Agenda Document Pack - Integration Joint Board - 11/12/2025
North Ayrshire Council · 11 December 2025
Back to Integration Joint Board — 11 December 2025 and its agenda
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Integration Joint Board Meeting Thursday, 11 December 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 13 November 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 Unpaid Carers Strategy & Delivery Plan Submit report by Scott Hunter, Chief Social Work Officer (NAHSCP) on the Unpaid Carers Strategy & Delivery Plan (copy enclosed). 6 Refreshed Strategic Plan 2026-2030 Submit report by Caroline Cameron, Director (NAHSCP), on the refreshed Strategic Plan for 2026-2030 (copy enclosed). 1
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7 2025-26 – Month 7 Financial Performance Submit report by Eleanor Currie, Chief Finance Officer and Section 95 Officer, providing an overview of the Integration Joint Board’s financial performance as at month 7 (October) (copy enclosed). 8 Medium-Term Financial Outlook 2026-2029 Submit report by Eleanor Currie, Chief Finance Officer and Section 95 Officer, on the Medium-term financial outlook 2026-2029 (copy enclosed). 9 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. 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 2
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IJB Sederunt Voting Members Joyce White (Chair) NHS Ayrshire & Arran Cllr Chloe Robertson (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 Lisa Davidson 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 3
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North Ayrshire Health and Social Care Partnership Minute of Integration Joint Board meeting held on Thursday 13 November 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 Chloe Robertson, North Ayrshire Council (Vice-Chair) Councillor Anthea Dickson, North Ayrshire Council Linda Semple, NHS Ayrshire and Arran Professional Advisers Caroline Cameron, Director of Health and Social Care Partnership Thelma Bowers, Head of Service (Mental Health) (NAHSCP) Eleanor Currie, Interim Section 95 Officer Darren Fullarton, Associate Nurse Director/ Lead Nurse Lisa Davidson, Public Health Representative Scott Hunter, Chief Social Work Officer Stakeholder Representative Lynda MacFarlane, Staff Representative Present (Remote Participation) Voting Members Councillor Tom Marshall, North Ayrshire Council Councillor Robert Foster, North Ayrshire Council (Substitute) Professional Advisers Wendy Van Riet, Director of Psychological Services Stakeholder Representative Paul Smith, Carer Representative Vicky Yuill, Third Sector Representative In Attendance (Physical Participation) Elizabeth Stewart, Head of Service (Children, Families & Criminal Justice) Kerry Logan, Head of Service (Health and Community Care) Michelle Sutherland, Partnership Facilitator (Health & Community Care) Karen Andrews, Team Manager (Governance) Stuart MacMillan, Principal Manager (Planning, Performance and Transformation) Agenda Item 3 5
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Kevin McGinn, Planning Manager (Planning, Performance and Transformation) Arthur Coutts, Team Manager (Children, Families & Criminal Justice) Eileen Bray, Acting Senior Manager (CAMHS) Ruth Wilson, Team Leader (Litigation) Hayley Young, Senior Committee Services Officer Mark Sugden, Communications Officer Apologies Councillor Nairn Angus-McDonald, North Ayrshire Council Tom Hopkins, NHS Ayrshire and Arran Lorna Sim, Staff Representative NHS Ayrshire and Arran Sharon Hackney, Lead Allied Health Professional Aileen Craig, IJB Monitoring Officer 1. Apologies for Absence Apologies for Absence were noted. 2. 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. Linda Semple declared her civil partner was the Chair of North Ayrshire Women’s Aid. 3. Minutes The accuracy of the Minutes of the meeting held on 25 September 2025 were confirmed and the Minutes signed in accordance with Paragraph 7(10 of Schedule 7 of the Local Government (Scotland) Act 1973. 4. Unscheduled Care Improvement Plan Update Submitted report by Kerry Logan, Head of Service (Health and Community Care) on the Urgent and Unscheduled Care Funding, Performance and Improvement Plans. The renewal monies proposal was set out at appendix A to the report. Officers responded to members’ questions on various aspects of the report. The Board agreed to (a) note the performance for Delayed Discharges in North Ayrshire and associated improvement plans; (b) note the updates provided in relation to Urgent and Unscheduled Care Funding and the Pan Ayrshire plans for spend; (c) endorse continued progress at pace with plans to ensure optimal utilisation of allocated funds; (d) approve progression of plans to enhance Care at Home Reablement capacity via NHS Renewal Funding; and (e) note the funding risk associated with uncertainty of recurring elements of funding allocation 6
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5. 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. Brighter Pathways: Re-Modelling Care Options Submitted a report and received a presentation by Elizabeth Stewart, Head of Service (Children, Families and Justice) on the Brighter Pathways Programme. The programme was a strategic initiative aimed at transforming children’s services in North Ayrshire, which focuses on improving outcomes for care-experienced children and young people, addressing systemic challenges, and ensuring sustainable care models. The Strategic Vision emphasises collaboration, investment, and a rights- based approach to create a sustainable, responsive, and a nurturing care system for children and young people in North Ayrshire and aligns with The Promise. Officers responded to members’ questions on various aspects of the report. The Board agreed to (a) note the current challenges we face, including over- occupancy in residential houses, reliance on external placements, decline in foster care capacity, supporting unaccompanied asylum-seeking children (UASC) and financial impacts; (b) endorse the Brighter Pathways Strategic Vision and the actions therein; (c) approve the financial proposals outlined which includes investment in internal Fostering to attract and retain Foster Carers and a Supported Accommodation Model of care for transitions, noting the forecast pay-back period; and (d) note the financial position and future financial modelling based on re-investment of resources on a spend to save basis. Councillor Foster left the meeting at this point. 7. Child and Adolescent Mental Health Services (CAMHS): Neurodiverse CAMHS Team Waiting Times and Mitigation Plans Update Submitted a report by Thelma Bowers, Head of Service (Mental Health) on the Neurodiverse CAMHS Team Waiting Times and Mitigation Plans. The Implementation of the National CAMHS Specification report, presented to the North, South and East Ayrshire Integration Joint Boards was set out at Appendix , the details of the redesign work in CAMHS was set out at Appendix 2 and the response submitted to the committee in review to a call for views was set out at Appendix 3 to the report. Officers responded to members’ questions on various aspects of the report. Noted. 7
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8. 2025-26 – Month 6 Financial Performance Submitted report by Eleanor Currie, Interim Chief Financial Officer (HSCP) on the Integration Joint Board’s financial performance as at Month 6 (September). Appendix A to the report detailed the financial overview of the Partnership position, while Appendix B provided an overview of the service changes that did not have financial savings attached and the BRAG status around the deliverability of each saving. Appendix C highlighted the movement in the budget position following the initial approved budget, with further detail on the reserves set out at Appendix D. The proposed recovery action was outlined in Appendix E, while Appendix F highlighted information on the costs of bank and agency staff. Officers responded to members’ questions on various aspects of the report. The Board agreed to (a) note the overall integrated financial performance report for the financial year 2025-26 and the current overall projected yearend overspend of £4.957m reducing to £1.604m after planned recovery actions; (b) note the progress with delivery of agreed savings; (c) approve the actions which are being taken to progress financial recovery and that an updated recovery plan will be presented to the next IJB; and (d) note the remaining financial risks for 2025-26. 9. Meeting Dates 2026 Submitted report by Caroline Cameron, Director (NAHSCP) on the proposed timetable for meetings of the Integration Joint Board, Performance and Audit Committee and Strategic Planning Group for 2026, set out at Appendix 1 to the report. The Board agreed to approve the timetable for the meeting for the Integration Joint Board, Performance and Audit Committee and Strategic Planning Group for 2026, 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 4 June 2025. Noted. The meeting ended at 12.20 p.m. 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 11th December 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 CARE Culture – Agency – Respect – Equity COSLA Convention of Scottish Local Authorities OT Occupational Therapy 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. 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. Agenda Item 4 9
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3. CURRENT POSITION National Developments 3.1 Grant Funding to Help Reduce Inequity in Cancer Care Macmillan Cancer Support has launched a new £1.5m grants programme for voluntary, community, faith and social enterprise organisations who can help reduce inequity in cancer care. This pilot programme is called the Macmillan CARE (Culture • Agency • Respect • Equity) Grants Programme. Grants are for between £50,000 and £150,000 over one or two years and focus on three main areas of health inequity: • Cultural Responsiveness: Making cancer care more sensitive to diverse cultural needs • Shared Decision Making: Empowering people to actively participate in their care • Dementia-Friendly Cancer Care: Supporting those living with both cancer and dementia The application process is now open and will close on Friday 23 January 2026. If you know of any groups who may be interested in applying, they can find out more on the Macmillan website. 3.2 The Promise Scotland Update The Promise Scotland has updated its logo to help give more clarity over what the organisation is, as well as the difference between The Promise Scotland and The Promise. The Promise is that all Scotland’s children and young people will grow up loved, safe and respected so that they will realise their full potential - with The Promise Scotland being the organisation set up to help Scotland achieve that. The new logo has a tagline and graphic to represent the organisation’s role in supporting those working to keep The Promise, and you can download it via the organisation’s new Partner Pack. 10
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A new website for the Oversight Board for The Promise has created, with its own style and branding. The Promise Scotland also restructured and revamped its website, providing a clearer focus on what it does, the areas it works in, and how it supports people to keep The Promise. 3.3 Local Government Promise Annual Report 2025 COSLA also launched the ‘Local Government Promise Annual Report 2025.’ On 19th November 2025. 2025 marks the halfway point in Scotland’s journey to Keep The Promise - a commitment made in response to the Independent Care Review to transform the lives of babies, children and young people experiencing care by 2030. This milestone encourages reflection on the achievements over the last 5 years, as well as the barriers to change and what needs to happen next. As we reach the halfway point, this report offers a powerful reflection on both the achievements and the realities of delivering change. Local Government remains deeply committed to supporting babies, children, young people and families. Across Scotland, councils are delivering vital services shaped by strong relationships with local communities and a clear understanding of their needs. The report is available on the COSLA website here: Local Government Promise Annual Report 2025 | COSLA 3.4 Scotland’s New HIV Learning Hub HIV charity Waverley Care launched HIV Informed on World AIDS Day. This free online learning hub has been developed in partnership with NHS Scotland, people living with HIV, and funded by the Scottish Government as part of its national commitment to end new HIV transmissions and tackle stigma. To support the launch of this online learning hub Waverley Care have created a communications toolkit to make this as easy as possible, with ready-to-use materials for websites, newsletters, and social media. The toolkit includes: • Key messages to help you talk about HIV Informed • Short videos highlighting real-life experiences of people living with HIV • Social media posts and graphics to raise awareness • Email signature graphics to show support and engagement • Template emails and suggested copy for internal communications • Website copy and guidance for partner sites These communication resources are available to download from: HIV Informed 11
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While huge progress has been made in HIV treatment and prevention, stigma and outdated attitudes still persist in some health and social care settings. Research shows that people living with HIV can still face discrimination or inappropriate treatment — experiences that can make them reluctant to access care or share important health information. This can have serious consequences for their health and wellbeing. 3.5 Mental Health and Substance Use Toolkit Healthcare Improvement Scotland has recently launched the Mental Health and Substance Use Toolkit. This is for people working within mental health and alcohol and drug recovery services. The toolkit provides accessible, evidence-informed tools and resources that staff can use to improve care. The National Mental Health and Substance Use Protocol Explore the National Mental Health and Substance Use Protocol for guidance on local interface documents and systems of care for people with co-occurring mental health and substance use conditions. 3.6 State of Caring : The Cost of Caring in Scotland 2025 On Carers Rights Day, Carers Scotland launched its latest research: State of Caring: The Cost of Caring in Scotland 2025. Their findings revealed: • 48% have cut back on essentials like food and heating because of their caring role – a 71% increase on last year’s research. • 35% have taken on debt just to make ends meet. • 40% have reduced working hours or left employment, • 39% report poor mental health and 30% poor physical health. • 50% are providing more care but just 13% had received a formal break from caring • Parent carers of children are particularly hard hit, with 62% cutting back on essentials and 56% taking on debt to make ends meet. Unpaid carers are providing more care with less support, facing financial insecurity, deteriorating health, and restricted life opportunities. You can read the full report here: https://www.carersuk.org/media/yqzk0fjv/state-of- caring-the-cost-of-caring-in-scotland-2025-web-version.pdf 12
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3.7 Publication of Health and Care (Staffing)(Scotland) Ministerial Report 2024/25 The first Annual Ministerial Report on the Health and Care (Staffing) (Scotland) Act 2019 has now been published. This report marks an important milestone to ensure safe and effective staffing decisions across Scotland’s health and care services, following the full commencement of the Act on 1 April 2024. The Act provides a statutory framework to support the delivery of high-quality care and improved outcomes for people who use services, underpinned by guiding principles that place the wellbeing of both service users and staff at the heart of decision making. Contributions from Health Boards, Local Authorities, and Integrated Authorities informed the significant work undertaken to embed the duties of the Act into policies and practices. This commitment has been essential in creating a culture of openness, transparency, and continuous improvement in staffing decisions. The Annual Ministerial Report provides an overview of progress to date, highlights achievements, and sets out areas for continued focus as we move forward together. You can access the report here. North Ayrshire Developments 3.8 Compassionate Care Award Congratulations to Elaine Tizzard, who has just received an Isabella Kimmett Compassionate Care Award. Presented twice a year, the awards celebrate nursing, midwifery, allied health professionals, GP and care home staff who have shown outstanding compassionate care. Elaine, who is an OT Technical Instructor based at the Honeycomb in Woodland View, was nominated for consistently going above and beyond in her role, demonstrating an exceptional level of compassion and empathy. The nomination also describes how she supports her patients holistically, giving extra time to really listen, with her colleagues also valuing the support she gives the team in terms of wellbeing. 13
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3.9 Global Leadership Excellence Award Congratulations to Mark Fleming as recipient of the eMHIC Leadership Excellence Award for Scotland. As one of the highest honours in digital mental health, this award recognised Mark’s visionary leadership and steadfast commitment to advancing innovation in mental health, thereby improving timely access to mental health information, care, support, and treatment. This award is presented to only one recipient per country annually. Mark was not only honoured to be nominated in the first place but is delighted to have been selected to receive the award for 2025. Mark was unable to attend the International Conference and awards Ceremony in Toronto, Canada last week, however is award is in the post! 3.10 Supporting Communities to Plan Ahead Two successful community events hosted by Arran CVS and TACT brought residents together recently to learn about the importance of planning ahead through Power of Attorney arrangements and the Herbert Protocol. The sessions aimed to support individuals, carers, and families in preparing for the future and ensuring the wellbeing of vulnerable loved ones. Each event featured expert speakers who provided clear, practical guidance on legal and safeguarding measures, with discussions highlighting the benefits of establishing a Power of Attorney early - offering greater control over future decisions for individuals and peace of mind for families. Attendees also learned about the Herbert Protocol, a Police Scotland initiative designed to assist when a person with dementia or memory loss goes missing. Both events emphasised how these tools can offer protection, reassurance, and quicker responses in times of crisis. Feedback from participants was overwhelmingly positive, with many expressing their appreciation for the accessible, community-focused approach. More information about Power of Attorney and the Herbert Protocol can be found by clicking on the links below. Power of Attorney in Scotland (Age Scotland) Herbert Protocol (Police Scotland) 14
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3.11 Occupational Therapy Week North Ayrshire Health and Social Care Partnership Assessment and Reablement Team hosted a coffee morning to celebrate OT Week. It was a fantastic event that attracted attendees from a wide range of organisations. We had valuable discussions with Pharmacy Technicians, VoiceAbility, Community Development Workers, Acute Mental Health OTs, the Douglas Grant Rehabilitation Service, Community OT, and Link Up Cameo. The morning was a great success, offering opportunities for positive conversations, networking, and promoting joint working. It provided a welcoming space for teams to engage, share ideas, and strengthen partnerships. 3.12 Delivering Social Care Services within Budget – Share your Views North Ayrshire Health and Social Care Partnership has launchied a six-week consultation with individuals, families, carers and professionals to find out their priorities around how it delivers social care services within budget. NAHSCP is facing significant financial pressures, with demand for services continuing to rise at an unprecedented rate. With these challenges increasing and set to continue, some extremely difficult decisions must be made in the coming months as the Integration Joint Board works towards setting its budget for the coming year, which will affect the level and types of care NAHSCP is able to provide across many of its services. As such, the partnership wants to have open, frank and honest conversations with North Ayrshire residents around the challenges being faced, what this means for services, and how that might affect them, their loved ones, or the people they care for. To help NAHSCP consider its priorities and plan what frontline services look like as it navigates these challenges, the partnership is asking North Ayrshire residents, service users, staff, unpaid carers, community groups and care providers to take part in a consultation, where they can share their views and ideas on how best to prioritise the available budget to ensure those most in need are able to receive the care and support they need. 15
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There are a number of ways for staff, providers and members of the public to get involved, both online and in person. Our online public survey went live on Friday 5 December, and can be accessed until Friday 16 January. • A series of drop-in locality events are being held at the following dates and times, where members of the public can go along and discuss and share their views: Fullarton ConneXions, Irvine: Wednesday 7 January, 11am to 2pm Kilwinning Sports Centre: Wednesday 7 January, 4pm to 7pm Brodick Hall: Thursday 8 January, 1.30pm to 4.30pm Hayocks Community Centre, Stevenston: Tuesday 13 January, 11am to 2pm Bridgend Community Centre, Kilbirnie: Wednesday 14 January, 4pm to 7pm Clark Memorial Church, Largs: Thursday 15 January, 11am to 2pm IJB members are asked to share the consultation within their networks to ensure we are able to reach and hear from as many North Ayrshire residents as possible. 4. IMPLICATIONS 4.1 Financial None 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 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 16
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Integration Joint Board 11th December 2025 Subject : Unpaid Carers Strategy & Delivery Plan Purpose : • Awareness of the Unpaid Carers Strategy and Delivery Plan Recommendation : • Endorse ‘Together We Care’ Carers Strategy 2026-2029 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. NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership CGNA Carers Gateway North Ayrshire NACE North Ayrshire Council Education Service ACSP Adult Carer Support Plan YCS Young Carers Statement TTL Time to Live IJB Integrated Joint Board EPiC Equal Partners in Care SWGB Social Work Governance Board PSMT Partnership Senior Management Team 1. EXECUTIVE SUMMARY 1.1 This update brings forth progress of a 3-year Carer Strategy: ‘Together We Care’ 2026 – 2029 in conjunction with a delivery plan and progress report on Carers Strategy: ‘Building Caring Communities’ 2023-25. 1.2 The paper highlights four pillars to be taken forward as a strategic partnership with our partner Carers Gateway North Ayrshire (CGNA), Unity. Both the strategy and delivery plan detail the importance of supporting carers to sustain their caring roles and look after their own health and wellbeing, resource and crucially how we will continue to expand reach and improve carer identification, information, assessment and support. Agenda Item 5 17
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Health and Social Care Partnership (HSCP) aspires to involve more carers and key partners in collaborative decision making on services for carers and the people they care for. 1.3 Ultimately progress ensures HSCP continues with the implementation of the Carer (Scotland) Act 2016 and the statutory responsibilities therein. 2. BACKGROUND 2.1 Duties under the Carer’s (Scotland) Act 2016 came into force in April 2018. The Act sets out several responsibilities including the development and publishing of a local carer strategy. HSCP met our duties under local carer strategies with our interim Carers Strategy: Building Caring Communities 2023-2025. The intent was to use the interim strategy period to work with CGNA, our carers and the broader sector to engage in a medium-term strategy to be ready to cover the period 2026 – 2029. The strategy must cover the following areas to meet the statutory definition of a carer strategy, at least: 1. Plans for identifying relevant carers and obtaining information about the care they provide to cared-for persons in North Ayrshire. 2. An assessment of the demand for support to relevant carers. 3. Support available to relevant carers in North Ayrshire. 4. An assessment of unmet need for carers. 5. Plans for supporting carers. 6. Plans for putting arrangements in place for the provision of care to the cared- for person in emergencies. 7. As assessment of the extent to which plans in place may reduce any impact of caring on carers’ health & wellbeing. 8. Intended timescales for preparing adult carer support plans and young carer statements. 9. Information relating to the particular needs and circumstances of young carers. Contextually, the carer population is just over 17,000 people in North Ayrshire according to the Scottish Census Priority 1: Carers are actively sought and identified. Progress to date: 1,888 (1,358 adults & 530 young carers) carers were known and registered with CGNA at the last count on 31st October 2025. This includes 921 individuals newly identified and registered carers since June 2023. Predominantly increased referrals for carer registration have come from self-referral, Social Work Teams, Friends and 18
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family and North Ayrshire Council Education (NACE). To support growth, CGNA has expanded its staffing complement from 4.5 to 17 staff members. The strategic deployment of community-based support staff within local communities and educational settings has significantly strengthened carer identification efforts across all six localities: Irvine, Kilwinning, Three Towns, North Coast & Isle of Cumbrae, Garnock Valley, and the Isle of Arran. Specialist roles have been introduced to CGNA including, Marketing Officer, Engagement Officer, Administration & Evaluation Officer, Short Breaks Officer and Wellbeing & Activities Officer. In partnership with English Speakers of Other Languages (ESOL), MECOPP, and support via the Coalition of Carers in Scotland Supporting Ethnically Diverse Carers group, the identification and engagement of hidden carers across North Ayrshire have significantly been strengthened. This includes increased outreach to carers from ethnic minority backgrounds and gypsy/traveller community groups that have historically faced barriers in identifying as carers and accessing support. Recording and reporting processes have been strengthened through the CGNA’s recording system Charity Log, along with a data cleansing exercise which ensures data is now accurate and relevant. Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. Progress to date: A new Carer Information Pack, co-produced with carers, has been developed to provide relevant support and guidance in one accessible resource. This pack reflects the lived experiences of carers and ensures that the information is practical, clear, and meaningful. To further improve accessibility, CGNA information leaflets are now available in multiple formats and languages, including Arabic, Ukrainian, Vietnamese, Kurdish Sorani, and Pashto/Dari supporting carers from diverse backgrounds to access the information and help they need. Social media continues to be a powerful tool for information and engagement, particularly Facebook, with CGNA page now having 1,612 followers, the majority of whom are women aged 35 to 54 years old. This platform has proven highly effective in reaching carers with timely updates, resources, and opportunities for connection. The launch of CGNA new website alongside the digital self-help portal has significantly enhanced digital accessibility. These digital platforms offer carers 24/7 access to information, personalised support planning, and a centralised hub for resources, empowering carers to take control of their support journey in a way that suits their needs. 19
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The HSCP Carers Team In collaboration with CGNA, have worked with professionals across multiple services have developed a deeper understanding of caring roles and their impacts, enabling earlier identification of carers and more effective signposting to appropriate support. Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement Progress to date: Until now carers support plans were only available through NACE/ HSCP services. CGNA now offer all carer coming through their service a support plan. Since early 2025 CGNA now complete plans which give alternative routes for young and adult carers to flexibly be offered or request a carer conversation and access to support. HSCP has delegated equal responsibility to NACE for young carer identification and offers of support. Across our primary and secondary schools 549 young carers under 18 years old were identified on Seemis in October 2025. These figures do not account for anyone living out with the local authority area but caring for someone who resides in our North Ayrshire communities. By way of assessment leading to support, for the reporting years 2023/ 2025, HSCP services staff offered 937 Adult Carer Support Plans (ACSP) with 191 accepted. HSCP Carers Team, Carers Support Officer also received 226 referrals for ACSP reporting years 2023/ 2025 via HSCP Service Access, CGNA and Self-referrals from carers with 163 following on to completion. NACE staff report 439 Young Carer Statements (YCS) offered with 358 accepted and completed in the year 2024/ 2025. Over 2.5 times more than in 2022/ 2023. From the young carer statements, it is noted 30% required a break away from their caring role, 51% required information or advice around their caring role or for their own health and wellbeing, 35% needed emotional support meaning school staff being aware of caring roles, their anxieties and having someone to talk to. 24% requested practical support with homework, schoolwork or a place to study. Priority 4: Promoting variety in breaks from caring. Progress to date: In February 2025, we published our updated Short Breaks Services Statement, outlining how carers can access a break from caring and what that might look like both locally and further afield. Between 2023 and 2025, the HSCP provided an additional £70,000 in one-off direct funding to support carers who completed an ACSP or YCS. This funding enabled carers to: 20
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• take a much-needed break from their caring role. • access life opportunities that improved their overall quality of life • access KA Leisure memberships to provide health and wellbeing opportunities. This increase in funding reflects a strong and ongoing commitment to supporting carers’ health and wellbeing, ensuring more carers can benefit from the help they need at critical moments in their caring journey. Through CGNA and Shared Care Scotland’s Time to Live (TTL) funding, carers now have more opportunities to enjoy life outside of their caring role. These breaks have been vital in sustaining carers’ health and wellbeing and preventing burnout. TTL funding increased from £70,594 2024/ 2025 to £128,959 2025/ 2026 offering more carers the opportunity to benefit from a break from caring. CGNA have delivered variety of seasonal activities over the last two years, including residential trips for young carers to the Honey Pot and the Young Carers Annual Festival. Notably, 52 families attended a local pantomime, benefiting 203 individuals with a joyful break from caring. Adult Carers support groups, and one to one session’s are hosted across all six localities, offering carers a safe and supportive space to share experiences, access peer and professional support, and take a break from their caring role. Priority 5: Carers feel involved as equal partners in care design/ delivery. Progress to date: To strengthen the carer voice and influence, two new platforms were established: • Adult Carers Champions Board (February 2025) • Young Carers Champions Board (July 2025) These boards empower carers to shape decisions and services that impact their lives and those they care for, ensuring their experiences are heard and reflected in service design and delivery. Strategic representation is embedded at the highest level, with two Carer Representatives sitting on the Integrated Joint Board (IJB), which oversees the planning and delivery of health and social care services. Their presence ensures carers’ perspectives are considered in decisions that affect local carers and communities, aligning with national outcomes. We continue to invest in meaningful engagement. CGNA Carers Conference, first held during Carers Week 2024 at Riverside, Irvine and again in 2025 at Oscars, Saltcoats, brought together over 200 young and adult carers and professionals. 21
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These events combined practical workshops and talks with relaxation opportunities, acknowledging both the emotional and practical needs of carers. In partnership with our Mental Health Engagement Officer and clinical teams at Woodland View, we explored carers’ experiences within acute inpatient mental health and addiction settings. The 2024 Carers Survey provided valuable insights into the lived experiences of carers supporting someone with mental ill health. These findings will inform future service redesign and ongoing engagement across NHS Ayrshire and Arran. In response to carer feedback, and in partnership with CGNA and VoiceAbility, we launched the Pan Ayrshire Mental Health Carers Forum. Meeting monthly across community and hospital settings, these sessions offer: • Information and updates • Peer support • Opportunities for carers to be actively involved in service design. This forum strengthens the voice of carers in shaping mental health services and ensures their experiences are central to future improvements. Responding to carer feedback, we now offer monthly Moving and Handling Information Sessions. These three-hour sessions provide carers with hands-on guidance on equipment and techniques such as profiling beds, hoists, slings, and slide sheets, making caring tasks safer and more manageable. We also worked in partnership with CGNA and NACE Services to co-deliver consultation sessions across schools with young people and partners. These sessions shaped the updated YCS, launched in 2025, ensuring it reflected young carers’ voices and needs. Priority 6: Strong partnership working/ engagement. CGNA has embedded a wide range of community-based support for both adult and young carers. A summary of what's available across North Ayrshire can be found on CGNA website. The introduction of the Adult and Young Carers Champions Boards builds on this foundation, enhancing partnership working and ensuring carers are central to shaping services and decisions. In 2024, 175 carers responded to a survey exploring health and wellbeing opportunities across all six localities. Key findings included: • 42% of carers identified cost as a barrier to accessing local health and leisure services. 22
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In response, we partnered with KA Leisure to offer discounts via the Carers Appreciation Card and secured annual memberships at reduced rates through completion of an ACSP or YCS. We continued to engage with carers through surveys, face-to-face conversations, regular feedback from carer groups, and post-event evaluations (e.g. Roadshows and Carers Conference). This helps us understand what is working well, what needs improvement, and how carers prefer to engage. Recent feedback revealed: • 16% of carers prefer online engagement. • 40% would like access to services in the evening or at weekends. Our collaboration with local GP surgeries has led to increased visibility of carer support, with practices now displaying CGNA posters or hosting carer-specific displays. In 2024, CGNA began reviewing therapies provision for carers, moving away from a centralised model to better align with their locality-based approach. A survey with over 150 responses. Based on feedback CGNA engaged 17 local therapy providers, with 28 more expressing interest. They are now developing robust referral processes to ensure carers can access support in a way that suits their individual needs. Additionally, in partnership with local counsellors, CGNA supported ten carers in 2024 to 2025 to access one-to-one Cognitive Behavioural Therapy (CBT). Referrals are triaged by the counsellor, who then offers up to ten tailored 60-minute sessions Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. Progress to date: Young Carers information and awareness sessions have been delivered across schools, youth groups and at community events, helping to normalise conversations about caring and reduce stigma. We have worked closely with third sector and voluntary partners to raise awareness and strengthen identification efforts across all six localities in North Ayrshire. These partnerships continue to play a vital role in reaching young carers who may not be visible through traditional or education services. In October 2024, we launched the Young Carers Education Information Pack, providing NACE staff with clear guidance on how to identify, support and work with young carers. This resource supports a consistent and informed approach across all North Ayrshire schools. In January 2025, North Ayrshire Council and CGNA signed the Young Carers Covenant, committing to outcomes shaped by young people. Twelve schools have 23
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already joined, with each school nominating a Young Carers Champion supported by CGNA Young Carer staff, embedding young carer awareness and tailored support into school culture. We are encouraging and supporting schools to participate in the Young Carers in Schools Challenge. These initiatives promote a whole-school approach to identifying and supporting young carers, embedding carer awareness into school culture. In March 2025, CGNA digital self-help portal for young carers was launched. The platform offers 24/7 access to a wide range of resources, information, and support. This digital tool enhances accessibility and ensures young carers can find help whenever they need it and an improved version was launched in August 2025. A structured transition pathway has been developed to support young carers as they move through key stages of life, particularly from age 16 onwards. Helping young carers to manage and prepare for changes in their caring role as they approach adulthood. The pathway ensures that changes in life circumstances such as education, employment, home life or caring roles trigger tailored information, advice and support. Carer identification, information, activities and support is now closer to carers homes, embedded in their own communities. 3. PROPOSALS 3.1 Carer Strategy ‘Together We Care’ is intended to help deliver consistency of message and approach for all carers. It advises carers of their rights, sets out plans to identify carers, routes for assessment and support, and information about local and national services. The strategy advises carers, those they care for, professional staff and partner agencies of how we currently identify and support carers, and what this will look and feel like in the future through CGNA’s expanded service. We are continuing with a programme of review, change and growth as to how we work with and involve carers in and around our communities and in service design to shape and implement better carer services and services for the individual they support. The aim is that all North Ayrshire carers are identified, supported and valued and are afforded an opportunity to live, work, thrive and stay connected to their communities enjoying a life alongside caring, where they choose to continue to care. It is also our ambition that all unpaid carers have their voices heard and ideas considered in the design and delivery of information and support services provided 24
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across HSCP through a more collaborative/ network model of Champion Boards led by CGNA, Carers Champion and IJB Carer Representatives. We understand that often caring roles are demanding and complex and we hope the strategy offers support and guidance to carers when they need it most. In the development of the strategy, four pillars have been identified for growing young and adult carer services. HSCP will work closely with North Ayrshire carers, CGNA and other key partners to implement and improve identification, information, involvement and support options through the following four pillars: • Pillar 1 Identify – “Carers will be identified at the earliest opportunity”. • Pillar 2 Inform - “Carers will be provided with the right information at the right time”. • Pillar 3 Involve - “Carers and the individuals they support work together with professionals and services, rather than having decisions made for them”. • Pillar 4 Support - “Carers are supported to lead a healthy and fulfilling life”. The strategy and pillars have been developed over the past year with carers, CGNA and partners and have been endorsed by our Carers Champion Board on 2nd September 2025. It has also been endorsed through Social Work Governance Board (SWGB) (31st October) and Partnership Senior Management Team (PSMT) (20th November). Key outcomes for development across all four pillars Pillar 1 Identify – We are committed to embedding a proactive, consistent approach to early identification of carers across all services by working in partnership with health, social care, education, council, and community organisations. This includes equipping primary care professionals with tools via platforms like CGNA digital self- help portal, investing in workforce capacity through resources such as Equal Partners in Care (EPiC), and expanding roles like Carers Support Workers in community hospitals to support carers during discharge. We will adopt outreach strategies to engage underrepresented communities, collaborate with care homes and supported living settings to address barriers, and use social media and digital campaigns to encourage self-identification, reduce stigma, and promote available support. Pillar 2 Inform – We aim to ensure carers have clear, accurate, and timely information to make informed decisions and access support. This will be achieved by providing personalised resources through CGNA, extended service hours, and key transition support; maintaining accurate digital information across partnership websites and digital self-help portal; promoting carers’ rights under the Carers (Scotland) Act and 25
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Carers Charter through workshops and targeted materials; partnering with Money Smart for financial advice and benefits support; working with local organisations and trusted spaces to raise awareness and expand peer support opportunities; and addressing digital barriers by skills training, and online resources to ensure equitable access. Pillar 3 Involve – We believe carers should be equal partners in care, actively involved in planning and decision-making while supported to maintain their own wellbeing. This pillar prioritises co-production and person-centred approaches by strengthening carer involvement in service design through Carers Champions Boards, commissioning processes, and feedback mechanisms. We will promote the use of ACSP and YCS, implement inclusive engagement strategies, and provide training and peer support for carer representatives. Additionally, we will work with advocacy services and use digital tools to amplify carers’ voices and ensure they can confidently influence service development. Pillar 4 Support – Caring should not come at the cost of a carer’s health, aspirations, or quality of life. This pillar focuses on creating a culture that values and sustains carers through access to breaks, emotional support, financial advice, and opportunities for personal development. We will achieve this by promoting ACSP and YCS, improving access to emotional wellbeing support and routine health checks, and partnering with businesses to support employment opportunities through initiatives like Carer Positive. Additionally, we will develop respite and day support services, create pathways to address critical caring concerns, and provide future planning toolkits to reduce stress during emergencies, ensuring carers can thrive not just cope. Young carers may have different challenges or support needs compared to adult carers. These Pillars focuses on young carers in North Ayrshire to make sure their needs, rights and experiences are properly understood and supported. Key outcomes for development for young carers across all four pillars Pillar 1 – Identify We aim to identify and support young carers early by expanding training for education, health, and social care staff, and raising awareness through campaigns, events, and the CGNA digital self-help portal. Resources will be co-developed with young carers for use in youth and community settings, while schools and partners will be encouraged to sign the Young Carers Covenant and take part in the Young Carers Challenge Scotland. We will strengthen safe disclosure pathways through Carers Champions in schools and work with health professionals to identify young carers during routine appointments, ensuring timely and tailored support. 26
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Pillar 2 – Inform We aim to ensure young carers have access to clear, age-appropriate information tailored to their needs. This includes co-developing a Young Carers Information Pack in plain language, offering feedback opportunities, and providing learning sessions for staff to share information at key transition points. We will create resources for families, involve young carers in shaping how information is shared across multiple formats including the CGNA portal and develop tools to explain the roles of professionals supporting them. Additionally, we will work with schools, colleges, universities, and employers to establish pathways that identify young carers early and provide the right information to help them succeed. Pillar 3 – Involve We aim to empower young carers as confident, informed partners in decisions affecting their lives. This includes developing training and awareness opportunities to build self-advocacy skills, increasing uptake of YCS to help them set goals, and championing peer-led initiatives like the Young Carers Champions Board and National Young Carers Festival to amplify diverse voices. We will co-design pathways for participation in mental health and wellbeing decisions and create resources and campaigns shaped by young carers lived experience to drive meaningful change. Pillar 4 – Support We aim to ensure young carers can access the right support and opportunities to maintain their wellbeing and thrive. This includes partnering with schools, youth, and community groups to provide social activities and local support, creating pathways for timely specialist help, and expanding access to one-to-one support, peer groups, and residential breaks. We will raise awareness of financial support options such as the Young Carers Grant and promote short breaks through CGNA and community resources. Additionally, we will strengthen referral pathways between young carers and adult services, offering tailored transition workshops focused on life skills, education, and employment. HSCP will fine tune this strategy with a proposed launch online in January 2026 and work commencing on design for a printable alternative early 2026. We will move forward with the content, pillars and associated action plan to ensure all carers in North Ayrshire can experience a good quality of life, sustain or improve their wellbeing and realise their goals by accessing information and support closer to home that enables them to continue caring, where they wish to do so. We are aware that the Care Reform (Scotland) Act 2025 will bring changes to timescales for the offer and completion of support plans. We will continue to monitor this and take these changes into account, ensuring the strategy reflects updated national priorities and continues to meet the needs of carers in North Ayrshire. 27
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As a final point the strategy acknowledges the challenges currently faced across HSCP services and systems, but we also recognise that often means rising pressure for many carers. Carers are paramount to the wealth and sustainability of our communities and the health and social care system. This is why carers needs are of priority across North Ayrshire. 3.2 Anticipated Outcomes The results we hope to achieve through the strategy and delivery plan for carers are: Pillar 1 Identify – “Carers will be identified at the earliest opportunity”. • Improved carer identification in primary care settings. Health professionals are better informed and more confident in identifying and referring carers. • Carers and professionals have easier access to helpful resources and information. Professionals have a better understanding of carers' needs and rights. EPiC becomes a standard part of staff training and development. - Improved identification and support for carers across services. • Stronger partnerships between carers and professionals. Carers receive timely information, advice, and support during transitions. • More carers supported during hospital admission/ discharge and reduced readmissions, delayed discharge and improved outcome for all. • More carers are identified earlier and receive timely support. Outreach becomes more targeted and effective. • Carers feel heard and valued. Professionals are better equipped to recognise and support carers. • Increased awareness and access to support among underrepresented communities. Stronger relationships between services and diverse groups. More carers from minority backgrounds feel recognised and supported. Improved inclusivity in service design and delivery. • More carers in supported living and care settings are identified and supported. Carers receive relevant and accessible information. Reduced isolation and improved wellbeing for carers facing access barriers. Stronger partnerships with supported living partners and care providers. • Greater visibility of carer support services. - Increased engagement from carers and communities. More carers accessing support through digital platforms. Improved messaging based on audience feedback and data. Pillar 2 Inform - “Carers will be provided with the right information at the right time”. • Carers can access support when they need it, including evenings and weekends (supporting working carers). Carers feel better prepared and supported during major life changes. Increased satisfaction and engagement with CGNA services. 28
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• Audit and update carer-related content on the HSCP website, CGNA website, and self-help portal. Maintain and regularly promote the CGNA digital self- help portal through newsletters, social media, and partner networks. • Professionals are more aware of carers’ rights and responsibilities. Carers feel more informed and empowered. Increased recognition and support for carers in health settings. Consistent messaging about carers’ rights across services. • Carers feel more confident managing finances and accessing benefits. Increased uptake of financial support services. Reduced financial stress among carers. Stronger partnerships between financial support services and carer networks. • Increased visibility of carer support in local communities. Greater understanding of carers’ roles among professionals and the public. Stronger representation of carers in decision-making. More carers accessing support through trusted community spaces. • More carers can access digital support and information. Increased confidence and independence in using online tools. Reduced digital exclusion among carers. Improved access to services and resources for all carers. Pillar 3 Involve - “Carers and the individuals they support work together with professionals and services, rather than having decisions made for them”. • Carers feel heard, valued, and involved in decision-making. Services better reflect the real needs and experiences of carers. Stronger partnerships between carers and professionals. Continuous improvement based on lived experience. • Carers feel valued and included in care processes. Improved communication and planning between carers and professionals. Increased uptake of support plans and statements. Better outcomes for both carers and the people they support. • Increased participation from underrepresented carer groups. Carers feel respected, understood, and included. Services are shaped by a wider range of voices and experiences. Improved equity in access to support and decision-making. • Carer representatives feel confident and well-informed. Increased and meaningful participation in strategic forums. Stronger representation of carer voice in planning and decision-making. Improved outcomes through lived experience input. • More carers actively involved in service design and decision-making. Increased awareness of advocacy and involvement opportunities. Carers feel confident and supported to express their views. • Services better reflect the needs and experiences of carers. Pillar 4 Support - “Carers are supported to lead a healthy and fulfilling life”. 29
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• More carers access personalised support tailored to their needs. Staff feel confident and equipped to offer and deliver support planning. Improved wellbeing and outcomes for carers. Data driven improvements to service delivery. • Carers feel emotionally supported and less isolated. Increased access to counselling and peer support. Greater awareness and use of emotional wellbeing resources. Services are more sensitive to the impact of trauma and caring responsibilities. • Improved health awareness and early intervention for carers. Increased engagement in wellbeing activities, to reduce isolation and increase health and wellbeing. Greater accessibility and uptake of flexible support services. • Increased employer awareness and engagement. More carers supported to remain in or return to work. Growth in Carer Positive accredited organisations. • Services better aligned with carers’ needs and those they support. Increased access to and uptake of breaks from caring. Enhanced social connection and wellbeing among carers • Earlier intervention in complex or crisis situations. More responsive and resilient support systems. Data-informed service improvements aligned with carers’ needs. • Toolkit reflects real needs and experiences of carers across North Ayrshire. Increased awareness and confidence in accessing support. Wider reach for carers through CGNA and community networks. 3.3 Measuring Impact We will demonstrate what good carer support looks like through governance and performance monitoring of the strategy, delivery plan and above anticipated outcomes. CGNA and its associated developments remain accountable to the IJB and North Ayrshire Council. Scheduled updates will be tabled through PSMT for continued oversight and direction with escalation to SWGB where required. Carer Champions Boards will provide a robust measure of impact/ success of the strategy. Developments will be monitored through the voices, wisdom and experiences of our carers. A Strategic Planning Group will commence early January 2026 to support the strategy and delivery plan including representatives from HSCP, CGNA, NACE, carers and other relevant stakeholders and partners. CGNA also work with Evaluation Support Scotland who support organisations to measure, monitor and report on their impact for improvement. The role of Administration & Evaluation Officer in CGNA will also enhance the services ability to capture better, quality data to interrogate for service design and improvement. 4. IMPLICATIONS 4.1 Financial None 4.2 Human Resources 30
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None 4.3 Legal North Ayrshire Council and NHS Ayrshire & Arran must meet their duties under the Carers (Waiving of Charges for Support) 2014 Regulations, Carers (Scotland) Act 2016, Terminal Illness Regulations (July 2021) and Carer Reform (Scotland) Act 2025. This legislation should be held in the same regard as any other directive pertaining to professional assessment of need and provision of support. 4.4 Equality/Socio-Economic Under the Fairer Scotland agenda, it is commonly noted that unpaid care places added strain on multiple areas of a person’s life including personal health relationships & social opportunities, finances, appropriate housing, ability to retain education or employment. It is also known that carers predominantly are female and in the mid – older stages of life. The strategy and delivery plans contained in the report bring together four pillars, new approaches and better routes for information and support to ensure carers are equally recognised, informed and supported whilst trying to reduce any negative impacts caring may have on people’s lives. 4.5 Risk The integrated joint board should note the risks if this work does not continue to be a key priority. • Carers will not be aware of their rights or how to access information and support at the right time on their caring journey. • More carers will not be identified, informed and supported resulting in carer roles/ relationship breakdown and carers experiencing further impact on their own physical and emotional wellbeing. • Carers and HSCP services will be further overwhelmed and experience increasing pressure, leading the carer into crisis and resulting in higher demand and cost for health and social care services. • Statutory carer duties will not be met. • Fiscally conditions are not going to improve immediately for citizens, carers, local government or the care sector. Mobilising resources to mitigate some of the pressure’s carers are experiencing is the right thing to do. (Moderate) 4.6 Community Wealth Building None 4.7 Key Priorities The carers strategy and delivery plan outlined in this report will assist the IJB to deliver the following Strategic Objectives from its Strategic Plan to: • Continue to provide support in the community for unpaid carers, prioritising identifying people providing care in the community and ensuring their health and care needs are supported. 31
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• Continue working closely in partnership with the local Third and Community sectors, looking for opportunities to support peer-support groups, family and parental support. • Consider current and future options to enable independent living in the community • Review information and links available on the HSCP website, ensuring information is up to date and accessible, including language availability and alternative formats. • Review available tools and resources available to the community outside of services to ensure people have access to information and support if they are not at a stage of requiring clinical support. • Ensure that lived experience is used in the design and delivery of services and people are supported to participate in decision making. • Ensure people can participate in their own care plans and future planning to improve services. 5. CONSULTATION The contents of this report reflect the collaboration between HSCP, CGNA, Carers Champion Board and Groups and the wider carer population. Lead: Scott Hunter, Chief Social Worker Prepared by – Kerryanne Owens, Carers Development Officer – Professional Standards Kerryowen@north-ayrshire.gov.uk • 3 attachments 32
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North Ayrshire Carer Strategy Together We Care 2026 to 2029 33
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2 Contents Page Forewords ............................................................................................................................................................................................3 Introduction ..........................................................................................................................................................................................5 North Ayrshire’s Vision – A Promise to Identify, Inform, Involve and Support .......................................................................................6 What do we mean by carer ..................................................................................................................................................................7 Caring roles ..........................................................................................................................................................................................7 The Carers Landscape in North Ayrshire .............................................................................................................................................8 National Policy ................................................................................................................................................................................... 13 Local Policy ........................................................................................................................................................................................ 14 What we have achieved 2023-2025 ................................................................................................................................................... 16 A Promise to Identify, Inform, Involve and Support ............................................................................................................................. 17 North Ayrshire Young Carers .............................................................................................................................................................. 22 Why should we identify, inform, involve, and support young carers: .................................................................................................. 28 Supporting young carers in transition to adulthood ............................................................................................................................ 33 Support for former carers ................................................................................................................................................................... 34 Monitor and Review............................................................................................................................................................................ 35 34
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3 Forewords In North Ayrshire, we proudly recognise the vital role unpaid carers play in supporting those who cannot manage without help due to disability, illness, addiction, or mental health challenges. This strategy reflects our shared commitment to carers of all ages and has been shaped by their voices and lived experiences. We are deeply grateful to every carer who contributed their time and insight, and we also acknowledge the invaluable input from Carers Gateway North Ayrshire, colleagues across the Health and Social Care Partnership, Education, North Ayrshire Council, and the third and voluntary sectors. This strategy is a product of true collaboration, setting a clear direction for improving outcomes for carers. Recognising that caring can be both rewarding and challenging, we are committed to early identification, tailored support, and fostering a culture that values and empowers carers. Over the next three years, we will work alongside carers and partners to deliver on these priorities, ensuring carers in North Ayrshire feel recognised, supported, and able to thrive. Together, we can build a community where carers are not only seen but truly involved and supported. Caroline Cameron Director North Ayrshire Health and Social Care Partnership 35
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4 “I did not set out to be a carer, I just saw someone I love, my mammy, who needed me, and I did what many would do. However, caring takes its toll, and what I need is simple: to be recognised, supported, and treated like I matter too. This strategy gets to the heart of that, it is about making sure carers are not overlooked, that we are part of the decision-making process, that we get the right information and support when we need it. It is not just about supplying services, it is about seeing carers as people with lives, hopes, and challenges of our own.” Paul Smith, Integrated Joint Board Carer Representative 36
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5 Introduction We recognise carers need time and support to look after their own health and wellbeing, achieve their educational, employment and life ambitions and ensure they stay connected to family, friends, and their communities. This strategy sets out the shared priorities and actions North Ayrshire Health and Social Care Partnership, Carers Gateway North Ayrshire and other partners will work towards to help all carers achieve a life alongside their caring role. Based on what carers told us our focus is on early identification, meaningful engagement, and co-designed support. We aim to help carers build skills, improve health and wellbeing, and feel recognised and empowered. By working within communities and evolving services to meet diverse needs, we aim to reduce isolation and promote inclusion for carers. Importantly, we are committed to reaching underrepresented carers and communities ensuring carers in North Ayrshire feel seen, supported, and able to continue in their caring role, if they choose to do so. Who the strategy is for This strategy is designed for anyone who provides care to a family member, friend or neighbour who is living within North Ayrshire. It is intended to serve as a valuable resource for all staff, partners, and third sector organisations, including our strategic partner Carers Gateway North Ayrshire, as well as anyone seeking to understand how we support carers in North Ayrshire. The strategy will inform other North Ayrshire Health and Social Care Partnership strategies and transformation plans, ensuring that the needs and aspirations of carers are met and embedded across all Health and Social Care Partnership services, including those commissioned externally. Including Carers Gateway North Ayrshire, which delivers information, advice, signposting, and support services to carers across North Ayrshire. 37
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6 North Ayrshire’s Vision – A Promise to Identify, Inform, Involve and Support Through our four pillars to identify, inform, involve, and support, we will ensure that carers are acknowledged, their voices are heard, and they are empowered to flourish both within and beyond their caring roles. In North Ayrshire, our vision is made up of four pillars for unpaid carers: Identify Carers will be recognised at the earliest stages in their caring role and seen for the vital role they play in supporting others, including those who may not see themselves as carers. Inform Carers are made aware of their rights and the support available to them in ways that are accessible, clear, and meaningful. Involve Carers are included in decisions that affect their own lives and the lives of those they care for, with their voices shaping services and policy. Support Carers are empowered to have control over their caring role and supported to lead healthy, fulfilling lives including access to a break from caring, flexible wellness opportunities and emotional support when needed. 38
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7 What do we mean by carer The Carers (Scotland) Act 2016 recognises the importance of identifying and supporting caring roles and defines a carer as “an individual who provides or intends to provide care for another individual”, but not if this is only because of that person’s age (where they are under 18 years old) or if you caring because you have a contract or as voluntary work. In North Ayrshire carers are defined as: Someone who looks after a family member, friend or neighbour who needs support due to illness, disability, mental health issues, substance use issues or just needs extra help and support as they grow older. It is important to acknowledge that not all carers identify themselves. People often see the help and support they offer as a natural extension of those relationships. We recognise that cultural differences, language barriers, and lack of awareness can hinder access to information, support, and services. Identifying carers from LGBTQ+ communities, ethnic backgrounds and the gypsy/traveling community is crucial because these groups often face unique barriers to accessing support and recognition. Caring roles Caring roles vary significantly due to the diverse needs of individuals, the range of support required, and the changing circumstances of those being cared for. By relationship to the cared for person: • Young Carers – children and young people under 18 years old. • Young Adult Carers – adult over 18 years old who is not at school up to age 25. 39
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8 • Adult Carers – adults over 18 years old who are caring for another adult, often a parent, partner, or friend (Carers (Scotland) Act 2016). • Parent Carers – caring for a child with additional needs or disabilities. • Sibling Carers – brothers or sisters caring for a sibling with support needs. • Spousal/Partner Carers – caring for a husband, wife, or partner. • Sandwich Carers – supporting both children and older relatives simultaneously. Rita cares for her mum who has recently moved to a residential care home. She has Power of Attorney and takes care of mum’s finances, offers emotional support, and ensures mum is still able to access community resources. Rita does all this while balancing work and her own family. For many carers there are positive and rewarding aspects to helping or supporting someone else. Caring however can leave carers needing their own support and help. The Carers Landscape in North Ayrshire This strategy recognises the diversity of carers’ experiences and the need for tailored, locality-based approaches to ensure that all carers regardless of age, background, or caring intensity are identified, valued, and supported. Reviewing our data helps us to build a clearer picture of the local carers landscape in North Ayrshire. It enables us to: • Understand the scale and profile of unpaid carers in our communities. • Identify trends such as the ageing population, rising health concerns, and increasing demand to formal supports. • Predict future needs, allowing us to plan proactively for services that will likely see increased demand. • Ensure resources are targeted effectively, supporting both carers and the people they care for. • Strengthen strategic planning, ensuring our policies and services are responsive, inclusive, and sustainable. 40
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9 North Ayrshire is made up of six localities: Irvine, Kilwinning, Three Towns, Garnock Valley, North Coast and Cumbrae, and the Isle of Arran. Carers are present in every community, and their contribution is vital to the wellbeing of individuals and families across North Ayrshire. According to Scotland’s Census 2022, there are 17,222 unpaid carers in North Ayrshire, an increase of 23.9% since 2011. This places North Ayrshire as having the fifth highest proportion of carers in Scotland relative to its population. However, the true number is likely higher, as many individuals do not identify themselves as carers. In parallel, the 2022 Census also recorded an 18.5% increase in the number of people in North Ayrshire living with a health condition or disability that limits their daily activities. This rising level of need reinforces the importance of identifying and supporting carers at the earliest opportunity across all communities. 41
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10 In North Ayrshire, unpaid carers are predominantly women (74%) and of working age (18 to 64 years old), with the highest representation among those aged 50 to 64 years old. This demographic is particularly vulnerable, as many female carers within this age group are likely to be managing their own health conditions while simultaneously providing care to others. Managing personal health issues while caring for someone else can lead to serious physical, emotional, and financial stress for carers. Notably, nearly 60% of all unpaid carers are aged 50 years old and over, showing how caring responsibilities often come at a time when people are dealing with key life transitions such as declining health and retirement planning. In recent years, there has also been a marked increase of 25.5% in the number of men identifying as unpaid carers. This shift reflects a broader recognition of the caring role across genders and reinforces the need for support services to be inclusive, equitable, and responsive to the diverse needs of carers, regardless of age, gender, or background. 42
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11 Irvine has historically recorded higher numbers of registered carers with Carers Gateway North Ayrshire, which may have been influenced by several factors. Irvine is one of the larger town areas in North Ayrshire and has hosted the Carers Centre for over 20 years and carers often prefer local, familiar networks, making a centralised base seem disconnected from community needs. Carers Gateway North Ayrshire has seen an increase of registered carers across all six localities since 2023. A key development has been the transformation of our strategic partner moving away from a central base in Irvine High Street to embedding support staff in all six localities, making it easier for young and adult carers to access support closer to home. As of 30 September 2025, there were 1,888 carers registered with Carers Gateway North Ayrshire, the diagrams below represent the percentage across each locality with 1,358 being adult carers aged 18 years old and over and 530 young carers. 43
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13 National Policy Carers (Scotland) Act 2016 • Accessible information and advice for carers. • Offer Adult Carer Support Plan or Young Carers Statement. • Adult carers and young carers to be involved in service planning. • Support and involvement of carers at point of hospital discharge. • Development of local adult carer and young carers strategies. • Development of Short Breaks Service Statement. Care Reform (Scotland) Act 2025 • Unpaid carers have a legal right to take breaks from caring. • Local authorities must promote financial and other support for carers. • Section 14 formally recognises carers of people in residential care. Residents can nominate an Essential Care Supporter; someone they can stay in contact with, who can support with decisions about their health and care (known as Anne’s Law). National Carers Strategy (2022) The Strategy is built around five key pillars that aim to support unpaid carers in a holistic and sustainable way. These pillars reflect the lived experiences of carers and are designed to ensure that carers are recognised, supported, and empowered. 1. Living with COVID-19 2. Valuing, recognising, and supporting carers. 3. Health and Social Care Support 4. Social and financial inclusion 5. Young Carers 45
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14 Social Care (Self-directed Support) (Scotland) Act 2016 If you are classed as having eligible needs as a carer, your council must provide support to you. Your local council must also consider whether breaks from caring should be part of the support you receive. If you are eligible for support, this should be done in a way that gives you as much choice and control as you would like. Equal Partners in Care (EPiC) EPiC is a learning resource for health and social care staff. It aims to help staff identify carers, improve carer outcomes, and make a positive difference to their lives. Scotland’s Public Service Reform Strategy The Public Service Reform Strategy sets out commitments to change the system of public services to be preventative, to better join up and to be efficient to better deliver for people. It sets out how we will tackle systemic barriers to change. Carers’ Charter The Carers Charter sets out the rights of carers in or under the Carers (Scotland) Act 2016. Local Policy North Ayrshire Health and Social Care Partnership (HSCP) Strategic Plan 2026-2030 The HSCP Strategy notes a growing reliance on unpaid carers, attributing this to an aging population in North Ayrshire, healthcare pressures, and economic conditions. Priorities include community services and a whole person approach, both of which are reflected in the Carers Strategy, ensuring carers are supported to live well, with access to appropriate and effective community services, while respecting and promoting individual needs and differences. 46
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15 North Ayrshire Alcohol and Drug Partnership (ADP) Strategy 2025-2028 References the importance of providing support to family members and carers of people who have substance use issues in their strategic plan. Supporting someone who has an issue with alcohol and drugs can have a significant impact on the wider family and the ADP are committed to ensuring support for families and carers is accessible to people in North Ayrshire. Local Housing Strategy Shared priorities include improved mental and physical health and wellbeing, provision of early and effective support, maintaining independent living, reducing loneliness and isolation, adaptable housing, and care and support. This housing strategy aims to make it easier for everyone to get involved, especially groups who are often hard to reach such as unpaid carers. What's Next for Learning Disability Services in North Ayrshire Two of the main themes in this report relate to connecting with people and independence. By ensuring carers are supported to take breaks from their caring responsibilities, our Strategy links to these themes by establishing scenarios where the cared for person can develop their independence and social interaction without the unpaid carer, benefiting both. Customer Connections Strategy North Ayrshire Councils Housing Services ‘Customer Connections Strategy’ aims to make sure all tenants and residents in North Ayrshire have the chance to be informed and take part in decisions, policy changes and service designs that affect their lives. 47
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16 What we have achieved 2023-2025 Our interim Carers Strategy ‘Building Caring Communities’ was in place 2023 to 2025 and aimed to develop a more effective model for identifying and supporting more carers across North Ayrshire. Through collaboration with carers, Carers Gateway North Ayrshire, and partners we worked to improve access to information, co-develop services, and invested in practical tools that responded to young and adult carers needs. Detailed below are the seven priorities for 2023 to 2025. More information on what has been achieved can be found in our Carers Strategy Progress Report. 48
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17 A Promise to Identify, Inform, Involve and Support Our Carers Strategy is built around four interconnected pillars shaped through direct consultation with carers that reflect their lived experiences and the values that underpin our approach. These pillars provide a clear framework for action, ensuring that carers are identified and recognised for their caring role, informed of their rights and supported with clear concise information, involved in the planning and design of services that affect them or the individual they care for, and are supported at every stage of their caring journey. Each pillar is rooted in our commitment to early identification and intervention, co-production, and continuous improvement to enable carers to continue in their caring role if able and willing, without compromising their own aspirations or quality of life. 49
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18 Pillar 1 Identify – “Carers will be identified at the earliest opportunity”. Early identification is critical to ensuring carers receive timely support. We are committed to embedding a consistent and initiative- taking approach across all services, working in partnership with health, social care, education, council, and community organisations. By recognising carers early, we can reduce critical situations and improve outcomes for both carers and the people they support. We will achieve this by: 1. Working with carers, partners and using digital platforms like Carers Gateway digital self-help portal to equip primary care professionals, GP’s, dentists and community nurses with tools and resources to identify carers at the earliest opportunity. 2. Invest in building workforce capacity through learning opportunities like the Equal Partners in Care (EPiC) resource, targeting professionals across health and social care, local authority, primary care, third sector and community services. 3. Expand and promote the Carers Support Worker (health) role in community hospital across North Ayrshire to identify carers, provide tailored carers advice and support them through the hospital discharge process. 4. Adopt outreach approach to identify, engage, and support carers from underrepresented communities, including ethnic minorities, LGBTQ+ individuals and individuals from Gypsy/Traveller communities ensuring equitable access to services. 5. Work closely with carers and partners in care homes, supported living for individuals with learning disabilities and sheltered housing to identify carers facing additional barriers to accessing support. 6. Use social media and digital tools to run targeted campaigns that encourage self-identification, reduce stigma, and promote available support and resources. “I did not realise I was a carer because I saw myself just as a daughter and you just do what you need to. People expect you do it, including professionals. At crisis point, I did not know where to turn so I went to the carers service who helped me to find the information and support I needed.” 50
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19 Pillar 2 Inform - “Carers will be provided with the right information at the right time”. Access to clear, accurate, and timely information empowers carers to make informed decisions and navigate available support. This pillar focuses on improving the visibility and accessibility of information about carers’ rights, entitlements, and services ensuring no carer is left unaware of the help available to them. We will achieve this by: 1. Ensuring carers receive timely, relevant, and personalised information through Carers Gateway North Ayrshire, extended service hours (8am to 8pm, 7 days a week), and tailored resources at key transition points in their caring journey. 2. Providing accurate online digital carer information on North Ayrshire Health and Social Care Partnership website, Carers Gateway’s North Ayrshire website and Carers Gateway North Ayrshire self-help portal. 3. Promoting Carers Rights and entitlements through workshops, training opportunities and targeted materials that raise awareness of their rights under the Carers (Scotland) Act, the Carers Charter and during medical and hospital interactions. 4. Partner with Money Smart and other partners to improve carers access to financial advice, benefits information, and practical support to reduce financial pressures on carers and those they support. 5. Work with local organisations and use trusted spaces like libraries, schools and community spaces to promote carer awareness, deliver support, and expand peer support opportunities including “lunch and learn” sessions and the Carers Champions Boards for both adult and young carers. 6. Identify carers who face digital barriers and provide access to devices, skills training, and online resources to ensure equitable access to information and support. “You get directed to look things up for yourself and you get exhausted trying to navigate around the system. It is worse now that everything is digital and automated. There is a lack of accountability and compassion. You feel like you are part of a business process.” “Rebranding “carers” so they are valued. Most things we found out ourselves. From diagnosis there was no pathway to help. We were just given a load of printouts which was not helpful.” 51
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20 Pillar 3 Involve - “Carers and the individuals they support work together with professionals and services, rather than having decisions made for them”. We believe carers should be equal partners in care. This means involving them in planning and decision-making, and ensuring they have the tools, training, and flexibility to manage their caring role while maintaining their own wellbeing. Co-production and person- centred approaches are central to this pillar. We will achieve this by: 1. Strengthening carer involvement in service design and decision-making enabling carers to actively shape services through the Carers Champions Boards, commissioning processes, and structured feedback mechanisms. Ensure carers voices influence planning, delivery, and evaluation of services. 2. Support carers to engage in care planning conversations, including during hospital stays and discharge. Promote the use of Adult Carer Support Plans and Young Carer Statements to ensure carers are recognised and involved in decisions affecting their own health and wellbeing and the individual they support. 3. Implement an engagement plan that reflects carers diverse circumstances and backgrounds offering accessible, culturally sensitive, and flexible opportunities for involvement beyond traditional formats. 4. Provide training, peer support and timely information to carer representatives involved in forums such as the Integrated Joint Board and Carers Champions Boards, enabling confident and informed participation. 5. Work with North Ayrshire advocacy service and use digital tools such as Carers Gateways self-help portal, social media to amplify carers voices, promote opportunities for involvement and ensure carers are supported to express their views and influence service development. When mum could still make decisions, we made them together and I would go to appointments with her to make sure she would ask the right questions and get the right advice. Once she had dementia and I had Power of Attorney (POA), that opened a whole different scenario. I do not think people realise how much is involved [in POA/guardianship] and it can be difficult to make the right decisions on their behalf. 52
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21 Pillar 4 Support - “Carers are supported to lead a healthy and fulfilling life”. Caring should not come at the cost of a carer’s own health, aspirations, or quality of life. This pillar is about building a culture that values and sustains carers through access to breaks, emotional support, financial advice, and opportunities for personal development. We aim to create a system that supports carers to thrive, not just cope. We will achieve this by: 1. Promoting and increasing the uptake of Adult Carer Support Plans and Young Carer Statements to ensure carers receive personalised tailored support meaningful to them which is aligned with the local carers’ eligibility criteria. 2. Working with partners to create safe spaces for carers to discuss emotional health and wellbeing concerns, access counselling, and emotional support during and after caring roles end. 3. Work with carers and partners to improve access to routine health checks for carers and explore opportunities that help carers to maintain their own health, physical and mental wellbeing. 4. Partner with local businesses and communities to support carers in gaining, maintaining, or returning to employment. Promote the Carer Positive initiative to raise awareness of carers value in the workforce. 5. Develop and improve in partnership with carers and the individuals they support, day support and respite services. Identify barriers to accessing breaks and promote social inclusion through group activities and wellbeing initiatives. Align with the Care Reform (Scotland) Act to support carers right to regular, sufficient breaks. 6. Create coordinated pathways to identify critical concerns in caring situations, build service capacity to respond, and use feedback and data to continuously improve support services for carers. 7. Work with carers and partners to develop a toolkit to support future and emergency plans to reduce stress during unexpected events. “I feel I can contact my social worker any time. The support I get I have built up with other unpaid carers over the years. I have been able to build community connections, but it has taken years. I was never offered any emotional or mental health support and was labelled as being overanxious, not looking at the reasons for it. For the first time in all the years I have been caring, I have been able to engage with an intergenerational group which allows me to go out and make a difference within my community. It has made me realise I need to take time back for myself.” 53
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22 North Ayrshire Young Carers Young carers may have different challenges or support needs compared to adult carers. This part of the strategy focuses on young carers in North Ayrshire to make sure their needs, rights and experiences are properly understood and supported. It also follows national legislation and policies. Young carers often need to look after someone while also going to school, making friends and growing up. Without the right help and information, they can feel lonely, fall behind in school, or struggle with their own mental and physical health. The Carers (Scotland) Act 2016 says young carers should get the right support through a Young Carers Statement. This helps make sure their voices are heard, and their needs are not forgotten in general carer plans. It also means support services should be designed with young carers in mind. A Jargon Buster for young carers was developed to help young people understand some of the key points that matter to them within the Carer (Scotland) Act 2016. Who is a young carer? Some children or young people start caring at an early age and do not really realise they are young carers. Other young people may become young carers overnight. 54
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23 Tasks a young carer could do. A young carer might do one or more of the following things, which can have a big impact on their lives. They help with these tasks because of someone’s illness or disability. Domestic This might be things like cooking, cleaning, laundry, shopping, looking after siblings, or paying bills. Emotional This can be things like spending time with the person they care for, keeping them company, keeping them safe or helping them when they feel low, or communicating for the person they support. Personal Care You might help the person you care for wash and shower, use the toilet, shave, or brush their teeth and hair. 55
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24 Local and national support for young carers Carers Gateway North Ayrshire offer a wide range of support for young carers to help them balance their caring responsibilities with their own wellbeing, education, and personal development. Here is a summary of the key support available: → Emotional and practical support → Support in education → Digital and financial support → Transitions and future planning → Breaks from caring → Peer support, social and recreational opportunities Further national support across Scotland which young carer may be able to access: Young Carers Grant: a yearly payment of £390.25 for young carers aged 16 to19 years old who provide care for an average of sixteen hours per week over at least three months. Young Carers Package – Young Scot is part of the Scottish Government’s commitment to recognising and supporting young carers. ARC Compass – A Guide Through Transitions is a powerful, free online tool designed to support young people with additional support needs, their families, and professionals through the transition to adult life in Scotland. Young Carers Scotland – Carers Trust provides policy, practice, and direct support for young carers, including research, toolkits, and links to local services. Scottish Young Carers Services Alliance is a national network that brings together all young carer initiatives across Scotland. Its goal is to share information and best practice, provide support and coordination and strengthen the quality and consistency of services for young carers. 56
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25 Young Carers across North Ayrshire In 2025 Carers Gateway North Ayrshire and North Ayrshire Council Education Services reported approximately 650 young carers identified across North Ayrshire. There are around 29,000 young carers in Scotland under the age of 18 years old and the real number might be even higher, because not everyone who helps care for someone is known or getting support. Research from Carers Trust Scotland says that one in five school aged children could have caring responsibilities. North Ayrshire’s identified young carers represent a small but significant portion of this population, highlighting the importance of continued local investment in support and recognition for young carers. Between October 2022 and March 2023, the number of young carers identified in schools went up by 50%. This shows that schools are getting better at spotting young carers and helping them get the support they need. 57
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26 In the same reporting period: • the number of Young Carers Statements offered to young carers more than trebled compared to previous years. • enhanced collaboration between education, health and social care partnership and Carers Gateway North Ayrshire showed a direct result in growth. • ongoing efforts to raise awareness and embed carer identification into routine practice also contributed to continued growth beyond 2023. Between April 2024 and March 2025, a total of 363 Young Carers Statements were completed via Education and Carers Gateway North Ayrshire staff. 58
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27 These results show how important it is to have everyone working together to identify and support young carers. It means young carers needs are noticed early, and they can get the help they deserve. Young carers do something important they help look after someone in their family who might have a physical or mental health condition, a disability, need support to communicate or have problems with alcohol or drugs. Many young carers say they feel close to their families and proud of what they do. But caring can also be tough, it can affect young carers own health and wellbeing, impact how well they do at school, or how easy it is to spend time with friends, being able to achieve at college or university, taking on a job or just having time to be by themselves. 59
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28 Why should we identify, inform, involve, and support young carers: The main strategy supports both young and adult carers, but we recognise that young carers may have unique needs or levels of support to allow them to be children and young people first and foremost. Young carers should receive age-appropriate information about their rights and services available to support them, and have their voices included in service design and care planning. They also should have access to practical and emotional support to help maintain their own health and wellbeing, stay in education or work and to reach their full potential the same as their peers. 60
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29 Pillar 1 Identify – Young Carers will be identified at the earliest opportunity. Identifying and recognising young carers at the earliest possible stage in their caring journey helps to improve their health, wellbeing and overall life chances and opportunities. By recognising young carers promptly, we can provide timely and appropriate information and support that enables them to thrive both in their caring role, if able and willing and as children and young people first and foremost. We aim to: 1. Expand training opportunities for education, health and social care staff and community groups to help them recognise how to identify young carers earlier. 2. Raise awareness through campaigns, events, and social media, including promotion of Carers Gateway North Ayrshire young carers self-help portal. 3. Develop resources with young carers for youth or community groups to identify and support young carers in informal settings. 4. Encourage schools, services, colleges and community partners to sign the Young Carers Covenant. 5. Promote and support schools across North Ayrshire to take on the Young Carers Challenge Scotland. 6. Work with Carers Champions within schools to create safe pathways for young carers to disclose their caring roles and access personalised tailored information and support. 7. Work with health professionals to identify young carers during routine appointments like routine vaccinations or school nurse visits. 61
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30 Pillar 2 Inform - Young Carers will be provided with the right information at the right time. To ensure that all young carers are provided with timely, accessible, and age-appropriate information that empowers them to understand their rights, access support, and make informed decisions. Ensuring young carers have the right information to support their health and wellbeing, education, and personal development. We aim to: 1. Ensure information is accessible and age appropriate to all young carers, including those with additional needs or language barriers (e.g. visual, translated, digital or one to one format). 2. Co-develop with young carers a clear, age-appropriate Young Carers Information Pack using plain language and offer regular feedback opportunities. 3. Provide learning sessions for staff to share information at key transition points (e.g. school changes, family circumstances, moving to college or work). 4. Create a parent/family resource to help families understand the importance of identifying and supporting young carers. 5. Involve young carers in shaping how information is shared, using multiple formats including the Carers Gateway North Ayrshire young carers self-help portal. 6. Develop resources to help young carers understand the roles of professionals and services that support them. 7. Work with schools, colleges, universities, and employers to work on pathways to ensure young carers are identified early, provided with the right information, and supported to succeed. 62
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31 Pillar 3 Involve – “Young Carers and the individuals they support work together with professionals and services, rather than having decisions made for them”. It is important to listen and value young carers' experiences and involve them to create positive change for their own caring roles and the services which are delivered to them and the individuals they support. We aim to: 1. Develop training and awareness opportunities to help young carers build confidence and self-advocacy skills. 2. Increase uptake of Young Carers Statements, encouraging young carers to set their own goals and priorities. 3. Champion peer-led initiatives like the Young Carers Champions Board or National Young Carers Festival to amplify young carers voices ensuring diverse voices are heard including young carers from minority ethnic groups, LGBTQ+ communities and young carers with their own disabilities or health needs. 4. Co-design pathways with young carers and partners to help them to participate in decisions affecting their own mental health and wellbeing. 5. Co-design resources and awareness campaigns with partners and young carers, using their lived experience to drive change. 63
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32 Pillar 4 Support - “Young Carers are supported to lead a healthy and fulfilling life”. Offering support at the right time means young carers can be supported to look after their own health and wellbeing. They can also access appropriate breaks from their caring role and look at opportunities to enhance practical life skills and training opportunities to achieve in education, employment or to be supported to have their voices heard. We aim to: 1. Partner with schools, youth, and community groups to help young carers access social activities, events, and access local support. 2. Create pathways for timely specialist support for young carers with health and social care teams, education, and partners. 3. Develop opportunities for young carers to engage in activities that support their own physical and mental wellbeing. 4. Develop and expand access to one-to-one support, peer support groups, social activities, and residential trips, removing barriers to participation for young carers. 5. Collaborate with partners to promote the offer and completion of Young Carers Statement to identify individual support needs. 6. Raise awareness of financial support options available to young carers like the Young Carers Grant, Independent Living Fund and Young Scot Young Carers Package. 7. Promote access to short breaks through Carers Gateway North Ayrshire, Young Carers Education Fund and the use of community supports. 8. Create clear referral pathways between young carers and young adult/ adult carer services, with tailored support for young carers moving into adulthood. This includes transition workshops focused on life skills, education, and employment. 64
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33 Supporting young carers in transition to adulthood The transition from adolescence to adulthood is a significant period of change, often accompanied by important decisions about education, employment, and personal development. For young carers, transition can be particularly complex as they balance their own aspirations with ongoing caring responsibilities. We are committed to ensuring that young carers approaching adulthood are not left to navigate this journey alone. Through the Young Adult Carer Service, delivered via Carers Gateway North Ayrshire, we provide tailored support to help young carers plan for their future while continuing to care for those who matter most to them. How Carers Gateway North Ayrshire can help: One-to-one support, to talk through personal goals and challenges with someone who understands the caring experience. Peer Support, to connect with other young adult carers, share experiences and build confidence in a safe and supportive environment. Help with your next steps, transition from Young Carers Statement to an Adult Carer Support Plan, support with college or university applications or exploring financial supports like Young Carers Transition Voucher, Young Carers Grant or Carers Support Payment. Ongoing advice and signposting, whether it is education, work, or just life skills to support young adult carers in building a positive and sustainable future. 65
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34 Support for former carers Caring can be a deeply meaningful part of life, but roles often change or end due to recovery, health changes, or bereavement. These transitions can leave former carers facing emotional, practical, or financial challenges. Support is available to help former carers rediscover their identity, rebuild confidence, and connect with others. Opportunities like peer support, volunteering, and involvement in forums such as the Carers Champion Boards can foster healing and reduce isolation. Former carers are encouraged to reconnect with their communities. Carers Gateway North Ayrshire, The Ayrshire Community Trust (TACT), and Arran Community & Voluntary Service (ACVS) can all help to explore volunteering opportunities. Carers Gateway North Ayrshire offers up to two years of post-caring support, including counselling referrals, financial and housing guidance, and help accessing education, training, or employment opportunities. Additional resources available locally and nationally include: • NHS Scotland – Anticipatory and Advance Care Planning • Healing Hearts Bereavement Group – Support in Irvine and Kilwinning • Breathing Space – Free, confidential support for those feeling low or anxious • Macmillan Cancer Support – Help for people affected by cancer. No matter what stage you are at in your caring journey, support is here to help you take the next steps with confidence and connections. 66
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35 Monitor and Review Keeping track of this Strategy is just as important as setting its goals. It helps make sure we are staying on the right path and are accountable to the carers we support. Publishing the Strategy is not the end, we will keep working to improve and find new, creative ways to support carers. We see this Strategy as a flexible, living document that will guide our work over the next three years. It can be updated to reflect changes in policy, law, or technology. The Health and Social Care Partnership Carers Team is responsible for reviewing and monitoring the Strategy. The Action Plan will be conducted in partnership with Carers Gateway North Ayrshire, carers, and other relevant partners. We will regularly check progress and share updates with carers and partners through groups like the Carers Champions Boards and the Integrated Joint Board. Complaints, Compliments and Comments You can make a complaint or pass on compliments and comments about this strategy by emailing the Carers Team. You can comment, make a complaint, or pass on compliments about the North Ayrshire Health and Social Care Partnership or North Ayrshire Integration Joint Board policies, decisions or decision making processes by visiting our complaints, compliments and comments page. You can also do so by: Speaking to a member of staff at your local Health and Social Care Partnership office Calling: 01294 317700 Writing to: Chief Officer, North Ayrshire Health and Social Care Integration Joint Board, 5th Floor West, Cunninghame House, Irvine, KA12 8EE 67
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‘Together We Care’ Carers Strategy 2026 - 2029 - Delivery Plan Pillar 1 - Identify Objectives Actions Expected Outcomes Assigned to Date Equip Primary Care and health professionals to identify carers earlier. • Promote use of Carers Gateway digital self-help portal. • Deliver awareness sessions to GPs, dentists, and community nurses and hospital staff. • Share tools and resources via digital platforms. -Improved carer identification in primary care settings. - Health professionals are better informed and more confident in identifying and referring carers. - Carers and professionals have easier access to helpful resources and information. HSCP Project Delivery Officer, Carers Gateway and NHS & Primary Care Increase awareness and understanding of carers' roles among professionals and build workforce capacity by embedding EPiC learning. • Promote Equal Partners in Care (EPiC) resource. • Facilitate learning sessions across sectors. • Embed EPiC in induction for staff. - Professionals have a better understanding of carers' needs and rights. - EPiC becomes a standard part of staff training and development. - Improved identification and support for carers across services. - Stronger partnerships between carers and professionals. HSCP Learning & Development Team, Carers Development Officer, Carers Gateway Promote and embed the role Carers Support Worker in community hospitals to support carers during hospital stay and discharge planning. • Monitor carer engagement and discharge support -Carers receive timely information, advice, and support during transitions. -More carers supported during hospital admission/ discharge and reduced readmissions, delayed discharge and improved outcome for all. HSCP Carers Development Officer, Carers Gateway, Hospital Discharge Teams. 68
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Gather and analyse feedback from carers and professionals to refine identification methods and outreach. • Gather feedback from carers and professionals through surveys, interviews, and focus groups etc. • Analyse the feedback to identify strengths, gaps, and areas for improvement. • Update identification methods and outreach strategies based on findings. • Share insights and improvements with relevant teams and partners. -More carers are identified earlier and receive timely support. -Outreach becomes more targeted and effective. -Carers feel heard and valued. -Professionals are better equipped to recognise and support carers. HSCP Carers Development Officer, HSCP Project Delivery Officer, Carers Gateway. Ensure carer support is inclusive and accessible to diverse communities. • Develop outreach strategies with community groups co-design materials with ethnic minority, LGBTQ+, and Gypsy/Traveller communities. • Deliver targeted engagement and activities/ events. - Increased awareness and access to support among underrepresented communities. - Stronger relationships between services and diverse groups. - More carers from minority backgrounds feel recognised and supported. - Improved inclusivity in service design and delivery. Carers Project Officer/ Carers Gateway, ESOL, MECOPP. Identify carers in supported living and care settings • Engage with care homes, supported living and sheltered housing • Identify carers facing access barriers • Provide tailored information, advice and signposting - More carers in supported living and care settings are identified and supported. - Carers receive relevant and accessible information. - Reduced isolation and improved wellbeing for carers facing access barriers. - Stronger partnerships with supported living partners and care providers. Carers Development Officer, Carers Gateway, Leads for care homes, supported living & sheltered housing. 69
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Run social media awareness campaigns encouraging self- identification and reducing stigma. • Run targeted social media campaigns to reach carers and the wider community. • Share real-life carer stories and clear pathways to support to build trust and understanding. • Monitor engagement (likes, shares, comments, reach) and adjust messaging to improve impact. - Greater visibility of carer support services. - Increased engagement from carers and communities. - More carers accessing support through digital platforms. - Improved messaging based on audience feedback and data. Carers Gateway, HSCP Communication Officer, Project Delivery Officer. Pillar 2 - Inform Objectives Actions Expected Outcomes Assigned to Date Make carer support more accessible and responsive to key life events. • Extend Carers Gateway North Ayrshire service hours (8am–8pm, 7 days) • Develop tailored resources for key transition points (e.g. diagnosis, hospital discharge, bereavement) - Carers can access support when they need it, including evenings and weekends (supporting working carers). - Carers feel better prepared and supported during major life changes. - Increased satisfaction and engagement with Carers Gateway services. HSCP Carers Development Officer, Carers Gateway. Ensure carer information is accurate, accessible, and up to date across digital platforms. • Audit and update carer content on HSCP, Carers Gateway websites & Self- Help Portal • Maintain and promote Carers Gateway North Ayrshires self-help portal - Content reflects current policies, services, and resources, reducing misinformation. - More carers use the websites and portal due to improved usability. HSCP Carers Project Officer, HSCP Communication Officer, Carers Gateway. 70
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More carers know about the portal through targeted promotion campaigns. Increase understanding of carers’ rights among professionals and carers. • Deliver workshops and training sessions on Carers Rights and the Carers Charter across sectors. • Design and distribute targeted materials for health settings (e.g. GP surgeries, hospitals, dental practices). - Professionals are more aware of carers’ rights and responsibilities. - Carers feel more informed and empowered. - Increased recognition and support for carers in health settings. - Consistent messaging about carers’ rights across services. HSCP Carers Project Officer, Carers Gateway. Improve access to financial advice and benefits support for carers. • Partner with Money Smart to deliver tailored benefits advice and financial guidance to carers. • Promote financial support services through Carers Gateway and community outreach. • Ensure carers are aware of available resources and how to access them. - Carers feel more confident managing finances and accessing benefits. - Increased uptake of financial support services. - Reduced financial stress among carers. - Stronger partnerships between financial support services and carer networks. Carers Gateway, HSCP Money Smart. Raise awareness of carer support and strengthen community connections. • Use libraries, schools, and community spaces to host carer-focused events and drop-ins. • Deliver informal “lunch and learn” “Tea and Talk” sessions for professionals and community members to Increased visibility of carer support in local communities. - Greater understanding of carers’ roles among professionals and the public. - Stronger HSCP Carers Development Officer, Carers Gateway. 71
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increase understanding of carers’ needs. • Support and promote Carers Champion Boards for both adult and young carers to ensure their voices are heard. representation of carers in decision-making. - More carers accessing support through trusted community spaces. Ensure carers with limited digital access can benefit from online resources and support. • Identify carers who face barriers to using digital tools (e.g. no device, internet access, or digital skills). • Look at alternative funding and opportunities to provide devices such as tablets or laptops where needed. • Offer digital skills training and ongoing support to help carers confidently use online resources like the Carers Gateway self-help portal. - More carers can access digital support and information. - Increased confidence and independence in using online tools. - Reduced digital exclusion among carers. - Improved access to services and resources for all carers. HSCP Project Delivery Officer, Carers Gateway. Pillar 3 - Involve Objectives Actions Expected Outcomes Assigned to Date Strengthen carer involvement in service design and decision-making • Support carers to actively participate in Carers Champion Boards and commissioning processes. • Develop structured feedback methods such as surveys, focus groups, and listening events. • Use carer feedback to inform planning, service delivery, and evaluation. - Carers feel heard, valued, and involved in decision-making. - Services better reflect the real needs and experiences of carers. - Stronger partnerships between carers and professionals. - Continuous improvement based on lived experience. HSCP Carers Development Officer, HSCP Engagement Team, Carers Gateway. 72
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Ensure carers are recognised, involved, and supported in care planning and hospital processes. • Promote the use of Adult Carer Support Plans and Young Carer Statements to identify needs and provide tailored support. • Involve carers during hospital stays and discharge planning to ensure continuity of care. • Train staff to recognise carers and include them in care discussions and decisions. -Carers feel valued and included in care processes. - Improved communication and planning between carers and professionals. - Increased uptake of support plans and statements. - Better outcomes for both carers and the people they support. HSCP Carers Support Worker (SWA), Carers Gateway. Ensure carers from all backgrounds feel included and have opportunities to engage meaningfully. • Develop an engagement plan that reflects the needs and experiences of carers from ethnic minority, LGBTQ+, and Gypsy/Traveller communities. • Offer culturally sensitive and flexible ways to get involved, such as online and in-person sessions, multilingual materials, and trusted community-led approaches. - Increased participation from underrepresented carer groups. - Carers feel respected, understood, and included. - Services are shaped by a wider range of voices and experiences. - Improved equity in access to support and decision-making. HSCP Carers Development Officer, HSCP Engagement Team, Carers Gateway, ESOL, MECOPP. Empower carer representatives to confidently participate in decision- making forums. • Provide training and peer support opportunities for carer reps to build skills and confidence. • Share timely and accessible information ahead of meetings (e.g. IJB, Carers Champions Boards). • Offer ongoing support and check-ins to ensure reps feel prepared and valued. - Carer reps feel confident and well- informed. - Increased and meaningful participation in strategic forums. - Stronger representation of carer voice in planning and decision-making. - Improved outcomes through lived experience input. HSCP Carers Development Officer/Carers Gateway. 73
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Empower carers to express their views and influence services. • Partner with North Ayrshire Advocacy Service to support carers in speaking up and being heard. • Use the Carers Gateway portal and social media to promote opportunities for carers to get involved. • Provide guidance and support to help carers share their views and take part in shaping services. - More carers actively involved in service design and decision- making. - Increased awareness of advocacy and involvement opportunities. - Carers feel confident and supported to express their views. - Services better reflect the needs and experiences of carers. HSCP Project Officer, Carers Gateway, VoiceAbility. Pillar 4 - Support Objectives Actions Expected Outcome Assigned to Date Increase uptake of Adult Carer Support Plans and Young Carer Statements. • Promote awareness of personalised support options through Carers Gateway and partner networks. • Training opportunities for staff to confidently offer and complete Adult Carer Support Plans and Young Carer Statements. • Monitor uptake of plans/statements and evaluate outcomes to inform future improvements. - More carers access personalised support tailored to their needs. - Staff feel confident and equipped to offer and deliver support planning. - Improved wellbeing and outcomes for carers. - Data driven improvements to service delivery. HSCP Project Officer, HSCP Carers Support Worker (SWA), Carers Gateway. 74
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Improve emotional wellbeing support for carers during and after their caring role. • Partner with counselling services to offer support that reflects carers’ unique challenges. • Set up peer-led wellbeing groups to create safe spaces for carers to connect and share. • Promote emotional health resources through Carers Gateway, social media, and community networks. • Engage with and promote trauma-informed approaches across services. - Carers feel emotionally supported and less isolated. - Increased access to counselling and peer support. - Greater awareness and use of emotional wellbeing resources. - Services are more sensitive to the impact of trauma and caring responsibilities. HSCP Learning and Development Team, Carers Gateway. Enhance carers’ health, wellbeing, and access to support through collaborative and flexible approaches. • Partner with health services to deliver routine health checks • Promote physical and mental wellbeing initiatives (e.g. stress management, peer support, access to health and wellbeing opportunities) • Pilot flexible access options (e.g. evening/weekend services, virtual and mobile outreach) - Improved health awareness and early intervention for carers. - Increased engagement in wellbeing activities, to reduce isolation and increase health and wellbeing. - Greater accessibility and uptake of flexible support services. HSCP Carers Development Officer, Carers Gateway. Support carers in employment and promote Carer Positive • Partner with local businesses to raise awareness of carers need. • Promote flexible working and return-to-work support for carers. • Encourage uptake of Carer Positive accreditation. - Increased employer awareness and engagement. - More carers supported to remain in or return to work. - Growth in Carer Positive accredited organisations. HSCP Carers Development Officer, NAC HR, Carers Gateway. 75
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Empower carers through inclusive, co-designed support and improved access to meaningful breaks, wellbeing activities, and day services. • Co-design services with carers and those they support. • Identify and address barriers to accessing breaks. • Promote inclusive group activities and wellbeing initiatives. • Explore access to day support, respite services and use of Self-directed Support. - Services better aligned with carers’ needs and those they support. - Increased access to and uptake of breaks from caring. - Enhanced social connection and wellbeing among carers. HSCP Carers Development Officer, Carers Gateway. Strengthen carer support through proactive risk identification, responsive services, and continuous improvement. • Identify high-risk caring situations. • Build service capacity to respond. • Use feedback and data to improve services. Earlier intervention in complex or crisis situations. - More responsive and resilient support systems. - Data-informed service improvements aligned with carers’ needs. HSCP Carers Development Officer, Carers Gateway, HSCP Services. Create toolkit for future and emergency planning • Co-design future and emergency planning toolkit with carers and partners. • Include practical guidance and digital resources. • Promote through Carers Gateway North Ayrshire and community networks. - Toolkit reflects real needs and experiences of carers across North Ayrshire. - Increased awareness and confidence in accessing support. - Wider reach for carers through Carers Gateway and community networks. HSCP Project Officer, Carers Gateway. 76
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Young Carers Delivery Plan Pillar 1 - Identify Young Carers Objectives Actions Expected Outcome Assigned to Date Increase awareness and engagement among young carers through co-designed resources and targeted outreach. • Engage young carers in resource content and design • Distribute materials to youth clubs, sports groups, and community hubs *Youth and community groups better equipped to identify and support young carers *Increased visibility and support in informal community settings. HSCP Project Officer, Carers Gateway, NAC Youth Services. Encourage and support sign-up to the Young Carers Covenant. • Promote the Young Carers Covenant to schools, colleges, local supports and services. • Provide guidance and support for implementation *More organisations committed to supporting young carers *Consistent standards of support Carers Gateway, Education. Promote and support the Young Carers Challenge in schools. • Support schools to deliver the Challenge • Celebrate achievements through events and recognition *Increased engagement and awareness in schools *Empowered young carers Carers Gateway, Education. Create safe, supportive environments for young carers through trusted relationships and tailored resources. • Work with Carers Champions in schools to establish safe spaces for young carers to self-identify. • Provide tailored information and support for young carers. - Increased emotional safety and trust - Improved access to relevant personalised support and guidance for young carers. HSCP Carers Development Officer, Carers Gateway, Education. 77
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Improve identification and support for young carers during health appointments. • Provide training/ awareness opportunities for health professionals to recognise young carers. • Embed identification prompts in routine appointments (e.g. vaccinations, nurse visits) - Earlier recognition of young carers. - Increased access to appropriate support. - Stronger relationships and emotional safety for young carers. - Increased identification through health services. - Better integration of support pathways for young carers. HSCP Carers Development Officer Carers Gateway, Primary Care Staff, School Nurses, Education. Pillar 2 - Inform Young Carers Objectives Actions Expected Outcome Assigned to Date Equip young carers with accessible, relevant information through co- designed resources and targeted promotion. • Collaborate with young carers to design content for a Young Carers Information Pack. • Use plain language and include regular feedback. - Resources reflect young carers lived experiences. - Increased awareness and confidence in young carers accessing support. - Increased engagement with support services for young carers. HSCP Project Officer, Carers Gateway, Education, Youth Services. Strengthen staff capacity to support young carers during key life transitions. • Deliver training/ awareness to staff on supporting young carers during transitions (e.g. school changes, family changes, moving to college/work). • Embed carer awareness in transition planning across services. - Improved staff awareness and confidence. - More consistent support for young carers during key life transitions. Carers Development Officer, Carers Gateway, Education, HSCP Services. 78
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Support families of young carers through accessible, co-designed resources and guidance. • Develop materials to help families understand young carers’ roles. • Promote through schools, community, health & social care services, and Carers Gateway. - Increased awareness and understanding among families. - Improved access to relevant support for young carers and families. - Stronger family engagement in young carers’ wellbeing. - Increased. identification and engagement from young carers and families. HSCP Carers Development Officer, Carers Gateway. Help young carers understand and navigate support systems through age-appropriate, role-specific resources. • Create guides to help young carers understand who supports them and how. • Include visuals and plain language. - Increased understanding of who does what in support networks - Greater confidence in seeking help and stronger engagement with professionals and services. - Improved trust in services supporting young carers. HSCP Project Delivery Officer, Carers Gateway. Pillar 3 - Involve Young Carers Objectives Actions Expected Outcome Assigned to Date Strengthen recognition and support for young carers through proactive identification and personalised planning. • Promote the benefits of setting personal goals • Support young carers to complete statements with guidance - More young carers receiving tailored support. - Earlier identification and intervention. - Improved wellbeing for young carers and HSCP Carers Support Worker (SWA), Carers Gateway. 79
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• Monitor uptake and outcomes of Young Carers Statements • Increase the offer and uptake of Young Carers Statements. support in achieving goals to support their own health, wellbeing and life opportunities. Empower young carers by amplifying their voices and fostering peer-led support. • Support participation in Young Carers Champions Board and National Young Carer Festival. • Ensure representation from minority ethnic groups, LGBTQ+ communities, and young carers with disabilities. - Increased confidence and leadership among young carers. - More inclusive and representative support materials for all young carers. - Stronger peer networks and sense of belonging. HSCP Carers Development Officer, Carers Gateway. Improve mental health support for young carers through collaborative design and accessible pathways. • Collaborate and co-design with mental health pathways with young carers and mental health services. • Create accessible pathways for involvement in wellbeing decisions. - Mental health support reflects lived young carers experiences. - Increased trust and engagement with services. - More inclusive and responsive mental health pathways. HSCP Carers Development Officer, Carers Gateway, Mental Health services. Pillar 4 - Support Young Carers Objectives Actions Expected Outcomes Assigned to Dates Develop and enhance wellbeing and social opportunities for young carers through accessible community-based opportunities. • Improve access to social activities and local supports for young carers. • Promote inclusive events and local support services aimed at young carers. - Increased participation in social and community life. - Stronger peer connections and reduced isolation HSCP Carers Development Officer, Carers Gateway. 80
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• Offer physical and mental wellbeing programmes • Include creative, outdoor, and therapeutic activities - young carers will be supported to maintain their own health. *Increased engagement in wellbeing initiatives. Improve financial awareness and access for young carers and their families. • Promote Young Carers Grant, ILF, and Young Scot Package etc. • Provide guidance through schools and Carers Gateway North Ayrshire. - Increased uptake of financial support. - Reduced financial stress for young carers and families. - Better-informed decision-making around available entitlements. HSCP Carers Development Officer, Carers Gateway, Education, Money Smart. Increase awareness, accessibility, and uptake of short breaks and education funds for young carers. • Launch targeted campaigns via social media, schools, GP surgeries, and community hubs to raise awareness of available short breaks. • Deliver short training sessions or briefing packs to professionals (teachers, social workers, health staff) to help them identify and signpost carers. • Offer one-to-one or group- based support sessions to help young carers complete applications for short breaks. - Increased visibility and uptake of short break opportunities and use of education fund. - Young carers can access meaningful breaks from caring responsibilities. HSCP Carers Development Officer, Carers Gateway, Education. Create clear referral pathways between young carers and young adult/ adult carer services, with tailored support for young carers moving into adulthood. This includes transition workshops focused on life skills, education, and employment. • Set up clear referral pathways between young carer and young adult/ adult carer services. • Run transition workshops focused on life skills, education, and employment. *Young carers feel supported and prepared for adulthood. *Increased engagement with young adult and adult carer services. *Improved confidence, wellbeing, and future opportunities for young carers as they transition. HSCP Carers Development Officer, Carers Gateway, Education. 81
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Progress Report ‘Building Caring Communities’ North Ayrshire Carers Strategy 2023-2025 83
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Contents Introduction ..................................................................................................................... 3 Priority 1: Carers are actively sought and identified .................................................... 5 Priority 2: Carers are informed, confident, and supported ........................................... 6 Priority 3: Carers Are Offered and Supported to Prepare Adult Carer Support Plans and Young Carers Statements ........................................................................................ 8 Priority 4 - Promoting variety in breaks from caring ..................................................... 9 Priority 5 - Carers feel involved as equal partners in care design and delivery........ 11 Priority 6 - Stronger partnership working and engagement ....................................... 12 Priority 7 - Improved identification, information, and support for young carers with a focus on transition periods through to adulthood ...................................................... 14 Challenges and lessons learned .................................................................................. 17 Future recommendations .............................................................................................. 18 84
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Introduction In 2023, North Ayrshire Health and Social Care Partnership launched its interim Carers Strategy, ‘Building Caring Communities’, covering the years 2023 to 2025. This strategy showed our commitment to extending our reach to identify more carers across North Ayrshire. We identified seven key priorities to help strengthen carer services, focusing on better information, systems, and support. By working closely with carers, Carers Gateway North Ayrshire (formerly North Ayrshire Carers Centre) and other partners, we aimed to create a more inclusive, flexible, and long-lasting community support system for carers. For consistency, Carers Gateway North Ayrshire will be referred to as Carers Gateway throughout this document. In July 2023 our strategic partner, was awarded the new Carers Service contract with key requirements designed to enhance the provision of information and support for carers across North Ayrshire, while improving accessibility to services. These included but not limited to: • Collaborative working: to work in partnership to achieve the seven strategic priorities and to meet service delivery specifications. • Recruitment and partnerships: increased recruitment efforts and comprehensive partnership mapping to strengthen local networks. • Team expansion: to grow the team by introducing additional outreach and specialist roles to engage more carers, in more places, in more ways. • Continuity of service: ensuring uninterrupted support for carers while expanding service capacity. 85
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• Improved information access: development of clearer information pathways and digital enhancements, including a new information and advice portal. • Extended service hours: expanding service availability to support carers, offering greater flexibility and accessibility to all carers. This report outlines the progress achieved to date and highlights key accomplishments during the lifetime of the strategy. It also examines challenges encountered and lessons learned along the way, providing recommendations to inform the development of our new Carers Strategy “Together We Care”. 86
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Priority 1: Carers are actively sought and identified. As of October 2025, Carers Gateway has registered 1,888 carers aged five years and above. This includes 921 individuals newly identified and registered since June 2023. These figures represent approximately 10% of the 17,222 unpaid carers identified in North Ayrshire through Scotland’s Census 2022. To support this growth, Carers Gateway has expanded its staffing complement from 4.5 to 17 staff members. The strategic deployment of community-based support staff within local communities and educational settings has significantly strengthened carer identification efforts across all six localities: Irvine, Kilwinning, Three Towns, North Coast & Isle of Cumbrae, Garnock Valley, and the Isle of Arran. Over the past two years, Carers Gateway has successfully delivered Carers Roadshows across all six localities, bringing vital information, resources, and support directly to carers in their communities. These events have played a key role in raising awareness of carers' rights and services, while fostering stronger local connections. Future roadshows will be strategically aligned with major community events in each locality. This approach aims to broaden engagement, increase visibility, and ensure that more carers especially those who may not yet be connected to support networks can access the help they need in familiar, welcoming settings. In partnership with English Speakers of Other Languages (ESOL), MECOPP, and support via the Coalition of Carers in Scotland Supporting Ethnically Diverse Carers group, the identification and engagement of hidden carers across North Ayrshire have significantly been strengthened. This includes increased outreach to carers from ethnic minority backgrounds and gypsy/traveller community groups that have historically faced barriers in identifying as carers and accessing support. The launch of the Carers Gateway digital self-help portal has been pivotal in transforming access to information and support for carers. This 24/7 platform empowers carers to explore resources, build personalised support plans, and connect with services at their own pace. Combined with a targeted Google Ads campaign, the portal has reached over 5,107 new carers, with more than 4,000 users accessing information and 4,644 carers creating self-help plans. This marks a significant step forward in identifying hidden carers using digital innovation. 87
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Priority 2: Carers are informed, confident, and supported. A new Carer Information Pack, co-produced with carers, has been developed to provide relevant support and guidance in one accessible resource. This pack reflects the lived experiences of carers and ensures that the information is practical, clear, and meaningful. To further improve accessibility, Carers Gateway information leaflets are now available in multiple formats and languages, including Arabic, Ukrainian, Vietnamese, Kurdish Sorani, and Pashto/Dari supporting carers from diverse backgrounds to access the information and help they need. Social media continues to be a powerful tool for information and engagement, particularly Facebook, with Carers Gateway page now having 1,612 followers, the majority of whom are women aged 35 to 54 years old. This platform has proven highly effective in reaching carers with timely updates, resources, and opportunities for connection. The launch of Carers Gateway’s new website alongside the digital self-help portal has significantly enhanced digital accessibility. These digital platforms offer carers 24/7 access to information, personalised support planning, and a centralised hub for resources, empowering carers to take control of their support journey in a way that suits their needs. Carers Gateway has embedded a dedicated Carer Support Worker (Health) post within Woodland View, Irvine and Lady Margaret Hospital, Millport, ensuring carers are identified and receive timely information and support during key stages of their cared-for person's journey from admission through to discharge planning. In Arran War Memorial Hospital, carers are being supported by the local Carers Gateway Family Carer Support Worker, providing continuity of care and tailored assistance within the community. 88
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This integrated approach strengthens the connection between health services and carer support, ensuring carers are recognised and supported throughout the healthcare experience. Carers Gateway has developed dedicated outreach services across all six localities, ensuring carers are supported within their own communities. This includes: • targeted outreach in schools to identify, inform, and support young carers. • community-based engagement for adult carers, helping to raise awareness, provide information, and connect individuals with the support they need. In addition, Carers Gateway continues to support two constituted carers groups in the Three Towns and North Coast areas, strengthening peer support and local networks. This locality-based approach strengthens visibility, accessibility, and early intervention ensuring carers of all ages are recognised and supported wherever they live in North Ayrshire. In collaboration with Carers Gateway, professionals across multiple services have developed a deeper understanding of caring roles and their impacts, enabling earlier identification of carers and more effective signposting to appropriate support. Additional resources to inform and support carers across North Ayrshire are available including: Carers UK Digital Resource Carers Academy (Dementia support) VoiceAbility (Advocacy) Money Smart (Financial and Welfare advice) 89
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Priority 3: Carers Are Offered and Supported to Prepare Adult Carer Support Plans and Young Carers Statements Since 2018, Adult Carer Support Plans and Young Carer Statements have enabled carers to identify and address their own support needs. In May 2025, an updated Young Carers Statement was launched, with ongoing work to enhance the current Adult Carer Support Plan based on carers feedback due to be launched early 2026. Carers now have flexible options to complete assessments via Health and Social Care Partnership teams, schools, or Carers Gateway, empowering carers to choose the most suitable individual to support them. Annual quality reviews of completed plans ensure evolving needs for carers are being met. For carers supporting someone with a terminal illness, an Adult Carer Support Plan or Young Carer Statement are offered to carers within two days of identification, ensuring timely and compassionate support. The table below shows that the offer and completion of Adult Carer Support Plans and Young Carers Statements has continued to increase between 2023 and 2025. Between 2023 and 2025, North Ayrshire Health and Social Care Partnership provided an additional £70,000 in one-off funding to support carer who completed an Adult Carer Support Plan or Young Carers Statement. This funding enabled carers to: • take a much-needed break from their caring role. • Access life opportunities that improver their overall quality of life. • Access KA Leisure memberships to provide health and wellbeing opportunities. This increase in funding reflects a strong and ongoing commitment to supporting carers health and wellbeing, ensuring more carers can benefit from the help they need at critical moments in their caring journey. We are aware that the Care Reform (Scotland) Act 2025 will bring changes to timescales for the offer and completion of support plans, as well as recognition for carers of those in residential care. The next Carers Strategy will take these changes into account, ensuring the strategy reflects updated national priorities and continues to meet the needs of carers in North Ayrshire. 90
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Priority 4 - Promoting variety in breaks from caring. In North Ayrshire, we believe short breaks should be personalised, creative, and unique to each carer. These breaks are essential in helping carers maintain their wellbeing, recharge, and continue in their roles with confidence and support. In February 2025, we published our updated Short Breaks Services Statement, outlining how carers can access a break from caring and what that might look like both locally and further afield. Through Carers Gateway and Shared Care Scotland’s Time to Live funding, carers now have more opportunities to enjoy life outside of their caring role. These breaks have been vital in sustaining carers’ health and wellbeing and preventing burnout. The impact of this funding, delivered by Carers Gateway, is clear: This growth demonstrates our commitment to making short breaks more inclusive and accessible, ensuring carers across North Ayrshire feel supported in maintaining their own health and wellbeing. A carer applied for Time to Live funding to access a non-UK version of a wireless magic keyboard for their tablet. The carer is a keen writer and having a keyboard in their own language enabled them to use free time from their caring role to write creative stories that are meaningful to them. This has had a positive impact on the carer’s mental health and wellbeing. 91
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Carers Gateway have delivered variety of seasonal activities over the last two years, including residential trips for young carers to the Honey Pot and the Young Carers Annual Festival. Notably, 52 families attended a local pantomime, benefiting 203 individuals with a joyful break from caring. Additional support was provided through: • The Carers Fund (via Carers Trust): Supporting household items, repairs, courses, equipment, driving lessons, and breaks. In the financial year 2024/25, 16 applications by Carers Gateway resulted in over £5,000 additional funding for carers. • North Ayrshire Carers Appreciation Card: With over 1,200 carers signed up and 48 supporting businesses, the card offers discounts and concessions to promote wellbeing and provide everyday breaks from caring. • Carefree: A flexible short breaks initiative offering carers affordable overnight stays across the UK, enabling multiple breaks per year at just £33 per break. Carers Gateway is also proud to deliver Respitality in partnership with Shared Care Scotland. This initiative provides meaningful breaks and wellbeing experiences for carers. To date, several successful events have been delivered: • Taste of History Tickets – Irvine • Scottish Maritime Museum Visit – Irvine • Lunch and Learn Sessions – Riverside, Irvine (focused on Power of Attorney and Guardianship) Plans are underway to expand the Lunch and Learn model with future sessions on topics that matter most to carers. Carers Gateway, in collaboration with Ayrshire College Kilwinning campus, supported carers to participate in a therapy afternoon, combining relaxation with practical support and information about short break opportunities. Adult Carers support groups, and one to one session’s are hosted across all six localities, offering carers a safe and supportive space to share experiences, access peer and professional support, and take a break from their caring role. We remain committed to expanding opportunities for carers to access relevant information, learning, community-based networks, and meaningful breaks that support their wellbeing and resilience. 92
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Priority 5 - Carers feel involved as equal partners in care design and delivery. In North Ayrshire, we believe carers should be included and involved as much as possible in key decisions about their own support and the support of those they care for. We apply the Equal Partners in Care (EPiC) principles across all sectors, ensuring carers of all ages are recognised as equal and active partners in care. These principles promote a shared understanding among professionals of how to work collaboratively with carers. To strengthen the carer voice and influence, two new platforms were established: • Adult Carers Champions Board (February 2025) • Young Carers Champions Board (July 2025) These boards empower carers to shape decisions and services that impact their lives and those they care for, ensuring their experiences are heard and reflected in service design and delivery. Strategic representation is embedded at the highest level, with two Carer Representatives sitting on the Integrated Joint Board (IJB), which oversees the planning and delivery of health and social care services. Their presence ensures carers’ perspectives are considered in decisions that affect local carers and communities, aligning with national outcomes. We continue to invest in meaningful engagement. Carers Gateway’s Carers Conference, first held during Carers Week 2024 at Riverside, Irvine and again in 2025 at Oscars, Saltcoats, brought together over 200 young and adult carers and professionals. These events combined practical workshops and talks with relaxation opportunities, acknowledging both the emotional and practical needs of carers. In partnership with our Mental Health Engagement Officer and clinical teams at Woodland View, we explored carers’ experiences within acute inpatient mental health and addiction settings. The 2024 Carers Survey provided valuable insights into the lived experiences of carers supporting someone with mental ill health. These findings will inform future service redesign and ongoing engagement across NHS Ayrshire and Arran. In response to carer feedback, and in partnership with Carers Gateway and VoiceAbility, we launched the Pan Ayrshire Mental Health Carers Forum. Meeting monthly across community and hospital settings, these sessions offer: • Information and updates • Peer support • Opportunities for carers to be actively involved in service design. This forum strengthens the voice of carers in shaping mental health services and ensures their experiences are central to future improvements. 93
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Responding to carer feedback, we now offer monthly Moving and Handling Information Sessions. These three-hour sessions provide carers with hands-on guidance on equipment and techniques such as profiling beds, hoists, slings, and slide sheets, making caring tasks safer and more manageable. We also worked in partnership with Carers Gateway and education teams to co- deliver consultation sessions across schools with young people and partners. These sessions shaped the updated Young Carers Statement, launched in 2025, ensuring it reflected young carers’ voices and needs. We remain committed to co-producing services with carers, ensuring their voices continue to shape the future of support in North Ayrshire. 94
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Priority 6 - Stronger partnership working and engagement. We continue to promote and encourage effective relationships with carers, professional staff, and partner agencies to achieve better outcomes and opportunities for carers. We have strengthened our presence across all six localities by collaborating with local community groups and partners. Carers Gateway has embedded a wide range of community-based support for both adult and young carers. A summary of what's available across North Ayrshire can be found on Carers Gateway’s website. A Carers Gateway Locality Officer connected with a local lunch group and was able to identify and support carers facing poverty, poor mental health, and isolation. The worker continues to maintain the relationship with these carers through regular visits. The introduction of the Adult and Young Carers Champions Boards builds on this foundation, enhancing partnership working and ensuring carers are central to shaping services and decisions. In 2024, 175 carers responded to a survey exploring health and wellbeing opportunities across all six localities. Key findings included: • 42% of carers identified cost as a barrier to accessing local health and leisure services. In response, we partnered with KA Leisure to offer discounts via the Carers Appreciation Card and secured annual memberships at reduced rates through completion of an Adult Carer Support Plan or Young Carer Statement. We continued to engage with carers through surveys, face-to-face conversations, regular feedback from carer groups, and post-event evaluations (e.g. Roadshows and Carers Conference). This helps us understand what is working well, what needs improvement, and how carers prefer to engage. Recent feedback revealed: • 16% of carers prefer online engagement. • 40% would like access to services in the evening or at weekends. 95
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This highlights the need for extended service hours (8am to 8pm) and more online and out-of-hours events, particularly to support working carers. We ensure carers’ voices are heard at both local and national levels, through promotion and participation in events such as Carers Parliament, Young Carers Festival, and Coalition of Carers meetings. Our collaboration with local GP surgeries has led to increased visibility of carer support, with practices now displaying Carers Gateway posters or hosting carer- specific displays. In 2024, Carers Gateway began reviewing therapies provision for carers, moving away from a centralised model to better align with their locality-based approach. A survey with over 150 responses revealed: • Over one third preferred accessing therapies outside standard office hours. • Nearly two thirds favoured a voucher-based system for flexible appointments. • Most carers preferred accessing therapies within their own locality. In response, Carers Gateway engaged 17 local therapy providers, with 28 more expressing interest. They are now developing robust referral processes to ensure carers can access support in a way that suits their individual needs. Additionally, in partnership with local counsellors, they supported ten carers in 2024 to 2025 to access one-to-one Cognitive Behavioural Therapy (CBT). Referrals are triaged by the counsellor, who then offers up to ten tailored 60-minute sessions. A carer attended a three-day Serenity Life Coaching training course, focused on anxiety management and relationship skills. Delivered in a ‘train-the-trainer’ format, the course not only supported the carer’s personal wellbeing but also equipped them to share knowledge and techniques with other carers in the future. In the carer’s own words: “It was such a refreshing and empowering experience. I not only learned how to manage my own anxiety better, but I now feel confident to help other carers who are going through similar struggles.” In June 2024, in partnership with Carers Gateway, we delivered a dynamic young carers awareness initiative at Arran High School. The programme featured three engaging activity sessions, team-building experiences, and a range of interactive elements designed to celebrate and support young carers in our community. Over 120 young people from the Arran locality participated, making it a vibrant and meaningful event that fostered understanding, connection, and peer support. Since August 2023, young carer registrations with Carers Gateway on Arran have risen dramatically from just one registered young carer to thirty. This growth demonstrates the increasing awareness, trust, and accessibility of available support, and underscores the critical importance of sustained outreach and engagement within the community. 96
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Priority 7 - Improved identification, information, and support for young carers with a focus on transition periods through to adulthood Young Carers information and awareness sessions have been delivered across schools, youth groups and at community events, helping to normalise conversations about caring and reduce stigma. We have worked closely with third sector and voluntary partners to raise awareness and strengthen identification efforts across all six localities in North Ayrshire. These partnerships continue to play a vital role in reaching young carers who may not be visible through traditional or education services. In October 2024, we launched the Young Carers Education Information Pack, providing school staff with clear guidance on how to identify, support and work with young carers. This resource supports a consistent and informed approach across all North Ayrshire schools. In January 2025, North Ayrshire Council and Carers Gateway signed the Young Carers Covenant, committing to outcomes shaped by young people. Twelve schools have already joined, with each school nominating a Young Carers Champion supported by Carers Gateway Young Carer staff, embedding young carer awareness and tailored support into school culture. We are encouraging and supporting schools to participate in the Young Carers in Schools Challenge. These initiatives promote a whole-school approach to identifying and supporting young carers, embedding carer awareness into school culture. In March 2025, Carers Gateway digital self-help portal for young carers was launched. The platform offers 24/7 access to a wide range of resources, information, and support. This digital tool enhances accessibility and ensures young carers can find help whenever they need it and an improved version was launched in August 2025. 97
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Between April 2024 and March 2025, a total of 363 Young Carers Statements were completed via Education and Carers Gateway staff. The graphics below demonstrate the level of support provided to young carers. Additionally, in July 2025, Carers Gateway launched the Young Carers Champions Board, a platform that empowers young carers to share their experiences, raise awareness, and influence decision-makers. This board ensures that young carers have a meaningful voice in shaping the services and policies that affect them. A structured transition pathway has been developed to support young carers as they move through key stages of life, particularly from age 16 onwards. Helping young carers to manage and prepare for changes in their caring role as they approach adulthood. The pathway ensures that changes in life circumstances such as education, employment, home life or caring roles trigger tailored information, advice and support. The improvements for carers throughout the seven priorities reflect a strategic shift toward co-produced, locality-based, and flexible support, ensuring carers are recognised, empowered, and supported in ways that matter most to them in their own communities. 98
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Challenges and lessons learned Here’s a summary of the significant obstacles encountered during the implementation of the Carers Strategy in North Ayrshire, along with the key insights and lessons learned: Cost barriers to accessing services. Many carers (42%) reported that financial constraints limited their ability to access health, leisure, and wellbeing opportunities. This highlighted the need for more inclusive and subsidised options. Limited-service hours Feedback revealed that a significant number of carers, especially working carers, struggled to engage with services offered only during standard office hours. This created a gap in provision and limited accessibility. Centralised therapy provision Therapies were initially only available at the Carer Centre in Irvine, which did not align with the locality-based model or carers preferences for flexibility and proximity. Under-representation in strategic planning Prior to the establishment of the Adult and Young Carers Champions Board and carer representation on the Integrated Joint Board, carers had limited formal avenues to influence decision making. Digital and engagement gaps While some carers preferred online engagement, others valued face to face interaction. Balancing these preferences requires a more hybrid and responsive approach. 99
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Future recommendations Future recommendations to build on the success of North Ayrshire’s Building Caring Communities Carer Strategy and address ongoing challenges in the ‘Together We Care’ Strategy 2026 to 2029. Expand flexible and inclusive service delivery. • Extend Carers Gateway hours to include evening and weekends (for example 8am to 8pm) to better support working carers and those with limited availability. • Continue developing hybrid engagement models (online and in-person) to meet diverse preferences and accessibility needs. Strengthen locality-based support. • Further decentralise services such as therapies, training and peer support to ensure carers can access help within their own communities. • Increase visibility and outreach in underrepresented areas through community partnerships and local events. Enhance financial support and accessibility. • Continue working with leisure and wellbeing partners to expand discount schemes and subsidised memberships. • Explore additional funding streams to support carers with digital access, cost of living pressures and access to breaks from caring. Deepen co-production and carer involvement. • Build on the Adult Carer and Young Carer Champion Boards by creating pathways for local advisory panels, peer support groups or focus groups to feed in and inform service design. • Increase opportunities for carers to participate in training, consultation and leadership roles within the partnership. Improve data collection and impact measurement. • Develop a centralised dashboard to track engagement, outcomes and feedback across North Ayrshire Health and Social Care Partnership, Carers Gateway and partners. • Use data to identify gaps, monitor progress and inform strategic planning. Expand mental health and emotional wellbeing support. • Scale up access to Cognitive Behavioural Therapy and other therapeutic interventions, including trauma informed and culturally sensitive approaches. • Introduce group therapy or peer led wellbeing sessions to complement one-to- one support. 100
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Promote awareness and early identification. • Continue working with GP’s, hospitals, schools and community organisations to identify carers early and connect them to support. • Launch targeted campaigns to raise awareness of carers rights, services and the Carers Appreciation Card. Invest in training and development. • Offer carers ongoing training opportunities (for example moving and handling, digital skills, legal rights) tailored to their needs. • Provide professional development for staff to ensure consistent application of the EPiC principles and carer centred practices. North Ayrshire Health and Social Care Partnership remain deeply committed to recognising, valuing, and supporting carers of all ages. Through collaborative working, co-designed services, and a strong focus on accessibility and wellbeing, we have made significant strides in improving outcomes for carers across our communities. The insights gained and lessons learned have shaped a forward-thinking Strategy that places carers at the heart of decision-making. As we move ahead, our focus will remain on strengthening partnerships, expanding flexible support, and ensuring carers are identified earlier in their caring journey, empowered to make decisions for themselves and the individual they care for, included in the service delivered and service design, and supported throughout their caring journey. 101
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Integration Joint Board 11th December 2025 Subject: Refreshed Strategic Plan 2026-2030 Purpose: This report presents the refreshed Strategic Plan for 2026-2030 and is seeking:- • Approval Recommendation: Approve the refreshed Strategic Plan, to cover the remainder of the Caring Together period, from 2026-2030. 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 SMT Senior Management Team PSMT Partnership Senior Management Team APR Annual Performance Report 1. EXECUTIVE SUMMARY 1.1 The current Strategic Plan ‘Caring Together 2022-2030’ has been reviewed and refreshed at the midway point, and this report presents a new Strategic Plan which updates the HSCPs priorities for delivery and long-term planning. The new plan will be in place for the new reporting period beginning on the 1st of April 2026, and following finalisation of this Strategic Plan a suite of documents to prepare for delivery will be developed in order to enable delivering and monitoring prior to this. 1.2 The proposed Strategic Plan replaces the current priorities of the Caring Together 2022-2030, which are Enable Communities, Develop and Support our Workforce, Provide Early and Effective Support, Improve Mental and Physical Health and Wellbeing, and Tackle Inequalities. It proposes a renewed approach, outlining Strategic Priorities for anticipating and improving future health and care needs, and Service Delivery Priorities, reflecting the current requirements for delivering services. 1.3 The new proposed vision going into the next 10 years, is: “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services”. Agenda Item 6 103
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The proposed Strategic Priorities are: 1. Supporting the Improvement of Population Health 2. Addressing the Changing Needs of an Ageing Population 3. Tackling the Root Causes of Health and Care Inequality The Proposed Service Delivery Priorities are: 1. Prevention 2. Community Based Services 3. Life Stages 4. Whole Person Approach 5. Accessibility and Communication 6. Evidence and Performance 1.4 The Refreshed Strategic Plan follows an initial review of Caring Together 2022-2030 which was completed in January 2025. A new plan was developed using the methodology outlined in paragraph 2.4, and a draft was presented to the Strategic Planning Group on 3rd September 2025. Following approval of the draft, a consultation on the draft plan took place between the 29th of September and 9th of November, and the final Strategic Plan was approved by the Strategic Planning Group on the 26th of November to be presented to IJB for approval and adoption. 1.5 Appendix 1 presents the final Refreshed Strategic Plan 2026-2030. 2. BACKGROUND 2.1 The Public Bodies (Joint Working) (Scotland) Act 2014 (29-39) outlines a requirement for all Integration Authorities to prepare a Strategic Plan. The Strategic Plan must: • Set out arrangements for carrying out integration functions • Set out how it will contribute to the National Health and Wellbeing Outcomes • Include separate arrangements for (a minimum of 2) localities • Consider the integration delivery principles • Consider the views of the Strategic Planning Group • Consider other IJB Strategic Plans operating in the same area • Be reviewed at least every 3 years 2.2 The Statutory Guidance for developing Strategic Plans was revised and updated in July 2024. It outlines further information about what should be carried out when developing a Strategic Plan, including: • Consideration of local priorities in other local plans and strategies. • Consideration of the views of relevant stakeholders such as service users, carers, staff, third sector organisations and providers. 104
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• Development of a Joint Strategic Needs Assessment to analyse the needs of local populations and to inform and guide the commissioning of health, wellbeing and social care services within the area. • A clear recording and measurement framework so that there is an ongoing process to assess whether aims are being achieved. 2.3 The current Strategic Plan for North Ayrshire HSCP ‘Caring Together’ 2022-2030 is a long-term strategy for the area, developed in 2021 after a review of local data and engagement. This Plan was reviewed at the end of 2024, where it was concluded that the HSCP is currently operating in a different financial and operational climate than when the plan was developed. In 2021 the HSCP was in a period of recovery from the pandemic and in the last few years there have been a number of significant changes that have affected the way in which the HSCP operates, including financial, operational, performance and workforce pressures, and the development of the transformation programme and financial recovery plans. As a result, it was decided that the Strategic Plan would undertake a complete refresh. 2.4 PLAN DEVELOPMENT The draft Strategic Plan was developed between January and August 2025, and consisted of the following workstreams: • Strategic Needs Assessment: A review of national and local data was carried out in order to assess the performance of our services, local outcomes, and the current and future health and care needs of the North Ayrshire population. This is now available for wider use and will be published alongside the refreshed plan. • Engagement: At the end of 2024, an exercise was carried out which collated the results of engagement pieces from across the HSCP from January 2023 to December 2024. A total of 47 engagement pieces were collated which included events, forums, online surveys, 1-1 interviews, panels and workshops. A total of 2,887 people were reached over the 2 years spread over these engagement pieces. For the Strategic Plan, a meta-analysis was carried out, analysing what was learned across these engagement exercises, summarising these into key themes as well as analysing by service. Details are in Appendix 2 of the plan. • Policy review: A review of national and local policies was carried out to ensure the Strategic Plan was consistent with these and maintains the ‘golden thread’ from Government policy to local action. The review identified any national outcomes and prescribed services and goals, and existing identified local priorities. A total of 66 policies were reviewed through this process, the full list is in appendix 4 of the plan. • Service Challenges and Feedback: Throughout May and June 2025, services across the HSCP were asked to provide their opinions about the challenges they were seeing regarding delivering services, or particular issues they were seeing from service users that they viewed as a priority. They were also asked to provide areas of opportunity they saw from their services, either 105
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for service efficiency, joined up working, or new programmes they expected to see improved outcomes from. • Analysis: An analysis exercise was carried out in summer 2025 to reach the draft priorities using information collated from the strategic needs assessment, engagement analysis, policy review, service feedback and service performance information. It summarised the key themes under a range of headings, which allowed common themes to be identified for across the whole HSCP and regarding specific services. • Senior Manager Collaboration: Following the initial drafting of the new priorities, every service and senior manager was consulted to support the development of the activity outlined in the plan, either through service SMTs or individually. The draft Plan was presented to the Strategic Planning Group on the 3rd of September 2025. Following this, the draft was subject to 6 weeks of public consultation from the 29th of September to the 9th of November, where it was made available online alongside a public survey asking for feedback on the draft plan. The consultation was advertised via the staff newsletter, care improvement network, partners and staff. 30 people took part in the online consultation, which is a positive number for a draft strategy consultation given the requirement to read the full plan in order to participate, with the average time to take the survey sitting at 25 minutes. The highlights of the survey are included in appendix 2 of the attached plan, which includes that 77% agreed with the approach to have both strategic priorities for future service delivery and service delivery priorities for immediate delivery, and there was a minimum of 80% agreement across all priorities. 3. FINAL PLAN 3.1 The new priorities reflect a move towards focussing on health improvement and long- term planning to meet the changing needs of the population. This plan outlines two different sets of priorities: • Strategic Priorities: These aim to address future service requirements based on demographic changes and local inequalities and aim to better understand and assess how we may influence improved health and wellbeing. Strategies will be aligned to these goals and decision making will consider these priorities and impacts when implementing change. • Service Delivery Priorities: These reflect how services will be designed and delivered to address the health and care needs of the population. Service Planning will be aligned to these principles. 106
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3.2 Strategic Priorities: The three new Strategic Priorities are all interlinked and intended to reduce the pressures on the HSCP by anticipating future demand and aiming to improve outcomes at a population level. The Health and Social Care partnership will align its strategies, plans, and change projects to these priorities and will aim to carry out research into these priorities and create recommendations for future service delivery. The Strategic Priorities are: 1. Supporting the Improvement of Population Health 2. Addressing the Changing Needs of an Ageing Population 3. Tackling the Root Causes of Health and Care Inequality By focussing on these priorities at a strategic, organisational level, the HSCP aims to research and identify whether any changes to service delivery could lead to improved health and care outcomes. 3.3 Service Delivery Priorities: These priorities reflect what we have learned from data, service user engagement, national policy, and the perspectives of services about strengths and challenges in our health and care services. Decision making about new services or the change of existing services will consider these principles, and a Delivery Plan will be developed which will show how our services will implement these priorities and actions. The Service Delivery Priorities are: 1. Prevention 2. Community Based Services 3. Life Stages 4. Whole Person Approach 5. Accessibility and Communication 6. Evidence and Performance 3.4 Enabling Plans: The Enabling Plans are supporting plans that will help with the delivery of the Strategic Plan, however they are fundamental to supporting the way the organisation works, so they require separate planning and analysis which are delegated into their own plans. Although these plans are separate to the Strategic Plan, they do reflect the needs of the organisation, and the activity planned and developed through these plans will be reflected in the Strategic Plan Delivery Plan to ensure coordinated delivery of all plans. The Enabling Plans are the Workforce Plan (tbc), the Digital and Data Plan 2024- 2027, the Participation and Engagement Strategy 2026-2030, and the Transformation Plan 2024-2027. 107
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3.5 Vision and Values The Vision outlined in Caring Together 2022-2030 - ‘People in North Ayrshire are able to have a safe, healthy and active life’ - has now been in place for 10 years, since the inception of the HSCP. During consultation on the draft Strategic Plan in Autumn 2025, people were asked whether they felt the vision was an accurate reflection of the aspirations for health and wellbeing for people in North Ayrshire and asked for suggestions or comments where they felt it could be improved. The Strategic Planning Group took these suggestions into consideration and agreed that a new vision that reflected the future goals of the organisation, to maintain service delivery with dwindling resources, while being aspirational for the area, should be adopted. The new proposed vision going into the next 10 years, is: “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services”. The values were also updated following consultation and discussion and agreement of Strategic Planning Group members, from ‘care, empathy, and respect’ to caring, compassionate, respectful, and inclusive. People wanted the values to be reflective of the organisation’s approach to service delivery rather than how they expected to be treated by staff: • We will be caring, supporting the health and wellbeing needs of everyone with whom we work. • We will be compassionate, understanding the personal circumstances of everyone will be different. • We will be respectful, making sure people are seen and heard in their care journeys. • We will be inclusive, enabling access for all. 4. DELIVERY AND MONITORING 4.1 Following approval of the new Strategic Plan, a suite of complementary documents will be completed in order to clearly communicate how we will deliver and monitor the plan from the 1st of April 2026: • A Participation and Engagement Strategy 2026-2030: Outlining how we will engage over the duration of the plan to assist plan delivery and ensure continuous feedback from communities. This has been drafted and will be brought for approval in February 2026. • A 3-year Delivery Plan: This plan outlines the activity the HSCP plans to achieve over the life of the plan. A delivery plan will outline in more detail how this will be achieved through specific actions, including activity outlined in our enabling plans. This is in development with services and will be presented to the Strategic Planning Group in February 2026. 108
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• A revised Performance Management Framework: This will be developed to ensure performance management is coordinated across the strategic plan and related plans. This will ensure performance indicators are linked to the strategic plan and show how service delivery contributes towards the national health and wellbeing outcomes. New Indicators to measure the Strategic Plan will be presented to Strategic Planning Group in February 2026 and Performance and Audit Committee before adoption in March 2026. 4.2 The Annual Performance Report for 2024-25 currently reflects the Strategic Priorities outlined in the current Strategic Plan Caring Together. This updated plan is due to be adopted for the beginning of 2026-27, so the Annual Performance Report for 2025-26 will also reflect the priorities of Caring Together. Following the adoption and publication of this Strategic Plan, the Annual Performance Reporting format will be revised to ensure it reflects the updated Priorities of this Strategic Plan, which will be reported in summer 2027, to reflect the previous reporting year of 2026-27. The first Quarterly Report to reflect the new Strategic Plan priorities will be Quarter 1 of 2026/27, reflecting 1st April to 30th June 2026. 5. PROPOSALS 5.1 It is recommended that IJB: • Approve the refreshed Strategic Plan, to cover the remainder of the Caring Together period, from 2026-2030, • Note the activity to be carried out following approval of the draft plan regarding delivery and monitoring, • Note the reporting schedule which will align the updated priorities to the reporting period of the Annual Performance Report, Following approval, a copy of the updated Strategic Plan will be provided to North Ayrshire Council and NHS Ayrshire and Arran, as the new Strategic Plan for North Ayrshire Integration Joint Board. 5.2 Anticipated Outcomes The introduction of Strategic Priorities in addition to Service Delivery Priorities reflects a move towards long-term planning in terms of anticipated future health and care needs of the population. The strategic priorities aim to understand the root causes of inequality and how these impact health and care needs, population health such as healthy activity and preventative health care, and the impact of the changing demographics on our care services. Over the course of the plan it is anticipated these workstreams will lead to changes to delivery that will support the overall health and wellbeing of the population. The service delivery priorities aim to achieve a number of improvement outcomes, including a preventative approach to reduce conditions worsening over time, a whole 109
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systems approach to ensure other aspects of people’s lives are supported, continuing to shift the balance of care into communities to allow care and support closer to home, improved accessibility for different groups of people and improved communication about our services. The refreshed Strategic Plan and priorities align with the focus of the CHES programme being taken forward in North Ayrshire with local and national partners, where our plan focuses on making meaningful progress in closing inequities, closing the gap between policy intent and impact and focussing on data and needs and targeted approaches to tackling poorer health and wellbeing outcomes. 5.3 Measuring Impact A robust Performance Management Framework will be developed alongside the final plan which will show how we will evidence our performance, as well as monitor overall health and care outcomes in the community in order to monitor the longer-term impacts of our services on the community. A delivery plan will also be developed which will, outline what we intend to do over the life of the plan to deliver our health and care services. The Annual Performance Report will continue to report on our activity and performance, providing transparent updates to our communities and partners. 6. IMPLICATIONS 6.1 Financial The Strategic Plan considers the HSCPs medium term financial outlook and recognises the difficult financial operating context. The plan whilst aspirational in improving outcomes is also realistic and acknowledges the financial constraints, this will be further reflected in the enabling plans. 6.2 Human Resources The Plan outlines the Workforce Plan as a key enabler. And a new workforce plan will be developed in 2026-27 that will support the delivery of the strategic plan. 6.3 Legal The Strategic Plan is a requirement of the Public Bodies (Joint Working) (Scotland) Act 2014. 6.4 Equality/Socio-Economic An ECRIA has been carried out and is attached in Appendix 2. There are no adverse or negative impacts highlighted. 6.5 Risk The risk register contains demographic, equality and workforce risks. The Strategic Plan aims to support the minimisation of risks through the planning of priorities and activity for the HSCP. 110
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6.6 Community Wealth Building None. 6.7 Key Priorities This plan contains proposals for new Priorities for the HSCP. 7. CONSULTATION Between January 2023 and December 2024, the Health and Social Care Partnership conducted 47 engagement activities, reaching approximately 2,887 individuals. These activities included events, focus groups, surveys, interviews, and workshops, and were carried out for a variety of reasons. The feedback gathered has been analysed and summarised into key themes, divided into two categories: overarching issues and service-specific insights. This analysis informed the development of the Draft Strategic Plan and the development a new Participation and Engagement Strategy, which will accompany the Strategic Plan launch in March 2026. Senior Managers were consulted to develop the plan regarding the issues and opportunities they were seeing across their services, and then again to support the development of the activity outlined in the plan to deliver the priorities. PSMT was consulted in July and August in order to inform them of activity to develop the priorities and gain approval of the approach. Strategic Planning Group has been consulted on the process of development at each meeting since March 2025 and were presented with the Draft Plan on 3rd September 2025. The Draft Plan was subject to formal consultation from the 29th of September to the 9th of November and changes were made to the draft based on the feedback that was received. Strategic Planning Group received the final Strategic Plan on the 26th of November for final agreement prior to this IJB meeting. Director: Caroline Cameron Author: Seony Ross, Team Manager Strategic Planning and Equalities, seonyross@north-ayrshire.gov.uk Appendices • Strategic Plan 2026-2030 • ECRIA for the Strategic Plan 111
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2026 Strategic Plan 2026- 2030 REFRESH OF ‘CARING TOGETHER 2022-2030’ 112
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1 Contents Foreword ............................................................................................................................... 2 ABOUT US ............................................................................................................................. 3 Introduction ........................................................................................................................... 3 THE PLAN .............................................................................................................................. 7 How the plan was developed .................................................................................................. 7 Vision and Values ................................................................................................................... 9 Priorities .............................................................................................................................. 10 Enabling Plans ..................................................................................................................... 28 Locality Planning .................................................................................................................. 31 DELIVERING THE PLAN ........................................................................................................ 33 Finance ............................................................................................................................... 33 Commissioning .................................................................................................................... 36 Delivery and Monitoring ........................................................................................................ 38 WORKING IN PARTNERSHIP ................................................................................................. 41 APPENDICES ....................................................................................................................... 44 Appendix 1: Lead Partnership Statement ............................................................................... 44 Appendix 2: Consultation Statement ..................................................................................... 51 Appendix 3: Summary of Housing Contribution Statement ..................................................... 54 Appendix 4: Full List of Policies Reviewed ............................................................................. 58 113
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2 Foreword North Ayrshire Health and Social Care Partnership deliver integrated health, care and social work services across our communities in North Ayrshire, ensuring care is delivered closer to home. We first published ‘Caring Together 2022-2030’ as a long-term plan outlining our ambitions for improving health and wellbeing of residents in North Ayrshire in an uncertain period of recovering from the pandemic. Over the course of 2025, we have developed and published a new Strategic Needs Assessment which outlines data and information about people’s health and care needs in North Ayrshire and identifies areas where outcomes are poorer locally. We have also considered the newly published national Population Health Framework 2025-2035 and Health and Social Care Service Renewal Framework 2025-2035 in the development of our priorities, to ensure our services and priorities are contributing to the overall goals to make Scotland healthier and to keep people independent and well. We are proud of our approach to engaging and listening to our communities and have reviewed engagement feedback collected over the last two years to identify what people consider to be priorities for delivering services, and where people feel like changes need to be made. We have asked staff across our services what they consider the key challenges to be and considered and also taken into account feedback we have received from partners and communities. This refreshed Strategic Plan for 2026 to 2030 sets out a renewed dual-priority approach to delivering services in line with new Service Delivery Priorities to meet the current needs of our communities within an increasingly challenging financial context, and new Strategic Priorities which will consider future needs and how we may need to transform our services to meet the needs of our changing demographics. Alongside this refreshed Strategic Plan, we are developing a Delivery Plan which will outline how we will work with communities and partners to deliver these priorities, and a new Performance Framework which will measure and evidence the success of the plan. Our new Strategic Plan sets out a clear vision and priorities to support our focus on reducing inequalities in North Ayrshire. We are committed partners in the Collaboration for Health Equity in Scotland (CHES) for North Ayrshire with national partners committed to closing the gap between policy gap and intent in our local area and making real progress in tacking inequalities for our residents. Through this renewed focus and aligned priorities, we aim to work with our communities and partners, to listen to our communities, and to deliver local health and care services that are sustainable for the future. Caroline Cameron Caroline Cameron, Director, North Ayrshire Health and Social Care Partnership Chief Officer, North Ayrshire Integration Joint Board 114
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3 ABOUT US Introduction The Public Bodies (Joint Working) (Scotland) Act 2014 (integration legislation) introduced health and social care partnerships which would be responsible for delivering integrated health and social care in order to reduce organisational barriers to joint working for people in receipt of care. There are 31 Health and Social Care Partnerships (HSCPs) across Scotland, with each delivering some services in their area, delegated by the Local Authority and the local Health Board in accordance with the local Integration Scheme. The Strategic Plan is a requirement of the legislation, for the purpose of setting out the arrangements for carrying out the integration functions for the area and setting out how the HSCP will contribute to the national health and wellbeing outcomes. North Ayrshire Health and Social Care Partnership North Ayrshire Health and Social Care Partnership (HSCP) provides integrated health and care services to residents of North Ayrshire, as outlined in the Integration scheme. North Ayrshire Services • Adult Community Mental Health: community teams, suicide prevention • Adult Social Work: hospital and community, sensory impairment, adult protection • Alcohol and Drugs Services: North Ayrshire Alcohol and Drugs Partnership, Drug and Alcohol Recovery Service • Allied Health Professionals: physiotherapy, occupational therapy, podiatry, speech and language, dietetics, enhanced intermediate care • Care at Home: home support, telecare, reablement • Carer’s Support Services • Children’s Health: health visiting, school nursing Integration Delivery Principles: Services Should - • Be integrated from the point of view of service-users • Take account of the particular needs of different service-users • Take account of the particular needs of service-users in different parts of the area in which the service is being provided • Take account of the particular characteristics and circumstances of different service-users • Respect the rights of service-users • Take account of the dignity of service-users • Take account of the participation by service-users in the community in which service-users live • Protect and improve the safety of service-users • Improve the quality of the service • Be planned and led locally in a way which is engaged with the community • Best anticipate needs and prevents them arising, and • Make the best use of the available facilities, people and other resources. 115
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4 • Children’s Mental Health: Child and Adolescent Mental Health (CAMHS) north locality team, neurodiverse CAMHS • Children’s social work: locality social work, child protection, care experience, children’s residences • Clinical Nursing services • Community Link Workers • Criminal Justice services • Learning Disability Services: day services, residential care, and respite Lead Partnership Services North Ayrshire HSCP has lead partnership responsibility for delivering specialist and in-patient Mental Health Services and some children’s health services on behalf of NHS Ayrshire and Arran on a Pan-Ayrshire basis, meaning they are for residents of North, East and South Ayrshire. • Adult Mental Health Unscheduled care services: emergency mental health, assessment hub, liaison and intensive community teams • Alcohol and Drugs: Alcohol and Drug residential service, prevention and service support • Children’s Health: immunisations and infant feeding services • Children’s Mental Health: Child and Adolescent Mental Health Service North Locality team) (CAMHS), Neurodiverse CAMHS, Urgent Assessment and Intensive Treatment • Community Eating Disorder Service (CEDS) • Inpatient Mental Health: Woodland View community hospital wards, Warrix Avenue community rehabilitation (centre) facility, Elderly (acute) Hospital Based Complex Continuing Care at Ailsa Hospital, Acorn day activity service, Community Forensic Services • Perinatal, Infant, Maternity & Neonatal Mental Health Services • Psychological services North Ayrshire Integration Joint Board The Integration Joint Board (IJB) is the constituted legal governing body of North Ayrshire Health and Social Care Partnership and is the decision-making board of the Health and Social Care Partnership. It is responsible for the strategic direction, effectiveness, and efficiency of the Partnership by making decisions in relation to services, strategic planning, and finances. The membership of the IJB is outlined within the Public Bodies (Joint Working) (Scotland) Act 2014, and consists of: • North Ayrshire Council Elected members (voting members) • NHS Ayrshire and Arran Non-Executive Members (voting members) • Professional Advisers – NAHSCP Staff • Service user, carer, and partner representatives Meetings are public and recorded, and papers can be found online. Strategic Planning Group The Strategic Planning Group is also required by integration legislation for the purpose of supporting the development of the Strategic Plan on behalf of the IJB, providing oversight of the implementation of the plan, and providing advice and support on the Strategic Direction of the 116
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5 HSCP to the IJB. The group consists of senior managers, partners, and professional leads, and meets quarterly to monitor progress of the plan’s development and delivery. 117
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6 Draft Strategic Plan Vision “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services” Values Strategic Priorities Priorities for Service Delivery Enabling Workstreams Supporting the Improvement of Population Health Addressing the Changing Needs of an Ageing Population Tackling the Root Causes of Health Inequality Workforce Digital Participation Transformation 118
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7 THE PLAN How the plan was developed This Draft Strategic Plan refreshes the current Strategic Plan: Caring Together 2022-2030. Although it was due to be in place for an 8-year period, the IJB is required to review it every 3 years. In December 2024 the plan was reviewed against updated Strategic Planning Statutory Guidance, to assess how well it had achieved its objectives, met performance targets, and if there was evidence of improved outcomes. Following this evaluation, the Strategic Planning Group decided that a refreshed plan was required in order to reflect the current circumstances under which the HSCP is operating, which were considered to be significantly different to when Caring Together was developed. Caring Together was developed in 2021, during Covid-19 pandemic restrictions, and when priorities were focussed on recovery from the impacts of the pandemic. Activity to refresh the Strategic Plan commenced in January 2025. Strategic Needs Assessment A review of national and local data was carried out in order to assess the performance of our services, local outcomes, and the current and future health and care needs of the North Ayrshire population. The needs assessment researched demographics and population changes, general health, mental health, substance use, disability, hospital care, community care, pregnancy and children, justice, economy and inequality. The Strategic Needs Assessment was carried out between January and August 2025, and the full document and a summary will be made available on the HSCP website. Engagement Engagement is carried out on a regular basis in the Health and Social Care Partnership, whether for specific purposes such as consultation on a decision or service, or through ongoing engagement, such as Locality Planning or What Matters to You. The Health and Social Care Partnership aims to continually build on our knowledge and understanding of the experience of service users by ensuring their feedback is used to continuously improve services and functions, so their views count for more than a single engagement exercise. At the end of 2024, an exercise was carried out which collated the results of all pieces of engagement across the HSCP from January 2023 to December 2024. A total of 47 engagement pieces were collated which includes events, forums, online surveys, 1-1 interviews, panels and workshops. Approximately 2,887 people were reached over the 2 years spread over these engagement pieces. For the Strategic Plan, a meta-analysis was carried out, analysing what was learned across these engagement exercises, summarising these into key themes and analysing by service. It was felt we could learn more from feedback by looking at everything people contributed over this time, than we could from carrying out a single engagement exercise for the purpose of developing the plan. 119
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8 A report of engagement will be published alongside this plan on the HSCP website, and engagement will continue to be collated and analysed on an annual basis so we can continue to build our understanding of service user experiences. Policy Review A review of national and local policies was carried out to ensure the Strategic Plan was consistent with these and maintained the ‘golden thread’ from Government policy to local action. The review identified any national outcomes, prescribed services or goals, and any existing local priorities committed in local plans. The policies were summarised by theme, including service delivery, health literacy and digital, children and families, older people and long-term conditions, carers, disability, mental health, substance use, justice, workforce and local outcomes. The Scottish Government published 2 new national policy frameworks in June 2025: the Health and Social Care Service Renewal Framework 2025-2035 and Scotland’s Population Health Framework 2025-2035. These outline the Governments vision for delivering health and care services and influenced the final proposed local priorities in this Strategic Plan. A total of 66 policies were reviewed through this process; the full list is available in appendix 3. Service Challenges and Feedback Throughout May and June 2025, services across the HSCP were asked to provide their opinions about the challenges they were seeing regarding delivering services, or particular issues they were seeing from service users that they viewed as a priority. They were also asked to provide areas of opportunity they saw from their services, either for service efficiency, joined up working, or new services from which they expected to see improved outcomes. Feedback came from a range of services across the HSCP which provided good insight from a cross section of the organisation. Analysis An analysis exercise was carried out in summer 2025 to reach the draft priorities using information collated from the strategic needs assessment, engagement analysis, policy review, service feedback and service performance information. It summarised the key themes under a range of headings, which allowed common themes to be identified for across the whole HSCP and regarding specific services. The final priorities and short- and medium-term activity were developed using this analysis, which has also been used to inform the Delivery Plan. 120
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9 Vision and Values Our Vision for North Ayrshire Health and Social Care Partnership is: “To empower people in North Ayrshire to live safe, healthy and active lives with fair and equal access to sustainable health and care services” This replaces the previous vision which has been in place since the inception of the Integration Joint Board and the very first Strategic Plan in 2015, which was ‘People in North Ayrshire are able to have a safe, healthy and active life’. During consultation on the draft Strategic Plan in Autumn 2025, people were asked whether they felt the vision was an accurate reflection of the aspirations for health and wellbeing for people in North Ayrshire and asked for suggestions or comments where they felt it could be improved. The updated vision reflects people’s comments that accessibility, empowerment and sustainable services should be prioritised. The values were also updated following consultation, from ‘care, empathy, and respect’. People wanted the values to be reflective of the organisations approach to service delivery rather than how they expected to be treated by staff, which should always be with care. The Values of North Ayrshire Health and Social Care Partnership are: The Health and Social Care Partnership delivers a range of services, working directly with people to keep them well both in clinical spaces and their own homes. We want to people to feel comfortable and know that they are safe and treated well in our care. To embody these values: We will be caring, supporting the health and wellbeing needs of everyone with whom we work. We will be compassionate, understanding the personal circumstances of everyone will be different. We will be respectful, making sure people are seen and heard in their care journeys. We will be inclusive, enabling access for all. 121
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10 Priorities The Health and Social Care Partnership is facing a challenging position, where our funding and resources are not keeping up with the demand for services. Over the last few years, difficult decisions have been made that have led to reduction in some services to balance the budget. Unfortunately, our current service model is unsustainable, and the new priorities reflect a move towards health improvement and long-term planning to meet the changing needs of the population within more efficient systems. This plan outlines two different sets of priorities: • Strategic Priorities: These aim to address future service requirements based on demographic changes and local inequalities and aim to better understand and assess how we may influence improved health and wellbeing. Strategies will be aligned to these goals and decision making will consider these priorities and impacts when implementing change. • Service Delivery Priorities: These reflect how services will be designed and delivered to address the health and care needs of the population. Service Planning will be aligned to these principles. Strategic Priorities The three new Strategic Priorities are all interlinked and intended to reduce the pressures on the HSCP by anticipating future demand and aiming to improve outcomes at a population level. The Health and Social Care Partnership will align its strategies, plans, and change projects to these priorities and will aim to carry out research into these priorities and create recommendations for future service delivery. The Strategic Priorities are: By focussing on these priorities at a strategic, organisational level, the HSCP aims to research and identify what changes to service delivery could lead to improved health and care outcomes. SP1: Supporting the Improvement of Population Health The Scottish Government published a new Population Health Framework for 2025-2035 outlining a broad range of actions which aims to tackle the drivers of ill health. It states that up to 80% of what affects health happens outside of the health and care system, and the framework sets out how national and local government will work with partners and community organisations to improve population health. The framework outlines that in Public Health approaches there are three recognised types of prevention: • Primary Prevention: Investing in actions at a population level that reduce risks or addressing the cause of a problem to prevent health problems from occurring. Supporting the Improvement of Population Health Addressing the Changing Needs of an Ageing Population Tackling the Root Causes of Health Inequality 122
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11 • Secondary Prevention: Actions focussed on early detection to support early treatment and reducing the level of harm. • Tertiary Prevention: Minimising the negative consequences of a health issue or condition through careful management. Primary prevention has been found to be 3 to 4 times more cost-effective than investing in treatment with every £1 invested in health protection worth £34. The health of the North Ayrshire population is poorer than nationally, and it frequently ranks near the bottom for health and care outcomes. It has the 6th lowest life expectancy compared to other local authority areas and current figures are 79.3 for females and 74.9 for males, both lower than Scotland and have reduced over the last 5 years. Healthy life expectancy is even lower-ranking, and deaths for those aged 15-44 is particularly high and is rising in the long term. North Ayrshire has seen a rise in the occurrence of long-term conditions in the population, higher rates of cancer and heart disease than nationally, and behaviours which can impact population health are more negative. For example, there is lower uptake for bowel screening and a decline in uptake for cervical screening. Smoking prevalence, although declining, remains high with 19% of the population smoking, the second highest local authority area, and the prevalence of vaping has increased from 9% to 12% in the space of 1 year. Smoking is a major public health issue in Scotland and a leading cause of preventable ill health, premature death and disability. Alcohol consumption has been identified as a risk factor for over 200 diseases, injuries, and health conditions and is linked to wider social and economic losses. In Scotland, male hazardous drinking is twice as high as female at 30% and 15% respectively, and in North Ayrshire male hazardous drinking is 41% compared to 14% for females. Drug use continues to be a local and national concern, with high rates of hospital admissions and drug related deaths in North Ayrshire. There are high rates of smoking during pregnancy, with 21.5% of mothers reportedly smoking during pregnancy—markedly higher than the Scottish average of 12.9%, and the highest of all local authority areas, which ranges from 3.8% to North Ayrshire’s 21.5%. This disparity reflects broader socioeconomic challenges and is a known risk factor for poor birth outcomes. Childhood immunisation uptake, although still strong, has been steadily declining over the last decade with the 6-in-1 vaccine going from 98.8% to 96.7%. Although this doesn’t seem significant, it is a higher decline than nationally, and it is a downward trend that could have implications for future immunity and disease outbreak control. Similarly for the MMR vaccine the rate has fallen from 96.2% to 93.1% over a 10-year period. MMR coverage below 95% threatens herd immunity levels – especially important for preventing measles outbreaks, and only 11 council areas in Scotland have rates above 95% currently. Encouraging a reduction in behaviours such as smoking, alcohol and drug consumption, and increasing healthy and preventative behaviours such as healthy eating and physical activity, social activities to improve mental wellbeing, maintaining active brain health, immunisations, screening and health checks can support a healthy population and reduce the need for interaction with health and social care services. A strategic approach to supporting the improvement of population health will consider: 123
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12 • Maternal and infant health, including breastfeeding rates, child healthy weight, and immunisations. • Population mental health and wellbeing outcomes. • Healthy activity, including promoting a healthy diet and physical activity. • Harmful activity, including harmful social media use, gambling, tobacco products and substance use. • Brain health and dementia prevalence. SP2: Addressing the Changing Needs of an Ageing Population The total population of North Ayrshire is currently in decline and is forecast to continue to decline. Between 2013 and 2023 the population declined by 2.6% and is due to decline a further 8.4% by 2043, from a current population of 133,570 to 122,334. The most significant reduction has been the 0–4 age group, which declined by 23.8%, suggesting a reduction in births or possible out-migration of young families from the area. Currently, 24.2% of North Ayrshire’s population is aged 65 and over, compared to 20.3% of Scotland’s. In the last 10 years (2013-2023) the over 65 population has increased by 16.05% while the under 65 population decreased by 7.37%, which has meant a growing demand for care services. By 2043, despite the projected overall decline in the population, the 75+ population is due to increase by 40.7%. This represents a significant demographic shift and equates to 17,147 fewer people in North Ayrshire under the age of 75, and 6,132 more people aged 75 and older. In addition to an increase in the older population, healthy life expectancy, which is the amount of time a person can expect to live in good health, is lower in North Ayrshire than any other council area. In North Ayrshire, male healthy life expectancy is 52.6 years, and female healthy life expectancy is 52.5 years, both the lowest in Scotland compared to other council areas and an overall reduction of 5 years over a period of 5 years. Long term health concerns are also increasing, with the percentage of people reporting a long- term illness, disease or condition increasing from 21% in 2011 to 24.8% in 2022. The top five physical long-term conditions are asthma, arthritis, cancer, heart disease and diabetes and all are more prevalent in North Ayrshire than Scotland. For those over 65, prevalence of cancer is 20.4%, arthritis is 19.3%, heart disease is 18.8% and diabetes is 12%. These figures indicate that the growing older population in North Ayrshire is contributing to higher prevalence of conditions which could impact ability to maintain independence in older people. Compared to other Council areas, North Ayrshire has the 5th highest percentage of carers relative to the population which could be due to the higher older population creating more need for care. Carers are more likely to be older and female, and the amount of unpaid care they provide is increasing over time and increases with age. Between the 2011 and 2022 censuses, reported unpaid care in North Ayrshire increased by 23.9%, and local insights suggest a growing reliance on unpaid care, likely due to the ageing population and increasing healthcare pressures. This increasing reliance on unpaid carers could have a long-term effect on the health of the carers themselves, who over time are reporting less positive experience in their caring role. The ageing population is having an increasing effect on the demand placed on health and care services, and the increasingly precarious funding situation is compounding challenges to service delivery. Waiting lists for care at home services remain high, delayed discharges and 124
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13 unplanned bed days continue to increase, care home spaces for older people have reduced by more than 20% over the last decade, and perceptions of care services continue to decline. The ability to continue to deliver services in the future will be contingent on the HSCP’s ability to adapt to these changing demographics, prioritising service redesign over minor budget cuts. A strategic approach to addressing the changing needs of an ageing population will consider: • Frailty prevention, mobility and balance in older people. • Unpaid care, enabling carers, and recognising their contribution to care in the community. • The impact of an ageing population on service support, such as ageing unpaid carers, foster carers, and ageing staff. • Housing aids and adaptations, and care home needs. • Care delivered closer to home. • Future proofing care services through resourcing and training. • Increasing complexity in mental health care and support needs for older adults, including neurological conditions. SP3: Tackling the Root Causes of Health and Care Inequality Health and care inequalities are caused by different social, economic, and environmental factors which are thought to contribute to around 50% of the unfair differences in health (Public Health Scotland). One of the most influential determinants in poorer health and care outcomes is poverty. People living in the most deprived areas across Scotland tend to have poorer mental and physical health outcomes, and greater instances of care experience and interactions with social work. Other health determinants could include barriers to accessing services, including rural and remote places, systemic barriers, including language, race, gender and disability, and behavioural factors, including participation in healthy activity and ill-health prevention. North Ayrshire has generally poorer health and care outcomes than nationally. There are high levels of deprivation with a total of 28% of all data zones in the area within the 15% most deprived in Scotland, most concentrated in Irvine and Three Towns. Around 40.5% of the North Ayrshire population lives within one of the 20% most deprived areas in Scotland, and only half of North Ayrshire residents consider themselves to be managing financially. The percentage of children in poverty after housing costs was rising steadily in the 9-year period between 2014/15 and 2022/23, from 24.8% to 29.2%. In the most recent year the rate has dropped back down to 24.3%, however this reflects a drop across the country as the child poverty rate in 27 local authorities reduced. Despite the national reduction, the poverty gap has widened between the highest and lowest rates of child poverty across the local authorities. North Ayrshire consistently has one of the highest rates of children on the Child Protection register, with higher concentrations tending to be from the areas of deprivation, and services are seeing an increase of families who lack the resources to assist them to have positive family relationships and lack basic amenities to maintain their home and participate socially. The link between child protection and social work demand and deprivation is a complex one and is not the only factor, but North Ayrshire sees high rates of child poverty, deprivation, child protection, and care experienced young people. There is a significant issue in relation to over- occupancy of internal children’s houses, external placements, and a national and local crisis in the recruitment and retention of foster carers. 125
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14 North Ayrshire's economic inactivity rate is 10 percentage points above the national average, driven largely by long-term sickness and family care responsibilities. 23% of the working age population is economically inactive, with 42.2% of that due to long-term sickness and 21.2% due to family or home care responsibilities, both higher than nationally. Nearly 1 in 4 economically inactive people in North Ayrshire want to work, which could highlight a latent workforce that could be activated with the right support, such as health or childcare. Welfare rights and debt advice by the financial inclusion service has increased, with twice as many self- referrals to the service in 2023-24 than the previous year. Poverty can also increase the risk of mental health issues both in terms of causing a pressure point and being a consequence of poorer mental health, and there is an understood correlation between living in an area of socio-economic deprivation and a higher risk of suicide. Financial and employment insecurity and family breakdowns can add stressors into people’s lives having a complicated impact on mental wellbeing. The same can be said for substance use, with individuals in the most deprived areas over 3.5 times more likely to be admitted for alcohol- related conditions, and drug-related hospital admissions 10 times higher in the 20% most deprived areas than the 40% least deprived areas. People with No Recourse for Public Funds have the right to access healthcare, however their status can impact their ability to access other publicly funded services and their ability to work which could cause greater inequalities affecting their health and care needs. Additionally, social care services have a duty to safeguard the welfare of children and vulnerable people, and North Ayrshire has high instances of Unaccompanied Asylum Seeking Children who often require care placements. These situations can be unpredictable and result in high costs that are difficult for which to plan. A strategic approach to tackling the root causes of health and care inequality will consider: • The outputs and recommendations of the Collaboration for Health Equity Scotland programme, of which North Ayrshire is a pilot area and is working as part of a national programme to develop recommendations to improve outcomes. • Local impacts of poverty on health and care outcomes. • The link between poverty, care experience, and child protection. • Local initiatives to support families to access basic amenities • Vulnerable adults and wraparound support. • The experiences of refugees, unaccompanied asylum seeking children, and those with no recourse to public funds. • The experiences of different equality groups. 126
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15 Service Delivery Priorities These priorities reflect what we have learned from data, service user engagement, national policy, and the perspectives of services about strengths and challenges in our health and care services. Decision making about new services or the change of existing services will consider these principles, and a Delivery Plan will be developed which will show how our services will implement these priorities and actions. The Service Delivery Priorities are: 127
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16 SDP1: Prevention The Scottish Government recently published a new Health and Social Care Framework for 2025- 2035 and prevention is the cornerstone of the approach to improving the health of the population and the system around it. In North Ayrshire there has been a rise in the occurrence of long-term conditions in the population, higher rates of cancer and heart disease than nationally, higher unscheduled bed days and delayed discharges, and a higher proportion of unpaid carers which potentially means a higher proportion of people needing care. For children and young people, services are seeing increasing developmental concerns, increasing health concerns in primary school aged children, higher instances of neurodevelopmental differences, and increasing reports of mental health conditions. People report difficulty accessing some social work services, with some residents feeling they need to reach a crisis point to receive adequate support. Some feel as though there is an insufficient social work resource to meet the needs of the population, and services themselves report rising caseloads and insufficient support staff to support the social work teams. The mental health of the population also appears to be in decline, with self-reported perceptions of wellbeing reducing and self-reported mental health problems increasing, increased prescribed drugs for treating mental health conditions, and increasing suicide rates. Engagement suggests that accessing referrals to support can be challenging, with long waiting times and delays to accessing support, and limited availability of community-based support. Additionally, children and young people’s mental health services are frequently raised during engagement as insufficient, particularly in relation to neurodevelopmental difference, either due to waiting lists or lack of psychological support available once support is accessed. Primary care barriers are raised frequently with the GP considered the first point of contact for addressing an issue, but it is often also the first point of delaying treatment, as people find it challenging to access appointments. This strategic plan has set out a strategic aim to improve population health, which is the first stage of prevention. Although prevention at a community level is not within the scope of our remit, the HSCP aims to consider a strategic approach to our service delivery which could support this primary prevention. For delivering our services under this priority, we will focus on secondary prevention, so services will be designed around early detection of a problem and reducing the level of harm. For the long-term sustainability of our services, the HSCP cannot afford to prioritise the worst-cases to make the budget balance and instead must prioritise identifying an issue as early as possible to prevent deterioration. Short term activity • Continue to invest in early intervention support services so that families are supported to stay together and children are less likely to progress into further care experience or require further social work intervention • Ensure children’s social work teams have sufficient resources to provide practical and emotional support to children and their families, to prevent the need for further intense intervention and prevent negative or risk-taking behaviour from escalating. • Prioritise early-intervention support to minimise mental health conditions advancing further without treatment. 128
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17 • Continue to work with schools, youth groups, and communities regarding alcohol and drug use, providing education and support for young people to minimise the risk of problematic substance use. • Review and promote the availability of self-management tools and the benefits of preventative care to minimise deterioration of conditions. Medium term activity • Ensure clear structures in child social development and support pathways for children and young people that take account of their individual needs, allowing them to reach their full potential. • Optimise the use of diversion and intervention at the earliest opportunity in justice services. • Review available early intervention mental health support in the community to ensure people access the right services to meet their needs • Consider the capacity of the Allied Health Professions, to ensure they are appropriately resourced to be able to prioritise preventative care. • Consider current methods of early-intervention and monitoring conditions and look for areas of innovation to make improvements in delivering care. Long-term outcomes Fewer children are engaged with social services, and those that are, are supported at the earliest opportunity and provided with emotional and wellbeing support. People in North Ayrshire access care and support at the earliest opportunity, and conditions are managed early and effectively. 129
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18 SDP2: Community Based Services There has been an ongoing national drive to shift the balance of care out of hospitals and into the community and evidence of the benefit is already visible locally, with reducing admissions in the older population and lower inpatient numbers in mental health services. Providing care in the community has many benefits, including supporting a preventative approach by managing conditions earlier, improving independence and quality of life by keeping people supported in their community, and reducing costly hospital treatment. The care at home service, community nursing, and allied health professionals provide care in the community that allows people to remain at home for longer even with the increasingly complex needs being seen across the community. The Scottish Government has vowed to support the shift from hospital to communities by supporting local systems to improve community capacity, increasing responsive community home care support, optimising community rehabilitation and reablement services, expanding Hospital at Home, and increasing step down facilities that provide rehabilitation and prolonged periods of assessment. It also aims to improve access to GPs and other primary and community care clinicians. Children and young people’s services are hosted within the community as much as possible, with health visitors offering support and guidance for families in their own homes and communities, and school nursing and immunisations available in the community. Locality social work teams are based within their communities to provide support in or near home, and child protection and care experience teams aim to keep children within their own communities as much as possible. There has also been a shift towards community-based justice solutions, with an increase in community sentencing and reduction in custodies. The shift to community-based services comes with its own challenges, particularly in terms of resources. Teams across the HSCP report increasing complexity in cases, increasing caseloads, vital services at capacity, high waiting lists, and in some cases this is reflected in declining performance. Short term activity • Consider resources around community teams, monitoring caseloads and performance to consider where resources are strained and may need to be reviewed. • Develop a strategy to outline the goals for health and community care services to keep people in their homes and independent for longer. • Ensure a robust care service around hospital admission and discharge, increasing care in the community with an aim of minimising time spent in hospital. • Provide support in the community for unpaid carers, prioritising identifying people providing care in the community and ensuring their health and care needs are supported. • Continue to develop a range of innovative unpaid work projects and services that have tangible benefits for our communities whilst providing service users with opportunities to desist from further offending, provide payback and learn new skills. Medium Term Activity • Deliver coordinated planning at a locality level to consider the health and care needs of each locality ensuring local needs are met. • Review community-based mental health support available for low and mid-level mental health support. 130
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19 • Continue to review models of care for young people to shift the balance of care from external residential resources to family-based care. • Review provision on Arran related to social care and nursing to ensure care needs are met equally in Arran as they are on the mainland. Long term outcomes People can remain independent for longer, and more care is delivered in the community and out of hospitals. Children and young people with care experience are cared for closer to home. 131
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20 SDP3: Life Stages A life stage approach is about being mindful of the different major stages throughout life and ensuring that healthy activity, prevention and risk factors are planned for in terms of care, from prenatal to end of life. For the Health and Social Care Partnership, this means ensuring seamless pathways and transitions through services to ensure different stages of life are considered, and service experience does not change as people transfer between services in the care they receive. This includes a focus on early years to give children the best start in life and ensure they have the building blocks of good health and social skills, in order to improve outcomes from the start, and identifying and addressing the risk factors at key life stages. Common themes we have heard from service users include communication issues regarding unclear care pathways and difficulty navigating systems. Feedback suggests that some people feel as though there isn’t a cohesive enough approach regarding transitions between services, such as from adult to children’s services or from hospital to home, which can lead to drop-off from services and care needs not being met. Instances of neurodevelopmental differences are increasing, with many services raising associated challenges, including children’s social work, mental health, and justice services. Engagement suggests there is limited support for children coping academically but struggling socially, and for children in the low or middle range of severity. Untreated issues earlier in life can lead to problems in other aspects of life such as education or employment, healthy relationships and social skills. Similarly for children and young people with experience of care, the longer they are in care the greater the risk of negative outcomes in other areas of life. Engagement also raised issues that some people experienced with their loved ones when accessing end of life care. People shared stories about a lack of awareness of having access to pain medication for their loved one, lack of out of hours services meaning a bed not being made available for their home in their last days, and end of life wishes not being carried out. Short term activity • Ensure the health and developmental needs of infants and young children are met to give them the best start in life. • Ensure adequate support for people with neurodevelopmental differences, prioritising the critical points where people are more likely to experience disadvantage as a result of a difference, such as education, justice and employment. • Ensure systems are in place to identify and support older people who live with frailty. • Review current palliative and end of life care arrangements with an aim to make improvements across the system. Medium Term Activity • Embed the principles of Getting it Right for Everyone (GIRFE) with a multi-agency approach to health and social care support and services from young adulthood to end of life care. • Review care and treatment pathways where possible to ensure they are streamlined and well-communicated. 132
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21 • Ensure smooth transitions between services to provide consistent service delivery from the point of view of the service user, and in the most appropriate manner to suit the needs of the service user. • Investigate service gaps in relation to service-users that experience multiple health and care requirements, and work to address barriers to service access and ensure seamless care. • Ensure young people leaving care have well-planned throughcare and aftercare arrangements to support them to live independently into adulthood. Long term Outcomes North Ayrshire residents have the building blocks for good health and care throughout their life course, from pre-birth to older age. Health and care services are planned through different stages of life to ensure internal structures have no impact on the care received. 133
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22 SDP4: Whole Person approach A whole person approach considers not just the condition that is being treated, or the support they are accessing; it ensures that other aspects of a service-users life are considered in their care, whether it is family support, financial health, or wellbeing. We have heard from communities and service users that community-based and peer support models are invaluable, particularly in mental health and children and families contexts. Third sector and community organisations are consistently highlighted as providing meaningful, trusted support, often bridging the gaps where services are not available, and community centres serve as important access points for services and social support for tackling isolation, promoting health literacy, and connecting people to care. Cross-agency working and whole family support services are praised, particularly in children’s services, and multi-disciplinary teams in adult care are seen as effective in providing joined-up, person-centred support which helps improve care planning and family confidence. Community Link Workers are seen as a great resource, helping people to access extra support in other aspects of their lives, and the attentive follow-ups they provide are appreciated. For unpaid carers, the locality model offered by the Carer’s Gateway Service is highly regarded, and respite offered is seen as a lifeline to allow them to continue their caring role and look after their own health. There are areas of improvement to be made, with people concerned about continuity of care, particularly within the mental health and community care services. Patients report not being able to see the same professionals, and inconsistent follow ups. Parents report isolation, often feeling alone or unsupported, particularly young or new parents, and working parents struggle to access peer support groups. Some also report a lack of postnatal mental health support, though health visitors are praised for the level of support they offer. People report a shortage of options for bereavement support, and family support for those affected by substance use or mental illness. There is also a persistent stigma around accessing substance use services and a perception that the ADP is more for drug support than alcohol. Co-occurring mental health and substance use is an area people consider more resource to be required, and parents report a lack of support for coping with their child’s neurodivergence, particularly accessing support when they are undiagnosed. Trauma-informed care is mentioned across service-users, with desire for more training to ensure staff can consider personal circumstances when providing services. Short term activity • Continue working closely in partnership with the local Third and Community sectors, signposting to services and considering existing community support when considering new or changes to services. • Support service users to access support in other aspects of their life • Work to improve stigma in accessing mental health and substance use services • Continue to adopt a partnership approach to preventing harm related to domestic violence by working with victims, perpetrators, and families, and aiming to find family- based solutions. 134
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23 Medium Term Activity • Prioritise a family-inclusive approach through services, considering the service user, their families and carers. • Consider current and future options to enable independent living in the community. • Prioritise recovery-focussed care for those experiencing mental health concerns, conditions, or crises, and/ or those affected by substance use. • Review current throughcare services provided by justice services and work with partners to further develop wraparound support for those involved with justice services. • Embed a trauma-informed approach to service delivery to ensure service users experience compassionate services that consider their experiences and needs. Long term Outcomes People receiving care and their families can access the support they need in all aspects of life, including financial and emotional. North Ayrshire has a strong and independent Third and Community Sector with whom the Health and Social Care Partnership works to provide joined up care and support to the community. 135
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24 SDP5: Accessibility and Communication Over the last 2 years, the HSCP has carried out formal engagement with around 2,900 people through a variety of engagement exercises, and further informal engagement through conversations with service-users. The two biggest areas of feedback we have received has been regarding access to services, and the need to improve communication. People feel as though they don’t know what services are available, or they don’t know how to access them. Access to services remains the most consistent concern, with people citing barriers to timely and equitable access, especially in rural and island communities, long wait times, gaps in post- discharge and transitional support and limited out of hour availability. Diagnostic pathways, especially for neurodiverse individuals and mental health, were often seen as convoluted or inconsistent. People feel as though there are information and communication gaps, with many reporting confusion with navigating services due to eligibility, fragmented information, lack of follow-up, and unclear care pathways. Digital tools are viewed positively when people can access them, such as online prescriptions and wellbeing apps, but there is concern that this could limit equitable access, with older people, carers, and rural residents particularly affected due to digital literacy, connectivity, and inaccessible platforms. People report having to repeatedly share their stories to different practitioners, which can be emotionally draining and inefficient. Some groups may find accessing information more challenging than others, and improved information accessibility, such as using plain language, visual aids, translations, and audio versions, was viewed as essential to ensure all people, regardless of background or ability, can understand and benefit from available supports. Children and young people report that they find it difficult to access information regarding health and care and have suggested more could be done through schools to ensure they are aware of what support they have access to, particularly around mental health support. Short term activity • Publish information regarding the structure and teams within the HSCP to enhance understanding of team functions and services with the public as well as between services. • Review information available on the HSCP website and in community spaces, ensuring information is up to date and accessible, including language availability and alternative formats. • Investigate local barriers to accessing health and social care services in North Ayrshire and explore how to make them more accessible • Consider how digital tools can support wellbeing outside of direct access to services. Medium Term Activity • Deliver actions outlined in the IJB Equality Outcomes for 2025-2029, which aim to improve information and communication for specific protected characteristics. • Review available tools and resources available to the community outside of services to ensure people have access to information and support if they are not at a stage of requiring clinical support. 136
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25 Long term outcomes People in North Ayrshire understand the role of the Health and Social Care Partnership, what services are available, and how to access them. Information provided by the Health and Social Care Partnership is clear, and available in a range of formats to meet the needs of the community. 137
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26 SDP6: Evidence and Performance The Scottish Government published its first data strategy for health and social care, ‘Greater access, better insight, improved outcomes: A strategy for data-driven care in the digital age’ in 2023. It aims to make the best use of data in the design and delivery of services by making it more accessible and readily available for service-users, staff, and decisionmakers. The use of data is widespread across the HSCP, but it is not always joined up or shared, creating duplication between teams and services and a lack of transparency in decision making. Over the next 3 years, in terms of its use of data, the HSCP aims to make improvements regarding: • Using data to inform decision making • Using data to evidence performance • Using data to improve services • Using data to create insights To inform this Strategic Plan, the HSCP developed a comprehensive Strategic Needs Assessment to investigate how the demography and population was changing, how health and care needs were changing, and how our services were performing. We aim to continue using data to inform our planning processes and create a clear link from population insights through to service delivery through the use of service planning and evaluation processes. Another key focus in terms of creating an evidence base, is the use of engagement in the design and delivery of services. North Ayrshire HSCP has a proven track record of using lived experience to support the design of services, but at times services can carry out engagement where the results are used within the service but are not shared more widely which can lead to people being asked the same questions across different services. To inform this Strategic Plan, the HSCP collated all existing insights we have collected via engagement methods over the previous 2 years and analysed it for themes and prevalent issues. The aim is to continue to build on the knowledge we have collected by continually adding to the centralised engagement record through the engagement caried out across the HSCP. This could include HSCP wide engagement, engagement with specific communities, engagement with specific services users, or engagement with staff. We want to ensure that when people take the time to share their opinions with us, we use it as much as we can to inform the way our services are delivered. Short term activity • Develop a revised performance management framework for the HSCP. • Increase the transparency of our use of data and share data across services and partners where possible, to reduce duplication and enhance partnership working. • Develop a new Participation and Engagement strategy which will outline how and with whom we plan to engage to ensure delivery of the strategic plan and inform future plans and services. • Ensure that lived experience is used in the design and delivery of services and people are supported to participate in decision making. • Ensure people can participate in their own care plans and future planning to improve services. 138
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27 Medium Term Activity • Continue to engage with services and staff to understand their challenges and develop a new Workforce Plan to ensure sustainability of services. • Promote public engagement processes and online participation to ensure people can provide feedback on the care and support services they receive. • Develop service plans which will demonstrate how services plan to deliver the strategic plan, improve services, and respond to changing demographics and demand. • Carry out an audit of performance, data, and service quality reporting carried out across the HSCP and identify any duplication and areas of inefficiency in order to streamline reporting processes and ensure services are focussed on delivering quality services and improving outcomes. • Involve children, young people and their families or carers in all decisions/plans that affect them, including the design, planning, delivery and review of services. Long term Outcomes North Ayrshire Health and Social Care Partnership can demonstrate clearly how data and engagement is used to design, deliver, and improve its services. Service users understand how our services operate and how their feedback is being used to influence decision making and planning processes. 139
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28 Enabling Plans The Enabling Plans are supporting documents that will help with the delivery of the Strategic Plan. They are fundamental to supporting the way the organisation works and require detailed planning and analysis so are delegated into their own plans. Although these plans are separate to the Strategic Plan, they do reflect the needs of the organisation, and the activity planned and developed through these plans will be reflected in the Strategic Plan Delivery Plan to ensure coordinated delivery. Workforce The last 5 years have presented unique challenges for the health and social care workforce across Scotland and in North Ayrshire. The Covid-19 pandemic created changing priorities, and we are still seeing the impacts with the backlogs created. The demographic shift to an older population has created greater care challenges, and the financial strain created by inflation, austerity and global economic challenges, has meant working in a time where more care is required with less resource with which to provide it. There are persistent challenges for the health and social care workforce that cause difficulty and risks in delivering services. The social care sector is considered to have a fragile workforce due to factors such as workforce demographics, ageing, burnout and wellbeing, and although the workforce is growing, the vacancy rate is much higher than across the economy as a whole. NHS staff also has high vacancy rates and the number of people leaving the health sector has increased since the pandemic. This Strategic Plan sets out priorities for service delivery which will impact the resources of teams, as well as strategic priorities which will look across the organisation at the way services are being delivered more broadly. In order to deliver this Strategic Plan, the workforce must also be planned for to ensure that we have the right resources in the right places, and that we are not creating pressures on teams that could lead to burnout, stress, or turnover. We want to ensure our workforce is well trained, adequately resourced, and feel supported to do their jobs well, within the context of the financial and service challenges we face. North Ayrshire Health and Social Care Partnership published its 2022-2025 Workforce Plan in October 2022, which outlined the 5 priorities for workforce planning: 1. Plan: Understanding our Workforce 2. Attract: Promoting our Organisation 3. Train: Investing in our People 4. Employ: Building our Workforce 5. Nurture: Growing our People The Scottish Government published a Health and Social Care Service Renewal Framework in June 2025 which outlines a how it plans to deliver the vision for health and social care in Scotland. This addresses that there will be impacts on the workforce, and outlines that it will work with partners to strengthen workforce planning to deliver services that are planned and designed based on population needs. 140
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29 North Ayrshire Health and Social Care Partnership awaits further guidance around workforce planning in a national context and will work to develop a new Workforce Plan to support delivery of this Strategic Plan in 2026/27. Digital A Digital and Data delivery plan was developed in 2024 to enable more digital use across communities and staff, and address some of the challenges that remain as we work in partnership across different organisations and digital systems. It aims to: • Enable individuals and groups to access the health and social care services they need by providing digital access to information, opportunities to access self-management resources, and allow access to personal information. • Create digital care pathways that support early intervention and preventive care through remote monitoring and online assessments, including smart supports, AI, and robotics, and offer digital service options such as telehealth and virtual consultations. • Streamline administrative processes with the use of digital tools. • Enhance digital infrastructure to ensure staff across the NHS and Council have the access they need to deliver integrated services and have the foundational technologies to do their jobs well. • Promote digital skills across staff and communities and encourage the use of digital tools and transformation. • Work with community partners to improve health literacy and raise awareness of technologies that can support people’s health and wellbeing. • Use data analytics to drive change, improve services, and make informed decisions, including using data to identify and address disparities, inform preventive care strategies and early interventions, and improve outcomes for individuals and communities. The Digital and Data delivery plan will enable the delivery of the Strategic Plan by supporting the improvement of digital skills and digital technologies, which will support continued transformation and service efficiency. Participation and Engagement People across North Ayrshire engage with the Health and Social Care Partnership in a range of ways through their interactions with services. It can be through complaints or feedback related to their experiences of services, through surveys and organised engagement sessions for specific purposes, or it could just be in the conversations they have with clinicians or support staff. The feedback we receive from service users is an integral part of service design and improvement, as a way of understanding what works and what doesn’t work, where there are gaps or flaws, or where things could be made more efficient from the point of view of the user. It is essential that as we engage with our communities and service users, we consider those that may not share their views with as much ease as others, such as those that experience language or accessibility barriers, those that aren’t available during the day, and those that we haven’t historically sought the views of such as children. 141
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30 One of our service priorities is to use evidence for decision making, and this includes the lived experience of those accessing services, their families or carers, as well as the employees of services. The Health and Social Care Partnership will develop a new Participation and Engagement Strategy for 2026-2030, which will outline our approach to engagement at an organisation level, how we will enable people to participate in the design and delivery of services, and how we will use engagement to support the delivery of this Strategic Plan. Transformation Transformation is making best use of available resources to change services to achieve better outcomes and experiences. The Transformation Plan 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 services in North Ayrshire. It delivers measurable improvement by fundamentally changing how care is delivered, what staff do, and the role of communities and individuals. The Transformation Programme supports the delivery of the Strategic Plan by reviewing areas where there is the potential for improvements and efficiencies, which help financial sustainability in the long run. This allows services to focus on responding to the current and future health and care needs of the community set out in this plan. The current Transformation Plan was agreed in March 2024 and is in place until 2027, and projects are designed to consider areas to make savings or reduce overspend without compromising the quality of services, and areas of potential investment to make improvements to the way services are delivered. Major transformation projects in the plan include: • Brighter Pathways: the remodelling of children’s care options with an aim to reduce overspend by providing more local care options and support pathways. This aligns with the aspirations of The Promise, and the overall aim is to improve outcomes for care experienced children and young people and to provide intensive support to prevent family breakdown and children needing formal care. • Woodland View: Reviewing models of care within Woodland View, including reviewing high-cost placements, reviewing inpatient care options and reviewing the workforce. • Coming Home: reviewing complex care within the Learning Disability service. • Digital: reviewing options for using technology to improve administrative burden, care options, and efficiencies. The Transformation Programme is monitored via Transformation Board on an ongoing basis and will be evaluated and reviewed in 2027 in order to develop the next iteration of the plan, in line with the strategic aims set out in this plan. 142
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31 Locality Planning The Public Bodies (Joint Working) (Scotland) Act 2014 is the integration legislation that outlines how a Health and Social Care Partnership must operate. As part of the Strategic Planning requirements, each HSCP must divide the area into a minimum of 2 localities and set out separate arrangements for carrying out integration functions within each locality. The purpose of localities is to enable localised services based on the circumstances and needs of smaller areas to ensure services are set out how they are needed, and to ensure local leadership for service planning, allowing localities to have influence on how resources are spent in their area. The Community Planning Partnership (CPP) also has a requirement to carry out locality planning, with the purpose of tackling inequalities and empowering community bodies to participate in decision-making. The IJB is a member of the Community Planning Partnership and therefore participates in this function as well, but the Locality Planning outlined in the integration legislation is for the IJB specifically because it is about ensuring services are meeting the health and care needs of smaller communities. In North Ayrshire, there are 6 Localities for the purpose of Locality Planning, both for Integration and for Community Planning. These localities are: • Arran • Garnock Valley – Beith, Dalry, Glengarnock, Kilbirnie • Irvine • Kilwinning • North Coast and Cumbrae – West Kilbride, Fairlie, Largs, Skermorlie • Three Towns – Ardrossan, Saltcoats, and Stevenson Arran Arran is a small island community and locality arrangements are long established within Arran due to the unique geography and circumstances. These arrangements bring together the Community Planning and Health and Social Care Partnership locality requirements into one Locality Planning Partnership, and the themes that are set out within the Arran Island Plan are the themes used for all locality and island planning processes. The Locality Priorities for Arran are: • Economy • Community • Environment Each of these themes has a community-led working group which feeds into a Local Island Plan Delivery Group, which in-turn feeds into the Arran Locality Planning Partnership. Mainland & Cumbrae localities Locality Arrangements for the mainland and Cumbrae localities have evolved over time and are currently under further review. Initially, each area had a Locality Planning Forum where local staff would come together to discuss issues and actions for each community, but due to the Covid-19 pandemic, meetings were no longer able to take place in person, and the HSCP had to deliver services in new ways, which meant they had to focus on ensuring their service-users were supported. 143
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32 Between 2024 and 2025, the HSCP refocussed locality planning to be more engagement- orientated, to ensure feedback was collected from a wide range of people within each locality. • April 2024: Engagement events held in each locality with the general public. • September 2024: Targeted engagement with existing community groups with shared characteristics. • April 2025: Targeted engagement with children and young people including a survey and participation in the joint youth cabinet. Locality Planning Review Groups were also set up within each locality in order to review the results of the engagement as well as data from locality profiles and local staff insights. This process us currently being evaluated to look at options for better integration with the Community Planning Partnership and more effective use of resources. CPP Locality Partnerships For the 5 mainland (including Cumbrae) localities, the Community Planning Partnership has Locality Partnerships, which include officers from Community Planning Partners and community representatives. This approach was reviewed in 2025 and a set of recommendations have been proposed which include opportunities to better support locality planning partnerships, the form and content of meetings, and a renewed focus on locality action plans. The proposed next steps will build upon existing good practice to further strengthen the role of locality planning and the involvement of communities in local democracy. The Community Planning Partnership is currently working on the roll out of these recommendations. Each Locality Partnership has its own set of locality priorities which the Partnership works together to achieve and reports progress annually. Developing Locality Plans In 2026, following the adoption of the Strategic Plan, the Health and Social Care Partnership will review all available evidence for each locality to develop individual locality plans. These plans will: • Consider the available locality-level data collected through Public Health Scotland Locality Profiles. • Consider previous engagement through both locality planning sessions and engagement collated as part of the Strategic Planning Process at a locality level. • Consider the local priorities of each locality set out through the Community Planning Partnership Locality Planning Partnerships. • Align with the priorities of this Strategic Plan. • Consider the existing HSCP service arrangements in each locality. • Involve staff from locality services within localities. 144
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33 DELIVERING THE PLAN Finance The Integration Joint Board has responsibility for delivering services that have been delegated by the Council and the NHS Board in order to carry out integrated functions, and as such, is delegated budgets to deliver these functions. North Ayrshire Council and NHS Ayrshire and Arran provide funding to North Ayrshire Health and Social Care Partnership in order to deliver the health and care services set out in the Integration Scheme. North Ayrshire Integration Joint Board has a duty to deliver these services while aligning the budget to the Strategic Plan. 2025-2026 Budget The North Ayrshire Health and Social Care integrated budget for 2025-26 is expected to be £335.731m (including Set Aside budget of £36.058m). This consists of £137.739m from North Ayrshire Council and £197.992m from NHS Ayrshire and Arran (including £36.058 set aside, which is a delegated hospital budget for unplanned care). Total net budget pressures for health and social care services total £14.943m, which includes pressures from pay deals, demographics, contract inflation, and employers National Insurance, as well as service delivery pressures. The table below summarises the projected financial position for 2025-2026, which includes the opening position, additional funding and cost pressures, projected planned savings, and the leftover projected position for the end of the year if further savings are not identified. NAC £m NHSAA £m Total £m 2025/26 Opening Position (overspend from last year) (1.055) (0.484) (1.539) Funding Increase 7.834 4.040 11.874 Service Pressures (10.680) (4.263) (14.943) Budget Gap (2.176) (0.893) (3.069) Projected Savings 2.903 1.116 4.019 (Surplus)/Deficit 1.163 (0.213) 0.950 Leftover surplus/ deficit 0.108 (0.697) (0.589) Since the budget was set there have been various budget reductions and increase to reflect budget changes and allocation of funds. This takes the budget to £340.8m at month 6. 145
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34 The budget for 2025-26 has been allocated for use as follows: The above info can also be split info: OR: Partnership Budget - Objective Summary 2025/26 Budget £'000 COMMUNITY CARE AND HEALTH 100,020 : Locality Services 38,874 : Community Care Service Delivery 41,771 : Rehabilitation and Reablement 2,136 : Long Term Conditions 11,529 : Community Link Workers 374 : Integrated Island Services 5,336 MENTAL HEALTH SERVICES 118,496 : Learning Disabilities 32,676 : Community Mental Health 8,924 : Addictions 3,926 : HBCCC 353 : Lead Partnership Mental Health NHS Area Wide 72,617 CHILDREN & JUSTICE SERVICES 42,224 : Irvine, Kilwinning and Three Towns 3,259 : Garnock Valley, North Coast and Arran 3,619 : Intervention Services 1,827 : Care Experienced Children & Young people 22,749 : Head of Service - Children & Families 1,363 : Justice Services 3,101 : C&F Health Team 5,426 : Lead Partnership NHS Children's Services 880 COMMUNITY CARE AND HEALTH 27% MENTAL HEALTH SERVICES 31%CHILDREN & JUSTICE SERVICES 11% CHIEF SOCIAL WORK OFFICER 1% PRIMARY CARE 14% ALLIED HEALTH PROFESSIONAL 3% MANAGEMENT AND SUPPORT COSTS 3% LARGE HOSPITAL SET ASIDE 10% 2025/26 Budget 146
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35 CHIEF SOCIAL WORK OFFICER 1,983 PRIMARY CARE 54,721 ALLIED HEALTH PROFESSIONALS 11,504 MANAGEMENT AND SUPPORT COSTS 11,819 OUTTURN ON A MANAGED BASIS 340,767 Large Hospital Set Aside Budget 36,058 MONTH 6 PROJECTION 376,825 OR £m % share Community Health Care Services 119,434 32% Social Care Services 166,612 44% Primary Healthcare Services 54,721 15% Large Hospital Services 36,058 10% TOTAL 376,825 100% Medium Term Financial Outlook A Medium-Term Financial Outlook identifies what the financial position may look like over a 3- year period. The Medium-Term Financial Outlook has been carried out for 2026-27 and 2027-28, but this has not been published in full at the present time as the Scottish Government intend to publish their Fiscal Sustainability Delivery, alongside a revised Medium Term Financial Strategy. It is also considering options for a Scottish Government Spending Review in 2025, following the conclusion of the UK Government’s multi-year Spending Review in late Spring. Following this, a full update report will be brought to IJB covering the period 2026-27 to 2028-29. The modelling which has been carried out across best, medium and worst-case scenarios for 2026/27 and 2027/28 is as follows: POTENTIAL BUDGET GAP 2026-27 £m 2027-28 £m Based on Best Case Scenario 8.130 0.658 Based on Medium Case Scenario 13.630 5.716 Based on Worst Case Scenario 21.436 14.698 The budget position for 2025/26 has proven to be between the medium and the worst-case scenario which was previously projected for that year, and it would be prudent to assume a similar position for the following years. For 2026/27 this would mean identifying savings between £13.6 and £21.4m. For 2027/28 this would mean identifying savings between £5.7m and £14.7m. 147
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36 Financial Risks There are a number of ongoing financial risk areas that may impact on the 2025-26 budget during the year, these include: • Growing Demand for Services and High service costs: Increasingly complex needs, ageing population, and overspend on low volume / high-cost services e.g. Children’s residential placements, UNPACs, and supplementary staffing across community, mental health and learning disability wards. • Staffing Costs: increase in Employers National Insurance Contributions, higher than anticipated pay deal (assumed increase of 3%, agreement of 4% for NAC, and 4.25% for NHS for 2025/26) • Service Delivery Challenges: Staff recruitment and retention challenges across a number of service areas, the expectation that performance will continue to be maintained or improved despite the significant resource challenges. The National Position Overall, the financial outlook for Health and Social Care Partnership is challenging with significant budget gaps across the country to maintain the current service provision (national budget gap of £497.5m for 2025-2026). Budget gaps for IJBs across Scotland range from 1.3% to 12.6% with significant level of variation. Many IJBs also have depleted reserves (national total at April 2025 £55m) and of those with reserves only one meets the best practice contingency reserve level of 2-4% of revenue budget. Whilst there are variations in the scale of the gap, the areas contributing to the pressures across the system are similar and include: • Increases in demand, complexity and demographics • Prescribing • Recurring deficits/ baseline pressures/ inflation • Pay pressures • Contract inflation for commissioned services These critical financial pressures facing IJBs have been shared by Health and Social Care Scotland with Scottish Government to seek additional financial support for community-based health and social care services. Commissioning Under the Public Bodies (Joint Working) (Scotland) Act 2014, Integration Joint Boards are required to produce and publish a Strategic Commissioning Plan otherwise known as a Market Facilitation Plan (MFP). This MFP is aligned directly to this Strategic Plan, which aims to ensure the right social care services are available at the right time and in the right place. It will support existing and potential social care providers to make strategic decisions about their operations and investments by sharing data and insights into current and future service needs and how this will result in changing landscapes for social care. There are three fundamental areas of care within the HSCP: Children and Families, Health and Community Care and Mental Health. The MFP provides a breakdown of services currently being 148
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37 commissioned, drivers for change, current developments, and future commissioning objectives where they are known. It is worth noting that the details may be subject to change based on evolving need, objectives, and challenges. The Market Facilitation Plan will: • Detail how commissioning will support the Integrated Joint Boards to meet the strategic objectives outlines in this Strategic Plan. • Outline national and local policies which direct our commissioning and procurement practice. • Outline how the HSCP aims to ensure effective joint working with a wide range of internal and external partners to ensure choice, control and access to good quality care and support services. • Detail how our contract management approach will contribute towards market development, leading to positive outcomes for individuals and their carers. • Outline how the HSCP and others will support Provider organisations to understand the challenges care and support services face. • Identify areas where services are insufficient or where there are unmet needs, allowing for targeted support and development of services in those areas. • Encourage collaborative working between commissioners, providers, and individuals receiving care, fostering a more integrated and person-centred approach to service delivery. • Ensure a commitment to providers views being sought when developing new and innovative services that better meet the evolving needs of individuals and their carers. • Work towards ensuring ethical commissioning principles, and that services are procured and delivered in a fair and transparent manner. • Ensure that social care services remain relevant and effective. The Market Facilitation Plan is currently under development in order to align to the objectives and priorities set out within this Strategic Plan. The Market Facilitation Plan will be in place alongside the Strategic Plan from April 2026. 149
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38 Delivery and Monitoring This Strategic Plan will be published alongside a suite of complementary documents before the delivery period begins on 1st April 2026. • Participation and Engagement Strategy: Outlining how we will engage over the duration of the plan to assist plan delivery and ensure continuous feedback from communities. • Delivery Plan: This plan outlines the activity the HSCP plans to achieve over the life of the plan. A delivery plan will outline in more detail how this will be achieved through specific actions, including activity outlined in our enabling plans. • Performance Management Framework: This will be developed to ensure performance management is coordinated across the strategic plan and related plans. This will ensure performance indicators are linked to the strategic plan and show how service delivery contributes towards the national health and wellbeing outcomes. Performance As outlined above, the Delivery Plan and Performance Management Framework will go into detail about how this plan will be delivered and how performance and outcomes will be monitored. Annual Performance Report The IJB is required to produce an Annual Performance Report each summer setting out an assessment of performance during the previous reporting year. Regulations attached to integration legislation sets out the required content of these plans, which must include: • An assessment of performance against the National Health and Wellbeing Outcomes (NHWBO), including: o A description of how the strategic plan has achieved what it was set out to over that year, including finances set out, in relation to the National Health and Wellbeing Outcomes, o Performance against the Key Performance Indicators in relation to the National Health and Wellbeing Outcomes, o A comparison of Performance Indicators in that reporting year compared to the previous 5 reporting years. • An assessment of performance in relation to the Integration Delivery Principles. • An assessment of performance in relation to the Strategic Plan, and any significant decision made outside of the Strategic Plan. • Information about financial performance, including total spent on hospital inpatients, other health care services, social care services, unpaid carers, and other care services. • Information about best value, and how the planning and delivery of services contributed to securing best value. • An assessment of performance in respect of localities, including engagement in localities, spend in each locality, and comparison of previous years. • Information about an inspection carried out of services over the year. • A statement regarding whether the Strategic Plan was reviewed over that year, and whether this led to a revised plan. 150
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39 The Annual Performance Report for 2024/25 currently reflects the Strategic Priorities outlined in the current Strategic Plan Caring Together. This updated plan is due to be adopted for the beginning of 2026, so the Annual Performance Report for 2025/26 will also reflect the priorities of Caring Together. Following the adoption and publication of this Strategic Plan, the Annual Performance Reporting format will be revised to ensure it reflects the updated priorities, which will be reported in summer 2027, to reflect the previous reporting year of 2026/27. Quarterly Reporting In addition to the Annual Performance Report, the Performance and Audit Committee monitors the performance of the HSCP on a quarterly basis. These reports also provide highlights of achievements and challenges over the quarter, as well as providing regular updates on performance indicators across services. The Quarterly Report contains: • MSG Performance Indicators: These are indicators that are reported to the Ministerial Strategic Group for Health and Community Care which outline how the HSCP is progressing against a range of whole system level measures related to unscheduled care and delayed discharges. • Service-level Performance Indicators: These are indicators that monitor performance within the three operational services: Children, Families and Justice, Mental Health and Addictions, and Health and Community Care. • Workforce Data: Absence rates provided by service and absence reasons across the Partnership. • Financial Information: including budget, spend and variance, by service. The first Quarterly Report to reflect the new Strategic Plan priorities will be Quarter 1 of 2026/27, reflecting 1st April to 30th June 2026. National Health and Wellbeing Outcomes Regulations to the Integration legislation set out outcomes that all HSCPs across Scotland should aim to contribute to. The Strategic Plan should outline how activity will support their delivery, and the Annual Performance Report should report how this has been achieved each year. The outcomes are: 1. People are able to look after and improve their own health and wellbeing and live in good health for longer. 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community. 3. People who use health and social care services have positive experiences of those services, and have their dignity respected. 4. Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services. 5. Health and social care services contribute to reducing health inequalities. 6. People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well-being. 7. People who use health and social care services are safe from harm. 151
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40 8. People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide. 9. Resources are used effectively and efficiently in the provision of health and social care services. The Strategic Plan Delivery Plan will outline full details of actions to deliver the priorities set out in this Strategic Plan, including how these will contribute to the National Health and Wellbeing Outcomes. 152
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41 WORKING IN PARTNERSHIP The Community Planning Partnership Community Planning was first introduced in Scotland in 2003 as a statutory requirement to bring public sector organisations and communities together to jointly plan for services in each local authority area. The Community Empowerment Act (Scotland) 2015 strengthened this duty, placing explicit requirements on partners to work together to improve local outcomes and strengthen community rights and participation. Community Planning Partners include the local authority, local Health Board, Integration Joint Board, Scottish Enterprise, Police Scotland, Scottish Fire and Rescue service, local colleges or university Boards, Historic Environment Scotland, and Skills Development Scotland, among others. The North Ayrshire Community Planning Partnership’s Partnership Plan for 2022-2030 outlines the priorities for improving local outcomes under the themes of ‘Wellbeing, Work and World’ to achieve its local vision of ‘Fair for All’. North Ayrshire Health and Social Care Partnership participates in all Community Planning structures in order to work with local public and third sector organisations with the goal of achieving the priorities set out in the plan. In addition, the HSCP regularly works with partners to deliver our services to ensure whole- person support for our services users. The Third Sector Interface Third-sector organisations in North Ayrshire are diverse and play a significant role in supporting the community. They include charities, voluntary groups, social enterprises, and community- based organisations. In North Ayrshire, the third sector is vibrant and consists of numerous organisations serving the community. The Ayrshire Community Trust (TACT) and Arran Community and Voluntary Service (ArranCVS) work in partnership to form the Third Sector Interface North Ayrshire (TSINA) who assist with support and coordination of the sector. ArranCVS hold lead responsibility for the integration of third sector services, and staff act as a bridge between statutory services and the third sector, making sure teams and organisations supporting people in the community are connected to the right support at the right time. They link social worker teams, community link workers, health care teams and community partners to the local charities, voluntary groups, and social enterprises they work with to ensure services such as befriending projects and low-level mental health support are easy to access. Beyond linking services, they have a strategic role in bringing partners together, highlighting gaps or duplication, and helping design more joined-up care. By supporting smaller organisations with funding, governance, training, networking opportunities, and advocacy and by being a source of knowledge on the sector both locally and nationally, they strengthen connections and make it possible for community voices to shape local health and social care. In practice, this means that issues like loneliness, poverty, or poor health can be tackled through coordinated action between the NHS, the council, the HSCP, and community groups. The TSI makes sure the third sector is not just delivering services but also influencing how care is planned and delivered across North Ayrshire. 153
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42 Third-sector organisations in North Ayrshire can be grouped into several broad categories, including charities, voluntary groups, social enterprises, Community Interest Companies (CICs), advocacy and campaigning groups, faith-based organisations, sports and recreation groups, and Health and Social Care Providers. By working together, North Ayrshire Health and Social Care Partnership, stakeholders and third- sector organisations can strengthen the health and social care landscape in North Ayrshire, ensuring the community receives comprehensive and equitable care. Commissioned Services Health and social care services are responsible for identifying and commissioning care and support services to meet the specific needs of their population in line with the Strategic Plan. This includes ensuring a range of high-quality, accessible, and responsive services are available which promote the independence and well-being of individuals while ensuring best use of resources. The Partnership commissions external care and support services through a Self-Directed Support mixed delivery model with a scheduled programme of tender and procurement related projects; along with a single purchase model aligned with user choice. The total value of Care and Support contracts the Partnership holds is approximately £41.8m annually, delivered by approximately 92 providers. Housing Services Housing is a key component of meeting the health and care needs of people in North Ayrshire. There are numerous different service-users that have specific housing needs that impact the way they receive care, for example: • Older people, people with physical or learning disabilities, or people with mental health disorders may require housing adaptations to allow them to remain independent at home. • Older people, people with physical or learning disabilities, or people with mental health disorders may require specialist housing in the community to maintain independence and prevent hospitalisation. • Older people, people with physical or learning disabilities, or people with mental health disorders may require specialist care homes for provide further care if they are unable to remain at home. • Children and Young People with Care Experience may require support from the Council and Health and Social Care Partnership to meet their housing needs, such as children’s homes, foster care, or throughcare support into their own tenancy. A Housing Contribution Statement has been prepared to accompany the Strategic Plan, which sets out the shared ambition between the HSCP and Housing service to support everyone living in North Ayrshire to have healthy and thriving lives. It outlines how the services will work together to support households with more complex needs, whether that be identifying bespoke housing or support solutions or prioritising repairs for vulnerable households. The Housing Contribution Statement identifies shared outcomes, key areas for improvement and how the HSCP and Housing services will work together over the life of this Strategic Plan to support its priorities. 154
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43 A summary of the Housing Contribution Statement has been included as Appendix 3, and the full Statement will be published alongside this Plan. 155
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44 APPENDICES Appendix 1: Lead Partnership Statement North Ayrshire HSCP North Ayrshire HSCP will continue to manage and deliver the following services on behalf of the East and South Partnerships. Mental Health Inpatient Services Mental Health Inpatient services across Ayrshire, including: • Acute inpatient assessment for individuals experiencing functional and/or organic presentation • Low Secure male inpatient services • Intensive Psychiatric care provision • Generic and forensic rehabilitation services, including community-based provision at Warrix Avenue, Irvine • Hospital Based Complex Continuing Care for individuals 65 and over on Ailsa site • Inpatient addiction service, offering inpatient detoxification programme, residential and day attendance rehabilitation programme Also included within the inpatient portfolio of services are: • Community Forensic Team • Acorn – service based at Ailsa offering structured activity, sheltered employment opportunity and supporting individuals who have/are experiencing mental disorder to develop a range of skills Inpatient services are split between Woodland View on Ayrshire Central Hospital site in Irvine and on Ailsa Hospital site in Ayr, the majority of adult services being based at the new bespoke provision within Woodland View. Pan Ayrshire Mental Health Unscheduled Care Service The Pan Ayrshire Unscheduled Care Mental Health Service is operationally managed by the North Ayrshire HSCP, however has bases and touchdown points within East and South HSCP as well as its mainland Acute and Community Hospital sites. The following teams are included: • Intensive CPN Team • Mental Health Liaison Team • Alcohol & Drug Liaison Team • Elderly Mental Health Liaison Team • Mental Health Advanced Nurse Practitioner Team • The Emergency Services Pathway falls within this service and is supported by the above teams. This pathway is operational 24 hours per day, 7 days per week, 365 days of the year and provides a professional-to-professional response to our colleagues from Police Scotland and Scottish Ambulance Services. 156
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45 • The Mental Health Unscheduled Care Assessment Hub within Woodland View (Ward 7B) will also be supported and manned by the staff from the above teams. This service will provide an alternative setting of intensive assessment for adults aged 18-65 who would have been previously admitted to adult acute admission wards at Woodland View. Psychology Services Psychological Services are provided across Ayrshire and Arran and are embedded within various specialist teams. Specialities covered are: • Child Psychology • Community Paediatric psychology • Medical Paediatric psychology • Infant Mental Health • Perinatal Mental Health • Adult Mental Health • Older Adults • Clinical Health psychology • Neuropsychology • Staff Wellbeing service • Learning disability services • Adult Forensic psychology • Adult Inpatient psychology • NASIS • Addictions psychological service • Eating Disorders Psychological service • V1P Veteran Service The service deploys a range of staff within these specialist roles to undertake focused work and leadership roles. Child and Adolescent Mental Health Service (CAMHS) The CAMHS service is a specialist Pan Ayrshire mental health services providing assessment, diagnosis, and treatment for young people with mental health conditions. CAMHS deliver services in line with the National CAMHS Specification published Sept 2021. CAMHS teams include: • Specialist Community CAMHS (SCCAMHS) • CAMHS Unscheduled and Intensive Treatment (CUAIT) Team • Neurodiverse-CAMHS (N-CAMHS) Community Eating Disorder Service (CEDS) Community Eating Disorder Services provide a Pan Ayrshire life span service for individuals experiencing an eating disorder such as Anorexia Nervosa and Bulimia Nervosa who require intensive community treatment, CEDS also provide input to acute inpatient services. 157
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46 Ayrshire & Arran Perinatal and Infant Mental Health Service The Ayrshire & Arran Perinatal Team is a specialist, tertiary care community mental health service offering assessment, diagnosis and treatment to individuals in the perinatal period across Ayrshire. The team works with women who wish to start a family but are at risk of becoming severely mentally unwell. The service also treats women who are pregnant or in the post-natal period and have severe mental illness or are at high risk of becoming severely unwell. The Infant Mental Health Team “Mini Minds Matter” focus on both indirect and direct work. Indirect work includes teaching, training, consultation, supervision, reflective practice, and strategic input; a focus is on upskilling the other member of the IMH system. Direct work will include evidence-based assessment and intervention approaches (once appropriate clinical space has been found). In addition, North Ayrshire has lead responsibility for the following Early Years Services: Children’s Immunisation Team The routine childhood vaccination schedule for pre-school children is delivered by locality- based teams in East, South and North Ayrshire. The schedule for school aged children is co- ordinated and delivered on a pan-Ayrshire basis by the school immunisation team based in North Ayrshire. Community Infant Feeding Service A pan-Ayrshire Community Infant Feeding Nurse post works across Ayrshire to provide a specialist service to families requiring more specialist support due to complex feeding challenges. The service supports health visiting and Family Nurse Partnership (FNP) staff with advice, and provides direct support to families via telephone, face to face discussions or home visits. The role also plays a critical part in taking forward strategic work in relation to breastfeeding including the UNICEF Baby Friendly accreditation. Child Health Administration Child Health Administration team co-ordinates, manages and supports the delivery of Ayrshire’s child immunisation programme and development screening programmes. The team maintains all records and information in relation to its remit and provides information to the Information Statistics Division (ISD) via nationally established data systems. East Ayrshire HSCP East Ayrshire HSCP will continue to manage and deliver primary care services across Ayrshire and Arran through Lead HSCP arrangements on behalf of the North and South Health and Social Care Partnerships: • General medical services • Community pharmacy • Community Optometry • Dental Services: General Dental Service and the Public Dental Service • Ayrshire Urgent Care Service In addition NHS Ayrshire & Arran directly commission East Ayrshire HSCP to conduct Primary Care Contracting on behalf of the Board. The vision for Primary Care services in Ayrshire and 158
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47 Arran is to have sustainable, safe, effective and person-centred services, which will be delivered in partnership between communities, Primary Care, Health and Social Care Partnerships and the Acute, Third and Independent Sectors. The Ayrshire and Arran vision aligns to the Scottish Government’s vision for the future of Primary Care service delivery, which is for multi- disciplinary teams, comprising a variety of health professionals, to work together to support people in the community. General Medical Services Primary Care is usually a patient’s first point of contact and it is estimated that around 90% of NHS contacts take place within general practice. There are 53 GP practices across Ayrshire and Arran who all operate as separate independent businesses in their own right. General practice brings a range of healthcare services to work alongside people and families in local communities. To help strengthen this, a new control was introduced in 2018 to facilitate a refocusing of the GP role as Expert Medical Generalist (EMG). This is still being delivered locally through the Primary Care Improvement Plan (PCIP). This integrated health and care model brings a number of additional professionals into general practice, including: nursing staff, pharmacists, mental health practitioners, MSK physiotherapists and community link workers to promote the GP role as an EMG within the practice team. In addition, patients are also signposted, where appropriate, to other primary healthcare professionals within the community. The Macmillan Improving the Cancer Journey service will become a key partner providing primary healthcare in the community by supporting the clinical and social needs of people, families and carers affected by cancer diagnoses. This aligns to the Caring for Ayrshire vision which focusses on individuals, families and communities with general practice and primary care providing accessible, continuing and co-ordinated care. Community Pharmacy NHS Pharmacy First Scotland was introduced in July 2020, replacing the local Minor Ailments Service. This service is delivered by every pharmacy in Scotland and is primarily a consultation- based service, designed to encourage the use of community pharmacy as the first port of call for all minor illnesses and common clinical conditions. An increasing number of Community Pharmacists are qualified Prescribers and can provide advice, care and treatment where appropriate, often without the need for an appointment. This offers people an alternative way to access care close to home at a time suitable to them rather than the need to see their GP. Community Optometry Community Optometrists provide a first point of treatment for minor eye ailments. If people require medicine for an eye problem this is provided free of charge from the community pharmacy through Pharmacy First Scotland. Community Optometry provides a range of services in addition to routine eye examinations and dispensing glasses etc. Optometry practices can carry out post-operative cataract reviews, some are accredited to undertake Diabetic Eye Screening and some provide the Low Vision Aid service. Geographical access to eye care at optometrist practices across all HSCPs in Ayrshire & Arran is good. Some fixed site practices also provide a domiciliary service and further coverage is available from large mobile optometry providers, which offers a service to those who are unable to access high street practices for their eye care needs. 159
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48 A number of Community Optometrists are becoming independent prescribers. These contractors are able to manage and treat a wider range of presenting eye conditions within the scope of their practice and in the community setting. Recently Community Optometrists were given increased digital access to clinical systems to enhance patient access and information sharing with secondary care services. This reduces the need for urgent referrals into secondary care services and supports the national Right Person, Right Place campaign. Dental Services NHS General Dental Services (GDS) is typically the first point of contact for NHS dental treatment for patients within the community. People register with a dentist in order to receive the full range of NHS treatment available under GDS. The Public Dental Service (PDS) acts as both a specialised and safety-net service providing care for individuals who are unable to obtain care through the GDS such as those with special care needs or patients living in areas where there were few NHS dentists providing GDS. The PDS provides out of hours dental care and a range of programmes supporting health inequality and dental education is also incorporated within the service. Oral health prevention is a key priority across Ayrshire and Arran. The Scottish Government published the Oral Health Improvement Plan (OHIP) in January 2018. The aims of the OHIP are to focus on prevention, encouraging a more preventive approach to oral health care for patients of all ages to ensure that everyone can have the best oral health possible and that education and information sharing is specifically targeted at individuals and groups most at risk such as those who do not attend regularly for check-ups, communities in low income areas and particularly those people who either smoke or drink heavily. The Childsmile toothbrushing Programme is a supervised programme also delivered by the oral health team aimed at helping children develop an important life skill at an early age, supporting positive development in their immediate social and physical environment. Ayrshire Urgent Care Service Primary Urgent Care Services are delivered through the Ayrshire Urgent Care Service (AUCS) which provides a 24/7 urgent care response to the population including out of out of hours General Medical Services. Over recent years, the service has adopted a multi-disciplinary integrated approach to out of hours services in Ayrshire bringing together Primary Care services, Social Work, and Mental Health services. AUCS operates from the Lister Centre at University Hospital Crosshouse supported by local primary care treatment centres based at University Hospital Ayr and Ayrshire Central Hospital in Irvine and the home visiting service as required for patients who need urgent care when their GP Practice is closed. In partnership with NHS24, there is continued promotion of self-care and redirection to the most appropriate services, i.e. local pharmacists. As well as providing General Medical Services during the out of hours period, AUCS acts as a 24/7 Flow Navigation Centre (FNC) to support patients navigate through various community led urgent care pathways. These innovative pathways support an improved patient journey with continued focus on community-based services. The success of the new pathways and ways of working is a result of good working relationships across Ayrshire and Arran and wider system partners including NHS 24, Scottish Ambulance Service, Police Scotland, as well as strengthened connections with GP practices and Community Pharmacy. The COVID-19 Therapeutics pathway is also delivered through the COVID Treatment Centre within AUCS. 160
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49 Data from the service demonstrates the effectiveness of avoiding unnecessary hospital attendances or avoidable admission to hospital which has better outcomes for patients. AUCS continues to build on the unique 24/7 model which incorporates OOH and FNC through continuous review of all pathways to evaluate efficiency and effectiveness to create and sustain fully person centred pathways for all patients, getting the right care in the right place at the right time. South Ayrshire HSCP South Ayrshire HSCP will continue to manage and deliver the following services on behalf of the East and North Partnerships. Community Equipment Store The Community Equipment Store supports the provision of equipment, such as hospital beds, mattresses, hoists, slings etc., across the Ayrshire and Arran Health Board. As lead, South Ayrshire Health and Social Care Partnership are responsible for oprational management and budget of the service. The service supports discharges from two acute hospital sites and rural/community hospitals, as well as supporting care in the community across the three Health and Social Care Partnerships. Community Equipment meets a wide range of needs across all care groups and ages, maximising independence and promoting functional abilities. The equipment provided enables children and adults to carry out the activities of daily living within their own home, including transfers, toileting, bathing and mobility. It can also offer specialist equipment solutions such as profiling beds, mattresses, seating and moving and handling equipment for people with more complex needs and longer-term health conditions, allowing them to be cared for at home. The Community Equipment service continues to be in high demand and has experienced significant increases in both deliveries of equipment and impact to budget. Despite this increase in demand the delivery times have improved, particularly for individuals requiring equipment at end of life. The store continues to have a focus to drive down lead times for equipment deliveries, whilst also enabling the ongoing focus on supporting quick access to equipment to avoid hospital admission, support hospital discharges and support individuals in the community. In January 2023, Scottish Government published “Equipment and Adaptations: Guidance on provision”. This guidance highlights the importance of equipment provision in enabling individuals to live safely and independently in their own home. Access to community equipment was an overarching theme referenced within the Caring For Ayrshire Rehab Workstream and has also been a key focus of the Palliative/End of Life workstreams. To adhere to the Scottish Government guidance and progress the actions required to develop the service, the Community Equipment Store has a number of key areas identified and an action plan has been developed. Key to this is the continued development ELMS, (Electronic Loan Management System) to manage and maintain stock, develop a more efficient referral system and improve service delivery. The HSCP is currently reviewing the demand and performance of the Community Equipment Store in order to promote efficient and effective management of the store and improve upon the support to the disciplines and communities who require its services. 161
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50 Continence The Integrated Continence Service promotes continence by empowering patients to self- manage through behaviour and lifestyle interventions. The objectives of the service are to offer intermediate clinics across Ayrshire and to offer an advisory service to patients, carers, care homes and voluntary organisations. Whilst also providing educational service to NHS clinicians. The service is advisory for all clinicians in Primary Care. This includes Children’s services, Health Visitors and School Nursing Teams across Ayrshire. Family Nurse Partnership The Family Nurse Partnership programme (FNP) is a licensed, intensive preventative home visiting programme. FNP focuses on helping first-time mothers, 19 years old and under) to engage in preventative health practices, supporting parents to provide responsive, sensitive, and positive parenting, and helping them to develop self- efficacy to both identify and achieve their future goals. Family Nurses in Scotland also deliver the Universal Health Visiting Pathway to the families they serve, alongside the FNP home visiting schedule. Family Nurse Partnership is a structured programme of tailored visits delivered by specially trained Family Nurses. This begins early in pregnancy and continues until the child’s second birthday. The three key goals of FNP are to: • improve pregnancy and birth outcomes, through improved prenatal behaviours. • improve child health and development, through positive, responsive caregiving; and • improve economic self- sufficiency of the family, through developing a vision and plans for the future. The FNP’s priorities that lie ahead are: • Started to roll out Motivational Interviewing Workshops for our Health Visiting, School Nursing and other colleagues within the multi-agency team. The motivational interviewing workshops for colleagues in other areas will also continue to be supported looking at a variety of ways in which these skills can be used to help explore different topics including breastfeeding. • The service is working with the Perinatal Mental Health service steering group to look at how it can best support clients both ante-and-post-natally with experienced trauma. • Developing a contraceptive champion model which will allow a Family Nurse (qualified in Family Planning) to deliver certain methods of contraception to clients within their home. This model is currently working well in FNP – NHS Lothian. • Continuing to develop our breastfeeding champion model by using new resources and cascading up to date learning and training to members of the team. The motivational interviewing workshops for colleagues in other areas will also continue to be supported looking at a variety of ways in which these skills can be used to help explore different topics including breastfeeding. 162
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51 Appendix 2: Consultation Statement Purpose of Engagement Engagement is carried out on a regular basis in the Health and Social Care Partnership, whether for specific purposes such as consultation on a decision or service, or through ongoing engagement, such as Locality Planning or What Matters to You. The Health and Social Care Partnership aims to continually build on its knowledge and understanding of the experience of service users by ensuring their feedback is used to continuously improve services and functions, so their views count for more than a single engagement exercise. For the Strategic Plan, it was decided that rather than do a standalone engagement collecting views for the purpose of developing the plan, we would learn from what people had already told us through their participation over the last couple of years. Service users, community members and staff have taken the time to submit their views on various services, strategies and projects on a continual basis, and we wanted to make sure their voices were heard and reflected in the development of the plan. Engagement Approach Between January 2023 and December 2024, the Health and Social Care Partnership conducted 47 engagement activities, reaching approximately 2,887 individuals. These activities included events, focus groups, surveys, interviews, and workshops, and were carried out for a variety of reasons. Engagement activities carried out by the HSCP reflect a commitment to inclusive, accessible design, with formats ranging from locality conversations and digital surveys to creative arts- based events, one-to-one interviews, and visual focus groups. Targeted outreach was delivered in partnership with local organisations, ensuring that feedback from seldom-heard voices— including unpaid carers, people in recovery, individuals with learning disabilities or neurodevelopmental differences, Gypsy/Traveller communities, and residents of rural areas like Arran—was captured. These sessions have strengthened the Strategic Plan’s foundation in lived experience and place-based insight. The feedback gathered has been analysed and summarised into key themes, divided into two categories: overarching issues and service-specific insights. This analysis informed the development of the Strategic Plan and will directly contribute to the development a new Participation and Engagement Strategy. The engagement analysis process revealed a shared commitment to improving local systems, alongside deep concerns about access, communication, sustainability, and inclusion. The feedback, collected from individuals with lived experience, carers, staff, and third-sector partners, identified several recurring themes and opportunities for action. To support inclusion, a range of engagement methods were used, including: • Local pop-up events, information stalls, and drop-in sessions • Focus groups with target populations, such as carers, young people, people with disabilities, Gypsy/Traveller communities, and Ukrainian refugees • Online and paper-based surveys • Thematic workshops involving staff and provider organisations 163
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52 • Digital forums and social media campaigns • Locality-based conversations • Creative workshop activities Inclusive formats such as easy read adaptations, visual workshops, and multilingual support were used throughout, alongside digital platforms, printed surveys in community venues, and in-person outreach to improve accessibility and widen participation. Who We Engaged We actively engaged with a broad cross-section of North Ayrshire’s population, including: • People who use health and social care services. • Unpaid carers and family members. • Health and social care staff. • Community planning and locality partnership groups. • Groups with shared characteristics (e.g. Gypsy/Travellers, unpaid carers, people in recovery, refugees, digitally excluded individuals). • Third sector and voluntary organisations. • Children and young people, including those with neurodevelopmental conditions • People with learning disabilities and their families. • Community voices from rural and island localities, particularly Arran and Garnock Valley. • The general public. Targeted efforts were made to reach underrepresented groups including rural residents, people with neurodevelopmental conditions, minority ethnic communities, and individuals with lived experience of poverty and exclusion. Key Themes from the Engagement Participants shared views on what is working well and what needs to improve. The most commonly raised themes included: • The need for improved access and shorter waiting times for services. • Better visibility of information and support for service navigation. • Greater investment in early intervention and community-based models. • Enhanced support for carers and improved transitions across life stages. • More trauma-informed, inclusive, and person-centred approaches. • Clearer communication and greater accountability in service planning. A full summary of engagement findings is available in the Engagement Report 2025, which supports this Strategic Plan. The feedback also forms the foundation of the accompanying Participation and Engagement Strategy, which will outline how we will continue to listen, co-design, and remain accountable to our communities throughout the implementation of the Strategic Plan. Draft Consultation Online consultation on the Draft Plan took place between the 29th of September and 9th of November. 164
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53 This allowed staff, service users, partners, communities and community bodies to comment on the draft and raise any additional concerns or changes they feel should be made. The consultation was advertised via the staff newsletter, care improvement network, partners and staff. 30 people took part in the online consultation, which is a positive number for a draft strategy consultation given the requirement to read the full plan in order to participate, with the average time to take the survey sitting at 25minutes. The majority of respondents were residents or staff, and participants could pick multiple options if it applied to them. 13 residents, 11 HSCP staff, 5 community groups, 4 third sector organisations, 2 providers, 2 other, and 1 community planning partner participated in the survey Summary of Results • 77% agreed with the dual priority approach • 87% agreed and 7% disagreed with Strategic Priority 1: Supporting the Improvement of Population Health • 93% agreed and 3% disagreed with Strategic Priority 2: Addressing the Changing Needs of an Ageing population • 83% agreed and 7% disagreed with Strategic Priority 3: Tackling the Root Causes of Health Inequality. • 87% agreed and 3% disagreed with Service Delivery Priority 1: Prevention • 93% agreed and no one disagreed with Service Delivery Priority 2: Community Based Services • 83% agreed and no one disagreed with Service Delivery Priority 3: Life Stages • 80% agreed and 7% disagreed with Service Delivery Priority 4: Whole Person Approach • 90% agreed and no one disagreed with Service Delivery Priority 5: Accessibility and Communication • 83% agreed and no one disagreed with Service Delivery Priority 6: Evidence and Performance A full report of consultation will be published alongside the final Strategic Plan. 165
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54 Appendix 3: Summary of Housing Contribution Statement Introduction The Housing Contribution Statement forms a key part of the North Ayrshire Health and Social Care Partnership’s Strategic Plan 2026–2030. It sets out how housing services contribute to shared health and social care outcomes and strengthens the link between the Local Housing Strategy 2023–2028 and the HSCP Strategic Plan. The Housing Contribution Statement acts as a bridge between the housing and health and social care planning systems. Key Challenges North Ayrshire faces a range of housing, health and social care challenges that reflect both national trends and local circumstances. The area continues to experience high levels of deprivation, an ageing population and increasing complexity of need, all of which place growing pressure on housing, health and care systems. Demand for specialist and accessible homes, adaptations and homelessness services continues to rise while resources remain constrained. Ensuring that housing supports people to live safely and independently at home is becoming increasingly important, particularly as more people present with multiple or complex needs. In respect of improving housing’s contribution to the health and wellbeing of individual care groups, the associated challenges are summarised in the table below. How Housing and the Health and Social Care Partnership are addressing these needs is outlined through the narrative and evidence presented within the full Housing Contribution Statement. Care Group Housing Challenge Older People An ageing population could increase the demand for accessible homes, adaptations, and care services to help people remain independent at home Physical Disabilities There could be a growing need for specialist and adapted housing to support independent living and prevent unnecessary hospital or residential care admissions. Learning Disabilities People with learning disabilities could require more community- based housing options to reduce reliance on institutional settings and ensure choice and control over where they live. Mental Health Increasingly complex needs make it difficult to sustain recovery and reduce unplanned admissions or delayed discharges and appropriate supported accommodation options may be required to support this. Substance Use Individuals in recovery may require additional supports to enable them to access secure, settled housing, which can impact long- term recovery and integration into communities. 166
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55 Homelessness Demand on homeless services continue whilst the housing system is under pressure resulting in an inability to achieve the outcomes of the Rapid Rehousing Transition Plan. Children and Care Experienced Young People Young people leaving care and families affected by deprivation require suitable, stable housing and ongoing support to prevent homelessness and promote positive transitions to independent living. Justice People leaving the justice system may face challenges in securing suitable accommodation options that enable safe reintegration and reduce the risk of reoffending. Island Residents (Arran & Cumbrae) Island residents face additional housing pressures from limited supply, high costs, and challenges accessing care services locally, as well as high fuel costs which can affect health and wellbeing. Shared Outcomes and Service Priorities The Housing Contribution Statement (HCS) aligns the priorities of North Ayrshire Health and Social Care Partnership with the four overarching outcomes of the North Ayrshire Local Housing Strategy (LHS) 2023-2028. The table below shows a clear alignment of HSCP Service Delivery Priorities with LHS Outcomes, to create agreed shared outcomes. HSCP Service Delivery Priority LHS Overarching Outcome Linked Housing Contribution Shared Outcome Prevention Affordable warmth and zero emissions; Improving the quality of our homes; Affordability and choice; Collaboration Provide adaptations and energy efficient homes. Reduce fuel poverty and increase affordable warmth. Support homelessness prevention and early intervention. • People live in warm, safe homes, improving health and wellbeing. • Fewer hospital admissions and crises. • Lower fuel poverty and carbon emissions. Community Based Services Collaboration; More homes at the heart of great places; Affordability and choice; Improving the quality of our homes Develop accessible, adaptable homes that enable care at home. Invest in Estate Based regeneration through the Estate Based Regeneration Programme. • More people live independently at home. • Reduced delayed discharges from hospital • Stronger, thriving communities. Life Stages Affordability and choice; More homes at the heart of great places; Improving the quality of our homes Provide housing for tenants and their families. Provide housing support for those who need it. Ensure people are aware of their housing options at • Seamless links between housing, health, and care. 167
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56 an early stage, for changing needs and key life transitions. Housing Services will provide advice and information through our Scheme of Assistance, as well as financial assistance to cover eligible costs for adaptations to private properties. • Better outcomes for people at every stage of life. Whole Person Approach Affordability and choice; Affordable warmth and zero emissions Work in partnership to identify where housing and health and social care can be better integrated. Address wider factors like finances, environment, and social inclusion. Promote community-led, person- centred design. • Holistic support that improves health and housing outcomes. • More resilient, inclusive communities. Accessibility & Communication Collaboration; Affordability and choice Provide clear, accessible information on housing options and support. Work in partnership with the HSCP to identify ways in which referral pathways between housing and health/social care could be strengthened. • Easier access to services. • Greater equity and informed housing choices. Evidence & Performance Collaboration, Affordability and choice, Improving the quality of our homes Work in partnership with the HSCP to share data and evidence; identify ways in which we can jointly plan, monitor, and evaluate services; and have open engagement about where to target potential investment to meet shared needs. • Better targeting of resources. • Stronger accountability and measurable joint outcomes. Conclusion The Housing Contribution Statement 2025 reaffirms the vital role that housing plays in supporting the health, wellbeing, and independence of North Ayrshire’s residents. Through strong collaboration between Housing Services and the Health and Social Care Partnership, the area continues to deliver integrated, person-centred solutions that respond to complex needs, reduce inequalities, and promote community resilience. By aligning housing strategy with health and social care priorities, North Ayrshire is better equipped to meet the challenges of an ageing population, rising demand for specialist 168
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57 accommodation, and the need for early intervention and prevention. The shared commitment to accessible, affordable, and energy-efficient homes ensures that people can live safely and with dignity in the place they choose. The Full Housing Contribution Statement will be available on the website alongside the Strategic Plan. 169
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58 Appendix 4: Full List of Policies Reviewed Service Delivery • National health and social care delivery plan, 2016 • Scottish Government 2024 vision for Health and Social Care • NHS Scotland Operational Improvement Plan, 2025 • Delivering Value Based Health & Care A Vision for Scotland, NHS Scotland 2022 • Public Bodies (Joint Working) (National Health and Wellbeing Outcomes) (Scotland) Regulations 2014 • National Healthcare Standards • Health and Social Care Standards: my support, my life, 2017 • Scotland’s public health priorities, 2018 • Primary care: national monitoring and evaluation strategy 2019-2028 • Social care - self-directed support: framework of standards - May 2024 • Maximising Recovery, Promoting Independence: An Intermediate Care Framework for Scotland, 2012 • National clinical strategy, 2016 • NHS Ayrshire and Arran Delivery Plan 2023-2026 • Physical Activity for Health Scotland’s National Framework, 2024 • Population Health Framework 2025-2035 • Health and Social Care Service Renewal Framework, 2025-2035 • Scotland's Public Service Reform Strategy: Delivering for Scotland 2025-2028 • Future trends for Scotland, 2025 Health Literacy and Digital • Making it easier: a health literacy action plan 2017-2025 • A changing nation: how Scotland will thrive in a digital world 2021 • Enabling, Connecting and Empowering: Care in the Digital Age, 2021 • Greater access, better insight, improved outcomes: a strategy for data-driven care in the digital age, 2023 • NAHSCP Digital and Data Plan, 2025 Children and families • GIRFEC • The Promise – Plan 24-30 • National Health Visiting Action Plan 2025-2035 • Scotland’s 5 Year Vaccination and Immunisation Strategy and Delivery Plan, 2025 • North Ayrshire Child Poverty Strategy 2023-2026 • North Ayrshire Children’s Services Plan, 2023-2026 • NAHSCP Corporate Parenting plan, 2023-2026 Older People/ Long Term Conditions • Age, Home and Community: next phase 2018 • Palliative and End-of-Life Care by Integration Authorities: advice note, 2018 • New dementia strategy for Scotland: Everyone's Story 2023 170
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59 • My Health, My Care, My Home - healthcare framework for adults living in care homes, 2022 • Social isolation and loneliness: Recovering our Connections 2023 to 2026 Carers • National carer’s strategy December 2022 • NAHSCP Building Caring Communities: 2023 – 2025 Disability • Learning/intellectual disability and autism: transformation plan 2021 • NAHSCP Learning Disability Learning plan 2025 • See hear strategy, 2014 Mental health • Mental Health and Wellbeing Strategy, June 2023 • Mental health and wellbeing strategy delivery plan 2023 • Core mental health standards 2023 • Psychological therapies and interventions specification, 2023 • Child And Adolescent Mental Health Services: national service specification, 2020 • Self harm strategy and action plan 2023 to 2027 • Creating Hope Together: suicide prevention strategy 2022 to 2032 Substance Use • Rights, respect and recovery: alcohol and drug treatment strategy 2018 • Alcohol Framework 2018 • National Mission on Drug Deaths Plan 2022-2026 • Drug Deaths Taskforce response: cross government approach, 2023 • Medication Assisted Treatment (MAT) Standards, 2022 Justice • The Vision for Justice in Scotland 2022 • National Strategy for Community Justice 2022 • Community Justice Ayrshire Partnership Outcomes Improvement Plan, 2024-2029 Workforce • Health and Social Care: National Workforce strategy, 2022 • NAHSCP Workforce plan 2022-2025 • NAHSCP Be the Best You Can Be, Learning and Development Plan 2023 Local Outcomes • North Ayrshire Partnership Plan 2022-2030 • NAC Council Plan 2023-2028 • NAC Community Wealth Building Strategy 2024-2027 • NAC Local Housing Strategy 2023-2025 • NAHSCP Financial inclusion strategy 2023-2028 171
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60 • NAHSCP Empowering Inclusion Independent Advocacy Strategic Plan 2022 to 2026 • NAHSCP Transformation Plan 2024-2027 • NAHSCP Equality outcomes 2025-2029 172
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Version: 6.0 North Ayrshire Council Equality & Children’s Rights Impact Assessment (Full Form) Introduction This form will assist in carrying out an Equality Impact Assessment and where appropriate, Socio-Economic, Children’s Rights, Island Communities and Consumer Duty Impacts of new, revised and existing policies and practices. Guidance on how to complete assessments is given in the Council’s Equality and Children’s Rights Impact Assessment Toolkit. The form is mandatory and must be published on the Council website once the policy or practice has been approved. Section 1: General Details 1.1 Directorate/Service HSCP: Section: Planning, Performance and Transformation 1.2 Name of Policy, Practice of Proposal being assessed: Refreshed Strategic Plan 2026-2030 Is it New ☐ Existing (being reviewed): ☒ Budget Proposal: ☐ Please insert Budget Reference number (if applicable) Click or tap here to enter text. 1.3 List of participants in the assessment Seony Ross 1.4 Manager responsible for the impact assessment Name: Seony Ross Designation: Team Manager Strategic Planning and Equalities 1.5 Timetable (should be started during the development phase of the proposal) Date Assessment Started: 15 September 2025 Interim Review Date: 01/12/2025 173
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Version: 6.0 Final sign off by Head of Service at the end of the form. Section 2 – Aims and Relevance 2.1 What is the purpose of the policy practice or proposal? The Public Bodies (Joint Working) (Scotland) Act 2014 (29-39) outlines a requirement for all Integration Authorities to prepare a Strategic Plan. The Strategic Plan must: Set out arrangements for carrying out integration functions, Set out how it will contribute to the National Health and Wellbeing Outcomes, Include separate arrangements for (a minimum of 2) localities, Consider the integration delivery principles, Consider the views of the Strategic Planning Group, Consider other IJB Strategic Plans operating in the same area, Be reviewed at least every 3 years. This Plan refreshes North Ayrshire’s Strategic Plan ‘Caring Together’ for 2022-2026, for the remainder of the period of 2026-2030. 174
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Version: 6.0 Section 3 – Equality and Diversity 3.1 What evidence were you able to access about the relevant needs of protected groups as outlined in section 3.3 below (Please include your sources – links to equality providers and evidence can be found in both the toolkit and the Promoting Equality Page on Connects). Evidence for the plan consisted of a Strategic Needs Assessment and Engagement analysis. The needs assessment contains the following information regarding protected characteristics: male and female population; age groups; racial demographics, religious demographics, LBGT population, long-term conditions, learning disability population, mental health information by age and sex, children’s mental health information, substance use information by age and sex, unpaid carer information by age and sex, care home resident information by age and sex, fall and hip fracture information in older people, information about pregnancy and maternity, information about children’s care, child poverty data, and homelessness information. All sources can be found in the Strategic Needs Assessment. The engagement analysis included engagement pieces with protected characteristics, such as: Children and young people, gypsy traveller community, Refugees, mental health care users, people with learning disabilities, neurodiverse people and families, people with experience of substance use, unpaid carers, parents, people with experience of dementia, LGBT people, members of religious groups etc. full details of findings are available in the engagement report. 3.2 Are there any gaps in your evidence or areas of uncertainty? No 3.3 From the list of protected characteristic groups identified in section 2.3 please identify any potential positive and negative impacts on any of these protected characteristics? Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) Age - Older people, children and young people – please identify which categories will be affected ☒ ☐ Positive Impact Relevant aims: SP2: aims to address the changing needs of an ageing population. SDP1: Prevention aims to promote self-management to prevent deterioration of conditions, and look for innovations in monitoring conditions. It aims to ensure children’s social work teams have 175
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) the resources to support children and families, and work with schools to minimise the risk of substance use in children. SDP2: Community based services aims to review resources of community teams, develop a strategy for keeping older people independent for longer, ensure robust care around hospital admissions and discharge, provide support for unpaid carers, review adult care provision on Arran, and review models of care for looked after children. SDP3: Life Stages aims to ensure systems are in place to support older people who live with frailty, review palliative care arrangements, review care pathways, and ensure smooth transitions of care between services. It aims to ensure the health visiting service can promote the developmental needs of children and ensure children have well planned throughcare and aftercare. SDP 4 Whole Person approach aims to support families, carers, and other aspects of service-users’ lives to ensure well rounded support. SDP5 accessibility and communication aims to ensure information is accessible to all groups, including considering digital tools and health literacy and ensuring groups with lower digital skills such as older people are supported. 176
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) SDP6: Evidence aims to involve children in decisions and plans Disability - Physical and Learning ☒ ☐ Positive Relevant aims: SDP1: Prevention aims to promote self-management to prevent deterioration on conditions SDP2: Community based services aims to provide support for unpaid carers and deliver more care in the community SDP3: Life Stages aims to ensure adequate support for people with NDD and investigate service gaps in relation to service-user with multiple health and care requirements. SDP5 Accessibility & Communication aims to ensure information is accessible to all groups and investigate accessibility barriers Gender reassignment - Where a person is living as the opposite gender to their birth ☐ ☒ While the Strategic Plan itself has no aims specific to gender reassignments, it does include the delivery of the IJB Equality outcomes 2025-2029, which has some aims to improve access for trans or non-binary people Pregnancy and Maternity ☒ ☐ Positive Relevant aims: SP1 aims to support the improvement of population health 177
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) and includes maternal and infant health in the approach. Race, ethnicity, colour, nationality or national origins (including gypsy/ travellers, refugees and asylum seekers) ☒ ☐ Positive Relevant aims: SP3 aims to tackle the root causes of health and care inequality and includes the experience of refugees, unaccompanied asylum seeking children, and those with no recourse to public funds in the approach. SDP5 accessibility and communication aims to investigate barriers to accessing services for different groups, and consider resources in place for supporting refugees’ access to health and social care Religion or belief (includes religious and philosophical beliefs, including no belief) ☐ ☐ No impact. Sex - Women and Men ☒ ☐ Positive Although there are no aims targeted to males or females specifically, the aims of the plan are for services which will affect either males or females more, which will be considered in the delivery approach. For example, there are aims around substance use which tends to affect more males than females. Unpaid care services are used more be females as they are more likely to be carers. Care at home and frailty services are also more likely to be 178
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) used be females who have a longer life expectancy Sexual Orientation - Lesbian, gay and bisexual people ☐ ☒ While the Strategic Plan itself has no aims specific to sexual orientation, it does include the delivery of the IJB Equality outcomes 2025-2029, which has some aims to improve access for the LGBT community Marriage and Civil Partnership - marriage between same sex couples is included ☐ ☒ No impact Human Rights ☐ ☒ The strategic Plan should have no impact on human rights as it does prevent or constrain anyone’s human rights. 179
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) Care Experienced - This term refers to anyone who is currently in care or has been for any length of time regardless of their age and includes Kinship Care (other family members); Looked After at Home (with support from social work); Residential Care; Foster Care; Secure Care; Adoption. ☒ ☐ Positive Relevant aims: SP3 aims to tackle the root causes of health inequality, including investigating the link between poverty, care experience and child protection. SDP1: Prevention aims to support families to stay together so children are less likely to progress into further care experience, SDP2: Community based services aims to review models of care for young people to shift the balance of care from external residential resources to family-based care. SDP3: Life Stages aims to ensure young people leaving care have well-planned throughcare and aftercare to support them to live independently into adulthood. SDP 4 Whole Person approach aims to prioritise a family inclusive approach through services and consider options for independent living in the community. 180
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Version: 6.0 Protected Characteristic Yes No Please Explain (Positive or Negative or Neutral) Other - Poverty, homelessness, ex-offenders, isolated rural communities, carers, part-time workers, or people in a marriage/civil partnership ☒ ☐ Positive Relevant aims: SP3 aims to tackle the root causes of care inequality, with a clear focus on the impacts of poverty and deprivation. The plan aims to support those in the justice system e.g. through optimising diversion and continue to develop innovative unpaid work projects. The plan aims to support those affected by domestic violence, working with victims, perpetrators and families. The plan aims to support carers, identifying them and ensuring their health and care needs are met. The plan aims to support the workforce, through the development of a new workforce plan. 3.4 Describe any consultation or engagement undertaken, including details of the groups involved and the methods used. Engagement is carried out on a regular basis in the Health and Social Care Partnership, whether for specific purposes such as consultation on a decision or service, or through ongoing engagement, such as Locality Planning or What Matters to You. The Health and Social Care Partnership aims to continually build on our knowledge and understanding of the experience of service users by ensuring their feedback is used to continuously improve services and functions, so their views count for more than a single engagement exercise. At the end of 2024, an exercise was carried out which collated the results of all pieces of engagement across the HSCP from January 2023 to December 2024. A total of 47 engagement pieces were collated which includes events, forums, online surveys, 1-1 interviews, panels and workshops. Approximately 2,887 people were reached over the 2 years spread over these engagement pieces. 181
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Version: 6.0 For the Strategic Plan, a meta-analysis was carried out, analysing what was learned across these engagement exercises, summarising these into key themes and analysing by service. It was felt we could learn more from feedback by looking at everything people contributed over this time, than we could from carrying out a single engagement exercise for the purpose of developing the plan. Questions 3.5 – 3.7 refer to the ‘Three Key needs (or aims) of the Equality Duty’ 3.5 Which aspects of the policy eliminate unlawful discrimination, harassment and victimisation? None 3.6 Which aspects of the policy advance equality of opportunity between people who share a relevant protected characteristic and those who do not? None 3.7 Which aspects of the policy foster good relations between people who share a protected characteristic and those who do not? (Does it tackle prejudice and promote a better understanding of equality issues). None 3.8 If you have identified any negative impacts of your proposal how will you mitigate these? N/A 3.9 Is the policy or practice intended to promote equality by permitting positive action or lead to positive outcomes for people based on a protected characteristic? Yes, section 3.3 outlines the ways in which the strategy will lead to positive outcomes for protected characteristics. 182
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Version: 6.0 Section 4 – The Fairer Scotland Duty The Fairer Scotland Duty (‘the Duty’), Part 1 of the Equality Act 2010 places a legal responsibility on the Council to actively consider (‘pay due regard to’) how we can reduce inequalities of outcome caused by socio-economic disadvantage when making decisions. 4.1 Does the proposal have the potential to have a significant impact on inequalities of outcome caused by socio-economic disadvantage? (consider low income; low wealth; material deprivation; area deprivation; communities of place or interest, socio-economic background). Yes ☒ No ☐ If No, please go to Section 5. If Yes please provide more information under any of the below headings which are relevant, highlighting any evidence and sources of evidence used to inform your information. 4.2 Low Income/Income Poverty: Cannot afford to maintain regular payments such as bills, food and clothing SP3 aims to tackle the root causes of care inequality, with a clear focus on the impacts of poverty and deprivation. 4.3 Low/and or no wealth: Having enough money to meet basic living costs and pay bills but have no savings to pay for any unexpected spends and no provision for the future. SP3 aims to tackle the root causes of care inequality, with a clear focus on the impacts of poverty and deprivation. 4.4 Material Deprivation: Being unable to access basic goods and services, i.e. financial products like life insurance, repair/replace broken electrical goods, warm home, leisure/hobbies SP3 aims to tackle the root causes of care inequality, with a clear focus on the impacts of poverty and deprivation. 4.5 Area Deprivation: Where you live (rural areas), where you work (accessibility of transport. 183
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Version: 6.0 The plan outlines the process by which the HSCP will develop locality plans, which will consider the circumstances of those in each locality compared to other areas, and aim to address the particular health and care needs within each. 4.6 If impacts have been identified how will these be mitigated or explored in more detail? (please outline below) Mitigation not necessary as impacts identified are positive. Section 5 – Children’s Rights When considering the Children’s Right’s Impact process, some of the key considerations include any evidence, research and consultation (specifically including any consultation or engagement with young people). 5.1 Are any Children’s Rights impacted by this proposal? (please refer to Appendix 1 of this document, where the Children’s Rights Articles have been matched against the Getting It Right For Every Child (GIRFEC) wellbeing indicators. This is solely to make it easier to identify which rights might be impacted on; the Rights are the key element of this section). Yes ☒ No ☐ 5.2 Please indicate, if possible, how many children and young people (nearest estimate) are likely to be affected by the policy or measure? N/A 5.3 Are some children and young people more likely to be affected than others? Yes ☒ No ☐ If, Yes what groups? (consider protected characteristics – e.g. disabled young people, LGBT etc) Care experienced, or children and young people with experiences with children’s social work. Children and young people with experience of mental health services, children and young people with NDD, children and young people transitioning from children’s to adult social work, children and young people with experience of substance use. 184
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Version: 6.0 5.4 What Children’s Rights are likely to be affected by the policy/proposal? Please refer to Table 2 (Appendix 1) ‘Links between Wellbeing Indicators and Articles of the UNCRC’ and insert the relevant rights and indicators in the table below. Wellbeing indicator (e.g. safe, healthy etc) Children’s Right (e.g. 22 – refugee children) Safe 9 – separation from parents 19 – protection from violence, abuse and neglect 22 – refugee children 33 – drug abuse Healthy 3 – best interests of the child 6 – life, survival and development 24 – health and health services Achieving 4 – implementation of the convention 18 – parental responsibilities and state assistance Nurtured 20 – children deprived of a family 21 – adoption 27 – adequate standard of living Active 23 – Children with Disabilities Respected 12 – respect for the views of the child Responsible 40 – juvenile justice Included 26 – social security 185
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Version: 6.0 5.5 What likely impact will the policy/proposal have on Children’s Rights and Wellbeing? Either Positive, Negative or Neutral. Children Rights - Positive Other Protected Characteristics N/A 5.7 What consultation or engagement has taken place with young people? The engagement analysis includes engagement carried out with young people. For example transitions engagement, NDD engagement, and children and young people’s engagement about health and care priorities. 5.6 If Negative impacts are identified how will these be mitigated, or the effect reduced? Click or tap here to enter text. 186
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Version: 6.0 Section 6 – Island Communities Impact (or Island Proofing) Island Proofing is about considering the particular needs and circumstances of island communities when public sector organisations exercise their functions and make decisions. This has been added to the process of assessing the Council Plan and includes a range of issues such as access to services, digital connectivity, employment and access to education, transport and access to goods and services. 6.1 Do the intended outcomes of the proposal potentially differ or have a different impact for our Island Communities? Yes ☐ No ☒ 6.2 What are the potential impacts for our Island Communities? The expected positive impacts are due to be the same for our island communities as they are for mainland communities. It is outlined in the plan that a review of services in Arran will be carried out regarding adult social care to ensure parity with the mainland, and the island communities will have their individual circumstances considered during the outlined locality planning process. 6.3 Please explain if the impacts are different for communities on different islands? Click or tap here to enter text. 6.4 What consultation or engagement has taken place with the Island Communities? Engagement on Arran has been considered as part of the engagement analysis including locality engagement, and primary care engagement. 6.5 How will you address any potential barriers or wider impacts for Island Communities as identified through this assessment? Click or tap here to enter text. Section 7 – The Consumer Duty The Consumer Duty is about the impact of Council proposals on consumers in Scotland. A Consumer is an individual or a small business that purchases, uses or receives goods or services in Scotland, that are supplied either by a business or a public body – please see What is the Consumer Duty. 7.1 Will your proposal impact on consumers? Yes ☐ No ☒ 187
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Version: 6.0 If no, please complete the ‘Assessment not required’ template by emailing northayrshireperforms@north-ayrshire.gov.uk 7.2 What are the impacts, if any, on consumers in general? Is it likely that consumers will experience harm because of this proposal? Click or tap here to enter text. 7.3 What are the impacts if any, on consumers in vulnerable circumstances? Is it likely that consumers in vulnerable circumstances will experience harm because of this proposal? (please include any relevant evidence or engagement with consumers) *Vulnerable circumstances may be temporary in nature and may or may not arise as a resulted of a consumer’s protected characteristics. For more information, please see page 31 of Consumer Scotland’s draft guidance on the consumer duty. Click or tap here to enter text. 7.4 What consultation and engagement has taken place with consumers around your proposal? Click or tap here to enter text. 7.5 What alternative proposals are there that could improve outcomes for consumers and/or reduce harm to consumers? How do these compare to the original proposal? Click or tap here to enter text. 188
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Version: 6.0 Section 8 – Crosscutting Impacts 8.1 Have any cross-cutting impacts been identified from other Council Services or Partner Agencies (multiple discrimination or accumulated effects of multiple proposals on a protected characteristic group)? No 8.2 If Crosscutting issues identified with other Services, what discussion/interaction has taken place to mitigate any potential negative impacts of accumulated proposals? Click or tap here to enter text. 189
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Version: 6.0 Section 9 – Outcome of the Assessment 9.1 Please detail the outcome of the assessment: 1. No major alterations to the policy assessed: the Impact Assessment demonstrates the policy is robust and there is no possible discrimination or adverse impact. All opportunities to minimise negative impacts and enhance positive outcomes have been taken. ☒ Or 2. Adjust the policy: the Impact Assessment identifies potential problems or missed opportunities. Adjust the policy to address any issues identified or to better promote equality. ☐ Or 3. Continue the policy: the Impact Assessment identifies the potential for adverse impact or missed opportunities to promote equality. Set out the justifications for continuing with it in section 9.3. For the most important policies and proposals, compelling reasons will be needed. ☐ Or 4. Stop and remove the policy/proposal: following assessment a decision has been taken not to proceed with the proposal for examples due to actual or potential unlawful discrimination or other harmful impact. ☐ 9.2 For Outcome 2. in section 9.1 above - please detail recommendations, including any action required to address negative impacts identified or to better promote equality. Click or tap here to enter text. 9.3 If Outcome 3 is chosen from section 9.1 above, please outline the justifications for continuing the policy/procedure. Click or tap here to enter text. 9.4 Please state the key issues, recommendations and future actions arising from the Integrated Impact Assessment. Click or tap here to enter text. 190
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Version: 6.0 Section 10 – Monitoring 10.1 Describe how you will monitor the impact of this policy e.g. performance indicators used, other monitoring arrangements, who will monitor progress, criteria used to measure if outcomes are achieved, timescales including any future reviews of the impact of the proposal? The Strategic Plan will be monitored via the annual performance report, quarterly reports to the Performance and Audit Committee, and via the Strategic Planning Group. Section 11 – Sign Off 11.1 Head of Service who has approved the impact assessment. Name: Click or tap here to enter text. Title: Click or tap here to enter text. Date: Click or tap here to enter text. Section 12 – Publication 12.1 Following approval by Head of Service, completed Impact Assessments need to be published on the Council’s External Website. Please email: northayrshireperforms@north-ayrshire.gov.uk 191
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Version: 6.0 Appendix 1 - GIRFEC Wellbeing Indicators and Children’s Rights Table 1 - GIRFEC Wellbeing Indicators Safe Protected from abuse, neglect and harm Healthy Having the best possible standards of physical and mental health; support to make healthy, safe choices Achieving Accomplishing goals and thereby boosting skills, confidence and self-esteem; ‘being all they can be’. Nurtured Having a loving and stimulating place to live and grow Active Having opportunities to take part in a wide range of activities Respected Being enabled to understand their world, being given a voice, being listened to, and being involved in the decisions that affect their wellbeing. Responsible Taking an active role within their home, school and community. Included Being a full member of the communities in which they live and learn; receiving help and guidance to overcome inequalities. 192
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Version: 6.0 Articles of the UNCRC matched against the GIRFEC indicators Summary of the UNCRC Articles from 1 – 54 (UNICEF) Table 2 - Links between Wellbeing Indicators and Articles of the UNCRC *Please note in general the use of the term Governments, includes public sector organisations such as the Council, some articles will have stronger relevance for the work of the Council than others. Wellbeing Indicator – Safe There are 12 relevant articles of the UNCRC (Rights of the Child) linked to the Safe indicator. Article 9 – Separation from parents Children must not be separated from their parents against their will unless it is in their best interests (for example, if a parent is hurting or neglecting a child). Children whose parents have separated have the right to stay in contact with both parents, unless this could cause them harm. 10 – Family reunification Governments must respond quickly and sympathetically if a child or their parents apply to live together in the same country. If a child’s parents live apart in different countries, the child has the right to visit and keep in contact with both of them. 11 - Abduction and non-return of children Governments must do everything they can to stop children being taken out of their own country illegally by their parents or other relatives or being prevented from returning home. 19 - Protection from violence, abuse and neglect Governments must do all they can to ensure that children are protected from all forms of violence, abuse, neglect and bad treatment by their parents or anyone else who looks after them. Children and Young People have the right to be kept safe from harm. They must be given proper care by those looking after them. 22 - Refugee children If a child is seeking refuge or has refugee status, governments must provide them with appropriate protection and assistance to help them enjoy all the rights in the Convention. Governments must help refugee children who are separated from their parents to be reunited with them. Children and Young People have the right to special help and be allowed to live somewhere that is safe if they are a refugee. 193
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Version: 6.0 32 - Child labour Governments must protect children from economic exploitation and work that is dangerous or might harm their health, development or education. Governments must set a minimum age for children to work and ensure that work conditions are safe and appropriate. If they are under 16 there are laws about where, when and for how long they can work. 33 - Drug abuse Governments must protect children from the illegal use of drugs and from being involved in the production or distribution of drugs. 34 - Sexual exploitation Governments must protect children from all forms of sexual abuse and exploitation. Children and Young People have the right to never be pressurised or forced into doing anything sexual. They have the right to be protected from it. 35 - Abduction, sale and trafficking Governments must protect children from being abducted, sold or moved illegally to a different place in or outside their country for the purpose of exploitation. People should never make them do anything against their will, like marry someone for instance. 36 - Other forms of exploitation Governments must protect children from all other forms of exploitation, for example the exploitation of children for political activities, by the media or for medical research. Children and Young People have the right to be protected from being taken advantage of in any way. 37 - Inhumane treatment and detention Children and Young People have the right to be treated with respect. If they have committed a crime children should be arrested, detained or imprisoned only as a last resort and for the shortest time possible. They must be treated with respect and care, and be able to keep in contact with their family. Children must not be put in prison with adults. They should not be locked up unless it is absolutely necessary and they will get legal help. 38 - War and armed conflicts Governments must not allow children under the age of 15 to take part in war or join the armed forces. Governments must do everything they can to protect and care for children affected by war and armed conflicts. In Scotland, they have to be 16 to join the armed forces and are not normally allowed to fight until they are 18. 194
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Version: 6.0 Wellbeing Indicator – Healthy There are 4 relevant articles of the UNCRC (Rights of the Child) linked to the Healthy indicator. 3 – Best interests of the child The best interests of the child must be a top priority in all decisions and actions that affect children. Children and Young People have the right to have their interests considered if a decision is being made by any person about them. What is best for them is what matters. 6 – Life, survival and development Every child has the right to life. Governments must do all they can to ensure that children survive and develop to their full potential. Children and Young People have the right to be kept safe from harm, they have the right to be alive, survive and develop through life. 24 - Health and health services Every child has the right to the best possible health. Governments must provide good quality health care, clean water, nutritious food, and a clean environment and education on health and well-being so that children can stay healthy. Children and Young People have the right to be given good healthcare (if they are ill) so they can get well again. They have the right to live in a safe, healthy environment with good food and clean drinking water. 39 - Recovery and rehabilitation of child victims Children who have experienced neglect, abuse, exploitation, torture or who are victims of war must receive special support to help them recover their health, dignity, self-respect and social life. 195
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Version: 6.0 Wellbeing Indicator – Achieving There are 4 relevant articles of the UNCRC (Rights of the Child) linked to the Achieving indicator. 4 – Implementation of the Convention Governments must do all they can to make sure every child can enjoy their rights by creating systems and passing laws that promote and protect Children’s Rights. Children and Young People have the right to have their rights protected and an environment where they can grow up safe. 18 - Parental responsibilities and state assistance Both parents share responsibility for bringing up their child and should always consider what is best for the child. Governments must support parents by creating support services for children and giving parents the help they need to raise their children. 28 - Right to education Every child has the right to an education. Primary education must be free and different forms of secondary education must be available to every child. Discipline in schools must respect children’s dignity and their rights. Richer countries must help poorer countries achieve this. In Scotland education is free and children three years old+ are entitled to a free nursery place. 29 - Goals of education Education must develop every child’s personality, talents and abilities to the full. It must encourage the child’s respect for human rights, as well as respect for their parents, their own and other cultures, and the environment. It must help to prepare them for adult life. 196
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Version: 6.0 Wellbeing Indicator – Nurtured There are 8 relevant articles of the UNCRC (Rights of the Child) linked to the Nurtured indicator. 4 – Implementation of the Convention Governments must do all they can to make sure every child can enjoy their rights by creating systems and passing laws that promote and protect children’s rights Children and Young People have the right to have their rights protected and an environment where they can grow up safe. 5 - Parental guidance and a child’s evolving capacities Every child has the right to be registered at birth, to have a name and nationality, and, as far as possible, to know and be cared for by their parents. Children and Young People have the right to their parents being responsible to guide them through their childhood and help them learn how to use their rights. 9 – Separation from parents Children must not be separated from their parents against their will unless it is in their best interests (for example, if a parent is hurting or neglecting a child). Children whose parents have separated have the right to stay in contact with both parents, unless this could cause them harm. 10 – Family reunification Governments must respond quickly and sympathetically if a child or their parents apply to live together in the same country. If a child’s parents live apart in different countries, the child has the right to visit and keep in contact with both of them. 18 - Parental responsibilities and state assistance Both parents share responsibility for bringing up their child and should always consider what is best for the child. Governments must support parents by creating support services for children and giving parents the help they need to raise their children. 20 - Children deprived of a family If a child cannot be looked after by their immediate family, the government must give them special protection and assistance. This includes making sure the child is provided with alternative care that is continuous and respects the child’s culture, language and religion. Children and Young People have the right to special care if they can’t live with their parents. They may be looked after by other members of their family or by a different family. 21 - Adoption Governments must oversee the process of adoption to make sure it is safe, lawful and that it prioritises children’s best interests. Children should only be adopted 197
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Version: 6.0 outside of their country if they cannot be placed with a family in their own country. 25 - Review of treatment in care If a child has been placed away from home for the purpose of care or protection (for example, with a foster family, in hospital, a care home or somewhere else away from home), they have the right to a regular review of their treatment, the way they are cared for and their wider circumstances to help make sure they are still getting what’s best for them. 27 - Adequate standard of living Every child has the right to a standard of living that is good enough to meet their physical and social needs and support their development. Governments must help families who cannot afford to provide this. Children and Young People have the right to a safe place to live, food, clothing and to take part in things they enjoy. 198
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Version: 6.0 Wellbeing Indicator – Active There are 8 relevant articles of the UNCRC (Rights of the Child) linked to the Nurtured indicator. 3 - Best interests of the child The best interests of the child must be a top priority in all decisions and actions that affect children. Children and Young People have the right to have their interests considered if a decision is being made by any person about them. What is best for them is what matters. 23 - Children with disabilities A child with a disability has the right to live a full and decent life with dignity and, as far as possible, independence and to play an active part in the community. Governments must do all they can to support disabled children and their families. Children and Young People have the right to if they have any kind of disability, have special help to make sure they can join in with things. 31 - Leisure, play and culture Children and Young People have the right to rest, play and have the chance to join a wide range of artistic and cultural activities. It is really important to remember to have a balance in their life. 199
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Version: 6.0 Wellbeing Indicator – Respected There are 12 relevant articles of the UNCRC (Rights of the Child) linked to the Nurtured indicator. 2 - Non-discrimination Children and Young People have the right to have the convention that applies to everyone under the age of 18, no matter who they are, whether they are a boy or a girl, what their religion is, whether they have a disability, or what type of family they come from. 3 - Best interests of the child The best interests of the child must be a top priority in all decisions and actions that affect children. Children and Young People have the right to have their interests considered if a decision is being made by any person about them. What is best for them is what matters. 4 – Implementation of the Convention Governments must do all they can to make sure every child can enjoy their rights by creating systems and passing laws that promote and protect children’s rights. Children and Young People have the right to have their rights protected and an environment where they can grow up safe. 5 - Parental guidance and a child’s evolving capacities Every child has the right to be registered at birth, to have a name and nationality, and, as far as possible, to know and be cared for by their parents. Children and Young People have the right to their parents being responsible to guide them through their childhood and help them learn how to use their rights. 8 - Protection and preservation of identity Every child has the right to an identity. Governments must respect and protect that right, and prevent the child’s name, nationality or family relationships from being changed unlawfully. Children and Young People have the right to know who they are – official records should be kept. If they are over 16 years old and adopted, they can try to find out who their birth parents are. 12 - Respect for the views of the child Every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. This right applies at all times, for example during immigration proceedings, housing decisions or the child’s day-to-day home life. Children and Young People have the right to speak up and have their opinions listened to and be taken seriously by adults on things that affect them. 200
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Version: 6.0 13 - Freedom of expression Every child must be free to express their thoughts and opinions and to access all kinds of information, as long as it is within the law. Children and Young People have the right to say whatever they believe as long as it does not harm or offend other people. They also have the responsibility to respect the rights and freedom of others. 14 - Freedom of thought, belief and religion Every child has the right to think and believe what they choose and also to practise their religion, as long as they are not stopping other people from enjoying their rights. Governments must respect the rights and responsibilities of parents to guide their child as they grow up. Children and Young People have the right to choose their own religion and beliefs. Their parents should help them think about this. 16 - Right to privacy Every child has the right to privacy. The law should protect the child’s private, family and home life, including protecting children from unlawful attacks that harm their reputation, for example, they shouldn’t have their personal letters opened or anyone listening in to their personal phone calls. 17 - Access to information; mass media Every child has the right to reliable information from a variety of sources, and Governments should encourage the media to provide information that children can understand. Governments must help protect children from materials that could harm them. Children and Young People have the right to access information which is important to their wellbeing. Adults should help them find information they are looking for and make sure it’s not harmful. 18 - Parental responsibilities and state assistance Both parents share responsibility for bringing up their child and should always consider what is best for the child. Governments must support parents by creating support services for children and giving parents the help they need to raise their children. 30 - The right to learn and use the language, customs and religion of their family Every child has the right to learn and use the language, customs and religion of their family, whether or not these are shared by the majority of the people in the country where they live. 201
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Version: 6.0 Wellbeing Indicator – Responsible There are 5 relevant articles of the UNCRC (Rights of the Child) linked to the Responsible indicator. 3 - Best interests of the child The best interests of the child must be a top priority in all decisions and actions that affect children. Children and Young People have the right to have their interests considered if a decision is being made by any person about them. What is best for them is what matters. 12 - Respect for the views of the child Every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. This right applies at all times, for example during immigration proceedings, housing decisions or the child’s day-to-day home life. Children and Young People have the right to speak up and have their opinions listened to and be taken seriously by adults on things that affect them. 14 - freedom of thought, conscience and religion Every child has the right to think and believe what they choose and also to practise their religion, as long as they are not stopping other people from enjoying their rights. Governments must respect the rights and responsibilities of parents to guide their child as they grow up. Children and Young People have the right to choose their own religion and beliefs. Their parents should help them think about this. 15 - Freedom of association Every child has the right to meet with other children and to join groups and organisations, as long as this does not stop other people from enjoying their rights. 40 - Juvenile justice A child accused or guilty of breaking the law must be treated with dignity and respect. They have the right to legal assistance and a fair trial that takes account of their age. Governments must set a minimum age for children to be tried in a criminal court and manage a justice system that enables children who have been in conflict with the law to reintegrate into society. Children and Young People have the right to be given legal assistance if they have committed a crime. The Convention also states that they should only be sent to prison if they have committed a serious crime. 202
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Version: 6.0 Wellbeing Indicator – Included There are 5 relevant articles of the UNCRC (Rights of the Child) linked to the Included indicator. 3 - Best interests of the child The best interests of the child must be a top priority in all decisions and actions that affect children. Children and Young People have the right to have their interests considered if a decision is being made by any person about them. What is best for them is what matters. 6 - Life, survival and development Every child has the right to life. Governments must do all they can to ensure that children survive and develop to their full potential. Children and Young People have the right to be kept safe from harm, they have the right to be alive, survive and develop through life. 18 - Parental responsibilities and state assistance Both parents share responsibility for bringing up their child and should always consider what is best for the child. Governments must support parents by creating support services for children and giving parents the help they need to raise their children. 23 - Children with disabilities A child with a disability has the right to live a full and decent life with dignity and, as far as possible, independence and to play an active part in the community. Governments must do all they can to support disabled children and their families. Children and Young People have the right to special help to make sure they can join in with things. 26 - Social security Every child has the right to benefit from social security. Governments must provide social security, including financial support and other benefits, to families in need of assistance. 27 - Adequate standard of living Every child has the right to a standard of living that is good enough to meet their physical and social needs and support their development. Governments must help families who cannot afford to provide this. Children and Young People have the right to a safe place to live, food, clothing and to take part in things they enjoy. 203
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Integration Joint Board 11th December 2025 Subject: 2025-26 – Month 7 Financial Performance Purpose: To provide an overview of the IJB’s financial performance as at Month 7 (October). Recommendation: It is recommended that the IJB: (a) notes the overall integrated financial performance report for the financial year 2025-26 and the current overall projected year- end overspend of £4.946m reducing to £1.881m after planned recovery actions; (b) notes the progress with delivery of agreed savings; (c) approves the proposed and current actions (para 2.14) which are being taken to progress financial recovery and that an updated recovery plan will be presented to the next IJB; and (d) notes the remaining financial risks for 2025-26. 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 1. EXECUTIVE SUMMARY 1.1 The report provides an overview of the financial position for the Partnership and outlines the projected year-end outturn position informed by the projected expenditure and income commitments; these have been prepared in conjunction with relevant budget holders and services. It should be noted that, although this report Agenda Item 7 205
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refers to the position at the end of October further work is undertaken following the month end to finalise projections, therefore the projected outturn position is as current and up to date as can practicably be reported. 1.2 The projected outturn is a year-end overspend of £4.946m (1.5%) reduced to £1.881m through already identified financial recovery actions. There is an increasing risk to achieving financial balance during 2025-26, the projected outturn position is summarised below with the residual risk following already identified financial improvement actions: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth7 4.946 0.976 3.970 Financial Recovery Plan Projections 3.007 0.918 2.089 Residual Risk 1.939 0.058 1.881 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 funds. The projection assumes 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. At this stage in the financial year there is a high risk of not being able to deliver financial balance by the year-end. 1.3 The movement in the projected outturn position for the 2025-26 financial year is illustrated in the graph below: 5.187 5.259 4.957 4.946 1.175 1.733 1.604 1.939 0.519 0.776 0.001 0.058 0.656 0.957 1.603 1.881 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 Period 3 Period 4 Period 6 Period 7 Projected Outturn Movement Gross PO Net Total PO Net NHS PO Net LA PO £m 206
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This illustrates the movement in the gross and net projected overspend and the residual overspend or risk split between NHS and LA funding partners. 1.4 From the core projections, overall, the main areas of pressure are: care at home, residential placements for children, physical disability care packages, supplementary staff in wards, staff costs in Montrose House and Unplanned Activities (UnPACs) within the lead partnership for mental health. The main areas of movement from Period 6 to Period 7 are: • LD- £0.213m adverse re one new high-cost care package and an under- recovery in income • Primary Care - £0.101m favourable due to a detailed review of the projection • Management and Support - £0.176m favourable as the NHS budget shortfall has reduced. 1.5 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. 1.6 Since the setting of the budget in March 2025 the 2025-26 financial position has been adversely impacted by the below factors out-with the control of the IJB. • National Care Home Contract (NCHC) – the recent increase to the NCHC rate to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. • NHS Board allocation for the Employers National Insurance increase confirmed at 60% of funding – full year impact £0.664m • The current allocation for the Agenda for Change costs in relation to the reduced working week are currently being queried with the NHS finance team to ensure we receive our ‘fair share’ of the funding. The current funding allocated is £0.659m, the cost of covering all reduced hours is £1.497m. A recent exercise collated from services on the actual impact and cost indicated that the cost of cover is £1.210m (84% of staff covered) which is £0.551m higher than the current allocation. A request has been submitted to NHS A&A to review the funding allocation on a recurring basis. The IJB will be update on progress with this request. • Pay settlements for both NHS and Local Government staff have been agreed for 2025-26. The NHS element has been funded, and the current assumption 207
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is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. 2. CURRENT POSITION 2.1 The report includes an overview of the financial position including commitments against the available resource, explanations for the main budget variances and an update on progress in terms of savings delivery. 2.2 FINANCIAL PERFORMANCE – AT MONTH 7 At month 7 against the full-year budget of £339.363m there is a projected year-end overspend of £4.946m (1.5%). 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 a projected overspend of £3.970m in social care services and a projected overspend of £0.976m in health services. Appendix A provides the financial overview of the Partnership position. The sections that follow outline the significant variances in service expenditure compared to the approved budgets. Appendix F provides information on the costs of bank and agency staff. 2.3 Health and Community Care Services Against the full-year budget of £99.882m there is a projected overspend of £4.116m (4.1%) which is a favourable movement of £0.051m and the main variances are: a) Care home placements – net projected overspend of £0.545m (£0.020m favourable). This includes an overspend on placements of £1.095m (£0.020m favourable) which includes a provision for an average of 7 interim beds and reflects the recent increase to the NCHC to reflect the impact of the nursing pay award resulted in an additional unfunded cost of £0.175m. The budgeted number of permanent placements was 765 and at month 7 there were 815 placements resulting in a projected overspend of £1.095m. The plan to manage down the number of permanent placements to reach the target is challenging due to the need to respond to referrals 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 and gross funded placements which is projected to be £0.550m over recovered (no movement). This income is challenging to predict as it depends on the length of 208
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the legal process and time taken to sell the property that the charging order is registered to and access to the funds or estate of service users. b) Care at home is projected to be £1.721m overspent (£0.032m adverse). The position reflects the cost of meeting the significant demand and level of provision for care at home support. c) Physical Disability Services – projected overspend of £0.298m (£0.188m favourable) split as follows: £0.935m over in residential placements, £0.412m under in direct payments due to increased clawbacks and £0.225m under in community care packages. d) Integrated Island Services is projected to overspend by £0.487m (£0.020m favourable). The most significant variance is a projected overspend at Montrose House of £0.339m which relates to the net overspend on agency staff (i.e. net of underspend on employee costs). There is also an under recovery of income and a write off of aged debt. In addition, there are overspends outwith Montrose House across property, continence and medical supplies, admin and transport. The Arran Patient Transfer contract is projected to overspend by £0.040m. e) Specialist Rehab wards – projected overspend of £0.157m (£0.018m favourable) (Redburn ward £0.194m overspend and Douglas Grant £0.037m 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 – Projected overspend of £0.770m (£0.004m favourable). The overspend is due to increased use of supplementary staffing. All rehabilitation wards are operating at 100% occupancy supporting a high level of patient needs/complexity, which places pressure on staffing levels and the use of bank and agency staff to support additional patient observations. The senior manager has developed an action plan which will reduce this overspend and the reduction is reflected in the recovery plan. 2.4 Mental Health Services Against the full-year budget of £118.527m there is a projected overspend of £1.503m (1.3%) which is an adverse movement of £0.285m prior to the re-allocation of the Lead Partnership variance to East and South HSCP. The main variances are: • Learning Disabilities are projected to overspend by £1.249m (£0.213m adverse). The adverse movement is mainly due to one new high-cost care LD package with £0.174m part year costs in 2025-26 and a projected under recovery of income £0.189m (£0.036m adverse). 209
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• Community Mental Health services are projected to underspend by £0.091m (£0.031m favourable movement). The main reason for underspend in community packages is the availability and capacity of adult community providers to deliver new packages of care. • There is a projected underspend of £0.353m in relation to the cost of Hospital Based Complex Continuing Care (HBCCC), this reflects the impact of change in provision for these services. There were plans to reinvest this in the service, but these plans are on hold as holding the funding was agreed as part of the recovery plan at month 3. • The Lead Partnership for Mental Health is projected to be £0.689m overspent (£0.002m adverse) and the main variances are as follows: • Adult Inpatients – projected overspend by £0.954m (£0.077m adverse) due to very high levels of continuous intervention which require additional supplementary staff and enhanced observations (1:1 and 2:1) and use of bank staff. The month 5 and 6 costs were materially higher than the month 1 – 4 average, this was due to high levels of staff cover required to respond to an IPC incident at Woodland View. The projection assumes that £0.338m of costs are recharged to another HSCP on a cost basis for an outwith authority placements which has incurred additional costs in relation to usage of supplementary staffing due to sustained enhanced observations. • The UNPACS (Unplanned Activities) budget – projected overspend of £1.147m (£0.093m adverse) based on current placements. Since month 6 there has been an admission plus a potential further planned admission in January. These have been accounted for in the projection. 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 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. Part of the additional control measures agreed in month 3 was to expand the high- cost care package review group to include all UNPACS placement 210
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requests, the projected position includes provision for any new placements approved. • Learning Disability Services – projected to overspend by £0.305m (£0.044m favourable). The overspend relates to the delay in achieving the saving from Ward 7A. Whilst the ward closed there are still legacy costs as the staff are still being redeployed. • Elderly Inpatients – projected overspend of £0.121m (£0.004m adverse) 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. • Eating Disorders – projected to overspend by £0.135m (no movement) due to the staffing level being higher than the funding allocation. This is being considered alongside the overall resource allocation. • Enhanced Mental Health Outcome Framework (EMHOF) – projected underspend of £0.624m (no movement). There was £0.624m of reserves held for EMHOF and the recovery plan approved the draw down of these reserves which is the reason for the favourable movement. • Psychiatry – is projected to overspend by £0.271m (£0.050m favourable) mainly due to junior doctor costs. A mitigation plan is being developed and the rota for junior doctors is being reviewed. • MH Pharmacy – is projected to overspend by £0.112m (£0.044m favourable). The overspend is less than projected due to a prior year rebate. Prior to this rebate there was an overspend due to increased demand and cost of medicines, and particularly the cost of Buvidal. This position is after investing £0.510m on a Pan Ayrshire basis (£0.170m per HSCP). • Action 15 – is projected to underspend of £0.321m (£0.042m favourable). There was £0.487m of reserves held for Action 15 and the recovery plan approved the draw down of these reserves which is the reason for the underspend. The projected underspend is after considering the legacy costs from the 2024/25 review of funding. Innovation Fund – projected underspend of £0.021m (no movement) assuming that the posts to be redeployed as part of the EMHOF review are actioned. 211
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• 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 a projected over recovery of the vacancy savings target of £1.103m (favourable movement of £0.131) in 2025-26. Further information is included in the table below: Vacancy Savings Target (£1.160m) Projected to March 2026 £2.263m Over/(Under) Achievement £1.103m 2.5 Children and Justice Services Against the full-year budget of £42.324m there is a projected overspend of £1.610m (3.8%) which is a favourable movement of £0.026m and the main variances are: a) Care Experienced Children and Young People is projected to overspend by £2.016m (£0.020m adverse). 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: • The children’s residential placements are projected to overspend by £2.798m (£0.084m adverse) based 35 placements in month 7. This demonstrates an increase of 6 places since the start of the financial year. There are several factors leading to this challenging position: o 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. o There remains an acute shortage of foster carers leading to residential care being necessary in emergency placement situations. o 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. o A number of young people in residential care have requested Continuing Care, whereby a young person can remain in their placement until age 21. o 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. o Contractual inflation has still to be agreed for 15 providers. If this is higher than the assumed contractual inflation and it is likely that this will increase the projected costs of residential places which is outwith the control of the service. 212
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o 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. • Looked After and Accommodated Children (fostering, adoption, kinship etc) is projected to be £0.898m (£0.039m adverse) underspent. • Residential respite – placements are overspent by £0.070m (£0.001m fav movement). These short-term placements are used to prevent an admission to full time care or to avoid placement breakdown. • Employee costs – are projected to overspend by £0.149m (£0.021m favourable), largely due to staffing levels in the children’s houses and regrading of posts. • Care Leavers – projected underspend of £0.043m (£0.015m favourable) in rent costs. • Section 29 Payments (Throughcare Team) are projected to overspend by £0.045m (£0.004m favourable movement). b) Head of Service – is projected to underspend by £0.622m (£0.060m favourable). This consists of a projected overspend of £0.158m in relation to the previous staff reconfiguration saving in the children’s houses which was not achieved in 23-24 or 24-25 and this is offset by the grant funding in relation to Unaccompanied Asylum-Seeking Children (UASC), which is projected to amount to £0.765m £0.012m adverse) and which contributes to costs incurred across a number of C&F service areas. The favourable movement relates to a reduced projection for the Child Protection team and settlement of some contractual increases. c) C&F Health Team – is projected to overspend by £0.144m (£0.062m 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 was incorporated into budget pressures for 2025/26. The favourable movement is due to ongoing work by the senior manager to reduce the overspend. 2.6 ALLIED HEALTH PROFESSIONALS (AHP) The non-employee costs element of the AHP services are projected to be on-line. All underspends in employee costs have contributed to payroll turnover. 2.7 CHIEF SOCIAL WORK OFFICER This is projected to underspend by £0.156m (£0.029m adverse). One contract has ceased at the end of June and there are savings against other areas. There is also 213
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an over-recovery of income in Learning and Development for social work student placements. 2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £1.831m (£0.146m favourable) and the main areas of variance are: • There is projected slippage on the LD and MH transition funding of £0.482m (£0.009m favourable) due to delays in children transitioning into adult services. 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. • There is also a balance of overachieved savings of £0.137m (no change) as a result of the 25/26 budget decision. • NHS shortfall in savings of £0.230m (£0.176m favourable) which is not coded to specific areas and held centrally until recurring savings can be identified. • The funding for the Reduced Working Week (non-Lead Partnership element) is coded to Management and Support pending final confirming of the allocation. It is projected to underspend by £0.293m as the overspends in relation to these costs are shown on other lines outwith Management and Support. • An over-recovery of payroll turnover of £0.550m (£0.050m adverse) for social are services and an over-recovery of £0.205m (£0.064m adverse) 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 (£3.400m) (£1.567m) Projected to be achieved by March 2026 £3.950m £1.811m Over/(Under) Achievement £0.550m £0.244m 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 all non-essential posts. 214
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For 2025-26 there will be a further recruitment delay with vacancy scrutiny approved vacancies being held for four weeks before they are advertised to create more payroll turnover. This will be for all vacancies except clinical or registered services vacancies or those which will incur cover costs. 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 The approved 2025-26 budget included £4.019m of savings. BRAG Status Position at Budget Approval £m Position at Month 7 £m Red - - Amber 2.984 2.027 Green 1.035 - Blue - 1.992 TOTAL 4.019 4.019 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. Any shortfall in relation to the amber rated savings are already reflected in the projected outturn. 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 Transfer Methadone LES to East GMS (0.008) 2 Post to Medical records (0.037) 3 GP Prescribing budget adjustment (1.094) 4 ADP MAT Standards Allocation (0.045) 5 ADP ABI to East (0.010) 215
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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. At Month 7 the MH lead partnership is projected to overspend by £0.689m (£0.225m NRAC share for East and £0.196m for South). South HSCP (month 6 info) – projected overspend of £0.282m (£0.148m adverse) of which £0.104m (£0.054m adverse) will be allocated to North. The variance is mainly due to an overspend of £0.131m in the community store. This includes the costs of replacing mattresses, repairs and maintenance contract and equipment costs. The adverse movement is due to the purchase of additional mattresses when the wash bay was temporarily closed, and this impacted on the recycling of mattresses. There is also a projected overspend of £0.087m in the Family Nurse Partnership as the SG funding was based on the mid-point of the salary scale and all post are now at the top point of the scale. This will be a pressure in 2026/27. East HSCP (month 6 info) - projected overspend of £0.104m (£0.326m favourable) of which £0.038m will be allocated to North - £0.121m favourable movement). The main variances are: Allied Health Professions (Lead Partnership) There is a projected underspend of £0.420m on AHPs services which mainly relates to staffing savings. An increase in overall supplies expenditure has seen a small adverse movement from month 4 projected underspend £0.445m. Primary Care and Out of Hours Services (Lead Partnership) The Primary Care and Out of Hours Services £139.701m budget is projected to overspend by £0.416m, which is a small favourable movement of £0.206m from month 4. There are projected additional costs within Primary Care Contracting and Support £0.402m (£0.493m overspend month 4), due to a number of variances, including new Office 365 licence costs, as well as additional spend related to the GP’s Sub- Committee and staffing costs. Primary Medical Services are projected to overspend by £0.643m (£0.686m at month 4), largely due to increased pension and sickness cover costs. Primary Medical Services payments also show an overspend and IT continues to overspend. These projected additional costs are being partially offset by a projected underspend £0.309m (£0.170m at month 4) against Ayrshire Urgent Care Services based on average of month 1 to 6 expenditure and cross charges based on 2024/25 trends (and is after building-in an allowance for public holiday cover in the remainder of the financial year). Funding has been allocated to partially offset Urgent 216
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Care Pathway costs £0.823m (projected to outturn £0.248m over allocated funding). Funding has also been allocated to Covid-19 Therapeutics of £0.274m, with costs projected at £0.229m. There is a projected underspend of £0.555m (£0.304m at month 4) in Dental services that reflects that staffing numbers are running at less than establishment, alongside reduced equipment costs. The financial recovery plan includes anticipated reduced spend on Dental equipment £0.035m. Prison and Police Healthcare (Lead Partnership) The projected overspend of £0.013m at month 6 (£0.106m overspend month 4) is largely due to reduced staffing costs. Due to extended periods of vacancy, there has been a favourable movement of £0.119m, however this is partially offset by additional prescribing costs. Prison prescribing was highlighted as a budget pressure as part of the 2025/26 budget. Both East Ayrshire and South Ayrshire IJBs have approved additional funding to offset this pressure however North Ayrshire IJB did not provide for this in their approved budget. The additional funding has not been allocated against the prescribing budget at this stage, with further pan-Ayrshire discussions to be undertaken to determine how to account for this in the current financial year and going forward. It is possible that the Prison and Police Healthcare projected overspend highlighted in this report can be reduced as a consequence of this work. Other Services (Lead Partnership) The £0.095m projected overspend (£0.146m overspend month 4) is due to increased Area Wide Evening Services and Palliative Care Services costs. This is mainly due to additional staffing costs including high use of bank staff to meet service demands which are expected to reduce when vacancies are filled. As part of the recovery plan, recovery actions will be undertaken to reduce costs by an estimated £0.069m in the remainder of the financial year within Area Wide Evening Services: • Caseload and rota review to ensure prioritisation of essential criteria for overnight interventions. • Reviewing skills mix and reducing teams from eight to seven. • Reducing bank usage by ensuring optimum recruitment to vacancies and maximising attendance at work Palliative Care Services budgets continue to be closely monitored and reviewed; however increased costs largely reflect demand for provision of services. This pressure will require to be considered on a pan-Ayrshire basis, as part of the 2026/27 budget-setting process. Alongside financial recovery plan actions, it is anticipated that the prison prescribing pressure can be considered through forthcoming pan- Ayrshire discussions. East Ayrshire Financial Recovery Plan (approved on 29th October 2025) A financial recovery plan will be presented to the IJB on 29 October 2025 for consideration and approval (and presented to North and South Ayrshire IJBs for approval). The initial hosted services financial recovery plan assumes that costs can 217
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be contained at month 6 projected outturn position levels overall, with specific savings highlighted in the table below to achieve overall financial balance in 2025/26. Proposed Saving 2025/26 £m Primary Care – Dental equipment balance (revenue) 0.035 Area Wide Evening Services – Staff Cost Reductions 0.069 TOTAL 0.104 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 2024/25 prices. The 2025/26 actual usage information is not known until later in the year. IJB Baseline at 2024/25 prices (£) East 31.870 North 39.966 South 34.488 Total 106.324 The annual budget for Acute Services is £491.3million. The directorate is overspent by £20.3 million after 7 months including legacy CRES. This was caused by overspends on medical and nursing staff, together non pay overspends on equipment and supplies. These are required due to the level of operational pressure experienced. Unfunded wards contributed an overspend of £4.2m after 7 months. 218
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Within the overall £20.3 million overspend Medicine are over by £8.2 million, Emergency Care by £6.4 million, Surgery by £2.2 million, Labs and Diagnostics by £2.3 million and Women and Children by £1.5 million. Legacy CRES and underspends on other budgets make up the difference. There is a material underlying deficit caused by: • 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. In respect of Lead Partnership Services, the 3 Chief Officers and CFOs have met to consider improvements in the reporting and visibility of financial and operational performance for those services which we lead or are led by another HSCP. Actions have been agreed to develop more regular shared information to be shared across all 3 IJBs with an intention to incorporate this further detail into future financial monitoring reports from month 9. 2.12 FINANCIAL RISKS There are a number of financial risk areas that impact or may impact on the financial position. • Current overspend areas, especially in low volume / high-cost services e.g. Children’s residential placements, UNPACs, and supplementary staffing across community, mental health and learning disability wards. • Growing demand for services. • Staff recruitment and retention challenges across a number of service areas. • The expectation that performance will continue to be maintained or improved despite the significant resource challenges. • Ongoing delivery costs of Scottish Government policy directives, particularly where these are not fully funded or inflation proofed. • Pay settlements for both NHS and Local Government staff have been agreed for 2025/26. The NHS element has been funded, and the current assumption is that the shortfall between budget planning assumptions and actual settlements will be fully funded for Local Government staff. • Unearmarked reserves are depleted, there is no scope to absorb in-year variances, with any overspends requiring additional funding from partners. • The ongoing review of the Integration Schemes, where there is a focus on financial arrangements and risk share. 219
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• The wider system financial challenges and impact across the whole system, for example the financial position of NHS AA and the decisions taken to reduce the Board’s deficit may have impacts on other parts of the health and care system. • Removal of brokerage for NHS Boards, NHS AA have been asked by Scottish Government to deliver further financial improvement beyond their Board approved financial plan. • The overall sustainability of commissioned care providers, with eNICs compounding historic challenges re financial sustainability, there is a heightened risk of provider failure leading to handing back of care and contracts. • The ongoing ability to source packages of care for service users. • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • The recurring underlying levels of overspend which may impact on the Partnership’s ability to continue to sustain service levels in the future. • The use of supplementary staffing for enhanced observations across a number of service areas and 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. • Scot Excel inflationary increases for children’s services have been 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. • Risk related to NHS Reform investment being allocated by Scottish Government on a payment by results basis and in arrears. • Local Government Settlement and Distribution Group (SDG) – The SDG periodically review existing distributions to ensure that they remain fit for purpose. There is an agreed review of indicators for Adult Social Care Services, whilst the quantum is unknown North Ayrshire are noted to be an area with an increase, however there is a risk that this funding will not be available in future years due to North Ayrshire Council overall not receiving any additional funding through the floor mechanism. These risks will continue to be monitored during 2025-26. Audit Scotland’s recent audit of the IJB Annual Accounts concluded that North Ayrshire IJB has effective financial management and reporting arrangements in place. The audit also highlighted success in achieving approved recurring savings. This demonstrates that the current financial recovery situation is not a result of inadequate financial oversight, poor reporting, or an inability to deliver efficiencies. Instead, the ongoing challenge relates to rising levels of need within the North Ayrshire population and the wider, and national, issue of ensuring the long-term financial sustainability of health and social care services. It is essential that the IJB 220
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works with all partners to accelerate and resource service redesign and transformation, in order to provide sustainable care for the future. An Internal Audit review of IJB transformation submitted to the September 2025 Performance and Audit Committee gave an opinion of substantial assurance in relation to the governance of the Transformation Plan. 2.13 RESERVES The IJB opening reserves position are summarised in the table below. General Fund Reserve Earmarked Reserves Total Unearmarked External Funding HSCP £m £m £m £m Balance – 1 April 2025 - 2.381 0.780 3.161 Anticipated Drawdown - (2.381) (0.780) (3.161) Balance – 31 March 2026 - - - - The £0.780m HSCP earmarked reserve relates to the Service Redesign and Change Fund which is fully committed in 2025-26. Further detail on the reserves is given in Appendix D. 2.14 Financial Recovery Plan The IJB set a balanced budget for 2025/26 on 20th March 2025. This did not include any draw on reserves but did include the approval of £4.019m of savings to achieve financial balance. Services will continue to work towards implementing the recovery plan to deliver cost reduction targets while carefully managing the level of risk. This will include the preparation of equality impact assessments. The management actions and governance framework outlined below which were agreed in 2024/25 will continue throughout 2025/26: MANAGEMENT ACTIONS/CONTROLS AGREED IN 2024/25 • Review of expenditure authorisation levels across the Partnership and escalation of specific decisions to senior officers. In particular, a new governance group has been introduced, involving the Director and Heads of Service, to oversee the agreement of higher value packages of care (above £40,000 per annum). • Staff communication in relation to discretionary/non-essential spend. • Review of temporary posts and robust vacancy management/approval. The vacancy scrutiny group now has representation from all of the Heads of 221
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Service and a recruitment freeze will be implemented for all but essential frontline posts. • Restrictions on all but essential overtime working. • Ongoing review of future year savings or transformation programmes to identify scope for acceleration. • Maximise opportunities from the recently reopened Independent Living Fund (ILF) Scotland. GOVERNANCE MEASURES AGREED IN 2024/25 • Establishment a ‘Finance Working Group’, chaired by the IJB Chair or Vice Chair. The Director and Heads of Service are members of the group. It meets monthly to facilitate increased oversight and scrutiny of the financial position and transformation programme as well as detailed budget planning for future financial years. • Strengthened support from Finance Team to front line services and increased engagement with Heads of Service and Senior Management Teams, including line by line reviews of all budget areas. MANAGEMENT ACTIONS/CONTROLS AGREED IN 2025/26 (AUGUST 2025 and SEPTEMBER 2025) • Recruitment delay – there will be a recruitment drag with vacancy scrutiny approved vacancies being held for four weeks before they are advertised to create more payroll turnover. This will be for all vacancies except clinical or registered services vacancies or those which will incur cover costs. • High-cost care package group – the remit of this group will be expanded to include care packages for children with a disability and all UNPACs placement requests. • Oversight group for looked after and accommodated children in residential care – this group meets fortnightly to actively review all placements. • The senior managers for the main areas of overspend have been tasked with preparing an SBAR reports to be considered at the PSMT. This will cover current action being taken to reduce the overspend and future planned action. • The Director and Chief Finance Officer have started a rolling programme of one-to-one meetings with individual budget holders across the HSCP to consider opportunities for cost reduction, service change and any spend to save propositions – to support the development of the 2026/27 budget but also to identify further cost reductions for the current financial year. RECOVERY ACTIONS – MONTH 7 UPDATE • The updated recovery action is outlined in Appendix E. This includes the proposals agreed since month 3 and updated progress at month 7 and any changes to target reductions. The actions are a mix of cost reduction targets across various services and a drawdown of reserves. 222
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• There is a significant risk at this point in the financial year that the all of the recovery action can be delivered especially around the residential placements for children and care home placements. • A summary of the residual risk is below: Residual Risk TOTAL Health/ NHS AA Social Care/NAC Month 3 1.175 0.519 0.656 Month 4 1.733 0.776 0.957 Month 6 1.604 0.001 1.603 • At month 7 this deteriorated to: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth7 4.946 0.976 3.970 Financial Recovery Plan Projections 3.007 0.918 2.089 Residual Risk 1.939 0.058 1.881 • This plan is monitored and reviewed each month, and the following recovery actions are being proposed: a) Care home placements – move to one admission for every two discharges as per PSMT approval on 20th November 2025. The care placements at CARG to be approved on the basis of risk and need rather than current care setting. These levels will be exceeded where the risk to adults remaining in the community is considered too great and the only alternative is in immediately accessing a care placement. This may impact on delayed discharges within our acute and community hospitals. b) Care at home – recruitment freeze to gradually reduce the overspend position. Again, this will impact on wait times and service performance. c) All care packages (outwith in house care at home and older people placements agreed via CARG) will be considered for approval by the high- cost care package group. The financial consequences of these measures are not fully known at this stage and will be closely monitored. Services continue to work on further recovery actions to come to IJB in February – these will impact further on waits and service performance. 223
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PROPOSALS 3.1 Anticipated Outcomes Continuing to closely monitor the financial position will allow the IJB to take corrective action where required to 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 Ongoing updates to the financial position will be reported to the IJB throughout 2025- 26. 4. IMPLICATIONS 4.1 Financial The outturn is an overall year-end overspend of £4.946m (1.5%) prior to recovery action. The report outlines the main variances for individual services. The IJB unearmarked reserve balance is zero. This current position poses a financial risk to North Ayrshire Council and NHS Ayrshire and Arran. 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 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. 4.6 Community Wealth Building None. 4.7 Key Priorities 224
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The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025-26 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, consideration may be given to revising the strategic commissioning 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, Chief Finance Officer [eleanorcurrie@north-ayrshire.gov.uk] 225
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PUBLIC INFORMATION 2025-26 Budget Monitoring Report–Objective Summary as at 31st October 2025 Appendix A Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance Budget Outturn Projected Over/ (Under) Spend Variance £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 £'000 COMMUNITY CARE AND HEALTH 78,879 81,835 2,956 21,003 22,163 1,160 99,882 103,998 4,116 4,167 (51) : Locality Services 32,859 33,758 899 5,897 5,897 0 38,756 39,655 899 987 (88) : Community Care Service Delivery 41,750 43,427 1,677 0 41,750 43,427 1,677 1,611 66 : Rehabilitation and Reablement 2,127 2,178 51 0 2,127 2,178 51 40 11 : Long Term Conditions 896 935 39 10,612 11,576 964 11,508 12,511 1,003 1,026 (23) : Community Link Workers 366 365 (1) 0 0 0 366 365 (1) (4) 3 : Integrated Island Services 881 1,172 291 4,494 4,690 196 5,375 5,862 487 507 (20) MENTAL HEALTH SERVICES 41,157 42,324 1,167 77,370 77,706 336 118,527 120,030 1,503 1,218 285 : Learning Disabilities 32,027 33,276 1,249 727 727 0 32,754 34,003 1,249 1,036 213 : Community Mental Health 7,110 7,019 (91) 1,833 1,834 1 8,943 8,853 (90) (157) 67 : Addictions 2,020 2,029 9 1,880 1,880 0 3,900 3,909 9 5 4 : HBCCC 0 0 0 353 0 (353) 353 0 (353) (353) 0 : Lead Partnership Mental Health NHS Area Wide 0 0 0 72,577 73,265 688 72,577 73,265 688 687 1 CHILDREN & JUSTICE SERVICES 36,449 37,981 1,532 5,875 5,953 78 42,324 43,934 1,610 1,636 (26) : Irvine, Kilwinning and Three Towns 3,226 3,297 71 0 0 0 3,226 3,297 71 85 (14) : Garnock Valley, North Coast and Arran 3,621 3,702 81 0 0 0 3,621 3,702 81 68 13 :Intervention Services 1,822 1,834 12 0 0 0 1,822 1,834 12 9 3 : Care Experienced Children & Young people 22,842 24,858 2,016 0 0 0 22,842 24,858 2,016 1,996 20 : Head of Service - Children & Families 1,406 784 (622) 0 0 0 1,406 784 (622) (562) (60) : Justice Services 3,101 3,101 0 0 0 0 3,101 3,101 0 0 0 : C&F Health Team 431 405 (26) 4,995 5,109 114 5,426 5,514 88 82 6 : Lead Partnership NHS Children's Services 0 0 0 880 844 (36) 880 844 (36) (42) 6 CHIEF SOCIAL WORK OFFICER 1,978 1,822 (156) 0 0 0 1,978 1,822 (156) (185) 29 PRIMARY CARE 0 0 0 53,627 53,610 (17) 53,627 53,610 (17) 84 (101) ALLIED HEALTH PROFESSIONALS 0 11,608 11,608 0 11,608 11,608 0 1 (1) MANAGEMENT AND SUPPORT COSTS 7,725 6,196 (1,529) 3,692 3,390 (302) 11,417 9,586 (1,831) (1,685) (146) OUTTURN ON A MANAGED BASIS 166,188 170,158 3,970 173,175 174,430 1,255 339,363 344,588 5,225 5,236 (11) Return Hosted Over/Underspends to East 0 0 0 0 (225) (225) 0 (225) (225) (225) 0 Return Hosted Over/Underspends to South 0 0 0 0 (196) (196) 0 (196) (196) (196) 0 Receive Hosted Over/Underspends South 0 0 0 0 104 104 0 104 104 104 0 Receive Hosted Over/Underspends East 0 0 0 0 38 38 0 38 38 38 0 OUTTURN ON AN IJB BASIS 166,188 170,158 3,970 173,175 174,151 976 339,363 344,309 4,946 4,957 (11) Over/ (Under) Spend Variance at Period 6 Movement in variance from Period 6 TOTAL Partnership Budget - Objective Summary Council Health 2025/26 Budget 226
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2025-26 Savings Tracker Appendix B Social Care: Ref Description Deliverability Status at budget setting Deliverability Month 7 2025/26 Saving Previously Agreed Savings (Full year impact) 1 Review of Day Care provision Green Blue 0.100 2 Service redesign (CAAST Team and Corporate Parenting team) Green Blue 0.034 Adjustments 3 Payroll Turnover Green Blue 0.099 Mental Health 4 LD Responder Service Amber Amber 0.150 Children, Families & Criminal Justice 5 Brighter Pathways Amber Amber 1.000 Community Care & Health 6 Review of Day Care provision Amber Blue 0.107 7 Care at Home Amber Blue 0.500 8 Care Package Review (all services) Amber Blue 0.200 9 Deletion of vacant posts Green Blue 0.056 10 Increase to charging Green Amber 0.186 11 Admin Post Savings Green Blue 0.114 12 Financial Inclusion Green Blue 0.357 TOTAL SOCIAL CARE SAVINGS 2.903 Cross Service 227
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Health: Ref Description Deliverability Status at budget Deliverability Month 7 2025/26 Saving Adjustments 13 Increase recharge to East Ayrshire for beds at Woodland View Green Blue 0.010 14 Payroll Turnover Green Blue 0.079 Other Savings 15 Admin Savings Amber Blue 0.186 16 Trindlemoss House - move to social care model Amber Amber 0.250 17 EICT/Rehab Amber Blue 0.150 18 Community MH/Wellbeing Review Amber Amber 0.100 19 Ward 7A - Woodland View Amber Amber 0.341 TOTAL HEALTH SAVINGS 1.116 TOTAL NORTH HSCP SAVINGS 4.019 228
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2025-26 Budget Reconciliation Appendix C COUNCIL Period Permanent or Temporary £'m Initial Approved Budget 137.739 Adjustments to baseline 0.014 Revised Budget 137.753 Resource Transfer 25/26 1-3 25.045 Additional Funding - 24/25 Adult Social Care RLW 1-3 P 0.073 Additional Funding RLW 1-3 P 0.126 Additional Funding - Money Smart 1-3 P 0.094 ICT Transfers 1-3 P (0.005) Additional Funding - Whole Family Wellbeing Funds 1-3 T 0.179 CJSW - S27 1-3 P 3.280 Development of People working in Childrens SW 1-3 P (0.390) Change Fund Allocation - HSCP FIO Team 7 T 0.021 Internal Commerical Waste 7 P 0.010 Roundings 7 0.002 166.188Social Care Budget Reported at Month 7 HEALTH Period Permanent or Temporary £'m Initial Budget exc set aside 161.934 Month 10-12 Adjustments and adjusting for the full year impact of part years amounts and temporary funding. 8.532 Revised Budget 170.466 Resource Transfer 24/25 24.640 Resource Transfer 25/26 (25.045) NORTH NATIONAL INS 25-26 AMBUS 1 0.997 PRESCRIBING 25-26 AMBUSH 1 2.754 PRESCRIBING CRES 25-26 AMBUSH 1 (0.715) Training Grade Adj - April 1 (0.058) Training Grade Rates Adj - April 1 0.030 MH: Anticipate PDS Dementia (North) 25/26 1 0.094 MH: Anticipate Delivery of Veteran Specific 25/26 1 0.105 Anticipated RWW from SG 1 0.659 Anticipate 20% Tranche 2 ADP 1 0.174 229
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HEALTH Period Permanent or Temporary £'m Training Grade Adj - May 2 (0.013) Bwp 25-26 East Chest Heart Stroke 2 0.001 Bwp 25-26 East Nest Expansion 2 0.023 Bwp 25-26 East - Sds Advice Service 2 0.013 Bwp 25-26 East Sub Prescribing 2 0.170 25-26 South Budget Paper - North Substitute Prescribing 2 0.170 25-26 South Budget Paper - Pan Ayrshire Chest Heart And Stroke 2 0.001 25-26 North Budget Paper - Pan Ayrshire (vision Support Service 2 (0.005) 25-26 North Budget Paper - Pan Ayrshire (communitystore) 2 (0.155) HD52: EARLY INTERVENTION PSYCHOSIS 3 0.100 25-26 Pay Award Increase North 3 1.179 Training Grade Adjustment (Dean Funding) 4 0.011 Medical Pay Award - Senior Medical - Additional 1% 4 0.086 Medical Pay Award - Specialty Doctors - Additional 1% 4 0.006 Virement to Medical Directorate from Mental Health Admin 4 (0.028) Transfer MAT Standards Psychiatrist 0.2 WTE 4 0.029 Primary Care Prescribing Tariff Reduction 4 (0.556) BBV transfer from Public Health 4 0.269 Training Grade Adjustment (Dean Funding) - August 5 0.129 Budget transferred to Capital for INV-3395435821 5 (0.006) Transfer from South - ANP contribution 5 0.030 Primary Care Prescribing Budgets reworked 5 0.130 HD157 3% pay award ADP North 5 0.057 North MDT funding to Arran Medical Group (Virement 11) 5 (0.043) Training Grade Adjustment (Dean Funding) - September 6 0.018 Transfer Methadone LES to East GMS 7 (0.008) Post to Medical records 7 (0.037) GP Prescribing budget adjustment 7 (1.094) ADP MAT Standards Allocation 7 (0.045) ADP ABI to East 7 (0.010) ANTICIPATED BUDGETS INCL HERE (NOT IN LEDGER) 7 (1.347) Roundings (0.001) 173.175 TOTAL COMBINED BUDGET 339.363 Health Budget Reported at Month 7 230
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25-26 IJB Reserves Position Appendix D Area of Reserves Balance at 31 March 2025 Earmarked Funds £ : Alcohol & Drug Partnership 353 : Mental Health Action 15 135 : Primary Care Improvement Fund 46 : Service Redesign / Challenge Fund 780 : Family Wellbeing Fund 934 : Breastfeeding Network 36 : MH Recovery and Renewal /Enhanced MH Outcome Framework 365 : Early Intervention in Psychosis 92 : LD funding 82 : Donation (Police Scotland) 1 : Primary Care Improvement Fund IP 303 : GP Premises Improvements - tranches 1 and 2 3 : Dental Practice Improvement 29 : Appropriate Adult 2 Total Earmarked 3,161 231
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Financial Recovery Action Plan Appendix E £m Projected Overspend at Month 7 4,946 SERVICE AREA Target at Month 7 Achieved at Month 7 Still to be achieved Target set (IJB Date) Comment Community Care and Health a) Care home placements (568) (79) (489) August 2025 - month 3 report This will bring the overall budget for placements and charging order income online. b) Physical Disability Services (res, community and DPs) 0 0 0 August 2025 - month 3 report Some PD residential packages £508K (prev £575K) have moved to the older people Care Home placements budget. The older people placements will need to manage this transfer within the existing budget. c) Specialist Rehab wards (75) (57) (18) August 2025 - month 3 report Based on planned action developed by the senior manager. d) Wards 1 and 2 (275) (57) (218) August 2025 - month 3 report Based on planned action developed by the senior manager. e) Care at Home (300) 0 (300) August 2025 - month 3 report Reflects the potential reduction to costs as an impact of the SG investment in unscheduled care TOTAL (1,218) (193) (1,025) Mental Health Services Target at Month 7 Achieved at Month 7 Still to be achieved Target set (IJB Date) Comment a) Learning Disabilities 0 0 0 August 2025 - month 3 report b) Community Mental Health services 0 0 0 August 2025 - month 3 report c) Lead Partnership for Mental Health : - Adult Inpatients (150) 0 (150) August 2025 - month 3 report Inpatient Review being undertaken - Elderly Inpatients (150) (62) (88) August 2025 - month 3 report Inpatient Review being undertaken - Psychiatry (150) (50) (100) August 2025 - month 3 report Junior doctor rota still to be revised. - Action 15 Reserves (486) (486) 0 August 2025 - month 3 report Draw down of the full pan Ayrshire reserve - agreed with the CFOs at East and South - Enhanced MH Outcome Framework Reserves (624) (624) 0 August 2025 - month 3 report Draw down of the full pan Ayrshire reserve - agreed with the CFOs at East and South NORTH AYRSHIRE ELEMENT 38.65% (603) (472) (131) August 2025 - month 3 report TOTAL (603) (472) (131) No cost reduction proposed but the service need to maintain the current position. All new placements need to be offset by discharges or reductions from care package reviews. 232
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FINANCIAL RECOVERY PLAN SERVICE AREA Target at Month 7 Achieved at Month 7 Still to be achieved Target set (IJB Date) Comment Children and Justice Services a) Residential Placements (1,000) 0 (1,000) August 2025 - month 3 report Based on some placements moving to tenancies and other placements moving from external to in-house provision. TOTAL (1,000) 0 (1,000) ALLIED HEALTH PROFESSIONALS 0 0 0 August 2025 - month 3 report No cost reduction proposed but the service need to maintain the current position. CHIEF SOCIAL WORK OFFICER 0 0 0 August 2025 - month 3 report No cost reduction proposed but the service need to maintain the current position. MANAGEMENT AND SUPPORT a) Payroll turnover (200) 0 (200) August 2025 - month 3 report Increase to the current projection based on dragging vacancies for 4 weeks after vacancy scrutiny approval. b) Transition slippage (100) (100) 0 August 2025 - month 3 report Based on historic slippage. c) Contractual inflation (100) (100) 0 August 2025 - month 3 report d) Service Redesign Fund (100) (100) November 2025 - moth 6 report TOTAL (500) (200) (300) OTHER AREAS b) Agenda for Change - assume fully funded (551) 0 (551) August 2025 - month 3 report Based on 100% cost of the half hour reduction in working week being funded. (551) 0 (551) TOTAL RECOVERY ACTION (3,872) (865) (3,007) Remaining projected overspend 1,939 233
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Bank and Agency Costs to Month 7 Appendix F 1) NHS 4863 (Registered) 4864 (Unregistered) 4853 (Registered) 4854 (Unregistered) 4865 (Agency Locum Consultant) TOTAL NORTH CORE SLT ADULT 30,634 3,098 33,731 WARD 1 WOODLANDS VIEW 17,556 199,119 216,675 WARD 2 WOODLANDS VIEW 19,121 261,789 280,911 ACH REDBURN REHAB WARD NRS 18,499 120,454 138,953 ACH DOUGLAS GRANT REHAB WD NRS 6,584 40,831 47,415 WARD 3 WOODLANDS VIEW NURSING 1,240 247,018 248,258 WARD 4 WOODLANDS VIEW NURSING 68,149 26,444 94,594 NEW CLONBEITH NURSING(JURA) 3,392 83,282 86,674 WVIEW THE GLEN ECT 3,362 6,341 9,703 WVIEW WARD 10 ACUTE MH NRS 13,953 198,334 212,287 WVIEW WARD 8 ACUTE MH NRS 2,562 537,449 540,011 WARD 5 WOODLANDS VIEW 2,302 27,681 29,983 WVIEW WARD 7B REHAB MH NRS 23,135 23,135 NEW DUNURE NURSING(CLONBEITH) 18,374 109,503 127,878 MH BED MANAGEMENT - TRINDLEMOSS 40,906 173,511 214,417 ARRAN HOSPITAL NURSING 45,884 40,943 86,827 CAMHS MANAGEMENT 1,944 1,944 CAMHS UNSCHEDULED CARE 801 801 EARLY YRS-C/F TEAM 1 923 923 EARLY YRS-C/F TEAM 3 974 974 IMMUNISATION NURSING 23,843 6,374 30,217 ARRAN DN 13,607 13,607 PACKAGE OF CARE (P) - AMG 86,687 86,687 PACKAGE OF CARE (P) - LMO 598 598 NC POC TEAM 2 990 990 NC POC TEAM 3 3,843 3,843 THREE TOWNS DN 677 677 FOXGROVE(NSAIS)ADVANCE RECRUIT - NORTH AHP MANAGEMENT TEAM 7,329 7,329 IRVINE DN 16,516 16,516 NORTH WEST COAST DN 26,322 26,322 GARNOCK VALLEY DN 42,847 42,847 LADY MARGARET NURSING 8,076 3,857 11,933 PREVENTION + SERVICES SPT TEAM 2,397 2,397 LD HEALTH CHECKS 12,238 12,238 NORTH CLDT 5,777 164 5,941 LDS MANAGEMENT 4,890 4,890 MHANPS MH UNSCHEDULED CARE 2,355 57 2,412 MHS INPATIENT MGT 14,886 210 15,096 CMHT NURSING-NORTH AYRSHIRE 3,117 4,273 7,390 WVIEW WARD 7C FORENSIC REHAB N 6,963 102,048 371 109,382 INTENSIVE COMMUNITY NURSING TEAM 27,857 1,862 29,719 ADULT MENTAL HEALTH LIASION TEAM 27,237 27,237 PCMHT NORTH 1,798 1,798 WVIEW WARD 6 LOW SECURE NRS 29,447 103,918 133,365 WARRIX AVE 69,724 59,808 129,532 ICFN - COMMUNITY PHLEBOTOMY 7,906 7,906 ACTION 15 - ADULT LIAISON - FORENSIC PSYCHOLOGY 3,248 3,248 CHILD HEALTH ADMIN 1,797 1,797 WVIEW WARD 7A LD A+T NRS 25,610 425,962 1,804 14,532 467,906 WVIEW WARD 9 ACUTE MH NRS 17,000 257,233 226 274,459 WVIEW WARD 11 ACUTE MH NRS 26,356 146,085 172,441 ADULT EAST 1,114 1,114 733,082 3,296,799 2,400 14,532 1,114 4,047,928 2) SOCIAL CARE Mth 7 Spend 239,781 17,439 342,959 134,415 734,594 Mh Acm Bank Agency Montrose House Brodick Unscheduled Care Funding Ld Acm 234
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Integration Joint Board 11th December 2025 Subject: Medium-Term Financial Outlook 2026-2029 Purpose: • Awareness • Discussion Recommendation: That IJB notes the Medium-term financial outlook 2026-2029 and also notes that work continues on the preparation of the detailed budget for 2026-27 which will be brought to the March 2026 meeting for approval. 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 MTFO Medium-Term Financial Outlook 1. EXECUTIVE SUMMARY 1.1 This Medium-Term Financial Outlook (MTFO) covers the three-year period 2026- 2029. The MTFO looks at the range of factors which influence the financial planning of the Integration Joint Board. 1.2 A range of possible scenarios for the financial position in each year are considered based on the information currently available. This helps to identify the financial challenges which will be faced by the IJB, enabling the IJB to see the impact of current and future decisions on its medium-term financial health. 2. BACKGROUND 2.1 The Integration Joint Board has responsibility for planning how community health and social care services are delivered across North Ayrshire. It does this by directing North Agenda Item 8 235
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Ayrshire Council and NHS Ayrshire and Arran to work together to deliver integrated services through the Health and Social Care Partnership. 2.2 A Medium-Term Financial Outlook (MTFO) is a critical part of the strategic planning process. The financial context for public services is extremely challenging and so it is vital that the IJB’s strategic ambitions are set against the financial resources which are anticipated to be available. The Strategic Plan is currently undergoing a 3-year refresh and will be brought to the December 2025 IJB. 2.3 There are a range of factors which influence the financial planning of the IJB. These are considered through the MTFO and include the following: • Demographic changes • Local priorities • Workforce challenges • The UK and Scottish Economy • Policy and Legislation • Cost and demand pressures • Available funding 3. Local Context 3.1 Our Strategic Needs Assessment details a range of demographic and health factors which will see growing demand for services: • Decreasing and ageing population – with 23.7% of residents over 65, this is anticipated to increase to 29% by 2040 • High levels of deprivation – over 40% of the population live in the most deprived SIMD, compared to the Scotland average of 20% • Long-term health conditions which increase in older people – 28.2% of residents compared with Scotland average of 22.1% • Healthy life expectancy being at average of 52.5 years for women and 52.6 years for men, the lowest of all areas in Scotland • Unplanned and emergency admissions to hospital which increase in older people. • Increasing mental health concerns • Higher than average numbers of Looked After and Accommodated Children 3.2 The IJB faces workforce challenges with an ageing workforce and already there are difficulties in recruiting to certain job roles. There is a reducing working age population and a national shortage of appropriately trained staff for particular professions. 4. UK Budget 4.1 The UK budget was delivered on 26th November 2025; there were a number of key points of note for the IJB: 236
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• Barnett Consequentials: Scotland receives £820 million additional funding from UK spending decisions, allocated by the Scottish Government across devolved services. The Scottish Government will need to decide how to allocate the £820 million, balancing NHS pressures with demands from councils, social care, and other devolved services. • Health & Social Care Spending - Scotland gains headline funding increases, but inflation erodes much of the benefit, leaving health and social care budgets flat in real terms. • NHS Scotland Workforce Crisis: The Royal College of Nursing Scotland warns the system is short of over 3,000 nurses, with recruitment and retention worsening. The Budget does not directly address this gap. • Social Care Uncertainty: While health spending is protected, social care and third-sector providers face continued uncertainty, with no clear new funding streams. • Capital Investment: UK-wide announcements include £300 million for NHS technology upgrades and 250 new Neighbourhood Health Centres, which may benefit Scotland indirectly, but allocation details remain unclear. 4.2 The updated Office for Budget Responsibility forecast (November 2025) projects UK GDP growth of 1.5% in 2025 and 1.4% in 2026, a downgrade from earlier expectations of 2.0% and 1.8% respectively. Inflation and unemployment are also expected to be higher than previously forecast. 4.3 Inflation is predicted to average 2.5% in 2026 (2.3% previous forecast) and 2% in 2027 (in line with forecast). 5. Scottish Budget 5.1 As the UK government budget was later than usual the Scottish Budget will not be delivered until 13th January 2026. The main points of note for the IJB at this stage are as follows: • 2025/26 pay awards have already been agreed: NHS 3.75% and Local Authority 3.5%. • Agenda for Change pay reforms will continue: A further reduction in the working week from 37 hours to 36 hours at an estimated cost of £2.5m. The Band 5/6 regrades, and protected learning time will also continue in 2025-26. • The Real Living Wage has increased from £12.60 to £13.45 (6.75% increase), this will be reflected in the contractual rates for commissioned adult and children’s social care providers. • Free Personal and Nursing Care rates usually increase each year. 237
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At the time of writing, full clarity on the funding position for these areas is not yet available. 5.2 In December 2024 the Scottish Government published an updated Public Sector Pay Policy. It should be noted that this applies to the NHS workforce but not to local government employees, where pay is delegated to local authorities to negotiate through COSLA. 5.3 The Policy allows a pay envelope covering the 3 financial years 2025-26, 2026-27 and 2027-28 totalling 9% and allows flexibility for employers to configure three-year proposals within the 9% pay envelope. 6. Funding 6.1 The MTFO uses three possible scenarios to estimate what our additional funding could look like across the financial years 2027-28 and 2028-29. These are as follows: • Best Case – an annual uplift of 2% for social care and health. The funding assumptions have been scaled back based on the Scottish Govt Medium Term Financial Strategy 2025. This includes a forecast 3.3 per cent real-term average growth per annum, however, this is before required savings and efficiencies. • Medium Case – this allows for 1% uplift in 2026-27, 2027-28 and 2028-29. This is linked to the midpoint between Best- and Worst-case scenario. • Worse Case – flat cash from both Council and NHS Board. For 2026-27 the current assumption is flat cash for social care with National Priorities fully funded and 2% for health. 7. Cost and Demand Pressures 7.1 The MTFO sets out a range of cost pressures across each of the financial years. These cover pay inflation, demand and demographic pressures across health and social care services, and the possible costs of delivering national priorities. As Scottish Government budgets continue to be for one year only, assumptions are made for future years. 7.2 Cost pressures are currently estimated at £25.533m for 2026-27, £11.209m for 2027- 28 and £11.226m for 2028-29. The significantly higher figure in 2026-27 reflects the estimated cost of the expected uplift in local government employers’ superannuation contributions from 6.5% to 17.5% on 1st April 2026. 7.3 The main areas of pressure in 2026-27 are: • Pay inflation (3.5% per annum social care and 3.75% health) - £7.7m • Superannuation rate increase for local govt employees (Council only) - £7.2m 238
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• Demand and demographic pressures - £2.4m • Contractual Inflation £2.4m • National Priorities (Living wage & FPC) - £4.6m • Lead Partnership Pressures - £1.3m TOTAL £25.6m The share of pressures is illustrated below: The only budget pressures for which funding is assumed at this stage is a Scottish Government funding contribution to the national commitment to the Scottish Living Wage for Social Care Staff and the annual uplift to Free Personal Care rates. The main driver of cost and demand pressures are externally set and agreed increases and inflationary factors including Local Government and NHS Scotland staff pay awards, contractual inflation including the National Care Home contract and other Scotland Excel procured services. It should be noted that these together with the national inflationary uplifts all contribute the cost of care rather than being available to deliver any additional capacity and on an annual basis further increase the cost of delivering core services – these pressures reflect the position for services to stand still rather than expand and grow in line with demographic pressures and demands. 239
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8. Medium-term Financial Outlook 8.1 A detailed Medium-term financial outlook has been developed which brings together the three different funding scenarios and the estimated cost pressures to establish what the financial position might look like for the next 3 financial years. 8.2 A summary of the MTFO is shown below and identifies that, based on the current assumptions made, there could be a budget gap across the period 2026-2029 ranging from £27.746m in the best case to £47.968m in the worst case if no new funding is provided. 8.3 The split of the budget gaps above into health and social care per year are given below: 8.4 240
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8.5 8.6 8.7 It is certain that additional budget savings will require to be identified to achieve a balanced budget position for approval by the IJB in March 2026. The budget gap in 2026-27 is a greater challenge due to the £7.2m local government pension scheme increase, however despite this the savings gap is expected to continue to increase in the medium term. 9. PROPOSALS 9.1 It is proposed that the IJB notes the Medium-term Financial Outlook and the potential financial position across financial years 2026-27, 2027-28 and 2028-29. 241
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9.2 Anticipated Outcomes The development of the Medium-term Financial Outlook provides key information on the possible financial position of the IJB over the next three years. It identifies the financial challenges which will be faced by the IJB enabling the IJB to see the impact of current and future decisions on its medium-term financial health. The MTFO will also be used to identify pressure points and inform decisions which are required to ensure the Partnership remains financially sustainable. 9.3 Measuring Impact The IJB receives in-year financial monitoring reports which assist with monitoring the financial position and addressing any concerns. The MTFO will support the development of future annual budgets. 10. IMPLICATIONS 10.1 Financial The Medium-term Financial Outlook outlines potential funding and expenditure scenarios for 2026-2029, identifying possible budget gaps for each financial year. 10.2 Human Resources None. 10.3 Legal The IJB requires to agree a balanced budget each financial year, and a Medium-term Financial Outlook helps to support that requirement in future years. 10.4 Equality/Socio-Economic Equality Impact Assessments are carried out as necessary in relation to any new savings proposals. 10.5 Risk 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. 10.6 Community Wealth Building None. 10.7 Key Priorities A Medium-term Financial Outlook helps to support the delivery of the Strategic Plan. 242
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11. CONSULTATION 11.1 No consultation has been required in the preparation of this report. Caroline Cameron, Director Author Name: Eleanor Currie, Chief Finance Officer, Eleanorcurrie@north- ayrshire.gov.uk 243
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