close proximity that meet infection prevention and control guidelines. 157
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32 References [1] D. C. L.-W. M. Lunt C, “The role of day care in supporting older people living with long- term conditions,” December 2018. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221434/. [Accessed June 2024]. [2] The Dunhill Medical Trust, Social Care Workforce Research Unit, Institute of Gerontoloty, King's College London, “Evidence briefing for commissioners: day centres for older people,” February 2018. [Online]. Available: https://www.ageuk.org.uk/bp- assets/globalassets/gwyneddamon/keep-well-keep-warm/day_centres_for_op-- evidence_briefing__for_commissioners.pdf. [Accessed June 2024]. [3] M. J. T. A. Orellana K, “Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived.,” April 2020. [Online]. Available: https://www.cambridge.org/core/journals/ageing-and- society/article/day-centres-for-older-people-a-systematically-conducted-scoping-review-of- literature-about-their-benefits-purposes-and-how-they-are- perceived/8469C5AB75F8540BE4617E6B11E753C1. [Accessed June 2024]. [4] A. Braton, Interviewee, Snr Accountant. [Interview]. Nov 2024. [5] North Ayrshire Council, “Social Services Policies and Procedures, Day Services,” North Ayrshire Council, Irvine, 2005. [6] J. Davies, Interviewee, Principal Manager, Business Support. [Interview]. 30 July 2024. [7] K. Rennie, Interviewee, Team Manager. [Interview]. Nov 2024. [8] R. Bently, Interviewee, Snr Maanger, Arran Services. [Interview]. 2024. 158
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Integration Joint Board 19th June 2025 Subject: 2024-25 – Year End Financial Performance Purpose: To provide an overview of the IJB’s financial performance for the year ended 2024-25 and the implications for the IJB’s overall financial position Recommendation: It is recommended that the IJB: (a) Notes the overall integrated financial performance for the financial year 2024-25 and the overall year-end overspend of £1.212m pre earmarking, adjusted to £3.593m after earmarking, adjusted to on-line after additional funding contributions. (b) Notes the progress with delivery of agreed savings. (c) Approves the budget reductions which are detailed at paragraph 2.10. (d) Approve the proposed earmarking as detailed in the report, leaving a balance of £3.161m in earmarked funds. 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 MH Mental Health MDT Child & Adolescent Mental Health Services BRAG Blue, Red, Amber, Green UNPACS UNPACS, (UNPlanned Activities) – Extra Contractual Referrals NRAC NHS Resource Allocation Committee PAC Performance and Audit Committee MHOF Mental Health Outcome Framework MDT Multi-Disciplinary Team Agenda Item 9 159
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1. EXECUTIVE SUMMARY 1.1 The report provides an overview of the financial position for the Partnership and outlines the unaudited year-end outturn position for 2024-25. 1.2 The outturn is an overall year-end overspend of £1.212m on an IJB basis, which when adjusted for new earmarked reserves of £2.381m is increased to £3.593m (1.1%), which is a favourable movement of £1.387m from month 10. Of this favourable variance the majority relates to LD care packages due to the variance between planned care and actual care delivered. There was significant progress throughout the 2024/25 to contain costs through the financial recovery plan, which delivered a £4m improvement, the full benefits of this were not fully attributed to the bottom line as other in-year pressures impacted on the overall position. The graph below illustrates the movement in the financial outturn throughout the year: 1.3 The Integration Scheme outlines that there is an expectation that the IJB takes account of the totality of resources available to balance the budget in year. Following this approach, an integrated view of the financial position should be taken, however it is useful to note that this overall position consists of an overspend of £2.036m in social care services and an overspend of £1.557m in health services. 1.4 The Integration Scheme describes the required approach where there is a projected overspend on the IJB integrated budget, which includes the requirement to agree a recovery plan to balance the overspending budget. Only if the recovery plan is unsuccessful will the Health Board and Council consider making available interim 160
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funds. At month 7 the IJB requested that the Chief Officer write formally to North Ayrshire Council and NHS Ayrshire and Arran to request additional in-year funding and at month 12 the following has been agreed: Social Care element – overspend of £2.036m. North Ayrshire Council considered this at their Cabinet meeting of 3rd June and agreed to fund this with a non-recurring funding increase and no requirement to repay the funds in future years. Health element – overspend of £1.557m. NHS Ayrshire and Arran have funded this, previous discussions with NHS AA colleagues in relation to repayment indicated the Health Board would wait to consider this following North Ayrshire Council’s consideration. The outcome of the decision by North Ayrshire Council has been communicated to NHA AA Director of Finance for consideration. Following these additional funding contributions the final position is on-line. 1.5 Projecting the IJB financial position continued to be challenging during 2024-25 as there were a number of areas of uncertainty throughout the year. Social care service provision in particular is difficult to project, with variability due to capacity and demand and can move significantly with low volume/high-cost packages of care. The ongoing financial risks were reported to the IJB during the year. These challenges will continue into 2025-26. 1.6 The projected IJB outturn position has been adjusted to reflect the impact of Lead Partnership services. The overspend in relation to North Lead Partnership services for Mental Health is not fully attributed to the North HSCP as a share has been allocated to East and South HSCPs, similarly the impact of the outturn on East and South led services has been shared with North, both on an NRAC basis in line with the agreed risk sharing mechanism. There is a requirement for the 3 IJBs to be aware of the position for Lead Partnership services and plans to deliver services from within allocated budget, on that basis further information will be brought forward with further detail on Lead Partnership services. 1.7 Financial balance was not been achieved in 2024-25 and the 2025-26 budget highlights several areas of significant risk. Financial modelling also anticipates a very challenging position in subsequent years. 1.8 The 2024/25 financial position was adversely impacted by several factors outwith the control of the IJB, these have been noted previously by the IJB and include in-year funding allocation reductions and externally negotiated contract inflation increases. The allocation for the Agenda for Change costs in relation to the reduced working week were queried with the NHS finance team to ensure we receive our ‘fair share’ of the funding but there has been no change to the allocation which adversely impacts on the IJB position. 161
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2. 2024-25 UNAUDITED BUDGET OUTTURN POSITION 2.1 The report includes an overview of the financial position, explanations for the main budget variances and an update on progress in terms of savings delivery. 2.2 FINANCIAL OUTTURN 2024-25 Against the full-year budget of £326.629m there is a reported overspend of £1.212m pre-earmarking. After earmarking the overspend of £3.593m consists of an overspend of £2.036m in social care services and an overspend of £1.557m in health services. Following additional funding contributions this position was brought on-line. Appendix A provides the financial overview of the partnership position, this details the outturn on an HSCP managed basis, on an IJB delegated basis (following Lead Partnership recharge adjustments) and the final adjusted outturn position after accounting for new earmarked reserve balances. The sections that follow outline the most significant variances in service expenditure compared to the approved budgets. 2.3 Health and Community Care Services Against the full-year budget of £92.549m there is an overspend of £5.632m (6.1%) and the main variances are: a) Care home placements – net overspend of £0.176m (£0.092m favourable movement). The budgeted number of permanent placements was 765 and at month 12 there were 771 placements which is a reduction of 8 places from month 10. The overspend is £1.010m (£0.074m favourable) on placements including additional support costs. Respite placements are £0.037m under spent (£0.001m favourable). The plan to manage down the number of permanent placements to reach the target was challenging due to the need to minimise delayed discharge from hospital and to continue to support those in critical and substantial need in the community. The overspend is partially offset by income recovered from charging orders which is £0.834m over recovered (£0.018m favourable). This income is challenging to predict as it depends on the length of the legal process and time taken to sell the property that the charging order is registered to. b) Care at home is £2.712m overspent (net £0.077m adverse). The position reflects the cost of meeting the significant demand and level of provision for care at home support. 162
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c) Physical Disability Services overspend of £0.714m (£0.016m favourable) split as follows: £1.295m over in residential placements, £0.298m under in direct payments and £0.283m under in community care packages. d) Integrated Island Services are £0.682m (£0.207m adverse movement). The most significant variance is an overspend at Montrose House of £0.464m (£0.049m adverse movement) which relates to the net overspend on agency staff (i.e. net of underspend on employee costs) and overspends across property, supplies, admin and transport. A new contract to procure agency nursing staff commenced in November. The full benefit of the lower rates will be seen in 25-26. There is also an overspend on supplies of £0.297m (continence and medical supplies) but this is partially offset by an underspend in employee costs of £0.156m. e) Specialist Rehab wards – overspend of £0.076m (£0.070m adverse movement) (Redburn ward £0.133m overspend and Douglas Grant £0.057m underspend). The overspend is due to cover costs for vacancies as well as supplementary staffing for patients who require one to one support. f) Wards 1 and 2 – overspend of £0.735m (£0.058m adverse movement). The overspend is due to increased use of bank and supplementary staffing. g) District Nursing – overspent by £0.088m (£0.017m adverse) mainly due to an overspend on nursing supplies. h) Equipment and Adaptions – overspend of £0.235m (£0.095m favourable movement) mainly due to an overspend on the supply of stairlifts. 2.4 Mental Health Services Against the full-year budget of £108.721m there is an underspend of £0.898m (0.8%) (favourable movement of £3.593m) prior to the re-allocation of the Lead Partnership variance to East and South HSCP. This favourable swing is mainly due to: 1) The inclusion of £2.237m of underspends that will be earmarked and carried forward for use in 2025-26. These are £1.884m of Lead Partnership underspends and £0.353m for the ADP; and 2) A favourable movement of £1.308m in Learning Disabilities mainly due to the variance between planned care and actual care delivered. 163
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The areas of main variance are: • Learning Disabilities care packages are underspent by £0.322m (£1.018m favourable movement) across community care packages, direct payments and residential placements. This improvement reflects the positive impact of assertive reviews of care packages and increased clawbacks from direct payments. The year end reconciliation also highlighted a higher than anticipated invoice variation which is the difference between planned care and delivered care which is the main cause of the favourable swing. There was also an underspend of £0.197m in supported accommodation property costs. These budgets will be reviewed and reconfigures in 2025/26. • Community Mental Health services are underspent by £0.632m (£0.343m favourable movement) across community care packages, direct payments and residential placements. The main reason for underspend is the availability and capacity of adult community providers to deliver new packages of care and the variation between planned and actual care. There was also an underspend of £0.136m in relation to supported accommodation at Nethermains as full year budget was provided for a service that incurred part year costs. • There is an underspend of £0.102m (£0.027m favourable) in relation to the cost of Hospital Based Complex Continuing Care (HBCCC), this reflects the impact of change in provision for these services. • The Lead Partnership for Mental Health is £0.716m overspent prior to earmarking of £1.884m resulting in an overspend of £2.600m (£0.243m adverse movement) and the main variances are as follows: • Adult Inpatients – overspent by £0.150m (£0.029m adverse) due to overspends in supplementary staff for enhanced observations (1:1 and 2:1) and use of bank staff. There is a favourable impact from the opening of the adult mental health assessment hub which has seen the adult inpatient areas with reduced occupancy. There has also been a continuing reduction in bank costs. • The UNPACS (Unplanned Activities) budget – overspent by £1.143m (£0.083m adverse movement) based on current placements. UnPACS placements are for individuals with very specific needs that require a higher level of security and/or care from a staff group with a particular skill set/competence. There are no local NHS secure facilities for women, people with a learning disability or people with neurodevelopmental disorder. This can necessitate an UNPACs placement with a specialist provider which can be out-of-area. The nature of mental health UNPACs spend is that it is almost exclusively 164
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on medium- or long-term complex secure residential placements which are very expensive so a small change in placements can have a high budgetary impact. Due to the complexity and risk involved, transitions between units or levels of security can take many months. Applications to approve a placement are made to the Associate Medical Director for Mental Health who needs to be satisfied that the placement is appropriate and unavoidable prior to this being agreed. A new group has been established to review the UnPACS budget and placements with a wider service representation. • Learning Disability Services – underspent by £0.212m (£0.080m favourable). This position is after recharging other areas on a cost basis for two outwith authority placements which have incurred additional costs in relation to usage of supplementary staffing due to sustained enhanced observations. There is a risk in relation to recovering this income as the two areas receiving the charges are currently refusing to pay and legal advice is being sought. The projected income due from prior and the current year is £2.308m. • Elderly Inpatients –overspend of £0.447m (£0.004m favourable movement) due to the use of supplementary staffing. The elderly mental health wards continue to operate at full occupancy and at times with waiting lists, with several patients who are on enhanced observations and bank costs remain high. • Enhanced Mental Health Outcome framework is underspent by £0.624m all of which will be earmarked and carried forward for use in 2025-26 to cover legacy costs for projects and posts that are discontinuing and continued pressures within the Lead Partnership. • Eating Disorders – overspent by £0.107m (£0.003m adverse movement) due to the staffing level being higher than the funding allocation. This will be considered alongside the overall resource allocation in future years. • Psychiatry – is overspent by £0.495m (£0.045m adverse movement) due to the use of agency staff and junior doctors. A mitigation plan has been developed by the Associate Medical Director to reduce this overspend in 2025-26. • MH Pharmacy – overspent by £0.675m (£0.017m adverse movement) due to increased demand and cost of medicines and in particular the cost of Buvidal, further detail on this area of pressure has been shared at the Finance Working Group. There is pan Ayrshire investment in this area for 2025-26. 165
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Innovation Fund – underspend of £0.104m (£0.004m adverse movement) due to slippage within some of the projects and not all of the funding has been allocated. • Action 15 has underspent by £0.487m all of which will be earmarked and carried forward for use in 2025-26 to cover legacy costs for projects and posts that are discontinuing. • There is also an underspend in MH Infrastructure of £0.322m which will be earmarked and carried forward for use in 2025-26. • The turnover target for vacancy savings for the Lead Partnership is held within the Lead Partnership as this is a Pan-Ayrshire target. There is an over recovery of the vacancy savings target of £0.479m (£0.279m favourable) in 2024-25. Further information is included in the table below: Vacancy Savings Target (£1.116m) Projected to March 2025 £1.445m Over/(Under) Achievement £0.329m 2.5 Children and Justice Services Against the full-year budget of £43.717m there is an overspend of £0.577m (1.3%) (£0.981m favourable movement of which £0.934m relates to an underspend for the Whole Family Wellbeing Fund which will be earmarked and carried forward for use in 2025-26) and the main variances are: a) Care Experienced Children and Young People is overspent by £1.903m (£0.005m favourable). Some of these costs are offset by the contribution from the Home Office for Unaccompanied Asylum-Seeking Children which is detailed below. The main areas within this are noted below: • Following budget investment of £4m the children’s residential placements are overspent by £1.837m (£0.089m adverse) based 28 placements. This demonstrates a reduction of 9 places since the start of the financial year. There are a number of factors leading to this challenging position: • We have 32 places available in our internal children’s houses, due to demand these have been operating at 100% occupancy or over for some time, leading to increased use of external placements where residential care is required. • The requirement to support Unaccompanied Asylum-Seeking Children (UASC) under the National Transfer Scheme and to support trafficked young people who have been identified in North Ayrshire. 166
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• A number of young people in residential care have requested Continuing Care, whereby a young person can remain in their placement until age 21. • Where appropriate young people are placed to meet their educational needs, the cost of Residential School Placements in the most cases is shared 50/50 with Education services. • Contractual inflation has increased the projected costs of residential places which is outwith the control of the service. Children’s Services are continuing to work with other services including Education and Housing to address the challenges through the work of the ‘Brighter Pathways’ Programme Board and associated workstreams. The Brighter Pathways progress and recommendations are being finalised and will be presented to the IJB after the summer recess. • Looked After and Accommodated Children (fostering, adoption, kinship etc) is £0.859m underspent (£0.136m favourable). • Children with disabilities – there is a net overspend of £0.496m (£0.041m favourable movement) across residential placements, direct payments and community packages. The adverse movement is due to the confirmed costs of a recent placement being higher than previously estimated. • Residential respite – placements are overspent by £0.138m (£0.005m favourable). These short-term placements are used to prevent an admission to full time care or to avoid placement breakdown. • Employee costs – are overspent by £0.130m (£0.016m adverse movement), largely due to staffing levels in the children’s houses and regrading of posts. b) Head of Service – is underspent by £0.787m (£0.068m favourable movement). This consists of a projected overspend due to the planned saving of £0.223m in relation to the staff reconfiguration in the children’s houses which was not achieved in 23-24 and this is offset by the grant funding in relation to Unaccompanied Asylum-Seeking Children (UASC), which is projected to amount to £0.922m (no change) and which contributes to costs incurred across a number of C&F service areas. c) C&F Health Team – is projected to overspend by £0.351m (£0.067m adverse) mainly in relation to the Band 6 to 7 regrade for Health Visitors and the progression of posts up the Band 7 scale. Part of this recurring cost (£0.246m) has been approved as a budget pressure for 2025/26. 167
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2.6 ALLIED HEALTH PROFESSIONALS (AHP) The non-employee costs element of the AHP services are on-line as all underspends in employee costs have contributed to payroll turnover. 2.7 CHIEF SOCIAL WORK OFFICER This is overspent by £0.090m (£0.053m adverse) which relates to an overspend in Learning and Development costs. 2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £3.721m (£0.035m favourable) and the main areas of variance are: • There is slippage on the LD and MH transition funding of £0.974m (£0.013m favourable) due to delays in children transitioning into adult services and actual costs being less than estimated. This involves complex planning by services with service users and families and can change over time based on assessed need when moving into adult services. • The 2024-25 budget included a budgeted deficit on the social care side of £0.437m which is offset by a budgeted surplus of £0.437m on the health side of the budget. The net impact is neutral, but Appendix A shows this position for each element. • The £0.100m saving in relation to recovery and rehab was not achieved in 2024-25 but will be achieved in 2025-26. • The recovery plan actions in relation to the reserves and service redesign funds totalling £0.686m are now reflected in the outturn. • An over-recovery of payroll turnover of £1.163m for social care services and an over-recovery of payroll turnover of £0.483m for health services as outlined in the table below. The turnover targets and achievement for the financial year for Health and Social Care services outwith the Lead Partnership is noted below: Social Care Health Vacancy Savings Target (£3.301m) (£1.522m) Achieved at March 2025 £4.464m £2.005m Over/(Under) Achievement £1.163m £0.483m The areas contributing to the health and social care vacancy savings are spread across a wide range of services with vacancy savings being achieved in most areas. As part of the recovery plan, the vacancy scrutiny group has been enhanced with the Heads of Service and professional leads attending. Each post is scrutinised and filled only where deemed necessary with a recruitment freeze now implemented for 168
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all non-essential posts. This has led to an increase in the level of turnover when projected to the year end. The turnover target for the North Lead Partnership for Mental Health services is detailed separately within the Lead Partnership information at section 2.4. 2.9 Savings Progress a) The approved 2024-25 budget included £10.290m of savings. BRAG Status Position at Budget Approval £m Position at Month 12 £m Red - - Amber 0.523 0.475 Green 9.767 - Blue - 9.815 TOTAL 10.290 10.290 b) The main area to note is that the amber savings in relation to care homes and recovery and rehab will not be fully achieved in 2024-25 but there is a plan to fully deliver in 2025/26. Appendix B provides an overview of those service changes which do have financial savings attached to them and the BRAG status around the deliverability of each saving. 2.10 Budget Changes The Integration Scheme states that “either party may increase it’s in year payment to the Integration Joint Board. Neither party may reduce the payment in-year to the Integration Joint Board nor Services managed on a Lead Partnership basis…. without the express consent of the Integration Joint Board.” Appendix C highlights the movement in the budget position following the initial approved budget. Reductions Requiring Approval: Ref Description Amount (£000) 1 ICT budget transfer 0.004 2 Reduction in SG Allocation for Global sum within prescribing budget 0.002 3 Return Anticipated Specialist Com Perinatal MH, Infant & Neonatal 24/25 as this was reclaimed as part of the EMHOF bundle. 0.750 169
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4 Training grade adjustment 0.036 5 Mh: Foxgrove - North Share to Reserves 24/25 0.074 6 Mh: Foxgrove - East Share 0.103 7 Mh: Foxgrove - South Share 0.107 8 Balance prescribing to zero 0.364 2.11 Pan Ayrshire Lead Partnership services and Large Hospital Set Aside Lead Partnerships: - The IJB position is adjusted to reflect the impact of Lead Partnership services. The outturn for all Lead Partnership services is shared across the 3 Partnerships on an NRAC basis. The outturn in relation to North Lead Partnership services is not fully attributed to the North IJB as a share is allocated to East and South Partnerships; similarly, the impact of the outturn on East and South led services is shared with North. South HSCP: Overspend of £0.598m of which £0.221m will be allocated to North. The variance is mainly due to an overspend of £0.454m in the community store due to overspends on beds and mattresses and moving and handling equipment. There is also a projected overspend of £0.145m in the continence service. East HSCP: Prior to earmarking against specific commitments, there is an underspend of £2.119m on services managed by East Ayrshire IJB under pan- Ayrshire Lead Partnership arrangements. After taking account of earmarking £2.001m, the underspend reduces to £0.118m. The main variances are: Primary Care and Out of Hours Services (Lead Partnership) On a managed services basis, there is an overall underspend of £1.857m on the Primary Care Lead Partnership budget (prior to pan-Ayrshire earmarking £2.001m), resulting in a small overspend of £0.144m. Earmarking includes a net overall underspend of £1.091m on the Primary Care Improvement Fund (PCIF) which has been earmarked for carry-forward on an actual spend basis at individual IJB level, as well as specific PCIF Phased Investment funding £0.819m, which has also been carried-forward to offset expenditure commitments on a pan-Ayrshire NRAC basis. In addition, pan-Ayrshire earmarking of sums to offset future costs in GP premises improvements £0.007m, and Appropriate Adult funding £0.005m have been accounted for on a NRAC basis. Primary Medical Services have overspent £0.556m, due to additional staffing costs, including increased pension, maternity, paternity and sickness cover costs. There are additional costs in Ayrshire Urgent Care Services of £0.064m, with work ongoing to re-design the service to mitigate pressures going forward. Funding has been allocated to fully offset Urgent Care Pathway costs £0.977m, as well as Covid-19 Therapeutics costs £0.202m. 170
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There is a £0.654m underspend in Dental services that reflects that staffing numbers are running at less than establishment. A sum of £0.079m has been earmarked on a pan-Ayrshire NRAC basis to offset future expenditure on Dental Practices improvements. Prison and Police Healthcare (Lead Partnership) The £0.024m overspend at month 12 is largely due increased staffing costs due to recruitment to vacant posts, as well as increased prescribing costs. Allied Health Professions (Lead Partnership) There is an underspend of £0.391m on AHPs services hosted by East Ayrshire for the current year. This mainly relates to staffing savings in Physiotherapy / MSK and Podiatry services and is partially offset by increased Orthotics costs. Other Services (Lead Partnership) The £0.105m overspend is due to increased Area Wide Evening Services costs, mainly due to additional staffing costs including high use of bank staff, which will require to be further addressed going forward. Set Aside: Work has been undertaken with partnerships to progress and develop set aside arrangements to fully implement the legislative requirement. This includes arrangements in relation to the use of Directions, Joint Commissioning Plans and overall progression towards fair share allocations of resources. Further work has been undertaken through the Ayrshire Finance Leads group to establish baseline resources for each partnership and how these compare to the NRAC “fair share” of resources. Ayrshire Finance Leads have now agreed a baseline methodology for set aside budgets which involves using the four full years prior to the pandemic, 2016/17 – 2019/20 inclusive. The HSCPs require to agree their final share of the baseline with each other, however the aggregate will remain unchanged. The table below shows the cost of the historic baseline at 2023/24 prices. IJB Baseline at 2024/25 prices East 31,869,955 North 39,965,941 South 34,488,109 Total 106,324,005 The annual budget for Acute Services is £462.6million. The directorate overspent by £36.9 million in the 12 months to 31 March 2025. This was caused by overspends on agency medical and nursing staff, together with medicines expenditure, 171
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equipment and supplies. These have been required due to the level of operational pressure being experienced, in common with many other areas in Scotland. November saw a successful reduction in unfunded beds. Operational challenges in December carried on into the final quarter. Ayr had 24 additional beds open between Station 8 and Station 12 every day and an average of 13 on Station 11. Crosshouse continued with 78 unfunded beds open in March, and in addition 24 full capacity beds were open each day on average. The SAFER programme in Crosshouse is progressing well and early indications show a reduction in Length of Stay (LoS) across two wards by 2.5 days each. The cohorting of patients in the active wards is also demonstrating a reduction in LoS in other areas. There is a material underlying deficit caused by: • Unachieved efficiency savings • Length of Stay (LoS) and emergency admission rates in NHS Ayrshire and Arran acute hospitals are above the Scottish average. • High expenditure on medical and nursing agency staff, high rates of absence and vacancies causing service pressure. • Delayed transfers of care and high acuity of patients. The IJBs and the Health Board work closely in partnership to maintain service and improve performance. Initial work has commenced to develop a joint strategic commissioning plan for the provision of unscheduled care services, which will outline these services will be delivered over the medium-term using the set aside resources available. This will support a shift in the balance of care into the community and support a reduction in the number of acute beds. 2.12 FINANCIAL RISKS There were a number of financial risk areas during the year that impacted on the financial position. Some of these will continue into 2025-26 and there are increased risks as a result of the 2024-25 outturn. • The announcements by Scottish Government in relation to public sector finances and in-year spending reductions. • Continued growing demand for services. • Staff recruitment and retention challenges across a number of service areas. • The provider market and the ongoing ability to source packages of care for service users. • The expectation that performance will continue to be maintained or improved despite the significant resource challenges, for example the joint mission for delayed discharge improvement. • Ongoing delivery costs of Scottish Government policy directives, particularly where these are not fully funded or inflation proofed. • The ongoing review of the Integration Scheme. 172
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• Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • The wider system financial challenges, especially the financial position of NHS Ayrshire and Arran Health Board, their financial deficit and the risks around further escalation in the national framework for financial escalation. • The recurring underlying levels of overspend which may impact on the Partnership’s ability to continue to sustain service levels in the future. • The IJB free general fund reserves are fully used during this financial year. • High risk areas of low volume / high-cost services areas e.g. Children’s residential placements, Learning Disability care packages and complex care packages. • Lead / hosted service arrangements, including managing pressures and reporting this across the 3 IJBs. • The impact on Lead Partnership and acute services from decisions taken by other Ayrshire areas. • The use of supplementary staffing for enhanced observations across a number of service areas. • The use of high-cost agency staff to support frontline service delivery in areas where there are recruitment challenges. • Agenda for Change Pay Reform programme – including Nursing Band 5-6 re- grade, protected learning time and reduction to the working week. Some funding has been provided to meet costs associated with this but it is unclear whether this will be sufficient. • Scot Excel inflationary increases for children’s service are significantly higher than assumed. • There is a risk in relation to recovering recharge income in relation to the LD Assessment and Treatment patients from outwith Ayrshire. These risks will continue to be monitored during 2025/26. 2.13 RESERVES The IJB reserves position is summarised in the table below. General Fund Reserve Earmarked Reserves Total Unearmarked External Funding HSCP £m £m £m £m Balance – 1 April 2024 0.357 3.379 1.774 5.510 Drawdowns (0.357) (3.379) (0.994) (4.730) New Earmarking - 2.381 - 2.381 Balance – 31 March 2025 - 2.381 0.780 3.161 173
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The £0.780m HSCP earmarked reserve relates to the Service Redesign and Change Fund which is fully committed across 2024/25 and 2025/26. Further detail on the reserves is given in Appendix D. 2.14 Financial Recovery Plan The IJB set a balanced budget for 2024/25 on 14th March 2024. This did not require any draw on reserves but did include the approval of £10.290m of savings to achieve financial balance. Following the finalisation of the 2023/24 outturn position, the IJB agreed some initial recovery actions at the meeting in June. In line with the requirements of the integration scheme, work has continued to develop the financial recovery plan and identify further targets for financial improvements. Since the initial recovery plan was agreed in June 2024, where there was a forecast overspend position of £6.555m, there has been a £4.002m impact on costs, the full benefits of this were not fully attributed to the bottom line as other in-year pressures impacted on the overall position. It is assumed that all mitigations and controls established in 2024-25 continue throughout 2025-26 as it is recognised that the same uncertainty and risks remain into 2025-26 and there needs to be tight grip and control over expenditure overall. INTEGRATION SCHEME The Integration Scheme describes the required approach where there is a projected overspend: The Chief Officer will deliver the Outcomes within the total delegated resources (paid and Set Aside) and where there is a forecast overspend against an element of the operational budget, the Chief Officer, the Chief Finance Officer of the Integration Joint Board and the appropriate finance officers of the Parties must agree a recovery plan to balance the overspending budget, which recovery plan shall be subject to the approval of the Integration Joint Board. If the recovery plan is not successful the Parties will consider making interim funds available based on the agreed percentage contribution for joint responsibilities, as outlined above, with repayment in future years on the basis of a revised recovery plan agreed by the Parties and Integration Joint Board. At month 7 the IJB requested that the Chief Officer write formally to North Ayrshire Council and NHS Ayrshire and Arran to request additional in-year funding and at month 12 the following has been agreed: 174
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Social Care element – overspend of £2.036m. North Ayrshire Council considered this at their Cabinet meeting of 3rd June and agreed to fund this with a non-recurring funding increase and no requirement to repay the funds in future years. Health element – overspend of £1.557m. NHS Ayrshire and Arran have funded this, previous discussions with NHS AA colleagues in relation to repayment indicated the Health Board would wait to consider this following North Ayrshire Council’s consideration. The outcome of the decision by North Ayrshire Council has been communicated to NHA AA Director of Finance for consideration. Following these additional funding contributions the final position is on-line. 3. PROPOSALS 3.1 Anticipated Outcomes Continuing to closely monitor the financial position will allow the IJB to take corrective action where required to ensure the Partnership can deliver services in 2025-26 from within the available resource, thereby limiting the financial risk to the funding partners. The transformational change programme will have the greatest impact on the financial sustainability of the partnership, the IJB require to have a clear understanding of progress with the delivery of the transformation plan. 3.3 Measuring Impact The financial position reported is the unaudited year-end outturn position for 2024- 25, further information will also be contained within the unaudited IJB annual accounts. Ongoing updates to the financial position including the reserves position will be reported to the IJB throughout 2025-26. 4. IMPLICATIONS 4.1 Financial The outturn is an overall year-end overspend of £1.212m, which when adjusted for new earmarked reserves of £2.381m is increased to £3.593m. This overspend was brought on-line by additional funding contributions from North Ayrshire Council and NHS Ayrshire and Arran. The report outlines the main variances for individual services. 4.2 Human Resources The report highlights vacancy or turnover savings achieved during the year. Services will review any staffing establishment plans and recruitment in line with normal practice when implementing service change and reviews as per agreement with the IJB. Tight vacancy scrutiny management arrangements are in place for the HSCP. 4.3 Legal 175
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None. 4.4 Equality/Socio-Economic None. 4.5 Risk Para 2.12 highlights the financial risks. The report falls in line with the agreed risk appetite statement which is a low-risk appetite in respect to adherence to standing financial instructions, financial controls and financial statutory duties and a high-risk appetite in relation to finance and value for money. The ‘financial viability of the HSCP’ risk on our strategic risk register has increased the risk score to reflect the 23/24 and 24/25 outturn and the known challenges in 25/26. 4.6 Community Wealth Building None. 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025-26 and 2026-27 and the increased focus required on financial rather than service improvement. This will be kept under close scrutiny throughout 2025-26. If we are unable to successfully develop a financial recovery plan to achieve financial balance, and consideration will be given as part of our current review of the strategic plan. 5. CONSULTATION 5.1 This report has been produced in consultation with relevant budget holders and the Partnership Senior Management Team. 5.2 The IJB financial monitoring report is shared with the NHS Ayrshire and Arran Director of Finance and North Ayrshire Council’s Head of Finance after the report has been finalised for the IJB. Caroline Cameron, Director Author – Eleanor Currie, Interim Chief Finance Officer [eleanorcurrie@north-ayrshire.gov.uk] 176
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PUBLIC INFORMATION 2024-25 Budget Monitoring Report–Objective Summary as at 31st March 2025 Appendix A Budget Outturn Over/ (Under) Spend Variance Budget Outturn Over/ (Under) Spend Variance Budget Outturn Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 COMMUNITY CARE AND HEALTH 72,796 77,311 4,515 19,753 20,870 1,117 92,549 98,181 5,632 : Locality Services 30,287 31,269 982 5,633 5,722 89 35,920 36,991 1,071 : Community Care Service Delivery 38,598 41,337 2,739 0 38,598 41,337 2,739 : Rehabilitation and Reablement 2,045 2,283 238 0 2,045 2,283 238 : Long Term Conditions 905 951 46 9,921 10,789 868 10,826 11,740 914 : Community Link Workers 331 319 (12) 0 0 0 331 319 (12) : Integrated Island Services 630 1,152 522 4,199 4,359 160 4,829 5,511 682 MENTAL HEALTH SERVICES 34,187 32,714 (1,473) 74,534 75,109 575 108,721 107,823 (898) : Learning Disabilities 25,451 24,956 (495) 568 568 0 26,019 25,524 (495) : Community Mental Health 6,835 6,202 (633) 1,748 1,749 1 8,583 7,951 (632) : Addictions 1,901 1,556 (345) 1,949 1,909 (40) 3,850 3,465 (385) : HBCCC 0 0 0 353 251 (102) 353 251 (102) : Lead Partnership Mental Health NHS Area Wide 0 0 0 69,916 70,632 716 69,916 70,632 716 CHILDREN & JUSTICE SERVICES 38,495 38,721 226 5,222 5,573 351 43,717 44,294 577 : Irvine, Kilwinning and Three Towns 2,946 2,974 28 0 0 0 2,946 2,974 28 : Garnock Valley, North Coast and Arran 3,076 2,196 (880) 0 0 0 3,076 2,196 (880) :Intervention Services 1,173 1,162 (11) 0 0 0 1,173 1,162 (11) : Care Experienced Children & Young people 27,358 29,261 1,903 0 0 0 27,358 29,261 1,903 : Head of Service - Children & Families 1,039 252 (787) 0 0 0 1,039 252 (787) : Justice Services 2,477 2,476 (1) 0 0 0 2,477 2,476 (1) : C&F Health Team 426 400 (26) 4,447 4,798 351 4,873 5,198 325 : Lead Partnership NHS Children's Services 0 0 0 775 775 0 775 775 0 CHIEF SOCIAL WORK OFFICER 1,635 1,725 90 0 0 0 1,635 1,725 90 PRIMARY CARE 0 0 0 53,575 53,662 87 53,575 53,662 87 ALLIED HEALTH PROFESSIONALS 0 10,748 10,749 1 10,748 10,749 1 MANAGEMENT AND SUPPORT COSTS 12,311 9,702 (2,609) 3,373 2,261 (1,112) 15,684 11,963 (3,721) OUTTURN ON A MANAGED BASIS 159,424 160,173 749 167,205 168,224 1,019 326,629 328,397 1,768 TOTAL Partnership Budget - Objective Summary Council Health 2024/25 Budget 177
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PUBLIC INFORMATION TOTAL Budget Budget Budget Outturn Over/ (Under) Spend Variance Budget Revised Outturn Over/ (Under) Spend Variance Budget Outturn Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 Return Hosted Over/Underspends to East 0 0 0 0 (122) (122) 0 (122) (122) Return Hosted Over/Underspends North 0 0 0 0 0 0 0 0 Return Hosted Over/Underspends to South 0 0 0 0 (229) (229) 0 (229) (229) Receive Hosted Over/Underspends South 0 0 0 0 221 221 0 221 221 Receive Hosted Over/Underspends East 0 0 0 0 (426) (426) 0 (426) (426) OUTTURN ON AN IJB BASIS 159,424 160,173 749 167,205 167,668 463 326,629 327,841 1,212 Adjusted for Earmarking ADP 0 353 353 0 0 0 0 353 353 Whole Family Wellbeing Fund 0 934 934 0 0 0 0 934 934 Action 15 0 0 0 0 135 135 0 135 135 Breastfeeding Network 0 0 0 0 36 36 0 36 36 Enhanced MH Outcome Framework 0 0 0 0 241 241 0 241 241 Early Intervention in Psychosis 0 0 0 0 92 92 0 92 92 Police Scotland 0 0 0 0 1 1 0 1 1 MH Infrastructure 0 0 0 0 124 124 0 124 124 LD SG Funding 0 0 0 0 82 82 0 82 82 Earmarking for East LP services 0 0 0 0 383 383 0 383 383 OUTTURN POSITION PRIOR TO ADDITIONAL FUNDING CONTRIBUTIONS 159,424 161,460 2,036 167,205 168,762 1,557 326,629 330,222 3,593 CONTRIBUTION FROM NORTH AYRSHIRE COUNCIL 2,036 0 (2,036) 0 0 0 2,036 0 (2,036) CONTRIBUTION FROM NHS AYRSHIRE & ARRAN 0 0 0 1,557 0 (1,557) 1,557 0 (1,557) FINAL OUTTURN POSITION 161,460 161,460 0 168,762 168,762 0 330,222 330,222 0 Partnership Budget - Objective Summary 2024/25 Budget Council Health 178
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PUBLIC INFORMATION 2024-25 Savings Tracker Appendix B Social Care: Description Deliverability Status at budget setting Deliverability Status at Month 12 2024/25 Saving Description of the Saving Children, Families & Criminal Justice Service redesign Amber Blue 0.123 Restructure areas of specialist service provision including substance use and corporate parenting, embedding the roles and functions of those teams within our locality-based early intervention approaches and strategic planning including engagement. Community Care & Health Review of Day Care provision Amber Blue 0.100 Carry out a review and streamline day care provision. Sensory Impairment Team Green Blue 0.062 Remove the dedicated management post and realign the team into core social work teams. Care Home places Green Amber 0.375 Reduce the number of funded care home places by 15, leaving budgetary provision for 765 places at average cost. Charging for community alarm provision to sheltered housing tenants Amber Blue 0.200 Introduce a charge for community alarm provision in council sheltered housing units to ensure an equitable approach across all housing tenures. Montrose House capacity Green Amber 0.111 Restrict the capacity at Montrose House care home to the current level of residency. Voluntary Early Release Green Blue 0.174 Recurring savings achieved by the release of back-office staff through the council's voluntary early release scheme. Carers Strategy funding Green Blue 0.384 Utilise the remaining Carer's Strategy funding to invest in respite provision and short breaks for carers and to support existing investments in services which support unpaid carers. Increase to charging Green Blue 0.131 Increase charges for non-residential care by 10% and charges for residential care by 5% Remove vacant posts Green Blue 0.280 Remove a number of vacant posts across support services. Employers' superannuation contributions Green Blue 7.238 Align the budget to the new employer superannuation contribution rates from 1st April 2024. Payroll Turnover Green Blue 0.077 Increase targets for payroll turnover through the recruitment process. TOTAL SOCIAL CARE SAVINGS 9.255 Support Services and Partnership-wide savings 179
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PUBLIC INFORMATION Health: Description Deliverability Status at budget setting Deliverability Status at Month 12 2024/25 Saving Description of the Saving Hospital Based Complex Continuing Care (HBCCC) provision Green Blue 0.500 Align the budget to the level of ongoing need for HBCCC provision. Increase recharge to East Ayrshire for beds at Woodland View Green Blue 0.021 Apply an inflationary increase to the recharge to East Ayrshire HSCP. Community Recovery and Rehab provision Amber Amber 0.100 Review and streamline a range of current provisions to remove duplication. Enhanced ICT Green Blue 0.100 Carry out a review of the service delivery model and release recurring staffing savings. Payroll Turnover Green Blue 0.314 Increase targets for payroll turnover through the recruitment process. TOTAL HEALTH SAVINGS 1.035 TOTAL NORTH HSCP SAVINGS 10.290 180
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PUBLIC INFORMATION 2024-25 Budget Reconciliation Appendix C COUNCIL Period Permanent or Temporary £'m Initial Approved Budget 156.190 Adjustments to baseline (0.574) Less Resource Transfer 23/24 (24.640) Revised Budget 130.976 Resource Transfer 24/25 P 26.217 Realign Girfec Team To Connected Commu 1-3 P (0.073) ICT Budget Transfers 1-3 P (0.006) CJSW Funding 2425 1-3 T 0.053 Childrens Living Wage Allocation 1-3 T 0.525 ICT Budget Transfers 6 P (0.002) ICT Budget Transfers 6 P (0.003) Post Realigned from the Policy, Performance & Elections Team 6 P 0.059 Transfer to FM Services re Cleaning Services at West Road 6 P (0.010) Transfer to Capital re West Road 7 T (0.281) Transfer from NAC Commercial Waste 7 T 0.007 ICT Budget Transfers 9 P (0.002) Summer Activities EMF Q2 & Q3 Draw- Down 9 T 0.002 Pay Award 24/25 9 P 1.057 Scottish Disability Allowance 9 P 0.134 Transfer from Housing re Domestic Abuse Alarns 10 P 0.008 Drugs Taskforce post 12 T 0.009 ICT Budget Transfers 12 P (0.004) Summer Activities Q4 Draw-Down 12 T 0.001 Apprenticeship Levy 12 P 0.010 EM Funds Victim Witness Support 12 T 0.009 Insurance Excess 12 T 0.026 Change fund - equipment and adaptations 12 T 0.024 Storm Costs 12 T 0.019 CFCR 47 West Road 12 T 0.090 24/25 Insurance Allocation 12 T 0.088 HSCP trf from EM Funds& Invest fund 12 T 0.260 Financial Inclusion VER costs 12 T 0.234 Additional contribution re overspend 12 T 2.036 Roundings 12 T (0.003) 161.460Social Care Budget Reported at Month 12 181
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PUBLIC INFORMATION HEALTH Period Permanent or Temporary £'m Initial Budget exc set aside 157.894 Add Resource Transfer 23/24 24.640 Month 10-12 Adjustments and adjusting for the full year impact of part years amounts and temporary funding. (0.033) Revised Budget P 182.501 Add resource Transfer 24/25 (26.217) North Superannuation 24/25 uplift 1 1.134 MH: ANTICIPATE HOLLYBUSH COMBAT STRESS 24/25 1 1.424 MH: ANTICIPATE DELIVERY OF VETERAN SPECIFIC 24/25 1 0.105 MH: ANTICIPATE PERINATAL MH, INFANT MH (INCL MNPI) 24/25 1 0.750 Training grade ADJ - April 1 0.063 Pecos Nurse Post 1 (0.018) Script Switch To Pharmacy 1 (0.002) Breastfeeding Pay Award - South 2 0.005 Nest - South 2 0.066 24-25 Bwg Foxgrove North 2 0.033 24-25 E Bwp Breast Feeding - North 2 0.005 24-25 E Bwp Huntingtons North 2 0.005 24-25 E Bwp Nest North 2 0.066 Phlebotomy Admin Returned 2 0.005 23-24 - 50% North Share to East - Tier 3 Weight Management 2 (0.077) 24-25 North Share to East - Tier 3 Weight Management 2 (0.022) Anticipate Adp Afc Pay Uplift 3 0.091 Anticipate Adp Drug Prevalence 3 0.084 Anticipate Adp Lived & Living Exp 3 0.013 Anticipate Adp Mat 3 0.250 Anticipate Adp National Mission 3 0.296 Anticipate Adp Residential Rehab 3 0.134 Anticipate Adp Whole Family Approach 3 0.094 Training Grade Adj - Jun 3 (0.054) Ambush North Rx 3 1.573 Ambush North Rx Cres 3 (1.477) 182
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PUBLIC INFORMATION HEALTH Period Permanent or Temporary £'m 24-25 North Budget Paper - Office 365 (to East) 3 (0.073) 24-25 North Budget Paper - Prison Pharm Contract (to East) 3 (0.093) South Mat Funding - Psychiatrist 3 0.029 Hd198: Early Intervention In Psychosis/ Body Image And Social Media Resource 3 0.242 Hd203: Digital Mental Health Programme Licence & Support 3 0.005 Reduction to the Working Week (mth 2 - 4) 4 0.105 Post to medical records 4 (0.037) HD107: breast Feeding project funds 4 0.056 BBV 4 0.282 Rww 1/2 Hour Overtime M5 5 0.006 Min Anp Allocation 5 0.020 Ml: Nr Prog - Mappa 5 0.004 Training Grade Adj - August 5 0.051 Training Grade Vac Adj - August 5 (0.025) MH: Return Hollybudh anticipated budget back to reserves 24/25 5 (1.424) HD271: Combat Stress Clinical services for Veterans 5 0.583 Reduction to the Working Week 1/2 Hour Overtime M6 6 0.002 Hd283 24-25 Pharmacy Tariff Red 6 (0.031) Reduction to the Working Week 1/2 Hour Overtime M7 7 0.003 Afc Partnership Pay Award 7 4.710 Training Grade Adj - October 7 (0.026) 24-25 E Bwp Huntington's North - Return To East 7 (0.005) Mh - Afc Reform Reduced Working Week 7 0.037 Pharmacy Tarrif reduction reinstated 7 0.031 Return Anticipated MDT 7 (0.316) MDT reduction by SG 7 0.179 Rww 1/2 Hour Overtime M8 8 0.002 Ret Antic Mdt 24-25 Alloc Correct 8 (0.017) Virement No. 14: North Mdt Funds To Arran Medical Group 8 (0.041) 183
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PUBLIC INFORMATION HEALTH Period Permanent or Temporary £'m HD231: PDS Dementia 8 0.094 Mh: Return Afc Partnership Pay Award 8 0.146 Fund RX Overspend at M8 8 0.396 Rww Worked November Paid December 9 0.001 MH: ALLOCATE MAT STANDARDS - MAT 7 PRIMARY CARE (PAN AYRSHIRE) PHARMACIST 9 (0.041) MH: ADP 24/25 - ABI to East 9 (0.010) HD413: Veterans Specific Services - Combat Stress 9 0.010 Medical Pay Award Part 1 9 0.804 Med Pay Award - December 9 0.182 Fund Rx Overspent At M9 9 0.325 Specialist/specialty Docs Pay Award 11 0.038 Training Grade Adj - February 11 0.017 Virement 23 Fr Aml443 - part year costs of a Bsnd 3 post transferring from South to North 11 0.001 Hd490 Reduction in SG Allocation for Global sum within prescribing budget 11 (0.002) Rx To Fund Overspend 11 0.110 Reduced Working Week - Mth 9 -12 11 0.220 Mh: Return Anticipated Specialist Com Perinatal Mh, Infant & Neonatal 24/25 - reclaimed via EMHOF 12 (0.750) Enhanced Mental Health Outcome Framework 12 0.968 Medcial Discretioanry Point funding 24/25 12 0.024 Training Grade Adj - March 12 (0.006) Mh: 23/24 Foxgrove Frm Reserves - North Share 23/24 12 0.045 Mh: Foxgrove - North Share To Reserves 24/25 12 (0.074) Training Grade Adj - March 12 (0.030) Mh: Foxgrove - East Share 23/24 12 (0.103) Mh: Foxgrove - South Share 23/24 12 (0.107) Balance Prescribing To Zero 12 (0.364) Learning Disabilities Physical Adaptations 12 0.212 Alzheimer Scotl Dementia Consultants Programme 12 0.010 Additional contribution re overspend 12 1.557 168.762 TOTAL COMBINED BUDGET 330.222 Health Budget Reported at Month 12 184
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PUBLIC INFORMATION 24-25 IJB Reserves Position Appendix D Balance at 31 March 2024 Area of Reserves Transfers Out 2024-25 Transfers In 2024-25 Balance at 31 March 2025 Earmarked Funds 641 : Alcohol & Drug Partnership (641) 353 353 57 : Mental Health Action 15 (57) 135 135 0 : Primary Care Improvement Fund 0 46 46 1,774 : Service Redesign / Challenge Fund (994) 780 377 : Community Living Change Fund (377) 0 1,313 : Family Wellbeing Fund (1,313) 934 934 50 : Wellbeing Funding (50) 0 0 26 : Breastfeeding Network (26) 36 36 546 : MH Recovery and Renewal /Enhanced MH Outcome Framework (546) 365 365 0 : Early Intervention in Psychosis 0 92 92 23 : Buvidal (23) 0 : LD funding 0 82 82 5 : Brooksby (5) 0 4 : Cossette Funding (4) 0 0 : Donation (Police Scotland) 0 1 1 0 : Primary Care Improvement Fund IP 0 303 303 55 : Expansion of Primary Care Estates (55) 0 63 : GP Premises Improvements - tranches 1 an (63) 3 3 81 : Mental Health Wellbeing in Primary Care (81) 0 0 29 : Dental Practice Improvement (29) 29 29 2 : Appropriate Adult (2) 2 2 19 :Adult Tier 3 Weight Management Service (19) 0 0 22 : Phlebotomy Service (22) 0 0 20 : LD Health Checks (20) 0 46 : LD Health Checks - NHS (46) 0 5,153 Total Earmarked (4,373) 2,381 3,161 357 Unallocated General Fund - NAC (357) 0 0 5,510 General Fund (4,730) 2,381 3,161 185
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Integration Joint Board 19th June 2025 Subject : Risk Appetite Statement Purpose : To approve the Risk Appetite Statement. Recommendation : That the IJB approve the Risk Appetite Statement. 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 NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership 1. EXECUTIVE SUMMARY 1.1 This report provides an overview of the risk appetite statement for the partnership. The purpose of the report is to allow IJB members to approve the Risk Appetite Statement. 2. BACKGROUND 2.1 Risk appetite is the amount of risk which is judged tolerable and justifiable. It is the amount of risk that any organisation is prepared to tolerate or be exposed to at any one point in time. 2.2 The Risk Appetite Statement has been developed to recognise that the planning and delivery of health and social care services involves having to manage risk and that staff must have the confidence to work with uncertainty. 2.3 The Statement reflects the ‘normal’ risk appetite, but it is recognised that risk appetite accepted in responding to delivering services during exceptional circumstances e.g. a pandemic, may be higher. 2.4 The Statement focuses on the key elements of service, quality, people and finance. Appendix A details the assessed risk appetite for each of these key elements of service. Agenda Item 10 187
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2.5 It has been reviewed and no changes have been found necessary. Future reviews of the risk appetite statement will routinely be conducted alongside the review of the risk management strategy, with the next one due in June 2028. It may be reviewed in the interim in the event of an urgent need. 3. PROPOSALS 3.1 It is proposed to approve the risk appetite statement as detailed in Appendix A. 3.2 Anticipated Outcomes Appropriate and effective risk management practice will be embraced throughout the IJB as an enabler of success, whether delivering 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. 3.3 Measuring Impact The IJB aims to provide safe and effective care and treatment for patients and clients, and a safe working environment within the IJB and for others who interact with the services delivered under the direction of the IJB. Effective risk management practice will support this. 4. IMPLICATIONS 4.1 Financial The Risk Appetite Statement is relevant to finance in framing the approach to value for money, the balance of risk and reward from alternative courses of action. 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk Failure to approve the report would result in a gap in the governance structure of the partnership. 4.6 Community Wealth Building None. 188
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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 The risk appetite statement has been reviewed and agreed by the Partnership Senior Management Team. Caroline Cameron, Director Author – Eleanor Currie, Interim Chief Finance Officer [eleanorcurrie@north-ayrshire.gov.uk] Appendices • Appendix A – Risk Appetite Statement 189
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Appendix A North Ayrshire Integration Joint Board Risk Appetite Statement Version 3.0 Prepared by –Interim Chief Finance Officer Effective from 19th June 2025 Review Date June 2028 Lead Reviewer Chief Officer 190
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Introduction The Integration Joint Board (IJB) is committed to a culture where the workforce is encouraged to develop new initiatives, improve performance and achieve goals safely, effectively and efficiently by appropriate application of good risk management practice. Appropriate and effective risk management practice will be embraced throughout the IJB as an enabler of success, whether delivering 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. In doing so the IJB aims to provide safe and effective care and treatment for patients and clients, and a safe working environment within the IJB and for others who interact with the services delivered under the direction of the IJB. The IJB purposefully seeks to promote an environment that is risk ‘aware’ and strives to place risk management information at the heart of key decisions. This means that the IJB can take an effective approach to managing risk in a way that both address significant challenges and enable positive outcomes. Risk appetite is the amount of risk which is judged tolerable and justifiable. It is the amount of risk that any organisation is prepared to tolerate or be exposed to at any one point in time. The approved risk strategy requires a formal risk appetite statement to be agreed annually by the IJB. The Risk Appetite Statement has been developed to recognise that the planning and delivery of health and social care services involves having to manage risk. The IJB is responsible for the oversight of services and through the Chief Officer is responsible for the operational management and delivery of these services. Caring for people, managing staff, facilities and finances are all, by their nature, activities that involve risk. These risks cannot be avoided completely but can be managed to an acceptable level. In considering the development of the risk appetite statement the focus was on the key elements of service, quality, people and finance. The IJB’s appetite for risk in each of these elements has been assessed as either none, low, moderate or high. Risk Appetite Statement North Ayrshire Health and Social Care Partnership’s Vision is ‘All people who live in North Ayrshire are able to have a safe, healthy and active life’. This vision is supported by five strategic priorities: • Tackling inequalities • Engaging communities • Improving mental and physical health and wellbeing • Provide early and effective support • Develop and support our workforce Service We acknowledge that health and social care operates within a regulated environment and we have to meet compliance expectations from various regulatory sources. We will endeavour to meet those expectations whilst being creative and operating within regulation. We therefore have a low appetite for taking risk in relation to compliance and regulatory requirements but a high appetite for risk in relation to service innovation and transformation. This high-risk 191
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appetite reflects those innovative developments are needed to present real change to the way services are being delivered, with a realism that continuing to deliver services in the same way is no longer sustainable and changes need to be made in the way services are accessed and provided. Quality We are committed to a culture of quality improvement and learning ensuring that quality of care is above all else. Safe delivery of integrated services is the highest priority for the partnership. There is a low appetite for risk related to the safety of service users or the workforce. At the same time the partnership sees a need to enable calculated risk-taking in relation to achieving positive individual outcomes and improving service quality in terms of person- centred support. The IJB aims to commission services of the highest quality and the partnership needs to reinforce that exercising creativity is to be welcomed. There is a need to enable calculated risk-taking for both supported people and the workforce and to share and learn from positive practice and for this area we have a high-risk appetite. People We want to attract, recruit and retain the right people with the right skills in the right place. We have a high appetite for addressing workforce challenges in relation to delivering on our Workforce Plan. There is a recognition that support is required across the workforce to foster creativity and new ways of working. This is coupled with a full commitment to partnership with trade unions, ethical standards and staff governance standards and minimal appetite for risks to these principles. In doing so challenges are recognised in relation to workforce demography and the cultural change required to have a more flexible innovative workforce and to attract a younger workforce. Finance We have a low appetite for taking risk in respect of adherence to standing financial instructions, financial controls, and financial statutory duties. We have a high-risk appetite in relation to the financial and value for money element. There is a requirement to set a balanced budget and that supports caution in budgetary management terms, particularly where decisions on required spend can constitute a sizeable proportion of the budget (for example secure care for children and young people or complex care packages). The IJB has robust, proactive budget management arrangements in place. There is a need for greater risk appetite with an open attitude to shifting towards earlier stage intervention and towards maturity in a context of the need to think differently in the context of transformation and sustainability. We need to work proactively to address the financial challenges, while at the same time, providing high-quality and sustainable health and social care services for the communities in North Ayrshire. Overall Risk Appetite The partnership is open in terms of risk appetite. The partnership encourages innovation and creativity and creates the permission, trust and support required to meet its vision. At the same time this needs to be balanced against the risk related to the safety of service users or the workforce. 192
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Appendix A Risk Appetite Matrix Low Moderate High Compliance Want to adhere to all regulations with no deviation. Adhering to all regulations but being creative in doing so. Not adhering to regulations. Innovation & Transformation Tendency to stick to the status quo, innovation is generally avoided Innovation supported only with evidence of improvement. Innovation pursued - desire to challenge current practice. Empower staff to be innovative. Safety No risk related to the safety of supported people or the workforce. Limited risk related to the safety of supported people or the workforce. Unlimited risk related to the safety of supported people or the workforce. Positive Practice No sharing of positive practice. Limited local sharing but not partnership wide. Networks/ forum / procedures in place to share and learn from positive practice on partnership wide basis. Respond well and learn from critical incidents. People Workforce Challenges No workforce plan or recognition of future challenges. Future changes known but no plan in place to address them. Aware of future challenges and a robust workforce plan in place. High ambition to be innovative, testing new ways of working and recruiting alongside calculated risk taking supporting people and workforce. Look to be innovative in recruiting and have a robust workforce plan. Compliance Want to adhere to all regulation with no deviation. Adhering to all regulations but being creative in doing so. Not adhering to regulations. VFM and financial Planning Budgets focus is on recovery and renewal. Balanced budget with strong financial management in place despite challenge of annual budget setting processes. Investment in new approaches to improve service and to increase efficiency and effectiveness. Service Finance Quality RISK APPETITE 193
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Integration Joint Board 19 June 2025 Subject: Risk Management Strategy Purpose: To seek approval for the updated partnership risk management strategy. Recommendation: The IJB are asked to approve the risk management strategy detailed in Appendix 1. 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 IJB Integration Joint Board HSCP Health and Social Care Partnership PSMT Partnership Senior Management Team PAC Performance and Audit Committee 1. EXECUTIVE SUMMARY 1.1 The partnership's Risk Management Strategy outlines the process established to identify risk, evaluate the potential consequences and to support plans for the most effective method of controlling or responding to risks. 1.2 To ensure that the management of risk is integrated within the partnership, the process forms part of the partnership’s governance framework. The Risk Management Strategy is due for review, having been last reviewed in June 2022. 2. BACKGROUND 2.1 The previous strategy was approved by the North Ayrshire IJB in June 2022 and the strategy needs to be reviewed every three years as a minimum. 2.2 The updated Strategy reflects the process for North Ayrshire with only minor presentational changes. 2.3 The Strategy includes a requirement for: Agenda Item 11 195
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• The preparation of a risk appetite statement which is covered on a separate agenda item; and • The preparation of a Strategic Risk Register which was approved by the IJB in March 2025. 3. PROPOSALS 3.1 It is proposed to approve the risk management strategy detailed in Appendix 1. 3.2 Anticipated Outcomes The primary objectives of this strategy will be to: • Promote awareness of risk and define responsibility for managing risk within the IJB. • Establish standards and principles for the efficient management of risk, including regular monitoring, reporting and review. This strategy takes a positive and holistic approach to risk management. The scope applies to all risks, whether relating to the clinical and care environment, employee safety and wellbeing, business risk, opportunities or threats. 3.3 Measuring Impact The PSMT is responsible for providing assurance to the IJB that the Risk Management Strategy is being applied effectively across the Partnership. Reviewing the IJB’s risk management arrangements on a regular basis will also constitute a ‘Plan/ Do/ Study/ Act’ review cycle that will shape future risk management priorities and activities of the IJB, inform subsequent revisions of this policy and strategy and drive continuous improvement in risk management across the IJB. 4. IMPLICATIONS 4.1 Financial None 4.2 Human Resources None 4.3 Legal None 4.4 Equality/Socio-Economic None 4.5 Risk Failure to approve the report would result in a disconnect between the Risk Management Strategy and the partnership practice in relation to risk management. 4.6 Community Wealth Building 196
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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 None. 6. CONCLUSION The IJB are asked to approve the risk management strategy detailed in Appendix 1. For more information please contact: Eleanor Currie, Interim Chief Finance Officer at eleanorcurrie@north-ayrshire.gov.uk Appendices Appendix 1 197
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Version No. 4.0 Date Effective: 19 June 2025 Review Date: 18 June 2028 Appendix 1 North Ayrshire Integration Joint Board Risk Management Strategy Version No: 4.0 Prepared By: Eleanor Currie, Principal Manager - Finance Effective From: 19th June 2025 Review Date: 18th June 2028 Lead Reviewer: Caroline Cameron, Chief Officer Dissemination Arrangements: “This Strategy underpins the commitment to robust risk management within the North Ayrshire Health and Social Care Partnership and must be read in conjunction with NHS Ayrshire & Arran and North Ayrshire Council Risk Management Strategies” – Chief Officer 198
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1 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 CONTENTS Policy – the risk management approach .............................................................................................. 2 Strategy - Implementing the policy ....................................................................................................... 3 Introduction .......................................................................................................................................... 3 Risk management process .................................................................................................................... 3 Application of good risk management across the IJB activities ......................................................... 4 Risk leadership and accountability ....................................................................................................... 5 Governance, roles and responsibilities ................................................................................................ 5 Resourcing risk management ............................................................................................................... 6 Resourcing the risk management framework ...................................................................................... 6 Training, learning and development ..................................................................................................... 7 Risk management training and development opportunities ............................................................... 7 Monitoring activity and performance .................................................................................................... 7 Monitoring risk management activity and performance ...................................................................... 7 Communicating risk management ........................................................................................................ 7 Communicating, consulting on and reviewing the risk management framework .............................. 7 Appendix 1 Risk Management – A Quick Guide ................................................................................... 9 All of our publications are available in different languages, larger print, Braille (English only), audio tape or another format of your choice. Email whatmatterstoyou@north-ayrshire.gov.uk for more information. 199
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2 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Policy – the risk management approach The Integration Joint Board (IJB) is committed to a culture where the workforce is encouraged to develop new initiatives, improve performance and achieve goals safely, effectively and efficiently by appropriate application of good risk management practice. Appropriate and effective risk management practice will be embraced throughout the IJB as an enabler of success, whether delivering 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. In doing so the IJB aims to provide safe and effective care and treatment for patients and clients, and a safe working environment within the IJB and for others who interact with the services delivered under the direction of the IJB. The IJB purposefully seek to promote an environment that is risk ‘aware’ and strives to place risk management information at the heart of key decisions. This means that the IJB can take an effective approach to managing risk in a way that both address significant challenges and enable positive outcomes. Risk appetite is the amount of risk which is judged tolerable and justifiable. It is the amount of risk that any organisation is prepared to tolerate or be exposed to at any one point in time. A formal risk appetite statement requires to be agreed annually by the IJB. The IJB promotes the pursuit of opportunities that will support the delivery of the Strategic Plan. Opportunity related risk must be carefully evaluated in the context of the anticipated benefits for patients, clients and the organisation. The IJB and PAC will receive regular updates on the strategic and operational risks to provide assurance on the adequacy but also the effectiveness of its risk management arrangements. The IJB through the following risk management strategy, has established a Risk Management Framework, which covers risk policy, procedure, process, systems, risk management roles and responsibilities. The IJB recognise that the planning and delivery of health and social care services involves having to manage risk. The IJB is responsible for the operational oversight of services and through the Chief Officer is responsible for the operational management and delivery of these services. Caring for people, managing staff, facilities and finances are all, by their nature, activities that involve risk. These risks cannot be avoided completely but can be managed to an acceptable level. This Risk Management Strategy describes the risk management arrangements for North Ayrshire IJB and forms part of the wider framework for corporate governance and internal control. Key benefits of effective risk management: risk ‘aware’ not risk ‘averse’ decisions are based on a balanced assessment of risk and enable acceptance of certain risks in order to achieve a particular goal or reward; high achievement of objectives and targets; high levels of morale and productivity; better use and prioritisation of resources; high levels of user experience/ satisfaction with a consequent reduction in adverse incidents, claims and/ or litigation; and a positive reputation established for the IJB. 200
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3 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Strategy - Implementing the policy Introduction The primary objectives of this strategy will be to: promote awareness of risk and define responsibilities for managing risk within the IJB; maximise opportunities to improve service delivery; establish communication and sharing of risk information through all areas of the IJB; outline measures to reduce the IJB exposure to risk and potential loss; and, establish standards and principles for the efficient management of risk, including regular monitoring, reporting and review. This strategy takes a positive and holistic approach to risk management. The scope applies to all risks, whether relating to the clinical and care environment, employee safety and wellbeing, business risk, opportunities or threats. Strategic risks represent the potential for the IJB to achieve (opportunity) or fail to meet (threat) its desired outcomes and objectives as set out within the Strategic Plan. Typically these risks requirestrategic leadership to identify and implement appropriate mitigations to manage the risk. Operational risks represent the potential for impact (opportunity or threat) within or arising from the activites of an individual service area or team operating within the scope of the IJB’s activities. Parent bodies will retain responsibility for managing operational risks as operational risks will be more ‘front-line’ in nature and the development of activities and controls to respond to these risks can be led by local managers and team leaders. Where an operational risk impact across multiple service areas or, because of interdependencies, require more strategic leadership, then these can be proposed for escalation to ‘strategic risk’ status for the IJB and where required the parent organisation. All risks will be evaluated consistently with risks categorised as being very high/high/moderate/low and red/amber/yellow/green. Further information can be found at Appendix 1. Risk management process Risk Management is about the culture, processes and structures that are directed towards realising potential opportunities whilst managing adverse effects1 It is pro-active in understanding risk and uncertainty, it learns and builds upon existing good practice and is a continually evolving process. The risk management framework ensures that information about risks is adequately reported and used as a basis for decision making and accountability at all levels. The IJB embeds risk management practice by consistent application of the risk management process shown in the diagram on the right, across all areas of service delivery and business activities. Further information in relation to the Risk Managment Process can be found at Appendix 1. Figure 1 Risk Management Process 1 Australia/ New Zealand Risk Management Standard, AS/NZS 4360: 2004 201
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4 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Application of good risk management across IJB activities The following standard procedures will be implemented across all areas of activity that are under the direction of the IJB in order to achieve consistent and effective implementation of the Risk Managment Strategy. 1. Implementation of the risk management process, means that risk management information should (wherever possible) be used to guide decision making in the same way that cost and benefit analysis is used. 2. Identification of risk using standard methodologies, and involving subject experts who have knowledge and experience of the activity or process under consideration. 3. Categorisation of risk under the headings below: • Strategic Risks: such as risks that may arise from Political, Economical, Social, Technological, Legislative and Environmental factors that impact on the overall delivery of the Strategic Plan outcomes. • Operational Risks: such as risks that may arise from or impact on Clinical Care and Treatment, Social Care and Treatment, Customer Service, Employee Health, Safety & Well-being, Business Continuity/ Supply Chain, Information Security and Asset Management. 4. Appropriate ownership of risk. Specific risks will be owned by/ assigned to whoever is best placed to manage the risk and oversee the development and implementation of mitigation/control measures. 5. Consistent application of the agreed risk matrix. Necessary to analyse and prioritise risk in terms of consequences and likelihood of occurrence, taking into account the effectiveness of risk control measures in place. Consistent application of the risk matrix is also key to compare risks against tolerance thresholds. The risk matrix to be used is attached in Appendix 1. 6. Consistent response to risk that is proportionate to the level of risk. This means that risk may be terminated; transferred elsewhere (ie to another partner or third party); tolerated as it is; or, treated with measures to bring it to a level where it is tolerable for the IJB in keeping with its appetite/ tolerance for risk. In the case of opportunities, the IJB may ‘take’ an informed risk in terms of tolerating it if the opportunity is judged to be (1) worthwhile pursuing and (2) the IJB is confident in its ability to achieve the benefits and to manage/ contain the associated risk. Further information can be found at Appendix 1. 7. Implementation and maintenance of live risk registers. Used as a means of collating and recording risk information in a consistent format allowing comparison of risk evaluations, informed decision-making in relation to prioritising resources and ease of access to information for risk reporting. 8. Reporting of strategic risks to the IJB annually or more frequently if required. 9. Reporting of operational risks to the Partnership Senior Management Team based on the frequency outlined in table 5. These risks are then remitted to the Clincial and Care Governance Group. The CCG 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. 10. Routine reporting of risk information as part of business as usual. Reporting and review within and across teams and a commitment to a ‘lessons learned’ culture that seeks to learn from both good and poor experience in order to replicate good practice and reduce adverse events and associated complaints and claims. 202
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5 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Risk leadership and accountability Governance, roles and responsibilities Integration Joint board Members of the Integration Joint Board are responsible for: Oversight of risk management arrangements through the Performance and Audit Committee; Seeking assurances from the Partnership Senior Managment Team that effective risk management arrangements are in place; Receipt and review of reports on strategic risks and any key operational risks that require to be brought to the IJB’s attention; and, Ensuring they are aware of any risks linked to recommendations from the Chief Officer concerning new priorities/ policies/ emerging risks and opportunities. The IJB delegated certain aspects of risk governance to the Clinical Care and Goverance Group and the Performance and Audit Committee. Each Committee has a responsibility to provide assusrance to the IJB in respect of the areas detailed below: • PAC – the PAC through Internal Audit, external audit and other sources will provide independent objective assurance to the IJB on the extent to which the risk management arrangements in place are effective: • Clinical Care and Governance Group will monitor and review risks falling within it’s remit, this including regular consideration of all high or very high operational risks. Chief Officer The Chief Officer has overall accountability for the IJB’s risk management framework, ensuring that suitable and effective arrangements are in place to manage the risks relating to the functions within the scope of the IJB. The Chief Officer will keep the Chief Executives of the IJB’s partner bodies and members of the IJB informed of any significant existing or emerging risks that could seriously impact the IJB’s ability to deliver the outcomes of the Strategic Plan or the reputation of the IJB Section 95 Officer The IJB’s Section 95 Officer will be responsible for promoting arrangements to identify and manage key business risks, risk mitigation and insurance. Partnership Senior Management Team (PSMT) Members of the Partnership Senior Management Team are responsible (either collectively, or by nominating a specific member of the team) for: supporting the Chief Officer and Chief Finance and Transformation Officer in fulfilling their risk management responsibilities; arranging professional risk management support, guidance and training from partner bodies; receipt and review of regular risk reports on strategic, shared and key operational risks and escalating any matters of concern to the IJB; 203
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6 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 ensure the impact of decisions made in terms of risk and opportunities do not have a negative impact on insurance and self insurance arrangments. Key specialist advisors should be involved in decision making processes at the earliest opportunity where practicable; and ensuring that the standard procedures set out in this doucment and supporting documentation are actively promoted across their teams and within their areas of responsibility. Individual Risk Owners It is the responsibility of each risk owner to ensure that they understand their responsibility in relation to the managment of risk and specifically; risks assigned to them are analysed in keeping with the agreed risk matrix; measure effectiveness of existing controls and the mitigations in place to manage the risk are proportionate to the context and level of risk;. monitor the timely implementation of additional mitigation/controls where required; risk is reviewed not only in terms of likelihood and impact of occurrence, but takes account of any changes in context that may affect the risk; and risks are defined clearly to make explicit the scope of the challenge, opportunity or hazard and the consequences that may arise. All persons working under the direction of the IJB Risk management should be integrated into daily activities with everyone involved in identifying current and potential risks where they work. Individuals have a responsibility to make every effort to be aware of situations which place them or others at risk, report identified hazards and implement safe working practices developed within their service areas. This approach requires everyone to understand: the risks that relate to their roles and activities; how their actions relate to their own, their patients, their services users / clients and public safety; their accountability for particular risks and how they can manage them; the importance of flagging up incidents and/ or near misses to allow lessons to be learned and contribute to ongoing improvement of risk management arrangements; and, that good risk management is a key part of the IJB’s culture. Partner Bodies It is the responsibility of relevant specialists from the partner bodies, (such as internal audit, external audit, clinical and non clinical risk managers and health and safety advisers) to consider the implications of risks and provide relevant advice. It is the responsibility of the partner bodies to ensure they routinely seek to identify any residual risks and liabilities they retain in relation to the activities under the direction of the IJB. Resourcing risk management Resourcing the risk management framework The work on developing and leading the ongoing implementation of the risk management framework and accociated training for the IJB and employees will be resourced through the Partnership Senior Management Team’s arrangements. Final decisions in respect of the risk management arrangements will sit with the Chief Officer and Chief Financial Officer. 204
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7 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Training, learning and development Risk management training and development opportunities To implement effectively this strategy, it is essential for staff to have the competence and capacity for managing risk and handling risk judgements with confidence, to focus on learning from events and past experience in relation to what has worked well or could have been managed better, and to focus on identifying malfunctioning ‘systems’ rather than people. Training is important and is essential in embedding a positive risk management culture across all activities under the direction of the IJB and in developing risk management maturity. Training can be accessed via North Ayrshire Council or NHS Ayrhire and Arran. Specific training sessions can also be delivered. Monitoring activity and performance Monitoring risk management activity and performance A suitable system is required to ensure risk management activity and performance is monitored. Monitoring will include review of the IJB’s risk profile at Partnership Senior Management Team level. The PSMT is responsible for providing assurance to the IJB that the Risk Management Strategy is being applied effectively across the Partnership. Key Performance Indicators (KPIs) will be linked where appropriate to specific risks to provide assurance on the performance of certain control measures. For example, specific clinical incident data can provide assurance that risks associated with the delivery of clinical care are controlled. The performance data linked to the Strategic Plan will also inform the identification of new risks or highlight where existing risks require more attention. Reviewing the IJB’s risk management arrangements on a regular basis will also constitute a ‘Plan/ Do/ Study/ Act’ review cycle that will shape future risk management priorities and activities of the IJB, inform subsequent revisions of this strategy and drive continuous improvement in risk management across the IJB. It is expected that partner bodies will use IJB risk reports to keep their own organisations updated on the management of the risks, highlighting any IJB risks that might impact on the partner organisation. Communicating risk management Communicating, consulting on and reviewing the risk management framework Effective communication of key risk management information across the IJB is essential to developing a consistent and effective approach to risk management. Copies of this policy and strategy will be widely circulated via the Partnership Senior Management Team and will form the basis of any risk management training arranged by the IJB. This strategy will be reviewed every three years or earlier if required to ensure that it reflects current standards and best practice in risk management and fully reflects the Integration Joint Board’s business environment. 205
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8 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 206
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9 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 Appendix 1 Risk Management – A Quick Guide What is Risk Management and why do we have to do it? Risk is something that may have an impact on the achievement of our objectives. This could be an opportunity as well as a threat. Good risk management means that we have a better understanding of what risks and opportunities the organisation may face and how it can best manage them. This quick guide provides basic details on the risk management process more detailed information in relation to using risk register software, service risk registers, peer review process etc can be found in the supporting Management of Risk Guidance document. Understanding and managing threats or risks comes down to four very simple questions: 1. What are the things that could happen to us? 2. What is the likelihood of them happening? 3. What would be the impact? 4. What can we do about it? (How can we prevent it from happening, or what can we put in place to manage it if it should?) There are several tools which can be used to answer these questions. For simplicity and ease of understanding our approach is to use a simple 4 stage process of identification, assessment, management and review to ensure our risks are recorded and effectively managed. This approach is shown in Figure 2 and described in the four sections below. Figure 2 – Four Steps to Managing Risk 1. Identifying risks 2. Assessing risks 3. Managing and controlling risks 4. Monitor and review risks Risk Management – A Quick Guide 207
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10 Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 To identify risks, think through the things that could prevent or hinder your team from achieving its business objectives. There are three parts to a risk – an event that has a consequence that leads to an impact on our objectives. Typical risk phrasing could be: Loss of… Failure of….. Failure to... leads to …... results in…… Lack of… Development of… Opportunity for You will also need to identify whether the risk is: • Strategic: risks that are significant scale and will impact on the reputation and performance of the IJB and parent organisations as a whole and in particular the IJB’s ability to deliver on strategic objectives. • Operational: risks specific to the delivery of individual services/service performance/project. Residual/Net risk = the level of risk remaining after managing it through treatment and/or control measures. To identify the Residual/Net Risk we simply identify the consequence score from the appropriate domain listed in Table 2 after we have identified the control measure. We then multiple the consequence score by the likelihood of the event occurring. The likelihood score is taken from the matrix at Table 3. Multiplying the consequence x likelihood then provides us with the Residual Risk. The Residual risk score helps to make decisions about the significance of risks to the IJB and how they will be managed, the controls required and the treatment of the risk. This can be found in Table 4. 1. Identifying risks 2. Assessing risks 208
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Version No. 4.0 Date Effective: 19 June 2025 Review Date: 18 June 2028 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. 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 claim. 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 Short term disruption to service with minor impact on patient care. Some disruption in service with unacceptable impact on patient care. Sustained loss of service which has serious impact on delivery of patient care resulting in major Permanent loss of core service or facility. 209
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Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 continue to provide service Temporary loss of ability to provide service. contingency plans being invoked. 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. 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). Table 2 – Consequence/Impact Matrix Likelihood 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. Table 3 – Likelihood Matrix Risk Rating 210
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Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 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 Table 4 – Risk Rating Table 5 – How Risks should be managed Level of Risk Risk How the risk should be managed Very High (20-25) Immediate Action Required Intolerable Requires active management to manage down and maintain the exposure at an acceptable level. Escalate upwards. The activity or process should not be started or allowed to continue until the risk level has been reduced. While the control measures selected should be cost-effective, legally there is an absolute duty to reduce the risk. Review every 3 months. High (10-16) Immediate Action Required Unacceptable Contingency plans may suffice together with early warning mechanisms to detect any deviation from the profile. Escalate upwards. If a new activity or process, it should not be started until the risk has been reduced. Considerable resources may have to be allocated to reduce the risk. Where the risk involves an existing activity or process, the problem should normally be remedied within one to three months. Review every 6 months. Moderate (4-9) Action Required Efforts should be made to reduce the risk, but the cost of reduction should be carefully measured and limited. Risk reduction measures should normally be implemented within three to six months. Re-assess annually Low (1-3) Acceptable No further preventative action is necessary, but consideration should be given to more cost-effective solutions or improvements that impose no additional cost burden. Monitoring is required to ensure that the controls are maintained. Review annually to ensure conditions have not changed. 211
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Version No. 4.0 Date Effective: 19 June 2025 Review Date: 18 June 2028 THE FOUR T’s The level of the inherent risk will help determine the best treatment for a risk, whether strategic or operational. Once the type of risk has been determined, consideration must be given to the most appropriate course of action to treat the risk, an action plan will be required to be drawn up and implemented. The rating and prioritisation of the risk will determine the pace with which the risk action plan should be implemented and at which level of the organisation the risk needs to be reported. Tolerating A risk may be tolerated where: • the risk is effectively mitigated by internal controls, even if it is a high risk • the risk cannot be mitigated cost effectively • the risk opens up greater benefits These risks must be monitored, and contingency plans should be put in place in case the risk occurs. Treating This is the most widely used approach. The purpose of treating a risk is to continue with the activity which gives rise to the risk, but to bring the risk to an acceptable level by taking action to control it in some way through either: • containment actions (these lessen the likelihood or consequences of a risk and are applied before the risk materialises) or • contingency actions (these are put into action after the risk has happened, thus reducing the impact. These must be pre-planned) Terminating Doing things differently and therefore removing the risk. This is particularly important in terms of project risk but is often severely limited in terms of the strategic risks of an organisation. Transfer Transferring some aspects of the risk to a third party, e.g., via insurance, or by paying a third party to take the risk in another way. This option is particularly good for mitigating financial risks, or risks to assets. However, it is a limited option. Table 6 – The Four T’s CONTROLS Any action, procedure or operation undertaken to either contain a risk to an acceptable level (the impact), or to reduce the likelihood. Where future actions are planned these should have a date by which they will be implemented. REPORTING RISK Nothing stays the same forever. By talking to your staff and monitoring incident rates and control measures, you will be able to judge whether your risk control measures are effective. Managers and staff must be given responsibility to oversee the process and develop reporting procedures, discussing and helping to implement solutions, as well as monitoring the solutions for effectiveness. Risks should be reviewed regularly to ensure that the risk has not changed and that no further control measures are needed. A risk should also be reviewed if any changes occur that may increase the risk of an adverse event occurring. 3. Managing and controlling risks 4. Monitor and Review Risks 212
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Document Title: Risk Management Policy and Strategy Owner: Chief Officer Version No. V4 Superseded Version: V3 Date Effective: 19 June 2025 Review Date: 18 June 2028 There is no legal time frame for when you should review your risk assessment. The IJB has adopted an interactive process with discretion when a review is deemed necessary. The risk assessment and register are a live working document and, as your business experiences change, this information should be recorded and updated. As a guide, it is recommended that risk assessments be reviewed as a minimum on an annual basis. 213
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