7. Transformation Plan Update Aug 2025 IJBFINAL
North Ayrshire Council · 21 August 2025
Back to Integration Joint Board — 21 August 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Integrated Joint Board 21st August, 2025 Subject : Transformation Plan – Progress Update Purpose : This paper updates the IJB on the progress of the HSCP transformation plan. Recommendation : The Integration Joint Board are asked to note the progress to date. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required x 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership IJB Integrated Joint Board PID Project Initiation Document SDS Self Directed Support 1. EXECUTIVE SUMMARY 1.1 The North Ayrshire HSCP Transformation Plan 2024-27 is an ambitious programme of change consisting of a range of improvement and reform projects across all service areas, each aiming to improve the quality of our services and contribute to the long- term sustainability of health and care in North Ayrshire. This report highlights key activity and general updates on progress made in the last six months. 2. BACKGROUND 2.1 The 3 year Transformation Plan was approved by IJB in March 2024. There are 77 change projects and programmes on the plan, from across every area of the partnership. The Plan is kept under review and updated through the Transformation Board. 2.2 Six-month progress updates were provided to IJB in September 2024, December 2024 and a further update on Q3 at the meeting on 6th February 2025. It has been agreed that updates will be every six months. 2.3 Through 24-25 the financial outlook deteriorated, and the need for transformation and the redesign of services became more urgent and more important to the long-term sustainability of the functions for which we are responsible. At the same time our
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capacity for change diminished due to increasing demands on people’s capacity including the short-term actions required to deliver the financial recovery plan. There remains a focus and commitment across services to progress the high priority areas agreed as part of the Plan. Key Activity 2.4 January to March 2025 January • ‘Focus on Adult Health and Community Care’ with a review of 24/25 and five new projects initiated, as well as the successful closure on the plan of the Blue Badges project. February • ‘Focus on Children, Families, and Justice’, with a review of 24/25 and a deep dive into the progress of the Brighter Pathways programme. March • The fourth Ayrshire-wide Innovation Event with colleagues from Public Health Scotland presenting their Innovation Strategy; the Service Design Academy provided an overview of their approach (which is the Scottish Government approach) to service design. We also had colleagues from South Ayrshire sharing their new Integrated Impact Assessment, as well as a useful recap from the Digital Health and Care Scotland 2025 conference in Edinburgh. • The Health and Social Care Transformation conference 2025 was also in March, and North Ayrshire was well represented, learning about the progress of the national Digital Front Door programme as well as other policy and strategy updates, alongside a range world-class industry and health and social care speakers. AI was a key theme with a number of impactful examples from the health sector. • ‘Focus on Mental Health and Learning Disabilities’ with a review of 24/25, one new project was initiated, and one new project added to the Plan. April to June 2025 April • A new Pan-Ayrshire Digital and Data Integration Group met for the first time. This was an action from the Digital and Data Plan and the first priority for the group is to address network access issues across our shared estate. The group also discussed opportunities for collaborating around skills development and improving data sharing. June • Successful implementation of phase 1 our new Care Management System, Eclipse. • Fifth Innovation Event with colleagues from the SSSC talking about their new resource 23 Things to support your practice and learning in Technology Enabled Care; SAMH on their Digital Strategy; NHS Ayrshire & Arran on their
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evaluation of AI clinical documentation tools (Heidi and Corti); Edinburgh Council on their pilot of Magic Notes, the AI note-taking tool designed for social work that's being rolled out in areas of Ayrshire later this year; and also South Ayrshire HSCP talking about their use of data and dashboards in evaluating the quality of external providers. The past six months have also seen teams work closely with internal audit to review the governance and monitoring arrangements for the transformation programme. There was a deep dive into Brighter Pathways, as an example of a large programme, TrakCare, as an example of a pan-Ayrshire project with a strong NHS focus, and Blue Badges, as an example of a smaller project. The findings are reported separately. Service Updates 2.10 Health and Community Care • ACH & Ailsa Hospital Inpatient Services Review: A site-wide review is underway to improve efficiency and align spend with budget. Several quick wins have been delivered in HCC Community Wards, with most medium-term actions due to commence between late summer 2025 to March 2026. • Aids & Adaptations Policy Review: Progress is delayed pending SLA agreement with Housing Services (draft paper with Housing for review). An extension to March 2026 is being sought due to this dependency. • Analogue to Digital Telecare Switchover: 4,807 installations have been completed in service users’ homes, including 3,422 in-situ digital units. The call centre has transitioned to a digital platform, and user migration is now underway. • Arran SPOC: Netcall telephony implementation is progressing, with a test system in place. Completion is now expected by August 2025 following delays due to infrastructure challenges on the island. • Care Packages (Lower Level): Project is nearing completion, with approval of final recommendations due by end June and implementation planned during July. Delays were due to staffing and winter pressures. • Community Rehab: Three distinct subgroups have identified the work required to complete this project in a deliberate and considered manner. Given the amount of work identified, a project extension to May 2026 will be sought. • Complex Care Model (Change Fund): This options appraisal project has concluded successfully, and a closure report will be submitted to the
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Transformation Board. A new project is being scoped based on the preferred outcome. • Day Service Review: The team are now working to implement the preferred option, as per IJB report in June 2025 (ie. All day services provided by HSCP with an alternative role around carer support and outreach delivered by a third party). • Delayed Discharge & Winter Preparedness: Project has concluded. A performance framework has been introduced to monitor trends and is analysed monthly. An annual action plan will support future winter preparedness and has been embedded in our ‘business as usual’ processes. • Enhanced Intermediate Care Team (eICT): The project has now concluded, pending submission of a closure report to the Transformation Board. Improvements include simplified escalation, refined triage roles, and enhanced documentation and training. A full review of policy and process has also been undertaken, where it has been concluded that current working practices are fit for purpose. • HomeFirst Strategy: Work has commenced, aligned with the Strategic Commissioning Plan. This strategy will utilise the needs assessment data used in that plan, to ensure consistent and joined-up strategic planning across the partnership. • MDTs in Localities: The project has successfully concluded, delivering key outcomes including improved person-centred care through integrated working, enhanced efficiency via shared caseloads, better access to specialist input, and strengthened communication across disciplines—leading to more effective decision-making and streamlined care pathways. • Moving & Handling: The project concluded ahead of schedule, delivering a number of key achievements including enhanced training for staff, improved risk assessment processes, and the introduction of QR-coded instructional videos and RAG-rated user guidance. These initiatives have strengthened staff support, optimised equipment use and extended good practice to wider services including providers and carers. • OT Service Provision: Project concluded with a reduction in Service Access OT waiting lists from 812 (May 2024) to 86 (Feb 2025). • Podiatry: Project concluded with a 40% reduction in waiting lists (433 in Oct 2024 to 263 in May 2025) and improved triage and referral processes. Waiting times for new patients reduced from 58 weeks to 4 weeks.
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• Speech & Language Therapy: The project has now commenced, and a staff workshop has established a draft project delivery plan, which is currently in the process of being finalised. • Technology First: Progress continues with plans for a central hub at Castleview, Ardrossan being finalised. Staff training and public engagement are key components of this project. 2.11 Children, Families, and Justice • Brighter Pathways: Strategic Report detailing the outputs from each of the workstreams is in development, weekly meetings with the Director are scheduled to assist with the development of the report. Scheduled to report to IJB and Cabinet in September 2025. • Supported Accommodation Service: Business Case was presented to the PSMT on the 3rd of July to develop step down model of care for young people moving on from care. • Service Access; The 2023 Desktop Review has been updated to reflect the present situation with regards to service delivery. • North Ayrshire Children and Young People’s Neurodevelopmental Specification Implementation Group: The remit of the Group has not been without challenge; however, through dedicate multi-agency and multi-disciplinary working, significant progress has been made in relation to non-clinical aspects of the neurodevelopmental service specification. North Ayrshire benefits from positive working relationships between services and this has facilitated constructive discussions and progress in key areas: • We understand what supports are available to children and families in North Ayrshire in relation to NDD. • Information on supports, including training and advice, has become more accessible to parents and carers via platforms such as NEST. • We have a baseline value for confidence and competence in the children’s services’ workforce in relation to supporting children with known or suspected NDD and their families and have a plan in place to improve this over the next year. • We have proactively sought the views and experiences of parents and carers in relation to aspects of the service specification and will continue to do so. In addition, we have consistently feedback to parents and carers in line with good practice standards for engagement. • We understand the journey of the children “meaningfully redirected” from CAMHS since August 2023 and what supports, if any, these children continue to access.
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• NDD Connect Event: Planning meetings have been scheduled into the diary, set dates for the event have not been agreed at the time of writing, further updates will be provided accordingly. 2.12 Mental Health and Learning Disabilities • ACH & Ailsa Hospital Inpatient Services Review: A site-wide review is underway to improve efficiency and align spend with budget. The PID has been agreed and a programme board is meeting regularly to monitor progress and share ideas across Ward groups • MAT Standards: all 10 MAT Standards have been rated green by the national support team. This is the highest level before a final RAG rating of blue achieved only by evidence of two years of sustained delivery. Evaluation and search for permanent funding for MAT Standard 7 (MAT in Primary Care) continues. • Early Intervention in Psychosis Service: development of care pathways, system set ups and data benchmarks continues in anticipation of service launching. Some delays to recruitment have meant a delay to service launch and now working towards a date of September 2025. • Community Wellbeing Services: a third workshop was held to develop recommendations for an additional £100,000 of savings from this area. The recommendations have been drafted and further consultations are ongoing. • Learning Disabilities Intensive Support Team: work continues to identify an alternative solution for the day assessment hub. A Project Initiation Document has been agreed with the Scottish Government and Health Improvement Scotland for the funded test of change. • Complex Care Accommodation Requirements: Work is underway with Housing, Mental Health, CDIS and Learning Disabilities colleagues to accurately reflect the demand for future housing needs including for supported type models. The service are also exploring options within the Ayrshire Central Housing Development. • Review Acute Assessment model (Ward 7A) based at Woodland View: All reports complete including benchmarking and previous admission analysis. Ward has been closed/paused pending review. Consultation, engagement and research underway to develop options appraisal allowing the creation of recommendations for the way forward.
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• Implementation of Recommendations to Support people with Learning Disabilities through the entire life course: workplan was approved by the Transformation Board and Social Work Governance Board. Short life Working Groups are being set up to take six pieces of work forward. • West Road: the reconfiguration of West Road was completed and officially opened on 22 May 2025. The re-opened and refurbished facility will serve the Community Eating Disorders and Neuro-CAMHS services. • Community Eating Disorders Service (CEDS): The previous PID has been updated to reflect the current circumstances. Operational solutions have been identified and a business case for permanent funding is being developed. • Digital Transformation: TrakCare Implementation continues with two more teams live on the system. A delivery plan to support the Digital Transformation work in Mental Health is being looked at, this was part of the digital strategy work in 2024 and part of the original scope still to be delivered. The Strata system has is being piloted in a number of areas. • Psychological Therapies Specification: a self-assessment tool has been developed to allow mass collection of information from all teams and a test of the tool is underway with two teams. 2.13 Partnership-wide Eclipse The Eclipse social work case management system went live on the 11th June. This was culmination of a significant effort over many years by the Performance and Information System Team in collaboration with operational colleagues. The team, with service support, undertook a substantial final manual migration process to move all data to the new system and provide the best starting position for all workers. The new system provides the functionality that has been at the core of many reviews, namely reducing system downtime, reducing the bureaucracy of form-filling, providing outputs that are person and service specific, and, having a modern system that can integrate with other systems to meet the future requirements of Partnership services. The team will continue to support all users over the coming few months to bed-in the system processes then ease back into a business-as-usual function moving into a process review, development, reporting, and training cycle. A formal evaluation of the implementation is planned. Workforce Plan The Scottish Government Director of Health Workforce issued a letter on 17 December 2024 which advised that it recognised the workload pressure facing NHS
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Boards and HSCPs and difficulty in planning for the workforce in the current environment, and contained a requirement to complete a reporting template regarding information about the current workforce. The Interim return was developed by senior managers and approved by PSMT, and submitted to the Scottish Government on the 17th March. This may mean the Scottish Government is looking at further guidance nationally. We are now in year 3 of the workforce plan, and work to carry out an evaluation of the plan and final year three report will commence over the summer to be completed in October 2024. Work to carry out a revised workforce plan will commence following the development of a new Strategic Plan and will therefore take place in 2026. The Carer Partnership has achieved the following highlights: • North Ayrshire Short Breaks Services Statement published in February 2025 • Carers Champions Board established in January 2025 (monthly meetings in Feb/ March) • Continued work on Bridgit (digital self-help portal for carers) with Young Carer section live in March 2025 • Improved process and pathways for offering/ completion of ACSP and YCS - CGNA completing from March 2025 • Revised YCS engagement and update of assessment paperwork complete (SWGB April 25). • Development of Section 28 – Identifying & Involving Carers in Hospital Discharge. Post recruited in February 2025. • CGNA aim, role and offer embedded across schools in January 2025. • Joint Carer Partnership Action Plan compiled. The following work is ongoing and of priority for future reporting: • Communication and marketing materials - Carer Pack aligned with the self-help resource/ work is ongoing • Revised longer term HSCP Carer Strategy with a draft due in the autumn before submission to the IJB. • Introduction of an Engagement role with Carers Gateway North Ayrshire (CGNA). • Increased variety in breaks from caring and improved process in the distribution of short break funds to carers. Shared Care Short Breaks Funding received has been almost doubled for 25/ 26 to CGNA to distribute. • The second annual carers conference driven by what carers need was held during Carers Week in June at Oscars in Saltcoats. Self-Directed Support In the past twelve months the following has been achieved: • An initial desktop review of all policy relating to SDS. • Several design sessions with a core HSCP project team to identify areas to progress.
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• A series of individual interviews with a range of senior staff and practitioners across the Partnership to better understand the future direction of SDS, barriers and current organisational cultures. • Service user interviews to capture the difference choice and control makes to people’s lives as part of the change story for North Ayrshire to be used as case studies for staff training purposes. • Three SDS sessions with Team Managers to share progress to date, refresh on SDS duties and options and ask what improved choice and control could look like in their service. • Creation of an overall design brand kit to help make SDS and the options for choice and control clearer. • Graphic design work to support related work in other areas such as unpaid carers and learning disability. • The design of a new SDS microsite to help people seeking information and support navigate SDS and provide staff with a space to host resources to support their practice in relation to options, choice and control. • Two cohorts of a value-based leadership programme for North Ayrshire staff creating the space to consider culture and behaviours required to bring about system level changes. • Developed the beginnings of a new overarching ethical framework correlating with the digital resource, and comprising a public value proposition, 7 anchors of great practice and visible, local stories to bring choice and control to life. • Drafting of an SDS Policy to advice of duties, local decision making and promote consistency and best practice across all HSCP services. 3. PROPOSALS 3.1 It is proposed that IJB note the progress to date. 3.2 Anticipated Outcomes Informing IJB and the people of North Ayrshire on the progress of the Transformation Plan, and also providing assurance of the governance arrangements and that the Transformation Board has appropriate oversight. 3.3 Measuring Impact Stakeholders are assured of progress. 4. IMPLICATIONS 4.1 Financial A number of the transformation projects will deliver financial savings once they are fully operational; some financial targets have been identified as part of the budget development for 2025/26 (reflected in the Medium-Term Financial Outlook). Identified
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savings and overspend reductions are tracked in the online Tracker (screenshot in Appendix I and exported version in Appendix III) and our online dashboard (screenshot in Appendix II). 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk None. 4.6 Community Wealth Building None. 4.7 Key Priorities None. 5. CONSULTATION 5.1 Consultation has taken place with Planning Managers in the Transformation Team, and with the Transformation Board. Scott Hunter, Chief Social Work Officer scotthunter@north-ayrshire.gov.uk 8th August 2025 Appendix 1 – Online tracker Appendix 2 – Online dashboard
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Appendix 1 – Online Tracker (Screenshot)
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Appendix 2 - Online Dashboard (Screenshot)